scholarly journals Weather Fluctuations May Have an Impact on Stroke Occurrence in a Society: A Population-Based Cohort Study

2020 ◽  
Vol 10 (1) ◽  
pp. 1-10
Author(s):  
Naoki Matsumaru ◽  
Hideshi Okada ◽  
Kodai Suzuki ◽  
Sho Nachi ◽  
Takahiro Yoshida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Meteorological Data ◽  
Significant Risk ◽  
Population Based ◽  
Japan Meteorological Agency ◽  
Humidity Change ◽  
Significant Difference ◽  
Target Period ◽  
Lower Temperature

Background: Stroke has been found to have a seasonally varying incidence; blood pressure, one of its risk factors, is influenced by humidity and temperature. The relationship between the incidence of stroke and meteorological parameters remains controversial. Objective: We investigated whether meteorological conditions are significant risk factors for stroke, focusing on the fluctuation of weather elements that triggers the onset of stroke. Methods: We collected ambulance transportation data recorded by emergency personnel from Gifu Prefecture. We included cases where the cause of the transportation was stroke and excluded cases of trauma. We combined these data with meteorological data as well as data on average temperature, average air pressure, and humidity provided publicly by the Japan Meteorological Agency. Our target period was from January 2012 to December 2016. Results: In the 5-year target period, there were 5,501 occurrences of ambulance transportation due to stroke. A seasonal tendency was confirmed, since ambulance transportation for stroke occurred more frequently at low temperatures (p < 0.001). Temperature (odds ratio: 0.91; p < 0.001) and humidity change (odds ratio: 1.50; p = 0.016) were identified as risk factors for ambulance transportation due to stroke. An increase in temperature incurs a lower risk than a decrease (odds ratio: 0.58; p = 0.09), although there is no statistically significant difference. Conclusions: Meteorological effects on the frequency of ambulance transportation due to stroke were studied. A lower temperature and radical humidity change were identified as risk factors for ambulance transportation due to stroke, and a decrease in temperature was also associated. We speculate on the possibilities of using meteorological data to optimize the assignment of limited medical resources in medical economics.

scholarly journals Risk Factors of COVID-19 among Patients Attending a Tertiary Care Centre in Delhi: A Case Control Study

2020 ◽  
Vol 05 (04) ◽  
pp. 5-11
Author(s):  
Aakanksha Bharti ◽  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Tertiary Care ◽  
Significant Risk ◽  
P Value ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Case Record ◽  
Significant Difference ◽  
Contact Data

Introduction: COVID-19 is an infectious disease caused by a newly discovered coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS CoV-2). Therefore, there is paucity of data on risk factors of COVID-19 in India which will help in designing preventive measures. Objective: To determine the risk factors of COVID-19 patients attending a tertiary care institution. Methods: The study was conducted at tertiary care hosipital in South Delhi, India among the patients admitted in Covid-19 wards or visiting the hospital for testing of SARS CoV-2 infection. Contact data of test results was collected from the medical record and detailed information was collected through telephone calls. 103 cases were selected who were found test positive by RT PCR and 103 negatives were selected as controls. Data was collected using pre-tested Questionnaire. The data were first captured in paper-based case record form and then entered in a Microsoft Excel and analyzed in SPSS Software version 21.0. Result: The mean age of all the participants was 37.63±15.32 years. On comparing cases and controls, it was found that symptoms like fever, general weakness, cough, sore throat, breathlessness and headache were significantly associated with cases, having an odds ratio of greater than 1 and p value< 0.05. On analysing various underlying medical conditions amongst controls and cases, it was found that there was a significant difference among cases and controls who had Diabetes Mellitus (DM) and Hypertension (p-value: 0.001) with a high odds ratio of 6.130 and 5.964 respectively. Around half of the cases (54.4%) and 23.3% of controls reported to have faced discrimination or changed attitude of their neighbours after revealing their RT-PCR report and this difference was statistically significant (p-value 0.001). Conclusion: Study revealed that majority of symptoms were not predictors of COVID-19 and only occupations and history of contact remained significant risk factors of COVID-19 in multivariate analysis. A multicenter research study is required to learn more about risk factors.

Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea

2021 ◽  
Author(s):  
Chang-Soon Lee ◽  
Young Jae Park ◽  
Jee Youn Moon ◽  
Yong-Chul Kim
Keyword(s):  
Risk Factors ◽  
South Korea ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Epidural Injection ◽  
Spinal Infection ◽  
Single Shot ◽  
Epidural Injections ◽  
Spinal Infections

Background Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection. Methods Using South Korea’s National Health Insurance Service sample cohort database, the 10-yr national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics. Results The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days postprocedurally (0.01% per injection). In multivariable analysis, age of 65 yr or more (odds ratio, 2.91; 95% CI, 1.62 to 5.5; P = 0.001), living in a rural area (odds ratio, 2.85; 95% CI, 1.57 to 5.0; P &lt; 0.001), complicated diabetes (odds ratio, 3.18; 95% CI, 1.30 to 6.7; P = 0.005), multiple epidural injections (three times or more) within the previous 90 days (odds ratio, 2.34; 95% CI, 1.22 to 4.2; P = 0.007), and recent use of immunosuppressants (odds ratio, 2.90; 95% CI, 1.00 to 6.7; P = 0.025) were significant risk factors of the infection postprocedurally. Conclusions The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Non-Intensive Continuous Treatment with a Tyrosine Kinase Inhibitor (TKI) Followed By Allo-HSCT Is an Effective Therapeutic Strategy for Adult Ph-Positive Acute Lymphoblastic Leukemia: Outcomes of the Russian Prospective Multicenter RALL Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4395-4395
Author(s):  
Olga A. Gavrilina ◽  
Elena N. Parovichnikova ◽  
Vera V. Troitskaya ◽  
Zalina Kh. Akhmerzaeva ◽  
Sergey N. Bondarenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymphoblastic Leukemia ◽  
Significant Risk ◽  
Continuous Treatment ◽  
Molecular Response ◽  
Monosomy 7 ◽  
Long Term Outcome ◽  
Landmark Analysis ◽  
Significant Difference ◽  
New Generation

Abstract Introduction. As Ph-positive (Ph+) ALL in adults remains less favorable in prognosis than other ALL, and by expert opinion needs non-intensive chemotherapy protocols and new generation TKI with the majority of pts undergoing allo-HSCT, the results of treatment based on the different approach: de-escalated but continuous treatment with the change of TKI according to the molecular response and allo-HSCT may be of interest and provide new insights to the treatment of Ph+ ALL. Aim. To evaluate survival and outcomes in different risk groups in pts with Ph+ ALL in the RALL-study (Ph+ALL-2009, Ph+ALL-2012 and Ph+ALL-2012m protocols). Patients and methods. Between January 2010 and June 2021, 74 new Ph+ ALL cases were diagnosed in 6 centers of the RALL-group and 63 of them were evaluable for analysis (median age 37 years (17-73), m/f 32(43%)/42(57%), CNS disease in 13(21%) pts, WBC&gt;30*10 9/l in 27(43%) pts, bcr/abl transcript p190/p210/p190+210 in 31(60%)/12(23%)/9(17%) cases). Standard cytogenetic was performed in all 63 pts, 1 had no mitosis, 6(10%) monosomy 7 and 2 (3%) complex karyotypes were detected. All pts were treated according to RALL protocols with continuous Imatinib. Ph+ALL-2009 protocol included 600 mg Imatinib with prednisone, VNCR, L-asp, Dauno, Cph, followed by 6-MP and MTX. Imatinib had to be changed to Dasatinib (140 mg) after non-achievement of molecular complete response (MolCR) on day 70. MolCR was defined as bcr/abl chimeric transcript &lt;0,01% by PCR with 10 -4 sensitivity. In protocols Ph+ALL-2012 and Ph+ALLm, we de-intensified chemotherapy: reduced Dauno, Cph and L-asp doses, accordingly. All pts were considered as candidates for allogeneic HSCT in CR1 if HLA-identical donor was available. 36 (57%) pts underwent HSCT in the first-line therapy: 2(6%) autologous, 9 (25%) matched related, 20 (56%) matched unrelated and 5 (13%) haplo-HSCT. Results. Hematological complete remission (CR) was achieved in 60 (95%) of 63 pts (1 early death and 2 refractory cases occurred). On day 70, MolCR was achieved in 21(38%) of 56 pts. Death on therapy in CR (within 5 months of induction/consolidation) was registered in 4 (6%) cases. The major causes of the non-relapsed mortality in unrelated allo-HSCT (n=9) were aGVHD and severe infections, at a median +4 months after HSCT. The 5-year overall survival (OS) and disease-free survival (DFS) for all 63 pts were 58% and 45%, respectively. The long-term outcome on different protocols (Ph+ALL-2009, Ph+ALL-2012 and Ph+ALL-2012m) were similar: 3-year OS - 55% vs 51% vs 75% (p=0,27), 3-year DFS - 56% vs 44% vs 50% (p=0,54), respectively. The 5-year OS was 65% vs 61% (p=0,84), and DFS was 57% vs 31% (p=0,24) in transplanted vs non-transplanted patients by landmark analysis with a median 5,3 month of CR. Landmark analysis of 5-year OS for transplanted and non-transplanted pts depending on age showed no significant difference for both groups: &gt;45y 40% vs 80%; and ≤45y 70% vs 49%, respectively (p=0,1625), although data for 5-year OS was still not mature at the time of analysis. DFS was significantly different in transplanted vs. non-transplanted pts: &gt;45y 40% vs 71%; ≤45y 61% vs 0%; respectively (p=0,0439). In a multivariate analysis for Ph+ ALL among common risk factors (age &gt; 45y, WBC&gt;30, LDH&gt;2N, immunophenotype, late MolCR &gt;70d, CNS leukemia) WBC&gt;30, HSCT were significant risk factors for OS and DFS. Conclusions. Our data demonstrate that de-intensification of chemotherapy does not affect the efficacy of Ph+ ALL therapy in the era of TKIs. We confirmed that patients older than 45y old could be treated by chemotherapy with TKI (new generation TKI if needed) only, but all pts younger than 45y should be considered for HSCT. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Socioeconomic, Psychiatric and Materiality Determinants and Risk of Postpartum Depression in Border City of Ilam, Western Iran

