Follow-up of gallbladder polyps in a high-risk population of gallbladder cancer: A cohort study and multivariate survival competing risk analysis

HPB ◽  
2021 ◽  
Author(s):  
Roberto Candia ◽  
Macarena Viñuela ◽  
Javier Chahuan ◽  
Luis Antonio Diaz ◽  
Vicente Gándara ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Risk Analysis ◽  
Gallbladder Cancer ◽  
High Risk Population ◽  
Competing Risk Analysis ◽  
Risk Population ◽  
Gallbladder Polyps ◽  
Multivariate Survival

Dementia screening in elderly high-risk patients following heart failure decompensation may predict unfavorable long-term clinical outcomes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Stepien ◽  
P Furczynska ◽  
M Zalewska ◽  
K Nowak ◽  
A Wlodarczyk ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Clinical Outcomes ◽  
Mmse Score ◽  
Coronary Revascularization ◽  
High Risk Population ◽  
Risk Population ◽  
History Of

Abstract Background Recently heart failure (HF) has been found to be a new dementia risk factor, nevertheless their relations in patients following HF decompensation remain unknown. Purpose We sought to investigate whether a screening diagnosis for dementia (SDD) in this high-risk population may predict unfavorable long-term clinical outcomes. Methods 142 patients following HF decompensation requiring hospitalization were enrolled. Within a median time of 55 months all patients were screened for dementia with ALFI-MMSE scale whereas their compliance was assessed with the Morisky Medication Adherence Scale. Any incidents of myocardial infarction, coronary revascularization, stroke or transient ischemic attack (TIA), revascularization, HF hospitalization and bleedings during follow-up were collected. Results SDD was established in 37 patients (26%) based on the result of an ALFI-MMSE score of <17 points. By multivariate analysis the lower results of the ALFI-MMSE score were associated with a history of stroke/TIA (β=−0.29, P<0.001), peripheral arterial disease (PAD) (β=−0.20, P=0.011) and lower glomerular filtration rate (β=0.24, P=0.009). During the follow-up, patients with SDD were more often rehospitalized following HF decompensation (48.7% vs 28.6%, P=0.014) than patients without SDD, despite a similar level of compliance (P=0.25). Irrespective of stroke/TIA history, SDD independently increased the risk of rehospitalization due to HF decompensation (HR 2.22, 95% CI 1.23–4.01, P=0.007). Conclusions As shown for the first time in literature patients following decompensated HF, a history of stroke/TIA, PAD and impaired renal function independently influenced SDD. In this high-risk population, SDD was not associated with patients' compliance but irrespective of the stroke/TIA history it increased the risk of recurrent HF hospitalization. The survival free of rehospitalization Funding Acknowledgement Type of funding source: None

scholarly journals Tibiotalocalcaneal Fusion Rate with a Novel Pseudoelastic Intramedullary Nail with NiTiNOL

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0004
Author(s):  
Travis Dekker ◽  
John Steele ◽  
Beau Kildow ◽  
James DeOrio ◽  
Mark Easley ◽  
...  
Keyword(s):  
High Risk ◽  
Bone Resorption ◽  
Intramedullary Nail ◽  
Fusion Rate ◽  
High Risk Population ◽  
Risk Population ◽  
Non Union ◽  
Significant Difference ◽  
History Of

Category: Ankle Arthritis Introduction/Purpose: Tibiotalocalcaneal (TTC) fusion is a salvage operation for patients with significant arthritis and deformity of ankle and subtalar joints. Despite overall clinic success, fusion across both joints continues to be a major challenge with nonunion rates reported up to 48% [Franceschi]. Aside from certain patient comorbidities, nonunion may result when compression across the joint is lost in the setting of bone resorption. The use of a pseudoelastic intramedullary nail has been shown to maintain compression across fusion site in response to bone resorption. The purpose of this study was to evaluate the fusion rate in a high-risk population at a tertiary care center using a psuedoelastic intramedullary nail with an internal nitinol element. Methods: After obtaining IRB approval, a retrospective review of consecutive patients that underwent procedures with TTC fusion with novel intramedullary nail system with super elastic internal nickel titanium (NiTiNOL, DynaNail, Medshape Inc, Atlanta, GA) was performed at a single academic institution. From 2014 to 2016, 58 patients were identified, 55 of which had minimum one year follow up or clinical and radiographic fusion (20 months average, range 6-41 months). The primary outcome was radiographic fusion analysis which was reviewed by three authors. Fusion was determined by consensus with criteria of 3 of 4 cortices with osseous bridging in asymptomatic patients[1, 2] or CT fusion based on Glazebrook et. al. criteria for hindfoot fusion[3, 4]. Average age of this cohort was 59 (SD= 16.3) years with BMI average 33.1 (SD= 8.87). Exclusion criteria include: follow-up less than 12 months in non-fused patients, and incomplete clinical or radiologic data. Results: The fusion rate in this high-risk population was 80.0% with the use of the NiTiNOL tibiotalocalcaneal nailing system. Univariate analysis demonstrated no significant difference (p>0.05) in fusion rates with patient comorbidities that portend to non-union: current or former history of tobacco use, diabetes mellitus, rheumatoid arthritis, nor patients with chronic kidney disease. The average BMI in the fusion group was 31.97 compared to 27.4 in the non-union group (p=0.016). There were 5 deep infections requiring reoperation with a single patient requiring a below the knee amputation. Seven patients required a second operation for removal of prominent interlocking screws. Conclusion: This preliminary data demonstrates fusion rates with this novel intramedullary device are consistent with historical data. These findings are encouraging in that this nailing system shows equal rates of fusion in patients with high risk comorbidities for non-union compared to historical controls demonstrating increased non-union rates in diabetics, patients with chronic renal failure and those with a history of smoking. This Tibiotalocalcaneal nailing system is safe and offers theoretical sustained compression with up to 6 mm of resorption or settling.

