Predictors of preterm birth.

OBJECTIVE: This is a systematic review to assess published scientific evidence on preterm birth predictors. METHODS: An Internet search for predictors of preterm birth was performed and the evidence level of each method was evaluated. RESULTS: There is strong evidence that preterm birth can be predicted using vaginal sonography to evaluate cervical characteristics, fetal fibronectin in cervicovaginal secretions and interleukin-6 in amniotic fluid. There is consistent evidence that digital cervical examination is a weak predictor, and controversy regarding home uterine activity monitoring. There is scanty evidence about the predictive ability of maternal history and perceptions of symptoms since the study design fails to provide high evidence level. CONCLUSION: Cervical evaluation by vaginal sonography, fetal fibronectin and interleukin-6 are the best methods for predicting preterm birth.     

The impact of gender on diabetes-related lower extremity amputations: An Italian regional analysis on trends and predictors

BackgroundDiabetes-related lower extremity amputations (LEAs) are a major public health issue. The aim of the study was to evaluate trends by gender and predictors of LEAs in an Italian region.MethodsData were collected from hospital discharge records between 2006 and 2015. Gender- and age-adjusted standardised hospitalisation rates for major and minor amputations were calculated. Poisson regression model was performed to estimate trends in LEAs.ResultsHospitalisation rates decreased for minor amputations both among males (?30.0%) and females (?5.3%), while the major amputation rates decreased only for males (?44.7%). Males were at higher risk of undergoing major (IRR 1.41, 95%CI 1.19–1.67) and minor (IRR 1.62, 95%CI 1.45–1.82) amputations. Peripheral vascular disease was the leading predictor of major and minor amputations.ConclusionA significant reduction of LEAs was observed only for males. Identifying their predictable factors may help caregivers to provide higher standards of diabetes care.     

血清铁蛋白水平预测急性肺损伤发生的临床应用价值

应用放射免疫分析法前瞻性检测１７６例发生急性肺损伤（ＡＬＩ）高危因素的患者血清铁蛋白水平,随后５６例发生了ＡＬＩ。结果发现高危患者血清铁蛋白水平显著高于正常对照组（Ｐ〈０．０１）,高危患者发展ＡＬＩ是又显著高于未发展为ＡＬＬ者（Ｐ〈０．０１）,女性以〉２８０μｇ／Ｌ预测ＡＬＩ灵敏度为８０．９％,特异度８６．８％,男性以〉６３０μｇ／Ｌ预测ＡＬＩ灵敏度为８５．７％,特异度８８．１％。结果表明血清铁蛋     

Visceral adiposity index as a predictor for type 2 diabetes mellitus in Asian population: A systematic review

BackgroundVisceral Adiposity Index (VAI) is a formula to estimate visceral fat accumulation which has been reported to have a better prediction for type 2 diabetes mellitus (T2DM) in Caucasian population. This systematic review is proposed to inquire whether VAI can be used as a predictor of T2DM in Asian population with different body composition compared to the Caucasian.MethodsAll studies performed in Asia and published in English on VAI prediction on the incidence of T2DM were included. The search keywords used in Pubmed and Cochrane database were visceral adiposity index, VAI and T2DM.ResultsSeven included studies, of which six studies were conducted in China and one in Iran. Four studies were prospective cohorts and the other three were cross-sectional. The largest study population were 7639 subjects, while the longest observation period was 15 years. This study found that VAI can be used as a predictor of T2DM in Asian population with better prediction values compared to Caucasian population. The reported odds ratio or hazard ratio ranged from 1.2 to 3.6.ConclusionsVAI is a practical formula used to estimate the accumulation of visceral fat which can be used as a predictor for T2DM in Asian population.     

Corticosteroid therapy in ulcerative colitis:Clinical response and predictors

AIM:To evaluate clinical response to initial corticosteroid(CS) treatment in Chinese ulcerative colitis patients(UC) and identify predictors of clinical response.METHODS:Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China,and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors.Short-term outcomes within one month were classified as primary response and primary non-response.Longterm outcomes within one year were classified as prolonged CS response,CS dependence and secondary non-response.CS refractoriness included primary and secondary non-response.Multivariate analyses were performed to identify predictors associated with clinical response.RESULTS:Within one month,95.0%and 5.0%of the cases were classified into primary response andnon-response,respectively.Within one year,41.6%of cases were assessed as prolonged CS response,while49.5%as CS dependence and 4.0%as secondary nonresponse.The rate of CS refractoriness was 8.9%,while the cumulative rate of surgery was 6.9%within one year.After multivariate analysis of all the variables,tenesmus was found to be a negative predictor of CS dependence(OR=0.336;95%CI:0.147-0.768;P=0.013)and weight loss as a predictor of CS refractoriness(OR=5.662;95%CI:1.111-28.857;P=0.040).After one-month treatment,sustained high Sutherland score(≥6)also predicted CS dependence(OR=2.347;95%CI:0.935-5.890;P=0.014).CONCLUSION:Tenesmus was a negative predictor of CS dependence,while weight loss and sustained high Sutherland score were strongly associated with poor CS response.     

疼痛灾难化预测术后疼痛的研究进展

疼痛灾难化是患者对疼痛产生的夸大且消极的思维定势。作为与疼痛相关的主要负面心理情绪之一,疼痛灾难化可以通过多种机制调控疼痛体验。因此,疼痛灾难化可能是各种疼痛相关疾病的潜在发病机制和治疗靶点。近年来,由于相对统一的量表出现,越来越多的研究将疼痛灾难化作为术前心理评估项目,探讨术前疼痛灾难化强度预测术后疼痛发生的可能性。全文对疼痛灾难化的相关概念、发生机制、评估手段以及疼痛灾难化对术后急慢性疼痛的预测能力的研究进展进行综述。