scholarly journals Genetic risk factors for knee OA display good predictive power in a high risk group of overweight and obese females

2013 ◽  
Vol 21 ◽  
pp. S27
Author(s):  
J.B. van Meurs ◽  
J. Runhaar ◽  
M. Verbiest ◽  
S. Bierma-Zeinstra
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Genetic Risk ◽  
Predictive Power ◽  
Risk Group ◽  
Genetic Risk Factors ◽  
High Risk Group ◽  
Knee Oa

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals A model for predicting carotid instability plaque in high risk group of stroke individuals

2019 ◽  
Author(s):  
Junxiong Yin ◽  
Chuanyong Yu ◽  
Hongxing Liu ◽  
Mingyang Du ◽  
Feng Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Predictive Model ◽  
Doppler Ultrasound ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
High Risk Population ◽  
Auc Value ◽  
Validation Set

Abstract Objective: To establish a predictive model of carotid vulnerable plaque through systematic screening of high-risk population for stroke.Patients and methods: All community residents who participated in the screening of stroke high-risk population by the China National Stroke Screening and Prevention Project (CNSSPP). A total of 19 risk factors were analyzed. Individuals were randomly divided into Derivation Set group and Validation Set group. According to carotid ultrasonography, the derivation set group patients were divided into instability plaque group and non-instability plaque group. Univariate and multivariable logistic regression were taken for risk factors. A predictive model scoring system were established by the coefficient. The AUC value of both derivation and validation set group were used to verify the effectiveness of the model.Results: A total of 2841 high-risk stroke patients were enrolled in this study, 266 (9.4%) patients were found instability plaque. According to the results of Doppler ultrasound, Derivation Set group were divided into instability plaque group (174 cases) and non-instability plaque group (1720 cases). The independent risk factors for carotid instability plaque were: male (OR 1.966, 95%CI 1.406-2.749)，older age (50-59, OR 6.012, 95%CI 1.410-25.629; 60-69, OR 13.915, 95%CI 3.381-57.267;≥70, OR 31.267, 95%CI 7.472-130.83) , married(OR 1.780, 95%CI 1.186-2.672)，LDL-c(OR 2.015, 95%CI 1.443-2.814), and HDL-C(OR 2.130, 95%CI 1.360-3.338). A predictive scoring system was created, range 0-10. The cut-off value of prediction model score is 6.5. The AUC value of derivation and validation set group were 0.738 and 0.737.Conclusion：For a high risk group of stroke individual, We provide a model that could distinguishing those who have a high probability of having carotid instability plaque. When resident’s predictive model score exceeds 6.5, the incidence of carotid instability plaque is high, carotid artery Doppler ultrasound would be checked immediately. This model can be helpful in the primary prevention of stroke.

scholarly journals Comparative Analysis of Atherosclerosis Risk Factors in the Staff of the Tbilisi (Georgia) Cleaning Service

2020 ◽  
Vol 2 (1) ◽  
pp. 1-10
Author(s):  
Murman Kantaria ◽  
Murman Kantaria ◽  
Pavle Machavariani ◽  
Giorgi Ormotsadze ◽  
Giorgi Ormotsadze ◽  
...  
Keyword(s):  
Risk Factors ◽  
Comparative Analysis ◽  
High Risk ◽  
Risk Group ◽  
Diagnostic Value ◽  
Redox Status ◽  
Pathological Process ◽  
High Risk Group ◽  
Average Value ◽  
Group I

Objective Search of pathogenetic mechanisms and risk factors of atherosclerosis in the employees of the cleaning service in Tbilisi. Materials and Methods As a result of a preliminary survey and examination of 200 employes of Tbilisi cleaning service aged 25-45 years (2014-2016), 22 patients with angina, hypercholesterolemia, intimae-media thickness > 0.65 mm, were selected into I group, and 23 individuals without these disorders into II group. In the blood plasma of the selected patients the intensity of oxidative metabolism parameters, TAA and MDA were determined. The variance and correlation analysis (АNOVA) was used for conducting the comparative analysis of the levels of studied parameters. Results In the combined group (I+II) there are several reliable correlations between the Age -TCol, Age-MDA, BMI-Tg, BMI-MDA, LDLChol-HDLChol, LDLChol–TChol, HDLChol-TChol, LDLChol-MDA, LDLChol-TAA. no correlation between these parameters in individual groups (I and II) was found. That indicates that we have an imaginary correlation related to the large intergroup difference between the average values of the group indicators, that is the values of various indicators change during the development of the pathological process, but there is no causal relationship between these alterations. The reliable TAA-MDA correlation in the combined group (I+II) is related to the high anticorrelation between these parameters and the significantly higher average value of TAA in the low-risk group (II) in comparison to the high-risk group (I). Conclusion The results analysis indicates both the diagnostic value of redox status indicators and their leading role in the atherogenesis processes. In populations with a high risk of atherosclerosis, monitoring of serum TAA is recommended.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea

2017 ◽  
Vol 58 (1) ◽  
pp. 16-24
Author(s):  
Insook Kim ◽  
Seonae Won ◽  
Mijin Lee ◽  
Won Lee
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Environmental Factors ◽  
Fall Prevention ◽  
Systems Approach ◽  
Risk Group ◽  
Past History ◽  
High Risk Group ◽  
Fall Injuries

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

Stem Cell Transplantation in Elderly Patients with Acute Lymphoblastic Leukemia (ALL) in First Complete Remission (CR1).

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1966-1966
Author(s):  
Renate Arnold ◽  
Dietrich Beelen ◽  
Martin Bornhaeuser ◽  
Donald Bunjes ◽  
Juergen Finke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
High Risk ◽  
Elderly Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Unrelated Donor ◽  
Matched Unrelated Donor ◽  
Conditioning Regimens ◽  
Very High

Abstract In the German Multicenter ALL studies (GMALL) patients aged >55 years with high risk (B-lineage ALL with WBC at diagnosis >30000, late CR, t (4; 11), complex aberrant karyotype or prae-T or mature T-ALL) or very high risk (Ph+/BCR-ABL+) ALL are increasingly candidates for allogeneic stem cell transplantation (allogeneic SCT with a HLA identical sibling donor, MRD or a matched unrelated donor, MUD) or autologous SCT. Here, we report on 31 elderly patients transplanted within the GMALL studies 06/99 and 07/03. Median age of the patients was 61 years (56–65). 22 patients belonged to the very high risk group (VHR), 8 patients to the high risk group (HR) and 1 patient from the standard risk group (SR) was transplanted because of detection of minimal residual disease.17/31 patients were transplanted from a matched unrelated donor, 9/31 patients from a HLA identical sibling donor and 5/31 patients underwent autologous SCT. Conditioning regimens for MRD SCT were myeloablative (MAC) in 6 patients (TBI 12 Gy and chemotherapy n=2, radioimmunotherapy + chemotherapy n=2, chemotherapy only n=2) and 3 patients received reduced intensity conditioning (RIC).Conditioning regimens for MUD SCT changed over time with an increasing number of RIC in the study 07/03. In total, 7/17 patients received MAC (TBI 12 Gy and chemotherapy n=5, chemotherapy only n=2) and 10/17 patients received RIC. Conditioning regimens in autologous SCT were myeloablative (MAC) in 5/5 patients. Results: After allogeneic MRD SCT 4/9 patients (44%) are alive in CCR (d+ 24, d+ 611, d+ 1721, d+ 2321), 3/9 patients died due to leukemia, 2/9 due to transplant related mortality (TRM). After allogeneic MUD SCT 8/17 patients (46%) are alive in CCR (from d+ 165 to d+ 2176). 1 further patient is alive after re- SCT for treatment of relapse. 7/17 patients died due to TRM and 1 patient died due to relapse. After autologous SCT 2/5 patients are alive in CCR (d+ 1703, d+ 1731), 3/5 died due to relapse. Risk factors for TRM: In allo SCT and MAC 8/13 patients died due to TRM in contrast to 1/13 patients with RIC. In auto SCT none of the patients died due to TRM. Risk factors for relapse: In allogeneic MRD SCT 3/9 patients died due to relapse and 2/17 patients relapsed after MUD SCT. Due to the small number of patients, no difference between MAC and RIC could be found. In autologous SCT 3/5 patients died due to relapse. In conclusion: The study shows that allo MRD but also MUD SCT is very effective in a selected population of elderly ALL patients. Since the survival of elderly patients with chemotherapy only is about 25%, more patients should be encouraged to have a MRD or MUD SCT.

Chemotherapy-associated thrombosis in cancer outpatients: Risk factors and decision making of a prophylactic approach.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20647-e20647
Author(s):  
Martina Torchio ◽  
Benvenuto Franceschetti ◽  
Carla Cavali ◽  
Sonia Zanirato ◽  
Angelo Olgiati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
High Risk ◽  
Scoring System ◽  
Risk Group ◽  
Venous Catheter ◽  
Risk Groups ◽  
High Risk Group ◽  
Factors Analysis ◽  
Negative Predictor

