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Logistic Analysis (logistic + analysis)

Distribution by Scientific Domains
Medical Sciences81%
4 Other Domains19%

Kinds of Logistic Analysis

  • multivariate logistic analysis
    		•

    Selected Abstracts

    The Effect of Capitation on Switching Primary Care Physicians

    HEALTH SERVICES RESEARCH, Issue 1p1 2003
    Melony E. S. Sorbero
    Objective To examine the relationship between patient case-mix, utilization, primary care physician (PCP) payment method, and the probability that patients switch their PCPs. Data Sources/Study Setting Administrative enrollment and claims/encounter data for 1994,1995 from four physician organizations. Study Design We developed a conceptual model of patient switching behavior, which we used to guide the specification of multivariate logistic analyses focusing on interactions between patient case-mix, utilization, and PCP reimbursement methods. Data Collection/Extraction Methods Claims data were aggregated to the encounter level; a switch was defined as a change in PCP since the previous encounter. The PCPs were reimbursed on either a capitated or fee-for-service (FFS) basis. Principal Findings Patients with stable chronic conditions (Ambulatory Diagnostic Groups [ADG] 10) and capitated PCPs were 36 percent more likely to switch PCPs than similar patients with FFS PCPs, controlling for patient age and sex and physician fixed effects. When the number of previous encounters was included in the model, this relationship was no longer significant. Instead high utilizers with capitated PCPs were significantly more likely to switch PCPs than were similar patients with FFS PCPs. Conclusions A patient's demographics and utilization are associated with the probability that the patient will switch PCPs. Capitated PCP payment was associated with higher rates of switching among high utilizers of health care resources. These findings raise concerns about the continuity and quality of care experienced by vulnerable patients in an era of changing financial incentives. [source]

    How to go extinct: lessons from the lost plants of Krakatau

    JOURNAL OF BIOGEOGRAPHY, Issue 5 2000
    Robert J. Whittaker
    Abstract Aim Few data sets exist that allow measurement of long-term extinction and turnover rates for islands of the size of the three main islands of the Krakatau group. We test the reliability of previous estimates of plant species extinction and examine structure within the extinction data. Location The data analysed are for the three older Krakatau islands: Rakata, Sertung and Panjang in the Sunda Strait, Indonesia. Methods Our analysis is based on a comprehensive database incorporating all species records for each island since recolonization began after the 1883 sterilization, plus attributes such as distribution, phylogeny, population status and dispersal mechanism for each species. We employ a combination of univariate and multi-term analyses in analysing structure, and derive Minimal Adequate Models using binary logistic analyses of variance and covariance. We compare the 1883,1934 data set with the contemporary flora as represented by (1) 1979,83 records (as used in previous analyses) and (2) 1979,94 data (original). Results The improved data for the contemporary flora reduces the number of missing species by one-third. We show that a variety of estimates of extinction rate can be produced depending on what assumptions are made concerning the status of particular species groups. Structural features in the extinction data persist despite the reduction in overall numbers of losses. Losses relate to: (1) the number of islands on which a species originally occurred, (2) the primary dispersal mode, and (3) the original abundance of a species (e.g. whether it was known to have established a successful resident population, and whether it was in decline or increasing in c. 1930). The ,best' descriptive model employs the variables denoted under (3). A high proportion of losses comprised species introduced by people and rare or ephemeral species. Losses of ,residents' that had colonized naturally could largely be accounted for by reference to (1) successional loss of habitat and, to a lesser degree, (2) other habitat disturbance or loss. Main conclusions Previous analyses, based on a more limited data set, have significantly over-estimated extinction from the Krakatau flora. Few naturally colonizing and established species have become extinct. The findings indicate that caution is necessary in interpreting ,headline' island ecological rates, and in analysing and modelling such data. Examination of structural features of the data appear to be valuable both in providing ecological insights in their own right, and in enabling refinements to estimates of extinction and thus turnover. [source]