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Pegah Taherifard ◽  
Ali Delpisheh ◽  
Ramin Shirali ◽  
Abdorrahim Afkhamzadeh ◽  
Yousef Veisani
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
Low Socioeconomic Status ◽  
Data Gathering ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Western Iran ◽  
Border City ◽  
Significant Difference

Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran.Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering.Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7–41.7). A significant difference was observed among depression scores before and after delivery (P≤0.001). Type of delivery (P=0.044), low socioeconomic status (P=0.011), and women having low educational level (P=0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22–2.28,P=0.003).Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports.

scholarly journals Risk analysis and clinical outcomes of intraoperative periprosthetic fractures: a retrospective study of 481 bipolar hemiarthroplasties

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Petri Bellova ◽  
Hinnerk Baecker ◽  
Sebastian Lotzien ◽  
Marvin Brandt ◽  
Thomas A. Schildhauer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Periprosthetic Fractures ◽  
Matched Pair ◽  
Categorical Variables ◽  
Bipolar Hemiarthroplasty ◽  
Exact Test ◽  
Displaced Femoral Neck Fractures ◽  
Significant Difference ◽  
Postoperative Mobility

Abstract Background Intraoperative periprosthetic fractures (IPF) are a well-described complication following hip hemiarthroplasty. Our aims were to identify risk factors that characterize IPF and to investigate postoperative mobility. Methods We retrospectively reviewed 481 bipolar hemiarthroplasties for displaced femoral neck fractures; of which, 421 (87.5%) were performed without cement, from January 2013 to March 2018. Data on the patients’ demographics, comorbidities, femoral canal geometry (Dorr canal type, Canal Flare Index), surgeon’s experience (junior vs. senior surgeon), and timing of surgery (daytime vs. on-call duty) were obtained. In patients with intraoperative fractures, further information was obtained. Patient mobility was assessed using matched-pair analysis. Mobility was classified according to the NHFD mobility score. The chi-square test, Fisher’s exact test, and Fisher-Freeman-Halton exact test were used for comparison between categorical variables, while the Mann-Whitney U test was used for continuous variables. The data analysis was performed using SPSS. Results Of 481 procedures, 34 (7.1%) IPFs were encountered. The Dorr canal type C was identified as a significant risk factor (p = .004). Other risk factors included female sex (OR 2.30, 95% CI .872–6.079), stovepipe femur (OR 1.749, 95% CI .823–3.713), junior surgeon (OR 1.204, 95% CI .596–2.432), and on-call-duty surgery (OR 1.471, 95% CI .711–3.046), although none showed a significant difference. Of 34 IPFs, 25 (73.5%) were classified as Vancouver type A. The treatment of choice was cerclage wiring. Within the 12 matched pairs identified, the postoperative mobility was slightly worse for the IPF group (delta = .41). Conclusions IPF is a serious complication with bipolar hemiarthroplasty. The identification of risk factors preoperatively, in particular femur shape, is crucial and should be incorporated into the decision-making process.

