scholarly journals Risk Factors for the Completion of the Cold Loop Hysteroscopic Myomectomy in a One-Step Procedure: A Post Hoc Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Ivan Mazzon ◽  
Alessandro Favilli ◽  
Mario Grasso ◽  
Stefano Horvath ◽  
Vittorio Bini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Cohort ◽  
Agonist Therapy ◽  
Hysteroscopic Myomectomy ◽  
Post Hoc Analysis ◽  
Step Procedure ◽  
Study Population ◽  
One Step ◽  
Post Hoc ◽  
Multiple Step

Introduction. The aim of the study was to analyze which variables influenced the completion of a cold loop hysteroscopic myomectomy in a one-step procedure in a large cohort of patients. Materials and Methods. A retrospective cohort study of 1434 cold loop resectoscopic myomectomies consecutively performed. The study population was divided into two groups according to the number of procedures needed to accomplish the treatment. Variables influencing the completion of hysteroscopic myomectomy in a one-step procedure were investigated. Results. A total of 1434 resections were performed and 1690 myomas in total were removed. The procedure was accomplished in a one-step procedure in 1017 patients (83.7%), whereas 198 women (16.3%) needed a multiple-step procedure. The multivariate analysis showed that the size, the number of myomas, and the age of patients were significantly correlated with the risk of a multiple-step procedure. No correlation was revealed with the grading of myomas, parity, and the use of presurgical GnRH-agonist therapy. Conclusions. In case of multiple fibroids, the intramural development of submucous myomas did not influence the completion of cold loop hysteroscopic myomectomy in a one-step procedure. The size of myomas and the age of patients were significantly correlated with the need to complete the myomectomy in a multiple-step procedure.

80-OR: Treatment with Once-Weekly Semaglutide 2.4 mg Improves Cardiometabolic Risk Factors in Adults with Overweight/Obesity and Type 2 Diabetes: STEP 2 Post-hoc Analysis

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 80-OR
Author(s):  
ROBERT F. KUSHNER ◽  
MELANIE J. DAVIES ◽  
JOHN DEANFIELD ◽  
W. TIMOTHY GARVEY ◽  
OLE JEPPESEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Influence of Foot Orthotics and Intrinsic Factors on Strain Measurements in the Fifth Metatarsal

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Jeffrey W. Hoffman ◽  
Rogerio C. Bitar ◽  
Daniel R. Sturnick ◽  
Glenn Garrison ◽  
Constantine A. Demetracopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Return To Play ◽  
Peak Strain ◽  
Lateral Plate ◽  
Intrinsic Factors ◽  
Post Hoc Analysis ◽  
Zone Ii ◽  
Post Hoc

Category: Midfoot/Forefoot; Sports Introduction/Purpose: Fractures of the fifth metatarsal occur in young, athletic populations and often result in sub-optimal clinical outcomes, even after surgical fixation. With such a high demand for decreased return to play in athletic populations, the development of intervention strategies which mitigate intrinsic and extrinsic risk factors of initial injury is important. Foot orthotics have been shown to decrease strain in the 2nd metatarsal. However, limited research has investigated the influence of intrinsic risk factors and the use of foot orthotics on fifth metatarsal strain. Therefore, the purpose of our study was to investigate the effect of foot orthotics and intrinsic risk factors on fifth metatarsal strain during cadaveric simulation. Methods: Ten specimens were loaded to simulate the stance phase of normal gait using a validated 6-degree of freedom robot with tendon actuators. Strain gauges were placed at the metaphyseal - diaphyseal junction (Zone II), and the proximal diaphysis (Zone III) to measure principal strain. Specimens were tested in a sneaker-only control condition and ten orthotic conditions, which include combinations of a commercial orthotic insole, three plates, and two foam wedges (Figure 1A). The average peak strain from three simulations were recorded for each orthotic condition. Relevant intrinsic factors were recorded from reconstructions of axially loaded computed tomography scans. A two-way repeated measures ANOVA was conducted to determine the effect of orthotic conditions on fifth metatarsal strains, with significantly correlated intrinsic factors included as covariates. Tukey-Kramer post-hoc analysis with a Bonferroni correction was used to analyze differences between individual orthotic conditions and main effects of components. Results: Metatarsus adductus angle, 4-5 intermetatarsal angle, and Meary’s angle (R2= 0.944; p<0.001) were included as covariates in analysis of Zone III strain. Significant (p<0.05) differences in Zone III strain were found for the both the main effect of a plate and individual orthotic cond itions with statistical adjustment for previously stated intrinsic measurements. However, post- hoc testing revealed no significant differences between non-plate conditions and full plate conditions(p=0.23), lateral plate conditions (p=0.025), or lateral cut plate conditions (p=0.026). Additionally, the Full Plate with Lateral Wedge condition reduced strains by 285 µΕ relative to the sneaker condition, no significant differences (p = 0.07) were found in post-hoc analysis. No significant differences were found in Zone II with the models considered. Conclusion: Zone III strains were shown to be significantly correlated with intrinsic factors in the current analysis. Plate conditions demonstrated a trend towards significant reduction of Zone III strain relative to the sneaker condition, despite failing to achieve statistical significance in conservative post-hoc analysis. However, these results may be clinically significant as the reduction of strain in plate conditions exceeded previously reported significant decreases in the 2nd metatarsal. Correlations found between intrinsic risk factors and strain in this study corroborate with previous studies. This indicates that the effectiveness of foot orthotics to reduce strain is strongly influenced by individual foot structure.

scholarly journals Is migraine a risk factor for pediatric stroke?