    Likelihood of Illegal Alcohol Sales at Professional Sport Stadiums

    ALCOHOLISM, Issue 11 2008
    Traci L. Toomey
    Background:, Several studies have assessed the propensity for illegal alcohol sales at licensed alcohol establishments and community festivals, but no previous studies examined the propensity for these sales at professional sport stadiums. In this study, we assessed the likelihood of alcohol sales to both underage youth and obviously intoxicated patrons at professional sports stadiums across the United States, and assessed the factors related to likelihood of both types of alcohol sales. Methods:, We conducted pseudo-underage (i.e., persons age 21 or older who appear under 21) and pseudo-intoxicated (i.e., persons feigning intoxication) alcohol purchase attempts at stadiums that house professional hockey, basketball, baseball, and football teams. We conducted the purchase attempts at 16 sport stadiums located in 5 states. We measured 2 outcome variables: pseudo-underage sale (yes, no) and pseudo-intoxicated sale (yes, no), and 3 types of independent variables: (1) seller characteristics, (2) purchase attempt characteristics, and (3) event characteristics. Following univariate and bivariate analyses, we a separate series of logistic generalized mixed regression models for each outcome variable. Results:, The overall sales rates to the pseudo-underage and pseudo-intoxicated buyers were 18% and 74%, respectively. In the multivariate logistic analyses, we found that the odds of a sale to a pseudo-underage buyer in the stands was 2.9 as large as the odds of a sale at the concession booths (30% vs. 13%; p = 0.01). The odds of a sale to an obviously intoxicated buyer in the stands was 2.9 as large as the odds of a sale at the concession booths (89% vs. 73%; p = 0.02). Conclusions:, Similar to studies assessing illegal alcohol sales at licensed alcohol establishments and community festivals, findings from this study shows the need for interventions specifically focused on illegal alcohol sales at professional sporting events. [source]

    Invasibility of a coastal strip in NE Spain by alien plants

    JOURNAL OF VEGETATION SCIENCE, Issue 4 2002
    Eduardo Sobrino
    Castroviejo et al. (1986,1999); Tutin et al. (1968,1980) Abstract. The alien plant species and the ecological factors that facilitate their invasion to a coastal strip in the Baix Camp region (Tarragona, NE Spain) were studied. A detailed inventory of the area showed that 20% of the plant species, most of them from the American Continent, were aliens, many of which were strongly invasive. At the habitat level, the relationships between the invasive behaviour and a number of autecological, ecological and habitat variables were analysed by means of logistic analyses. In the best model five variables were related to alien plant invasions: climatic affinity, disturbance of the invaded habitat, route of introduction, soil moisture during summer, and life form. To elucidate the environmental factors that could be responsible for alien plant invasions at a regional scale, the number of alien taxa and the environmental features at 13 localities of the western Mediterranean area were analysed. The warm lowlands, subjected to low annual rainfall and high population density, exhibited the greatest reception capacity for alien plants. It is concluded that various specific environmental features , high mean temperatures, the abundance of riparian systems, the existence of biotopes with favourable water balance which harbour a great richness of alien species and the high human pressure to which the enclave is subjected, combined with the ecological requirements of the alien species and certain species attributes (biotype) can interact at different scales and have caused the over-representation of alien plants. [source]

    Predictors of dental care utilization among working poor Canadians

    COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2009
    V. E. Muirhead
    Abstract,,, Objective:, This study used the Gelberg,Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians. Methods:, A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked ,20 h a week, were not full-time students and had annual family incomes <$34 300. A pretested questionnaire included sociodemographic items, self-reported oral health measures and two dental care utilization outcomes: time since their last dental visit and the usual reason for dental visits. Results:, Hierarchical stepwise logistic analyses identified independent predictors associated with visiting the dentist >1 year ago: male gender (OR = 1.63; P = 0.005), aged 25,34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P < 0.001), past welfare recipients (OR = 1.65; P = 0.03), <21 teeth (OR = 4.23; P < 0.001) and having a perceived need for dental treatment (OR=2.78; P < 0.001). Sacrificing goods or services to pay for dental treatment was associated with visiting the dentist within the past year. The predictors of visiting the dentist only when in pain/trouble were lone parent status (OR = 4.04; P < 0.001), immigrant status (OR = 1.72; P = 0.006), paying for dental care with cash or credit (OR = 2.71; P < 0.001), a history of an inability to afford dental care (OR = 1.62; P = 0.01), a satisfactory/poor/very poor self-rated oral health (OR = 2.10; P < 0.001), number of teeth <21 (OR = 2.58; P < 0.001) and having a perceived need for dental treatment (OR = 2.99; P < 0.001). Conclusions:, This study identified predisposing and enabling vulnerabilities that jeopardize the dental care-seeking practices of working poor persons. Dental care utilization was associated with relinquishing spending on other goods and services, which suggests that dental care utilization is a competing financial demand for economically constrained adults. [source]

    Patterns of Detection of Superficial Spreading and Nodular-Type Melanoma: A Multicenter Italian Study

