Geometric variations associated with posterior communicating artery aneurysms

2021 ◽  
pp. neurintsurg-2020-017062
Author(s):  
Jian Zhang ◽  
Anil Can ◽  
Pui Man Rosalind Lai ◽  
Srinivasan Mukundan, Jr. ◽  
Victor M Castro ◽  
...  
Keyword(s):  
Massachusetts General Hospital ◽  
Conditional Logistic Regression ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Size Ratio ◽  
Posterior Communicating Artery ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Conditional Logistic Regression Model ◽  
Small Aneurysms

BackgroundHemodynamic stress, conditioned by the morphology of the surrounding vasculature, plays an important role in aneurysm formation. Our goal was to identify image-based location-specific parameters that are associated with posterior communicating artery (PCoA) aneurysms.MethodsThree-dimensional morphological parameters obtained from CT angiography or digital subtraction angiography from 187 patients with unilateral PCoA aneurysms, diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. In order to control for genetic and clinical risk factors, we chose the contralateral unaffected PCoA as a control group. We examined diameters and angles of the surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small aneurysms (≤5 mm) only and an unmatched analysis of 432 PCoA aneurysms and 197 control patients without PCoA aneurysms were also performed.ResultsIn a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 1.45×10−5, 95% CI 1.12×10−7 to 1.88×10−3) and larger daughter-daughter angle (OR 1.04, 95% CI 1.02 to 1.07) were significantly associated with PCoA aneurysm presence after correcting for other variables. In subgroup analyses of small aneurysms (≤5 mm) and in an unmatched analysis the significance and direction of these results were preserved.ConclusionsLarger daughter-daughter angles and smaller diameter size ratio are significantly associated with the presence of PCoA aneurysms. These simple parameters can be utilized to guide the risk assessment for the formation of PCoA aneurysms in high risk patients.

scholarly journals Surrounding vascular geometry associated with basilar tip aneurysm formation

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jian Zhang ◽  
Anil Can ◽  
Pui Man Rosalind Lai ◽  
Srinivasan Mukundan ◽  
Victor M. Castro ◽  
...  
Keyword(s):  
Massachusetts General Hospital ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Three Dimensional ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Parent Artery ◽  
Morphological Parameters ◽  
Aneurysm Formation ◽  
Risk Patients

Abstract Hemodynamic stress is thought to play an important role in the formation of intracranial aneurysms, which is conditioned by the geometry of the surrounding vasculature. Our goal was to identify image-based morphological parameters that were associated with basilar artery tip aneurysms (BTA) in a location-specific manner. Three-dimensional morphological parameters obtained from CT-angiography (CTA) or digital subtraction angiography (DSA) from 207 patients with BTAs and a control group of 106 patients with aneurysms elsewhere to control for non-morphological factors, who were diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. We examined the presence of hypoplastic, aplastic or fetal PCoAs, vertebral dominance, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small (≤ 3 mm) aneurysms only and with angles excluded, were also performed. In multivariable analysis, daughter–daughter angle was directly, and parent artery diameter and diameter size ratio were inversely associated with BTAs. These results remained significant in the subgroup analysis of small aneurysms (width ≤ 3 mm) and when angles were excluded. These easily measurable and robust parameters that are unlikely to be affected by aneurysm formation could aid in risk stratification for the formation of BTAs in high-risk patients.

Association between statin use and the risks of glaucoma in Australia: a 10-year cohort study

2021 ◽  
pp. bjophthalmol-2021-318789
Author(s):  
Yixiong Yuan ◽  
Wei Wang ◽  
Xianwen Shang ◽  
Ruilin Xiong ◽  
Jason Ha ◽  
...  
Keyword(s):  
Large Scale ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Case Group ◽  
Conditional Logistic Regression Model ◽  
The People ◽  
Increased Risk ◽  
Nested Case Control ◽  
Statin Use

SynopsisIn a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users.PurposeTo investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study.MethodsThis nested case–control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009–2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset.ResultsThe proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use (>3 years vs <1 year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset.ConclusionsLong-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.

