scholarly journals AB0616 RISK FACTORS FOR PREVALENT VERTEBRAL FRAGILITY FRACTURES - STUDY IN A LONDON URBAN BOROUGH

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1342.4-1343
Author(s):  
N. Mothojakan ◽  
M. Zaman ◽  
A. Perren ◽  
S. Mahendrakar ◽  
R. Rajak
Keyword(s):  
Risk Factors ◽  
Thyroid Disease ◽  
Sedentary Lifestyle ◽  
Fragility Fractures ◽  
Management Approach ◽  
Modifiable Risk Factors ◽  
Early Menopause ◽  
Multiple Risk Factors ◽  
History Of ◽  
Multiple Risk

Background:Vertebral fragility fractures (VFFs) are commonly underdiagnosed, often resulting in chronic pain and reduced quality of life. It is particularly important to identify and manage VFFs, as they are important predictors of future VFFs and non-VFFs. Patients with VFFs often have multiple risk factors, which are important to identify to formulate a tailored and appropriate management plan. There is a paucity of studies that have investigated risk factors specifically for VFFs.Objectives:To identify the prevalence of osteoporosis risk factors in patients with VFFs.Methods:Retrospective review of patients seen between July 2018 and July 2019 at Purley Memorial Hospital, covering a large urban borough. Patients included in the study had prevalent moderate and severe VFFs (defined by Ghent criteria).Results:84 patients were included, of which there were 71 females and 13 males. Median age was 76 (IQR 67 – 82) and BMI was 25 (IQR 21 – 27), with 6% of patients noted to be underweight (BMI <18.5). 38% of patients had a family history of osteoporosis and 21% of patients reported a history of parental hip fracture. 21% of patients had experienced recurrent falls. Over half (56%) of patients were noted to have had 2-or-more previous fragility fractures. Of the female cohort, 24% had early menopause, 13% were nulliparous and 1% had late menarche. Of the modifiable risk factors, alcohol (24%), sedentary lifestyle (21%) and smoking (13%) were the most common. Thyroid-disease (18%) was the most common medical condition associated, followed by coeliac/malabsorption (7%), endocrinopathy (6%) and COPD (6%). Proton Pump Inhibitors (PPIs) and steroids were the most common medications associated with 16% and 14% of cases respectively. 73% of patients had good calcium intake and 62% had calcium supplements. Overall, 27 patients had 3-or-fewer risk factors, 35 patients had 4-to-6 risk factors, 19 had 7-to-9 risk factors, and 3 had greater than 10 risk factors.Conclusion:Our study identified several risk factors and their prevalence. The majority of patients were female, of which 24% had early menopause. Several modifiable risk factors such as low BMI, alcohol, smoking and sedentary lifestyle were commonly seen, emphasising the need to identify these risk factors in the initial consultation. Over half of patients (56%) had had 2-or-more previous non-VFFs, suggesting the need to screen for VFFs in patients with multiple fragility fractures at baseline assessment. A number of co-existing medical conditions were also observed with thyroid disease being the most prevalent. PPIs and steroids were found to be important risk factors, which may lead to the consideration of alternative medications. Overall, it was found that patients had multiple risk factors, thus it is important to have a holistic assessment of VFF patients and a multi-system management approach to prevent future fractures.Disclosure of Interests:None declared.

scholarly journals Identification of clinical features associated with mortality in COVID-19 patients

2021 ◽  
Author(s):  
Rahimeh Eskandarian ◽  
Zahra Alizadeh Sani ◽  
Mohaddeseh Behjati ◽  
Mehrdad Zahmatkesh ◽  
Azadeh Haddadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Clinical Features ◽  
Neurological Disorders ◽  
Tertiary Hospital ◽  
Multiple Risk Factors ◽  
Hospitalization Time ◽  
History Of ◽  
Multiple Risk

Background To prevent infectious diseases, it is necessary to understand how they are spread and their clinical features. Early identification of risk factors and clinical features is needed to identify critically ill patients, provide suitable treatments, and prevent mortality. Methods We conducted a prospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020. Of the 3008 patients (mean age 59.3 years, range 1 to 100 years), 1324 were women. We investigated COVID-19 related mortality and its association with clinical features including headache, chest pain, symptoms on CT, hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Findings There was a significant association between COVID-19 mortality and old age, headache, chest pain, respiratory distress, low respiratory rate, oxygen saturation less than 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, history of hypertension, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Interpretation Our results might help identify early symptoms related to COVID-19 and better manage patients clinically.

scholarly journals Leiomyosarcoma of the Tracheostomy Site in a Patient with History of Laryngeal Squamous Cell Carcinoma

2021 ◽  
pp. 912-917
Author(s):  
Zainub Ajmal ◽  
Abdul Moiz Khan ◽  
Lezah McCarthy ◽  
Allison Lupinetti ◽  
Syed Mehdi
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
English Literature ◽  
Neck Region ◽  
Multiple Risk Factors ◽  
History Of ◽  
Rare Malignancy

Leiomyosarcoma (LMS) of the trachea is an extremely rare malignancy with only a few reported cases in English literature. As such the diagnosis can be frequently missed or delayed. We present a case of a 69-year-old male who underwent tracheostomy for airway obstruction secondary to glottic squamous cell carcinoma and treated definitely with radiation therapy. Subsequently, the patient developed LMS of the tracheostomy site. The case further details multiple risk factors that could contribute to development of LMS including radiation exposure, prior malignancy, and chronic inflammation. These risk factors have been well established for LMS in other sites but less so in the head and neck region, which is the subject of our discussion. We also review the current guidelines for head and neck as well as limb sarcomas and discussed role of surgery or radiation and their accompanying challenges in management of this rare malignancy.

