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1.
Braz. j. biol ; 83: e249104, 2023. tab
Artículo en Inglés | MEDLINE, LILACS, VETINDEX | ID: biblio-1339389

RESUMEN

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Enfermedad Coronaria/embriología , Hiperhomocisteinemia/diagnóstico , Hiperhomocisteinemia/epidemiología , Estudios de Casos y Controles , Factores de Riesgo , Ayuno
2.
Oxid Med Cell Longev ; 2022: 6687626, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35340212

RESUMEN

Background and Aims: Elevated serum uric acid (SUA) is associated with an increased risk of nonalcoholic fatty liver disease (NAFLD); however, whether this association is causal is undetermined. Methods: Each participant from the Dongfeng-Tongji cohort study based on 27,009 retirees was interviewed face-to-face following a clinical examination. Covariance, logistic regression analysis, and instrumental variables were used to assess associations between SUA and (severity of) NAFLD and the causal link. Results: Among 8,429 subjects free of NAFLD at baseline, 2,007 participants developed NAFLD after 5 years of follow-up. The multivariable-adjusted odds ratio (OR) for NAFLD for individuals in the fourth quartile of SUA level versus those in the first was 1.71 (95% CI: 1.45-2.01, P for trend <0.001) and was more dramatic in women or normal-weight persons. Furthermore, SUA was materially associated with greater mean markers of hepatic necroinflammation and greater probabilities of fibrosis. In genetic analyses, both single nucleotide polymorphisms (rs11722228 to SLC2A9 and rs2231142 to ABCG2) were pronouncedly associated with increased SUA concentrations, ranging from 0.19 to 0.22 mg/dl. No significant associations were observed between SNPs and potential confounders. No association was observed between the SUA-increasing allele and NAFLD, with an OR of 0.98 (95% CI: 0.90-1.08) per genetic score. This was not significantly different (P = 0.25) from what was expected (1.03, 95% CI: 1.03-1.03). Conclusions: SUA was positively associated with NAFLD incidence especially in female and normal-weight individuals and the suspected progression risk of newly developed NAFLD. However, the Mendelian randomization analyses lend no causal evidence, suggesting high SUA as a marker and not a cause of NAFLD.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico , Ácido Úrico , Estudios de Cohortes , Femenino , Proteínas Facilitadoras del Transporte de la Glucosa , Humanos , Enfermedad del Hígado Graso no Alcohólico/genética , Oportunidad Relativa , Factores de Riesgo
3.
J Nerv Ment Dis ; 210(4): 257-263, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35212665

RESUMEN

ABSTRACT: We aimed to explore the prevalence and determinants of severe COVID-19 disease and mortality in patients with schizophrenia in this study. We conducted a retrospective observational study of 1620 patients with schizophrenia. Of the 1620 patients, 52 (3.2%) tested positive for SARS-CoV-19. Among SARS-CoV-2-positive patients, 40 patients were hospitalized, and 17 patients required intensive care unit admission due to COVID-19 (76.9% and 32.7%, respectively). Severe COVID-19 disease was noted in 17 patients (32.7%) requiring intubation. In the logistic regression analysis, antipsychotic dose, and comorbidity score were independently associated with a greater risk of severe COVID-19 disease in patients with schizophrenia. Our study suggests that factors such as age, sex, comorbidities, and a daily antipsychotic dose may have effects on the poor outcome of SARS-CoV-2 disease in schizophrenia patients. In addition, the current findings propose that mortality may be associated with an older age, comorbidity score, and a longer duration of psychiatric disease among the SARS-CoV-2-positive patients with schizophrenia. However, the findings of our study should be verified in prospective and larger sample studies.


Asunto(s)
COVID-19 , Esquizofrenia , COVID-19/epidemiología , Comorbilidad , Demografía , Hospitalización , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Esquizofrenia/epidemiología
5.
Artif Organs ; 46(4): 597-605, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34951495

