Impact of Young Age on the Presentation of Saccular Intracranial Aneurysms: Population-Based Analysis of 4082 Patients

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 815-823 ◽  
Author(s):  
Sari Räisänen ◽  
Juhana Frösen ◽  
Mitja I Kurki ◽  
Terhi Huttunen ◽  
Jukka Huttunen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Intracranial Aneurysms ◽  
De Novo ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Population Based ◽  
Young Age ◽  
Smoking History ◽  
Old Patients ◽  
First Diagnosis

Abstract BACKGROUND Formation and rupture of saccular intracranial aneurysms (sIAs) may have different pathobiologies in patients with younger age at first diagnosis of sIA disease. OBJECTIVE To study the phenotype of sIA disease and formation of new (de novo) sIAs in patients below 40 yr. METHODS A population-based cohort study was conducted in 613 young (<40 yr) sIA patients with first diagnosis between 1980 and 2014 and total angiographic follow-up of 3768 yr. RESULTS Of the 613 sIA patients <40 yr, 508 had aneurysmal subarachnoid hemorrhage (sIA-SAH) and 105 unruptured sIA(s) at first sIA diagnosis. Hypertension was 2 times less common among <40 than >40-yr-old patients (unruptured and ruptured). Smoking was very prevalent in <40-yr-old patients (33% in SAH, 68% unruptured). SAH patients <40 yr more often had family history of sIA, and lower PHASES scores (age omitted, P < .001). Ruptured sIAs were small (<7 mm) in 33% of 39 to 30 yr patients, in 44% of 29 to 20 yr patients, and 57% of <19 yr patients. Their shape was irregular in 90%, 94%, and 95%, respectively. Smoking history (hazard ratio [HR] 2.8, 95% confidence interval [CI] 1.2-7.0), family history for sIAs (HR 3.1, 95% CI 1.3-7.7), and age at presentation (HR .91 per year, 95% CI .85-.98) were risk factors for de novo sIA formation, diagnosed in 4% even after 20 yr (median 11.8 yr). CONCLUSION Smoking and family history are risk factors for sIA formation and aneurysmal SAH at young age. Young aneurysmal SAH patients had lower PHASES scores and often rupture from a small sIA, suggesting need for more aggressive management.

A Meta-Analysis of Risk Factors for the Formation of de novo Intracranial Aneurysms

Neurosurgery ◽  
2018 ◽  
Vol 85 (4) ◽  
pp. 454-465 ◽  
Author(s):  
Si Hu ◽  
NianZu Yu ◽  
YiYun Li ◽  
Zheng Hao ◽  
Zheng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Intracranial Aneurysms ◽  
De Novo ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cerebral Aneurysms ◽  
Smoking History ◽  
Meta Analyses ◽  
First Diagnosis

Abstract BACKGROUND Understanding the risk factors for the formation of de novo intracranial aneurysms (IAs) is important for patients who have ever suffered a cerebral aneurysm. OBJECTIVE To estimate the risk factors for the development of a de novo IA to identify which patients need more aggressive surveillance after aneurysm treatment. METHODS We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and searched the PubMed, CENTRAL, EMBASE, and LILACS databases using the key words cerebral aneurysms, de novo, IAs, risk factors combined using and/or. The search was performed in July 2017.We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using RevMan 5.3 (Cochrane, London, United Kingdom) to evaluate risk factors. Statistical significance was set at P < .05. RESULTS The analysis included 14 studies involving 6389 patients, of whom 197 patients had de novo IAs. The main risk factors for formation included sex (OR = 1.82, 95% CI [1.30,2.56], P = .0005, female vs male), age <40 yr (OR = 2.96, 95% CI [1.76,4.96], P < .0001), family history (OR = 2.05, 95% CI [1.07,3.93], P = .03), smoking history (OR = 2.73, 95% CI [1.81,4.12], P < .0001), and multiple saccular intracranial aneurysms (sIAs) at first diagnosis (OR = 2.10, 95% CI [1.12,3.91], P = .02), internal carotid artery (ICA) as the initial site (OR = 2.58, 95% CI [1.43,4.68], P = .002). Heterogeneous analysis showed that these I2 were less than 50% and the results were reliable. CONCLUSION Observational evidence identified multiple clinical and anatomic risk factors for the formation of de novo IAs, including female sex, age <40 yr, family history, smoking history, multiple sIAs at first diagnosis, and IC as the initial site. More aggressive long-term angiographic follow-up with digital subtraction angiography, computed tomography angiography, or magnetic resonance angiography is recommended for these patients.