Risk of adolescent offspring's completed suicide increases with prior history of their same-sex parents' death by suicide

2013 ◽  
Vol 44 (9) ◽  
pp. 1845-1854 ◽  
Author(s):  
C.-C. J. Cheng ◽  
W.-J. Yen ◽  
W.-T. Chang ◽  
K. C.-C. Wu ◽  
M.-C. Ko ◽  
...  
Keyword(s):  
Conditional Logistic Regression ◽  
Statistical Significance ◽  
Prior History ◽  
Same Sex ◽  
Birth Registry ◽  
Conditional Logistic Regression Model ◽  
Completed Suicide ◽  
Suicidal Death ◽  
History Of ◽  
Maternal Suicide

BackgroundTo investigate the risk of completed suicide in offspring during adolescence in relation to prior history of the same-sex parent's death by suicide and other causes.MethodA total of 500 adolescents who died by suicide at age 15–19 years between 1997 and 2007 were identified from the Taiwan Mortality Registration (TMR). For each case, 30 age- and time-matched controls were selected randomly from all adolescents registered in the Taiwan Birth Registry (TBR). A multivariate conditional logistic regression model was used to assess the risk of adolescent completed suicide in relation to their same-sex parent.ResultsAdolescent suicide risk was positively associated with both paternal [odds ratio (OR) 5.38, 95% confidence interval (CI) 2.17–13.33] and maternal suicide (OR 6.59, 95% CI 1.82–23.91). The corresponding risk estimates associated with paternal and maternal deaths from non-suicidal causes were much lower, at 1.88 and 1.94 respectively. The risk of suicide in male adolescents was significantly associated with prior history of paternal death by suicide (OR 8.23, 95% CI 2.96–22.90) but not of maternal death by suicide (OR 3.50, 95% CI 0.41–30.13). On the other contrary, the risk of suicidal death in female adolescents was significantly associated with prior history of maternal suicide (OR 9.71, 95% CI 1.89–49.94) but not of paternal suicide (OR 2.42, 95% CI 0.30–19.57). However, these differences did not reach statistical significance.ConclusionsAlthough limited by sample size, our study indicates that adolescent offspring suicidal death is associated with prior history of their same-sex parent's death by suicide.

Temporal bone Pneumatization in Otosclerosis

2008 ◽  
Vol 139 (6) ◽  
pp. 850-853 ◽  
Author(s):  
Daniel T. Ganc ◽  
Robert W. Jyung
Keyword(s):  
Temporal Bone ◽  
Statistical Significance ◽  
Three Dimensional ◽  
Neck Surgery ◽  
Adult Patients ◽  
Control Group ◽  
Test Analysis ◽  
Temporal Bone Pneumatization ◽  
History Of ◽  
Temporal Bones

Objectives To determine whether there is a difference in the pneumatization of temporal bones with otosclerosis versus normal temporal bones. Methods A retrospective study of 46 ears from 24 adult patients with otosclerosis and 64 ears from 47 adult patients in a control group. The study group included temporal bone CT scans available from patients with otosclerosis. The control group consisted of patients who had temporal bone CTs for reasons likely unrelated to a history of middle ear disease. Data were obtained with a virtual reality system that allows three-dimensional manipulation and analysis. Results The temporal bone pneumatization for the otosclerosis group was 4.82 ± 2.27 cm3 vs 6.06 ± 2.71 cm3 for the control group. Two-sample t test analysis revealed no statistical significance ( P = 0.059) between pneumatization in the control vs otosclerosis groups. Conclusion There is no difference in temporal bone pneumatization between patients with otosclerosis and a control population. Therefore, temporal bone pneumatization by itself is not an adequate explanation for the apparent protective effect of otosclerosis against otitis media. © 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.

scholarly journals Association between Previous Statin Use and Alzheimer’s Disease: A Nested Case-Control Study Using a National Health Screening Cohort

2021 ◽  
Vol 11 (3) ◽  
pp. 396
Author(s):  
Ji Hee Kim ◽  
Heui Seung Lee ◽  
Jee Hye Wee ◽  
Yoo Hwan Kim ◽  
Chan Yang Min ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
National Health ◽  
Total Cholesterol Level ◽  
Conditional Logistic Regression ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Conditional Logistic Regression Model ◽  
Statin Use

