Epidemiological Profile Of Patients Research Articles

P-431. Epidemiologic profile of patients with HIV/AIDS in critical care, a Colombian cohort study

Abstract Background The underlying cause of mortality in patients with HIV/AIDS admitted to critical care units has been changing since the advent of highly active antiretroviral therapy (HAART). This study was done to describe the clinical and epidemiologic profile of patients with HIV in a low-middle income country in the HAART era Baseline characteristics of 806 HIV admissions to ICU *Only patients with CD4 count ≤200 cel/ µL. Missing data in 21 of 743 patients with CD4 count data available and ≤200 cells/µL ART: antiretroviral therapy. CKD: chronic kidney disease. COPD: chronic obstructive pulmonary disease. Methods This was a retrospective cohort study which included adult patients with a diagnosis of HIV, admitted for at least 24 hours to the intensive care unit (ICU) in either of 5 hospitals in Medellín, Colombia, between January 2009 and December 2020. Demographic, clinical and laboratory data were collected. A descriptive analysis and an univariable analysis were done and missing data were imputed. A binomial logistic regression was performed with age and sex considered a priori as confounders; other variables were included in the multivariable analysis if p< 0.05. Causes for ICU admission in HIV-positive patients *Patients could have more than 1 cause of admission to ICU **Patients could have more than 1 opportunistic infection at ICU admission CMV: cytomegalovirus. CNS: central nervous system. HSV: herpes simplex virus. MAC: Mycobacterium avium complex. OI: opportunistic infection. PCP: Pneumocystis jiroveci. TB: tuberculosis. Results During the study period, 806 admissions of HIV patients to the ICU were recorded. More than 80% of patients had a CD4 count of < 200 cells/µL. ICU admission for an opportunistic infection (OI) was more frequent in patients who died, compared to patients without an OI. OIs explained 76% of admissions (Table 1). The main cause for ICU admission was respiratory failure followed by sepsis and central nervous system (CNS) compromise (Table 2). A recent diagnosis of HIV (< 1 year), history of a hematologic malignancy, an APACHE II score ≥20, acute respiratory failure, CNS compromise as the cause of ICU admission and empiric use of amphotericin B were all associated to higher mortality among HIV patients admitted to the ICU (Table 3). A trend to a lower proportion of OIs as the cause for admission, correlated with a lower mortality trend throughout the years (close to 50% mortality in 2009 and to 15% in 2020 (Graph 1). Variables associated with mortality in HIV infected patients admitted to the ICU AKI: acute kidney injury. ART: antiretroviral therapy. CNS: central nervous system. OI: opportunistic infection. ORa: adjusted Odds ratio Conclusion The main cause of mortality in VIH patients admitted to the ICU continues to be respiratory failure and sepsis secondary to OIs in low-middle income countries like Colombia. Mortality was associated to overall disease severity (respiratory failure, APACHE II score ≥20) and certain host conditions (hematologic malignancies and CNS compromise). Despite an epidemiologic profile typical for a low-middle income country, mortality has been decreasing consistently throughout the years. Trends in mortality and type of admission diagnosis in HIV infected patients admitted to the ICU Disclosures All Authors: No reported disclosures

P-142. Clinical and epidemiological profile of patients with malaria hospitalized at a tertiary level hospital of Central America

