scholarly journals Risk Factors for Corrective Septorhinoplasty Associated With Initial Treatment of Isolated Nasal Fracture

2018 ◽  
Vol 20 (6) ◽  
pp. 460-467 ◽  
Author(s):  
Kevin Li ◽  
Sami P. Moubayed ◽  
Emily Spataro ◽  
Sam P. Most
Keyword(s):  
Risk Factors ◽  
Initial Treatment ◽  
Nasal Fracture

Are there Psychological Risk Factors for Nasal Fracture?

2000 ◽  
Vol 25 (1) ◽  
pp. 88-89
Author(s):  
U.R. Ullal ◽  
I.J. Deary ◽  
J. Gordon ◽  
J.H. Hayes ◽  
J.A. Wilson
Keyword(s):  
Risk Factors ◽  
Psychological Risk Factors ◽  
Nasal Fracture ◽  
Psychological Risk

scholarly journals Risk Factors for Transformation to Higher-Grade Lymphoma and Its Impact on Survival in a Large Cohort of Patients With Marginal Zone Lymphoma From a Single Institution

2018 ◽  
Vol 36 (34) ◽  
pp. 3370-3380 ◽  
Author(s):  
Juan Pablo Alderuccio ◽  
Wei Zhao ◽  
Amrita Desai ◽  
Nicolas Gallastegui ◽  
Jeremy Ramdial ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lactate Dehydrogenase ◽  
Follicular Lymphoma ◽  
Lymphoid Tissue ◽  
Initial Treatment ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Competing Risk ◽  
Elevated Lactate ◽  
Elevated Lactate Dehydrogenase

Purpose Given the paucity of data on higher-grade transformation (HGT) to aggressive lymphoma in patients with marginal zone lymphoma (MZL), we report on a large cohort of patients, identify risk factors, and determine HGT impact on overall survival (OS). Methods We analyzed 453 patients with biopsy-proven MZL seen at our institution between 1995 and 2016. Kaplan-Meier, Cox proportional hazards regression, and competing risk methods were used in analyses of time-to-event outcomes. Results Thirty-four patients (7.5%) had biopsy-proven HGT to diffuse large B-cell lymphoma, including seven (21%) diagnosed at the time of initial MZL diagnosis. Among 27 incident patients, median time to HGT was 29 months (range, 1.3 to 135 months). Higher risk of HGT was observed in those with nodal/splenic MZL (subdistribution hazard ratio [SHR], 2.60; P = .023). On multivariable competing risk analysis, elevated lactate dehydrogenase (SHR, 2.71), more than four nodal sites (SHR, 2.97), and failure to achieve complete remission (CR) after initial treatment (SHR, 3.76) conveyed significantly higher risk for HGT ( P < .02). International Prognostic Index (IPI), Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were only significant predictors of HGT univariably. Patients with HGT had shorter OS (5-year rate, 65% v 86%; P < .001). Patients who presented with HGT within 12 months since MZL diagnosis had shorter OS than those with HGT at MZL diagnosis combined with those with HGT more than 12 months later (4-year rate, 43% v 81%, P < .001). Non-CR and higher scores of IPI, Follicular Lymphoma IPI, and Mucosa-Associated Lymphoid Tissue Lymphoma IPI were the main significant predictors for shorter progression-free survival and OS. Conclusion Failure to achieve CR after initial treatment, elevated lactate dehydrogenase, and more than four nodal sites at the time of MZL diagnosis are the main predictors of increased risk of HGT. Patients with HGT have shorter OS.

