جستجوی مقالات مرتبط با کلیدواژه "retrospective studies" در نشریات گروه "پزشکی"

The global problem of urinary tract infections (UTIs) caused by antibiotic-resistant bacteria is due to limited treatment options. This study aimed to examine the prevalence, etiology, and management implications of Escherichi coli causing UTI at Imam Hospital Ardabil, Iran.

2340 samples of retrospective data on E. coli causing UTIs were collected at Imam Hospital in Ardabil, Iran, spanning from 2012 to 2022. The samples were cultured and isolated, and their antibiotic susceptibility was determined using standard laboratory methods and data were then organized and systematically categorized using Python.

It was found that the lowest level of resistance was related to nitrofurantoin, followed by imipenem. In 2018, the number of E. coli patients resistant to trimethoprim was the highest. Cephalexin and ciprofloxacin trends indicate the reduction of the line during this retrospective period. There was a significant correlation between wards and some antibiotics like Cefepime, Cefotaxime, Ceftazidime, and Trimethoprim (P-Value <0.05).

Significant correlations were identified between specific hospital wards and resistance to antibiotics. These findings underscore the need for continuous surveillance and tailored antibiotic stewardship programs to combat the rising trend of antibiotic resistance.

Turkmens are an ethnic group mainly living in northeastern Iran. Despite previous studies on coronary artery bypass surgery (CABG) outcomes among different ethnicities, the effect of Turkmen ethnicity on outcomes of CABG surgery is still unknown. We aimed to assess the association between Turkmen ethnicity and postoperative outcomes following CABG.

We used the CABG data from two heart centers in northeastern Iran between 2007 and 2016. We included adult patients undergoing CABG surgery. The study outcomes were in-hospital major adverse cardiac and cerebrovascular events (MACCEs), consisting of myocardial infarction (MI), stroke, and cardiovascular death, and postoperative outcomes, including postoperative arrhythmia, acute atrial fibrillation (AF), major bleeding, and acute renal failure (ARF).

Over the course of one decade, 3632 patients, with an average age (standard deviation) of 59.0 (9.8) years, were studied. Of these, 3,331 patients were of non-Turkmen ethnicity, and 301 patients were Turkmens. According to adjusted analysis, ethnicity was not associated with MACCEs (OR: 1.15, 95 % CI: 0.61, 2.16; P = 0.663), postoperative arrhythmia (OR: 1.10, 95% CI: 0.78, 1.54; P = 0.588), acute AF (OR: 1.17, 95 % CI: 0.83, 1.66; P = 0.359), major bleeding (OR: 1.21, 95 % CI: 0.55, 2.67; P = 0.636), or ARF (OR: 2.60, 95 % CI: 0.60, 11.75, P = 0.224).

This study found that despite ethnic disparity and preoperative differences, Turkmen ethnicity was not associated with in-hospital MACCEs, AF, major bleeding, or ARF after coronary artery bypass.

The present study was conducted to report the incidence rate of ureteral avulsion and its management in two referral medical centers.

We retrospectively reviewed a total of 36683 transurethral lithotripsy procedures performed during 17 years. All ureteral avulsions were also included in the current study as an intraoperative complication of Transurethral Lithotripsy (TUL). Data including stone location, avulsion site and management details were recorded. 

Fourteen cases of complete ureteral avulsion had occurred in the study period (0.038%), consisting of 8 healthy males and 6 healthy females aged 26 to 73 years (mean age: 50 yrs). Out of these 14 cases, 7 cases had distal ureteral avulsion and seven others had proximal ureteral avulsion. Six cases of distal ureteral avulsion had been promptly treated by the reimplant method whereas immediate nephrectomy had been performed in the remaining case due to a history of poor condition of the renal unit. Proximal ureteral avulsions had been treated by combined Boari flap-psoas hitch procedures with renal mobilization in 3 cases, the autotransplant method in another 3 and by ileal interposition in one case. 

