scholarly journals Prevalence and Risk Factors of Silent Brain Infarction in Patients with Aortic Stenosis

2020 ◽  
Vol 10 (3) ◽  
pp. 116-123
Author(s):  
Ayaka Ito ◽  
Shinichi Iwata ◽  
Soichiro Tamura ◽  
Andrew T. Kim ◽  
Shinichi Nonin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Stenosis ◽  
Brain Infarction ◽  
Multiple Logistic Regression Analysis ◽  
Brain Magnetic Resonance Imaging ◽  
Multidetector Row Computed Tomography ◽  
Increased Risk ◽  
Lower Egfr ◽  
Silent Brain Infarction ◽  
Ischemic Attack

<b><i>Introduction:</i></b> Silent brain infarction (SBI) is an independent risk factor for subsequent symptomatic stroke in the general population. Although aortic stenosis (AS) is also known to be associated with an increased risk of future symptomatic stroke, little is known regarding the prevalence and risk factors for SBI in patients with AS. <b><i>Methods:</i></b> The study population comprised 83 patients with severe AS with no history of stroke or transient ischemic attack and paralysis or sensory impairment (mean age 75 ± 7 years). All patients underwent brain magnetic resonance imaging to screen for SBI and multidetector-row computed tomography to quantify the aortic valve calcification (AVC) volume. Comprehensive transthoracic and transesophageal echocardiography were performed to evaluate left atrial (LA) abnormalities, such as LA enlargement, spontaneous echo contrast, or abnormal LA appendage emptying velocity (&#x3c;20 cm/s), and complex plaques in the aortic arch. <b><i>Results:</i></b> SBI was detected in 38 patients (46%). Multiple logistic regression analysis indicated that CHA<sub>2</sub>DS<sub>2</sub>-VASc score and estimated glomerular filtration rate (eGFR) were independently associated with SBI (<i>p</i> &#x3c; 0.05), whereas LA abnormalities and AVC volume were not. When patients were divided into 4 groups according to CHA<sub>2</sub>DS<sub>2</sub>-VASc score and eGFR, the group with a higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score (≥4) and a lower eGFR (&#x3c;60 mL/min/1.73 m<sup>2</sup>) had a greater risk of SBI than the other groups (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> These findings indicate that AS is associated with a high prevalence of SBI, and that the CHA<sub>2</sub>DS<sub>2</sub>-VASc score and eGFR are useful for risk stratification.

scholarly journals The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

2013 ◽  
Vol 70 (11) ◽  
pp. 993-998 ◽  
Author(s):  
Djordje Milosevic ◽  
Janko Pasternak ◽  
Vladan Popovic ◽  
Dragan Nikolic ◽  
Pavle Milosevic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Brain Infarction ◽  
Statistical Significance ◽  
Brain Parenchyma ◽  
Plaque Morphology ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70%) extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%), but without a statistically significant difference (p > 0.05). The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus) showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a larger percentage of patients with silent brain infarction (36.4% : 29.3%) but without a significant statistical difference (p > 0.05). Conclusions. Even though silent brain infarction is more frequent in patients with unstable plaque of carotid bifurication, the difference is of no statistical significance. The effects of the number and type of risk factors bear no statistical significance on the incidence of morphological asymptomatic carotid plaque.

scholarly journals Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria

2013 ◽  
Vol 1 (1) ◽  
pp. 12 ◽  
Author(s):  
Ibrahim A. Yakasai ◽  
Imran O. Morhason-Bello
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Multiple Logistic Regression Analysis ◽  
Control Group ◽  
Northern Nigeria ◽  
Degree Relative ◽  
Factors Associated ◽  
Increased Risk ◽  
History Of ◽  
At Home

Pre-eclampsia (PE) is an important cause of maternal mortality. There have been several studies on risk factors assessment with conflicting reports across the globe on this disease; however, rigorous recent evaluation of these factors is uncommon in this region. The aim of the present study was to determine the risks factors in the early-onset PE in Aminu Kano Teaching Hospital (AKTH), Kano (Northern Nigeria). We conducted a case-control study in Nigeria between April 2009 and January 2010 to identify the risk factors associated with the early-onset PE in women attending antenatal clinic in AKTH. Information on socio-cultural characteristics, medical history, previous obstetrics history, level of stress at home, and type of family were obtained and recorded in a proforma designed for the study. Multiple logistic regression analysis was used to determine the risk factors for PE at 95% confidence level. Pregnant women with early-onset PE (150 in each case and control group). Risk factors associated with increased risk of early-onset PE were: history of pre-eclampsia/eclampsia (PE/E) in a previous pregnancy [adjusted odds ratio (AOR) 2.09]; exposure to passive smoking (AOR 1.34); inadequate antenatal supervision (AOR 15.21); family history of hypertension in one or more 1st-degree relative (AOR 8.92); living in a joint family (AOR 6.93); overweight (120% to 150% of pre-pregnancy ideal body weight, AOR 4.65). Risk factors among women in Northern Nigeria are similar to those reported from other studies. Good antenatal cares, early detection, reduction of stressful conditions at home are the most important preventive measures of early-onset severe PE among these women.

