Difference In Predictors Research Articles

Difference in Predictors of Seizure in Angiogram Negative Non-perimesencephalic Subarachnoid Hemorrhage Cases and Aneurysmal Cases (P7-5.020)

Difference in Predictors of Seizure in Angiogram Negative Non-perimesencephalic Subarachnoid Hemorrhage Cases and Aneurysmal Cases (P7-5.020)

Chinese Students Learning English as a Second Language

The way in which different cities teach children to read in Chinese may have an impact on the skills they later utilize to acquire English word reading skills. This study examined the relative contributions of several cognitive–linguistic measures to English word reading for Chinese students learning English as a second language in two Chinese cities, one whose school system teaches Pinyin (Beijing) and one whose school system does not teach Pinyin (Hong Kong). Students in grades 2–3 completed measures on Chinese morphological awareness (MA), Chinese phonological awareness (PA), Pinyin writing, and English word reading. In the Beijing group, it was found that PA (β = 0.334, p < 0.01) and Pinyin (β = 0.257, p < 0.05) were significant predictors of English word reading. In contrast, in the Hong Kong group, only MA (β = 0.263, p < 0.05) was found to be a significant predictor of English word reading. The difference in predictors could be due to the availability of a phonological tool (Pinyin) for the Beijing students when learning Chinese, while the Hong Kong group may have relied more heavily on learning using MA and rote memory techniques. Overall, the results from this study provide data supporting the benefits of having a phonological tool like Pinyin for Chinese children when learning to read in English.

Predictors of Quality-of-Life Improvement at Different Minimum Clinically Important Difference Values in Patients with Chronic Obstructive Pulmonary Disease after Climatic Rehabilitation Treatment.

The minimum clinically important difference (MCID) for the St George's Respiratory Questionnaire (SGRQ) is debated in chronic obstructive pulmonary disease (COPD) quality-of-life (QoL) assessments. This study aimed to determine whether there is a difference in predictors of clinically significant improvement between the traditional (value of 4) and newly proposed MCID SGRQ (value of 7) after climatic rehabilitation treatment. Climatic rehabilitation treatment consists of two main parts: climatotherapy, which typically involves the controlled exposure of individuals to natural environmental elements, and climatic rehabilitation, which includes other therapeutic factors such as physical activities as well as educating the patient to change their lifestyle. This study included 90 consecutive patients diagnosed with COPD who underwent structured complex pulmonary rehabilitation in High Tatras, part of the Carpathian Mountains. The examination before and after treatment included spirometry, QoL assessment using the SGRQ, 6 min walk test (6-MWT), and the Borg, Beck and Zung scale. Patients showed statistically significant improvement after the intervention in FEV1, FEV1/FVC, 6-MWT, (p < 0.001), anxiety scores, depression, and improvement in dyspnoea both before and after the 6-MWT (p < 0.001). For both MCID for SGRQ levels 4 and 7, we confirmed the same predictors of clinical improvement for bronchial obstruction grade (spirometry) and exercise capacity (6-MWT), for quality of life in activity score and total score. The results suggest that both the proposed MCID for SGRQ values could be sufficient to assess the clinical significance of the achieved change in health status when assessing the need for pulmonary rehabilitation comprising climatotherapy in patients with COPD.

Predictors of outcome after catheter ablation for atrial fibrillation: Group analysis categorized by age and type of atrial fibrillation.

The outcome of catheter ablation could probably differ among patients with atrial fibrillation (AF), depending on age and AF type. We aimed to investigate the difference in predictors of outcome after catheter ablation for AF among the patient categories divided by age and AF type. A total of 396 patients with AF (mean age 65.69 ± 11.05 years, 111 women [28.0%]) who underwent catheter ablation from January 2018 to December 2019 were retrospectively analyzed. We divided the patients into four categories: patients with paroxysmal AF (PAF) or persistent AF (PeAF) who were 75 years or younger (≤75 years) or older than 75 years (>75 years). Kaplan-Meier survival analysis demonstrated that patients with PAF aged ≤75 years had the lowest AF recurrence among the four groups (log-rank test, p=.0103). In the patients with PAF aged ≤75 years (N=186, 46.7%), significant factors associated with recurrence were female sex (p=.008) and diabetes (p=.042). In the patients with PeAF aged ≤75 years (N=142, 35.9%), the only significant factor associated with no recurrence was medication with a renin-angiotensin system inhibitor (p=.044). In the patients with PAF aged >75 years (N=53, 14.4%), diabetes was significantly associated with AF recurrence (p=.021). No significant parameters were found in the patients with PeAF aged >75 years (N=15, 4.1%). Our findings indicate that the risk factors for AF recurrence after catheter ablation differed by age and AF type.

