scholarly journals The Incidence and Risk Factors of Extrapulmonary Manifestations in Mycoplasma Pneumoniae Pneumonia

2021 ◽  
Author(s):  
Yoo Kyung Park ◽  
You Na Park ◽  
Ji Eun Moon ◽  
Hyo-Bin Kim ◽  
Mee Yong Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mycoplasma Pneumoniae ◽  
Respiratory Virus ◽  
Liver Enzymes ◽  
Multivariable Analysis ◽  
Clinical Aspects ◽  
Laboratory Findings ◽  
Neurologic Manifestation ◽  
Factors Associated ◽  
Elevated Liver Enzymes

Abstract Background: Mycoplasma pneumoniae pneumonia (MP) is a major cause of community acquired pneumonia (CAP) in children and it is known to be associated with extrapulmonary manifestations (EPM). The incidence and risk factors of EPM in children are not known.Methods: This is a retrospective study involving 65,243 pediatric CAP patients between 2010 and 2015 at 23 nationwide hospitals was conducted in South Korea. The medical records were reviewed to collect the information regarding the clinical characteristics, radiological results, and laboratory findings. In total, 9,190 children with MP were identified and included in the analysis. Logistic regression with multivariable analysis was performed to evaluate the risk factors associated with EPM in MP.Results: The mean age of the enrolled patients with MP was 64.3±39.8 months, and the proportion of male patients was 49.5%. The incidence of EPM was 23.9% and included elevation of liver enzymes (18.1%), mucocutaneous manifestations (4.4%), proteinuria (4.1%), cardiovascular and neurologic manifestation (0.4%), hematologic manifestation (0.2%) and arthritis (0.2%). Statistical analysis showed that mucocutaneous manifestations were significantly increased with elevated alanine aminotransferase (adjusted odds ratio [aOR] 3.623, 95% confidence intervals [CI] 1.933-6.790) and atopic sensitization (aOR 2.973, 95% CI 1.615-5.475) and decreased with respiratory virus co-infection (aOR 0.273, 95% CI 0.084-0.887). Elevated liver enzymes was significantly associated with the elevation of lactate dehydrogenase (aOR 3.055, 95% CI 2.257-4.137) and presence of pleural effusion (aOR 2.635, 95% CI 1.767-3.930) and proteinuria with respiratory virus co-infection (aOR 2.245, 95% CI 1.113-4.527). Conclusions: About 24% of pediatric MP patients were identified with various EPM. Since risk factors associated with each EPM was different, it is necessary to evaluate the various clinical aspects and findings of MP to predict and prepare for the occurrence of EPM.

The Biochemical Parameters and Vitamin D Levels in ICU Patients with Covid-19: A Cross-Sectional Study

2021 ◽  
Vol 21 ◽  
Author(s):  
Hamed Abdollahi ◽  
Farahnaz Salehinia ◽  
Mostafa Badeli ◽  
Elmira Karimi ◽  
Hossein Gandomkar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Immune System ◽  
Liver Enzymes ◽  
Serum Vitamin ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elevated Liver Enzymes ◽  
Vitamin D Levels

Background: In Covid-19 infection, leukopenia, inflammation, and elevated liver enzymes are found in most patients. Also, vitamin D deficiency attenuate the immune system and predispose a person more susceptible to infection. In this context, we aimed to evaluate vitamin D, Electrolytes, Complete blood count, Liver enzymes, Urea, Creatinine, Albumin, CRP and ESR levels in patients with Covid-19. Methods: We conducted a cross-sectional study on 118 patients with Covid-19 who were hospitalized from 2020/2/19 to 2020/4/3 in ICU. Serum levels of electrolytes, liver enzymes, blood factors, urea, creatinine, CRP and ESR as well as anthropometric parameters and serum vitamin D concentration were measured. Results: A total of 118 patients (80 male and 38 female) was enrolled in the study (65.05±15.75 years). Only 5.08% of patients had no risk factors and 55.9% had ≥ 2 risk factors. Diabetes (44.1%) and obesity (23.7%) were more common among patients. Laboratory finding showed that 80.50% of patients had hyponatremia, but other electrolytes included K, Mg, Ca and P were normal in majority of participants as well as CBC, Cr, Urea, Alb, ALT and ALKP. The AST concentration increased in most patients (66.94%). All patients had high levels of inflammatory factors such as CRP and ESR. The mean of 25-hydroxy-vitamin D levels in participants (25.95 ± 14.56 ng/mL) was lower than its levels in general papulation. However, it was not statistically significant (P= 0.88). A significant negative correlation found between vitamin D and ALT (P= 0.02, -0.21) as well as vitamin D and CRP (P= 0.05, -0.17). Conclusion: Regarding to the regulatory role of vitamin D in immune system and low levels of vitamin D in Covid-19 infected patients, the evaluation of vitamin D levels and prescribe supplements if necessary is suggested.