Follow-Up for Abnormal Papanicolaou Smears in a High-Risk Population

1999 ◽  
Vol 3 (1) ◽  
pp. 41
Author(s):  
L Engelstad ◽  
K Bedian ◽  
S. Stewart ◽  
M Rubin ◽  
J Koo ◽  
...  
Keyword(s):  
High Risk ◽  
High Risk Population ◽  
Risk Population ◽  
Papanicolaou Smears

scholarly journals 27 Determinants of referral to developmental resources among neonatal follow-up patients discharged from tertiary neonatal unit from 2005 UNTIL 2014

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e10-e10
Author(s):  
Maad Saleem ◽  
Lamia Hayawi ◽  
Nick Barrowman ◽  
Nadya BenFadel ◽  
Jana Feberova ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
High Risk ◽  
Premature Infants ◽  
Gestational Age ◽  
High Risk Population ◽  
Risk Population ◽  
Neurodevelopmental Impairment ◽  
Developmental Support

Abstract Background Lower gestational age or birth weight and higher rate of neurodevelopmental impairment have been commonly linked to higher need for developmental resources in premature infants. Existing evidence on need for developmental support in premature infants is limited in description of the needs, timing and method of assessment. Objectives To identify predictors for the needs for developmental resources among high-risk groups of infants born less than 29 weeks or with a birth weight (BW) less than 1250 grams. Secondarily, to compare the need of referrals to developmental resources and the rate of neurodevelopmental impairment defined as cerebral palsy, global developmental delay, blindness and deafness for this high risk population. Design/Methods We conducted a retrospective chart review of premature infants < 29+0 weeks GA or BW < 1250 grams born between January 2005 and December 31st 2014, who had at least one visit at the neonatal follow up clinic. Univariate and multivariate logistic regression analyses were conducted to examine potential predictors for referral to developmental resources. Results The study included 687 infants. Within this high risk population, 579 (85.0%) of infants were referred, of these 153 (26.4%) had one referral, 132 (22.8%) had 2 and 294 (50.8%) had 3 or more referral/s to developmental resources. Most frequent referrals were for speech therapy (339, 50.0%) physiotherapy (319, 46.8%) occupational therapy (262, 38.3%) and infant development program (232, 34.1%). The rates of referral to developmental resources decrease with increasing gestational age. Multivariate logistic regressions showed that gestational age (OR: 1.19, 95% CI: 1.05 - 1.35), birth weight (OR: 0.87, 95% CI: 0.77 - 0.99), female gender (OR: 0.70, 95% CI: 0.49 - 0.99), intraventricular hemorrhage grades III-IV (OR: 3.02, 95% CI: 1.28 - 7.16), and days on mechanical ventilator (OR:1.03, 95% CI: 1.01 - 1.05) were predictors for 2 or more referrals to developmental resources. Cerebral palsy was present in 4.4 % of the study population, deafness in 4% and blindness in 0.6%. The rate of referral to developmental resources was 54 (98.2%) among infants with neurodevelopmental impairment (NDI) compared to 522 (83.9%) in infants without NDI (p value= 0.01). Conclusion There is substantial need for developmental support among high-risk premature infants. Infants without neurodevelopmental impairments still need significant developmental resources to achieve their outcome.

scholarly journals A cohort study on the relationship between education level and high‐risk population of stroke

Ibrain ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 181-191
Author(s):  
Yan‐Yan Yu ◽  
Dan Lei ◽  
Qiong He ◽  
Wei Chen
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Education Level ◽  
High Risk Population ◽  
Risk Population ◽  
The Relationship

scholarly journals Association Between Digoxin Use and Cancer Incidence: A Propensity Score-Matched Cohort Study With Competing Risk Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chi-Jung Tai ◽  
Yi-Hsin Yang ◽  
Tzyy-Guey Tseng ◽  
Fang-Rong Chang ◽  
Hui-Chun Wang
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Risk Analysis ◽  
Cancer Prevention ◽  
Cancer Incidence ◽  
Competing Risk ◽  
Research Database ◽  
Competing Risk Analysis ◽  
Β Blocker

Background: Previous studies neglected death as a critical competing risk while estimating the cancer risk for digoxin users. Therefore, the current study aims to assess the effectiveness of digoxin on cancer prevention by competing risk analysis.Methods: We performed a population-based retrospective cohort study using the Taiwan National Health Insurance Research database between 1998 and 2010. After one-to-one propensity score-matching from 36,160 patients with defined criteria, we enrolled 758 patients both in digoxin and β-blocker group for further analysis.Results: The results showed that the digoxin group had higher all-cause mortality than the β-blocker group in the 4- year (10.4 vs. 4.9%) and 8 years (13.6 vs. 7.0%) follow-up. The subdistribution HR of cancer incidence in the digoxin group compared to the β-blocker group was 1.99 (95% confidence interval [CI]: 1.22–3.01) and 1.46 (95% CI: 1.01–2.15) in the 4 years and 8 years follow-up, respectively.Conclusions: The result of our study showed the usage of digoxin has no benefit in cancer prevention compared with β-blocker. The possibility of β-blocker as a new drug candidate for cancer prevention needs further clinical evaluation. The current study also emphasized the necessity of competing risk analysis applying to similar clinical researches.

Sign in / Sign up

Export Citation Format

Share Document