e20647 Background: Venous thromboembolism (VTE), is a negative predictor of survival in pts with advanced cancer. International guidelines don’t recommend routine prophlaxis but suggest to consider pts, undergoing chemotherapy (CT), with high risk of VTE. Many clinical risk factors for cancer-associated VTE have been evaluated in a 5 parameter-based (body mass index, platelet and leucocyte counts, hemoglobin value and tumor site) scoring system, the Khorana score, utilized to indicate a prophylactic approach. We prospectively applied this score in cancer outpts beginning CT and an implementation based on 6 addictional factors analysis (sex, age, central venous catheter, CT-agents, antiangiogenetic drugs, erithropoiesis stimulating agent) to evaluate their impact in pts assignment into risk groups. Methods: We studied adult pts, followed at our Department from August 2011 to December 2012, with advanced cancers (breast, NSCLC, colorectal, pancreatic/gastric, urogenital, LNH, Hodgkin's disease, HD, and MM), receiving a first or second line standard CT. We stratified pts into three risk groups (score 0= low; score 1-2=intermediate; score 3-4-5=high) considering both the Khorana scoring system and its implementation. Results: We analyzed 169 pts (103F/66M, median age 62.3, range 35-80 yrs), pt population included: 38 breast, 32 colorectal, 31 LNH, HD and MM, 27 urogenital, 22 NSCLC and 19 pancreatic/gastric. With the Khorana score 49 pts were assigned to the low risk, 87 pts to the intermediate risk (57 with score=1, 28 with score=2), 16 pts (9.4%) to the high risk group (9 with score=3, 4 with score=4, 3 with score=5). When we considered 11 parameters 37 pts (21.8%) were assigned to the high risk group. Conclusions: A more comprehensive quantification of VTE risk, also considering new independent factors, is mandatory for a correct decision making of an antithrombotic-prophylactic approach.

Oncologic Outcomes After Adjuvant Radiotherapy for Stage II Endometrial Carcinoma: A Korean Radiation Oncology Group Study (KROG 14–10)

2017 ◽  
Vol 27 (7) ◽  
pp. 1387-1392 ◽  
Author(s):  
Jinhong Jung ◽  
Young Seok Kim ◽  
Ji Hyeon Joo ◽  
Won Park ◽  
Jong-Hoon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Radiation Oncology ◽  
Adjuvant Radiotherapy ◽  
Lymphovascular Invasion ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Median Dose ◽  
Radiation Oncology Group

ObjectiveThe aim of this study was to investigate the survival, patterns of failure, and prognostic factors in patients with stage II endometrial carcinoma treated with adjuvant radiotherapy.MethodsWe reviewed the medical records of patients who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection followed by adjuvant radiotherapy in 10 participating hospitals of the Korean Radiation Oncology Group. Most patients received adjuvant external beam radiation therapy, with a median dose of 50.4 Gy; approximately 50% of these patients received an additional brachytherapy boost, with a median dose of 18 Gy. Adjuvant chemotherapy was administered to 19 patients.ResultsA total of 122 patients were examined. Over a median follow-up period of 62.7 months (range, 1.9–158.8 months), the 5-year overall survival (OS) and disease-free survival rates were found to be 91.1% and 85.1%, respectively. Recurrence was observed in 14 patients (11.5%), including 3 with local recurrence and 11 with distant metastases as the first site of recurrence. Univariate analysis indicated that lymphovascular invasion was related to an unfavorable OS. An age of 60 years or above, histologic grade 3, and lymphovascular invasion were identified as risk factors for OS. Because there were several risk factors related to OS, we assigned patients to a high-risk group (defined as cases with ≥1 risk factors) and a low-risk group. The 5-year OS rate of the high-risk group was significantly inferior to that of the low-risk group (82.9% vs 100%, P = 0.003).ConclusionsThe high-risk group had a significantly poorer survival rate than the low-risk group, and distant metastasis was the main pattern of recurrence, thus indicating that further adjuvant chemotherapy should be considered in high-risk patients.

The Prognosis and Risk Stratification Based on Pelvic Lymph Node Characteristics in Patients With Locally Advanced Cervical Squamous Cell Carcinoma Treated With Concurrent Chemoradiotherapy

2016 ◽  
Vol 26 (8) ◽  
pp. 1472-1479 ◽  
Author(s):  
Xin Li ◽  
Li-Chun Wei ◽  
Ying Zhang ◽  
Li-Na Zhao ◽  
Wei-Wei Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
High Risk ◽  
Risk Stratification ◽  
Concurrent Chemoradiotherapy ◽  
Risk Group ◽  
Locally Advanced ◽  
Figo Stage ◽  
Cervical Squamous Cell Carcinoma ◽  
High Risk Group

