• Title/Summary/Keyword: multivariable control

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A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward

  • Park, Jinyoung;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Song, Jae-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.49.1-49.8
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    • 2019
  • Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

Screening for Patients with Non-small Cell Lung Cancer Who Could Survive Long Term Chemotherapy

  • Wu, Xue-Yan;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.647-652
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    • 2015
  • Background: Lung cancer was one of the most common cancers in both men and women all over the world. In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods: We enrolled 186 patients with stage IV NSCLC after long term chemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age, gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastatic sites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multiple therapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) were selected. For consideration of factors influencing survival and response for patients with advanced NSCLC, logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening module for patients with elevated survival after long term chemotherapy become possible. Results: Of the total of 186 patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3 years (long-term group). For logistic regression analysis, the short-term group was taken as control group and the long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lung and liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronic bronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Cox regression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g. targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastatic site (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC. Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associated with long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logistic regression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associated with long-term survival. Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLC who had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. more than third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.

Modification of Microclimate to Improve Milk Production in Tropical Rainforest of Thailand

  • Suriyasathaporn, W.;Boonyayatra, S.;Kreausukon, K.;Pinyopummintr, T.;Heuer, C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.6
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    • pp.811-815
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    • 2006
  • The objective of this study was to evaluate the effect of electric fan installation for milk production improvement of dairy cattle in Thailand. The study was conducted using 2 small-holder dairy farms in Chiang Mai province, during April to August 2004. Electric fans were installed in front of each row of cows. Each of the two rows of cows in the barn was defined as an experimental unit, thus each farm had two experimental units. The fans were operated alternately in 7-day intervals between rows of cows within each farm during the day or between 8.00 am to 8.00 pm. Non-operation periods were used as control. Milk yields were recorded. Data on environmental temperature and humidity were obtained from Chiang Mai Meteorological Center. Result from statistically analysis of milk record suggested an interaction between lactation period and fan installation. Therefore, this interaction term of lactation period and fan installation (PERIOD_FAN) was added as a variable to the regression model. Due to the repeated data collection of milk yield from the same cow (alternate week), milk yield was analyzed by repeated measure analysis (Mixed model). Least square means were calculated for all levels and used to compare between each pair-wise values. The final data were collected from the total of 18 cows with 2,072 data. Overall means and SEM of milk yields and days in milk separated into farm were $14.7{\pm}0.06kg/day$ and $176.3{\pm}2.2days$, and $15.2{\pm}0.22kg/day$ and $202.5{\pm}3.7$ days for farm A and farm B, respectively. For multivariable analysis, only PERIOD_FAN and humidity were significantly associated with milk yield. Only the first period of lactation showed that the amount of milk yields during fan installation was higher than that of non-fan installation (p<0.05). Cows with fan installation produced approximately 1.2 kg/cow more milk than cows without fan installation during this period. In conclusion, the use of electric fan operated during the day time increased milk production of cows during the first period of lactation.

Risk factor analysis of additional administration of sedative agent and patient dissatisfaction in intravenous conscious sedation using midazolam for third molar extraction

  • Shin, Dong-Whan;Cho, Jin-Yong;Han, Yoon-Sic;Sim, Hye-Young;Kim, Hee-Sun;Jung, Da-Un;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.229-238
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    • 2017
  • Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

Nutrient Intake Status of the Elderly in Metropolitan, Middle & Small Cities, and Rural Areas according to Income Level within the Same Region: Korea National Health and Nutrition Examination Survey (2016-2018) (대도시·중소도시·읍면지역 및 동일한 지역내에서의 소득수준에 따른 노인의 영양소 섭취 현황: 국민건강영양조사 2016-2018년 자료 활용)

