Analysis of risk factors associated with primary bile reflux: A multicenter cross-sectional study.
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ABSTRACT:
SUBMITTER: Dong Q
PROVIDER: S-EPMC10344538 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
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Analysis of risk factors associated with primary bile reflux: A multicenter cross-sectional study.
Dong Qiang Q Li Songbo S Chen Shasha S Qu Xiaodong X Zhao Xingyu X Li Yani Y Wang Shasha S Shi Yongquan Y
Chinese medical journal 20230607 14
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Project description:Background: Endoscopic primary bile reflux is one of the main diagnostic criteria for bile reflux gastritis (BRG). Presently, the risk factors and prediction models of endoscopic primary bile reflux (EPBR) in gastropathy patients who cannot or will not undergo endoscopy due to contraindications are not clear. Thus, this study aimed to evaluate the risk factors of EPBR and to establish and verify a prediction model. Methods: A series of 844 patients (564 subjects with EPBR and 280 control subjects) were retrospectively selected for this study and divided into a training set (n = 591) and a validation set (n = 253) according to the usual ratio of 70:30% for the subsequent internal validation of the logistic regression model for EPBR. Fifteen parameters that might affect the occurrence of EPBR were collected. Subsequently, univariate and stepwise logistic regression analyses were introduced to reveal the risk factors and the multivariate prediction model. An R package was dedicated to the corresponding internal validation of the EPBR model. Results: The univariate analysis showed that gender, age, smoking, Helicobacter pylori (H. pylori) infection status, metabolic syndrome (MS), non-steroidal anti-inflammatory drugs (NSAIDs) use history, and previous medical histories of chronic liver diseases, cholelithiasis, and erosive gastritis were statistically significant between the two groups (P < 0.05). Multivariate regression described that being a male [OR (95%confidence interval (CI)) = 2.29 (1.50-3.50), P < 0.001], age≥45 years old [OR (95% CI) = 4.24 (2.59-6.96), P < 0.001], H. pylori infection status [OR (95% CI) = 2.34 (1.37-4.01), P = 0.002], MS [OR (95% CI) = 3.14 (1.77-5.54), P < 0.001], NSAIDs use history [OR (95% CI) = 1.87 (1.03-3.40), P = 0.04], cholelithiasis history [OR (95% CI) = 3.95 (2.18-7.18), P < 0.001] and erosive gastritis history [OR (95% CI) = 6.77 (3.73-12.29), P < 0.001] were the risk factors for the occurrence of EPBR. Based on the results of these risk factors, an EPBR prediction model with an adequate calibration and excellent discrimination was established [area under the curve (AUC): 0.839, 95% CI = 0.806-0.872]. Conclusions: Being a male, age ≥ 45 years old, H. pylori infection, histories of MS, NSAIDs use, cholelithiasis, and erosive gastritis appear to be the risk factors for EPBR, and our favorable prediction model might be an option for the prediction of EPBR.
| S-EPMC8631358 | biostudies-literature
Project description:To explore the effects of bile reflux on gastric cancer and its precancerous lesions, so as to better prevent the occurrence and development of gastric cancer.
| 2307610 | ecrin-mdr-crc
Project description:ObjectiveTo identify whether bile reflux on endoscopy and other related variables are risk factors for precancerous gastric lesions and gastric cancer (GC).MethodsA multicenter, cross-sectional and observational study was conducted in five centers in China from June to October 2019, 1162 patients were recruited and divided into the chronic gastritis (CG), the precancerous lesion (low-grade intraepithelial neoplasia and intestinal metaplasia), and GC groups (including high-grade intraepithelial neoplasia). All participants underwent detailed interviews, endoscopy and biopsy, and completed questionnaires. Odds ratio and 95% confidence interval were calculated with multivariate logistic regression models with or without adjustment for Helicobacter pylori infection.ResultsWe recruited 668 patients with CG, 411 with precancerous lesions and 83 with GC. By comparing the CG and precancerous lesion groups, independent risk factors for cancerous gastric lesions were the grade of bile reflux, patient's age, dietary habits and family history of GC. Similar results were obtained when comparing the CG and GC groups. In addition, bile reflux was confirmed as an independent risk factor for progression from precancerous lesions to cancer.ConclusionsBile reflux on endoscopy as well as age, dietary habits and a family history of GC were independent risk factors for the development of precancerous gastric lesions and GC.
