scholarly journals Predictors of Developing Hepatocellular Carcinoma in Treated HCV-Carriers in Morocco according to University Hospital Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Younès Cherradi ◽  
Rajaa Afifi ◽  
Hanaa Benbrahim ◽  
Wafaa Essamri ◽  
Imane Benelbarhdadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Antiviral Treatment ◽  
Significant Risk ◽  
University Hospital ◽  
Advanced Age ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Severe Fibrosis

Introduction. Hepatitis C is the first major cause for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC but few cases of HCC in HCV-treated patients were reported. We aimed to define this population’s features and to identify predictive factors of developing HCC. Patients and Methods. We included all HCV carriers who developed HCC after antiviral treatment from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results. 369 HVC-treated patients were considered, and 20 HCC were reported. The risk of HCC was not significant according to gender and genotypes (resp., P=0.63 and P=0.87). Advanced age and severe fibrosis were significant risk factors (resp., P=0.003 and P=0.0001). HCC was reported in 2.6% of sustained virological responders versus 12.5% of nonresponders (P=0.004). Conclusion. In our series, 5% of previously treated patients developed an HCC. Advanced age and severe fibrosis at HCV diagnosis are predictive factors of HCC occurrence. Sustained virological response reduces considerably the risk of HCC occurrence but screening is indicated even after SVR.

scholarly journals 670Lifestyle risk factors for hepatocellular carcinoma in treated chronic hepatitis C patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Tomoka Matsuura ◽  
Satoko Ohfuji ◽  
Masaru Enomoto ◽  
Akihiro Tamori ◽  
Shoji Kubo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Duodenal Ulcer ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Medical Information ◽  
Antiviral Treatment ◽  
Chronic Hepatitis C Patients ◽  
Severe Fibrosis

Abstract Background The purpose of this study was to identify lifestyle risk factors, such as cigarette smoking and alcohol consumption, associated with the development of hepatocellular carcinoma (HCC) among chronic hepatitis C patients who have achieved a sustained virological response (SVR). Methods This cross-sectional study was conducted between 2014 and 2017 using self-administered questionnaires and medical information at two tertiary hospitals in Osaka, Japan. Study subjects were chronic hepatitis C patients who had achieved SVR following antiviral treatment that was completed more than 1 year earlier. A logistic regression model was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for post-SVR HCC. Results Of 202 participants, 18 had been diagnosed with post-SVR HCC. After considering potential confounders, former drinkers at the time of SVR (OR, 9.51; 95%CI, 1.08 to 83.90), and patients with a history of gastric or duodenal ulcer (OR, 4.14; 95%CI, 1.37 to 12.46) were significantly associated with HCC. Among patients with severe fibrosis, current smokers at the time of SVR had an increased OR for HCC compared with non-smokers, with marginal significance (OR, 5.61; 95%CI, 0.97 to 32.63). Conclusions In chronic hepatitis C patients with severe fibrosis, continued smoking could be a risk factor for post-SVR HCC. The relationship between gastric or duodenal ulcer history and post-SVR HCC should be investigated further. Key messages Smoking cessation may be preferred for chronic hepatitis C patients with severe fibrosis to prevent post-SVR HCC.

scholarly journals Hepatocellular carcinoma screening is indicated even after sustained virological response: -Moroccan University Hospital Experience-

2016 ◽  
pp. 223-228
Author(s):  
Younes Cherradi ◽  
Rajaa Afifi ◽  
Hana Benbrahim ◽  
Hadj Omar El Malki ◽  
Mustapha Benazzouz ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Sustained Virological Response ◽  
Predictive Factors ◽  
Virological Response ◽  
Protective Factor ◽  
Advanced Age ◽  
Severe Fibrosis

Introduction: Hepatitis C is the first aetiologic agent for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC in patients with chronic hepatitis C but few cases of HCC have been still reported. We aimed to define population with high risk of HCC occurrence, confirm the protective role of SVR and to identify predictive factors of developing HCC after SVR. We'll try to present suggestions about screening strategies (indications and interval) after antiviral therapy according to level of HCC occurrence risk. Patients and Methods: We included all patients with chronic hepatitis C treated in our department from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results: 369 patients treated for hepatitis C were considered, and 20 HCC were reported. The risk of HCC occurrence was not significant according to gender and genotypes. Advanced age and severe fibrosis were significant risk factors. HCC was reported in 2.3% of sustained virological responders versus 12.5% of non responders. SVR is a significant protective factor. Conclusion: In our series, 5% of previously treated HCV carriers developed HCC and 2.3% of sustained virological responders developed. Achieving SVR after antiviral therapy is a protective factor. Advanced age (> 50 y. o), severe fibrosis (F>2) and lack of SVR at HCV diagnosis are predictive factors of HCC development in treated patients. Regular bi-annual ultrasonography screening should be indicated necessarily in patients with advanced fibrosis stage (F3- F4) even after SVR, particularly when co-morbid conditions are associated (advanced age, NASH, diabetes mellitus,...). Screening interval in sustained virological responders with reduced fibrosis stage may be limited to annual surveillance. Establishing guidelines about consensual strategy to survey sustained virological responders is now necessary especially with high rates of SVR and the extension of treatment indications in era of DAA drugs. Keywords: Hepatocellular Carcinoma (HCC), Screening, Sustained Virological Response (SVR)

scholarly journals Risk factors of poor prognosis and impairment of activities of daily living in patients with hemorrhagic gastroduodenal ulcers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Arai ◽  
Jun Kato ◽  
Nobuo Toda ◽  
Ken Kurokawa ◽  
Chikako Shibata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Poor Prognosis ◽  
Significant Risk ◽  
Care Facility ◽  
Significant Risk Factor ◽  
Advanced Age ◽  
Gastroduodenal Ulcers ◽  
Poor Outcomes