Risk factors associated with a second primary lung cancer (SPLC) in patients (pts) with a previous initial primary lung cancer (IPLC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13166-e13166
Author(s):  
Misako Nagasaka ◽  
Dina Farhat ◽  
Kimberly Belzer ◽  
Seongho Kim ◽  
Hirva Mamdani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Family History ◽  
Surgical Resection ◽  
Tobacco Use ◽  
Primary Lung Cancer ◽  
Smoking History ◽  
Factors Associated ◽  
Increased Risk ◽  
First Diagnosis

e13166 Background: The risk for development of a SPLC after treatment of an IPLC is around 1% to 2% per pt per year. The aim of this study was to characterize the risk factors associated with the development of a SPLC. Methods: Pts registered in the Karmanos Cancer Institute Tumor Registry diagnosed with an IPLC between 2000 and 2017 were included in this study. Pts with an IPLC who later developed a SPLC were matched for age, histology and stage to pts with an IPLC who did not develop a SPLC. SPLC was defined as a second lung cancer with a different pathology or if the same pathology, anatomically, molecularly, or chronologically distinct. Six variables including: stage at IPLC, histology, family history, surgery as a primary treatment for IPLC, and smoking history (determined by pack years, and continued tobacco use after first diagnosis) were reviewed. Logistic and Cox regression analyses were performed to determine the relationship of these characteristics with the development of a SPLC, and their association with overall survival (OS). Results: 121 pts with IPLC who later developed an SPLC were identified and compared to 120 pts with IPLC who did not develop a SPLC. Logistic analyses did not show that stage at first diagnosis, histology, family history, smoking history, and continued tobacco use after first diagnosis to be relevant for increased risk of SPLC. Pts who were primarily treated with surgical resection had a significantly higher probability of developing a SPLC (Odds Ratio: 0.24, 95% CI: 0.12 to 0.48, p < 0.001). Pts who did not have surgical resection as their primary mode of treatment for IPLC had a significantly higher risk of death than those who received surgical resection (HR 3.02, 95% CI: 1.99 to 4.57; p < 0.001). Conclusions: Based on our findings, pts who had surgical resection for an IPLC were found to have improved OS and a higher possibility of developing a SPLC. Stage at first diagnosis of IPLC, histology, family history, smoking history and continued use of tobacco after first diagnosis did not correlate with increased risk for SPLC. These results warrant further investigation and if confirmed could have an impact on surveillance recommendations post resection of initial lung cancers.

Demographic and clinical predictors of multiple intracranial aneurysms in patients with subarachnoid hemorrhage

2018 ◽  
Vol 128 (4) ◽  
pp. 961-968 ◽  
Author(s):  
Michael M. McDowell ◽  
Yin Zhao ◽  
Christopher P. Kellner ◽  
Sunjay M. Barton ◽  
Eric Sussman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Posterior Circulation ◽  
Smoking History ◽  
Relative Risk Ratio ◽  
Base Case ◽  
Black Race ◽  
Multiple Aneurysms ◽  
Female Sex

OBJECTIVEPathophysiological differences that underlie the development and subsequent growth of multiple aneurysms may exist. In this study, the authors assessed the factors associated with the occurrence of multiple aneurysms in patients presenting with aneurysmal subarachnoid hemorrhage (SAH).METHODSConsecutive patients presenting with aneurysmal SAH between 1996 and 2012 were prospectively enrolled in the Subarachnoid Hemorrhage Outcome Project. Patients harboring 1, 2, or 3 or more aneurysms were stratified into groups, and the clinical and radiological characteristics of each group were compared using multivariate logistic regression.RESULTSOf 1277 patients with ruptured intracranial aneurysms, 890 had 1 aneurysm, 267 had 2 aneurysms, and 120 had 3 or more aneurysms. On multinomial regression using the single-aneurysm cohort as base case, risk factors for patients presenting with 2 aneurysms were female sex (relative risk ratio [RRR] 1.80, p < 0.001), higher body mass index (BMI) (RRR 1.02, p = 0.003), more years of smoking (RRR = 1.01, p = 0.004), and black race (RRR 1.83, p = 0.001). The risk factors for patients presenting with 3 or more aneurysms were female sex (RRR 3.10, p < 0.001), higher BMI (RRR 1.03, p < 0.001), aneurysm in the posterior circulation (RRR 2.59, p < 0.001), and black race (RRR 2.15, p = 0.001). Female sex, longer smoking history, aneurysms in the posterior circulation, BMI, and black race were independently associated with the development of multiple aneurysms in our adjusted multivariate multinomial model.CONCLUSIONSSignificant demographic and clinical differences are found between patients presenting with single and multiple aneurysms in the setting of aneurysmal SAH. These predictors of multiple aneurysms likely reflect a predisposition toward inflammation and endothelial injury.