Risk factors for recurrent epistaxis: Importance of initial treatment

2014 ◽  
Vol 41 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Yuji Ando ◽  
Jiro Iimura ◽  
Satoshi Arai ◽  
Chiaki Arai ◽  
Manabu Komori ◽  
...  
Keyword(s):  
Risk Factors ◽  
Initial Treatment ◽  
Recurrent Epistaxis

Initial Outpatient Treatment of Venous Thromboembolism with Fondaparinux (Arixtra®): The Matisse Trials.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 705-705 ◽  
Author(s):  
Harry R. Buller ◽  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Hospital Discharge ◽  
Outpatient Treatment ◽  
Initial Treatment ◽  
Safety Data ◽  
Outpatient Basis ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Recurrent Vte

Abstract Background: The MATISSE trials showed that a single dose regimen of fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the treatment of venous thromboembolism (VTE). In these trials, outpatient treatment of fondaparinux was encouraged but left at the investigator’s discretion. We analyzed the data in patients who received fondaparinux on an outpatient basis. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.5 mg (5.0 mg and 10.0 mg in patients <50 kg and >100 kg, respectively). In the MATISSE-DVT trial, fondaparinux was compared with twice-daily subcutaneous enoxaparin (1 mg/kg) in patients with deep-vein thrombosis (DVT). In the MATISSE-PE trial, it was compared with adjusted-dose intravenous unfractionated heparin (UFH) in patients with pulmonary embolism (PE). Outpatient treatment of DVT with enoxaparin was possible whereas outpatient treatment of PE with UFH was not feasible. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. The primary efficacy and safety outcomes were recurrent VTE during 3 months’ follow-up and major bleeding (MB) and death during the initial treatment period. Results: In MATISSE-DVT, 31.4% and 33.8% of the fondaparinux- and enoxaparin-treated patients, respectively, received therapy on an outpatient basis. In MATISSE-PE, 14.3% of the patients received fondaparinux on an outpatient basis, compared with none in the UFH group. In both MATISSE-DVT and -PE, efficacy and safety data from the patients who received fondaparinux on an outpatient basis were similar to those from the total population (Tables). The rates of recurrent VTE and MB in fondaparinux outpatients were similar to those in enoxaparin outpatients or UFH inpatients. Conclusion: Outpatient initial treatment of both DVT and PE with once-daily fondaparinux is feasible, effective and safe. MATISSE DVT Enoxaparin Fondaparinux All patients Outpatients All patients Outpatients *As treated patients n 1107 374 (33.8%) 1098 345 (31.4%) Age, yr (mean±SD) 61±17 60±16 61±17 58±17 Male/female 578/529 201/173 581/517 197/148 Hospital discharge, days (mean±SD) 7.0±6.2 1.8±1.9 7.6±7.7 1.6±1.7 ≥2 VTE risk factors, n (%) 283 (25.6) 122 (32.6) 293 (26.7) 97 (28.1) VTE, n (%) 45 (4.1) 16 (4.3) 43 (3.9) 7 (2.0) MB*, n (%) 13 (1.2) 3 (0.8) 12 (1.1) 5 (1.5) MATISSE-PE UFH Fondaparinux All patients Outpatients *As treated patients n 1110 1103 158 (14.3%) Age, yr (mean±SD) 62±17 63±16 57±16 Male/female 477/633 501/601 82/76 Hospital discharge, days (mean±SD) 10.2±6.8 9.7±7.7 4.4±2.2 ≥2 VTE risk factors, n (%) 260 (23.4) 241 (21.8) 35 (22.2) VTE, n (%) 56 (5.0) 42 (3.8) 5 (3.2) MB*, n (%) 12 (1.1) 14 (1.3) 0 (0)

scholarly journals Characteristics and Risk Factors of Recurrent Epistaxis in Geriatric Patients

2021 ◽  
Vol 64 (8) ◽  
pp. 548-553
Author(s):  
So Jeong Kim ◽  
So Jeong Lee ◽  
Yu Jin Go ◽  
Sohl Park ◽  
Jung Ho Bae
Keyword(s):  
Risk Factors ◽  
Initial Treatment ◽  
The Elderly ◽  
Treatment Method ◽  
Recurrent Epistaxis ◽  
Group A ◽  
Ed Visits ◽  
Group B ◽  
Care Costs ◽  
Precise Area

