Diagnosis and endoscopic management of fallopian tube torsion: Prior history of tubal sterilization and pelvic inflammatory disease (PID) as independent risk factors

297 Background: We aim to evaluate in our institution the incidence of de novo malignancies following orthotopic liver transplantation (OLT) and their impact the prognosis of patients (pts). Methods: Pts treated with OLT from August 1991 To March 2009 were considered in this analysis. All pts data had been prospectively recorded in the database of French “Bio-medecine Agence”. Pts were considered for this analysis only if they survived at least 3-months after. Occurrence of de novo malignancies we analyzed and additional data (including immunosuppressive profile, type of cancer, potential independent risk factors of cancers, prognosis and the influence of immunosuppression protocols or risk factors on occurrence of cancers) were collected in patients who developed secondary cancers. Results: A total of 833 patients who underwent OLT were considered for this analysis. With a median follow-up of 7.9 years, 72 pts developed 92 de novo malignancies. The overall incidence of cancers in our population was 10.4% occurring with a median time of 6.1 years following OLT. Sixteen pts developed 2 different types of cancer and 2 pts had more than 3 tumor types. Before 12/1998, immunosuppression was primarily based on cyclosporine, steroids and/or azathiopirine, and since 01/1999 was switched to tacrolimus. Incidence of cancers regarding these two periods is summarized in the table. Before 1998, only 3 pts (17.6%) with secondary cancer had prior history of alcoholism and/or smoking compared to 27 pts (50%) after 1999. Thirty one deaths were observed and the median overall survival (OS) after the time of diagnosis of secondary malignancy was 5.62 years. Conclusions: The risk of de novo cancer after OLT is similar to reported series. History of smoking and alcohol use, increase the incidence of de novo malignancies especially head and neck and lung cancers however, immunosuppression type may not interfere with this risk. [Table: see text]

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Blastomycosis in Missouri: epidemiology and risk factors for endemic disease

Epidemiology and Infection ◽

10.1017/s0950268803008987 ◽

2003 ◽

Vol 131 (2) ◽

pp. 907-914 ◽

Cited By ~ 44

Author(s):

M. V. CANO ◽

G. F. PONCE-DE-LEON ◽

S. TIPPEN ◽

M. D. LINDSLEY ◽

M. WARWICK ◽

...

Keyword(s):

Risk Factors ◽

Genetic Factors ◽

Case Control Study ◽

Case Control ◽

Prior History ◽

Black Race ◽

Increased Risk ◽

History Of ◽

Independent Risk Factors ◽

Control Study

Between 1992 and 1999, 93 cases of blastomycosis, including 25 laboratory confirmed cases, were identified in Missouri (annual incidence, 0·2/100000 population). Mississippi County in southeastern Missouri had the highest incidence (12/100000) with a much higher rate among blacks than whites in this county (43·2/100000). The mortality rate, 44% was also higher among blacks. To determine risk factors for endemic blastomycosis, a case-control study was conducted among southeastern Missouri residents. Independent risk factors for blastomycosis were black race and a prior history of pneumonia. No environmental exposures or socioeconomic factors were significantly associated with increased risk. The increased risk among blacks may possibly be related to genetic factors, but further studies are needed to clarify this. However, heightened awareness of the disease and a better understanding of the risk factors are important and may lead to earlier diagnosis and start of treatment, possibly improving outcome.

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Risk factors for composite adverse outcomes of postpartum haemorrhage in a low-resource setting: a single-centre cross-sectional study in Mpilo Central Hospital, Bulawayo, Zimbabwe

F1000Research ◽

10.12688/f1000research.22769.1 ◽

2020 ◽

Vol 9 ◽

pp. 211

Author(s):

Solwayo Ngwenya

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Caesarean Section ◽

Postpartum Haemorrhage ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Prior History ◽