The relative and interactive impact of multiple risk factors in schizophrenia spectrum disorders: a combined register-based and clinical twin study

2021 ◽  
pp. 1-11
Author(s):  
C. Lemvigh ◽  
R. Brouwer ◽  
R. Hilker ◽  
S. Anhøj ◽  
L. Baandrup ◽  
...  
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Childhood Trauma ◽  
Cannabis Use ◽  
Paternal Age ◽  
Interactive Effects ◽  
Polygenic Risk Score ◽  
Multiple Risk Factors ◽  
Schizophrenia Spectrum ◽  
Multiple Risk

Abstract Background Research has yielded evidence for genetic and environmental factors influencing the risk of schizophrenia. Numerous environmental factors have been identified; however, the individual effects are small. The additive and interactive effects of multiple risk factors are not well elucidated. Twin pairs discordant for schizophrenia offer a unique opportunity to identify factors that differ between patients and unaffected co-twins, who are perfectly matched for age, sex and genetic background. Methods Register data were combined with clinical data for 216 twins including monozygotic (MZ) and dizygotic (DZ) proband pairs (one or both twins having a schizophrenia spectrum diagnosis) and MZ/DZ healthy control (HC) pairs. Logistic regression models were applied to predict (1) illness vulnerability (being a proband v. HC pair) and (2) illness status (being the patient v. unaffected co-twin). Risk factors included: A polygenic risk score (PRS) for schizophrenia, birth complications, birth weight, Apgar scores, paternal age, maternal smoking, season of birth, parental socioeconomic status, urbanicity, childhood trauma, estimated premorbid intelligence and cannabis. Results The PRS [odds ratio (OR) 1.6 (1.1–2.3)], childhood trauma [OR 4.5 (2.3–8.8)], and regular cannabis use [OR 8.3 (2.1–32.7)] independently predicted illness vulnerability as did an interaction between childhood trauma and cannabis use [OR 0.17 (0.03–0.9)]. Only regular cannabis use predicted having a schizophrenia spectrum diagnosis between patients and unaffected co-twins [OR 3.3 (1.1–10.4)]. Conclusion The findings suggest that several risk factors contribute to increasing schizophrenia spectrum vulnerability. Moreover, cannabis, a potentially completely avoidable environmental risk factor, seems to play a substantial role in schizophrenia pathology.

scholarly journals Modifiable and Non-Modifiable Risk Factors for Atherothrombotic Ischemic Stroke among Subjects in the Malmö Diet and Cancer Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1952
Author(s):  
Anna Johansson ◽  
Isabel Drake ◽  
Gunnar Engström ◽  
Stefan Acosta
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Family History ◽  
Diet Quality ◽  
Alcohol Intake ◽  
Modifiable Risk Factors ◽  
History Of ◽  
Diet And Cancer

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.

Multiple Risk Factors Before Pediatric Cardiac Transplantation Are Associated With Increased Graft Loss

2011 ◽  
Vol 33 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Scott R. Auerbach ◽  
Marc E. Richmond ◽  
Jonathan M. Chen ◽  
Ralph S. Mosca ◽  
Jan M. Quaegebeur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Transplantation ◽  
Graft Loss ◽  
Multiple Risk Factors ◽  
Multiple Risk

Obesity and Gallstones

2021 ◽  
pp. 1-9
Author(s):  
Nela Melissa Parra-Landazury ◽  
Jacqueline Cordova-Gallardo ◽  
Nahum Méndez-Sánchez
Keyword(s):  
Risk Factors ◽  
Gallstone Disease ◽  
Excess Body Weight ◽  
Modifiable Risk Factors ◽  
Multiple Risk Factors ◽  
Abdominal Perimeter ◽  
Prevalence Of Obesity ◽  
Medical Burden ◽  
Cholesterol Secretion ◽  
Consequent Increase

<b><i>Background:</i></b> The prevalence of obesity has been increasing globally and represents the main risk factor for the development of gallstone disease (GD). <b><i>Summary:</i></b> Excess body weight represents the main cause for the development of GD; nevertheless, there have been described multiple risk factors for its development, among them modifiable risk factors as diet, lifestyle, physical inactivity, and non-modifiable risk factors as ethnicity, female sex, advanced age, parity, and genetic mutations. Body mass index, abdominal perimeter, and waist-hip index have been used to determine the degree of adiposity of a person. Hence, central abdominal fat has been mostly associated with insulin resistance with the consequent increase in the hepatic cholesterol secretion; contributing as one of the multiple mechanisms associated with the development of gallstones. This disease has a low mortality; however, it has been associated with multiple diseases such as cardiovascular diseases, carotid atherosclerosis, metabolic associated fatty liver disease, and gallbladder cancer, probably because they share many of the risk factors. <b><i>Key Messages:</i></b> GD continues to be considered a disease with a high medical burden, in which it is sought to intervene in modifiable risk factors to reduce its development.

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