Although the present study is a case series which is normally classified as low level of evidence, it seems that both autotransplant and combined Boari flap-psoas hitch procedures with renal mobilization are safe and feasible techniques for the management of full-length complete ureteral injury.

Aneurysmal subarachnoid hemorrhage (SAH) constitutes a life-threatening condition, and identifyingthe ruptured aneurysm is essential for further therapy. This study aimed to evaluate the diagnostic accuracy of hypo-attenuating berry sign (HBS) observed on computed tomography (CT) scan in distinguishing ruptured aneurysms.

In this diagnostic accuracy study, patients who had SAH and underwent non-enhanced brain CT scan wererecruited. The HBS was defined as a hypo-attenuating area with an identifiable border in the blood-filled hyper-densesubarachnoid space. The screening performance characteristics of HBS in identifying ruptured aneurysms were calcu-lated considering the digital subtraction angiography (DSA) as the gold standard.

A total of 129 aneurysms in131 patients were analyzed. The overall sensitivity and specificity of HBS in the diagnosis of aneurysms were determinedto be 78.7% (95%CI: 73.1% - 83.4%) and 70.7% (95%CI: 54.3% - 83.4%), respectively. Notably, the sensitivity increased to90.9% (95%CI: 84.3% - 95.0%) for aneurysms larger than 5mm. The level of inter-observer agreement for assessing thepresence of HBS was found to be substantial (kappa=0.734). The diagnostic accuracy of HBS in individuals exhibitedenhanced specificity, sensitivity, and reliability when evaluating patients with a solitary aneurysm or assessing rup-tured aneurysms. The multivariate logistic regression analysis revealed a statistically significant relationship betweenaneurysm size and the presence of HBS (odds ratios of 1.667 (95%CI: 1.238 - 2.244; p < 0.001) and 1.696 (95%CI: 1.231- 2.335; p = 0.001) for reader 1 and reader 2, respectively).

The HBS can serve as a simple and easy-to-useindicator for identifying a ruptured aneurysm and estimating its size in SAH patients.

The availability of the COVID-19 vaccine during the pandemic has changed the disease course in the entire world. The current study aimed to compare various hematological parameters among COVID-19 patients with and without vaccination.

The present retrospective study included 26 vaccinated and 26 non-vaccinated COVID-19 patients. Various clinical and biochemical parameters of RT-PCR-positive patients were collected. The values are expressed in Mean±SD or median values IQR. Mann-Whitney U test was used for comparison between the groups. 

Among the vaccinated individuals, 17 cases (65.4%) were asymptomatic, one patient (3.8%) had moderate, eight cases (30.8%) had mild COVID-19 infection and all 26 patients were completely recovered. Among non-vaccinated COVID-19 patients, 25 cases (96.2%) had severe, one case (3.8%) had moderate COVID-19, and 16 patients (61.5%) recovered but ten cases succumbed to COVID-19. There were statistically significant differences in SpO2, total leucocyte count, and differential counts of neutrophils, lymphocytes, eosinophils, monocytes, and basophils between vaccinated and non-vaccinated patients (P<0.001). The neutrophil/lymphocyte ratio was found to be at a higher level (P<0.01) among non-vaccinated patients [10.9(4.28-23.63)]  compared to vaccinated [1.55(1.09-2.28)]. The blood urea, total and direct bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and inflammatory markers, like C-reactive protein (CRP), D-dimer, ferritin, and lactate dehydrogenase (LDH) were highly elevated in non-vaccinated patients (P<0.001). Moreover, lower values of total protein, serum albumin, and albumin and globulin (A/G) ratio were noted in the non-vaccinated compared to vaccinated individuals (P<0.001).

Vaccinated patients had milder disease with fewer derangements of hematological parameters compared to non-vaccinated patients. It can be concluded that vaccine has played a vital role during the COVID-19 pandemic in reducing mortality.

