O15 Venous Leg Ulceration: an assessment of associated lifestyle, sociodemographic and clinical factors using UK Biobank

Abstract Introduction A number of factors have reportedly been associated with venous leg ulceration (VLU) however many of these remain disputed. UK Biobank (UKB) is an electronic dataset that provides in-depth detail on the lives of its participants. The aim of this research is to utilise UKB to understand factors associated with VLU. Methods Participants in the UKB with historical or active venous ulceration were identified and an age, sex and comorbidity matched control group was formed. A multivariate logistic regression was used to explore factors associated with VLU with significant factors expressed through odds ratios (OR). Mortality was investigated using a Kaplan Meier plot and log-rank test. Data analysis was preformed using R Studio Version 1.2.5033 and Python 3.8.10. Results Factors associated with VLU included; male gender, older age, deprivation (OR 1.27), obesity (OR 1.40), current smoking (OR 1.21), immoderate alcohol intake (OR 1.32), previous deep vein thrombosis (OR 3.07), depression and loneliness (OR 1.21). Biochemical factors associated with VLU included low haemoglobin concentrations (OR 1.50), low circulating lymphocyte percentages (OR 1.57), raised glycated haemoglobin (HbA1c) (OR 2.92), raised c-reactive protein (OR 1.41), raised cystatin C (OR 1.11) and low Vitamin D levels (OR 1.52). At a median follow up of 11.5 years, the mortality in VLU participants was 28%; significantly higher than in controls (P < 0.001). Conclusion Participants with VLU are comorbid with poorer physical, social and psychological wellbeing.

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Improved Long-Term Survival with Edaravone Therapy in Patients with Amyotrophic Lateral Sclerosis: A Retrospective Single-Center Study in Japan

Pharmaceuticals ◽

10.3390/ph14080705 ◽

2021 ◽

Vol 14 (8) ◽

pp. 705

Author(s):

Hideki Houzen ◽

Takahiro Kano ◽

Kazuhiro Horiuchi ◽

Masahiro Wakita ◽

Azusa Nagai ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Rank Test ◽

Positive Pressure ◽

Control Group ◽

Single Center ◽

Term Survival ◽

Long Term Survival ◽

Kaplan Meier ◽

Lateral Sclerosis

Reports on the long-term survival effect of edaravone, which was approved for the treatment of amyotrophic lateral sclerosis (ALS) in 2015 in Japan, are rare. Herein, we report our retrospective analysis of 45 consecutive patients with ALS who initially visited our hospital between 2013 and 2018. Of these, 22 patients were treated with edaravone for an average duration of 26.6 (range, 2–64) months, whereas the remaining patients were not treated with edaravone and comprised the control group. There were no differences in baseline demographics between the two groups. The primary endpoint was tracheostomy positive-pressure ventilation (TPPV) or death, and the follow-up period ended in December 2020. The survival rate was significantly better in the edaravone group than in the control group based on the Kaplan–Meier analysis, which revealed that the median survival durations were 49 (9–88) and 25 (8–41) months in the edaravone and control groups, respectively (p = 0.001, log-rank test). There were no serious edaravone-associated adverse effects during the study period. Overall, the findings of this single-center retrospective study suggest that edaravone might prolong survival in patients with ALS.

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Electrolytes supplementation can decrease the risk of nephrotoxicity in patients with solid tumors undergoing chemotherapy with cisplatin

BMC Pharmacology and Toxicology ◽

10.1186/s40360-020-00448-9 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Omary M. S. Minzi ◽

Tatu E. Lyimo ◽

Francis F. Furia ◽

Alphonce I. Marealle ◽

Manase Kilonzi ◽

...

