scholarly journals Risk factors for lymphedema and method of assessment in endometrial cancer: a prospective longitudinal multicenter study

2021 ◽  
pp. ijgc-2021-002890
Author(s):  
Madelene Wedin ◽  
Karin Stalberg ◽  
Janusz Marcickiewicz ◽  
Eva Ahlner ◽  
Ulrika Ottander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Endometrial Cancer ◽  
Risk Factor ◽  
Body Mass ◽  
Multicenter Study ◽  
Volume Estimation ◽  
Patient Reported ◽  
Prospective Longitudinal ◽  
Clinical Grading

ObjectiveThe aim of the study was to determine risk factors for lymphedema of the lower limbs, assessed by four methods, 1 year after surgery for endometrial cancer.MethodsA prospective longitudinal multicenter study was conducted in 14 Swedish hospitals. 235 women with endometrial cancer were included; 116 underwent surgery including lymphadenectomy, and 119 had surgery without lymphadenectomy. Lymphedema was assessed preoperatively and 1 year postoperatively objectively by systematic circumferential measurements of the legs, enabling volume estimation addressed as (1) crude volume and (2) body mass index-standardized volume, or (3) clinical grading, and (4) subjectively by patient-reported perception of leg swelling. In volume estimation, lymphedema was defined as a volume increase ≥10%. Risk factors were analyzed using forward stepwise logistic regression models and presented as adjusted odds ratio (aOR) and 95% confidence interval (95% CI).ResultsRisk factors varied substantially, depending on the method of determining lymphedema. Lymphadenectomy was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 14.42, 95% CI 3.49 to 59.62), clinical grading (aOR 2.11, 95% CI 1.04 to 4.29), and patient-perceived swelling (aOR 2.51, 95% CI 1.33 to 4.73), but not when evaluated by crude volume. Adjuvant radiotherapy was only a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 15.02, 95% CI 2.34 to 96.57). Aging was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 1.07, 95% CI 1.00 to 1.15) and patient-perceived swelling (aOR 1.06, 95% CI 1.02 to 1.10), but not when assessed by crude volume or clinical grading. Increase in body mass index was a risk factor for lymphedema when estimated by crude volume (aOR 1.92, 95% CI 1.36 to 2.71) and patient-perceived swelling (aOR 1.36, 95% CI 1.11 to 1.66), but not by body mass index-standardized volume or clinical grading. The extent of lymphadenectomy was strongly predictive for the development of lymphedema when assessed by body mass index-standardized volume and patient-perceived swelling, but not by crude volume or clinical grading.ConclusionApparent risk factors for lymphedema differed considerably depending on the method used to determine lymphedema. This highlights the need for a ‘gold standard’ method when addressing lymphedema for determining risk factors.

scholarly journals Plasma Adiponectin Concentrations in Relation to Endometrial Cancer: A Case-Control Study in Greece

2003 ◽  
Vol 88 (3) ◽  
pp. 993-997 ◽  
Author(s):  
Eleni Petridou ◽  
Christos Mantzoros ◽  
Nick Dessypris ◽  
Panagiotis Koukoulomatis ◽  
Carol Addy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Endometrial Cancer ◽  
Risk Factor ◽  
Body Mass ◽  
Inverse Association ◽  
Cancer Risk Factors ◽  
Established Risk Factor ◽  
Igf System ◽  
Pelvic Prolapse

Adiponectin is a hormone secreted exclusively by adipocytes, and obesity is an established risk factor for endometrial cancer. We have, thus, evaluated the association of adiponectin with the occurrence of endometrial cancer. Questionnaire information and blood samples were taken before treatment from 84 women with newly diagnosed, histologically confirmed endometrial cancer and 84 control women who were admitted for minor gynecologic problems, mainly pelvic prolapse. Adiponectin levels were measured by immunoassay. The results were analyzed through multiple logistic regression and controlled for known risk factors for endometrial cancer, leptin, as well as major components of the IGF system (IGF-I, IGF-II, and IGF-binding protein 3). Among control women, there was no significant association of adiponectin with age or parity. Although there was no association of adiponectin with endometrial cancer among women 65 yr or older, there was an inverse, fairly strong, and statistically significant inverse association among younger women. Among women younger than 65 yr, an increase of adiponectin by 1 sd was associated with a more than 50% reduction of the risk for endometrial cancer [odds ratio (OR) 0.44; 95% confidence interval (CI) 0.24–0.81], even after controlling for body mass index and other potential confounders. Among all women, the adjusted OR for a 1 sd increase in adiponectin was not significant (OR, 0.78; 95% CI, 0.56–1.10) but was significant for a one quintile increase in adiponectin (OR, 0.74; 95% CI, 0.56–0.97). In women younger than 65 yr, among whom obesity represents a powerful risk factor for endometrial cancer, adiponectin is inversely and significantly related to the risk of this disease. This association is independent of possible effects of major components of the IGF system, leptin, body mass index, sociodemographic variables, and known endometrial cancer risk factors. Future studies are needed to prove causality and provide insight on both the mechanism of action of this hormone and its potential role in endometrial cancer.