Abstract Background During the last two years Panama has found itself in the midst of a malaria epidemic, with cases spiking by 65% from 4181 in 2021 to 7083 in 2022. As of October 2023, reported cases reached 8301. This situation is thought to be related with human movements of indigenous groups, and the unprecedented number of migrating people crossing Central America through the Darién Gap, a dense rainforest between Colombia and Panama. The increasing incidence of malaria is reflected in hospital admissions in a tertiary level hospital of the city, a non-endemic region of malaria in the country. Methods Retrospective study of malaria diagnosed at Hospital Santo Tomás, Panama City, Panama, between 2017 and 2024. Charts from patients hospitalized and confirmed to have malaria were collected. Demographic, clinical and biochemical variables were analyzed using Excell v.2403. Results A total of 46 cases were found from 2017 to 2024. The year with more admissions was 2023. Mean age was 34.52 years. Men and women were affected equally. Migrants represented 30% of the cohort and the most common origin was Venezuela. Admissions were more frequent in the months of February and March which coincides with the dry season of the country. The most frequent region to acquire malaria was Darién, in people crossing the Darien Gap or natives from the region. Mean time to onset of symptoms was 11 days and the most common clinical features were fever in 91%, malaise (80%) , and headache (60%). There were 9 cases of severe malaria and one case of cerebral malaria. Only one patient died. In the biochemical profile, the most common findings were thrombocytopenia in 87% and anemia in 76.5%. The diagnosis was made mostly by rapid diagnostic test of malaria (RDT) and thin smear in 52%. The most common Plasmodium species was vivax, with 43 cases, 2 cases of falciparum and 1 case of falciparum and vivax coinfection. The treatment used for vivax malaria was chloroquine and primaquine, and artemether lumefantrine for falciparum malaria. The most common coinfection was dengue fever. Conclusion Malaria admissions have been raising in Panama City. The latter raises concern and calls to action to strengthen community networks to diagnose and treat malaria with more laboratory professionals and vector technicians, as well as diagnostic supplies and treatment. Disclosures All Authors: No reported disclosures

Epidemiologic profile of patients with valvular heart disease in Tunisia: A hospital-based registry study

Epidemiologic profile of patients with valvular heart disease in Tunisia: A hospital-based registry study

Epidemiological profile of patients with prostatic neoplasia in a high complexity oncology center

Objective: To describe the profile of prostate cancer patients who sought hospital care at a Brazilian High Complexity Oncology Center, as well as their condition on arrival at the center. Methods: This is a descriptive observational study, based on secondary data from the tumor file in the Hospital Cancer Registry at Afecc-Hospital Santa Rita de Cássia. RStudio and R software were used for descriptive analysis. Results: A total of 5,403 new analytical and non-analytical cases of prostate neoplasms were analyzed between 2000 and 2016. The number of cases had a mean age of 69.40 years (SD=8.82), with an increasing trend over the period (p<0.001). The majority of patients were over 60 years old (86.82%), brown or white (91.97%), with incomplete primary education (52.88%), married (67.37%), referred by SUS (76.12%), with no other primary tumors (97.87%), and histological type classified as adenocarcinoma (96.22%). The variables age (p=0.017), race/skin color (p<0.001) and education (p<0.001) showed statistically significant differences between analytical and non-analytical cases. Conclusion: The analyses show an upward trend in the incidence of prostate cancer over the years, and prostate neoplasia has a tropism for older, married men with a low education level.

Epidemiological profile of patients with osteogenesis imperfecta assisted at a reference children's hospital in Brazil

Objective: To characterize the profile and care of patients with osteogenesis imperfecta (OI) treated at a reference hospital in southern Brazil. Method: This retrospective cross-sectional observational study analyzed secondary data from electronic medical records between 2010 and 2021. Data from patients aged 0–22 years with a confirmed OI diagnosis who underwent care at a reference hospital. Results: 97 medical records were included. The mean age of the children was 11 ± 4.99 years, with a prevalence of males (51.8%). Most obtained the postnatal diagnosis and were classified as type I (50.9%). The number of fractures, orthopedic surgeries, and cycles of pamidronate were higher in type III subjects. As for access to medication, 88.54% were hospitalized for the administration of pamidronate and 32.29% for zoledronate. Independent walking and type I modified independent walking (walker) and type IV, and the use of a wheelchair and type III had an association (X2 = 67.832; p=0.000) between them. Conclusions: The profiles of the individuals in this study reflect the characteristics of the classic division of types I to IV. The reference center offers multidisciplinary care, access to specific drugs, and essential orthopedic surgeries to improve the quality of life of patients with osteogenesis imperfecta.