Abstract 1528: Gender Differences In The Effect Of Traditional Cardiac Risk Factors On Age At Presentation With Stemi

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
William Herzog ◽  
Thomas Aversano
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Female Gender ◽  
Smoking History ◽  
Men And Women ◽  
History Of ◽  
Males And Females ◽  
Artery Disease

For coronary artery disease (CAD), female gender is ’protective’, so that women typically present with clinically apparent CAD a decade later than men. We examined the extent to which traditional cardiovascular risk factor influence the age at presentation with STEMI in men and women. The Cardiovascular Patient Outcomes Research Team (C-PORT) primary PCI registry includes 7197 patients (5070 males and 2109 females) who presented with STEMI at 33 participating hospitals. The table below depicts the average age at presentation with STEMI in males and females with and without diabetes, hypercholesterolemia, hypertension, a family history of coronary artery disease and smoking history (current or former). The effect of smoking, family history and hypertension on age at presentation remained significant in multivariate analysis in both men and women. In both males and females, a family history of CAD and a positive smoking history are associated with presentation with STEMI at a younger age. Both have a greater effect in females. This is particularly true of smoking with lowers the age of presentation by 9 years in women, compared with 3.8 years in men. Male and female patients with a history of hypertension are older at presentation with STEMI, perhaps because the anti-ischemic effects of anti-hypertensive medications. We conclude that while the effect of most traditional risk factors for CAD on age at presentation with STEMI are similar in men and women, smoking lowers the age at presentation to a much greater degree in women. In women who do not smoke, STEMI is delayed for a decade or more compared to men; for women who do, the protective effect of female gender is nearly obliterated.

Characteristics and Risk Factors of Interval Colorectal Advanced Adenomas after Negative Index Colonoscopy

2020 ◽  
Author(s):  
Haibin Dong ◽  
Yutang Ren ◽  
Bo Jiang
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Alcohol Intake ◽  
Proximal Colon ◽  
Smoking History ◽  
Advanced Adenoma ◽  
Pathological Grade ◽  
Adenoma Detection ◽  
History Of ◽  
Advanced Adenomas

Abstract Objectives Interval colorectal advanced adenoma (I-CRAA) carries insidious risk of interval colorectal cancer (I-CRC). The study aims to determine the frequency of I-CRAA after negative colonoscopy and discover the characteristics and the risk factors.Methods We retrospectively analyzed the information of the patients undergoing colonoscopy in the endoscopic center (2015-2019). Frequency of I-CRAA was calculated. The clinical features of I-CRAA were compared with sporadic colorectal advanced adenoma (Sp-CRAA). Results The frequency of I-CRAA was 0.71% (112/15759) per colonoscopy. I-CRAA was more likely to be located in the proximal colon (65.2% vs 34.8%, p<0.05) and has high pathological grade (5.4% vs 1.6%, p<0.05). Diabetes, family history of CRC, smoking, alcohol intake and diverticulosis are risk factors for I-CRAA（p<0.05）. Excellent bowel preparation (OR 3.727; 95% CI 2.425–5.73, p<0.001) and higher adenoma detection rate (OR 1.924; 95% CI 1.153–3.21, p = 0.012) are helpful for the detection of I-CRAA. I-CRAA found within 1 year other than 2 or 3 years after the initial colonoscopy were usually found by an endoscopist with higher ADR.Conclusions I-CRAA is usually located in the proximal colon and has high pathological grade. Diabetes, diverticulosis, smoking history, alcohol intake, and family history of CRC are the risk factors. Its occurrence is more related to low-quality colonoscopy, especially within one year.