scholarly journals Identification of Endothelial Proteins in Plasma Associated With Cardiovascular Risk Factors

2021 ◽  
Author(s):  
Maria J. Iglesias ◽  
Larissa D. Kruse ◽  
Laura Sanchez-Rivera ◽  
Linnea Enge ◽  
Philip Dusart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Risk Factor ◽  
Total Cholesterol ◽  
Body Mass ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factor ◽  
Venous Disease

Objective: Endothelial cell (EC) dysfunction is a well-established response to cardiovascular disease risk factors, such as smoking and obesity. Risk factor exposure can modify EC signaling and behavior, leading to arterial and venous disease development. Here, we aimed to identify biomarker panels for the assessment of EC dysfunction, which could be useful for risk stratification or to monitor treatment response. Approach and Results: We used affinity proteomics to identify EC proteins circulating in plasma that were associated with cardiovascular disease risk factor exposure. Two hundred sixteen proteins, which we previously predicted to be EC-enriched across vascular beds, were measured in plasma samples (n=1005) from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study) pilot. Thirty-eight of these proteins were associated with body mass index, total cholesterol, low-density lipoprotein, smoking, hypertension, or diabetes. Sex-specific analysis revealed that associations predominantly observed in female- or male-only samples were most frequently with the risk factors body mass index, or total cholesterol and smoking, respectively. We show a relationship between individual cardiovascular disease risk, calculated with the Framingham risk score, and the corresponding biomarker profiles. Conclusions: EC proteins in plasma could reflect vascular health status.

scholarly journals Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s377
Author(s):  
Feah Visan ◽  
Jenalyn Castro ◽  
Yousra Siam Shahada ◽  
Naser Al Ansari ◽  
Almunzer Zakaria
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Body Mass ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

scholarly journals Underweight increases the risk of pulmonary tuberculosis in adult

2017 ◽  
Vol 36 (1) ◽  
pp. 4
Author(s):  
Galuh Chandra Irawan ◽  
Ani Margawati ◽  
Ali Rosidi
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Risk Factor ◽  
Pulmonary Tuberculosis ◽  
Body Mass ◽  
Low Income ◽  
Smoking Behavior ◽  
Significant Risk ◽  
Low Body Mass Index

<p>Background<br />Tuberculosis (TB) is a leading cause of morbidity and mortality, especially in middle- and low-income countries. The risk of developing TB may be related to nutritional status. Socioeconomic and behavioral factors are also shown to increase the susceptibility to TB infection. The objective of this study was to determine nutritional factors as risk factors of pulmonary TB in adult.</p><p>Methods<br />This was an observational study of case control design. The study subjects were community members consisting of 19 adult cases of pulmonary tuberculosis and 38 controls. Data on nutritional intakes were obtained by semiquantitative food frequency questionnaire (FFQ), while smoking behavior, history of DM, body mass index, education, and income were obtained by structured interviews. The data were analyzed by independent t-test and logistic regression for calculation of the odds ratio (OR).</p><p>Results<br />The bivariate test showed that the adequacy levels for energy (OR=6.8; 95% CI: 1.51-30.54), protein (OR=5.1; 95% CI: 1.52-17.14), vitamin A (OR=4.2; 5% CI: 1.31-13.54), vitamin C (OR=3.8;95% CI: 1.21-12.36), selenium (OR=4.2; 95% CI: 1.34-13.58), body mass index (OR=4.4; 95% CI: 1.32-14.35) and smoking behavior (OR=3.7; 95% CI: 1.15-11.9), were significant risk factors for pulmonary tuberculosis. Multiple logistic regression test showed that low body mass index (&lt;18.5 kg/m2) (OR=6.0; 95% CI: 1.32-27.18) was a the most influential risk factor of pulmonary tuberculosis.</p><p>Conclusion<br />Low body mass index is the most influential risk factor for pulmonary tuberculosis incidence in adult. Nutrition profile in adult is an important determinant of TB incidence.</p>

Is Body Mass Index an Independent Risk Factor of Survival Among Patients With Endometrial Cancer?