Opioids have been the leading cause of death from poisoning in Iran for several years. This studyaimed to evaluate the clinical and para-clinical presentations of naltrexone intoxication, its toxic dose, andits epidemiological properties.

This retrospective cross-sectional study was conducted on medicalrecords of patients presenting to Toxicology Department of Loghman Hakim Hospital, Tehran, Iran, followingnaltrexone intoxication, from 2002 to 2016. Patients’ demographic and laboratory data, clinical signs, supposedingested dose, and intent of naltrexone consumption were collected, analyzed, and then interpreted.

907 patients with the mean age of 36.6 ±11.7 years were evaluated (94.3% male). The mean amount of naltrex-one consumed by the intoxicated patients reported in the medical records was 105.8 ± 267.8 mg. One hundredthirty patients (14.3%) used naltrexone to treat substance use disorder. Two hundred eighty-seven poisoned pa-tients (31.6%) were current opium users who intentionally or unintentionally used naltrexone concomitantly.The most common symptoms observed in these patients were agitation (41.8%), vomiting (16.4%), and nau-sea (14.8%). Among patients with naltrexone poisoning, 25 patients were intubated (2.8%), and three passedaway. Aspartate aminotransferase (AST) levels were significantly higher in patients intoxicated with naltrexonewho needed intubation (p = 0.02).

The probability of intubation of cases with naltrexone intoxica-tion was associated with AST elevation. It seems that, the number of intensive care unit (ICU) admissions andmortality rates are not high among these patients.

 Sexually transmitted infections (STIs) constitute a major public health problem in both developed and developing countries. Human immunodeficiency virus (HIV) and STIs are linked in their similar mode of transmission, with STIs facilitating the acquisition and transmission of HIV. The prevalence pattern of individual STIs may evolve over time necessitating a corresponding change in management strategies.

 The study was conducted to determine the burden and any change in the etiological trend among attendees of an STIs clinic at a tertiary care hospital.

 This retrospective study analyzed data retrieved from consecutive patients attending an STIs clinic over two years (July 2018 to July 2020).

 Overall, 1916 patients were diagnosed with STIs. The predominant age group was 25 - 44 years (59.23%). Genital ulcer disease was the foremost syndrome (1213, 63.3%). Overall, herpetic genital ulcer was the most common (682, 35.6%), followed by non-herpetic ulcers (531, 27.7%). Vaginal discharge, lower abdominal pain, and urethritis were found in 461 (24%), 219 (11.43%), and 23 (1.27%) of the patients, respectively. Amongst 237 (12.36%) In HIV seropositive attendees, genital ulcer disease (herpetic) was the most common syndrome (179, 75.53%), followed by vaginal discharge (42, 17.72%), lower abdominal pain (9, 3.8%), and urethritis (7, 2.9%).

 A definite change in the profile of STIs was observed with ulcerative STIs (particularly herpes genitalis) constituting the major burden against a discernible back drop of decreasing non-herpetic STIs. A systematic, regional, periodic synopsis would not only help to follow and document the dynamic trends, but also can help to assess the effectiveness of control programs.

Dental implants are a prominent scientific breakthrough and are frequently applied for replacement of the missing teeth. From the clinicians’ point of view, long-term studies are essential to find out the predictability of dental implant systems.

In this retrospective study, 1,626 patients who received 4,389 Dyna implants in a private office between 2013-2019 were evaluated. All statistical analyses were performed using SPSS 25 for Windows. P values less than 0.1 were considered significant for regression analysis.

Dyna implant
ts (4389) placed from 2013 to 2019 were evaluated in this study. One-hundred and thirty-three (3.03%) implants failed during the healing period or recall visits. Eighty-nine implants (2.03%) failed immediately and 44 (1%) failed after 3 months.

The present study showed that the Dyna dental implant system had high implant survival, and it had all the survival criteria similar to world-class dental implant systems.