scholarly journals Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares

2019 ◽  
Vol 124 ◽  
pp. 18-23 ◽  
Author(s):  
A.M. de Mestre ◽  
B.V. Rose ◽  
Y.M. Chang ◽  
D.C. Wathes ◽  
K.L.P. Verheyen
Keyword(s):  
Risk Factors ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Multivariable Analysis ◽  
Early Pregnancy Loss ◽  
Factors Associated

P0034IDENTIFICATION OF FACTORS ASSOCIATED WITH PROGRESSION, PROGNOSIS AND TOLVAPTAN INDICATION IN POLYCYSTIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Myrto Kostopoulou ◽  
Michaela Louka ◽  
Stavros Fokas ◽  
Eirini Tigka ◽  
Angelos Drakopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Kidney Volume ◽  
Polycystic Kidney ◽  
Factors Associated ◽  
Affected Parent ◽  
Male Sex

Abstract Background and Aims The identification of possible risk factors for the progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD) is an emerging field especially after the introduction of the first disease-specific treatment. The present study aims to explore the associations between epidemiological, clinical and imagining data in a large cohort of ADPKD patients. Method This study was from a single outpatient clinic following patients with ADPKD. Patients were included in the study if they had a recent Magnetic Resonance Imaging (MRI) for measurement of Total Kidney Volume (TKV), a validated biomarker for disease progression. For all patients, the Mayo Clinic Imagining Category (MCIC) and the respective prediction for End Stage Renal Disease (ESRD) were calculated. Patients eligible for tolvaptan treatment (MCIC 1C, 1D, 1E, age < 55 years old and estimated-glomerular filtration rate (e-GFR) ≥ 25 ml/min) were identified. Characteristics including individual medical history, clinical and laboratory data were examined for possible associations with renal and imagining parameters using linear regression models. Results A total of 158 patients were included. Based on measurements of height-adjusted TKV (ht-TKV) and age, 5% of the patients were classified as 1A, 20% as 1B, 34% as 1C, 25% as 1D and 16% as 1E, MCIC. In multivariable analysis, patient’s age (p = 0.01), male sex (p < 0.001), parent’s age at which ESRD was reached (adjusted for patient age) (p < 0.001) and proteinuria (p = 0.04) were associated with ht-TKV. Parent’s age at ESRD differed significantly between the MCICs of the offspring (mean±(SD)), 70.83 (12.90) in 1A, 63.79 (11.39) in 1B, 57.32 (10.42) in 1C, 51.42 (9.18) in 1D and 47.94 (5.73) years old in 1E, (p < 0.001). Similarly, there were significant differences in the presence and the age of hypertension onset (p =0.004 and p = 0.003, respectively). In 104 patients (50 females, 54 males) who were eligible for tolvaptan treatment age at ADPKD diagnosis, age at hypertension onset and parent’s age reaching at ESRD were all significantly lower (p < 0.001 for all) when compared to non-eligible patients. Finally, factors associated with the prediction score of ESRD (e-GFR 10/ml/min) were hypertension, uric acid and the age at ESRD of the affected parent (p = 0.001, 0.02 and 0.01, respectively). Conclusion The age at which an affected parent had reached ESRD, as heritability estimator, was significantly associated with a worst phenotype, prognosis and tolvaptan indication. Early diagnosis of the disease, hypertension and its early onset, proteinuria and male sex are also possible risk factors for the progression of ADPKD.

scholarly journals Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

2019 ◽  
Vol 119 (12) ◽  
pp. 785-789
Author(s):  
M. Dugatova ◽  
A. Kristufkova ◽  
B. Nemethova ◽  
J. Danis ◽  
M. Borovsky
Keyword(s):  
Risk Factors ◽  
Active Surveillance ◽  
Liver Enzymes ◽  
Elevated Liver Enzymes

scholarly journals Hemolysis, Elevated Liver Enzymes, Low Platelets Syndrome Superimposed on Hemolytic Uremic Syndrome

2017 ◽  
Vol 39 (04) ◽  
pp. 195-198 ◽  
Author(s):  
Inês Martins ◽  
Madalena Conceição ◽  
Paulo Gomes ◽  
Nuno Clode
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Future Research ◽  
Thrombotic Microangiopathies ◽  
Laboratory Findings ◽  
Reproductive Immunology ◽  
Elevated Liver Enzymes ◽  
Uremic Syndrome ◽  
Nephrotic Range Proteinuria