    DERMATOLOGIC SURGERY, Issue 11 2004
    Paolo Carli
    Background. Nodular histotype represents the condition that is mostly associated with diagnosis of thick melanoma. Objective. The objectives were to evaluate variables associated with and pattern of detection of nodular melanomas and to investigate variables associated with early diagnosis in accordance with histotype (nodular vs. superficial spreading melanomas). Methods. From the original data set of 816 melanomas, all the invasive lesions classified as superficial spreading (n=500) and nodular (n=93) melanomas were considered for the study. A multivariate logistic analysis was performed. Results. Nodular melanomas did not significantly differ from superficial spreading melanomas regarding sex, anatomic site, number of whole-body nevi, and the presence of atypical nevi. As expected, nodular melanomas were represented by a higher percentage of thick (>2 mm) lesions compared to superficial spreading melanomas (64.5% vs. 9.6%, p<0.001). The pattern of detection significantly differed between nodular and superficial spreading melanomas, the former being more frequently self-detected (44.1% vs. 38.0%) or detected by the family doctor (34.4% vs. 11.4%). Female sex, high level of education, and detection made by a dermatologist had an independent, protective effect against late (>1 mm in thickness) diagnosis in superficial spreading melanomas. No protective variable associated with nodular melanomas was found. Conclusion. Patterns of detection for nodular melanomas significantly differ from those for superficial spreading melanomas. For superficial spreading, but not for nodular, melanomas, variables associated with protective effect against late diagnosis can be identified. [source]

    Risk factors for faecal sand excretion in Icelandic horses

    EQUINE VETERINARY JOURNAL, Issue 4 2005
    L. HUSTED
    Summary Reasons for performing study: Sandy soil is often mentioned as a risk factor in the development of sand-related gastrointestinal disease (SGID) in the horse. There are other variables, but few studies confirm any of these. Objective: To investigate soil type, pasture quality, feeding practice in the paddock, age, sex and body condition score as risk factors for sand intake in the horse. Methods: Faeces were collected from 211 Icelandic horses on 19 different studs in Denmark together with soil samples and other potential risk factors. Sand content in faeces determined by a sand sedimentation test was interpreted as evidence of sand intake. Soil types were identified by soil analysis and significance of the data was tested using logistic analysis. Results: Of horses included in the study, 56.4% showed sand in the faeces and 5.7% had more than 5 mm sand as quantified by the rectal sleeve sedimentation test. Soil type had no significant effect when tested as main effect, but there was interaction between soil type and pasture quality. Significant interactions were also found between paddock feeding practice and pasture quality. Conclusion: To evaluate the risk of sand intake it is important to consider 3 variables: soil type, pasture quality and feeding practice. Pasture quality was identified as a risk factor of both short and long grass in combination with sandy soil, while clay soil had the lowest risk in these combinations. Feeding practice in the paddock revealed feeding directly on the ground to be a risk factor when there was short (1,5 cm) or no grass. Also, no feeding outdoors increased the risk on pastures with short grass, while this had no effect in paddocks with no grass. More than 50% of all horses investigated in this study had sand in the faeces. Potential relevance: The identification of risk factors is an important step towards prevention of SGID. Further research is necessary to determine why some horses exhibit more than 5 mm sand in the sedimentation test and whether this is correlated with geophagic behaviour. [source]

    Hepatocyte growth factor is a significant risk factor for white matter lesions in Japanese type 2 diabetic patients

    EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 7 2010
    Futoshi Anan
    Eur J Clin Invest 2010; 40 (7): 585,590 Abstract Background, The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Elevated hepatocyte growth factor (HGF) levels are associated with a high mortality rate in type 2 diabetic patients. The preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with HGF and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Material and methods, Based on brain magnetic resonance imaging, 92 type 2 diabetic patients were divided into two groups: WML-positive group (age 60 ± 5 years, mean ± SD, n = 35) and WML-negative group (age 59 ± 6 years, mean ± SD, n = 57. The level of blood glucose was assessed by fasting plasma glucose, fasting immunoreactive insulin, homeostasis model assessment (HOMA) index and haemoglobin A1c (HbA1c). Results, The body mass index was higher in the WML-positive group than that in the WML-negative group (P < 0·005). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol was lower in the WML-positive group than in the WML-negative group (P < 0·01 and P < 0·0001 respectively). Fasting plasma glucose (P < 0·0001), insulin concentrations (P < 0·0001), HOMA index (P < 0·0001) and HGF (< 0·0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high HGF and insulin resistance (P < 0·0001 and P < 0·0001 respectively). Conclusion, The results of this preliminary study indicate that the presence of WML was associated with the high HGF and insulin resistance in Japanese patients with type 2 diabetes mellitus. [source]