RESUMEN

BACKGROUND: M101 is an extracellular hemoglobin isolated from a marine lugworm and is present in the medical device HEMO2 life®. The clinical investigation OXYOP was a paired kidney analysis (n = 60) designed to evaluate the safety and performance of HEMO2 life® used as an additive to preservation solution in renal transplantation. The secondary efficacy endpoints showed less delayed graft function (DGF) and better renal function in the HEMO2 life® group but due to the study design cold ischemia time (CIT) was longer in the contralateral kidneys. METHODS: An additional analysis was conducted including OXYOP patients and patients from the ASTRE database (n = 6584) to verify that the decrease in DGF rates observed in the HEMO2 life® group may not be due solely to the shorter CIT but also to HEMO2 life® performance. Kaplan-Meier estimate curves of cumulative probability of achieving a creatinine level below 250 µmol/L were generated and compared in both groups. A Cox model was used to test the effect of the explanatory variables (use of HEMO2 life® and CIT). Finally, a bootstrap strategy was used to randomly select smaller samples of patients and test them for statistical comparison in the ASTRE database. RESULTS: Kaplan-Meier estimate curves confirmed the existence of a relation between DGF and CIT and Cox analysis showed a benefit in the HEMO2 life® group regardless of the associated CIT. Boostrap analysis confirmed these results. CONCLUSIONS: The present study suggested that the better recovery of renal function observed among kidneys preserved with HEMO2 life® in the OXYOP study is a therapeutic benefit of this breakthrough innovative medical device.


Asunto(s)
Isquemia Fría , Trasplante de Riñón , Isquemia Fría/efectos adversos , Isquemia Fría/métodos , Funcionamiento Retardado del Injerto , Supervivencia de Injerto , Hemoglobinas , Humanos , Riñón/fisiología , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/métodos , Estudios Prospectivos , Factores de Riesgo
6.
Horm Metab Res ; 54(2): 84-93, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35130569

RESUMEN

Long-term glycemic fluctuation has been associated with cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). However, the findings are inconsistent. We performed a meta-analysis to summarize the association between parameters of long-term glycemic variability and risk of cardiovascular events in T2DM patients. Medline, Embase, and Web of Science databases were searched for longitudinal follow-up studies comparing the incidence of cardiovascular events in T2DM patients with higher or lower long-term glycemic variability. A random-effect model incorporating the potential heterogeneity among the included studies was used to pool the results. Twelve follow-up studies with 146 653 T2DM patients were included. The mean follow-up duration was 4.9 years. Pooled results showed that compared to those with the lowest glycemic variability, patients with the highest glycemic variability had significantly increased risk of cardiovascular events, as evidenced by the standard deviation of glycated hemoglobin [HbA1c-SD: relative risk (RR)=1.44, 95% confidence interval (CI): 1.23 to 1.69, p<0.001; I2=70%], HbA1c coefficient of variation (HbA1c-CV: RR=1.46, 95% CI: 1.19 to 1.79. p<0.001; I2=83%), standard deviation of fasting plasma glucose (FPG-SD: RR=1.33, 95% CI: 1.07 to 1.65, p=0.009; I2=0%), and FPG coefficient of variation (FPG-CV: RR=1.29, 95% CI: 1.01 to 1.64, p=0.04; I2=47%). In conclusion, increased long-term glycemic variability may be an independent risk factor for cardiovascular events in T2DM patients.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Glucemia , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Diabetes Mellitus Tipo 2/complicaciones , Ayuno , Hemoglobina A Glucada/análisis , Humanos , Factores de Riesgo
7.
Horm Metab Res ; 54(2): 104-112, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35130571

RESUMEN

Some studies have suggested that diabetes may be a risk factor for osteoarthritis. However, whether prediabetes is also associated with osteoarthritis has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and osteoarthritis. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Ten datasets from six observational studies were included, which involved 41 226 general adults and 10 785 (26.2%) of them were prediabetic. Pooled results showed that prediabetes was not independently associated with osteoarthritis [risk ratio (RR): 1.07, 95% confidence interval (CI): 1.00 to 1.14, p=0.06, I2=0%]. Sensitivity limited to studies with adjustment of age and body mass index showed consistent result (RR: 1.06, 95% CI: 0.99 to 1.14, p=0.09, I2=0%). Results of subgroup analyses showed that prediabetes was not associated with osteoarthritis in cross-sectional or cohort studies, in studies including Asian or non-Asian population, or in studies with different quality scores (p for subgroup difference>0.10). Besides, prediabetes was not associated with osteoarthritis in men or in women, in studies with prediabetes defined as impaired fasting glucose, impaired glucose tolerance, or HbA1c (approximately 39-46 mmol/mol). Moreover, prediabetes was not associated with overall osteoarthritis, and knee or hip osteoarthritis. Current evidence does not support that prediabetes is independently associated with osteoarthritis in adult population.


