scholarly journals Longitudinal Analyses Indicate Bidirectional Associations Between Loneliness and Self-Rated Health in Adulthood

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 539-539
Author(s):  
Deborah Finkel ◽  
Dianna Phillips ◽  
Chandra Reynolds
Keyword(s):  
Temporal Dynamics ◽  
Univariate Analysis ◽  
Twin Studies ◽  
Change Score ◽  
Longitudinal Analyses ◽  
Physiological Changes ◽  
Self Rated Health ◽  
Physical Health Outcomes ◽  
Bidirectional Associations

Abstract Loneliness is a potent stressor that increases in prevalence with age in late life and has been linked with numerous adverse physical health outcomes and lower scores on measures of self-rated health (SRH). The association between loneliness and SRH is likely bidirectional—for example, experiencing loneliness may result in physiological changes that alter how individuals perceive their health, and worsening perceptions of one’s own health or mobility may act in an increasingly restrictive manner with respect to social interaction. Despite this, limited longitudinal work has examined temporal dynamics between loneliness and SRH. Recently completed harmonization of 9 loneliness items across three longitudinal twin studies of aging in Sweden resulted in sample of 1939 participants aged 40 to 98 at intake (mean age = 74.64) with up to 25 years of follow-up (mean = 7.63) across up to 8 waves (mean = 3.29). Univariate analysis indicated that SRH decreased with age up to age 82 and then leveled off, whereas loneliness continued to increase across the age span. Bivariate dual change score models were used to examine lead-lag relationships across time: which variable contributes to subsequent changes in the other variable. Results indicated a bi-directional relationship: loneliness does not increase after age 82 when SRH is included in the model, and SRH does not level off after age 70 when loneliness is included in the model. Thus, declining SRH may lead to reduced participation in social activities and also feelings of loneliness may intensify perceptions of poor health.

CLINICO-PATHOLOGICAL AND RADIOLOGICAL PROGNOSTIC FACTORS IN CANCER CERVIX TREATED WITH CONCURRENT CHEMORADIATION

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Manraj S. Kang ◽  
Kamal Sahni ◽  
Piyush Kumar ◽  
Rajneesh Madhok ◽  
Ratna Saxena ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mitotic Index ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Concurrent Chemoradiation ◽  
P Value ◽  
Publication Date ◽  
Cancer Cervix ◽  
Stage Ib

<bold>Introduction:</bold> Cervical cancer is most common cancer in the rural and second most common in urban areas of our country. It accounts for 16% of all cancers. There are various clinical, Paper Submission Datepathological and radiological factors which dictate the prognosis of these cancer cervix patients. The present study evaluates clinical, pathological and radiological prognostic factors in cancer cervix treated with concurrent chemoradiation. <bold>Material and Methods:</bold> A total of 32 patients seen between 2012 and 2014 patients planned concurrent chemoradiation were evaluated in terms of clinical (age, stage, Hb% and HPV Paper Publication Date infection), pathological (histopathology type and subtype, grade, mitotic index, lymph-July 2016 vascular invasion and necrosis) and radiological (parametrial extension, disease dimension, lymph node, hydronephrosis and vascularity of tumour) prognostic factors. After pre-DOI treatment evaluation patient was planned for 3 Dimentional-Conformal Radiotherapy (50Gy/25#/5 weeks) with concurrent chemotherapy (Cisplatin 35mg/m<sup>2</sup>) followed by 3 applications of Intracavitary radiotherapy (6Gy/fraction) with 6 months follow up. Response was accessed according to WHO response criteria and univariate analysis was done using chi-square test. <bold>Results:</bold> Clinical factors: Age – better disease free survival in older patients (p value=0.003), stage - Lower stage had better survival (for stage Ib-IIa vs stage IIb p value = 0.003 and for stage Ib vs. IIIb p value = 0.0005), Hb% - 57% patients with Hb <10g/dl had recurrence at end of 6 months (p value=0.00001), HPV – High recurrence with HPV presence. Pathological factors like high Mitotic Index had more residual disease (p=0.0009), grade - No statistical significance. Radiological factors- volume of disease - 35 % patients with volume of disease > 6 cm had disease at end of 6 months, hydronephrosis - 40 % patient with hydronephrosis had recurrence (p value = 0.0005) at end of 6 months follow up and vascularity of tumour showed statistically no difference. <bold>Conclusion:</bold> Hb <10%, HPV infection, Mitotic index (3-5/HPF), stage IIIB, pelvic nodes were concluded as the independent poor prognostic factors.