The Association Between Genetic Risk Factors and the Size of Intracranial Aneurysms at Time of Rupture

Neurosurgery ◽  
2013 ◽  
Vol 73 (4) ◽  
pp. 705-708 ◽  
Author(s):  
Rachel Kleinloog ◽  
Femke N.G. van 't Hof ◽  
Franciscus J. Wolters ◽  
Ingeborg Rasing ◽  
Irene C. van der Schaaf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genetic Risk ◽  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Association Studies ◽  
Genetic Risk Score ◽  
Genetic Risk Factors ◽  
Genome Wide Association Studies ◽  
Aneurysm Size ◽  
Genome Wide

Abstract BACKGROUND: Genetic risk factors for intracranial aneurysms may influence the size of aneurysms. OBJECTIVE: To assess the association between genetic risk factors and the size of aneurysms at the time of rupture. METHODS: Genotypes of 7 independent single-nucleotide polymorphisms (SNPs) of the 6 genetic risk loci identified in genome-wide association studies of patients with intracranial aneurysms were obtained from 700 Dutch patients with an aneurysmal subarachnoid hemorrhage (1997-2007) previously genotyped in the genome-wide association studies; 255 additional Dutch patients with an aneurysmal subarachnoid hemorrhage (2007-2011) were genotyped for these SNPs. Aneurysms were measured on computerized tomography angiography or digital subtraction angiography. The mean aneurysm size (with standard error) was compared between patients with and without a genetic risk factor by the use of linear regression. The association between SNPs and size was assessed for single SNPs and for the combined effect of SNPs by using a weighted genetic risk score. RESULTS: Single SNPs showed no association with aneurysm size, nor did the genetic risk score. CONCLUSION: The 6 genetic risk loci have no major influence on the size of aneurysms at the time of rupture. Because these risk loci explain no more than 5% of the genetic risk, other genetic factors for intracranial aneurysms may influence aneurysm size and thereby proneness to rupture.

scholarly journals Prevalence and Risk Factors of Amblyopia among Refractive Errors in an Eastern European Population

Medicina ◽  
2018 ◽  
Vol 54 (1) ◽  
pp. 6 ◽  
Author(s):  
Valeria Mocanu ◽  
Raluca Horhat
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Maternal Smoking ◽  
Smoking History ◽  
Maternal Body Mass Index ◽  
Refractive Errors ◽  
Eastern European ◽  
Maternal Risk ◽  
Toxic Environment ◽  
History Of

Background and objective: Amblyopia is the leading cause of visual impairment in children and adults and is very common during childhood. The aim of this study was to identify the prevalence and the risk factors of amblyopia in a pediatric population with refractive errors from an Eastern European country. Materials and methods: A total of 1231 children aged 5–16 years, who had refractive errors and were examined from January to August 2017, were enrolled in a cross-sectional population-based study. Every child underwent a complete ophthalmological exam. Amblyopia was defined as a visual acuity (VA) of less than 0.63. The study respected the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) criteria for defining amblyopia (MEPEDS, 2008). Parents participated in a face-to-face interview. The questionnaire contained details about their family history of amblyopia; the child’s maternal nutritional status in the preconception period; their history of maternal smoking or work in a toxic environment; the child’s birth, and the child’s history of congenital naso-lacrimal duct obstruction (CNLDO). Results: Amblyopia was identified in 2.8% of the participants. The ocular conditions hyperopia (p = 0.0079), astigmatism (p = 0.046), anisometropia (p < 0.001), esotropia (p < 0.001), exotropia (p = 0.0195), and CNLDO (p < 0.001), as well as a family history of amblyopia (p < 0.001), were associated with amblyopia. The non-ocular risk factors for amblyopia that were found in the study included low birth weight (p < 0.0009), prematurity (p < 0.001), an Apgar score under 7 (p = 0.0008), maternal age, maternal smoking history or work in toxic environment (p < 0.001), and maternal body mass index in the preconception period (p < 0.003). Conclusions: Some of the risk factors we identified for amblyopia are modifiable factors. This is an important observation as an adequate health education program can provide the relevant information for future mothers that will allow for a better management of the condition. We also wanted to highlight the need for amblyopia screening starting from the age of 3 years in case of significant parental refractive errors, strabismus, prematurity, and maternal risk factors.

