scholarly journals AB0132 THE STUDY OF SUBCLINICAL SYNOVITIS DETECTED BY ULTRASONOGRAPHY AND MRI IN RA PATIENTS AFTER REACHING CLINICAL REMISSION ON PATIENT’S SUBJECTIVE SYMPTOMS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1094.2-1094
Author(s):  
M. Nawata ◽  
K. Someya ◽  
T. Aritomi ◽  
M. Funada ◽  
K. Nakamura ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Research Funding ◽  
Morning Stiffness ◽  
Univariate Analysis ◽  
P Value ◽  
Research Support ◽  
Residual Symptoms ◽  
Logistic Analysis ◽  
Significant Difference ◽  
Multivariate Logistic Analysis

Background:The goal of treatment in rheumatoid arthritis (RA) is to achieve remission. There is the patient with residual symptoms in the Japanese RA patient who achieved clinical remission. There are not many studies to examine the relation between everyday life, social activity and evaluation of disease activities using high-sensitivity image examinations (musculoskeletal ultrasound (MSKUS) and MRI).Objectives:To examine the relationship between subjective residual symptoms and imaging examinations in RA patients who have achieved clinical remission.Methods:30 RA patients who achieved SDAI remission during RA treatment. Age, sex, disease duration, physical findings, serological markers, disease activity, HAQ, EQ-5D-5L, FACIT-F, Patient Reported Outcomes (PROs), EGA and medications were evaluated. 44 joints were assessed by MSKUS with gray scale (GS) and power doppler (PD) and contrast-enhanced bilateral joint MRI scoring with OMERACT-RAMRIS scoring.Results:1. The mean SDAI of the 30 RA patients was 1.3. 2.In the analysis of the presence or absence of subjective residual symptoms that led to remission of SDAI (Table 1).Table 1.Subjective residual symptoms/presence (N=17)Subjective residual symptoms/absence (N=13)Univariate analysisp valueMultivariate logistic analysisp valueTJC0.0±0.00.3±0.50.0173HAQ0.4±0.40.05±0.10.00950.00181EQ5D-5L0.8±0.10.9±0.00.0001FACIT-F14.5±9.84.6±4.30.0233Morning stiffness (min)256.5±564.80.0±0.00.0210Pain (VAS) (mm)9.2±9.50.9±1.50.00440.0455PGA (mm)7.7±9.00.5±1.10.0013(1). In the univariate analysis, the number of tender joints, HAQ, EQ-5D-5L, FACIT-F, morning stiffness, and pain VAS were extracted with significant differences.(2). In multivariate logistic analysis, HAQ and pain VAS were extracted as independent factors with significant differences. 3.In univariate analysis of the association between HAQ and pain VAS extracted in multivariate logistic analysis and imaging examinations (MSKUS/MRI), MRI-synovitis was extracted with a significant difference in HAQ.Conclusion:1. It was suggested that Pain VAS and HAQ due to RA could be identified in patients reaching SDAI remission. 2. In patients reaching SDAI remission, Pain VAS ≤10 or HAQ ≤0.5 suggested that subjective residual symptoms may be eliminated. 3. HAQ ≤ 0.5 suggests that synovitis is less likely to be detected on MRI. 4. In patients who have reached SDAI remission, little residual inflammation was observed on US, suggesting that induction of remission is important not only to prevent joint destruction, but also to improve and maintain long-term QoL.Disclosure of Interests:MASAO NAWATA Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Kazuki Someya: None declared, Takafumi Aritomi: None declared, Masashi funada: None declared, Katsumi Nakamura: None declared, SAITO KAZUYOSHI Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Yoshiya Tanaka Speakers bureau: I have received speaking fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Consultant of: I have received consulting fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Grant/research support from: I have received research grants from Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, Taisho-Toyama, Kyowa-Kirin, Abbvie, and Bristol-Myers