| S-EPMC8252397 | biostudies-literature
Project description:Colistin is a last-resort agent for the treatment of infections due to Gram-negative bacteria with difficult-to-treat resistance. The primary objective of this post hoc analysis of a cross-sectional study conducted in 22 Italian hospitals was to assess factors associated with inadequate intravenous colistin dosage. Overall, 187 patients receiving intravenous colistin were included in the analyses. Inadequate colistin dosages were administered in 27% of cases (50/187). In multivariable analysis, AKI (dummy variable with KDIGO stage 0 as a reference, odds ratio (OR) 3.98 with 95% confidence interval (CI) 1.48-10.74 for stage 1, OR 4.44 with 95% CI 1.17-16.93 for stage 2, OR 9.41 with 95% CI 1.59-55.70 for stage 3; overall p = 0.001) retained an independent association with inadequate colistin dosage, whereas the presence of a central venous catheter was associated with adequate colistin dosage (OR: 0.34 for inadequate dosage, 95% CI: 0.16-0.72, p = 0.004). These results were confirmed in an additional multivariable model with the center as a random effect. The association between AKI and inadequate dosage may reflect the perception of an increased risk of nephrotoxicity in patients with impaired renal function, which nonetheless should not be accompanied by dosage reductions beyond those recommended and could represent the target of dedicated antimicrobial stewardship efforts.
| S-EPMC8698974 | biostudies-literature
Project description:OBJECTIVE:Gastro-oesophageal reflux disease (GORD) is a relatively common disorder and manifests with extraoesophageal symptoms, such as dental erosions (DE), cough, laryngitis, asthma, and oral soft- and hard-tissue pathologies. This study aimed (1) to identify oral soft and hard-tissue changes in patients with GORD and (2) to evaluate these oral changes as indices for assessing GORD and its severity. SETTING:This cross-sectional study was conducted at four major tertiary care government hospitals, in two metropolitan cities of Pakistan. PARTICIPANTS:In total, 187 of 700 patients who underwent oesophago-gastro-duodenoscopy and having GORD were included in the study. Patients with GORD were divided according to the presence of DE into group A (with DE, chronic/severe GORD) and group B (without DE, mild GORD). Patients who were unconscious and had extremely limited mouth opening were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES:Abnormal conditions and lesions of the oral mucosa were recorded. The impact of oral hard and soft-tissue changes on the oral health-related quality of life was assessed using the Pakistani (Urdu) version of the validated Oral Health Impact Profile-14 (OHIP-14) instrument. RESULTS:Oral submucous fibrosis (66.3%), ulceration (59.4%) and xerostomia (47.6%) were significantly more common in group A (p<0.05). The prevalence of GORD was 26.7%, within which the prevalence of DE was 35.3%. Unhealthy dietary pattern, nausea/vomiting, oesophagitis, xerostomia, ulceration, gingivitis and angular cheilitis showed a statistically significant association with chronic GORD and DE. All subscales of OHIP-14 were positively correlated (p<0.05) in patients with GORD and DE, with notable impact on psychological discomfort (rs=0.30), physical disability (rs=0.29), psychological disability (rs=0.27) and functional limitation (rs=0.20). CONCLUSION:Patients with GORD and DE presented with more severe oral manifestations than did those with GORD and no DE. We recommend timely dental check-ups to assess the severity of both systemic and oral disease.