AbstractA pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology. It also reminds clinicians that the overlapping of clinical and laboratory findings in HELLP syndrome makes the diagnosis of other thrombotic microangiopathies during pregnancy a clinical challenge.

scholarly journals Assessment of Hepatic Steatosis and Fibrosis in Egyptian Patients with Type 2 Diabetes Mellitus

2021 ◽  
pp. 144-151
Author(s):  
Eman Basiouny ◽  
Faiza Lashin ◽  
Manal Hamisa ◽  
Amal Selim
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Hepatic Steatosis ◽  
Liver Enzymes ◽  
Early Management ◽  
Elevated Liver Enzymes

Aims: To assess hepatic steatosis and fibrosis in patients of type 2 diabetes mellitus (T2DM), their possible risk factors and their association with metabolic syndrome and micro or macro-albuminuria. Study Design: Cross sectional study. Place and Duration of Study: Outpatient Clinic of Diabetes, Metabolism and Endocrinology Unit in internal medicine department, Tanta University, Egypt in a period between September 2019 to March 2020. Methodology: We included 200 patients had a diagnosis of T2DM according to American Diabetes Association criteria. Then patients were assessed for presence of hepatic steatosis and fibrosis using fibroscan and we used liver stiffness measurements (LSMs, as a measure of fibrosis) and controlled attenuation parameter (CAP, as a measure of steatosis) and routine laboratory data were done to rule out possible risk factors. Results: 98.5% of participants had hepatic steatosis and 53.5% of participants had hepatic fibrosis. Those patients had longer duration of DM, higher BMI, bad control of T2DM, higher lipid profile values, association with metabolic syndrome, micro and macro-albuminuria and non-significantly elevated liver enzymes. Conclusion: Hepatic steatosis and fibrosis are highly prevalent in patients with T2DM, incidence of hepatic steatosis and fibrosis is positively correlated with longer duration of DM, higher BMI, bad control of DM, dyslipidemia, presence of metabolic syndrome, diabetic nephropathy, weakly correlated with liver enzymes. TE is an accurate and non-invasive tool to be used in screening for hepatic steatosis and fibrosis ,so we recommend screening for hepatic steatosis and fibrosis using fibroscan to help in early management and prevent its progression into liver cirrhosis.

scholarly journals Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

2021 ◽  
Vol 15 (6) ◽  
pp. 267-276 ◽  
Author(s):  
Chayamon Suwansumrit ◽  
Worawan Jittham
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Cigarette Smoke ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Maternal Exposure ◽  
Factors Associated ◽  
History Of

Abstract Background Congenital heart diseases (CHDs) are the most common types of birth defects and contribute to a large proportion of infant morbidities and mortalities worldwide. These defects may require multiple surgical interventions impacting the infant's quality of life. Objectives To identify risk factors associated with CHD in a population of Thai children. Methods We conducted a case–control study of patients attending the Pediatric Clinic, Naresuan University Hospital, Thailand. We included data from pediatric patients diagnosed with CHDs as cases, and patients without cardiovascular abnormalities as controls. Risk data were collected from July 2019 to April 2020 using face-to-face interviews. Multiple logistic regression was used to analyze parental factors associated with CHDs. Results We included 249 cases classified into 2 groups according to severity and 304 patients as controls. For those less-severely affected (155 patients, 62.2%), ventricular septal defect (27.7%) was the most prevalent, whereas for those with severe CHDs, tetralogy of Fallot was the most prevalent (14.0%). There was no difference in sex distribution or maternal obstetric history between the groups. In multivariable analysis, a family history of CHDs (adjusted odds ratio [AOR] 4.67, 95% confidence interval (CI) 1.61–13.57, P = 0.005) and maternal exposure to second-hand cigarette smoke (AOR 1.58, 95% CI 1.03–2.42, P = 0.002) were identified as significant risk factors for CHDs. Conclusion A family history of CHDs and maternal exposure to second-hand cigarette smoke are associated with having offspring with CHDs in the population studied. These findings help us to encourage affected parents to obtain a fetal echocardiogram.

scholarly journals Risk factors associated with COVID-19 Intensive Care Unit hospitalisation in Guyana: A cross-sectional study

2021 ◽  
Author(s):  
Steven A. Seepersaud
Keyword(s):  
Risk Factors ◽  
Retrospective Chart Review ◽  
Binary Logistic Regression ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Factors Associated ◽  
Independent Variables ◽  
Icu Admission