Adherence to the BCLC guidelines and impact on overall survival.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 345-345 ◽  
Author(s):  
Jesna Mathew ◽  
Sasha Slipak ◽  
Anil Kotru ◽  
Joseph Blansfield ◽  
Nicole Woll ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Benefit ◽  
Cox Regression ◽  
Early Stage ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Treatment Recommendations ◽  
Rank Test ◽  
P Value ◽  
Significant Difference

345 Background: Multiple studies exist that validate the prognostic value of the Barcelona Clinic Liver Cancer (BCLC) staging. However, none have established a survival benefit to the treatment recommendations. The aim of this study was to evaluate the adherence to the BCLC guidelines at a rural tertiary care center, and to determine the effect of following the treatment recommendations on overall survival. Methods: A retrospective chart review was conducted for 97 patients newly diagnosed with hepatocellular carcinoma (HCC) from 2000 to 2012. The treatment choice was compared with the BCLC guidelines and percentage adherence calculated. Overall survival was estimated using the Kaplan-Meier method and the log rank test was used to test the difference between the two groups. Cox regression tests were used to determine independent effects of stage, treatment aggressiveness, and guideline adherence on survival. A p-value <0.05 was considered statistically significant. Results: Of 97 patients, 75% (n=73) were male. Median overall survival was 12.9 months. In 59.8% (n=58) of the patients, treatment was adherent to stage specific guidelines proposed by the BCLC classification. There was no significant difference in overall survival between the adherent and non-adherent groups (11.2 vs 14.1 months, p<0.98). However on stage specific survival analysis, we noted a significant survival benefit for adherence to the guidelines for early stage HCC (27.9 vs 14.1 months, p<0.05), but a decrease in survival for adherence in the end stage (20 days vs 9.3 months, p<0.01). On univariate analysis, more aggressive treatment was associated with increased survival (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.22 to 0.87; p = 0.018). Multivariate analysis revealed that adherence did not independently affect survival when stage and aggressiveness of treatment were included in the model (HR, 1.3; 95% CI, 0.76 to 2.2, p = 0.34). Conclusions: Although the BCLC guidelines serve as a practical guide to the management of patients with HCC, they are not universally practiced. These results indicate that survival of patients with hepatocellular cancer is determined by stage and aggressiveness of treatment, not adherence to BCLC guidelines.

Activity of second line axitinib in metastatic renal cell carcinoma (mRCC) patients treated with sunitinib: Results from SAX Italian real world trial.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16054-e16054
Author(s):  
Sabrina Rossetti ◽  
Francesco Jacopo Romano ◽  
Carmine D'Aniello ◽  
Carla Cavaliere ◽  
Salvatore Pisconti ◽  
...  
Keyword(s):  
Real World ◽  
Medical Records ◽  
Kinase Inhibitor ◽  
Univariate Analysis ◽  
P Value ◽  
World Population ◽  
Second Line ◽  
First Line ◽  
Primary Endpoints ◽  
Significant Difference

e16054 Background: Axitinib, a selective tyrosine kinase inhibitor (TKI), is currently approved for the treatment of mRCC after failure of prior treatment with sunitinib or cytokine, according to AXIS trial results. The best sequence hasn’t been established: both axitinib and everolimus (a mTOR inhibitor) are viable therapeutic options, although recently immunotherapy agents entered this setting. This Italian multi-institutional retrospective analysis evaluated outcomes of Axitinib in exclusive sequence after sunitinib in second line treatment of mRCC Methods: Medical records of 148 patients treated with Axitinib from 21 Italian Oncology Centers were retrospectively assessed: PFS, OS, ORR DCR, and safety profile of axitinib were primary endpoints. Results: Median PFS and OS were 7.14 and 15.5 months, respectively. Overall, axitinib at standard schedule of 5 mg bid, was well tolerated, with no grade 4 toxicity event. Most common adverse events were hypertension (26% of the cases), fatigue (50 %), hypothyroidism (18%). At univariate analysis, when patients were stratified by Heng score, mPFS was 5.8, 7.0 and 9.0 months according to poor, intermediate and favourable risk group, respectively. When stratified by median duration of prior sunitinib therapy (≥ 13,1 mo vs < 13,1 mo), there was a statistically significant difference in PFS with 8.8 vs 6.3 months, respectively. Disease control rate (DCR) to previous sunitinib treatment was associated to longer PFS with axitinib ( 8.0 months vs4.0 months). The sequence sunitinib-axitinib was well tolerated, with a mOS of 41 months. At multivariate analysis, prognostic factors for progression were gender (p-value = 0,006), DCR to axitinib (p < 0,0001) and to previous sunitinib (p = 0,041); DCR to axitinib (p = < 0,0001), nephrectomy (p = 0,002) and Heng score (p = 0,025) independently affected overall survival. Conclusions: The preliminary SAX results in the real world population are consistent with available literature. The study confirms that Axitinib is effective and safe in routine clinical practice, and its efficacy seems to be greater in patients who most benefited from first-line sunitinib.

