scholarly journals Prediction of severe pre-eclampsia in low-risk women

2021 ◽  
Vol 6 (2) ◽  
pp. 51-58
Author(s):  
N. I. Frolova ◽  
T. E. Belokrinitskaya ◽  
K. A. Kolmakova
Keyword(s):  
Risk Factors ◽  
Medical History ◽  
Respiratory Infections ◽  
Kidney Diseases ◽  
First Trimester ◽  
Genotype Distribution ◽  
Past Medical History ◽  
Singleton Pregnancy ◽  
Uncomplicated Pregnancy ◽  
History Of

Aim. To find the predictors of severe pre-eclampsia in women without any established risk factors.Materials and Methods. We consecutively recruited 200 pregnant women (100 with severe pre-eclampsia and 100 with uncomplicated pregnancy and successful delivery). Criteria of inclusion were age from 18 to 35 years, absence of significant comorbid conditions (cardiovascular diseases, autoimmune diseases, metabolic disorders, and kidney diseases), absence of family history and past medical history of pre-eclampsia and thromboembolism, singleton pregnancy, and body mass index in the first trimester < 35 kg/m2 . We assessed allele and genotype distribution across several gene polymorphisms (ADD1-1378G>T, AGT704T>C, AGT-521C>T, AGTR1-1166A>C, AGTR2-1675G>A, NO3-894G>C, and NO3-786T>C) potentially associated with severe pre-eclampsia.Results. We found that the combination of AGTR2-1675АA and eNOS3-786СC polymorphisms (p = 0.04), bacteriuria (p < 0.001), acute respiratory infections (p = 0.011) and acute vulvovaginitis in second and third trimesters (p = 0.013), smoking (p < 0.001), and past medical history of abortions (p = 0.017) were risk factors of severe pre-eclampsia.Conclusions. Predictors of severe pre-eclampsia revealed in this study can be used in the development of personalised prognostication during pregnancy in patients without conventional risk factors of pre-eclampsia. 

Vasoactive genes as molecular and genetic predictors of severe preeclampsia

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 10-13
Author(s):  
Tatiana E Belokrinitskaya ◽  
Nataliya I Frolova ◽  
Natal'ia N Strambovskaya ◽  
Kristina A Kolmakova
Keyword(s):  
Incidence Rate ◽  
Mutant Gene ◽  
First Trimester ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Uncomplicated Pregnancy ◽  
Genetic Predictors ◽  
Homozygous Genotype ◽  
History Of

Aim. To analyze an incidence rate of polymorphisms and combinations of genes AGT-704T> C, AGT-521C> T, AGTR1-1166A> C, AGTR2-1675G> A, еNO3-786T> C, еNOS3-894G> C, ADD1-1378G> T, CYP11B2 -304C> T, GNB3-825C> T and to assess their association with a risk of severe pre-eclampsia. Materials and methods. The study included women of early fertile age (20-35 years old) with spontaneous singleton pregnancy, no bad habits (smoking, alcohol or drug use), no extragenital diseases and no family (mother or sister) or an individual history of pre-eclampsia and with body mass index in the first trimester of pregnancy less than 35 kg/m2. The study group consisted of 100 patients with severe preeclampsia and the control group included 100 women with uncomplicated pregnancy. Genotyping was carried out by method of polymerase chain reaction. Data analysis included compliance with the Hardy - Weinberg law, Cramer's V criterion, χ2 test, odds ratio (OR) and its 95% confidence interval (CI). To assess a distribution of stated polymorphisms of genes and their alleles a general (χ2 test, df=2) and multiplicative (χ2 test, df=1) inheritance models were used. Results and discussion. Patients with severe pre-eclampsia had statistically significantly higher incidence rate of mutant homozygous genotypes AGTR1-1166CC (χ2=5,54; p=0,05) and еNO3-786CC (χ2=23,05; p=1,0E-5). A significant association between a carrier of the mutant homozygous genotype eNO3-786СC (χ2=19,780; p=0,000) and severe pre-eclampsia (OR 45,07, 95% CI 2,68-759,30) was found out. Combinations of mutant alleles of potentially predictive polymorphisms of vasoactive genes in women with preeclampsia were recorded 7,7 times more often (23% vs 3%; χ2=17,683, p=0,000; average Cramer's V link) which led to a significant association link with a risk of a disease complication (OR 9,658, 95% CI 2,795-33,367). Conclusion. A synergistic interaction between polymorphic loci in severe preeclampsia was established. The mutant homozygous genotype eNO3-786СC as well as a combination of at least two mutant alleles of genes - candidates for arterial hypertension or their combination with the mutant gene ADD1-1378TT or GNB3-825TT can claim a role of molecular and genetic predictors of severe preeclampsia.