A number of studies report the incidence of Alzheimer’s disease (AD) in patients taking statins, but the results are inconsistent. (1) Background: The present study investigated the cross-sectional association between previous statin use and the risk of AD development in Korean residents. (2) Methods: We used the Korean National Health Insurance Service-National Sample Cohort; 17,172 AD patients were matched by age, gender, income, and region of residence with 68,688 control participants at a ratio of 1:4. We used a multiple conditional logistic regression model to analyse the association between the number of days of statin use and AD occurrence. Further analyses were performed to identify whether this association is maintained for different ages, genders, socioeconomic status groups, and covariates. (3) Results: The odds ratio, which was adjusted for potential confounders, for the days of statin use per year in the AD group compared to the control group was 0.95 (95% confidence interval = 0.92–0.98; p = 0.003). The number of days of statin use in the AD group was significantly smaller in the subgroups of non-smokers and individuals with normal weight, alcohol consumption less than once a week, total cholesterol level below 200 mg/dL, systolic blood pressure below 140, diastolic blood pressure below 90, and fasting blood glucose below 100 mg/dL. (4) Conclusions: Our results suggest that statin use prevents the occurrence of AD. The effects of statin use in preventing AD may be greater in individuals at relatively low risk.

Flu vaccination rate of patients with severe immune-related adverse events.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18234-e18234
Author(s):  
Ian Matthew Allen ◽  
Yonina Robbie Murciano-Goroff ◽  
Leyre Zubiri ◽  
Qun Li ◽  
Michael Sang Hughes ◽  
...  
Keyword(s):  
Nearest Neighbor ◽  
Massachusetts General Hospital ◽  
Statistical Significance ◽  
Control Group ◽  
P Value ◽  
Severe Toxicity ◽  
Current Recommendation ◽  
Oncology Patients ◽  
Pathologic Features ◽  
Increased Risk

e18234 Background: Infection with influenza in adults with cancer carries an increased risk of morbidity and mortality. Vaccination against seasonal influenza (Flu-V) can decrease the incidence of influenza, shorten its course, and reduce influenza-associated morbidity. Recent data has suggested that the administration of the Flu-V to patients on an ICI leads to an exaggerated inflammatory response and an increased risk of irAE. However, this trend was demonstrated in a small cohort of patients with lung cancer. Current recommendation for annual Flu-V in patients treated with ICI is unclear and literature about safety is limited. We compared rates of Flu-V for patients on ICI admitted with severe toxicity vs those patients on ICI who were admitted for reasons other than toxicity. We also evaluated rate of Flu-V among oncology patients who had received non-immunotherapy modalities. Methods: We retrospectively evaluated patients treated with ICI who were admitted to Massachusetts General Hospital from February 5, 2011- June 12, 2017. Patients received ipilimumab, pembrolizumab, nivolumab, atezolizumab, durvalumab, avelumab, or a combination in treatment of an advanced solid tumor malignancies including melanoma, NSCLC, SCCHN. Admissions due to irAE were confirmed by review of clinical, radiologic, and pathologic features. Flu-V status was determined by rigorous chart review. Nearest neighbor matching was used to create a control group of cancer patients treated with non-ICI modalities. Descriptive statistics compared rates and timing of Flu-V relative to admission. Statistical significance was determined using Fischer’s Exact Test, p < 0.05. Results: Of 540 patients on ICI, 28% were admitted for irAE, 72% had a non-irAE reason for admission. The rate of Flu-V in the flu season prior to admission for irAE group was lower than for non-irAE (18.5% vs 29.6%; p value = 0.01). There were no differences in vaccination rates within ≤30 days (2.7% vs 3.6%, p = 0.80), ≤90 days (4.0% vs 9.3%, p = 0.05), or ≤180 days of admission (11.9% vs 18.5%, p = 0.07). Flu-V rate overall in patients on ICI was 26.5%. In comparison, Flu-V rate in the nearest neighbor non-immunotherapy oncology patients was 67% (n = 101). Conclusions: Flu-V rates were much lower in patients treated with ICI compared to patients treated with non-ICI modalities. We did not see a higher rate of Flu-V in patients admitted with irAE compared to non-irAE which suggests that Flu-V and severe irAE may not be linked in clinical practice. Additional studies are needed, but Flu-V in patients on ICI holds potential to improve care.