An Observational Study Assessing the Predictors of Procedural Failure From the Radial Approach: Is Right Radial Access Always the Best?

ObjectiveThe study aimed to determine the predictors of procedural failure (coronary cannulation) in patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) from the transradial (TR) approach. MethodsWe conducted an observational study of 20,315 consecutive patients undergoing TR angiography between 2016 and 2020. TR failure was described as inability to cannulate the coronary arteries. Univariate and multivariate analyses were performed to determine independent predictors of TR failure. ResultsOut of the study population, TR failure was observed in 365 (1.8%) patients, out of which 281 (77%) crossed over successfully to the transfemoral (TF) route and 84 (23%) to left radial access (LRA). Unsuccessful procedures were most likely seen in patients who were elderly, female, BAME background, short stature or with a history of hypertension, diabetes, and renal disease. On regression analysis, age (OR: 1.024; 95% Cl: 1.014–1.035), female gender (OR: 0.729; 95% Cl: 0.555–0.957), BAME (OR: 0.786; 95% Cl: 0.612–0.959), height (OR: 0.988; 95% Cl: 0.977–0.999), hypertension (OR: 1.510; 95% Cl: 1.147–1.987) and RRA (OR: 1.977; 95% Cl: 1.105–3.538) were independent predictors of TR failure. On further analysis, these predictors of failure were not seen from the LRA approach. ConclusionThis study identifies that rates of TR failure are low and that predictors of failure differ between the RRA and LRA. The difference in predictors between the 2 routes suggests that in patients when coronary cannulation is unsuccessful via the RRA then the LRA could be considered as a second access site. Further study is needed to see if in selected patient groups the LRA could be used as the first-choice access route.

Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study.

Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50-59, 60-69, ≥70] for the frequency of arts participation outcome and [50-69 vs ≥70] all other outcomes. Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50-69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.

DIFFERENCE IN PREDICTORS OF ANASTOMOTIC LEAKAGE DEPENDING ON THE LEVEL OF ANASTOMOSIS AFTER COLORECTAL CANCER SURGERY.

SUMMARYAnastomotic leak (AL) after colorectal cancer surgery is one of the most serious postoperative complications which has major impact on outcomes. The aim of this study was to investigate preoperative and intraoperative risk factors for AL, as well as to examine whether there are differences in risk factors for AL depending on the primary tumor location. We retrospectively reviewed records of patients having undergone colorectal surgical procedures for malignancies between January 2013 and December 2017 in a single institution. Only procedures with primary anastomosis were included. Of the 153 patients, AL occurred in 10.6% of patients with primary tumor in the sigmoid colon and rectum, and in 8.2% of patients with primary tumor in the proximal sections of the colon. On univariate analysis, delayed oral intake and more advanced histologic stages of the tumor were significantly correlated with AL in patients with tumors in the sigmoid colon and rectum, and multiorgan resection and distant metastases in patients with tumors in the proximal sections of the colon. In conclusion, risk factors for the occurrence of AL vary depending on the primary tumor location and further investigation is needed to provide better insight into these differences.