scholarly journals Persistent cough and asthma-like symptoms post COVID-19 hospitalization in children

2021 ◽  
Author(s):  
hossein esmaeilzadeh ◽  
Anahita Sanaei Dashti ◽  
Negar Mortazavi ◽  
Fatemian Fatemian ◽  
Mohebat Vali
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Medical History ◽  
Laboratory Data ◽  
Previous History ◽  
Hospitalized Children ◽  
Past Medical History ◽  
Persistent Cough ◽  
History Of

Abstract Backgrounds: Respiratory viruses are the main triggers of asthma. Coronavirus is shown to contribute to infections of the respiratory tract that can lead to prolong cough and asthma. Objectives: Present study aimed to determine the risk of developing Persistent cough and asthma-like symptoms in hospitalized children due to COVID-19. Methods: This prospective study was carried out in a tertiary referral center. During the COVID-19 pandemic, 69 hospitalized pediatric patients admitted with COVID-19 were observed from February2020 to January 2021. Clinical and laboratory data were recorded, and after discharge, patients were followed and visited for cough and asthma evaluation in one, 2 and 6 months later. Patients with asthma-like diagnosis in follow up define as asthma-like group and patients without any sign of asthma categorized as the non-asthma group. Asthma-like co-morbids and risk factors were evaluated and compared between two groups. Results: Most of the COVID-19 hospitalized patients (N=42) (58.5%) were not affected by asthma-like symptoms in follow-up. 60.9% of the COVID-19 patients were male. The asthma-like group cases had a significantly familial history of asthma (63.0%), past medical history of asthma (33.3%), and Allergic rhinitis (85.2%). Rates of signs and symptoms during hospitalization were significantly higher in patients with COVID-19 and past medical history of asthma. Conclusions: We found an asthma-like prevalence of 41.5% in the cohort of COVID-19 hospitalized children. Family history of asthma and previous history of asthma and allergic rhinitis are risk factors for asthma-like after COVID-19 hospitalization. COVID-19 presentations are more severe in the asthma-like group.

scholarly journals Risk Factors for Hospital-Acquired Venous Thromboembolism in Children: Findings from the Children's Hospital-Acquired Thrombosis (CHAT) Registry

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 142-142
Author(s):  
Brian R. Branchford ◽  
Julie Jaffray ◽  
Stacy E. Croteau ◽  
Michael Silvey ◽  
Nihal Bakeer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical History ◽  
Research Funding ◽  
Venous Catheter ◽  
Past Medical History ◽  
Central Venous ◽  
History Of ◽  
Hospital Acquired ◽  
Active Cancer ◽  
Or History