Exclusive Bilateral Internal Thoracic Artery Grafts for Myocardial Revascularization Requiring Four Anastomoses or More: Outcomes from a Single Center Experience

2016 ◽  
Vol 65 (04) ◽  
pp. 265-271
Author(s):  
Andrea Perrotti ◽  
Enrica Dorigo ◽  
Camille Durst ◽  
Djamel Kaili ◽  
Sidney Chocron ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Univariate Analysis ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Wound Complication ◽  
Safe Procedure ◽  
Off Pump

Introduction Multivessel coronary artery bypass graft (CABG) with bilateral internal thoracic arteries (BITA) has only been uncommon and technically demanding. We describe our experience with BITA only CABGs requiring ≥ 4 anastomoses. Material and Methods The department's database was queried for patients undergoing isolated CABG with ≥ 4 anastomoses. The surgical technique included systematically a right internal thoracic artery (ITA) of left ITA Y graft. The multivariate model included variables with a p < 0.3 at univariate analysis. Results Between January 2006 and December 2009, 251 consecutive patients (71 ± 10 years) (on-pump: 130, off-pump: 121) had CABG with ≥ 4 anastomoses, representing 21% of total isolated CABGs for the same period; all patients received a totally arterial BITA only revascularization. Follow-up was 4.9 ± 1.6 years. Overall and cardiac cumulative survivals were 78 and 92%, respectively, at 5 years. The occurrence of any major postoperative complication was associated with overall and cardiac mortality (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.3–9.9 and OR: 5.4, 95% CI: 1.3–21.9, respectively). Major sternal wound complication requiring surgical revision was not associated with impaired glucose control (n = 9; diabetics: 6/82, 7.3%; nondiabetics: 3/169, 1.8%, p = 0.06). Preoperative kidney failure was associated with incomplete revascularization (OR: 6.2; 95% CI: 1.2–33.5), that was unfailingly due to ungraftable right coronary artery targets. Discussion BITA only revascularization was a valuable and safe procedure, with favorable results in terms of morbidity and mortality at a 5 years' follow-up.

scholarly journals 325 - Relationship quality in dementia: Preliminary longitudinal analyses of the EU-JPND Actifcare cohort study

2020 ◽  
Vol 32 (S1) ◽  
pp. 83-83
Author(s):  
Maria J. Marques ◽  
Bob Woods ◽  
Eva Y.L. Tan ◽  
Marjolein de Vugt ◽  
Frans Verhey ◽  
...  
Keyword(s):  
Social Support ◽  
Cohort Study ◽  
Relationship Quality ◽  
Sense Of Coherence ◽  
Unmet Needs ◽  
Neuropsychiatric Symptoms ◽  
Longitudinal Analyses ◽  
Family Carers ◽  
Over Time

INTRODUCTIONRelationship quality (RQ) in dyads of persons with dementia and their family carers is important both as a clinical outcome and as a determinant of health and quality of life. In previous work we studied RQ using baseline data of a large-scale European longitudinal study on timely access to and use of community formal services in dementia (EU-JPND Acticare). We concluded that neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad, which were less favourable when reported by family carers. This and other associations (e.g. between carer-rated RQ and sense of coherence) were cautiously interpreted, in the context of a cross-sectional analysis.OBJECTIVESTo analyse how carer-reported RQ varies over time and to examine its most important influencing factors.METHODSWe present preliminary longitudinal analyses from the Actifcare cohort study of 451 community-dwelling persons with dementia and their primary carers in eight European countries (12-month follow-up). Comprehensive assessments included the Positive Affect Index (PAI) to assess RQ, persons with dementia’s neuropsychiatric symptoms, persons with dementia and carers’ unmet needs, carers’ anxiety and depression, social support, sense of coherence and stress.RESULTSCarers’ mean PAI scores decreased over the 12 -month period. The person with dementia neuropsychiatric symptoms and unmet needs, and carers’ perceived social support were significant predictors of carers’ RQ change.DISCUSSION AND CONCLUSIONWe analysed carer-reported RQ variation over time and predictors in a large European sample of persons with dementia and their family carers. As expected, RQ decreased over the oneyear follow-up period as the disease progressed. Its main predictors in this sample (neuropsychiatric symptoms and the person’s unmet needs, together with carers’ social support) can all influence the impact that caregiving has on the carer and on how time and energy-consuming caregiving is. The role of increased clinical symptoms (also affecting communication difficulties), together with carers’ exhaustion, must be equated. Overall, these results may help us to tailor interventions addressing RQ and potentially improve dementia outcomes.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
pp. 1-29
Author(s):  
Amy H. Auchincloss ◽  
Jingjing Li ◽  
Kari A. B. Moore ◽  
Manuel Franco ◽  
Mahasin S. Mujahid ◽  
...  
Keyword(s):  
Healthy Eating Index ◽  
Dietary Quality ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Eating Out ◽  
Restaurant Meals ◽  
Sectional Analysis ◽  
Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

scholarly journals Insights on safety and efficacy of renal artery denervation for uncontrolled-resistant hypertension in a high risk population with chronic kidney disease: first Italian real-world experience