scholarly journals Primary Central Nervous System Lymphoma: A Retrospective Study of the Population of Texas and Florida with an Emphasis on Survival Outcomes on Hispanics Vs Non-Hispanics

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1443-1443
Author(s):  
Kana Tai Lucero ◽  
Lakene Raissa Djoufack Djoumessi ◽  
Joel E Michalek ◽  
Qianqian Liu ◽  
Adolfo Enrique Diaz Duque
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Retrospective Study ◽  
Research Funding ◽  
Central Nervous System Lymphoma ◽  
Survival Outcomes ◽  
P Value ◽  
Poverty Index ◽  
Significant Difference ◽  
The U.S

Abstract Introduction Primary central nervous system lymphoma (PCNSL) is a devastating subtype of extranodal non-Hodgkin's lymphoma (NHL) that accounts for ~4% of newly diagnosed central nervous system (CNS) tumors. (NeuroOncol PMID: 21915121) The age-adjusted incidence of PCNSL in the U.S. has increased since the 1970s. (ACS PMID: 19273630) despite advances in the treatment of lymphoma, and clinical outcomes remain poor with an estimated 5- year survival for immunocompetent patients at 30%. (NCBIPMID:31424729) Trends in outcomes of PCNSL have been reported, but sub-analyses for minorities like Hispanics (HI), have not been widely studied. Understanding ethnic disparities on outcomes and patterns of care in PCNSL are crucial given the rapid growth of HI in the U.S. This study aims to examine the demographics, treatment patterns, and survival outcomes of PCNSL in HI compared to Non-Hispanics (NH) in Texas (TX) and Florida (FL). Methods This is a retrospective study of a cohort of patients diagnosed with lymphoma (Hodgkin and Non-Hodgkin) from the TX Cancer Registry (TCR) and the FL Cancer Data System (FCDS) from 2006-2017. Patients with PCNSL were identified by the International Classification of Diseases for Oncology Third Edition (ICD-O-3) code list. Standard demographic variables collected include gender, ethnicity, dates at diagnosis and death, primary payer at diagnosis, type of treatment and poverty index (PI). The significance of variation in the distribution of categorical outcomes with ethnicity (HI and NH) was assessed with Fisher's Exact tests or Pearson's Chi-square tests as appropriate; age was assessed with T-tests or Wilcoxon tests as appropriate. Survival distributions were described with Kaplan-Meier curves and significance of variation in median survival with ethnicity was assessed with log rank testing. All statistical testing was two-sided with a significance level of 5%. Results The study included 1969 patients (TX: n=297 HI, n= 708 NH; FL: n=149 HI, n=415 NH). PCNSL was diagnosed at younger median age in HI (TX: 59,FL:59) compared to NH (TX: 62, FL:63),with a significant difference noted within each state (TX: p= 0.005; FL: p=0.007). HI in TX were identified primarily as Mexican, Spanish or NOS/Hispanic. There was a significant predominance of overall males (M) in TX (p=0.009). There was a non-significant predominance of M in FL. Regarding poverty index (PI), there were more HI (TX:51% and FL: 35%) in the 20-100% bracket than NH (TX: 25%; FL: 22%). Conversely there were more NH in all other PI in TX and FL. Government sponsored insurance was the most common insurance in all subgroups. This reached a significant predominance in HI (54%) and NH (54%) in TX (p&lt;0.001). There was no significant difference in insurance types between HI and NH in FL(p=0.772). Regarding chemotherapy there was a trend to either use multiple agents [(TX: 34% in HI vs 32% in NH; p=0.68); (FL: 33% in HI vs 67% in NH; p=0.042)] or to not offer chemotherapy at all [(TX: 26% in HI vs 29% in NH; p= 0.68); (FL: 44% in HI vs 33% in NH; p=0.042)] with significant differences noted in FL only. (Table 1) The median survival (MS) for HI and NH in TX was similar in years (y) at 0.8 while the MS time in FL for HI vs NH was higher (1.3 vs 0.6 respectfully) Thus, the MS for HI in FL was higher compared to NH in FL and HI and NH in both TX and FL. (Table 2) The survival probability for HI was shorter at 2 and 5 years compared to NH in TX with a non-significant overall survival (OS) probability (p-value=0.19) seen in Figure 1. Significantly, the survival probability of HI in FL at 2, 5 and 10 years was higher compared to NH with an OS probability (p-value=0.0063) seen in Figure 2. Conclusion This retrospective study showed a statistically significant difference in OS probabilities at all years between HI and NH in FL with PCNSL. The OS probability also remained higher in HI in FL compared to both HI and NH in TX. In addition, the study demonstrated a longer MS in HI in FL compared to not only HI in TX, but also both NH in TX and FL. Sociodemographic differences like gender and insurance types were noted between HI in TX and FL. HI origin groups are also a subject of interest. The primary HI origin group in TX were Mexican and not otherwise specified (NOS). This data was missing for FL HI. Future studies should be conducted to uncover any further disparities between these two HI populations to explore the impact of access to care and disease biology on PCNSL survival outcomes. Figure 1 Figure 1. Disclosures Diaz Duque: Incyte: Consultancy; Morphosys: Speakers Bureau; Astra Zeneca: Research Funding; Hutchinson Pharmaceuticals: Research Funding; Epizyme: Consultancy; ADCT: Consultancy.