scholarly journals Risk factors and health consequences of physical and emotional violence against children in Zimbabwe: a nationally representative survey

2018 ◽  
Vol 3 (3) ◽  
pp. e000533 ◽  
Author(s):  
Handrick Chigiji ◽  
Deborah Fry ◽  
Tinashe Enock Mwadiwa ◽  
Aldo Elizalde ◽  
Noriko Izumi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Health Outcomes ◽  
Peer Relationships ◽  
Emotional Abuse ◽  
Physical Violence ◽  
Significant Risk ◽  
Population Based ◽  
School Level ◽  
National Population

IntroductionThis study provides, for the first time, comparable national population-based estimates that describe the nature and magnitude of physical and emotional violence during childhood in Zimbabwe.MethodsFrom August to September 2011, we conducted a national population-based survey of 2410 respondents aged 13–24 years, using a two-stage cluster sampling. Regression models were adjusted for relevant demographics to estimate the ORs for associations between violence, risk factors and various health-related outcomes.ResultsRespondents aged 18–24 years report a lifetime prevalence (before the age of 18) of 63.9% (among girls) to 76% (among boys) for physical violence by a parent or adult relative, 12.6% (girls) to 26.4% (boys) for humiliation in front of others, and 17.3% (girls) to 17.5% (boys) for feeling unwanted. Almost 50% of either sex aged 13–17 years experienced physical violence in the 12 months preceding the survey. Significant risk factors for experiencing physical violence for girls are ever experiencing emotional abuse prior to age 13, adult illness in the home, socioeconomic status and age. Boys’ risk factors include peer relationships and socioeconomic status, while caring teachers and trusted community members are protective factors. Risk factors for emotional abuse vary, including family relationships, teacher and school-level variables, socioeconomic status, and community trust and security. Emotional abuse is associated with increased suicide attempts for both boys and girls, among other health outcomes.ConclusionPhysical and emotional violence often work in tandem causing poor mental and physical health outcomes. Understanding risk factors for violence within the peer or family context is essential for improved violence prevention.

scholarly journals Risk Factors for Lateral Meniscus Posterior Root Tears in the Anterior Cruciate Ligament–Injured Knee: An Epidemiological Analysis of 3956 Patients From the SANTI Study Group

2019 ◽  
Vol 47 (3) ◽  
pp. 598-605 ◽  
Author(s):  
Cesar Praz ◽  
Thais Dutra Vieira ◽  
Adnan Saithna ◽  
Nikolaus Rosentiel ◽  
Vikram Kandhari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Significant Risk ◽  
Posterior Root ◽  
Medial Meniscal Tear ◽  
Anterior Cruciate

Background: Lateral meniscus posterior root tears (LMPRTs) result in loss of hoop forces and significant increases in tibiofemoral contact pressures. Preoperative imaging lacks reliability; therefore, holding an appropriate index of suspicion, based on the epidemiology of and risk factors for LMPRT, may reduce the rate of missed diagnoses. Purpose: The primary objectives of this study were to evaluate the incidence of and risk factors for lateral meniscus root lesions in a large series of patients undergoing anterior cruciate ligament (ACL) reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: All patients who underwent primary or revision ACL reconstruction by a single surgeon between January 2011 and April 2018 were considered for study eligibility. From this overall population, all patients who underwent repair of an LMPRT were identified. The epidemiology of LMPRT was defined by the incidence within the study population, stratified by key demographic parameters. Potentially important risk factors for the presence of LMPRT were evaluated in multivariate logistic regression analysis. Results: A total of 3956 patients undergoing ACL reconstruction were included in the study. An LMPRT was identified and repaired in 262 patients (6.6%). Multivariate analyses demonstrated that significant risk factors for LMPRT included a contact sports injury mechanism (7.8% incidence with contact sport mechanism vs 4.5% with noncontact mechanism; odds ratio, 1.69; 95% CI, 1.266-2.285; P < .001) and the presence of a medial meniscal tear (7.9% incidence with medial meniscal tear vs 5.8% without; odds ratio, 1.532; 95% CI, 1.185-1.979; P < .001). Although the incidence of LMPRT in male patients (7.3%) was higher than in females (4.8%), this was not significant in multivariate analysis ( P = .270). Patient age, revision ACL reconstruction, and a preoperative side-to-side laxity difference ≥6 mm were not significant risk factors for LMPRT. Conclusion: The incidence of LMPRT was 6.6% in a large series of patients undergoing ACL reconstruction. Participation in contact sports and the presence of a concomitant medial meniscal tear were demonstrated to be important independent risk factors. Their presence should raise the index of suspicion for this injury pattern.