2021 ◽  
Author(s):  
Federico Marin ◽  
Simone Fezzi ◽  
Alessia Gambaro ◽  
Francesco Ederle ◽  
Gianluca Castaldi ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Therapy ◽  
Resistant Hypertension ◽  
Univariate Analysis ◽  
Daily Practice ◽  
Renal Sympathetic Denervation ◽  
High Risk Population ◽  
Safety And Efficacy ◽  
Renal Artery Denervation

Abstract Aims To evaluate the safety and efficacy of catheter-based radiofrequency renal sympathetic denervation (RSD) in a daily practice population of patients with uncontrolled resistant hypertension, on top of medical therapy. Methods Consecutive unselected patients with uncontrolled resistant hypertension undergoing RSD were enrolled. Office and ambulatory blood pressure (BP) measurements were collected at baseline and 3, 6 and 12 months after RSD. Efficacy was assessed even in patients with an estimated glomerular filtration rate (eGFR) below 45 mL/min/1.73 m2. Patients were defined as responders if systolic BP decreased by at least 5 mmHg at ambulatory BP or by 10 mmHg at office BP at their last follow-up visit. Results Forty patients with multiple comorbidities underwent RSD from 2012 to 2019. Baseline office and ambulatory BP was 159.0/84.9 ± 26.2/14.9 mmHg and 155.2/86.5 ± 20.9/14.0 mmHg, respectively. At 12-month follow up a significant reduction in office and ambulatory systolic BP, respectively by − 19.7 ± 27.1 mmHg and by − 13.9 ± 23.6 mmHg, was observed. BP reduction at 12-month follow-up among patients with eGFR < 45 mL/min was similar to that obtained in patients with higher eGFR. Twenty-nine patients (74.4%) were responders. Combined hypertension, higher ambulatory systolic BP and lower E/E’ at baseline emerged as predictors of successful RSD at univariate analysis. No major complications were observed and renal function (was stable up to 12 months), even in patients with the lowest eGFR values at baseline. Conclusion RSD is safe and feasible in patients with uncontrolled resistant hypertension on top of medical therapy, even in a high-risk CKD population with multiple comorbidities, with a significant reduction in systolic BP and a trend towards a reduction in diastolic BP lasting up to 12 months. Graphic abstract

scholarly journals Characteristics and recurrence of pterygium in Saudi Arabia: a single center study with a long follow‐up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Waleed Alsarhani ◽  
Saeed Alshahrani ◽  
Mahmood Showail ◽  
Nawaf Alhabdan ◽  
Osama Alsumari ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Dry Eye ◽  
Amniotic Membrane ◽  
Univariate Analysis ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
First Year ◽  
Conjunctival Autografting

Abstract Background This study described the clinical features of patients with pterygium and analyzed the recurrence rate of conjunctival autografting alone, conjunctival autografting combined with intraoperative mitomycin C, and amniotic membrane grafting. Methods A retrospective cohort study of primary pterygium was conducted between January 2017 and February 2020. Factors associated with pterygium severity and recurrence were analyzed by univariate analysis and logistic regression models. Results The study included 292 patients with an average age of 53.3 ± 14.1 years, while the number of operated cases was 94. Pterygia involving the cornea were observed in 55 % of the cases. The overall rate of recurrence for the three procedures was 17 %. The average time of recurrence was 14.2 ± 11.9 months, with 37 % of the recurrences occurring after the first year. The only factor associated with a significant risk of recurrence was dry eye disease in both univariate (p = 0.021) and multivariate analysis (p = 0.026). The recurrence rates following conjunctival autografting with and without mitomycin C were 15.6 and 15.8 %, respectively. The recurrence rate following the amniotic membrane graft was  twofold (OR= 2.02)  (27 %) that following the conjunctival autograft (15.8 %). Conclusions The only factor associated with the recurrence of pterygium was dry eye disease. More than one-third of recurrences developed after the first year, which stresses the importance of a long follow-up. The recurrence rate in our study following conjunctival graft was slightly higher compared to the literature mainly due to differences in study areas, populations, and follow-up periods.

scholarly journals Mitral valve prolapse - it"s possible to stratify prognosis in these patients?