Keyword(s):

Treatment Group ◽

Serum Creatinine ◽

Solid Tumors ◽

Normal Saline ◽

Controlled Trial ◽

Kidney Injury ◽

Rank Test ◽

Control Group ◽

Relative Risks ◽

Kaplan Meier

Abstract Background Cisplatin is an important drug in the treatment of various Cancers. However, this drug causes nephrotoxicity that is linked to electrolyte derangement. The aim of this study was to evaluate the effect of electrolyte supplementation in reducing kidney injury in patients receiving cisplatin-based regimen. Methods This was non-randomized interventional study conducted at Ocean Road Cancer Institute (ORCI) among patients with confirmed solid tumors. Patients who received cisplatin-based chemotherapy at a dose of ≥50 mg with intravenous normal saline supplemented with Magnesium, Calcium and Potassium (triple electrolyte supplementation) were compared with those who received cisplatin-based chemotherapy with normal saline alone. The patients were followed up for 4 weeks and serum creatinine was measured at every visit. Nephrotoxicity was defined as serum creatinine elevation > 1.5 times that at baseline. Results A total of 99 patients were recruited, whereby 49 patients (49.5%) received electrolyte supplementation (treatment group) and 50 patients (51.5%) did not receive electrolyte supplementation (control group). The incidence risk of nephrotoxicity was 20.41% (n = 10) in the treatment group and 54% (n = 27) in the control group. Patients in the control group were 2.6 times more likely to experience nephrotoxicity as compared to treatment group [Relative Risks (RR); 2.6, 95%CI; 1.5–4.9, P < 0.0001]. The most common malignancy was cervical cancer, n = 43 (87.8%) in treatment group and n = 45 (90.0%) in the control group (P = 0.590). The Kaplan-Meier analysis and the log-rank test revealed that electrolytes supplementation was associated with extended survival with less nephrotoxicity incidences [P = 0.0004; Hazard ratio (HR) 0.3149; 95% CI 0.165 to 0.6011]. Conclusions Electrolytes supplementation decreases the risk of nephrotoxicity after chemotherapy with cisplatin. A randomized controlled trial with a larger sample size is recommended to evaluate the robustness of these findings.

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Microsurgical rhizotomy for trigeminal neuralgia in MS patients: technique, patient satisfaction, and clinical outcomes

Journal of Neurosurgery ◽

10.3171/2017.12.jns171647 ◽

2019 ◽

Vol 130 (6) ◽

pp. 1877-1888

Author(s):

Mark G. Bigder ◽

Sandeep Krishnan ◽

E. Francis Cook ◽

Anthony M. Kaufmann

Keyword(s):

Trigeminal Neuralgia ◽

Treatment Failure ◽

Rank Test ◽

Control Group ◽

Chi Square ◽

Time To Treatment ◽

Pain Scores ◽

Kaplan Meier ◽

Time To Treatment Failure ◽

Chi Square Test

OBJECTIVEPatients with multiple sclerosis (MS)–associated trigeminal neuralgia (TN) have higher recurrence and retreatment rates than non-MS patients. The optimal management strategy and role for microsurgical rhizotomy (MSR) for MS-TN remains to be determined. The aim of this study was to report time to treatment failure (TTF) and pain scores following MSR compared to percutaneous and Gamma Knife procedures.METHODSTime to treatment failure was analyzed after MSR (n = 14) versus prior procedures (n = 53) among MS-TN patients. Kaplan-Meier curves and log-rank test were utilized to compare TTF after MSR versus prior procedures using the same cohort of patients as their own control group. Subsequent analysis compared TTF after MSR to TTF after 93 other procedures among a second cohort of 18 MS-TN patients not undergoing MSR. BNI pain scores were compared between MSR and other procedures among the MS-TN cohort using a chi-square test.RESULTSTTF was significantly longer after MSR than after other procedures in the MSR cohort (median TTF 79 vs 10 months, respectively, p < 0.0001). Similarly, TTF was longer after MSR than after prior procedures in the non-MSR cohort (median TTF 79 vs 13 months, respectively, p < 0.001). MSR resulted in a higher proportion of excellent pain scores when compared to other procedures in the non-MSR cohort (77% vs 29%, p < 0.001). Probability of treatment survival was higher after MSR than after other procedures at all time points (3, 6, 12, 24, 36, and 48 months). There were no deaths or major complications after MSR.CONCLUSIONSTTF was significantly longer following MSR compared to prior procedures in MS-TN patients. Additionally, a higher proportion of patients achieved excellent BNI pain scores after MSR.