Relation of microchannel identified by optical coherence tomography to clinical, angiography and other plaque morphological characteristics in ST-segment Elevation myocardial infarction patients

Abstract Background Previous studies have suggested that Microchannel (MC) is associated with plaque progression and vulnerability. Optical coherence tomography (OCT) could provide a chance to directly visualize plaque neovascularization in vivo. Methods 1268 STEMI patients who underwent OCT examination of culprit lesion were included and divided into MC group (the culprit plaque with MC, n=560) and no-MC group (the culprit plaque without MC, n=708). MC was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image. Clinical, angiography and other plaque morphological characteristics were compared between the two groups. Logistic regression analysis was used to identify independent predictors of MC in overall. In addition, the difference of predictors on MC was found in plaque rupture (PR) and plaque erosion (PE). Results Significant differences between MC group and no-MC group were found in the frequency of thin-cap fibroatheroma (74.6% vs 64.4%, p&amp;lt;0.001), lipid plaque (91.8% vs 82.9%, p&amp;lt;0.001), lipid core length (13.7±6.5mm vs 12.6±6.3mm, p=0.006) and the minimal lumen area (MLA, 1.95±0.98mm2 vs 2.10±1.58mm2, p=0.046). In MC group, the other vulnerable plaque morphological characteristics, such as macrophage (88.8% vs 75.1%, p&amp;lt;0.001), cholesterol crystal (39.6% vs 32.9%, p=0.013), spotty calcification (38.6% vs 29.5%, p&amp;lt;0.001) were more frequent. And compared with MLA the more locations of the culprit lesion in MC group was proximal (proximal, 47.3% vs 38.1%, at MLA, 38.2% vs 44.2%, distal, 14.5% vs 17.7%, p=0.004).The difference of Hemoglobin (Hb, 147.5±16.9g/L vs 144.1±18.2g/L, p&amp;lt;0.001), lipidemia (TC, 188.7±43.6mmol/L vs 180.8±40.0mmol/L, p&amp;lt;0.001, LDL-C, 121.5±37.4mmol/L vs 115.7±36.8mmol/L, p=0.005, and TC/HDL, 4.0±1.6 vs 3.8±1.0, p&amp;lt;0.001), and hypertension (50.7% vs 44.2%, p=0.021) between 2 groups was statistically significant. Multivariable logistic regression models showed 7 independent parameters associated with MC in culprit plaque of overall: hypertension, Hb, TC, MLA, lesion location (compared with MLA), lipid core length, macrophage, spotty calcification. In addition, Hb, TC and MLA were common predictors of MC in PR and PE, however, the predictive effect of MLA on MC was opposite in PR [OR (95% CI)=1.266 (1.095–1.463), p=0.001] and PE [OR (95% CI)=0.742 (0.597–0.922), p=0.007]. Conclusions MC in culprit plaque is associated with more lipid (especially cholesterol), higher Hb, hypertension, lesion location (compared with MLA) and the other vulnerable plaque morphological characteristics. The predictors of MC were different in plaque rupture and plaque erosion. Flow chart Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Natural Science Foundation of China (81827806, 81801861); National Key R&amp;D Program of China (2016YFC1301100)

Socioeconomic inequality in functional deficiencies and chronic diseases among older Indian adults: a sex-stratified cross-sectional decomposition analysis

ObjectivesOlder adults with adverse socioeconomic conditions suffer disproportionately from a poor quality of life. Stratified by sex, income-related inequalities have been decomposed for functional deficiencies and chronic diseases among older...

Location, seasonal, and functional characteristics of water holding containers with juvenile and pupal Aedes aegypti in Southern Taiwan: A cross-sectional study using hurdle model analyses.