Influence of young age at diagnosis and family history of breast or ovarian cancer on breast cancer outcomes in a population-based cohort study

2006 ◽  
Vol 105 (1) ◽  
pp. 69-80 ◽  
Author(s):  
Jane C. Figueiredo ◽  
Marguerite Ennis ◽  
Julia A. Knight ◽  
John R. McLaughlin ◽  
Nicky Hood ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cohort Study ◽  
Family History ◽  
Population Based ◽  
Young Age ◽  
Age At Diagnosis ◽  
Cancer Outcomes ◽  
Breast Cancer Outcomes ◽  
History Of

Familial aneurysmal subarachnoid hemorrhage: a community-based study

1995 ◽  
Vol 83 (3) ◽  
pp. 426-429 ◽  
Author(s):  
Wouter I. Schievink ◽  
Daniel J. Schaid ◽  
Virginia V. Michels ◽  
David G. Piepgras
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Family History ◽  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Familial Aggregation ◽  
Familial Occurrence ◽  
Content Type ◽  
First Degree Relatives ◽  
Increased Risk ◽  
Fine Print

✓ The familial occurrence of intracranial aneurysms has been well described. However, intracranial aneurysms are not rare and the great majority of reported families consist of only two affected members. Therefore, the familial aggregation of intracranial aneurysms could be fortuitous. The authors investigated the familial occurrence of aneurysmal subarachnoid hemorrhage (SAH) in their community to determine whether family members of patients with a ruptured aneurysm are at an increased risk of developing an SAH. All 81 patients from Rochester, Minnesota, who suffered an SAH between 1970 and 1989 from a proven aneurysmal rupture were identified, and they or their families were contacted and a family history was obtained. The number of expected SAHs among first-degree relatives was calculated using previously established age- and sex-specific incidence rates in the community of Rochester. Of the 81 index patients, 76 had complete follow up for family history. Fifteen (20%) of these 76 patients had a first- or second-degree relative with aneurysmal SAH. The number of observed first-degree relatives with aneurysmal SAH was 11, compared to an expected number of 2.66, giving a relative risk of 4.14 (95% confidence interval 2.06–7.40; p < 0.001). In the authors' community, aneurysmal SAH was familial in one of five patients, and this familial aggregation was not fortuitous. The increase in familial risk of aneurysmal SAH is approximately fourfold among first-degree relatives.

scholarly journals Risk Factors of Laryngeal Carcinoma in Otorhinolaryngology-Head and Neck Division of Dr. Hasan Sadikin Hospital Bandung

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Sarah A Putri ◽  
Yussy A Dewi ◽  
Birgitta M Dewayani
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Head And Neck ◽  
Laryngeal Carcinoma ◽  
Laryngopharyngeal Reflux ◽  
Smoking Habit ◽  
Neck Surgery ◽  
Smoking History ◽  
Case Group ◽  
Carcinoma Larynx

Laryngeal carcinoma is a squamous cell malignancy of larynx epithelial with the Indonesian incidence of 2.0 per 100,000 men and 0.2 per 100,000 women. The risk factors of laryngeal carcinoma include age, sex, family history, smoking habit, alcohol drink, and gastroesophangeal reflux disease (GERD)/ laryngopharyngeal reflux (LPR). This study aimed to know some risk factors for laryngeal carcinoma mentioned in Dr. Hasan Sadikin Hospital, Bandung. Hospital-based unmatched case control study was selected as the methods, involving 80 patients in Oncology Clinic of Otorhinolaryngology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital. The medical records of the carcinoma larynx patients was taken as a study instrument. The results were age percentage of 50-79 years old in the case group is 82.5% therefore, it increase the risk of having laryngeal carcinoma by 7.29 times. Male respondents dominate in the case group (90%) with OR =6.00. Respondents with GERD in the case group is 45%, increasing the risk 15.54 times and these results was significant (p<0.005). Other analyzed variables, such as family history, smoking history, and alcohol consumption is not significant statistically (p>0.005). This study shows the results of age, sex, and GERD/LPR are corresponding with the results with previous studies. Otherwise, the results of smoking, alcohol, and family history are not. Therefore, old age, male sex, and GERD increase the risk of having laryngeal carcinoma.

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