scholarly journals Harm Perception and Attitudes towards E-cigarette Use Among Qatar University Students: A Cross-Sectional Study

2021 ◽  
Author(s):  
Rana Kurdi ◽  
Hanan Abdul Rahim ◽  
Ghadir Al-Jayyousi ◽  
Manar Yaseen ◽  
Aetefeh Ali ◽  
...  
Keyword(s):  
University Students ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Smoking Prevention ◽  
Bivariate Analysis ◽  
P Value ◽  
Cigarette Use ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Background: Electronic cigarette (e-cigarette) use is becoming popular worldwide especially among youth. Research reported that university students have poor knowledge and misconceptions about the health risks of e-cigarettes, which may lead students to use them even in populations where prevalence of cigarette smoking is relatively low. At this age, the influence of peers is also significant. In this study, we assessed the prevalence of e-cigarette use among university students as well as their knowledge and attitudes towards e-cigarettes. Methodology: We conducted a cross-sectional study among Qatar University students using a self-administered online questionnaire. Descriptive univariate analysis of all variables was conducted as well as a bivariate analysis to check the association of e-cigarette use with selected variables. A binary logistic regression was conducted to assess predictors of e-cigarette use. Results: The prevalence of e-cigarette use among students was found to be 14% where 32% of them were daily users. Approximately 42% of the participants agreed that ‘e-cigarettes are less harmful to health compared to traditional cigarettes, and 45.7% of them agreed that ‘e-cigarettes can prevent smoking traditional cigarettes. The prevalence of e-cigarettes use was 16.2% among males and 12.8% among females, which showed no significant difference between the two genders. Females were more likely to use e-cigarettes because they “don’t smell” (P-value=0.023). The study showed a significant association between e-cigarette use and knowledge items (P-value < 0.05) and having a smoker among siblings or friends. At the multivariate analysis level, only the friends’ effect remained significant after controlling for the other variables (OR= 7.3, P-value=0.000). Conclusion: Our research found that university students have inadequate knowledge and misconceptions in regards to e-cigarettes use, especially among users. Effective smoking prevention policy and educational interventions are needed to enhance awareness among university students about the health effects associated with e-cigarettes use.