| S-EPMC6475213 | biostudies-literature
Project description:BackgroundHuman T cell lymphotropic virus type 1 (HTLV-1) is highly endemic in Brazil, necessitating surveillance studies to understand its epidemiology. While previous research has focused on either specific cities or populations, there is a need for multicenter studies encompassing epidemiologically relevant populations to ascertain more accurate prevalence rates and predictors of HTLV-1 infection in the country.MethodsWe conducted a multicenter, cross-sectional study involving 3,184 participants across seven cities and five study populations in Brazil. Blood samples were collected, and the prevalence of HTLV-1 infection was determined by enzyme-linked immunosorbent assay (ELISA) and Western blot. Binary logistic regression analysis was used to determine risk factors of HTLV-1 infection.ResultsAmong the total study population, 1,135 (35.7%) were aged >40 years and 1,704 (53.5%) were female. The overall prevalence of HTLV-1 infection was 0.5% (95% CI: 0.3-0.8), with variation observed among the cities or study populations. Factors associated with HTLV-1 infection included age > 40 years (OR, 8.867; 95% CI: 1.824-43.099), female gender (OR, 4.604; 95% CI: 1.184-17.903), and Hepatitis C virus (HCV) infection (OR, 13.995; 95% CI: 2.374-82.506). The identification of older age and female gender, coupled with the high prevalence of HTLV-1 in HIV-positive patients, suggests sexual transmission as the primary route of HTLV-1 infection.ConclusionOur study reveals varied prevalence rates of HTLV-1 infection across diverse populations and cities in Brazil. The association of older age, female gender, and HCV, emphasizes the need for tailored interventions to prevent HTLV-1 transmission.
| S-EPMC11911192 | biostudies-literature
Project description:BackgroundHealthcare-associated infections (HAIs) are a major global health threat, leading to higher morbidity and mortality, longer hospital stays, and increased healthcare expenses. Intensive care units (ICUs) present a particularly high risk of developing HAIs. This study aims to examine the risk factors of HAIs among healthcare workers (HCWs) in the ICUs of selected public hospitals.MethodsWe employed a cross-sectional design using an online survey. Respondents were randomly selected from seven large public hospitals located in different areas of Riyadh, the capital city of Saudi Arabia. Data collection was conducted between November 1st to 15th, 2023. Logistic regression analysis was employed to examine previous exposure to HAIs as the response variable and selected predictors.ResultsA total of 600 HCWs participated in the study (response rate 88.2%). Among the study HCWs, 75.1% were female, with nurses making up 50% of the sample. Of the respondents, 78% had at least a year's experience, 71% had applied infection prevention and control (IPC) training from the infection control department, and 93% reported they had good knowledge about infection control. The level of knowledge of IPC (OR = 0.9, p < 0.05) and applied IPC training (0.1, p < 0.001) were significantly associated with a lower risk of HAIs. Additionally, a higher risk of HAIs was associated with HCWs years of clinical experience (p < 0.001).ConclusionOverall, the findings indicated that HCWs who have poor knowledge of IPC, who reported no previous IPC applied training, and who have more years of clinical work experience have a greater risk of HAIs. Thus, legislators and Health officials should prioritize the prevention of infections linked to healthcare, paying particular attention to tailored and applied IPC initiatives.
| S-EPMC11651625 | biostudies-literature
Project description:Study objectiveDuring the delta surge of the COVID-19 pandemic in 2021, we sought to identify characteristics and beliefs associated with COVID-19 vaccination acceptance in parents of pediatric emergency department (ED) patients.MethodsWe conducted a cross-sectional survey-based study of the parents of children aged 3 to 16 years presenting to 1 of 9 pediatric EDs from June to August 2021 to assess the parental acceptance of COVID-19 vaccines. Using multiple variable regression, we ascertained which factors were associated with parental and pediatric COVID-19 vaccination acceptance.ResultsOf 1,491 parents approached, 1,298 (87%) participated, of whom 50% of the parents and 27% of their children aged 12 years or older and older were vaccinated. Characteristics associated with parental COVID-19 vaccination were trust in scientists (adjusted odds ratio [aOR] 5.11, 95% confidence interval [CI] 3.65 to 7.15), recent influenza vaccination (aOR 2.66, 95% CI 1.98 to 3.58), college degree (aOR 1.97, 95% CI 1.36 to 2.85), increasing parental age (aOR 1.80, 95% CI 1.45 to 2.22), a friend or family member hospitalized because of COVID-19 (aOR 1.34, 95% CI 1.05 to 1.72), and higher income (aOR 1.60, 95% CI 1.27 to 2.00). Characteristics associated with pediatric COVID-19 vaccination (children aged ≥12 years) or intended COVID-19 pediatric vaccination, once approved for use, (children aged <12 years) were parental trust in scientists (aOR 5.37, 95% CI 3.65 to 7.88), recent influenza vaccination (aOR 1.89, 95% CI 1.29 to 2.77), trust in the media (aOR 1.68, 95% CI 1.19 to 2.37), parental college degree (aOR 1.49, 95% CI 1.01 to 2.20), and increasing parental age (aOR 1.26, 95% CI 1.01 to 1.57).ConclusionOverall COVID-19 vaccination acceptance was low. Trust in scientists had the strongest association with parental COVID-19 vaccine acceptance for both themselves and their children.