Abstract Introduction Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates are increasing along with associated mortality, short- and long-term morbidity, and healthcare costs. National process improvement efforts are underway to decrease HA-VTE in children, but risk-stratified prevention strategies will be safest and most effective if informed by robust risk factor data. The objective of this work was to identify risk factors for HA-VTE in children via a multicenter study Methods The Children's Hospital-Acquired Thrombosis (CHAT) Registry is a multi-institutional pediatric HA-VTE registry that we created to generate a risk-prediction model for future use in clinical trials of thromboprophylaxis. Designed as a retrospective case-control study, CHAT Registry data has been entered by 7 U.S. pediatric institutions for subjects admitted between January 1, 2012 and December 31, 2016. Cases (aged 0-21 years) that developed HA-VTE during the admission were matched by institution and admission year with 1:1 frequency to randomly sampled non-HA-VTE controls. Univariate analyses tested associations between risk factors and the development of HA-VTE. Analyses utilized weighted logistic regression, in which controls were weighted by the inverse sampling probability in order to recreate the population from which the controls were sampled. Year of admission and hospital sites were included in the assessment of each predictor to control for effects of time and treating hospital. Results 825 HA-VTE cases and 841 controls from participating hospitals comprise the analytical cohort (total 1,666 hospital admissions). HA-VTE cases showed a male predominance (58%). The majority, 73%, were related to central venous catheters (CVCs). HA-VTE most commonly occurred in the lower extremity (32%) followed by upper extremity (16%), thorax/neck (16%), cerebral sinovenous (5%), abdomen (5%), lung (3%), cardiac (2%), and other (22%). VTE were asymptomatic or identified incidentally in 21% of cases. Subjects were most commonly located in an intensive care unit (ICU) (58%) when diagnosed with a VTE, followed by general medical ward (23%), hematology/oncology unit (13%), surgical unit (3%), emergency department (1%), and other (1%). Significant association with HA-VTE incidence (Table 1) was found with infancy compared to other age groups, prior hospitalization within 1 month (Odds Ratio [OR] 3.6, 95% Confidence Interval [CI] 2.7-4.8) compared to no recent prior admission, admission to ICU (cardiac/pediatric ICU OR 10.1, 95% CI 6.0-17.1 and NICU OR 9.0, 95% CI 5.2-15.7) or hematology/oncology units (OR 2.7, 95% CI 1.6-6.0) compared to admission to general pediatric ward, complete immobility acutely (OR 32.3, 95% CI 13.2-79.2 ) compared to no loss of mobility from baseline, chronic bed-bound/wheelchair-bound immobility (OR 2.2, 95% CI 1.4-3.6), and a past medical history of protein-losing state (OR 34.6, 95% CI 4.1-290.9), inflammatory/autoimmune disease (OR 31.8, 95% CI 3.9-262.1), congenital heart disease (OR 28.5, 95% CI 12.7-64.2), central venous catheter placed on the day of admission (OR 22.0, 95% CI 14.2-34.1) or prior to admission (OR 5.2, 95% CI 3.4-7.9) thrombophilia/VTE (OR 9.7, 95% CI 2.6-35.5), TPN dependence (OR 8.0, 95% CI 1.6-39.3), or history of cancer (OR 1.5, 95% CI 1.0-2.4) compared to the absence of past medical history. Additionally, active cancer conferred an overall odds ratio of 2.0, with the recurrent/metastatic subtype conferring an OR of 3.4 compared to other active cancer subtypes. Conclusions The multi-institution CHAT Registry contains a larger dataset of pediatric HA-VTE cases and controls than any similar collection published to date. Key demographic and clinical factors associated with HA-VTE include infant age, male sex, ICU admission, central venous catheter, decreased mobility, cancer, use of certain medications, or certain past medical history (protein-losing state, congenital heart disease, inflammatory/autoimmune condition, thrombophilia or history of VTE, and TPN dependence). Further analysis is being performed on these and other risk factors to develop a pediatric-specific HA-VTE risk-prediction model for future validation in an even larger multi-institutional cohort. This validated risk model will then be used to identify children at high risk of HA-VTE to guide preventative strategies to decrease the incidence in the pediatric population. Disclosures Jaffray: CSL Behring: Consultancy, Research Funding; Octapharma: Consultancy; Bayer: Consultancy. Croteau:Tremeau Pharmaceuticals: Consultancy; Baxalta/Shire: Consultancy, Research Funding; Biomarin: Consultancy; Bioveritiv: Consultancy; Catalyst Biosciences: Consultancy; CSL-Behring: Consultancy; Genetech: Consultancy, Research Funding; Novo Nordisk: Consultancy; Octapharma: Consultancy, Honoraria, Research Funding; Pfizer: Research Funding; Spark Therapeutics: Research Funding; Bayer: Consultancy. Silvey:Bayer: Honoraria; Pfizer: Honoraria; CSL Behring: Honoraria; Octapharma: Honoraria. Young:Bioverativ: Consultancy, Honoraria; Bayer: Consultancy; CSL Behring: Consultancy, Honoraria; Genentech/Roche: Consultancy, Honoraria; Kedrion: Consultancy; Novo Nordisk: Consultancy, Honoraria; Shire: Consultancy, Honoraria. Mahajerin:Genentech Inc.: Consultancy.