Cross Sectional ◽

History Of ◽

Independent Risk Factors

Background: Primary postpartum haemorrhage continues to cause considerable global maternal morbidity and mortality. The aim of this study was to determine the risk factors for composite adverse outcomes in postpartum haemorrhage using multivariable logistic regression. The findings could potentially be used to anticipate and prevent composite adverse outcomes in postpartum haemorrhage. Methods: This was a retrospective cross-sectional study carried out at Mpilo Central Hospital, a government tertiary referral centre, covering the period 1 July 2016 to 30 November 2019. Participants were included in the study if they had a diagnosis of postpartum haemorrhage. Those variables that had a p<0.2 from the univariate logistic regression analyses were considered for multivariable logistic regression. The association between independent variables and the dependent variable was assessed using odds ratio with 95% confidence intervals, to identify independent risk factors for composite adverse outcomes in PPH. Results: The independent risk factors for composite adverse outcomes in postpartum haemorrhage were place of dwelling (AOR 4.57, 95% CI 1.87-11.12, p=0.01), prior history of a Caesarean section (AOR 2.57, 95% CI 1.10-6.00, p=0.03), APH (AOR 5.45, 95% CI 2.23-13.27, p<0.0001), antenatal haemoglobin level (AOR 19.64, 95% CI 1.44-268.50, p=0.03), and delivery by Caesarean section (AOR 10.21, 95% CI 4.39-23.74, p<0.0001). Blood loss was also an independent risk factor for composite adverse outcomes in postpartum haemorrhage with the following blood loss; 1001-1500 ml (AOR 9.94, 95% CI 3.68-26.88, p<0.0001), 500-1000 ml (AOR 41.27, 95% CI 11.32-150.54, p<0.0001), and 2001 ml (AOR 164.77, 95% CI 31.06-874.25, p<0.0001). Conclusions: This study found that the independent predictors for composite adverse outcomes in PPH were rural dwelling, prior history of a Caesarean section, antenatal haemoglobin level, delivery by Caesarean section, and blood. In low- and middle-income countries, such information should help in increasing clinical vigilance and preventing maternal deaths.

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Ectopic Pregnancy - Is It Always a Threat to A Woman’s Life?

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.05.02.05 ◽

2021 ◽

Vol 5 (2) ◽

Keyword(s):

Risk Factors ◽

Laparoscopic Surgery ◽

Ectopic Pregnancy ◽

Pelvic Inflammatory Disease ◽

Fallopian Tube ◽

Inflammatory Disease ◽

The Past ◽

Internal Bleeding

Ectopic pregnancy is a condition in which the fertilized ovum implants outside the uterus or attaches to an abnormal portion of the uterus, like cervix, cornea, myometrium. Such state occurs in 2% of all reported pregnancies. There are plenty of risk factors for this state. Fallopian tube surgery in the past, pelvic inflammatory disease is one of them. Undiagnosed ectopic pregnancy may lead to serious complications, like rupturing of the fallopian tube and massive internal bleeding. We would like to present a case, in which the patient was not aware of being pregnant, until she got the histopathology results after laparoscopic surgery because of tumor in the rectouterine pouch.

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Incidence and risk factors associated with ectopic pregnancy: a prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210007 ◽

2021 ◽

Author(s):

Harish K. M. ◽

Shwetha N. ◽

Nalini N.

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Prospective Study ◽

Ectopic Pregnancy ◽

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Tertiary Care ◽

Care Hospital ◽

History Of ◽

A Prospective Study

Background: Increased incidence of ectopic pregnancy and its impact on women’s fertility in recent years need significant attention.Methods: A two years prospective study from January 2018 to December 2019 conducted to determine incidence, association of risk factors with ectopic pregnancy and find the most common risk factor of ectopic pregnancy in department of obstetrics and Gynaecology, a tertiary care Hospital in Pune.Results: During the study period 100 patients were diagnosed to have ectopic pregnancy. Incidence was 5.29 per 1000 births. Majority were in the age group of 20-24 years (42%), multiparous (59%) and belong to low socioeconomic state (62%). In majority of the patients (22%) no risk factors was found. Among the patients who had risk factors, the main risk factors for ectopic pregnancy were history of history of pelvic inflammatory disease (20%), previous tubal/abdominal surgery (12%), history of Infertility (10%), previous termination of pregnancy (10%), contraception with mirena IUS or IUCD in situ (8%) and a history of prior ectopic pregnancy (4%).Conclusions: In majority (78%) of patients risk factors for ectopic pregnancy was present and pelvic inflammatory disease was found to be a major risk factor for ectopic pregnancy.