| S-EPMC8806130 | biostudies-literature
Project description:Objective We assessed the factors associated with overlap between functional dyspepsia (FD) and nonerosive reflux disease (NERD) in endoscopy-based Helicobacter pylori-uninfected Japanese health checkup participants. Methods We utilized baseline data from 3,085 individuals who underwent upper endoscopy for health screening in a prospective, multicenter cohort study. The participants were asked to complete a questionnaire detailing their upper abdominal symptoms and lifestyle. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) score. FD, postprandial distress syndrome (PDS), and epigastric pain syndrome (EPS) were defined according to the Rome III criteria. NERD was defined as heartburn or regurgitation ≥1 day/week without erosive esophagitis. Results Of the 3,085 participants, 73 (2.4%), 97 (3.1%), and 84 (2.7%) had FD alone, NERD alone, and FD-NERD overlap, respectively. Factors associated with FD-NERD-overlap participants compared with participants with neither FD nor NERD were women [odds ratio (OR): 2.08, 95% confidence interval (CI): 1.24-3.52], body mass index (BMI) <18.5 (OR: 2.87, 95% CI: 1.56-5.07), alcohol consumption ≥20 g/day (OR: 1.85, 95% CI: 1.06-3.15), and a high STAI score (OR: 2.53, 95% CI: 1.62-4.00). Increasing age (OR: 1.06, 95% CI: 1.01-1.11) and EPS symptoms [pure EPS (OR: 3.67, 95% CI: 1.65-8.51) and PDS-EPS overlap (OR: 11.6, 95% CI: 4.09-37.2)] were associated with FD-NERD overlap vs. FD alone. Women (OR: 3.17, 95% CI: 1.47-7.04), BMI <18.5 (OR: 3.03, 95% CI: 1.04-9.90), and acid reflux symptoms ≥2 days a week (OR: 3.57, 95% CI: 1.83-7.14) were associated with FD-NERD overlap vs. NERD alone. Conclusion Understanding the clinical features of overlap between FD and NERD will lead to better management.
| S-EPMC10982007 | biostudies-literature
Project description:Long-term sequelae of the coronavirus disease (COVID-19) constitute Long COVID. Although Long COVID has been reported globally, its risk factors and effects on quality of life (QOL) remain unclear. We conducted a cross-sectional study using questionnaires and electronic medical records of COVID-19 patients who were diagnosed or hospitalized at five facilities in Japan. Responses were obtained from 285 out of 1,150 patients. More than half of the participants reported Long COVID symptoms of varying severity 1 year after COVID-19. Common sequelae included fatigue, dyspnea, alopecia, concentration problems, memory problems, sleeplessness, and joint pain, which often significantly reduced their QOL. COVID-19 severity was strongly associated with sputum production, chest pain, dyspnea, sore throat, and diarrhea, but not with fatigue, dysgeusia, anosmia, alopecia, and sleeplessness. Fatigue, dysgeusia, anosmia, alopecia, and sleeplessness affected the QOL among participants with asymptomatic or mild COVID-19 during the acute phase. Moreover, these sequelae persisted for prolonged periods.
| S-EPMC9793373 | biostudies-literature