scholarly journals P547 Safety and efficacy of vedolizumab in the treatment of patients with moderate to severe Ulcerative Colitis: a systematic review and meta-analysis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S516-S517
Author(s):  
M Khorshid Fasge ◽  
M Alboraie ◽  
W Abbas ◽  
Z E Sayed ◽  
M El-Nady
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
Cohort Studies ◽  
Clinical Response ◽  
Clinical Remission ◽  
Assessment Tool ◽  
Meta Analysis ◽  
P Value ◽  
Severe Ulcerative Colitis ◽  
Significant Difference

Abstract Background To perform a systematic review and meta-analysis discussing the efficacy and safety of vedolizumab (VDZ) treatment in patients with active moderate to severe ulcerative colitis (UC). Methods Using relevant keywords, we searched PubMed, Web of Science, Scopus, and Cochrane Central databases, until June 2020. We included interventional and observational cohort studies which assessed the safety and effectiveness of VDZ 300 mg intravenous infusion, in patients with active moderate to severe UC. We used the Cochrane risk of bias assessment tool and the Newcastle-Ottawa scale to assess the quality of included interventional and cohort studies, respectively. Dichotomous outcomes were pooled as proportion, 95% Confidence interval (CI), and p-value under the random-effects model in the open meta-analyst software. Results We found 10 interventional studies and 35 cohort studies, including 4,794 patients eligible for our review. Most of the included citations were single-arm studies. Our meta-analysis showed that VDZ therapy could induce a significant clinical response in UC patients up to 54 weeks (proportion 0.516, 95% CI [0.453, 0.578], p &lt; 0.001). VDZ was associated with clinically significantly clinical remission and steroid-free clinical remission after 54 weeks (p &lt; 0.0001). Durable clinical remission, histological remission, and endoscopic response rates were maintained in UC patients taking VDZ at the 52nd week. There was no significant difference between VDZ and placebo regarding the incidence of drug-related serious adverse events (p = 0.113) and death rates (p = 0.085). Conclusion Our systematic review and meta-analysis showed that the use of VDZ in patients with active moderate to severe UC was associated with high percentages of clinical response and remission rates in induction and maintenance treatment stages. VDZ seems to be well tolerated in UC patients, apart from some infections and inflammations. Future RCTs should compare VDZ to active treatments for longer follow-up periods with larger sample size.

scholarly journals Medical Students' Perception of the Educational Environment at Al-Nahda College by using DREEM inventory

2020 ◽  
Author(s):  
Hamdan Z. Hamdan ◽  
Marwa Yassin Ibrahim ◽  
Rania Hessian Mohamed ◽  
Liza Hassan Ali ◽  
Yasir A. Mohamedelhassan ◽  
...  
Keyword(s):  
Medical Students ◽  
Student Perceptions ◽  
Univariate Analysis ◽  
Well Being ◽  
Educational Environment ◽  
P Value ◽  
Social Self ◽  
Self Perception ◽  
Survey Tool ◽  
Significant Difference