Clinical and epidemiological profile of patients with ovarian cancer

The objective of this study was to describe the profile of patients with ovarian cancer from 2015 to 2019 in Montes Claros, Minas Gerais State, Brazil. This is a descriptive study with a quantitative approach using data from patients living in Montes Claros, Minas Gerais, Brazil, with a diagnosis of ovarian cancer in the hospital records of the José Alencar Gomes da Silva National Cancer Institute. 312 cases of ovarian cancer were identified in Montes Claros, Minas Gerais. Regarding sociodemographic variables, most women were between 35 and 59 years old (44.9%), 26 patients (29.8%) denied the use of tobacco or tobacco products, 64.3% of the patients were former consumers and 5 (5.9%) were active consumers. 195 patients (79.3%) had a positive family history of cancer, the combined use of tobacco and alcohol was recorded among 83.4 of the population, the detailed primary location of the neoplasm was in the ovary itself in 161 (51.7%) of the cases. Regarding the histological type of the neoplasms, squamous cell carcinoma was found in 303 records (97.4%) and in relation to the TNM staging, most referred to others (53.6%), followed by A4 (46.4%). The data indicate an advanced picture of the disease in this population and suggest that more effective health education and control measures should be implemented.

Epidemiological profile of patients with type 2 diabetes mellitus treated at a teaching-assistance unit in Northeast Brazil

Epidemiological profile of patients with type 2 diabetes mellitus treated at a teaching-assistance unit in Northeast Brazil

Demographic and epidemiological profile of patients with head-and-neck cancer in Bihar, India: A hospital-based retrospective study

ABSTRACT Background: The pattern of head-and-neck cancer (HNC) differs across India due to considerable differences in regional customs, tobacco consumption behaviors, socio-economic status, and other regional risk-factors. Objectives: The primary objective of this study was to assess the epidemiological and demographic profile of patients with HNC from Bihar, India. The secondary objective was to evaluate differences in the incidence of HNC across different anatomical sites with respect to tobacco use, gender, and geographical location. Materials and Methods: We conducted a retrospective analysis of 3230 newly diagnosed, biopsy-proven HNC cases from Bihar, treated at the Department of Head-and-Neck Cancer, Mahavir Cancer Institute and Research Center, Patna, between January 2021 and December 2022. Data on age, gender, address, tobacco habit, site of disease, and other details were extracted from clinical records for statistical analysis. Results: This hospital-based study showed a predominance of male patients, with a male-to-female ratio of 5.37:1. The majority of patients were aged between 41-60 years, with significant gender disparities noted across all the age groups (P < 0.05). The oral cavity was identified as the most common site of HNC, accounting for 71.6% in males (n = 1949/2723) and 50.5% in females (n = 256/507). Within the oral cavity, the buccal mucosa and tongue were the most prevalent subsites. The number of patients from North Bihar was more in comparison to South Bihar. The most common tobacco habits were khaini and betel quid, both widely cultivated in Bihar. Conclusion: This study highlights a high prevalence of non-smoking tobacco consumption among the patients with HNC in Bihar. The oral cavity, particularly the buccal mucosa, was found to be the most affected site. Variations in the pattern of HNC were noted with respect to tobacco use, gender, and geographical location.

Clinical and epidemiological profile of patients with atypical melanomas treated with immunotherapy.