    Frequency of and variables associated with the EGFR mutation and its subtypes

    INTERNATIONAL JOURNAL OF CANCER, Issue 3 2010
    Tomoaki Tanaka
    Mutation in the epidermal growth factor receptor (EGFR) is frequently seen in non-small cell lung cancers (NSCLCs), especially in Asian females with adenocarcinoma. The frequency of mutation and the factors associated requires to be elucidated by analyzing a large number of consecutive clinical samples. We summarized the result of the EGFR mutation analysis for 1,176 patients performed at the time of diagnosis or relapse. The PNA-LNA PCR clamp, a highly sensitive detection method for the EGFR mutation, was employed. For fresh cases a portion of samples isolated to establish the diagnosis of lung cancer was used. For cases with a relapsed disease archival tissue were tested. The variables associated with the EGFR mutation after removing the confound factors were investigated by the logistic analysis using the samples collected in our university (n = 308) where detailed information on patients were available. The frequency of the EGFR mutation and its subtypes were investigated using all samples (n = 1,176). The EGFR mutation was significantly associated with adenocarcinoma (p = 0.006) and light-smoking (p < 0.0001), but not gender. The deletions in exon 19 were more frequently associated with male gender while exon 21 deletions were with female gender (p = 0.0011). The overall frequency of the EGFR mutation was 31%. Our result suggests that the female predominance in the EGFR mutation rate is a reflection of a higher frequency of adenocarcinoma in females. The gender difference in the mutation subtypes may provide a clue for the mechanism of the occurrence of the EGFR mutation. [source]

    Nomogram to predict seminal vesicle invasion using the status of cancer at the base of the prostate on systematic biopsy

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2010
    Makoto Ohori
    Objective: The aim of this study was to predict seminal vesicle invasion (SVI) by developing a new nomogram based on clinical features including the status of cancer at the base of the prostate on systematic biopsy. Methods: We studied the 466 patients with T1,3N0M0 prostate cancer who were treated with radical prostatectomy at three institutions. Preoperative clinical variables were correlated with the presence or absence of SVI with an area under the curve (AUC) of receiver,operator characteristics analysis. A nomogram was developed to predict SVI based on logistic regression analysis. Results: A total of 81 patients (17%) had SVI. Cancer was present in a biopsy core from the base of the prostate in 209 patients, of whom 32.5% had SVI, compared with only 5% of the 257 patients without cancer at the base of the prostate (P < 0.005). On multivariate analysis, serum prostate-specific antigen, biopsy Gleason score, clinical T stage, and presence or absence of cancer in a biopsy core at the base of the prostate were significant predictors of SVI (P < 0.005 for all). The AUC of a standard model including clinical stage, Gleason score, and prostate-specific antigen was 0.83, which was significantly enhanced by including the presence of cancer at the base of the prostate (none, unilateral or bilateral lobes) (AUC 0.87, P= 0.023). Based on the logistic analysis, we developed the nomogram to predict SVI. The calibration plots appeared to be excellent. Conclusion: The information of presence or absence of cancer at the base from prostate biopsy and the resulting nomogram allow an accurate prediction of SVI in patients undergoing radical prostatectomy for prostate cancer. [source]

    Clustering of Ventricular Tachyarrhythmias in Heart Failure Patients Implanted with a Biventricular Cardioverter Defibrillator

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2006
    MAURIZIO LUNATI M.D.
    Background: Temporal patterns of ventricular tachyarrhythmia (VT/VF) have been studied only in patients who have received implantable cardioverter defibrillators (ICD) for secondary prevention of sudden death, and mainly in ischemic patients. The aim of this study was to evaluate VT/VF recurrence patterns in heart failure (HF) patients with biventricular ICD and to stratify results according to HF etiology and ICD indication. Methods and Results: We studied 421 patients (91% male, 66 ± 9 years). HF etiology was ischemic in 292 patients and nonischemic in 129. ICD indication was for primary prevention in 227 patients and secondary prevention in 194. Baseline left ventricular ejection fraction (LVEF) was 26 ± 7%, QRS duration 168 ± 32 msec, and NYHA class 2.9 ± 0.6. In a follow-up of 19 ± 11 months, 1,838 VT/VF in 110 patients were appropriately detected. In 59 patients who had ,4 episodes, we tried to determine whether VT/VF occurred randomly or rather tended to cluster by fitting the frequency distribution of tachycardia interdetection intervals with exponential functions: VT/VF clusters were observed in 46 patients (78% of the subgroup of patients with ,4 episodes and 11% of the overall population). On multivariate logistic analysis, VT/VF clusters were significantly (P < 0.01) associated with ICD indication for secondary prevention (odds ratio [OR]= 3.12; confidence interval [CI]= 1.56,6.92), nonischemic HF etiology (OR = 4.34; CI = 2.02,9.32), monomorphic VT (OR = 4.96; CI = 2.28,10.8), and LVEF < 25% (OR = 3.34; CI = 1.54,7.23). Cardiovascular hospitalizations and deaths occurred more frequently in cluster (21/46 [46%]) than in noncluster patients (63/375 (17%), P < 0.0001). Conclusions: In HF patients with biventricular ICDs, VT/VF clusters may be regarded as the epiphenomenon of HF deterioration or as a marker of suboptimal response to cardiac resynchronization therapy. [source]