Abstract Background: Educational environment encompasses everything that is found and occurs inside medical school. It affects students’ ability to achieve their academic goals, feelings of academic satisfaction, and well-being. Assessment of the educational environment is of paramount importance for stakeholders, administrators and educators in the academic field. The aim of this study was to measure student perceptions of the educational environment in a medical college in Sudan.Methods: This was an institutional-based cross-sectional study conducted in Al-Nahda College, Khartoum, Sudan, between January and February 2018 with a sample of 634 medical students (56.9% male; pre-clinical (83.9%) and clinical (16.1%) students). The Dundee Ready Education Environment Measure (DREEM) questionnaire was used as a survey tool. Overall DREEM score was compared with students’ academic levels by using one-way ANOVA after Tukey’s test. Students’ gender, academic levels and nationality were used as independent variables determining the overall DREEM score by using multivariate analysis. Student’s t-test was used to compare the overall scores among all students based on gender and academic levels (clinical and pre-clinical).Results: The overall mean (SD) DREEM score in this study was 130 (34.2), which indicates a more positive educational environment than negative. Student perception of teachers, academic self-perception, perception of atmosphere and social self-perception was positive. However, perception of learning was negative. Female students had a significantly higher mean (SD) overall DREEM score than males [136 (31.5) vs. 129 (35.5); P=0.008]. There was no significant difference in overall DREEM score between pre-clinical and clinical students [132 (33.3) vs. 132 (38.3); P= 0.946]. Females scored higher than males in the subclasses regarding students’ perception of teachers, academic self-perception and social self-perception [28.8 (7.8) vs. 27.1 (8.5); P= 0.024]; [22.2 (5.6) vs. 21.0 (7.2); P= 0.017]; [19.8 (4.9) vs. 18.8 (5.4); P= 0.019], respectively. Univariate analysis showed that student gender significantly determines the overall DREEM score [Beta± SE; P-value].Conclusions: The educational environment is generally perceived as positive in Al-Nahda College. Perception of learning was the only sub-scale regarded as negative. Females perceived the educational environment more positively than males.

Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study

2021 ◽  
Author(s):  
Xue-Cong Zheng ◽  
Jin-Bo Su
Keyword(s):  
Rectal Cancer ◽  
Univariate Analysis ◽  
Measurement Data ◽  
Preoperative Chemoradiotherapy ◽  
Anal Margin ◽  
Logistic Analysis ◽  
Cancer Group ◽  
Intervention Measures ◽  
Significant Difference ◽  
The Impact

Abstract Background：The impact of Hyperuricemia (HUA) on Dixon surgery is rarely reported. Anastomotic leakage (AL) is the main serious complication in Dixon surgery. We discussed the relationship between HUA and AL. Our aim was to identify these factors to provide intervention measures for clinical practice.Methods：The clinical data of 1147 patients who underwent Dixon operation for rectal cancer in the Second Affiliated Hospital of Fujian Medical University from January 2009 to December 2018 were retrospectively analyzed. Rank sum test was used for measurement data, and χ2 test was used for counting data. In univariate analysis, significant variables (P < 0.05) were used for multivariate analysis, and multivariable logistic regression was used to examine their independent roles. All tests were 2-sided, P<0.05 was considered statistically significant.Results：A total of 1147 patients with rectal cancer undergoing Dixon operation were included in the study, including 153 patients with HUA and 994 patients with normal uric acid (UA). The AL was 148 cases (14.9%) in UA group and 37 cases (24.2%) in HUA group. There was significant difference in AL (P = 0.006). The influence of HUA (P = 0.006), Tumor distance from the anal margin (TD) (P = 0.024) and preoperative chemoradiotherapy (PCT) (P = 0.040) on AL were significantly different. Logistic analysis showed that HUA (P = 0.021) and TD (P = 0.014) had significant effects on AL. In rectal cancer group with HUA, there were significant differences in the effects of male (P = 0.035), body mass index (BMI) (P = 0.017) and PCT (P = 0.013) on AL. Logistic analysis showed that there were significant differences between male (P = 0.001) and PCT (P = 0.004) on AL.Conclusions：HUA is an independent risk factor of AL in Dixon operation for rectal cancer. In patients with HUA undergoing Dixon operation, gender, BMI and PCT have significant difference on AL. Male and PCT are independent risk factors of AL.