Asunto(s)
Intolerancia a la Glucosa , Osteoartritis , Estado Prediabético , Adulto , Glucemia/metabolismo , Estudios Transversales , Femenino , Hemoglobina A Glucada/análisis , Humanos , Masculino , Estudios Observacionales como Asunto , Osteoartritis/complicaciones , Osteoartritis/epidemiología , Estado Prediabético/complicaciones , Estado Prediabético/epidemiología , Estado Prediabético/metabolismo , Factores de Riesgo
8.
Clin Exp Nephrol ; 26(1): 22-28, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34342776

RESUMEN

BACKGROUND: Cytomegalovirus (CMV) is a herpes virus that causes latent infections, and its reactivation due to immunosuppression can cause fatal complications. CMV reactivation is a complication frequently occurring in patients with kidney disease who require immunosuppressive therapy, and, therefore, this study retrospectively examined its risk factors. METHODS: Patients who received immunosuppressive therapy and underwent the CMV antigenemia test (CMV antigenemia: C7-HRP) for the treatment of primary nephritis (minimal change disease, membranous nephropathy, membranoproliferative glomerulonephritis, focal glomerulosclerosis, and IgA nephropathy) and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated nephritis diagnosed at Saiseikai Kurihashi Hospital from January 2014 to December 2019 were recruited as study participants. Risk factors of CMV reactivation were examined using univariable and multivariable analyses. RESULTS: Among the 64 patients (36 men and 28 women; median age, 72 years) included, 34 had primary nephritis (20 minimal disease changes, 10 membranous nephropathy, 1 membranoproliferative glomerulonephritis, 1 focal glomerulosclerosis, and 2 IgA nephropathy) and 30 had ANCA-associated nephritis. Regarding glucocorticoid (GC), 43 patients received oral GC therapy, whereas 21 received GC pulse therapy. CMV reactivation participants showed significant differences in age, ANCA-associated nephritis, hemoglobin level, lymphocyte count, maximum GC dosage, and hemodialysis in univariable analysis. Multivariate analysis showed significantly lower lymphocyte counts in CMV-reactivated patients, but no significant difference in other factors. CONCLUSION: In patients with kidney disease, who require immunosuppressive therapy, CMV reactivation risk is high in patients with low lymphocyte count, and monitoring CMV during the treatment course could lead to early diagnosis and treatment of CMV disease.


Asunto(s)
Citomegalovirus , Enfermedades Renales , Anciano , Femenino , Humanos , Enfermedades Renales/diagnóstico , Masculino , Estudios Retrospectivos , Factores de Riesgo , Activación Viral
9.
Anticancer Res ; 42(5): 2657-2663, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35489760

RESUMEN

BACKGROUND/AIM: Many head-and-neck cancer patients receive radiotherapy, which may be associated with significant toxicities. Xerostomia is considered one of the most debilitating late adverse events. This study was performed to identify risk factors for xerostomia. PATIENTS AND METHODS: Several characteristics were investigated for associations with late xerostomia in 159 patients irradiated for head-and-neck cancer including age, sex, tumor site and size, underlying pathology, histologic grading, upfront resection, systemic treatment, and type and dose of radiotherapy. RESULTS: Ninety (57%) and 35 (22%) patients experienced grade ≥2 and ≥3 xerostomia, respectively. Grade ≥2 xerostomia was significantly associated with tumor site (nasopharynx/oropharynx/oral cavity/floor of mouth, p=0.049). Grade ≥3 xerostomia was significantly associated with age ≥61 years (p=0.035); trends were found for tumor site (p=0.088), bilateral nodal involvement (p=0.093), definitive treatment (p=0.082), and systemic treatment (p=0.055). CONCLUSION: Risk factors for xerostomia following radiotherapy of head-and-neck cancers were identified including older age, unfavorable tumor site, bilateral involvement of lymph nodes, definitive treatment, and addition of systemic therapies. For patients with risk factors, sparing of the salivary glands is particularly important.


Asunto(s)
Neoplasias de Cabeza y Cuello , Xerostomía , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Persona de Mediana Edad , Factores de Riesgo , Glándulas Salivales , Xerostomía/epidemiología , Xerostomía/etiología
10.
J. Health Biol. Sci. (Online) ; 10(1): 1-6, 01/jan./2022.
Artículo en Portugués | LILACS | ID: biblio-1366907

RESUMEN

Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Asunto(s)
Demencia , Enfermedad de Alzheimer , Mujeres , Demencia Vascular , Evaluación Geriátrica , Salud Pública , Prevalencia , Factores de Riesgo , Trastornos Neurocognitivos , Geriatría , Personas
11.
Multimedia | Recursos Multimedia | ID: multimedia-9727

RESUMEN

O vídeo explica como os fatores de risco podem contribuir para o adoecimento ou aumentar o agravamento de uma doença. O aplicativo FioLibras é um projeto do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde da Fundação Oswaldo Cruz (Icict/Fiocruz), em parceria com o Núcleo de Estudos em Diversidade e Inclusão de Surdos da Universidade Federal Fluminense (Nuedis/UFF), e conta com financiamento do Fundo de Inovação da Fiocruz e do Ministério da Saúde, por meio do Programa Fiocruz de Fomento à Inovação (Inova Fiocruz).