    Prospective study of complier individuals under periodontal maintenance therapy: analysis of clinical periodontal parameters, risk predictors and the progression of periodontitis

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2009
    Telma Campos Medeiros Lorentz
    Abstract Aim: This prospective study aimed to evaluate the progression of periodontitis and the influence of risk variables among individuals attending a programme of periodontal maintenance treatment in an academic environment. Material and Methods: A total of 150 individuals diagnosed with chronic moderate-advanced periodontitis, and who had finished active periodontal treatment, were incorporated into the periodontal maintenance therapy. Social, demographic and biological variables of interest from subjects were collected at quarterly recalls, over a 12-month period. The effect of variables of interest and confounding on the periodontal status and progression of periodontitis was tested by univariate and multivariate logistic analysis. Results: A total of 130 subjects (86.7%) showed stable periodontal status, whereas 20 subjects (13.3%) presented periodontitis progression. Twenty-eight subjects (18.66%) presented tooth loss that resulted in a total of 47 lost teeth (1.38%). Diabetes was not found to be associated with periodontitis progression (p=0.67). Smoking was significantly associated with a greater progression of periodontitis (OR=2.7, 95% CI 1.01,7.22). Conclusions: Periodontal maintenance programmes in academic environment can stabilize the periodontal condition obtained after active periodontal therapy as well as control the action of risk variables for the progression of periodontitis. [source]

    Clinical characteristics and microbiota of progressing slight chronic periodontitis in adults

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2007
    Anne C. R. Tanner
    Abstract Aim: This study sought clinical and microbial risk indicators for progressing slight periodontitis. Material and Methods: One hundred and seventeen periodontally healthy or slight periodontitis adults (20,40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. Inter-proximal sites with >1.5 mm increase in clinical attachment over 18 months were considered disease active. Subgingival plaque was analysed by 78 16S rDNA and 38 whole-genomic DNA probes and by PCR to Porphyromonas gingivalis and Tannerella forsythia. Characteristics were compared between active and inactive subjects. Results: Twenty-two subjects showed disease activity principally at molars. Mean baseline gingival and plaque indices, bleeding on probing, probing depth and clinical attachment level (CAL) were higher in active subjects. DNA probes detected species and not-yet-cultivated phylotypes from chronic periodontitis, although few species were associated with active subjects. By PCR P. gingivalis (p=0.007) and T. forsythia (p=0.075) were detected more frequently during monitoring in active subjects. Stepwise logistic analysis associated baseline levels of gingival index, clinical attachment and bleeding with subsequent clinical attachment loss. Conclusions: Gingivitis and CAL were significantly associated with progressing slight periodontitis in 20,40-year-old adults. Species associated with moderate and advanced chronic periodontitis were detected in slight periodontitis. [source]

    Epidemiological study of symptomatic gastroesophageal reflux disease in China: Beijing and Shanghai

    JOURNAL OF DIGESTIVE DISEASES, Issue 1 2000
    Pan Guozong
    OBJECTIVE: To explore the 1-year point prevalences (July,September 1996) of symptomatic gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD) and reflux esophagitis (RE) in the adult population of two Chinese city-regions (Beijing and Shanghai) and to identify the conditions that predispose patients to GERD. METHODS: Phase I: 5000 residents of the two regions aged between 18 and 70 years were studied via a questionnaire. The study was carried out by cluster sampling from city, suburban and rural areas by using simple random sampling. Symptom scores (Sc) of the intensity and frequency of heartburn, acid reflux and regurgitation within 1 year of the time of study were taken as indices of acid reflux (highest score, Sc = 18) and Sc , 6 indicated the presence of symptomatic GER. Phase II: a small number of patients who were identified as having symptomatic GER in the survey were enrolled in a case, control study using gastroscopy and 24-h pH monitoring to obtain correct diagnostic rates of GERD and RE. Estimates of the prevalence of GERD and RE were then adjusted according to the rates of correct diagnosis. RESULTS: A total of 4992 subjects completed the survey, 2.5% had heartburn once daily, 8.97% had symptomatic GER (Sc , 6) and the male to female ratio was 1:1.11. Point prevalences for the year for GERD and RE were 5.77 and 1.92%, respectively. Stratified analysis indicated that the prevalence of symptomatic GER in Beijing (10.19%) was higher than that in Shanghai (7.76%) and there was also a higher prevalence of GER in males, manual laborers, people from rural areas and people older than 40 years of age in Beijing as compared with Shanghai. Stepwise logistic analysis indicated that GER had a close relationship with dental, pharyngolaryngeal disorders and respiratory diseases. The conditions that predispose patients to GERD are (OR, odds ratio): age > 40 (OR = 1.01), eating greasy/oily food (OR = 6.56), overeating (OR = 1.99), tiredness (OR = 2.35), emotional stress (OR = 2.22), pregnancy (OR = 6.80) and constipation (OR = 1.65). CONCLUSIONS: Gastroesophageal reflux disease is a common disease in the adult Chinese population and it is more common in Beijing than in Shanghai. [source]