  • Kim, Sangyeon;Hong, Hye-Sook;Lee, Hae-Jeung
    • Journal of the Korean Society of Food Culture
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    • v.36 no.1
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    • pp.92-102
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    • 2021
  • There is little information on the nutrient intake according to the city size and small town in Korean elderly. This study analyzed the nutritional consumption of older people in metropolitan, middle and small cities, and rural areas according to four income levels. The recent data from the 2016~2018 Korean National Health and Nutrition Survey, Centers for Disease Control and Prevention were used. The final analysis included 4,325 individuals (Male: 1,856, Female: 2,469) over 65 years old. Multivariable regression with a complex sample design was conducted to compare the nutrient intake among the groups. In a comparison within regions, the nutrition status of the elderly in small towns was more vulnerable than metropolitan and middle & small cities. The energy intakes were similar between the groups. The carbohydrate intake of middle & small cities was significantly higher than the other regions. The intake of other nutrients in metropolitan and middle & small cities appeared to be higher than in rural areas. The number of nutrients with statistical significance between low and high-income levels were 19 in metropolitan, 11 in middle & small cities, and 5 in rural areas. Each contribution of carbohydrate, fat, and protein to the total energy intake was lower in the low-income level than the high-income level in metropolitan and middle & small cities. On the other hand, in rural areas, only the contribution of protein to energy intake was lower in the low-income level than the high-income level. Cities with higher levels of urbanization had more severe nutritional inequality in relation to the income level. There was also nutritional inequality present in rural areas but it was to a lesser extent. Moreover, the generally low level of nutrient intake was problematic in rural areas. These findings could be used as fundamental evidence for developing community nutritional policies for the elderly.

Prospective Multi-Center Korean Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolics for Nodular Hepatocellular Carcinoma: A Two-Year Outcome Analysis

  • Myungsu Lee;Jin Wook Chung;Kwang-Hun Lee;Jong Yun Won;Ho Jong Chun;Han Chu Lee;Jin Hyoung Kim;In Joon Lee;Saebeom Hur;Hyo-Cheol Kim;Yoon Jun Kim;Gyoung Min Kim;Seung-Moon Joo;Jung Suk Oh
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1658-1670
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    • 2021
  • Objective: To assess the two-year treatment outcomes of chemoembolization with drug-eluting embolics (DEE) for nodular hepatocellular carcinoma (HCC). Materials and Methods: This study was a prospective, multicenter, registry-based, single-arm trial conducted at five university hospitals in Korea. Patients were recruited between May 2011 and April 2013, with a target population of 200. A DC Bead loaded with doxorubicin was used as the DEE agent. Patients were followed up for two years. Per-patient and per-lesion tumor response analysis, per-patient overall survival (OS) and progression-free survival (PFS) analysis, and per-lesion tumor control analysis were performed. Results: The final study population included 152 patients, with 207 target lesions for the per-lesion analysis. At one-month, six-month, one-year, and two-year per-patient assessments, complete response (CR) rates were 40.1%, 43.0%, 33.3%, and 19.6%, respectively. The objective response (OR) rates were 91.4%, 55.4%, 35.1%, and 19.6%, respectively. The cumulative two-year OS rate was 79.7%. The cumulative two-year PFS rate was 22.4% and the median survival was 9.3 months. In multivariable analysis, the Child-Pugh score (p = 0.019) was an independent predictor of OS, and tumor multiplicity (p < 0.001), tumor size (p = 0.020), and Child-Pugh score (p = 0.006) were independent predictors of PFS. In per-lesion analysis, one-month, six-month, one-year and two-year CR rates were 57.5%, 58.5%, 45.2%, and 33.3%, respectively, and the OR rates were 84.1%, 65.2%, 46.6%, and 33.3%, respectively. The cumulative two-year per-lesion tumor control rate was 36.2%, and the median time was 14.1 months. The Child-Pugh score (p < 0.001) was the only independent predictor of tumor control. Serious adverse events were reported in 11 patients (7.2%). Conclusion: DEE chemoembolization for nodular HCCs in the Korean population showed acceptable survival, tumor response, and safety profiles after a two-year follow-up. Good liver function (Child-Pugh score A5) was a key predictor of per-patient OS, PFS, and per-lesion tumor control.

The Association of Life Event Stress, Family Function and Cancer (암과 생활사건스트레스 및 가족기능의 연관성)

  • Choi, Youn-Seon;Lee, Young-Mee;Hong, Myung-Ho;Chun, Byung-Chul
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.114-124
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    • 1999
  • Purpose : To clarify the relation between psychosocial variables and cancer in Korea. Methods : Case-control study. Participants: 239 subjects in 2 university hospitals in Seoul completed a series of psychometric instruments(the Olson's FACES III and the Lee's 98-items life event scale). Results : In bivariable analysis, there were statistically significant difference in age and economic status(income): marginal significance in education status and marital status between the cases and controls. The family function type and stress score were not significantly different. The result of multivariable logistic regression, analysis showed that the risk of cancer was associated with economic status and marital status, but neither the family function nor the life event stress. Conclusion : In this study, we cannot prove the statistical association between the family function, life event stress and cancer. It is necessary to persevere in our efforts to clarify the relation between stress and disease and to develop the useful tools to measure the Korean family function and life event stress.

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