scholarly journals Association Between Previous Statin Use and Alzheimer’s Disease: A Nested Case-control Study Using a National Health Screening Cohort

2020 ◽  
Author(s):  
Ji Hee Kim ◽  
Heui Seung Lee ◽  
Jee Hye Wee ◽  
Chan Yang Min ◽  
Dae Myoung Yoo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
National Health ◽  
Total Cholesterol Level ◽  
Conditional Logistic Regression ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Conditional Logistic Regression Model ◽  
Statin Use

Abstract BackgroundA number of studies on the incidence of Alzheimer’s disease (AD) in patients taking statins have been reported; however, the results are inconsistent. This study aimed to investigate the association between previous statin use and the risk of AD development in Korean residents.MethodsWe assessed the Korean National Health Insurance Service-National Sample Cohort, which includes individuals aged older than 40 years from 2002 to 2015. A total of 17,172 AD patients were matched by age, sex, income, and region of residence with 68,688 control participants at a ratio of 1:4. We used a multiple conditional logistic regression model to analyze the association between the number of days of statin use and AD occurrence. Further analyses were performed to identify whether this association was maintained for different ages, sexes, socioeconomic statuses, and covariates.ResultsThe adjusted odds ratio (OR), which was adjusted for potential confounders, for the days of statin use per year in the AD group compared to the control group was 0.95 (95% confidence interval [CI] = 0.92-0.98, P = 0.003). The number of days of statin use in the AD group was significantly smaller than that in control group among women older than 75 years and in the subgroups of nonsmokers and individuals with normal weight, alcohol consumption less than once a week, total cholesterol level below 200, systolic blood pressure below 140 and diastolic blood pressure below 90, and fasting blood glucose below 100.ConclusionsOur results suggested that statin use may prevent the occurrence of AD. The effect of preventing AD in statin use may be greater in individuals with relatively low risk.

scholarly journals 1242. Evaluation of Risk Factors for Development of Total Hip Arthroplasty (THA) Surgical Site Infections (SSI)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S447-S447
Author(s):  
Sisham Ingnam ◽  
Jennifer Flaherty ◽  
Mark Lustberg ◽  
Julie E Mangino ◽  
Shandra R Day
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Conditional Logistic Regression ◽  
Revision Arthroplasty ◽  
Control Group ◽  
Observation Study ◽  
Conditional Logistic Regression Model ◽  
Steroid Use

Abstract Background THA is one of the most commonly performed surgeries for pathologic diseases of the hip. Multiple risk factors have been identified for SSI including: female gender, previous joint surgery, hematoma, joint dislocation, intraarticular glucocorticoid injection, rheumatoid arthritis, uncontrolled diabetes, anemia, malnutrition, and an immunosuppressed state. The objective of our study is to evaluate obesity (body mass index (BMI) >30) as an independent risk factor for THA SSI and identify other risk factors for SSI Methods A retrospective case–control (1:3) matched observation study was conducted from January 1, 2014–June 30, 2016. Patients with a THA SSI were identified using NHSN definitions and 3 controls were matched for sex and month of surgery for each SSI case. Patient information was extracted through chart review including BMI, revision surgery, chronic kidney disease (CKD), diabetes mellitus (DM), anemia, malnutrition, smoking, surgery duration, steroid use, pre-operative chlorhexidine (CHG) bathing and nasal povidone–iodine (PI) compliance. Multivariate analysis using a conditional logistic regression model was performed. Results Among 906 THA, 29 patients developed an SSI with 87 matched patients over the 2.5 years. The mean age in the SSI group was 61.0 years, and 37.9% were male. Mean age in the control group was 63.1, and 40.1% were male. In both groups, the most common indications for surgery were osteoarthritis followed by osteonecrosis and malignancy. Results of multivariate analysis identified five independent risk factors for SSI (see Table 1). Conclusion Obesity (BMI >30) was identified as an independent risk factor for THA SSI as well as CKD, steroid use and revision arthroplasty. While these risk factors are not easily modifiable, noncompliance with pre-operative CHG bathing and PI administration were also identified as significant SSI risk factor. These findings emphasize the importance of evaluating patients for SSI risk factors including obesity and improving compliance with all pre-operative SSI reduction measures. Disclosures All authors: No reported disclosures.