e21532 Background: Atypical melanomas, such as acral lentiginous, uveal, mucosal, spitzoid, desmoplastic, meningeal, and primary occult site, represent less than 5% of melanoma cases. Due to their different biological tumor behavior from cutaneous melanomas, their treatment is still challenging. Currently, checkpoint inhibitors are the main treatment based on extrapolations or data from small surveys. Methods: This study aims to describe the epidemiological profile, clinical and pathological characteristics, and treatment of patients with atypical melanomas treated with immunotherapy. It is an observational, descriptive, retrospective study that analyzed 72 medical records of patients with atypical melanomas, ECOG 0-1, > 18 years old, treated with immunotherapy (neo, adjuvant, and palliative lines), between January 2015 and December 2023 at the A.C. Camargo Cancer Center, São Paulo, Brazil. Results: We gathered 72 patients, 61% male and 39% female, with an average age of 58.89 (±13.63) years; 57% were white, 15% African-descendant (black and brown), 8% Asian, and 20% not specified. Regarding primary site, 26% were acral, 24% mucosal, 24% occult primary site, 15% uveal, 8% desmoplastic, 1% amelanocytic, 1% spitzoid, and 1% cauda equina meningeal. Regarding staging, (3%) were stage I, (15%) stage II, (25%) stage III, (47%) stage IV, and (10%) unknown. LDH: 372.5 (±360) mg/dL. Metastases: lymph node 29%; hepatic 23%; pulmonary 21%; bone 18%; central nervous system 15%; peritoneal carcinomatosis 5%; stomach 3%; cauda equina 3%; adrenal 1%; in transit 1%; intestine 1%; bone marrow 1%; parotid 1%. BRAF mutations were present in 23% of cases (variants V660E, V600K, V660R, and G469R); NRAS 6% (codons 13 and 61); KIT 1% (exon 11) and NTRAK 1% (S701F). In relation to treatment, 5 received neoadjuvant anti-pd1 + anti-ctla4 combination, 13 adjuvant with anti-pd1+/- anti-ctla4. About 50 patients received systemic treatment for metastatic disease anti-pd1+/- anti-ctla4. Overall survival: 26 (±14.8) months. Conclusions: Atypical melanoma primary occult site is the most prevalent, with the majority diagnosed at stage IV, with high LDH levels and lymph nodes as the main sites of metastases. Twenty-three percent had a BRAF gene mutation. The majority were treated palliatively with first-line immunotherapy, with median survivals of 14.8 months.

Liver Transplants from Donors with Schistosomiasis: Clinical and Epidemiological Profile of Patients at Clinics Hospital of Sao Paulo, Brazil

Abstract Organ transplantation is a surgical procedure that consists of awarding an organ. Considering that the transplantation of an organ or tissue is very competitive, due to the low rate of donors and as the function of the liver is preserved even in controlled schistosomatic fibrosis, it is possible to donate the organ even with the liver infected by verminosis. By analyzing the prevalence and evolution of liver donors with schistosomiasis in liver transplants performed at Hospital das Clínicas, Faculty of Medicine, University of São Paulo - HCFMUSP. This is a descriptive study, consisting of a series of cases, with a retrospective and cross-sectional analysis. The study evaluated the medical records of patients being followed up at the Liver Transplant Outpatient Clinic, at HCFMUSP, from January 2002 to December 2020. The Department of Pathology at USP found 16 patients with records of schistosomiasis reports, of which only one was effective as a donor, since the other patients were excluded due to the state of law of the organ. An analysis showed that almost all donors were men with schistosomiasis with a mean age of 52.55 years. In this context, there was a prevalence of a case of a liver donor with the hepatointestinal form of schistosomiasis, later the organ was transplanted, and the recipient, presented a good evolution until this moment, having been analyzed clinically and laboratory. It is noteworthy that this is the first HCFMUSP study that evaluates liver donors with schistosomiasis mansoni and the evolution of the respective recipient. Keywords: Schistosomiasis. Liver Transplantation. Epidemiology. Brazil. Resumo O transplante de órgãos é um procedimento cirúrgico que consiste na reposição de um órgão. Haja vista que o transplante de um órgão ou tecido é muito concorrido, em decorrência da baixa taxa de doadores e como a função do fígado está preservada mesmo na fibrose esquistossomatica avançada é possível doador o órgão mesmo com o fígado infectado pela verminose. O objetivo desse estudo foi analisar a prevalência e evolução de doadores fígado, portadores de esquistossomose, nos transplantes hepáticos realizados no Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - HCFMUSP. Trata-se de um estudo descritivo, composto por uma série de casos, sendo a analise retrospectiva e de corte transversal. O estudo avaliou os prontuários de pacientes em seguimento no Ambulatório de Transplante hepático, do HCFMUSP, no período de janeiro de 2002 a dezembro de 2020. O departamento de Patologia da USP constatou 16 pacientes com registros de laudos de esquistossomose, dos quais somente um foi efetivado como doador, uma vez que os outros pacientes foram excluídos em razão do estado de deterioração do órgão. A análise mostrou que quase a totalidade dos doadores eram homens com esquistossomose com idade média de 52,55 anos. Dentro desse contexto, houve a prevalência de um caso de um doador hepático portador da forma hepatointestinal de esquistossomose, posteriormente o órgão foi transplantado, e o receptor, apresentou uma boa evolução até este momento tendo sido analisado clinicamente e laboratorialmente. Vale ressaltar, que este é o primeiro estudo do HCFMUSP que avalia doadores de hepáticos portadores de esquistossomose mansoni e a evolução do respectivo receptor. Palavras-chave: Esquistossomose. Transplante de Fígado. Epidemiologia. Brasil.