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TB Meningitis in HIV-Positive Patients in Europe and Argentina: Clinical Outcome and Factors Associated with Mortality

BioMed Research International ◽

10.1155/2013/373601 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Anne Marie W. Efsen ◽

Alexander M. Panteleev ◽

Daniel Grint ◽

Daria N. Podlekareva ◽

Anna Vassilenko ◽

...

Keyword(s):

Eastern Europe ◽

Rank Test ◽

Hiv Positive ◽

Cumulative Probability ◽

Factors Associated ◽

Cell Counts ◽

Cd4 Cell Counts ◽

Kaplan Meier ◽

Adjusted Incidence Rate ◽

Cd4 Cell

Objectives.The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP).Methods.Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately.Results.A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4–61.6%), 12.3% for TBP (8.9–15.7%), and 19.4% for TBEP (16.1–22.6) (P<0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72–9.09), a prior AIDS diagnosis (aIRR=4.82(2.61–8.92)), and receiving care in Eastern Europe (aIRR=5.41(2.58–11.34))).Conclusions.TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.

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Usefulness of Serum Omentin-1 Levels for the Prediction of Adverse Cardiac Events in Patients with Hypertrophic Cardiomyopathy

Medical Principles and Practice ◽

10.1159/000487396 ◽

2018 ◽

Vol 27 (2) ◽

pp. 107-114 ◽

Cited By ~ 3

Author(s):

Suleyman Sezai Yıldız ◽

Irfan Sahin ◽

Gokhan Cetinkal ◽

Gokhan Aksan ◽

Suat Hayri Kucuk ◽

...

Keyword(s):

Logistic Regression ◽

Hypertrophic Cardiomyopathy ◽

Interventricular Septum ◽

Multivariate Logistic Regression Analysis ◽

Rank Test ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Cardiac Events ◽

Kaplan Meier ◽

Adverse Cardiac Events

Objective: To investigate the association between serum omentin-1 levels and adverse cardiac events in patients with hypertrophic cardiomyopathy (HCM). Subjects and Methods: This prospective, observational study included 87 patients with HCM and 50 age- and sex-matched control subjects. Serum omentin-1 and brain natriuretic peptide (BNP) levels were measured in all subjects, using enzyme-linked immunosorbent assay and electrochemiluminescence, respectively. Patients with HCM were divided into 2 groups according to their omentin levels, i.e., low: ≤291 ng/mL (n = 48) and high: > 291 ng/mL (n = 39). Cardiac mortality, hospitalization due to heart failure, and implantable cardioverter-defibrillator (ICD) implantation were considered adverse cardiac events. Statistical analysis included uni- and multivariant logistic regression, receiver-operating characteristic (ROC) analysis, and the Kaplan-Meier method. Results: Serum omentin-1 levels were significantly lower in the obstructive (253.9 ± 41.3 ng/mL) and nonobstructive (301.9 ± 39.8 ng/mL) HCM groups than in the control group (767.1 ± 56.4 ng/mL), p < 0.001, respectively. The BNP levels were higher in the obstructive and nonobstructive HCM groups than in the control group (269.5 ± 220, 241.0 ± 227, and 24.0 ± 18.9 pg/mL, respectively, p < 0.001). The Kaplan-Meier analysis indicated that patients with low omentin-1 levels showed a significantly higher (48.2%) 2-year cumulative incidence of overall adverse cardiac events than those with high omentin-1 levels (16.2%) (log-rank test, p = 0.001). In the multivariate logistic regression analysis, omentin-1, interventricular septum (IVS) thickness, and male gender were independent predictors of adverse cardiac events in the follow-up. Conclusion: Omentin-1 levels were lower in patients with HCM than in the control group, and this was associated with worse cardiac outcomes.