BackgroundAedes aegypti carries several viruses of public health importance, including the dengue virus. Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Prevention and control of dengue mainly rely on mosquito control as there is no antiviral treatment or a WHO-approved vaccine. To reduce the Ae. aegypti population, studying the characteristics of their habitats is necessary. Aedes aegypti prefer breeding in artificial water holding containers in peridomestic or domestic settings. Their juveniles (1st - 4th instar larvae and pupae) have a tendency to cluster in certain types of containers. To inform control strategies, it is important to assess whether the pupae subgroup has a distinct distribution by container type as compared to the overall group of juveniles. The objective of this study was to assess for distinct predictors (location, season, and function) of Ae. aegypti juveniles and pupae numbers in water holding containers by applying hurdle model analyses.MethodologyThe field component of this study was carried out from November 2013 to July 2015 in Southern Taiwan where annual autochthonous dengue has been reported for decades. Water holding containers with stagnant water were identified in a predefined urban area in Kaohsiung City (KH) and a rural area in Pingtung County. Given that mosquito survey data often include many containers with zero Ae. aegypti, a negative binomial hurdle model was applied to model the association between location, seasonal and functional characteristics of the water holding containers and the number of Ae. aegypti in each container.ResultsThe results showed that Ae. aegypti were almost exclusively present in the urban area. In this area, the negative binomial hurdle model predicted significantly more juveniles as well as pupae Ae. aegypti in water holding containers during the wet season when compared to the dry season. Notably, the model predicted more juveniles in containers located on private property compared to those on government property, irrespective of season. As for pupae, the model predicted higher amounts in indoor containers used for water storage compared to outdoor water storage containers, irrespective of season. However, for the specific category ‘other water receptacle’, higher amounts of pupae were predicted in outdoor compared to indoor in water receptacles, such as flower pot saucers and water catchment buckets.ConclusionsThe difference in predictors for juveniles and the pupae subgroup was identified and it may be of importance to the control strategies of the authorities in KH. At present the authorities focus control activities on all water holding containers found on government property. To improve the ongoing control efforts in KH, the focus of control activities maintained by the KH authorities should be expanded to indoor water storage containers and outdoor water receptacles on both private and government properties to adequately address habitats harboring greater numbers of pupae. In addition, it is proposed to increase community engagement in managing water in all types of water holding containers located on privately owned properties (indoor and outdoor), especially during wet season.

Aortic pulse wave velocity and augmentation index@75 measured by oscillometric pulse wave analysis in Gujarati nonhypertensives

BACKGROUND: Augmentation indexes (AIxs) and pulse wave velocity (PWV) are arterial stiffness parameters. They can be studied by pulse wave analysis (PWA) noninvasively. Before use, AIx and PWV need normative baseline study to find the predictors. MATERIALS AND METHODS: We conducted a cross-sectional study in 801 nonhypertensives, aged 15–65 (divided into five subgroups) years. PWA was accomplished by Mobil-o-Graph (IEM, Germany) based on oscillometric principle and cardiovascular parameters reported were further analyzed. Value of P RESULTS: There were five age-based subgroups from 15 to 65 years, showing an increase in AIx@75 and PWV with age. Females had significantly higher AIx in male in age groups (31.4 vs. 25.8, 34.95 vs. 27.21, 32.62 vs. 27.61, 34.32 vs. 26.36, 37.09 vs. 29.63; P CONCLUSIONS: Oscillometric measurement of PWV and AIx@75 is feasible in our population. They are dependent on each other and age, totally not dependent on blood pressure and have difference in predictors. This baseline data can be used as a reference for future studies.

Evaluating the influence of life-history characteristics on genetic structure: a comparison of small mammals inhabiting complex agricultural landscapes.

Conversion of formerly continuous native habitats into highly fragmented landscapes can lead to numerous negative demographic and genetic impacts on native taxa that ultimately reduce population viability. In response to concerns over biodiversity loss, numerous investigators have proposed that traits such as body size and ecological specialization influence the sensitivity of species to habitat fragmentation. In this study, we examined how differences in body size and ecological specialization of two rodents (eastern chipmunk; Tamias striatus and white‐footed mouse; Peromyscus leucopus) impact their genetic connectivity within the highly fragmented landscape of the Upper Wabash River Basin (UWB), Indiana, and evaluated whether landscape configuration and complexity influenced patterns of genetic structure similarly between these two species. The more specialized chipmunk exhibited dramatically more genetic structure across the UWB than white‐footed mice, with genetic differentiation being correlated with geographic distance, configuration of intervening habitats, and complexity of forested habitats within sampling sites. In contrast, the generalist white‐footed mouse resembled a panmictic population across the UWB, and no landscape factors were found to influence gene flow. Despite the extensive previous work in abundance and occupancy within the UWB, no landscape factor that influenced occupancy or abundance was correlated with genetic differentiation in either species. The difference in predictors of occupancy, abundance, and gene flow suggests that species‐specific responses to fragmentation are scale dependent.