Epidemiological and clinical description of patients with oropharyngeal cancer treated in a public oncology referral hospital in Chile.

The incidence of squamous carcinoma of the oropharynx (OPSCC) has presented an increase worldwide, a fact that occurs along with a phenomenon of epidemiological transition, whose pathogenesis is linked to human papilloma virus (HPV) in a significant part of the cases. Published evidence at the Latin American level is scarce. The present study aims to evaluate the epidemiological and clinical characteristics of patients with oropharyngeal cancer treated in a public oncology reference centre in Chile. A cross-sectional study was carried out. Patients with histological confirmation of OPSCC aged 18 years or older, referred to the National Cancer Institute of Chile between 2012 and 2023 were included. The association with HPV was determined by immunohistochemistry for p16. 178 patients were analysed, most of them in locoregionally advanced stages involving the palatine tonsil. Seventy-seven percent were male, with a median age of 60 years. Sixty-seven percent of patients were positive for p16, with a progressive increase to 85% in the last 2 years of the study. The p16(+) patients were younger and had fewer classical risk factors. Primary treatment was radiotherapy in 94% of patients. The epidemiological profile of patients with OPSCC treated in a Chilean public oncology referral centre reflects the epidemiological transition observed in developed countries. This change justifies the need to adapt health policies and conduct research that considers the characteristics of this new epidemiological profile.

Epidemiological profile of patients with chronic lower extremity ulcers in two public hospitals in southern Brazil

Epidemiological profile of patients with chronic lower extremity ulcers in two public hospitals in southern Brazil

Epidemiological profile of patients with cardiovascular morbidity in an insular population in Chile: Report from the Juan Fernández Archipelago

To characterize the biosocial profile of the population enrolled in the Cardiovascular Health Program (CHP) of the Juan Fernández archipelago and then compare them to the national dataset. A retrospective, descriptive, and longitudinal study using data collected from 269 patients over 15 years enrolled in the Juan Fernández CHP until March 31, 2022. Prevalence of cardiovascular disease and risk factors were obtained by reviewing a sheet database provided by the Juan Fernández Rural Health Care Center. They were contrasted to the latest national health survey, using the Z Test to determine statistical significance. We found significantly lower prevalences for hypertension (20.4% vs 27.6%), tobacco use (8.5% vs 33.3%), overweight (10% vs 39.8%), obesity (13% vs 31.2%), and myocardial infarction (0.7% vs 3.2%). Chronic kidney disease presents at earliest stages than national data. We observed a better cardiovascular profile in the Juan Fernández Archipelago than nationwide. These findings not only provide a basis for future public health actions but also inspire and motivate new lines of research that can bring context to these results and further our understanding of cardiovascular health.

Epidemiology of acute stroke presentations to an emergency ambulance service

Objective Stroke is a devastating condition with significant societal and personal costs. Attempts to improve outcomes have increasingly focussed on improvements in prehospital care of these patients. This study aims to provide an epidemiologic profile of stroke presentations to an ambulance service. Methods A descriptive quantitative analysis of linked administrative and clinical patient data across prehospital, hospital, and death records from a two-year period (2016–2017), was used to profile the acute stroke cohort transported by ambulance in Queensland, Australia. The epidemiologic profile of patients and sub-type of stroke is presented. Results There were 17,603 presentations of suspected acute stroke in Queensland during the study period amongst 2,078,140 ambulance responses. A total of 11,578 patients had a confirmed diagnosis of stroke at the time of their final discharge. Of this population 49.8% suffered an Acute Ischaemic Stroke, 12.9% had intracerebral haemorrhage, 4.5% had subarachnoid haemorrhage and 32.8% were transient ischaemic attack. Of those with acute ischaemic stroke (AIS) 9.2% were due to a large vessel occlusion. The three-month stroke related fatality rate was 10%. Conclusion This study demonstrated a lower annual presentation rate of stroke, to an emergency ambulance service, than would be expected based on population studies while the overall mortality rate amongst this population was higher. The reasons for these differences warrant further investigation.