To provide suggestions and treatment opinions by analyzing laboratory data of COVID-19 patients co-infected with bacteria.

We analyzed 63 patients with COVID-19 admitted to the isolation ward of the First Affiliated Hospital of Wenzhou Medical University. COVID-19 was detected using PCR, and bacteria were identified using culture. Patients were divided into two groups, including those with and those without bacterial infections, and differences in hematologic indices between the groups were analyzed.

There were 63 patients with median age of 55.82 years. The average hospital stay was 22.56 days. Seven patients (11.11%) had coincident bacterial infections. Detection rates in sputum/alveolar lavage and blood were the highest, 60.52% and 21.05%, respectively. Klebsiella pneumoniae, Acinetobacter, and Stenotrophomonas maltophilia were the most common found in 31.58%, 18.42%, and 15.79%, respectively. Interleukin 6 (IL-6) levels were elevated in 84.13% of patients, while IL-10 levels were elevated in 69.84%, blood ammonia levels were elevated in 82.05%, lactate levels were elevated in 75.41%, and LDH levels were elevated in 69.84%. There were significant differences between the groups in terms of expression levels of IgG, C4, AST, LDH, IL-6, IL-10, percentage of neutrophils, percentage of lymphocytes, and platelets.

For patients with COVID-19 suspected of having bacterial infections, empiric antibiotics should be given to cover K. pneumoniae, Acinetobacter, and S. maltophilia.

Axial load on thoracolumbar junction, both mechanical and anatomical transitional zone, causes the compression and flexion of the spine, and consequently thoracolumbar burst fractures.

This study aimed to investigate the effect and prognostic factors associated with the postural and instrumented reduction on the restoration of vertebral height and kyphosis angle in thoracolumbar burst fractures.

This retrospective cohort study was conducted on 41 patients with A3, A4, and B type thoracolumbar burst fractures, subjected to postural and instrumented reduction for the restoration of vertebral height and kyphosis angle. The magnitude and correction of kyphotic deformity and percentage of vertebral body collapse were measured before and after postural reduction, and after instrumental insertion to find if they were affected by fracture type and level, time-to-surgery, and use of pedicular screws at the fractured level.

Postural and instrumental reduction significantly improved both the kyphosis angle and the percentage of vertebral body height, regardless of AO types (p.value

AO type A3, and A4, time to surgery before 4 days, and fracture level at L2 were favorable prognostic factors to better restoration of kyphosis angle using both postural and instrumented reduction.

We aimed to identify the prevalence and risk factors of three outcomes after stone removal following treatment for obstructive acute pyelonephritis (APN) associated with urinary tract calculi: immediate postoperative febrile urinary tract infection (UTI), stone recurrence, and APN recurrence during the follow-up period.

We retrospectively reviewed the charts of 107 patients who underwent stone removal following treatment for obstructive APN associated with urinary tract calculi. Logistic regression analysis was used to identify the factors that contributed to postoperative febrile UTI after stone removal. Cox proportional hazard analyses were used to identify the factors contributing to stone recurrence and APN recurrence during the follow-up period.

Postoperative febrile UTI was observed in 23 out of  107 patients (21.5%). Multivariate logistic regression analysis revealed that female sex (P = .02) and having multiple stones (P < .01) were independently significant predictors of postoperative febrile UTI. One-year recurrence-free survival rates of stone disease and APN were 76.1% and 82.5%, respectively. Multivariable cox proportional hazard analyses revealed that presence of residual fragments was the only significant risk factor for stone recurrence (P < .01) and marginally significant for APN recurrence (P = .05).

Patients presenting with obstructive APN  frequently develop postoperative febrile UTI after active stone removal with the risk factors being female sex and having multiple stones. Residual fragments after stone removal in patients with obstructive APN can cause urolithiasis  and APN recurrence, indicating that complete removal of stone fragments ? 4 mm is imperative to the disease management.