Background and Objectives Recurrent epistaxis requiring emergency department (ED) visits results in increased morbidity in the elderly and associated with high health care costs. This study is to analyze the frequency and characteristics of epistaxis patients in the elderly and to find out the risk factors and effective treatment for recurrent epistaxis. Subjects and Method We studied retrospectively the clinical cases of 977 emergency patients and 155 patients, aged over 65, for the treatment of epistaxis during the last 10 years from January 2008 to January 2018. The group A, comprised of 95 patients (68.29%), was treated with an initial treatment. The group B, which comprised of 60 patients (38.71%), visited for re-bleeding following an initial treatment. Results Patients made 2 to 10 ED visits due to re-bleeding and 32 of the 60 patients (53.5%) visited twice. The electrocauterization was the most common (61.7%) for treatment method during rebleeding, followed by posterior packing (18.3%). The factors that increases the risk of recurrent epistaxis are anticoagulants, posterior epistaxis, anterior packing, inefficient ED packing. There was no correlation between comorbidities and rebleeding. Conclusion Accurate medical history taking of anticoagulants may enable personnel to provide more effective management of these patients. The most important factors in the failure of primary care were not being able to find the precise area of bleeding and ineffective packing during the initial treatment. Therefore, it is important that we must carefully check the areas using the endoscope to decrease the failure of initial treatment of epistaxis.

Impact of Treatment on Cessation of Air Leakage and Recurrence of Spontaneous Pneumothorax: A Case Control Study

2021 ◽  
Author(s):  
Takahito Nakano ◽  
Hiroyuki Kaneda ◽  
Kento Fukumoto ◽  
Hiroshi Matsui ◽  
Yohei Taniguchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Initial Treatment ◽  
Spontaneous Pneumothorax ◽  
Significant Risk ◽  
Lung Collapse ◽  
Air Leak ◽  
Initial Management ◽  
High Degree ◽  
Persistent Air Leak

Abstract Background: Conservative observation with/without oxygen supplementation, aspiration, or tube drainage is selected as an initial treatment for spontaneous pneumothorax. In this study, we have examined the efficacy of initial management for cessation of air leak and prevention of recurrence separately, with consideration of the degree of lung collapse.Methods: Spontaneous pneumothorax in patients who underwent initial management in our institute between January 2006 and December 2015 were included in this retrospective, single-institutional study. Multivariate analyses were conducted to identify risk factors related to the persistent air leak after initial treatment and those related to ipsilateral recurrence after last treatment.Results: In the multivariate analysis for predicting persistent air leak after first treatment, repeated episode of ipsilateral pneumothorax (p = 0.0022), high degree of lung collapse (p = 0.032), and bulla formation (p < 0.0001) were the statistically significant risk factors for treatment failure. Recurrence of ipsilateral pneumothorax was observed in 126 cases. In the multivariate analysis for predicting the recurrence, repeated episode of ipsilateral pneumothorax was the significant risk factor (p = 0.0032).Conclusions: Predicting factors for persistent air leak after initial treatment were recurrence of ipsilateral pneumothorax, high degree of lung collapse, and radiological evidence of bullae. The predictive factor for recurrence after the last treatment was recurrence of ipsilateral pneumothorax. Selection of either observational or interventional approach at initial management did not affect the outcomes evaluated. Therefore, because of treatment invasiveness, observation is recommended to be attempted first in cases sans risk factors.Trial Registration: retrospectively registeredDate of IRB approval: May 28, 2018Number of IRB approval: 2017320

scholarly journals National Analysis of Risk Factors for Nasal Fractures and Associated Injuries in Trauma

2019 ◽  
Vol 12 (3) ◽  
pp. 221-227
Author(s):  
Tiffany T. Pham ◽  
Ellen Lester ◽  
Areg Grigorian ◽  
Rachel E. Roditi ◽  
Jeffry T. Nahmias
Keyword(s):  
Risk Factors ◽  
National Database ◽  
Common Mechanism ◽  
Orbital Fracture ◽  
Associated Injuries ◽  
Open Wound ◽  
Nasal Fracture ◽  
National Analysis ◽  
Nasal Fractures ◽  
Maxillary Fracture