    The predictors of complications in patients with drug-induced liver injury caused by antimicrobial agents

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2010
    S. TREEPRASERTSUK
    Aliment Pharmacol Ther,31, 1200,1207 Summary Background, Antimicrobials are the leading cause of idiosyncratic drug-induced liver injury in most series. Aim, To determine the incidence and the predictors of complications in patients with drug-induced liver injury caused by antimicrobial agents requiring hospitalization. Methods, Medical records of patients with drug-induced liver injury caused by antimicrobial agents were identified by ICD-10, for the period between 2002 and 2006. Clinical information and blood tests during hospitalization were recorded. The causality assessment of drug-induced liver injury was determined by the Roussel UCLAF causality assessment method (RUCAM) scale. Results, Of 47 594 in-patient admissions per year, the annual incidence of drug-induced liver injury was 0.03%. Male: female ratio was 7:3 with a median age of 47 years. Eighty reactions of drug-induced liver injury were caused by anti-tuberculosis drugs (85%) and by antibiotics (15%). The median (IQR) of RUCAM scale was 6 (5,8). A total of 36% had HIV infection and 9% of patients had diabetes mellitus. Median (IQR) duration of hospitalization was 9 (5,15) days. Serious complications and death were found in 27.5% and 26%, respectively. By a multivariable logistic analysis, the presence of jaundice was found to be significantly associated with an unfavourable outcome. Conclusion, Although rare, antimicrobial agents-related drug-induced liver injury requiring hospitalization has a high mortality rate. The presence of jaundice predicts poor outcome. [source]

    48 weeks pegylated interferon alpha-2a is superior to 24 weeks of pegylated interferon alpha-2b in achieving hepatitis B e antigen seroconversion in chronic hepatitis B infection

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2006
    C.-K. HUI
    Summary Background/aim, Although 48-week therapy with pegylated-interferons has been shown to be effective for the treatment of chronic hepatitis B virus infection, the efficacy of a shorter duration of therapy with pegylated interferons is unknown. Method, We reviewed 53 hepatitis B e antigen positive Chinese patients treated with 48 weeks of pegylated interferon alpha-2a or 24 weeks of pegylated interferon alpha-2b. Sustained virological response was defined as hepatitis B e antigen seroconversion and hepatitis B virus DNA <105 copies/mL at week 72. Results, Twenty-nine patients were treated with 48 weeks of pegylated-interferon-alpha-2a and 24 patients with 24 weeks of pegylated-interferon-alpha-2b. At the end-of-therapy, hepatitis B e antigen seroconversion and hepatitis B virus DNA <105 copies/mL were similar between the two groups of patients [9/29 (31.0%) vs. 2/24 (8.3%), respectively, P = 0.09]. At week 72, 10 of the 29 patients (34.5%) treated with 48 weeks of pegylated-interferon-alpha-2a compared with two of the 24 patients (8.3%) treated with 24 weeks of pegylated-interferon-alpha-2b had sustained virological response (P = 0.04). By logistic analysis, 48 weeks of pegylated-interferon-alpha-2a was independently associated with sustained virological response (P = 0.04 adjusted hazards-ratio 9.37). Conclusion, Further studies are required to determine the optimal duration of therapy with pegylated interferons in chronic hepatitis B. [source]

    Clinical and urodynamic features of intrinsic sphincter deficiency

    NEUROUROLOGY AND URODYNAMICS, Issue 4 2003
    Cinzia Pajoncini
    Abstract Aims A prospective analysis of 92 patients with genuine stress incontinence was performed to identify the clinical and urodynamic features of intrinsic sphincter deficiency (ISD). Methods We divided the patients into two categories: 50 patients affected by pure ISD as they had severe stress incontinence and no urethral mobility; 42 patients suffering from stress urinary incontinence without ISD as they had mild stress incontinence and marked urethral hypermobility. Cystometry was normal in all patients. The presence/absence of ISD was considered the dependent variable and was correlated against the following independent variables: age, vaginal deliveries, menopause, previous urogynecological surgery and/or hysterectomy, supine stress test, irritative and/or obstructive symptoms, Valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), urethral functional length (UFL), and leakage during cystometry. Results The statistical analysis showed close correlations between ISD and age (P,<,0.001), menopausal status (P,<,0.001), previous surgery (P,<,0.0001), supine stress test (P,<,0.0001), leakage during cystometry (P,<,0.001), and UFL (P,<,0.01). The VLPP was below the cut-off value (,60 cm H2O) in 70% of ISD patients (P,<,0.0001), whereas the MUCP in 50% of ISD patients (P,<,0.0001). Multiple logistic analysis showed that lower VLPP, lower MUCP, and previous surgery correlate more significantly with ISD. After backward conditional stepwise logistic regression, the odds ratio of having ISD were VLPP,=,2.3, MUCP,=,7.7, VLPP + MUCP,=,62.8. Conclusions ISD is related to the presence of a more severe clinical picture and case history, but the most significant independent variables are the VLPP and MUCP. Neurourol. Urodynam. 22:264,268, 2003. © 2003 Wiley-Liss, Inc. [source]