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Silverio Antonio ◽  
T Rodrigues ◽  
R Santos ◽  
A Nunes-Ferreira ◽  
N Cunha ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Nyha Class ◽  
Univariate Analysis ◽  
Developed Countries ◽  
Maximum Distance ◽  
Conduction Delay ◽  
Systolic Pulmonary Artery Pressure ◽  
Lv Mass

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Mitral valve prolapse (MVP) is one of the most frequent causes of mitral valve disease in developed countries, traditionally with a benign prognosis, however some patients develop arrythmias and significant mitral regurgitation (MR) with need of intervention. Herein our purpose was to establish clinical, electrocardiographic and echocardiographic predictors of arrythmias, mitral valve intervention (MVI) and hospitalization in MVP patients to better characterize the prognosis in these patients. Methods  Single-center retrospective study of consecutive patients with MVP documented in transthoracic echocardiogram between January 2014 and October 2019. MVP was defined as systolic displacement of the mitral leaflet into the left atrium ≥ 2 mm from the mitral annular plane. Demographic, clinical, echocardiographic, electrocardiographic data were collected as well as adverse events at follow-up. The results were obtained using Chi-square and Student-t tests; predictors were found with logistic regression. Results  247 patients were included (mean age 62.9 ± 18 years, 61% males), most with MVP involving the posterior leaflet (48.6%). 40% were symptomatic, 47.4% had more than moderate MR, and 25% had interventricular conduction delay in the ECG. During a mean follow-up of 30 ± 19 months, 38% had arrythmias, 27.1% needed mitral valve intervention (95% surgery and 5% percutaneous), 27.1% had atrial fibrillation (AF), 3.4% had ventricular arrythmias, 19.2% had ventricular premature beats, 13.3% had hospital admission for cardiovascular cause and 8.5% (n = 21) died. 9.3% of the patients had mitral annulus disjunction (MAD). Palpitations (p = 0.018), AF (p &lt; 0.001), significant MR (p &lt; 0.001), higher NYHA class (p = 0.016), systolic pulmonary artery pressure (SPAP) (p &lt; 0.001), LV mass (p &lt; 0.001), QTc (p = 0.01) and MAD maximum distance (p = 0.02) associated with MVI. MAD maximum distance value presented an excellent capacity to predict the MVI (AUC 0.85 p = 0.019); the best cut-off was 11,5 mm (Sens = 80%; Spec = 83%). AF was a predictor of hospitalization in univariate analysis (OR = 2.57, CI95% 1.15-5.75, p = 0.022). Regarding arrhythmic events, we found association with aortic root dilatation (p = 0.032), NYHA III-IV (p = 0.013), age and LV mass (both with p &lt; 0.001). In multivariate analysis, LV mass (OR = 1.02, CI95% 1.005-1.027, p = 0.005) and age (OR = 1.038, CI95% 1.004-1.053, p = 0.021) were independent predictors of arrythmias. In this sample, MAD was not associated with arrythmias. Conclusion  Opposing to previous studies in our population, MAD was not associated with arrythmias but had an excellent capacity to predict MVI. Age and LV hypertrophy were independent predictors of arrythmias in our patients. Larger studies are needed to better stratify patients with MVP, as its association with arrhythmias, hospitalization and the need for intervention is not negligible.

scholarly journals Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhongcheng An ◽  
Chen Chen ◽  
Junjie Wang ◽  
Yuchen Zhu ◽  
Liqiang Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bone Cement ◽  
Vertebral Compression Fracture ◽  
Univariate Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Surgical Methods

Abstract Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

scholarly journals PROGNOSTIC FACTORS OF RENAL TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
G Martínez Izquierdo ◽  
A R Arnaiz Pérez ◽  
E Escolano Fernández ◽  
M Merayo Álvarez ◽  
B Carrasco Aguilera ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Radical Nephrectomy ◽  
Univariate Analysis ◽  
Malignant Neoplasms ◽  
Histopathological Analysis ◽  
Chi Square ◽  
Renal Sinus ◽  
Chi Square Test

Abstract INTRODUCTION Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary. MATERIAL AND METHODS A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively. RESULTS The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004). CONCLUSIONS Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.

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