2007 ◽  
Vol 30 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Sarah M. Temkin ◽  
John C. Pezzullo ◽  
Mira Hellmann ◽  
Yi-Chun Lee ◽  
Ovadia Abulafia
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Risk Factor ◽  
Body Mass ◽  
Independent Risk Factor

Physical activity-related differences in body mass index and patient-reported quality of life in socioculturally diverse endometrial cancer survivors

2017 ◽  
Vol 25 (7) ◽  
pp. 2169-2177 ◽  
Author(s):  
Amerigo Rossi ◽  
Carol Ewing Garber ◽  
Gurpreet Kaur ◽  
Xiaonan Xue ◽  
Gary L. Goldberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Body Mass Index ◽  
Endometrial Cancer ◽  
Cancer Survivors ◽  
Body Mass ◽  
Patient Reported

scholarly journals Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis

2021 ◽  
pp. 194173812097097
Author(s):  
Karrie L. Hamstra-Wright ◽  
Kellie C. Huxel Bliven ◽  
R. Curtis Bay ◽  
Burcu Aydemir
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Range Of Motion ◽  
Body Mass ◽  
Plantar Fasciitis ◽  
Observational Studies ◽  
Meta Analysis ◽  
Physically Active

Context: Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of understanding risk factors for preventive efforts. Objective: The purpose of this systematic review and meta-analysis was to determine what factors may put physically active individuals at risk of developing PF. Data Sources: CENTRAL, CINAHL, EMBASE, Gray Lit, LILACS, MEDLINE (PubMed), ProQuest, Scopus, SPORTDiscus, and Web of Science were searched through April 2018 and updated in April 2020. Study Selection: Studies were included if they were original research investigating PF risk factors, compared physically active individuals with and without PF, were written in English, and were accessible as full-length, peer-reviewed articles. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3, because of inconsistent definitions and blinding used in the included observational studies. Data Extraction: Data on sample characteristics, study design and duration, groups, PF diagnosis, and risk factors were extracted. The methodological quality of the studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. When means and standard deviations of a particular risk factor were presented 2 or more times, that risk factor was included in the meta-analysis. Results: Sixteen studies were included in the systematic review and 11 risk factors in the meta-analysis. Increased plantarflexion range of motion (weighted mean difference [MD] = 7.04°; 95% CI, 5.88-8.19; P < 0.001), body mass index (MD = 2.13 kg/m2; 95% CI, 1.40-2.86; P < 0.001; I2 = 0.00%), and body mass (MD = 4.52 kg; 95% CI, 0.55-8.49; P = 0.026) were risk factors for PF. Conclusion: Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with PF.

scholarly journals Swelling Among Women Who Need Education About Leg Lymphedema: A Descriptive Study of Lymphedema in Women Undergoing Surgery for Endometrial Cancer

2014 ◽  
Vol 24 (8) ◽  
pp. 1507-1512 ◽  
Author(s):  
Ritu Salani ◽  
Megan M. Preston ◽  
Erinn M. Hade ◽  
Jessica Johns ◽  
Jeffrey M. Fowler ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Body Mass ◽  
Lower Limb ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prolonged Standing ◽  
True Incidence ◽  
Patient Reported

ObjectivesIn addition to hysterectomy and bilateral salpingo-oophorectomy, comprehensive surgical staging for endometrial cancer includes pelvic and para-aortic lymphadenectomy. Clarifying and addressing the morbidity from these surgical procedures is imperative. The goal of this study was to assess the prevalence of lower extremity swelling after surgery for endometrial cancer.Materials and MethodsWe performed a descriptive, cross-sectional survey study of women who underwent surgery for endometrial cancer at our institution from 2006 to 2008. Survey information included symptoms, management, and education regarding lymphedema. Demographic information such as race and education was collected in addition to clinical data such as body mass index and age.ResultsOf the 482 patients identified, 440 were determined eligible and 305 (69.3%) responded to the survey with information on lower limb swelling (LLS). Of the 108 (35%) responders who reported swelling, only 68 (22%) participants reported a diagnosis of lower limb lymphedema (LLL). The most commonly experienced symptoms among those who reported LLS were tightness, pain/tenderness, and heaviness. Among those with a diagnosis of LLL, most (60%) stated it affected their daily activities and noted exacerbating factors such as prolonged standing, heat, and walking. The most common therapies used to reduce symptoms included leg elevation (96%), compression stockings (65%), diuretics (46%), massage therapy (35%), and bandaging (25%). There was no association between LLS or LLL diagnosis and body mass index, age, race, and tobacco use. Only 8% of responders reported receiving preoperative education regarding risks for LLS and a desire for more comprehensive education was frequently noted.ConclusionsThe patient-reported incidence of LLS occurred in approximately 35% of survey participants who underwent surgery for endometrial cancer. However, only 22% reported a diagnosis of LLL. Efforts to obtain the true incidence of LLL and to develop effective educational materials and programs to improve the management of lymphedema are warranted.

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