청소년의 휴대전화 의존 예측변인에 대한 성차 연구

The purposes of this study is to analyze gender difference in predictors of mobile phone dependency in youth. The analysis is performed with third-year panel survey data of middle school 1st grade students from Korean Child-Youth Panel Survey. The results are as follows. First, the female students` mobile phone dependency is more serious than the male students` mobile phone dependency. Second, while the identified male gender predictors are aggression, parental abuse, aprosexia, study activity and social withdrawal, the identified female gender predictors are depression, aprosexia, aggression, study activity and social withdrawal. Based on these results, theoretical and practical implications in planning of prevention or intervention of mobile phone dependency are proposed.

베이비부머의 삶의 만족도에 영향을 미치는 요인: 성별 차이를 중심으로

본 연구의 목적은 노부모와 성인자녀를 동시에 부양하는 샌드위치세대인 베이비부머의 삶의 만족도 영향요인에 있어서 성별 차이가 있는지 분석하는 것이다. 분석을 위한 자료는 "중년층(46-59세)의 생활실태 및 복지욕구조사(2010)" 데이터파일 가운데 1,152건을 분석 표본으로 활용하였다. 분석결과, 베이비부머의 성별에 따라 삶의 만족도 영향요인에 차이가 있는 것으로 나타났다. 여성 베이비부머의 삶의 만족도에 영향을 미치는 요인으로는 배우자부모부양부담(<TEX>${\beta}=-.205$</TEX>), 자녀관계만족도(<TEX>${\beta}=.202$</TEX>), 부부관계만족도(<TEX>${\beta}=.200$</TEX>), 주관적 건강상태(<TEX>${\beta}=.155$</TEX>), 10년 후 경제생활수준에 대한 기대(<TEX>${\beta}=.143$</TEX>)가 유의미한 것으로 나타난 반면 남성 베이비부머의 경우 여성 모형에서 유의하지 않았던 인터넷활용도(<TEX>${\beta}=.247$</TEX>)의 영향력이 크고 유의미한 것으로 나타났다. 특히 부양부담이 삶의 만족도에 미치는 영향에 대해 분석결과는 남성의 삶의 만족도에는 유의한 영향을 미치지 않았지만 여성의 경우, 배우자부모에 대한 부양부담이 삶의 만족도에 부적(-) 영향을 미치는 것으로 나타났는데 이는 부모와 자녀를 동시에 부양해야하는 베이비부머들에게 시부모부양은 여전히 부담스럽다는 것을 시사하고 있다. The purpose of this study is to investigate factors affecting Korean Baby Boomers' life satisfaction. Using data from Demographic Profiles and Welfare Needs of Middle Aged Persons(2010), this study focuses on whether there is a gender difference in predictors of life satisfaction. Analysis results show that there is a significant variability in predictors of life satisfaction by gender. Couple satisfaction, self-rated health status, and expectations for the standard of living after 10 years were significant for both male and female models. It was noticeable to report that internet use level and monthly household income were unique predictors for male model; spouse parent care burden and parent-child satisfaction were unique predictors for female model. These findings suggest that it is vital for policy planners to take gender differences into account when designing and formulating public policies for Korean Baby Boomer.

(717) - Lung Transplantation in Russian Federation

s S263 Results: Overall, 11 pts (55%) have died (7 in-hospital mortality, 4 late-mortality). 50% of the overall pts. had an INTERMACS 4 score and the remaining pts were of lower INTERMACS score, while there was no difference in the score between the surviving and expired pts. Of the relevant pre-op parameters, there was no significant difference between the survival groups: RV function was generally slightly decreased (FAC 21±10% vs 30±13%, TAPSE 1,5±0,4 cm vs 1.3±0.5 cm, alive vs expired, NS), the cardiac index was low (1.7±0.5 L/min/m2 vs 1.8±0.5 L/min/m2, alive vs expired, NS), TPG values were borderline (13±5.3 mmHg vs 12.6±8.3 mmHg, alive vs expired, NS) and PVR was moderately elevated (3.7±1.4 WU vs 3.2±2.6 WU, alive vs expired, NS). Preoperative data significantly differed only in the platelet count being lower in the expired pts (250±64x103/mm3 vs. 154±65x103/ mm3, p< 0.01). Significantly higher post-implant PVR was found in the expired compared to the living pts (3.8±2.8 WU vs. 1.8±0.4 WU, p< 0.05). Notably, all of the expired pts had a significant increase in postoperative PVR values (0.59±0.25 WU), while it was decreased in all but one of the surviving pts (2.02±1.74 WU, p= 0.02). Conclusion: These preliminary data show that there is no significant difference in predictors of survival among our patients with a generally low INTERMACS score, apart from a low platelet count. However, there is a clear increase in postoperative PVR values in the expired pts, which warrants further investigation.