Nasal fractures account for up to 58% of facial fractures. However, the literature characterizing associated injuries and risk factors for nasal fractures is sparse and is mostly composed of single-center experiences. This study sought to provide a large descriptive analysis and identify associated injuries and risk factors for nasal fractures in trauma using a national database. A retrospective analysis of the National Trauma Data Bank (NTDB) from 2007 to 2015 was performed. Patients ≥18 years of age with nasal fractures were included. A multivariable logistic regression model was used to identify predictors for nasal fracture in trauma. Of 5,494,609 trauma patients in the NTDB, 255,533 (4.6%) had a nasal fracture. Most were male (74.8%) with a mean age of 45.6 years. Blunt trauma accounted for 90.5% of fractures, with motor vehicle accident being the most common mechanism (27.5%). Closed fractures occurred in 93.0% of patients. Concomitant injuries included traumatic brain injury (TBI; 56.9%), malar/maxillary fracture (27.9%), and open wound of the face (38.6%) and nose (9.5%). Of all patients, 10.1% underwent closed or open reductions at index hospitalization. The strongest associated injuries with nasal fracture included open wound of the nose (odds ratio [OR]: 8.71, 95% confidence interval [CI]: 8.49–8.94, p < 0.001), epistaxis (OR: 5.26, 95% CI: 4.59–6.02, p < 0.001), malar/maxillary fracture (OR: 4.38, 95% CI: 4.30–4.45, p < 0.001), and orbital fracture (OR: 3.99, 95% CI: 3.91–4.06, p < 0.001). Nasal fractures are common traumatic injuries with more than 90% occurring by blunt mechanism and over half suffering from a concomitant TBI. The strongest associated injury with nasal fracture is an open wound of the nose.

scholarly journals Risk factors for lower limb lymphedema in gynecologic cancer patients after initial treatment

2020 ◽  
Vol 25 (5) ◽  
pp. 963-971 ◽  
Author(s):  
Teruyo Kunitake ◽  
Tatsuyuki Kakuma ◽  
Kimio Ushijima
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Lower Limb ◽  
Initial Treatment ◽  
Gynecologic Cancer ◽  
Significant Risk ◽  
Structural Models ◽  
University Hospital ◽  
Time Model ◽  
Gynecology And Obstetrics

Abstract Background Most studies on lower limb lymphedema have been conducted in gynecologic cancer patients who underwent surgery for gynecologic malignancy. This study aimed to evaluate the risk factors for lower limb lymphedema development in gynecologic cancer patients who underwent initial treatment. Methods A retrospective cohort design was used to follow 903 gynecologic cancer patients who underwent treatment at Kurume University Hospital between January 1, 2013 and December 31, 2015. Data analyses were performed in 356 patients, and the patients were followed up until December 31, 2017. The model comprised two components to facilitate statistical model construction. Specifically, a discrete survival time model was constructed, and a complementary log–log link model was fitted to estimate the hazard ratio. Associations between risk factors were estimated using generalized structural models. Results The median follow-up period was 1083 (range 3–1819) days, and 54 patients (15.2%) developed lower limb lymphedema, with a median onset period of 240 (range 3–1415) days. Furthermore, 38.9% of these 54 patients developed lower limb lymphedema within 6 months and 85.2% within 2 years. International Federation of Gynecology and Obstetrics stage, radiotherapy, and number of lymph node dissections (≥ 28) were significant risk factors. Conclusion Simultaneous examination of the relationship between lower limb lymphedema and risk factors, and analysis among the risk factors using generalized structural models, enabled us to construct a clinical model of lower limb lymphedema for use in clinical settings to alleviate this condition and improve quality of life.

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