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Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

10.21203/rs.3.rs-45885/v3 ◽

2020 ◽

Author(s):

Quyen Dao Bui Quy ◽

Tuan Pham Ngoc Huy ◽

Loc Nguyen Duc ◽

My Pham Van ◽

Dung Nguyen Huu ◽

...

Keyword(s):

Peritoneal Dialysis ◽

High Sensitivity ◽

Rank Test ◽

Reactive Protein ◽

Kaplan Meier ◽

Independent Risk Factors ◽

Hs Crp ◽

Low Serum

Abstract Background: In this study, we focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients over a 3-year period.Methods: We measured serum prealbumin concentration and OH by body composition monitor in 278 CAPD patients (159 males and 119 females) with a mean age of 46 years and a median peritoneal dialysis (PD) duration of 21 months. Cases of PD-related peritonitis were collected over 3 years.Results: After the 3-year follow-up, 44 patients were diagnosed with PD-related peritonitis (15.8%). Low education, serum albumin, and prealbumin, as well as high high-sensitivity C- Reactive Protein (hs-CRP) and OH, were independent risk factors for predicting peritonitis over 36 months in CAPD patients. Based on the ROC curve model and Kaplan-Meier analysis, we realized that low prealbumin and high OH were independent predictors of 3-year peritonitis in CAPD patients (Prealbumin: AUC = 0.838, cut-off value = 32.5 mg/dL, Se= 90.9%, Sp = 32.9%; OH: AUC = 0.851, cut-off value = 1.33 L, Se = 79.5%, Sp = 85.5%; and log-rank test p < 0.001, respectively).Conclusion: Overhydration and low serum prealbumin were the independent predictors of PD-related peritonitis in CAPD patients.

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Role of nicergoline in corneal wound healing in diabetic rats

BMC Ophthalmology ◽

10.1186/s12886-021-01835-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Amanda Lemos Barros Martins Portela ◽

Rafael Neves Moreno ◽

Maria Helena Madruga Lima Ribeiro ◽

Fernanda Miguel de Andrade ◽

Yale Viana Alves ◽

...

Keyword(s):

Wound Healing ◽

Cox Regression ◽

Survival Curve ◽

Diabetic Rats ◽

Rank Test ◽

Control Group ◽

Cox Regression Analysis ◽

Corneal Epithelial Defect ◽

Kaplan Meier ◽

Diabetic Keratopathy

Abstract Background To investigate the effect of nicergoline on the rate of complete corneal ulcer reepithelialization (CCUR) in diabetic rats with diabetic keratopathy. Methods Forty-eight streptozotocin-induced diabetic rats were randomly divided into two groups. The experimental group (n = 24) received nicergoline (10 mg.kg− 1.day− 1), while the control group (n = 24) received a placebo. A corneal epithelial defect was induced using a corneal diamond burr, and defect area was compared at time points of 0, 12, 24, 48 and 72 h after the injury using image analysis software. The probability of CCUR within 72 h was assessed using the Kaplan–Meier survival analysis log-rank test. Results When compared, 4 of the 24 rats (17%) in the placebo group and 12 of the 24 rats (50%) in the nicergoline group were found to have CCUR within 72 h (log-rank = 0.027). Cox regression analysis found no effect of the covariates blood glucose (P = 0.601) or weight (P = 0.322) on the corneal reepithelialization (survival) curve. Conclusions Nicergoline increased wound healing rates relative to placebo and may therefore be investigated as a treatment option in diabetic keratopathy.