Long Term Follow-Up of Pediatric Sickle Cell Disease Patients with Conditional Velocities on Transcranial Doppler (TCD).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2338-2338
Author(s):  
Lena Coïc ◽  
Suzanne Verlhac ◽  
Emmanuelle Lesprit ◽  
Emmanuelle Fleurence ◽  
Francoise Bernaudin
Keyword(s):  
Risk Factors ◽  
Color Doppler ◽  
Significant Risk ◽  
Biological Data ◽  
Treatment Intensification ◽  
Significant Difference ◽  
History Of ◽  
The Mean

Abstract Abnormal TCD defined as high mean maximum velocities &gt; 200 cm/sec are highly predictive of stroke risk and justify long term transfusion program. Outcome and risk factors of conditional TCD defined as velocities 170–200 cm/sec remains to be described. Patients and methods Since 1992, 371 pediatric SCD patients (303 SS, 44 SC, 18 Sß+, 6 Sß0) were systematically explored once a year by TCD. The newborn screened cohort (n=174) had the first TCD exploration between 12 and 18 months of age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. Biological data were assessed at baseline, after the age of 1.5 years and remotely of transfusion or VOC. We report the characteristics and the outcome in patients (n=43) with an history of conditional TCD defined by mean maximum velocities ranging between 170 and 200 cm/s in the ACM, the ACA or the ICA. Results: The mean follow-up of TCD monitoring was 5,5 years (0 – 11,8 y). All patients with an history of conditional doppler were SS/Sb0 (n=43). Mean (SD) age of patients at the time of their first conditional TCD was 4.3 years (2.2) whereas in our series the mean age at abnormal TCD (&gt; 200 cm/sec) occurrence was 6.6 years (3.2). Comparison of basal parameters showed highly significant differences between patients with conditional TCD and those with normal TCD: Hb 7g4 vs 8g5 (p&lt;0.001), MCV 82.8 vs 79 (p=0.047). We also had found such differences between patients with normal and those with abnormal TCD (Hb and MCV p&lt; 0.001). Two patients were lost of follow-up. Two patients died during a trip to Africa. Conditional TCD became abnormal in 11/43 patients and justified transfusion program. Mean (SD) conversion delay was 1.8 (2.0) years (range 0.5–7y). No stroke occurred. 16 patients required a treatment intensification for other indications (frequent VOC/ACS, splenic sequestrations): 6 were transplanted and 10 received HU or TP. Significant risk factors (Pearson) of conversion to abnormal were the age at time of conditional TCD occurrence &lt; 3 y (p&lt;0.001), baseline Hb &lt; 7g/dl (p=0.02) and MCV &gt; 80 (p=0.04). MRI/MRA was performed in 31/43 patients and showed ischemic lesions in 5 of them at the mean (SD) age of 7.1 y (1.8) (range 4.5–8.9): no significant difference was observed in the occurrence of lesions between the 2 groups. Conclusions This study confirms the importance of age as predictive factor of conditional to abnormal TCD conversion with a risk of 64% when first conditional TCD occured before the age of 3 years. TCD has to be frequently controled during the 5 first years of life.

Epidemiologic study of risk factors for meningioma in the Mayo Clinic Study of Aging.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 2067-2067
Author(s):  
Alissa Butts ◽  
Jeremy A. Syrjanen ◽  
Jeremiah Aakre ◽  
Paul D. Brown ◽  
Clifford R. Jack ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mayo Clinic ◽  
Large Population ◽  
Epidemiologic Study ◽  
Significant Risk ◽  
Female Gender ◽  
Population Based ◽  
Continuous Variable ◽  
Health Study ◽  
Clinic Study