BackgroundThe purpose of this study is to determine the prognostic significance of pelvic lymph node (PLN) characteristics and perform risk stratification in patients undergoing concurrent chemoradiotherapy for locally advanced cervical squamous cell carcinoma.MethodsWe retrospectively reviewed the records of 609 patients with Federation Internationale de Gynecologie et d’Obstetrique (FIGO) stage II to IVa who underwent concurrent chemoradiotherapy, compared overall survival (OS), distant metastasis-free survival (DMFS), and pelvic recurrence-free survival between patients with or without PLN involvement. We further analyzed prognostic factors for OS and DMFS including FIGO stage, tumor volume, and lymph node (LN) characteristics in 300 patients with PLN involvement.ResultsThe 3-year OS rate was 81.7% versus 92.8% (P = 0.002) and the 3-year DMFS rate was 79.3% versus 92.7% (P = 0.006) in patients with or without PLN involvement, respectively. With univariable analysis, FIGO stage, LN-volume, LN-number, LN-diameter, and matted/necrotic LN affected both OS and DMFS. Based on multivariable analysis, we created a risk stratification model. For OS, the independent risk factors were FIGO stage III or IVa, LN-volume of 3 cm3 or more, LN-diameter of 1.5 cm or more, and matted/necrotic LN. The low-risk group (no risk factors), mid-risk group (1 or 2 risk factors), and high-risk group (3 or 4 risk factors) had a 3-year OS of 96.6%, 84.9%, and 64.7%, respectively (P = 0.005). For DMFS, LN-diameter of 1.5 cm or more, LN-number of 3 or more, and matted/necrotic LN were the independent risk factors. The subgroups for DMFS were the low-risk group (no risk factors), the mid-risk group (1 risk factor), and the high-risk group (2 or 3 risk factors), and the 3-year DMFS was 92.4%, 76.2%, and 64.6%, respectively (P = 0.001).ConclusionsThe prognosis was significantly poorer for patients with high-risk lymph node characteristics. Using this risk stratification, we should select the most appropriate and individualized treatment modality to improve outcomes in those patients with a poorer prognosis.

scholarly journals A genetic risk score predicts recurrent events after myocardial infarction in young patients with a low level of traditional risk factors

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Mendonca ◽  
M I Mendonca ◽  
M Temtem ◽  
M Santos ◽  
J A Sousa ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Genetic Risk ◽  
Risk Group ◽  
Low Risk ◽  
Low Level ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Traditional Risk Factors

Abstract Introduction Coronary Heart Disease (CAD) is a multifactorial disease, including environmental and genetic risk factors. Current smoking, dyslipidemia and diabetes have a significant impact in long- term mortality and morbidity. However, several genetic variants associated with CAD but not with traditional risk factors (TRFs) has been reported to improve prediction of events and extended mortality, in younger CAD people. Aim To evaluate the clinical utility of a GRS composed by variants from GWAS associated to CAD but not with TRF to predict life-long residual risk in patients under 55 years old and a low level of TRFs. Methods We conducted a prospective study with 573 consecutive patients aged <55 years presenting with AMI and a low level of TRFs (without diabetes and with LDL cholesterol >150 mg/ml). We analysed several biochemical markers and performed a GRS with variants not associated with TRFs (TCF21 rs12190287, CDKN2B-AS1 rs1333049, CDKN2B rs4977574, PHACTR1 rs1332844, MIA3 rs17465637, ADAMTS7 rs3825807, ZC3HC1 rs11556924, SMAD3 rs17228212 and GJA4 rs618675). We studied the GRS association with a primary composite endpoint of all-cause vascular morbidity and mortality including recurrent acute coronary syndrome (myocardial infarct and unstable angina), coronary revascularization (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), re-hospitalization for heart failure, ischemic stroke and cardiovascular dead. Results A total of 573 patients were studied and followed up for a mean of 4.7±4.0 years. There were 169 recurrent cardiovascular events. The GRS was sub-divided into terciles, verifying that patients in the third tercile (high risk) had a higher number of risk alleles. Compared with the low-risk GRS tercile, the multivariate-adjusted HR for recurrences was 1.520 (95% CI 1.011–2.286); p=0.044 for the intermediate-risk group and was 2.051 (95% CI 1.382–3.044); p<0.0001 for the high-risk group. Inclusion of the GRS in the model with TRFs alone (low risk) improved the C-statistic analysis (C-statistic = 0.030; p=0.004), cNRI (continuous net reclassification improvement) (30.8%), and the IDI (integrated discrimination improvement index) (0.022). Conclusions A multilocus GRS may identify young coronary disease patients with a low level of TRFs but at significant risk of long-term events recurrence. The genetic information may improve prediction discrimination, and reclassification over the conventional risk factors alone, providing better cost-effective therapeutic strategies. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

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