Epidemiological profile of patients with hepatitis B in Rio Verde - GO, from 2013 to 2022

Epidemiological profile of patients with hepatitis B in Rio Verde - GO, from 2013 to 2022

Clinical-epidemiological profile of vestibular migraine patients: Indian scenario

Background: The main objective of this study was to observe the Indian clinical scenario and analyse the clinical and epidemiological profile of patients with vestibular migraine. Methods: This is a retrospective observational descriptive study. The outpatient records of the vertigo clinic at Department of Otorhinolaryngology of SGT medical college, Budhera, Gurgaon, Haryana was assessed from April 2023 to July 2023. Patients who were diagnosed with vestibular migraine based on ICD classification as follows was included in the study. Results: Study population predominantly comprised of 77% (17) females and 23% (5) of males. Almost 80% of the study population belonged to age group 31-40 years. Each episode of vertigo lasts for seconds in 50% of the patients and minutes in 45% of the patients. All patients had episodic vertigo.59% of patients described the vertigo as rotatory,18 % of the study population reported imbalance,18 % described swaying and 5% reported blackouts. Most of the examination was normal except 5 out of 22 patients reported giddiness on testing vertical saccades. Conclusions: Vestibular migraine is an underdiagnosed condition in India, there’s not much research and awareness, hence this study aims to overcome these limitations. Most of the patients were middle aged women. The physical and audiological examination of most patients were normal but showing abnormalities on testing saccades.

Syphilis: Is it Back with a Bang?

Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC). To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center. Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed. Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common. India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence.

Monitoring of pregnancy and labour by cardiotocography: 155 cases from the maternity ward of the institut hygiène sociale Hospital in Dakar

Objectives: To determine the epidemiological and clinical profile of patients monitored by cardiotocography, to assess the performance of the device in detecting labour abnormalities and to identify factors influencing the results of cardiotocography. Patients and methods: We conducted a retrospective, descriptive and analytical study of labour monitoring and pathological pregnancies using the cardiotocograph at the Maternity Unit of the Institut Hygiène Sociale hospital in Dakar over a two-year period from 1 January 2019 to 31 December 2020. All cardiotocographic tracings were subject to a 2nd blind interpretation by a senior. The results were interpreted using the 2007 classification of the Collège National des Gynécologues et Obstétriciens Français (CNGOF). An APGAR score of less than 7 at 1 minute was defined as neonatal asphyxia. Data were collected from the patients' records and entered on a computerised form. Data analysis was performed using SPSS version 22 software. Results: During the study period, 208 patients were monitored with the cardiotocograph out of a total of 4123 deliveries, i.e. a frequency of use of 5%. Of these, 155 were included in the study (74.5%). These included 118 parturients (76.1%) and 37 pathological pregnancies (23.9%). The epidemiological profile of the patients was that of a woman aged 28 years on average, of low socio-economic status (83.2%), paucigest (48.4%), pauciparous (46.5%), carrying a full-term pregnancy (67.7%) and living outside the South District (72.3%). Ninety-seven FHR tracings contained abnormalities (62.2%). These included 47 pathological FHR tracings (30.1%) and 50 FHR tracings at intermediate risk of acidosis (32.1%). The basic rhythm was most often normal (87.2%). The abnormalities found were bradycardia (4.5%), tachycardia (7.7%) and absent rhythm (0.6%). Variability was mostly normal (78.9%). However, it was reduced in 12.2% of cases. Fifty tracings showed accelerations (32.1%) and decelerations were noted in 49 foetuses (31.4%). These were most often early (16%) or late (7.1%) decelerations. Tocography was mostly normal (60%). The abnormalities noted were dominated by hypertonia (11.7%) followed by hyperkinesia of intensity (7.7%). The majority of patients (54.8%) had given birth by caesarean section and the indications were dominated by the non-reassuring state of the foetus (69.4%). Most of the newborns had an APGAR score greater than 7 at 1 minute (82.7%) and 5 minutes (91.7%). Comparison of the results of the ERCF with the neonatal status revealed 20 true positives, 7 false negatives, 27 false positives and 102 true negatives, giving the ERCF a sensitivity of 74.1%, a specificity of 79.1%, a positive predictive value of 42.1% and a negative predictive value of 93.6% for the diagnosis of non-reassuring foetal status. A bivariate analysis enabled us to identify factors associated with the occurrence of perinatal asphyxia. Basic rhythm abnormalities (p = 0.001) and variability (p = 0.004), hypertension in the pregnant woman (p = 0.034), premature rupture of the membranes of more than 6 hours (p = 0.044) and intrauterine growth retardation (p = 0.013) were significantly associated with the risk of neonatal asphyxia. Conclusion: Cardiotocography is a powerful tool for monitoring labour, but its effectiveness is influenced by the conditions in which it is performed and the qualifications of the operator.

