The data herein suggest that the identified predictor values applied to tree diagrams, which required no extraordinary measures, have a higher rate of correct identification of malignant, paramalignant and benign effusions when compared to techniques available today and proved most useful for usual clinical practice. Future studies are still needed to further improve the classification of patients.
Introduction:Arterial ischemic stroke in newborns is an important cause of neonatal morbidity and
mortality. Its pathophysiology and associated risk factors are not yet clearly
understood and defined.Objective:The aim of this retrospective study was to investigate possible risk factors in
diagnosed cases of PAIS (perinatal arterial ischemic stroke).Materials and methods:Case–control study. Clinical data of patients with PAIS diagnosis were analyzed. Two
healthy controls were selected for each PAIS case, matched for gestational age. Risk
factors were explored using univariable and multivariable analysis.Outcome:40 patients were included in the study, 24 males and 16 females; 52.5% of cases were
diagnosed within the first month of birth, and 47.5% were retrospectively diagnosed. The
results showed a male predominance (66.7%). The distribution of cerebral ischemic injury
was predominantly medial cerebral artery (87.5%) and occurred more commonly in the left
cerebral hemisphere (62.5%). Significant risk factors in the univariate analysis (P <
0.05) were primiparity, stillbirth, neonatal sepsis, asphyxia, twin pregnancy, placenta
abruption, emergency cesarean section, Apgar score ≤7 after 5 min, breech presentation,
and hyperbilirubinemia. In the multivariate analysis, primiparity (OR 11.74; CI
3.28–42.02), emergency cesarean section (OR 13.79; CI 3.51–54.13), birth asphyxia (OR
40.55; CI 3.08–532.94) and Apgar score ≤7 after 5 min (OR 13.75; CI 1.03–364.03) were
significantly associated factors with PAIS. Only five (16.6%) patients had an abnormal
thrombophilia study.Conclusion:Risk factors of primiparity, emergency cesarean section, birth asphyxia, and Apgar
score ≤7 after 5 min were significantly associated with perinatal stroke. More studies
with a larger number of patients and with prolonged follow up are required to establish
more clearly the associated risk factors involved in this pathology.
Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01–1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09–1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73–0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39–0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59–13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03–1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14–4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
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