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Natural history of Mycoplasma genitalium: incidence, persistence, transmissibility and progression to pelvic inflammatory disease: systematic review and meta-analysis

10.26226/morressier.5731a408d462b8028d88c8a3 ◽

2016 ◽

Author(s):

Nicola Low

Keyword(s):

Systematic Review ◽

Natural History ◽

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Meta Analysis ◽

Mycoplasma Genitalium ◽

History Of

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Clozapine-induced stuttering in the absence of known risk factors: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02803-8 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Florence Jaguga

Keyword(s):

Risk Factors ◽

Family History ◽

Side Effect ◽

Case Reports ◽

Extrapyramidal Symptoms ◽

Prior History ◽

Case Presentation ◽

Rare Side Effect ◽

History Of ◽

Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

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How prevalent are symptoms and risk factors of pelvic inflammatory disease in a sexually conservative population

Reproductive Health ◽

10.1186/s12978-021-01155-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Oqba Al-kuran ◽

Lama Al-Mehaisen ◽

Hamza Alduraidi ◽

Naser Al-Husban ◽

Balqees Attarakih ◽

...

Keyword(s):

Risk Factors ◽

Pelvic Inflammatory Disease ◽

Symptom Score ◽

Pelvic Pain ◽

Inflammatory Disease ◽

Scoring System ◽

Chronic Pelvic Pain ◽

Medical Procedure ◽

Adult Women ◽

Jordanian Population

Abstract Background Pelvic inflammatory disease (PID) is the inflammation of the adnexa of the uterus, that mainly manifests in a subclinical/chronic context and goes largely underreported. However, it poses a major threat to women’s health, as it is responsible for infertility and ectopic pregnancies, as well as chronic pelvic pain. Previous studies in Jordan have not reported PID, attributed mainly to the social structure of the country which largely represents a sexually conservative population. Our study aims to report the clinical symptoms that point towards PID and investigate the major risk determinants for the Jordanian population, in a cross-sectional study, using our scoring system based only on clinical data and examination. Methods One hundred sixty-eight consecutive adult women that came in the Outpatient Clinics of Gynaecological Department of the Jordan University Hospital were interviewed and their medical history and symptoms were registered and analysed. A Score for PID symptoms, we developed, was given to each woman. Results and correlations were then statistically tested. Results Our study population consisted of relatively young women (37.7 ± 11) that had their first child at an average age of 24.1 (± 4.8) and a mean parity of 3.1 (± 2.2). Fifty-eight women (34.5%) reported having undergone at least one CS, while the mean PID Symptom Score was 3.3 (± 2.3). The women in our study exhibited 8 symptoms of PID, namely dysmenorrhea and vaginal discharge; being the commonest (45.2% and 44.6% respectively), in addition to chronic pelvic pain, pelvic heaviness, menorrhagia, dyspareunia, urinary symptoms, and smelly urine. They also reported history of 3 conditions that can be attributed to PID, that is infertility, preterm labour, and miscarriages. Conclusions Our PID Scoring System seems to identify the risk factors of PID and predict well the PID likelihood. This score predicts that women with higher parity, who used contraceptives and underwent any invasive medical procedure are expected to score higher in the PID Symptom Score. Our data also suggest that PID should not be ruled out in the Jordanian population when symptoms are compatible to this diagnosis.

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Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China

Journal of International Medical Research ◽

10.1177/0300060520987398 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098739

Author(s):

Yuxia Cheng ◽

Ping Zu ◽

Jie Zhao ◽

Lintao Shi ◽

Hongyan Shi ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Blood Glucose Control ◽

Diabetes Duration ◽

Chinese Patients ◽

Foot Care ◽

Vascular Intervention ◽

History Of ◽

Independent Risk Factors ◽

Recurrence Group

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.

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Stroke prediction in patients presenting with isolated dizziness in the emergency department

Scientific Reports ◽

10.1038/s41598-021-85725-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

June-sung Kim ◽

Hong Jun Bae ◽

Muyeol Kim ◽

Shin Ahn ◽

Chang Hwan Sohn ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Multivariate Analysis ◽

Acute Stroke ◽

Neurological Deficits ◽

Cerebrovascular Injury ◽

Risk Patients ◽

History Of ◽

Independent Risk Factors ◽

Record Review

AbstractDiagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. The aim of this study was to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

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