    Relationship Between Abnormal Microvolt T-Wave Alternans and Poor Glycemic Control in Type 2 Diabetic Patients

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2007
    GIULIO MOLON M.D.
    Background:Abnormal microvolt T-wave alternans (TWA) predicts the risk of ventricular arrhythmias and sudden cardiac death. Although type 2 diabetes is associated with an increased risk of these events, there is a dearth of available data on microvolt TWA measurements in type 2 diabetic populations. Methods:We studied 59 consecutive type 2 diabetic outpatients without manifest cardiovascular disease (CVD) and 35 non-diabetic controls who were matched for age, sex, and blood pressure values. Microvolt TWA analysis was performed non-invasively using the CH-2000 system during a sub-maximal exercise with the patient sitting on a bicycle ergometer. Results:The frequency of abnormal TWA was significantly higher in diabetic patients than in controls (25.4 vs 5.7%; P < 0.01). Among diabetic patients, those with abnormal TWA (n = 15) had remarkably higher hemoglobin A1c (HbA1c) (8.1 ± 0.9 vs 7.1 ± 0.8%, P < 0.001) and slightly smaller time-domain heart rate variability parameters (i.e., RMSSD, root mean square of difference of successive R-R intervals) than those with normal TWA (n = 44). Gender, age, body mass index, lipids, blood pressure values, cigarette smoking, diabetes duration, microvascular complication status, QTc interval, and current use of medications did not significantly differ between the groups. In multivariate regression logistic analysis, HbA1c (OR 13.6, 95% CI 2.0,89.1; P = 0.0076) predicted abnormal TWA independent of RMSSD values and other potential confounders. Conclusions:Our findings suggest that abnormal TWA is a very common condition (,25%) among people with type 2 diabetes without manifest CVD and is closely correlated to glycemic control. [source]

    Delayed- and immediate-type reactions in the atopy patch test with food allergens in young children with atopic dermatitis

    PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1 2009
    A. C. A. Devillers
    In recent years, the atopy patch test (APT) has been suggested as an addition in the allergological work-up of children with atopic dermatitis (AD) and suspected food allergy. We initiated a prospective clinical study in children with AD younger than 3 yr, to evaluate the additional clinical value of the APT next to our own standardized allergological work-up in case of a suspected food allergy. One hundred and thirty-five children were included in the study. They were tested using the skin application food test (SAFT), the APT and measurement of specific IgE. The allergens used in the skin tests were freshly prepared food stuffs and included commercially available cow's milk (CM), the egg white of a hard boiled hen's egg and mashed peanuts in a saline solution. Allergy was defined using a flowchart incorporating the results from the SAFT, oral challenges (OCs) and elimination and (re)introduction periods. To determine the additional value of the APT next to the SAFT, we analyzed the SAFT negative patients per allergen and used an exact binary logistic analysis to evaluate the simultaneous effects of the APT and measurement of specific IgE, calculating mutually adjusted odds ratios (ORs) for positive APTs and specific IgE levels above 0.70 U/l. We found clinically relevant food allergies in 23% (egg white) to 28% (CM and peanut) of our study population. Positive SAFT reactions were observed in 14% (peanut), 16% (egg white) and 21% (CM) of our patient population. Next to the SAFT, we did not observe a significant additional value of the APT for the diagnosis of CM or egg white allergy, but we did find a significant additional value for the diagnosis of peanut allergy (OR = 11.56; p < 0.005, 2-sided). In clinical practice this statistically significant value does not exclude the need for OC and controlled elimination and (re)introduction periods due to the presence of false-negative as well as false-positive results in the APT. In conclusion, we could not find enough support for the current addition of the APT to our standardized allergological work-up in young children below the age of 3 yr with AD and suspected food allergy. At the moment the additional value of the classical delayed-type APT next to the SAFT seems to be very limited at best in this study population and does not justify the time-consuming nature of the skin test. [source]

    Factors Affecting Satisfaction Levels of Japanese Volunteers in Meal Delivery Services for the Elderly