2067 Background: An estimated 2% of the general population has a meningioma (Vernooij et al. 2007), which accounts for about 36% of all primary intracranial tumors (Ostrom et al. 2015). The most established risk factors are older age and female gender. One small study identified gender but no other risk factors with meningioma (Krampla et al 2004). A larger study using the Iowa Women’s Health study data found lower levels of physical activity, greater body mass index (BMI), greater height and uterine fibroids were associated with meningioma (Johnson et al. 2011). We sought to replicate these findings and to identify additional risk factors related to meningioma in a large population-based sample. Methods: Study participants were enrolled in the Mayo Clinic Study of Aging (MCSA), a population-based sample of Olmsted County, Minnesota residents used to study prevalence, incidence, and risk-factors for Mild Cognitive Impairment and dementia and includes a variety of medical factors. Using a text search of radiologists’ notes of 2,402 MCSA individuals, mean age 77±8 years and scanned between 2004-2014.We identified 52 subjects who had at least one meningioma. We estimated the association of selected potential risk factors with presence of meningioma using odds ratios and 95% confidence intervals from logistic regression models adjusted for age and gender, which informed the multivariable models. Results: In the initial models, significant risk factors identified included BMI (as a continuous variable) (OR = 1.06 95%CI 1.01 to 1.12), taking NSAIDS (OR = 2.11, 95%CI 1.13 to 3.95), aspirin (OR = 1.90, 95%CI 1.04 to 3.46), and blood pressure lowering medication (OR = 2.06, 95%CI 1.07 to 3.99). Protective factors included male gender (OR = 0.51, 95%CI 0.29 to 0.90), coronary artery disease (CAD; OR = 0.46, 95%CI 0.22 to 0.97) and higher Beck Anxiety Inventory (BAI) total score (OR = 0.88, 95%CI 0.78 to 0.98). Simultaneous adjustment for these factors in a multivariable model did not attenuate these associations. Conclusions: Findings reveal gender and BMI as risk factors for meningioma. Additionally, certain medications such as NSAIDS and BP lowering medications warrant follow up as potential factors related to development of meningioma.

Bleeding and thrombosis outcomes in patients with acute leukemia.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19501-e19501 ◽  
Author(s):  
Amar Harry Kelkar ◽  
Asha R. Dhanarajan ◽  
Mona Arti Kelkar ◽  
John R. Wingard
Keyword(s):  
Risk Factors ◽  
Acute Leukemia ◽  
Major Bleeding ◽  
Significant Risk ◽  
Bleeding Events ◽  
Logrank Test ◽  
Hospital System ◽  
Vte Prophylaxis ◽  
Vein Thrombosis ◽  
Significant Difference

e19501 Background: Management of acute leukemia is often complicated by acute venous thromboembolism (VTE) and bleeding. However, it is unknown which risk factors contribute to these VTE and bleeding events, how they impact survival, or whether they warrant VTE prophylaxis. Methods: A retrospective study was conducted at the University of Florida Health Shands Hospital System. The study included patients aged 18 or older with acute leukemia who received induction chemotherapy between January 2000 and December 2011. Bleeding was defined as clinically significant non-major bleeding and major bleeding per the International Society on Thrombosis and Haemostasis guidelines. VTE was defined as pulmonary embolism, deep vein thrombosis of the upper or lower extremities, or visceral vein thrombosis. Results: Of the 250 patients with acute leukemia, 65 had VTE, 60 had bleeding, and 152 had no significant VTE or bleeding. There were 27 patients with both VTE and bleeding. There were no significant differences in demographics or disease types between these three groups. There was a total of 77 VTE events and 72 bleeding events. We performed a logistic regression analysis in a mixed model to identify risk factors for VTE and bleeding, considering leukemia type, presence of infection, chemotherapy, number of comorbidities, VTE prophylaxis, and transplant as covariates. Presence of infection and number of comorbidities were significantly associated with VTE (p = 0.0094 and 0.0009, respectively). We did not find any significant risk factor associated with bleeding. Kaplan-Meier survival analysis showed a non-significant difference in survival between the non-VTE, non-bleed group and the VTE group (Logrank test, p = 0.52). In contrast, survival in the non-VTE, non-bleed group was significantly higher than the bleed group (Logrank test, p = 0.0006). The table demonstrates higher two-year survival in the non-VTE, non-bleed group (68.7%) compared to the VTE and bleed groups (54.4% and 30.3%, respectively). Conclusions: Acute leukemia patients without VTE or bleeding had significantly higher duration of survival than patients with bleeding. Patients with acute leukemia and presence of infection or multiple comorbidities may warrant greater consideration of VTE prophylaxis. [Table: see text]

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