Pregravid prognostic criteria of deciduitis

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 58-65
Author(s):  
Nelli I Kohno ◽  
Tatiana E Samoylova ◽  
Shahadat A Dokudaeva
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Medical History ◽  
Clinical Laboratory ◽  
Married Couple ◽  
Uterine Cavity ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Prognostic Criteria ◽  
History Of

Background. Lack of adequate management of female patients with non-developing pregnancy often contributes to persistence of infectious agents in the uterine cavity. The developed clinical protocol for pregravid preparation includes a detailed examination of a woman who is planning a pregnancy, while a comprehensive examination of a married couple can improve perinatal outcomes. This protocol states: "differentiated approach based on determining high-risk groups allows to avoid pregravid excessive preparation". For this reason it is advisable to determine the risk group for miscarriage due to infections given patient medical history and clinical laboratory pregravid prognostic criteria. Aim. To determine patient medical history and pregravid clinical and laboratory prognostic criteria for a disorder of decidualization of inflammatory genesis during the first trimester of pregnancy. Outcomes and methods. A retrospective analysis of medical history data of 30 pregnant women with non-developing pregnancies in terms of 8-10 weeks (group 1) and with histologically confirmed deciduitis was carried out. Comparison group included 50 pregnant women with a favorable course of pregnancy (group 2). Results. Patient history risk factors for non-developing pregnancy with decidual membrane infectious-inflammatory disorders are a history of acute or chronic endometritis (RR=15.83 and OR=41.45); a history of miscarriages (RR=13.33 and OR=17.82); recurrent colpitis of various etiologies (specific, non-specific) in the pregravid period (RR=6.67 and OR=8.73); a history of postpartum endometritis (RR=6.11 and OR=9.07); an increment of the placenta in a previous pregnancy (RR=5.83 and OR=7.30); a history of frozen pregnancies (RR=4.67 and OR=4.37). Pregravid risk factors for a non-developing pregnancy are a lack of both increased echogenicity and coiled arteries visualization in a middle secretory phase of menstrual cycle in a pregravidary period (RR=15,00 and OR=36.00) and endometrium thickness

scholarly journals EPIDEMIOLOGY OF RESPIRATORY PROBLEMS IN ASSOCIATION WITH VARIOUS RISK FACTORS: A CLINICAL STUDY AT ST. JOSEPH’S GENERAL HOSPITAL

2020 ◽  
Vol 11 (12) ◽  
pp. 35-40
Author(s):  
Vedantham Satya Chakravarthy ◽  
Dasari Rama Krishna Prasad ◽  
Reddy Pavan Teja ◽  
Darabadi Rispa
Keyword(s):  
Risk Factors ◽  
Medical History ◽  
General Hospital ◽  
Social History ◽  
Past Medical History ◽  
Respiratory Problems ◽  
Guntur District ◽  
History Of ◽  
Males And Females ◽  
Time Of Admission

The aim of the study was to identify the epidemiology of respiratory problems and to assess their association with various risk factors in patients of St. Joseph’s general hospital, Guntur, Andhra Pradesh. The study was conducted over a period of 8 months (July-2019 to February-2020) in 71 patients (both males and females) and the data was analyzed using EXCEL 2007 and SPSS version 6.0. The study was conducted throughout 3 seasons (Monsoon, autumn, winter) during which people are more prone to respiratory problems. Demographic information like the name, age, gender, address, and previous medical history was included. The risk factors like time of admission (month), location, age, gender, past medical history & other co-morbidities and social history were considered. The diagnosed pulmonary problems include Asthma, Bronchitis (acute, chronic & viral), COPD, Interstitial Lung Disease, LRTI, Lung Cancer, Pneumonia, Respiratory Failure, Tuberculosis, Tonsillitis and Shortness of Breath due to either Plural Effusion or Pulmonary Oedema. This study depicts the epidemiology of respiratory problems as Non-Guntur district (14.084%), Guntur urban (59.154%), Guntur rural (26.760%). This study shows the results as; patient with social history of tobacco and/or alcohol (10%), patients without any social history (90%), without any past medical history or other co-morbidities (51%), with some past medical history (49%), males (54.93%), females (45.07), July to October (50.7%), November to February (49.3%). And 61-to-70-year patients are at the top (23.94%) and 11 to 20 year patients are at the bottom (1.40%) of the distribution.

scholarly journals Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I

2021 ◽  
Author(s):  
Annamaria Biczok ◽  
Philipp Karschnia ◽  
Raffaela Vitalini ◽  
Markus Lenski ◽  
Tobias Greve ◽  
...  
Keyword(s):  
Medical History ◽  
Tumor Recurrence ◽  
Clinical History ◽  
Study Endpoint ◽  
Past Medical History ◽  
Who Grade ◽  
Increased Risk ◽  
History Of ◽  
Meningioma Recurrence ◽  
The Impact

Abstract Background Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before. Methods We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models. Results Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis. Conclusion Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.