    PUBLIC HEALTH NURSING, Issue 5 2008
    Hisayo Yanagisawa
    ABSTRACT Objectives: The purpose of this study was to investigate the factors affecting satisfaction with volunteer work of participants in a meal delivery service for the elderly. Design: A cross-sectional study with a self-administered survey was carried out. Sample: Of 364 volunteers assisting with a meal delivery service for the elderly in rural towns A (80), B (159), and C (125), 247 responded (response rate: 68%). Method: An anonymous self-administered questionnaire survey was administered seeking information about basic attributes, sense of satisfaction with volunteer work, and working circumstances such as human relationships with fellow volunteers, meal service users or professional staff members, opportunities for meetings or workshop, publicity through public relations magazines, and the like. Results: In multivariate logistic analysis, the sense of satisfaction of volunteers was closely associated with human relations among volunteers (odds ratio [OR] 5.15, 95% Confidence Interval (CI) 1.84,14.40, p<.01), meal service users (OR 3.84, 95% CI 1.37,10.77, p<.05), and professional staff members supervising the meal delivery service (OR 3.53, 95% CI 1.27,9.84, p<.05). Human relations were also affected by the emphasis on communication, consultation with supervisory staff members, having opportunities for meetings, having friends with whom to confer, and publicity through public relations magazines. Conclusion: Satisfaction levels of volunteers in meal delivery services for the elderly were most affected by human relations with fellow volunteers, meal service users, and professional staff members. Increasing opportunities for communication may be important to promote good human relationships among volunteers and volunteer activities. [source]

    Association of SLC6A12 variants with aspirin-intolerant asthma in a Korean population

    ANNALS OF HUMAN GENETICS, Issue 4 2010
    Charisse Flerida A. Pasaje
    Summary Aspirin-intolerant asthma (AIA) occurs from asthma exacerbation after exposure to aspirin. However, the underlying mechanisms of AIA occurrence are still unclear. The critical role of the solute carrier family 6 (neurotransmitter transporter, betaine/GABA) member 12 (SLC6A12) gene in GABAergic transmission, which is associated with mucus production in asthma, makes it a candidate gene for AIA association study. Eight single nucleotide polymorphisms (SNPs) in SLC6A12 were genotyped in 163 aspirin-intolerant asthma (AIA) and 429 aspirin-tolerant asthma (ATA) patients of Korean ethnicity. Associations between polymorphisms of SLC6A12 and AIA were analysed using multivariate logistic analysis. Results showed that two polymorphisms and a haplotype in SLC6A12, rs499368 (P= 0.005; Pcorr= 0.03), rs557881 (non-synonymous C10R, P= 0.007; Pcorr= 0.04), and SLC6A12_BL1_ht1 (P= 0.009; Pcorr= 0.05) respectively, were significantly associated with AIA after multiple testing corrections. In addition, SNPs of SLC6A12 were significantly associated with the fall rate of FEV1 by aspirin provocation suggesting that SLC6A12 could affect reversibility of lung function abnormalities in AIA patients. Although these results are preliminary and future replications are needed to confirm these findings, this study showed evidence of association between variants in SLC6A12 and AIA occurrence among asthmatics in a Korean population. [source]

    Synthesis and pp60c-Src Tyrosine Kinase Inhibitory Activities of Novel Indole-3-Imine and Amine Derivatives Substituted at N1 and C5

    ARCHIV DER PHARMAZIE, Issue 6 2009
    Zuhal Kiliç
    Abstract A series of novel 1,3,5-trisubstituted indole derivatives, namely, N -benzyl 5-phenyl indole-3-imine, N -benzyl-5-(p -fluorophenyl)indole-3-imine and their corresponding amine congeners, were designed and synthesized as pp60c-Src tyrosine kinase inhibitors, and their inhibitory activities toward pp60c-Src tyrosine kinase were evaluated by in-vitro kinase assay. Pre-screening at two doses of compounds against kinase target revealed that, except for the N -benzyl-5-phenyl indole imine derivatives 7a,7d, all indole derivatives show the target inhibition at varying levels. Consequently, the compounds, 8c, 8f, 8g, and 8h, were selected for prescreening tests. The dose-response curves for up to six concentrations (250 to 7.8 ,M) of the active compounds were obtained by tyrosine kinase assay and the four-parameter logistic analysis of these data resulted in the IC50s of 4.69, 74.79, 75.06, and 84.23 ,M for compounds 8c, 8f, 8g, and 8h, respectively. Therefore, compound 8c, 1-(1-benzyl-5-phenyl-1H -indole-3-yl)- N -(4-fluorobenzyl)methanamine·HCl, was the promising inhibitor for pp60c-Src, followed by compounds 8g and 8h. Under the same conditions, compound 8f did not provide any reasonable inhibition pattern to be considered as active compound. Therefore, among all four active compounds, compound 8f was not found suitable for further analysis. [source]