Abstract Background Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. Methods In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. Results Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08–16.2), and heart disease (OR 3.05; 95% CI 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36–28.7). Conclusion In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.

scholarly journals Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

2015 ◽  
Vol 7 (02) ◽  
pp. 108-111 ◽  
Author(s):  
Tuhina Banerjee ◽  
Shampa Anupurba ◽  
Joel Filgona ◽  
Dinesh K Singh
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Hospitalized Patients ◽  
University Hospital ◽  
North India ◽  
Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

A Single-Institute Experience with Sorafenib in Untreated and Previously Treated Patients with Advanced Hepatocellular Carcinoma

Oncology ◽  
2010 ◽  
Vol 78 (3-4) ◽  
pp. 210-212 ◽  
Author(s):  
Stephanie M. Balsom ◽  
Xiaobai Li ◽  
Elizabeth Trolli ◽  
Jeffrey Rose ◽  
Mark Bloomston ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Advanced Hepatocellular Carcinoma ◽  
Previously Treated Patients ◽  
Previously Treated

scholarly journals 186. Risk Factors for Extended Spectrum β-Lactamase Bacteremia and External Application of a Clinical Prediction Tool

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S113-S114
Author(s):  
Jacqueline Burnell ◽  
Rebecca Fallis ◽  
Peter Axelrod ◽  
Daniel Mueller
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Klebsiella Oxytoca ◽  
Significant Risk ◽  
University Hospital ◽  
Prediction Tool ◽  
External Application ◽  
The Past ◽  
Extended Spectrum ◽  
History Of

Abstract Background Extended spectrum β-lactamase (ESBL) bacteria are resistant to many antibiotics, which increases the risk of inadequate early antibiotic therapy. A previous single-center study had created a prediction tool to assist clinicians in identifying patients at risk for ESBL bloodstream infections. The purpose of our research project was to assess validity of this tool while also identifying risk factors for ESBL bacteremia within our own institution, which would allow for assessment of alternative prediction tools. Methods We performed a retrospective chart review of adult patients admitted to an urban university hospital who were found to have bacteremia with Escherichia coli, Klebsiella pneumoniae, and/or Klebsiella oxytoca between October 2016 and April 2018. Demographics and comorbidities were assessed, along with other potential risk factors including exposure to antibiotics and hospitalizations within the past 6 months. Results A total of 214 instances of bacteremia were identified and 14% were due to ESBL organisms. Risk factors for ESBL bacteremia in our cohort included history of positive culture for ESBL (RR = 5.9) or MRSA (RR = 3.5) and antibiotic usage in the past 6 months (RR = 2.3). Patients with ESBL bacteremia were hospitalized longer (mean 16 days vs. 6 days for non-ESBL), received longer durations of antibiotic therapy (11.7 days vs. 5.3 days), and were exposed to greater numbers of different antibiotics (1.9 vs. 0.7) in the previous 6 months. Multivariate logistic regression showed that history of prior ESBL infection (OR 14.7, CI 1.8–120) and increasing number of different antibiotic classes administered in the prior 6 months (OR 4.3, CI 1.7–11.2) were significant risk factors for ESBL bacteremia. The previously created prediction tool did not sufficiently differentiate higher and lower risk for ESBL bacteremia in our cohort. Conclusion Although risk factors were similar, the previously derived stepwise prediction tool did not predict ESBL bacteremia in our external cohort. Point-based prediction modeling might better assess risk across institutions. Additionally, the number of different antibiotics received was associated with risk for ESBL bacteremia and should be investigated further. Disclosures All authors: No reported disclosures.

scholarly journals Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea

2020 ◽  
Vol 17 (21) ◽  
pp. 8082
Author(s):  
Kyu Young Choi ◽  
Bum Sang Lee ◽  
Hyo Geun Choi ◽  
Su-Kyoung Park
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
University Hospital ◽  
Control Group ◽  
Brainstem Response

Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.

scholarly journals Parental factors associated with intrauterine growth restriction

2015 ◽  
Vol 143 (11-12) ◽  
pp. 701-706 ◽  
Author(s):  
Monica Hăşmăşanu ◽  
Sorana Bolboacă ◽  
Tudor Drugan ◽  
Melinda Matyas ◽  
Gabriela Zaharie
Keyword(s):  
Risk Factors ◽  
Intrauterine Growth Restriction ◽  
Newborn Infants ◽  
Significant Risk ◽  
Growth Restriction ◽  
University Hospital ◽  
Control Group ◽  
Parental Factors ◽  
Intrauterine Growth ◽  
Significant Difference

Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p>0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p=0.0278). The analysis of infants? comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p>0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR=2.4, 95% CI [1.3-4.5]). Conclusion. Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR.

Sign in / Sign up

Export Citation Format

Share Document