Abstract 1122‐000214: Clinical Factors Associated rTPA Administration in Acute Ischemic Stroke Patients with History of Atrial Fibrillation

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Chase A Rathfoot ◽  
Camron Edressi ◽  
Carolyn B Sanders ◽  
Krista Knisely ◽  
Nicolas Poupore ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Medical History ◽  
Clinical Decision Making ◽  
Past Medical History ◽  
Clinical Factors ◽  
Stroke Patients ◽  
Factors Associated ◽  
History Of

Introduction : Previous research into the administration of rTPA therapy in acute ischemic stroke patients has largely focused on the general population, however the comorbid clinical factors held by stroke patients are important factors in clinical decision making. One such comorbid condition is Atrial Fibrillation. The purpose of this study is to determine the clinical factors associated with the administration of rtPA in Acute Ischemic Stroke (AIS) patients specifically with a past medical history of Atrial Fibrillation (AFib). Methods : The data for this analysis was collected at a regional stroke center from January 2010 to June 2016 in Greenville, SC. It was then analyzed retrospectively using a multivariate logistic regression to identify factors significantly associated with the inclusion or exclusion receiving rtPA therapy in the AIS/AFib patient population. This inclusion or exclusion is presented as an Odds Ratio and all data was analyzed using IBM SPSS. Results : A total of 158 patients with Atrial Fibrillation who had Acute Ischemic Strokes were identified. For the 158 patients, the clinical factors associated with receiving rtPA therapy were a Previous TIA event (OR = 12.155, 95% CI, 1.125‐131.294, P < 0.040), the administration of Antihypertensive medication before admission (OR = 7.157, 95% CI, 1.071‐47.837, P < 0.042), the administration of Diabetic medication before admission (OR = 13.058, 95% CI, 2.004‐85.105, P < 0.007), and serum LDL level (OR = 1.023, 95% CI, 1.004‐1.042, P < 0.16). Factors associated with not receiving rtPA therapy included a past medical history of Depression (OR = 0.012, 95% CI, 0.000‐0.401, P < 0.013) or Obesity (OR = 0.131, 95% CI, 0.034‐0.507, P < 0.003), Direct Admission to the Neurology Floor (OR = 0.179, 95% CI, 0.050‐0.639, P < 0.008), serum Lipid level (OR = 0.544, 95% CI, 0.381‐0.984, P < 0.044), and Diastolic Blood Pressure (OR = 0.896, 95% CI, 0.848‐0.946, P < 0.001). Conclusions : The results of this study demonstrate that there are significant associations between several clinical risk factors, patient lab values, and hospital admission factors in the administration of rTPA therapy to AIS patients with a past medical history of Atrial Fibrillation. Further research is recommended to determine the extent and reasoning behind of these associations as well as their impact on the clinical course for AIS/AFib patients.

scholarly journals Osteopetrosis - A Case Series Exploring Complications and Multidisciplinary Management

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A209-A209
Author(s):  
Catherine Stewart ◽  
Paul Benjamin Loughrey ◽  
John R Lindsay
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Medical History ◽  
Scaphoid Fracture ◽  
Past Medical History ◽  
Dxa Scan ◽  
X Ray ◽  
Management Of Complications ◽  
History Of ◽  
Spine Mri