P–651 Strict embryo-endometrial synchrony does not contribute to the successful pregnancy during vitrified-warmed embryo transfer with hormone replacement cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
T Takahashi ◽  
K Ota
Keyword(s):  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Hormone Replacement ◽  
Time Lapse ◽  
Successful Pregnancy ◽  
Logistic Analysis ◽  
Significant Difference ◽  
The Mean ◽  
Multivariate Logistic Analysis

Abstract Study question Does strict embryo-endometrium synchronization relate to pregnancy during vitrified-warmed embryo transfer (ET) with hormone replacement (HRT) cycles? Summary answer A 12-hour delay in the embryo-endometrial synchrony was acceptable, and this delay was not an independent predictor of pregnancy during vitrified-warmed ET with HRT cycles. What is known already Embryo-endometrium synchrony is considered to be necessary for successful pregnancy in both fresh and frozen-thawed cycles. Until now, the date of ET has been determined by the synchronization of the embryo developmental stage and the endometrium on a daily basis. To date, with the advent of the time-lapse incubator, it is possible to observe the embryo development from fertilization over time and to calculate the exact time from fertilization of the transferred embryo. However, there are very few studies on the extent to which increases the accuracy of synchronization between embryo and endometrium contributes to a successful pregnancy. Study design, size, duration This retrospective cohort study included 319 consecutive cycles during vitrified-warmed ET with HRT between August 2016 and August 2018. This study was conducted in an academically affiliated private practice. Participants/materials, setting, methods We analyzed 319 vitrified-warmed single-blastocyst transfer cycles. All frozen expanded blastocysts were inseminated by intracytoplasmic sperm injection (ICSI) and cultured in a time-lapse incubator. We calculated time for the in vitro culture of the embryo after ICSI (t1) and time for progesterone-priming (t2) up to ET. The difference between t1 and t2 (delta-t) was used as an indicator of embryo-endometrium synchrony. We examined the relationship between delta-t and treatment outcomes using multivariate logistic analysis. Main results and the role of chance The mean patient’s age at oocyte retrieval was 35.7 (SD 4.3). The number of pregnant cycles was 157 in all treatment cycles (pregnancy rate, 49.2%). The mean value of delta-t was 9.9 h (SD 2.6) in all cycles. There was no significant difference of delta-t in pregnant (mean, SD: 10.0 h, 2.8 h) and non-pregnant cycles (mean, SD: 10.0 h, 2.3 h). Treatment cycles were classified according to the quartile of delta-t, and we examined the percentages of pregnant cycles in each group. There were no significant differences in pregnancy rates among the groups (p = 0.75). On multivariate logistic analysis, patient’s age (adjusted odds ratio [aOR]: 0.94, 95% confidence interval [CI]: 0.89–0.99), previous treatment cycles (aOR: 0.74, 95% CI: 0.56–0.99), endometrial thickness at ET (aOR: 1.19, 1.04–1.36), and good quality blastocysts (&gt;3BB according to Gardner’s classification) at vitrification (aOR: 2.49, 95% CI: 1.23–5.05) were independent predictive factors for pregnancy. On the other hand, delta-t did not contribute to pregnancy (aOR: 1.00, 95% CI: 0.99–1.00). Limitations, reasons for caution We did not examine the effects of embryo-endometrium synchrony during vitrified-warmed ET in a natural cycle. Therefore, careful interpretation of the significance of embryo-endometrium synchrony during the vitrified-warmed ET should be taken. Wider implications of the findings: We showed the embryo-endometrium synchrony did not contribute to the pregnancy during vitrified-warmed ET with HRT cycles. These results cast doubt on the existence of an optimal implantation window by changing the timing of ET with the results of gene expression testing of the endometrium. Trial registration number Not applicable

Effect of Household Income on Short-Term Outcomes Following Cerebellopontine Angle Tumor Resection

2021 ◽  
Author(s):  
Vincent Huang ◽  
Stephen P. Miranda ◽  
Ryan Dimentberg ◽  
Kaitlyn Shultz ◽  
Scott D. McClintock ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Household Income ◽  
Cerebellopontine Angle ◽  
Univariate Analysis ◽  
Tumor Resection ◽  
Index Admission ◽  
P Value ◽  
Short Term ◽  
Significant Difference ◽  
The Impact