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AB0274 USE OF TNF-INHIBITORS BIOSIMILARS IN CHRONIC INFLAMMATORY ARTHRITIDES: A THREE-YEAR EXPERIENCE IN A LARGE MONOCENTRIC COHORT OF PATIENTS FROM THE NORTH-EAST ITALY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4898 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1435.2-1436

Author(s):

D. Astorri ◽

F. Ometto ◽

L. Friso ◽

B. Raffeiner ◽

C. Botsios ◽

...

Keyword(s):

Regression Analysis ◽

Disease Duration ◽

Cox Regression ◽

University Hospital ◽

Rank Test ◽

Cox Regression Analysis ◽

Factors Associated ◽

Drug Survival ◽

Log Rank Test ◽

Kaplan Meier

Background::In recent years several biosimilars (BS) of tumour necrosis factor inhibitors (TNF-i) were introduced. At the Padova University Hospital the first BS of etanercept (bsETN) was available in October 2016 and the BS of adalimumab (bsADA) was available in November 2018.Objectives:The objectives of the study were to evaluate the rate of bioriginator-biosimilar (BO-BS) switch in all patients with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and axial spondiloarthritis (axSpA) in the cohort of the Padova University Hospital and to examine factors favouring BO-BS switch. Secondly, we investigated survival of BO-BS switch and BO treatment and factors associated with longer treatment survival.Methods:We considered all patients on ETN originator (boETN) treatment when the first bsETN was available (1st October 2016) and all patients on ADA originator (boADA) when bsADA was available (1st November 2018). Patients were followed until 30 August 2019 and were classified as BO-BS switchers if they underwent a switch from either boETN or boADA to BS during the follow-up, otherwise they were considered as continuing BO treatment. Factors associated with BO-BS switch were tested with a multivariable regression analysis. To test the survival of the BO-BS switch and of the BO treatment, Cox regression analysis was used including all variables achiving a p<0.10 in univariate analysis tested with Log-rank test and Kaplan-Meier curves.Results:Among 1208 patients (553 RA, 433 PSA, 215 axSpA), 560 (46.3%) patients switched to bsETN (391) or bsADA (169). Mean disease duration was 16 (14.2) years and mean duration of the bDMARD treatment was 96.3 (56.8) months. After adjustment for potential confounders, factors associated with BO-BS switch were a longer disease duration, a shorter duration of previous bDMARD treatments and diagnosis (Tab.1) RA patients had almost a 3 fold increased likelihood of being switched to BS compared to PSA and axSPA, while difference between PSA and axSPA was not significant.Following Cox regression analysis we observed a longer drug survival in BO-BS switchers compared to those continuing with BO (HR 1.38; 95% C.I. 1.2-1.58; p<0.001) (Fig. 1). A longer drug survival was also associated with a longer disease duration (.15years: HR 1.75; 95% C.I. 1.5-2; p<0.001), longer mean duration of previous bDMARDs (.5years: HR 4.1; 95% C.I. 3.5-4.7; p<0.001), and diagnosis (RA vs PSA: HR 1.22; 95% C.I. 1.02-1.47; p=0.030; RA vs axSpA: HR 0.89 95% C.I. 0.067-0.97; p=0.023; PSA vs axSpA: HR 0.66; 95% C.I. 0.57-0.77; p<0.001) (Fig 2).Figure 1.Kaplan-Meier curves for treatment survival, Log-rank test.Figure 2.Kaplan-Meier curves for treatment survival in all patients, Log-rank tesConclusion:BO-BS switch was undertaken in almost half of the patients. Patients with longer disease duration and longer bDMARD duration, were the most likely to be switched successfully to BS. BO-BS switching does not affect the survival of the treatment, indeed, it provides sustained effectiveness particularly if undertaken in patients with stable disease activity.Table 1.Factors associated with BO-BS switch, multivariate regression analysis.Disclosure of Interests:DAVIDE ASTORRI: None declared, Francesca Ometto: None declared, LARA FRISO: None declared, BERND RAFFEINER: None declared, Costantino Botsios: None declared, Andrea Doria Consultant of: GSK, Pfizer, Abbvie, Novartis, Ely Lilly, Speakers bureau: UCB pharma, GSK, Pfizer, Janssen, Abbvie, Novartis, Ely Lilly, BMS