Study of the clinical and epidemiological profile of heart failure

The purpose was to describe the clinical and epidemiological profile of patients with Heart Failure (HF) treated at a specialized clinic in the Unified Health System. This is a descriptive, individual and cross-sectional study, which collected data from medical records of patients with HF. Patients were divided into three groups according to the stroke volume: preserved, mid-range and reduced. A total of 545 medical records were evaluated, with a mean age of 64.9 ± 13.6 years, and 55.6% of which were male. Hypertension (76.7%), coronary artery disease (38.5%), and diabetes mellitus (37.2%) were the main risk factors. Myocardial ischemia was the main etiology (36.40%), followed by Chagas disease (20.22%). The valve etiology was frequently associated with reduced LVEF (left ventricular ejection fraction) (Pearson's ρ <0.06), with mid-range LVEF (Pearson's ρ <0.10) and with preserved LVEF (Pearson's ρ <0.39). The ischemic etiology was frequent in preserved LVEF (Pearson's ρ <0.08). The findings showed a strong association between valve disease and preserved LVEF; frequent association between mid-range LVEF and valve and ischemic disease; frequent association between valve disease and reduced LVEF.

Clinico-Epidemiological Profile of Patients with Chronic Kidney Diseases of Unknown Etiology: A Hospital-Based, Cross-Sectional Study from Central India.

Chronic kidney disease (CKD) not associated with known risk factors, called CKD of unknown etiology (CKDu), has been reported from several geographically distinct regions across the world. This study reports the clinical and epidemiological profile of patients with CKDu from a new hotspot in central India. This cross-sectional study describes the sociodemographic, clinical, and laboratory profile of the patients diagnosed with CKDu visiting a tertiary care public hospital in the state of Chhattisgarh in central India between June 2019 and June 2021. CKDu was diagnosed as progressive CKD, minimal proteinuria, absence of hematuria, diabetes, severe hypertension, systemic illness, glomerulonephritis or other urinary tract diseases, and presence of symmetrically contracted kidneyon ultrasound. A total of 166 (3.1%) out of 5365 patients with CKD were diagnosed with CKDu. The mean age was 53.6 ± 11.8 years. The patients were predominantly male (n = 113, 68.1%), belonged to rural areas (n = 147, 88.6%), and were engaged in farming (n = 105, 63.3%). The estimated glomerular filtration rate (eGFR) at presentation was 21.5 ± 15.1 ml/min/1.73m2. Forty-four (26.5%) had stage 3 CKD, 57 (34.3%) had stage 4 CKD, and 65 (39.2%) had stage5 CKD. There was an over-representation of CKDu cases in patients with CKD from Gariyaband (36.0%) and Mahasamund (25%) districts of Chhattisgarh and Nuapada (35.0%) and Balangir (30.0%) districts of Odisha. The study suggests clustering of cases of CKDu in certain districts of Orissa and Chhattisgarh.