Cephalalgia ◽  
2015 ◽  
Vol 35 (14) ◽  
pp. 1252-1260 ◽  
Author(s):  
Amy A Gelfand ◽  
Heather J Fullerton ◽  
Alice Jacobson ◽  
Stephen Sidney ◽  
Peter J Goadsby ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Incidence Rate ◽  
Stroke Risk ◽  
Stroke Incidence ◽  
Post Hoc Analysis ◽  
Ischemic Stroke Risk ◽  
Post Hoc

Importance Our understanding of risk factors for childhood stroke is incomplete. In adults, migraine with aura is associated with a two-fold increase in ischemic stroke risk. Objective In this cohort study we examine the association between migraine and stroke among children in Kaiser Permanente Northern California (KPNC). Design, setting, and participants Children ages 2–17 years who were members of KPNC for ≥6 months between 1997 and 2007 were included. Migraine cohort members had one or more of: an ICD-9 code for migraine, migraine listed as a significant health problem, or a prescription for a migraine-specific medication. The comparison group was children with no evidence of headache. Main outcome measures Main outcome measures included stroke incidence rates and incidence rate ratios (IR). Results Among the 1,566,952 children within KPNC during the study period, 88,164 had migraine, and 1,323,142 had no evidence of headache. Eight migraineurs had a stroke (three (38%) hemorrhagic; five (63%) ischemic). Eighty strokes occurred in children without headache (53 (66%) hemorrhagic; 27 (34%) ischemic). The ischemic stroke incidence rate was 0.9/100,000 person-years in migraineurs vs. 0.4/100,000 person-years in those without headache; IR 2.0 (95% CI 0.8–5.2). A post-hoc analysis of adolescents (12–17 years) showed an increased risk of ischemic stroke among those with migraine; IR 3.4 (95% CI 1.2–9.5). The hemorrhagic stroke incidence rate was 0.5/100,000 person-years in migraineurs and 0.9/100,000 person-years in those without headache; IR 0.6 (95% CI 0.2–2.0). Conclusions There was no statistically significant increase in hemorrhagic or ischemic stroke risk in pediatric migraineurs in this cohort study. A post-hoc analysis found that ischemic stroke risk was significantly elevated in adolescents with migraine. Future studies should focus on identifying risk factors for ischemic stroke among adolescent migraineurs. Based on adult data, we recommend that migraine aura status should be studied as a possible risk factor for ischemic stroke among adolescent migraineurs.

Relevance of correction for drift and day-to-day variation in cystatin C measurement: a post-hoc analysis of the PREVEND cohort, with independent replication in the ESTHER cohort

2015 ◽  
Vol 53 (9) ◽  
Author(s):  
Priya Vart ◽  
Stephan J. L. Bakker ◽  
Ben Schöttker ◽  
Dick de Zeeuw ◽  
Dietrich Rothenbacher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cystatin C ◽  
Cardiovascular Events ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Standard Laboratory ◽  
Post Hoc Analysis ◽  
Independent Replication ◽  
Post Hoc ◽  
Dutch Cohort

AbstractDespite standard laboratory quality control, drift and day-to-day variability in cystatin C measurements can be observed. We investigated whether correction for drift and day-to-day variation in cystatin C measurements improves the association of estimated glomerular filtration rate (eGFR) with chronic kidney disease (CKD) risk factors and prognosis.Plasma samples of the PREVEND study (Dutch cohort study, n=8592) were used to measure cystatin C (Gentian assay) on 243 random days. A correction factor was calculated for each measurement day. GFR was estimated with CKD-EPI equation using routinely measured cystatin C (eGFRCompared to non-reclassified participants, participants re-classified upward had significantly lower age, body mass index, blood pressure, cholesterol, glucose and albuminuria, whereas the opposite was true for participants reclassified downward. CKD risk factors explained more variance in eGFRCorrection for drift and day-to-day variation in cystatin C measurement improves eGFR using cystatin C for its association with CKD risk factors and incident cardiovascular events.