Changing Demographic Trends in Elderly Homeless: Findings in a Homeless Sample from Little Rock

Changing Demographic Trends in Elderly Homeless: Findings in a Homeless Sample from Little Rock

Prediction of responders for outcome measures of Locomotor Experience Applied Post Stroke trial

The Locomotor Experience Applied Post Stroke rehabilitation trial found equivalent walking outcomes for body weight-supported treadmill plus overground walking practice versus home-based exercise that did not emphasize walking. From this large database, we examined several clinically important questions that provide insights into recovery of walking that may affect future trial designs. Using logistic regression analyses, we examined predictors of response based on a variety of walking speed-related outcomes and measures that captured disability, physical impairment, and quality of life. The most robust predictor was being closer at baseline to the primary outcome measure, which was the functional walking speed thresholds of 0.4 m/s (household walking) and 0.8 m/s (community walking). Regardless of baseline walking speed, a younger age and higher Berg Balance Scale score were relative predictors of responding, whether operationally defined by transitioning beyond each speed boundary or by a continuous change or a greater than median increase in walking speed. Of note, the cutoff values of 0.4 and 0.8 m/s had no particular significance compared with other walking speed changes despite their general use as descriptors of functional levels of walking. No evidence was found for any difference in predictors based on treatment group.

Shaking chills and high body temperature predict bacteremia especially among elderly patients

PurposesThe difference in predictors of bacteremia between elderly and non-elderly patients is unclear despite the aging of society. The objective was to determine predictors of bacteremia among elderly patients aged 80 years and older compared to non-elderly patients aged 18 to 79 years.MethodsA referral hospital-based retrospective descriptive study from April 2012 to March 2013 in Okinawa, Japan. All enrolled patients were adults suspected of having bacterial infection who had been newly admitted into the Division of Infectious Diseases. HIV- infected patients were excluded. Exposures were a history of shaking chills, prior antibiotics use within 48 hours, vital signs, and laboratory inflammation markers on admission. Outcome was blood culture positivity.ResultsThree hundred and sixty-six patients were enrolled. Median age was 78.5 (interquartile range [IQR]: 62–88). Among patients aged 18 to 79 years, shaking chills (adjusted odds ratio [AOR] 2.22, 95% confidence interval [CI]: 1.09–4.51) and previous antibiotics use (AOR 0.08, 95% CI: 0.01–0.68) were significant. However, among patients aged 80 years and older, shaking chills (AOR 3.06, 95% CI: 1.30–7.19) and body temperature above 38.5°C (AOR 2.98, 95% CI: 1.30–6.83) were significant.ConclusionsA history of shaking chills and vital signs indicating high body temperature were two findings that were useful in predicting bacteremia, especially in elderly patients aged 80 years and older. Further study is needed to assess whether the result is applicable in other regions and populations.