Objective The purpose of the study was to determine risk factors associated with COVID-19 ICU hospitalisation at Georgetown Public Hospital Corporation (GPHC), Guyana. Methods A retrospective chart-review was conducted on all COVID-19 admissions from March to September 2020. The predictive factors were demographics, comorbidities, signs and symptoms of COVID-19 and laboratory findings on admission. Descriptive frequency analysis was done for all independent variables and the Chi-square test was used to compare differences between groups where suitable. Univariate and multivariate binary logistic regression was used to examine the association between the independent variables and the risk for ICU hospitalisation. Results There were 136 patients with COVID-19 at GPHC during March to September 2020 and after exclusion, 135 patients were used in the study. There were 72 (53.4%) patients who required non-ICU care, while 63 (46.6%) ICU care and average age ± SD (median) was 51 ±16 (n= 49) and 56 ±18 (n= 60), respectively. In the multivariate regression model, the odds of ICU admission for those aged 40-65 was 0.14 (p <.01) compared to those > 65 years. Patients with class 2 and above obesity had higher odds of ICU admission compared to non-obese patients OR 11.09 (p= .006). Patients with 2 and 3 or more comorbidities also had higher odds of ICU admission compared to those with no comorbidities OR 7.83 (p= .03) and 132 (p <.001), respectively. Patients with LDH 228-454 U/L and > 454 U/L on admission had higher odds of ICU admission compared to those with normal LDH OR 19.88 (p= .001) and 23.32 (p= .001), respectively. Patients with albumin < 3.50 mg/dL on admission also had higher odds of ICU admission compared to those with normal albumin OR 5.78 (p= .005). Conclusion Risk factors associated with ICU hospitalisation were advanced age, obesity, multiple comorbidities, elevated LDH and low albumin. Protecting the population at risk for ICU admission and prioritizing them for vaccination is recommended to reduce the risk of running out of ICU capacity.

scholarly journals Risk factors for illness severity in patients with COVID-19 pneumonia: a prospective cohort study

2020 ◽  
Author(s):  
Nannan Zhang ◽  
Hairong Zhang ◽  
Yanhua Tang ◽  
Hao Zhang ◽  
Aiying Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Case Series ◽  
Severity Of Illness ◽  
Illness Severity ◽  
Laboratory Findings ◽  
Factors Associated ◽  
Detection And Identification ◽  
Disease Hospital ◽  
Novel Coronavirus

Abstract Background Although COVID-19 pneumonia is spreading internationally, knowledge regarding the factors associated with the illness severity of patients remains limited. We aimed to identify the factors associated with the disease severity of patients with COVID-19 pneumonia induced by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We prospectively enrolled a single-center case series of adult patients with COVID-19 admitted to the Infectious Disease Hospital of Jining, Jining City, Shandong Province, China, from January 24 to March 1, 2020. Demographics, clinical characteristics, and laboratory findings were compared to investigate the risk factors related with the disease severity of COVID-19 pneumonia patients. Results We included a total of 78 patients with COVID-19 pneumonia, of whom 6 had the severe type. As compared to a moderately ill cohort, our analysis showed that shortness of breath, fatigue, neutrophil percentages > 70%, neutrophil counts > 6.3 × 10 9 /L, lymphocyte percentages < 20%, lymphocyte counts < 1.0 × 10 9 /L, platelet < 100 × 10 9 /L, C-reactive protein (CRP) > 10 mg/L, neutrophil to platelet ratio (NPR) > 2.3, neutrophil to lymphocyte ratio (NLR) > 3.9, aspartate aminotransferase (AST) > 40 U/L, albumin < 40 g/L, lactate dehydrogenase (LDH) > 245 U/L, and glucose > 6.1 mmol/L were predictors of disease severity in COVID-19 pneumonia. In the sex-, age-, and comorbid illness-matched case-control study, neutrophil percentages > 70%, neutrophil counts > 6.3 × 10 9 /L, lymphocyte percentages < 20%, NPR > 2.3, NLR > 3.9, albumin < 40 g/L, and LDH > 245 U/L remained associated with the early detection and identification of severe patients. Conclusion We demonstrated that neutrophil percentages > 70%, neutrophil counts > 6.3×10 9 /L, lymphocyte percentages < 20%, NPR > 2.3, NLR > 3.9, albumin < 40 g/L, and LDH > 245 U/L might predict the severity of illness in patients with COVID-19 pneumonia.

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