scholarly journals 685. Evaluating the Role of Medication-assisted Treatment (MAT) in the Management of Infectious Endocarditis in People Who Inject Drugs (PWID)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S445-S445
Author(s):  
Allison Gorseth ◽  
William Nolan ◽  
Monica Cluff ◽  
David O'Sullivan ◽  
Casey J Dempsey
Keyword(s):  
Infectious Disease ◽  
Primary Outcome ◽  
People Who Inject Drugs ◽  
Management Service ◽  
Post Hoc Analysis ◽  
Medication Assisted Treatment ◽  
Study Population ◽  
Multidisciplinary Group ◽  
Secondary Outcomes ◽  
Post Hoc

Abstract Background An estimated 1.29-2.59 million people practice intravenous drug use (IVDU) in the United States making it a growing risk factor for infective endocarditis (IE). In people who inject drugs (PWID), IE accounts for 5-10% of total yearly deaths. IE often requires weeks of intravenous therapy with extensive medical follow-up. The purpose of this study was to evaluate if medication-assisted treatment (MAT) increased treatment retention and survival to optimize addiction assistance and IE treatment efforts. Methods A single-center, retrospective chart review was approved for patients admitted with an ICD-10 code of IE. A multidisciplinary group was created in April, 2019 aimed to improve endocarditis patient outcomes, formed of complex case coordination, infectious disease, cardiology, and pharmacy pain management service members. The historical period was January 1, 2018-March 31, 2019 and the IE pathway (IEP) group was April 1, 2019-June 30, 2020. Patients were excluded if there was no documentation of IVDU (Figure 1). The primary outcome was successful endocarditis therapy, defined per study protocol. Secondary outcomes include: against medical advice (AMA) departures, discharge naloxone prescriptions, clinical opioid withdrawal score (COWS) and patient reported pain. Figure 1. Study Population Methods for study population inclusion and exclusion Results A total of 419 IE patients were evaluated with 166 patients meeting inclusion criteria. The primary outcome was achieved in 51.2% of historical group and 48.8% of the IEP group (p=0.302). AMA departures and inpatient mortality were similar between the two groups. There was increased presence of the pharmacy pain management service with decreased time to consult in the IEP group (Figure 2). Last documented COWS were increased in the IEP group (p=0.002), while last reported patient pain scores decreased (p=0.030). More patients were started on MAT and discharged with naloxone in the IEP group (Table 3). Readmission was found to be higher in the IEP group (p=0.046). Post hoc analysis evaluating outcomes for patients seen by the endocarditis pathway team were similar between the two groups (Table 4). Figure 2. Secondary Outcome (Consult Services) The secondary outcomes of the study population are described comparing the presence and time to various consult services. **P-value indicates statistical significance. Abbreviations: n, number; ID, infectious disease; CT, cardiothoracic Table 3. Secondary Outcomes Table 4. Post Hoc Analysis Conclusion The multidisciplinary group was effective helping to guide the inpatient care of PWID and improve symptom management, but this did not translate to increased successful IE therapy or fewer readmissions. Disclosures All Authors: No reported disclosures

scholarly journals Likelihood of Accomplishing an In-Patient Hysteroscopic Myomectomy in a One-Step Procedure: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-20
Author(s):  
Ugo Indraccolo ◽  
Vittorio Bini ◽  
Alessandro Favilli
Keyword(s):  
Meta Analysis ◽  
Intraoperative Complications ◽  
Random Effect ◽  
Qualitative Synthesis ◽  
Hysteroscopic Myomectomy ◽  
Step Procedure ◽  
Quantitative Synthesis ◽  
In Series ◽  
One Step ◽  
Complications Rate

Purpose. To assess the feasibility rate of one-step hysteroscopic myomectomy according to the technique adopted. Methods. In July 2016, PubMed, ClinicalTrials.gov, SCOPUS, Scielo, and AJOL databases were used for searching references. Series of in-patient hysteroscopic myomectomies reporting success rate in only one-step procedure, categorization of submucous fibroids, explanation of the surgical technique, and description of patients were considered eligible for meta-analysis (retrospective, prospective randomized studies). Two authors extracted the data. Rate of myomectomies accomplished in only a surgical step and rate of intraoperative complications were extracted per protocol. A modified GRADE score was used for quality assessment. Random-effect models were already assumed. Mean rates were compared among subgroups. Results. One thousand two hundred and fifty-seven studies were screened and 241 of these were read for eligibility. Seventy-eight series were included in qualitative synthesis and 24 series were included in quantitative synthesis. Wide heterogeneity was found. In series with <50% of G2 myomas treated, the slicing technique feasibility rate was 86.5% while techniques for enucleating the deep portion of the myomas showed a feasibility rate of 92.3% (p<0.001). In series with ≥50% of G2 myomas treated, the slicing technique feasibility rate was 70.6% while techniques for enucleating the deep portion of myomas showed a feasibility rate of 88.4% (p<0.001). Complications were significantly lower for alternative techniques to the classical slicing. Conclusion. In case of submucous myomas with intramural development, the slicing technique was correlated with a lower rate of in-patient hysteroscopic myomectomies accomplished in a one-step procedure and a higher complications rate.

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