Abstract Objectives The objective of this study is to elucidate the impact of income on short-term outcomes in a cerebellopontine angle (CPA) tumor resection population. Design This is a retrospective regression analysis. Setting This study was done at a single, multihospital, urban academic medical center. Participants Over 6 years (from June 7, 2013, to April 24, 2019), 277 consecutive CPA tumor cases were reviewed. Main Outcome Measures Outcomes studied included readmission, emergency department evaluation, unplanned return to surgery, return to surgery after index admission, and mortality. Univariate analysis was conducted among the entire population with significance set at a p-value <0.05. The population was divided into quartiles based on median household income and univariate analysis conducted between the lowest (quartile 1 [Q1]) and highest (quartile 4 [Q4]) socioeconomic quartiles, with significance set at a p-value <0.05. Stepwise regression was conducted to determine the correlations among study variables and to identify confounding factors. Results Regression analysis of 273 patients demonstrated decreased rates of unplanned reoperation (p = 0.015) and reoperation after index admission (p = 0.035) at 30 days with higher standardized income. Logistic regression between the lowest (Q1) and highest (Q4) socioeconomic quartiles demonstrated decreased unplanned reoperation (p = 0.045) and decreasing but not significant reoperation after index admission (p = 0.15) for Q4 patients. No significant difference was observed for other metrics of morbidity and mortality. Conclusion Higher socioeconomic status is associated with decreased risk of unplanned reoperation following CPA tumor resection.

Abstract WMP82: The Association Between Cerebral Microbleeds And Arterial Stiffness

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Tae-Jin Song ◽  
Jinkwon Kim ◽  
Dong-Beom Song ◽  
Hye Sun Lee ◽  
Chung Mo Nam ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Ankle Brachial Index ◽  
Automatic Device ◽  
Cerebral Microbleeds ◽  
P Value ◽  
Amyloid Angiopathy ◽  
Small Vessels ◽  
Logistic Analysis

Background and significance: Increased arterial stiffness causes vessel damage of the end-organs. Thus, in the brain, small vessels may be susceptible to increased arterial stiffness. Cerebral microbleeds (CMBs) are topographically categorized as non-lobar type, mostly due to hypertensive vasculopathy and lobar type, due to cerebral amyloid angiopathy. When considering CMBs in the nonlobar region are associated with small vessel pathology, arterial stiffness may be related with CMBs in the nonlobar region. We investigated relationship between CMBs by using brachial ankle pulse wave velocity (baPWV) representing arterial stiffness. Method: Between June 2006 and January 2012, we included 1290 consecutive patients with acute ischemic stroke admitted to hospital within 7 days after symptom onset and who underwent baPWV and brain gradient echo (GRE) and Fluid Attenuated Inversion Recovery (FLAIR) MRI. Patients with potential cardiac sources of embolism or peripheral arterial occlusive disease were not included. BaPWV was measured during ankle-brachial index examination using an automatic device. CMBs were classified as lobar and nonlobar type. Severity of leukoaraiosis was determined using the Fazekas’ scoring system. Binary and multinomial logistic regression analyses were performed to determine variables that were associated with presence and location of CMBs. Results: Mean age of the patients was 64±12 years and 61.9% (799/1290) were male. Of 1290 patients, CMBs were found in 28.6%. The patients with CMBs were older than those without CMBs (69±10 years versus 63±12 years, p=0.001). Mean baPWV was higher in patients with CMBs than those without (2240±512cm/s versus 1896±505cm/s, p=0.001). On multivariate binary logistic analysis, baPWV and high grade leukoaraiosis were independent predictors of the presence of CMBs. However, after adjustment of age, sex and variables with p value of less than 0.1on the univariate analysis, baPWV was independently associated with nonlobar CMBs. Conclusion: Arterial stiffness was independently associated with nonlobar CMBs but not with lobar CMBs. These findings suggest pathophysiologic association between arterial stiffness and CMBs in the nonlobar region.

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