Asunto(s)
Factores de Riesgo , Infecciones por Coronavirus , Difusión de la Información , Lengua de Signos , e-Accesibilidad
12.
Curr Opin Gastroenterol ; 38(3): 230-238, 2022 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-35645018

RESUMEN

PURPOSE OF REVIEW: Datasets of well characterized drug or herbal and dietary supplement-associated liver injury has provided a rich resource to identify genetic variants associated with hepatic injury that further supports the role of immune activation in drug-induced liver injury (DILI). RECENT FINDINGS: Using DNA microarrays, whole genome sequencing, HLA-restricted DNA sequencing with appropriate ethnically matched population controls have identified HLA-specific genetic variants for drugs or botanical compounds with the same HLA variant associated with different agents. In addition to HLAs, two genes involved with immune signaling were also identified: a functional PTPN22 variant associated with increased DILI risk to any agent or clinical presentation and a variant in ERAP2 hepatic gene expression that trims peptide in preparation for presentation in the HLA cleft increased the risk for DILI in amoxicillin-clavulanate DILI when present with known HLA risk alleles. SUMMARY: Variants in HLA and other genes involved in immune regulations further supports immune system activation in DILI. In the future, identifying these variants before exposure may minimize the risk for DILI events, help with assessment of drug causality for causing DILI and with greater understanding of DILI mechanisms, has important implication for future drug development.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Alelos , Aminopeptidasas/genética , Enfermedad Hepática Inducida por Sustancias y Drogas/genética , Antígenos HLA/genética , Humanos , Proteína Tirosina Fosfatasa no Receptora Tipo 22/genética , Factores de Riesgo
18.
Cleve Clin J Med ; 89(6): 329-335, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35649561

RESUMEN

New-onset post-cardiac surgery atrial fibrillation (PCSAF) is a frequent complication with estimated incidence of 17% to 64%, depending on type of surgery. It is associated with higher mortality, morbidity, and predisposition to stroke and systemic embolism postoperatively. Standard care involves rate or rhythm control, in addition to antithrombotic therapy in those with history of stroke, transient ischemic attack, or high risk of systemic thromboembolism. However, risk of bleeding is not negligible, and treating physicians should weigh the risks and benefits before committing to postoperative anticoagulation therapy. More investigations are warranted to explore antithrombotic therapy benefit, particularly postoperative anticoagulation, considering the potentially self-limited nature of the arrhythmia and high risk of postoperative bleeding.


Asunto(s)
Fibrilación Atrial , Procedimientos Quirúrgicos Cardíacos , Accidente Cerebrovascular , Anticoagulantes/uso terapéutico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/etiología , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Fibrinolíticos , Humanos , Factores de Riesgo , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/prevención & control
20.
Int J Clin Pract ; 2022: 5435656, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35685488

RESUMEN

Background: The prognosis is poor when acute pancreatitis (AP) progresses to sepsis; therefore, it is necessary to accurately predict the probability of sepsis and develop a personalized treatment plan to reduce the disease burden of AP patients. Methods: A total of 1295 patients with AP and 43 variables were extracted from the Medical Information Mart for Intensive Care (MIMIC) IV database. The included patients were randomly assigned to the training set and to the validation set at a ratio of 7 : 3. The chi-square test or Fisher's exact test was used to test the distribution of categorical variables, and Student's t-test was used for continuous variables. Multivariate logistic regression was used to establish a prognostic model for predicting the occurrence of sepsis in AP patients. The indicators to verify the overall performance of the model included the area under the receiver operating characteristic curve (AUC), calibration curves, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), and a decision curve analysis (DCA). Results: The multifactor analysis results showed that temperature, phosphate, calcium, lactate, the mean blood pressure (MBP), urinary output, Glasgow Coma Scale (GCS), Charlson Comorbidity Index (CCI), sodium, platelet count, and albumin were independent risk factors. All of the indicators proved that the prediction performance and clinical profitability of the newly established nomogram were better than those of other common indicators (including SIRS, BISAP, SOFA, and qSOFA). Conclusions: The new risk-prediction system that was established in this research can accurately predict the probability of sepsis in patients with acute pancreatitis, and this helps clinicians formulate personalized treatment plans for patients. The new model can reduce the disease burden of patients and can contribute to the reasonable allocation of medical resources, which is significant for tertiary prevention.


Asunto(s)
Pancreatitis , Sepsis , Enfermedad Aguda , Humanos , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Estudios Retrospectivos , Factores de Riesgo , Sepsis/diagnóstico
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