scholarly journals Comparative Study between the Effect of Induction Chemotherapy with 66 Gy Three Dimensional Conformal and 46 Gy Conventional Radiotherapy in Stage Iii Non- Small Cell Lung Cancer

2017 ◽  
Vol 12 (1) ◽  
pp. 18-24
Author(s):  
Asma Siddiqua ◽  
Md Nizamul Haque ◽  
Sheikh Golam Mostofa ◽  
Md Moarraf Hossain ◽  
Qamruzzaman Chowdhury
Keyword(s):  
Induction Chemotherapy ◽  
Statistical Significance ◽  
Intervention Group ◽  
Three Dimensional ◽  
Skin Toxicity ◽  
Complete Response ◽  
Stage Iii ◽  
Control Group ◽  
Radiological Response ◽  
Stage Iii Nsclc

A quasi experimental study was carried out among 60 stage III NSCLC patients attending at Radiation Oncology Department of National Institute of Cancer Research & Hospital, Mohakhali, Dhaka from August 2012 to July 2013. Patients were divided into group A and group B purposively to receive Induction Chemotherapy followed by conventional or 3D CRT respectively. The study was designed to observe the radiological response and acute toxicity of stage III NSCLC with induction CT and 3DCRT. Treatment related morbidity was more observed in the intervention group with 43.3% Grade ?2 Pneumonitis, 43.4% Grade ?2 Oesophagitis, 40% Grade 2 skin toxicity and 6.7% Grade?3 anemia. Regarding metastasis, 33.3% patients in the intervention arm and 30% patients in the control arm had presented with metastasis at different sites within this six months period. No statistically significance was found between these two groups (p = .781). Death during follow up was observed in 6.7% patients in the intervention group and 3.3 % patients in the control arm which was of no statistically significance difference. (p = 1.00). Complete response was found in 23.3 % patients in intervention group while in control group it was only 6.7%. Partial response was 46.7% and 43.3% respectively. No response was seen in 36.6% patients; 13.3% in the intervention group and 23.3% in the control group. More patients in control group (26.7%) were reported with progressive disease. No statistical significance was found regarding the radiological response between these two arms (p=.114). Both complete and overall responses were better in intervention group than control group.Faridpur Med. Coll. J. Jan 2017;12(1): 18-24

scholarly journals Relationship Between Occupational Noise and Hypertension in Modern Enterprise Workers: A Case–Control Study

2021 ◽  
Author(s):  
Xiaomei Wu ◽  
Yueyan Lan ◽  
Xiaohong Zhang ◽  
Chaoxiu Li ◽  
Bo Zhou
Keyword(s):  
Risk Factor ◽  
Noise Intensity ◽  
Noise Exposure ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Occupational Noise ◽  
Conditional Logistic Regression Model ◽  
Occupational Noise Exposure

Abstract Objective Many epidemiological studies have reported an association between occupational noise exposure and hypertension among workers, but have failed to obtain conclusive results. Thus we aimed to assess whether there is a relationship between hypertension and occupational noise. Methods This study adopted a case–control design to verified the relationship of occupational noise and hypertension. This study included 1527 subjects (case group, 509 individuals; control group, 1018 individuals) from a modern automobile manufacturing company. The information includes the general characteristics, occupational factors, and data collected from physical examination, hematology and serology testing. Two-sample t-tests, The Chi-square test, the Ridit analysis method were used for comparing variables. A non-conditional logistic regression model was used for multivariate analysis based on single factor analysis. Results Toxin exposure was found to be a risk factor for the occurrence of hypertension in workers who were exposed to noise in modern enterprises (OR=3.45).Heart rate was significantly different between the case and control groups (OR=5.98). Occupational noise exposure is a risk factor for hypertension, and the risk of hypertension for people exposed to noise intensity ≥80 dB is 2.23 times (95% CI 1.62–3.06) higher than that for people exposed to noise intensity <80 dB. Conclusions Occupational noise exposure is an independent risk factor for hypertension. it can be used to direct the new criteria of noise exposure limit to protect worker’s health.

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