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Role of Nicergoline in Corneal Wound Healing in Diabetic Rats

10.21203/rs.3.rs-107020/v1 ◽

2020 ◽

Author(s):

Amanda Portela ◽

Rafael Moreno ◽

Maria Helena Ribeiro ◽

Fernanda de Andrade ◽

Yale Alves ◽

...

Keyword(s):

Wound Healing ◽

Cox Regression ◽

Survival Curve ◽

Diabetic Rats ◽

Rank Test ◽

Control Group ◽

Cox Regression Analysis ◽

Corneal Epithelial Defect ◽

Kaplan Meier ◽

Diabetic Keratopathy

Abstract Background: To investigate the effect of nicergoline on the rate of complete corneal ulcer reepithelialization (CCUR) in diabetic rats with diabetic keratopathy.Methods: Forty-eight streptozotocin-induced diabetic rats were randomly divided into two groups. The experimental group (n=24) received nicergoline (10 mg.kg-1.day-1), while the control group (n=24) received a placebo. A corneal epithelial defect was induced using a corneal diamond burr, and defect area was compared at timepoints of 0, 12, 24, 48 and 72 hours after the injury using image analysis software. The probability of CCUR within 72 hours was assessed using the Kaplan–Meier survival analysis log-rank test. Results: When compared, 4 of the 24 rats (17%) in the placebo group and 12 of the 24 rats (50%) in the nicergoline group were found to have CCUR within 72 hours (log-rank = 0.027). Cox regression analysis found no effect of the covariates blood glucose (P=0.601) or weight (P=0.322) on the corneal reepithelialization (survival) curve. Conclusions: Nicergoline increased wound healing rates relative to placebo and may therefore be investigated as a treatment option in diabetic keratopathy.

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Abstract 105: Chagas Disease: an Independent Mortality Risk Factor for Patients with Pacemakers?

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.7.suppl_1.105 ◽

2014 ◽

Vol 7 (suppl_1) ◽

Author(s):

Rhanderson N Cardoso ◽

Daniel Garcia ◽

Alexandre Benjo ◽

Francisco Macedo ◽

Isabela Motta ◽

...

Keyword(s):

Risk Factor ◽

Mortality Rate ◽

Chagas Disease ◽

Proportional Hazards Model ◽

Prognostic Significance ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Control Group ◽

Endemic Region ◽

Kaplan Meier

Background: Almost 25% of patients with Chagas disease (CD) have some degree of cardiac compromise, including rhythm disturbances, which ultimately may require permanent pacemaker (PPM) implantation. CD has been shown to be an independent risk factor for mortality in heart failure. In PPM patients the prognostic significance of CD seropositivity is yet to be determined. Methods: Patients from a highly endemic region for CD with a PPM were divided into two groups: those with CD confirmed by immunofluorescence and those without CD. Patients were followed for a 3-year period. Cox proportional-hazards model and Kaplan-Meier method with log-rank test for mortality were calculated. Results: A total of 75 patients aged 65.3±12 years were included, of which 31 (41%) were males and 49 (65%) had positive serology for CD. Age, gender, diabetes, hypertension, ejection fraction, reason for PPM implantation and prior myocardial infarction were not significantly different between groups. After a 3-year follow up, 8 patients in the CD group and 1 in the control group died. Although mortality rate was higher in patients with CD seropositivity, the difference was not statistically significant (HR 3.86; p=0.17). Kaplan-Meier survival plot is illustrated bellow. Conclusions: CD was associated with a non-significant increased mortality rate in PPM patients. Larger prospective studies may reveal a significant prognostic role for CD seropositivity in this population.

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