Abstract Background: Osteopetrosis is a group of rare inherited skeletal dysplasias, with each variant sharing the hallmark of increased bone mineral density (BMD). Abnormal osteoclast activity produces overly dense bone predisposing to fracture and skeletal deformities. Whilst no cure for these disorders exists, endocrinologists play an important role in surveillance and management of complications. Clinical Cases: A 43-year-old female had findings suggestive of increased BMD on radiographic imaging performed to investigate shoulder and back pain. X-ray of lumbar spine demonstrated a ‘rugger jersey’ spine appearance, while shoulder X-ray revealed mixed lucency and sclerosis of the humeral head. DXA scan showed T-scores of +11 at the hip and +12.5 at the lumbar spine. MRI of head displayed bilateral narrowing and elongation of the internal acoustic meatus and narrowing of the orbital foramina. Genetic assessment confirmed autosomal dominant osteopetrosis with a CLCN7 variant. Oral colecalciferol supplementation was commenced and multi-disciplinary management instigated with referral to ophthalmology and ENT teams. A 25-year-old male presented with a seven-year history of low back pain and prominent bony swelling around the tibial tuberosities and nape of neck. Past medical history included repeated left scaphoid fracture in 2008 and 2018. Recovery from his scaphoid fracture was complicated by non-union requiring bone grafting with open reduction and fixation. Plain X-rays of the spine again demonstrated ‘rugger jersey’ spine. DXA scan was notable for elevated T scores; +2.9 at hip and +5.8 lumbar spine. MRI spine showed vertebral endplate cortical thickening and sclerosis at multiple levels. The patient declined genetic testing and is under clinical review. A 62-year-old male was referred to the bone metabolism service following a DXA scan showing T scores of +11. 7 at the hip and +13 at the lumbar spine. His primary complaint was of neck pain and on MRI there was multi-level nerve root impingement secondary to facet joint hypertrophy. Past medical history was significant for a long history of widespread joint pains; previous X-ray reports described generalized bony sclerosis up to 11 years previously. Clinical and radiological monitoring continues. Conclusion: Individuals with osteopetrosis require a multidisciplinary approach to management. There is no curative treatment and mainstay of therapy is supportive with active surveillance for complications.

scholarly journals Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection

2020 ◽  
Author(s):  
Donogh Maguire ◽  
Marylynne Woods ◽  
Conor Richards ◽  
Ross Dolan ◽  
Jesse Wilson Veitch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medical History ◽  
Teaching Hospital ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Early Warning Score ◽  
Past Medical History ◽  
Urban Teaching ◽  
Neutrophil Lymphocyte Ratio ◽  
History Of

Abstract BackgroundSevere COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age>70 years (p<0.001), past medical history of cognitive impairment (p<0.001), previous delirium (p<0.001), clinical frailty score>3 (p<0.001), hypertension (p<0.05), heart failure (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L (male) / <0.37 L/L (female)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On analysis, age >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.

scholarly journals Quality of Life and Psychological Distress during Cancer: A Prospective Observational Study Involving Liver Cancer Patients

2021 ◽  
pp. 576-585
Author(s):  
Madeeha Malik ◽  
Iqra Parveen Kiyani ◽  
Shazana Rana ◽  
Azhar Hussain ◽  
Muhammad Bin Aslam Zahid
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Liver Cancer ◽  
Medical History ◽  
Cancer Patients ◽  
Study Design ◽  
Negative Impact ◽  
Past Medical History ◽  
Symptom Scale

Introduction: Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients. Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan. Study Design:  A descriptive cross-sectional study design was used. Place and Duration of Study: The study was conducted in healthcare facilities of Islamabad and Rawalpindi, Pakistan between June 2020-December 2020. Methodology: Two pre-validated questionnaires i.e. EORTC QLQ-C30 and HADS were self-administered to a sample of 100 liver cancer patients selected using a convenience sampling technique for measuring QoL and depression, respectively. After data collection, data was cleaned, coded, and entered in SPSS. Results: The results highlighted that the lowest scores observed in the domain of symptom scale were: Nausea and Vomiting (23.72, ± 28.238), Dyspnea (25.27, ± 26.90), Constipation (26.03, ± 34.75) followed by Diarrhea (22.63, ± 28.42), whereas highest scores in the symptom scale were observed in the domain of fatigue (37.69, ± 20.06), pain (40.37, ± 18.44), insomnia (41.65, ± 32.37) and financial difficulties (60.33, ± 33.830). On the other hand, highest score on the functional scale was observed for physical functioning (64, ± 21.76) and the lowest score was observed in social functioning (53.19, ± 20.66). Conclusion: The present study concluded that liver cancer had a negative impact on risk factors/past medical history, co-morbidities, and poor socio-economic of life across all domains along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk factors/past medical history, co-morbidities and poor socio-economic status negatively affected functional and symptom scale. Appropriate health educational and psychological interventional programs targeting patients should be initiated to improve awareness and reduce depression among liver cancer patients.

Sign in / Sign up

Export Citation Format

Share Document