Efficacy of thoracic endovascular stent repair for chronic type B aortic dissection with aneurysmal degeneration

The Food and Drug Administration has approved devices for endovascular management of thoracic endovascular aortic aneurysm repair (TEVAR); however, limited data exist describing the outcomes of TEVAR for aneurysms attributable to chronic type B aortic dissection (cTBAD). This study was undertaken to determine the results of endovascular treatment of cTBAD with aneurysmal degeneration. A retrospective analysis of all patients treated for cTBAD with aneurysmal degeneration at the University of Florida from 2004 to 2011 was performed. Computed tomograms with centerline reconstruction were analyzed to determine change in aortic diameter, relative proportions of aortic treatment lengths, and false lumen perfusion status. Reintervention and mortality were estimated using life-tables. Cox regression analysis was completed to predict mortality. Eighty patients underwent TEVAR for aneurysm due to cTBAD (mean age [± standard deviation], 60 ± 13 years [male, 87.5%; n = 70]; median follow-up, 26 [range, 1-74] months). Median time from diagnosis of TBAD to TEVAR was 16 (range, 1-72) months. Prior aortic root/arch replacement had been performed in 29% (n = 23) at a median interval of 28.5 (range, 0.5-312) months. Mean preoperative aneurysm diameter was 62.0 ± 9.9 mm. In 75% (n = 60) of cases, coverage was proximal to zone 3, and 24% (n = 19) underwent carotid-subclavian bypass or other arch debranching procedure. Spinal drains were used in 78% (pre-op 71%, n = 57; post-op 6%, n = 5). Length of stay was 6.5 ± 4.7 days with a composite morbidity of 26% and in-hospital mortality of 2.5% (n = 2). Overall neurologic event rate was 17% (spinal cord ischemia 10% [n = 8], with a permanent deficit observed in 6.2% [n = 5]; stroke 7.5%). Aneurysm diameter reduced or stabilized in 65%. The false lumen thrombosed completely within the thoracic aorta in 52%, and reintervention within the treated aortic segment was required in 16% (n = 13).One- and 3-year freedom from reintervention (with 95% confidence interval [CI]) was 80% (range, 68%-88%) and 70% (range, 57%-80%), respectively. Survival at 1 and 5 years was 89% (range, 80%-94%) and 70% (range, 55%-81%) and was not significantly different among patients requiring reintervention or experiencing favorable aortic remodeling. Multivariable analysis identified coronary artery disease (hazard ratio [HR], 6.4; 95% CI, 2.3-17.7; P < .005), prior infrarenal aortic surgery (HR, 8.6; 95% CI, 2.3-31.7; P = .001), and congestive heart failure (HR, 11.9; 95% CI, 1.9-73.8; P = .008) as independent risk factors for mortality. Hyperlipidemia was found to be protective (HR, 0.2; 95% CI, 0.05-0.6; P = .004). No significant difference in predictors of mortality were found between patients who underwent reintervention vs those who did not (P = .2). TEVAR for cTBAD with aneurysmal degeneration can be performed safely but spinal cord ischemia rates may be higher than previously reported. Liberal use of procedural adjuncts to reduce this complication, such as spinal drainage, is recommended. Reintervention is common, but long-term survival does not appear to be impacted by remediation.

Is childhood OCD a risk factor for eating disorders later in life? A longitudinal study

It has been suggested that childhood obsessive-compulsive disorder (OCD) may be a risk factor for the development of an eating disorder (ED) later in life, but prospective studies are lacking. We aimed to determine the prevalence of ED at follow-up and clinical predictors in a longitudinal clinical sample of adolescents/young adults diagnosed with OCD in childhood. All contactable (n=231) young people with OCD assessed over 9 years at a national and specialist paediatric OCD clinic were included in this study. At follow-up, 126 (57%) young people and parents completed the ED section of the Developmental and Well-being Assessment. Predictors for ED were investigated using logistic regression. In total, 16 participants (12.7%) had a diagnosis of ED at follow-up. Having an ED was associated with female gender and persistent OCD at follow-up. There was a trend for family history of ED being predictive of ED diagnosis. Five (30%) of those who developed an ED at follow-up had ED symptoms or food-related obsessions/compulsions at baseline. A difference in predictors for an ED versus other anxiety disorders at follow-up was identified. This study provides initial evidence that baseline clinical predictors such as female gender and family history of ED might be specific to the later development of ED in the context of childhood OCD. Clinicians should be alert to ED subthreshold symptoms in young girls presenting with OCD. Future longitudinal studies are needed to clarify the relationship between childhood OCD and later ED.