Seizure rates in enzalutamide (ENZ)-treated men with metastatic castration-resistant prostate cancer (mCRPC) at increased risk of seizure: UPWARD study.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 147-147 ◽  
Author(s):  
Susan F. Slovin ◽  
William Clark ◽  
Joan Carles ◽  
Andrew Krivoshik ◽  
Jung Wook Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Period ◽  
Seizure Threshold ◽  
Castration Resistant Prostate Cancer ◽  
Open Label ◽  
Castration Resistant ◽  
Increased Risk ◽  
Seizure Rate ◽  
Report Data ◽  
Ischemic Attack

147 Background: ENZ is an androgen receptor inhibitor that improved survival in studies of men with mCRPC. Seizure is a risk of ENZ treatment, and patients (pts) with seizure risk factors were excluded in prior studies. In the TRUVEN report (data on file), pts with mCRPC and potential seizure risk factors, but no ENZ exposure, had a seizure rate of 2.8/100 pt-years. The UPWARD study assessed the seizure risk in ENZ-treated pts with mCRPC who had potential seizure risk factors. Methods: This was a global, multicenter, single-arm, open-label safety study. Enrolled pts had ≥ 1 baseline potential seizure risk factor, including medications lowering seizure threshold, stroke, or prior seizure history. Evaluable pts had ≥ 3 months (ms) of treatment with ENZ or ≥ 1 confirmed seizure in a 4-m treatment period. Exclusion criteria included seizure within the past 12 ms and receipt of anti-epileptic medication. Pts received ENZ (160 mg/day). The primary end point was the proportion of evaluable pts with ≥ 1 confirmed seizure during the 4-m treatment period. Results: A total of423 pts received ENZ; 366 were evaluable. Baseline seizure risk factors were medications lowering seizure threshold (n = 242), brain injury (n = 112), and cerebrovascular accident/transient ischemic attack history (n = 94). Four (1.1%) evaluable pts had ≥ 1 confirmed seizure within 4 ms of ENZ initiation. Four (1.1%) pts had a first seizure after 4 ms. The rate of confirmed seizure was 2.6/100 pt-years. 357 pts (84.4%) experienced ≥ 1 treatment-emergent adverse event (TEAE); 141 (33.3%) had ≥ 1 serious TEAE and 29 (6.9%) had ≥ 1 drug-related serious AE. 38 (9.0%) deaths were reported during treatment/within 30 days of discontinuation; four deaths were considered possibly drug related (cerebral hemorrhage, mCRPC progression, sudden cardiac death, and general deterioration). Conclusions: The incidence of confirmed seizures in the UPWARD study is similar to pts with mCRPC and similar risk factors but no ENZ exposure in the TRUVEN report. ENZ was generally well tolerated, and TEAE data are consistent with its known safety profile. These results suggest that ENZ did not increase the risk of seizures in the UPWARD study. Clinical trial information: NCT01977651.

scholarly journals Risk Factors Analysis of Pulmonary Cement Embolism during Percutaneous Vertebroplasty or Kyphoplasty for Osteoporotic Vertebral Compression Fracture.

2021 ◽  
Author(s):  
Dexin Zou ◽  
Shengjie Dong ◽  
Wei Du ◽  
Bing Sun ◽  
Xifa Wu
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Demographic Data ◽  
Multiple Logistic Regression Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Increased Risk ◽  
Significant Difference ◽  
Cement Embolism ◽  
Pulmonary Ct

Abstract Objective: The purpose of this research is to evaluate the risk factors and incidence of PCE during PKP or PVP for osteoporotic vertebral compression fracture (OVCF) based on postoperative computed tomography (CT).Methods: A total of 2344 patients who underwent PVP or PKP due to OVCF in our spine centre were analyzed retrospectively. According to the detection of postoperative pulmonary CT, the patients were divided into two groups: pulmonary cement embolism group (PCE group) and non pulmonary cement embolism group (NPCE group). Demographic data in both groups were compared using the χ2 test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was carried out to identify risk factors that were significantly related to the PCE resulting from cement leakage.Results: PCE was found in 34 patients (1.9% 34/1782) with pulmonary CT examination after operation. There was no statistically significant difference in the parameters such as age, gender, body mass index (BMI) and cement volume in the two groups. Patients with three or more involved vertebrae had a significantly increased risk to suffer from PCE than those with one involved vertebra (p=0.046 OR 2.412 [95% CI 1.017-5.722]). Patients who suffered thoracic fracture had a significantly increased risk to suffer from PCE than those suffered thoracolumbar fracture (p=0.001 OR 0.241 [95% CI 0.105-0.550]). And significantly increased PCE risk also was observed in thoracic fracture compared with Lumbar fracture patients (p=0.028 OR 0.094 [95% CI 0.114-0.779]). The risk of PCE within two weeks after fracture was significantly higher than that after two weeks of fracture (p=0.000 OR 0.178 [95% CI 0.074-0.429]). Patients who underwent PVP surgery had a significantly increased PCE risk than those underwent PKP surgery (p=0.001 OR 0.187 [95% CI 0.069-0.509])Conclusion: The real incidence of PCE is underestimated due to the lack of routine postoperative pulmonary imaging examination. The number of Involved vertebrae, fracture location, operation timing and operation methods are independent risk factors for PCE.

INCREASED RISK FOR SILENT BRAIN INFARCTION AND DEEP WHITE MATTER LESION IN ALCOHOLIC PATIENTS.

2004 ◽  
Vol 28 (Supplement) ◽  
pp. 22A
Author(s):  
Sachio Matsushita ◽  
Go Suzuki ◽  
Toshifumi Matsui ◽  
Toshihiro Masaki ◽  
Hiroyuki Arai ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Lesion ◽  
Brain Infarction ◽  
Deep White Matter ◽  
Increased Risk ◽  
Silent Brain Infarction

Influence of Hypertension and Diabetes on Postoperative Outcomes In Cancer Patients Undergoing Moderate/High Risk Surgical Procedures

2021 ◽  
Author(s):  
Lafayete William Ferreira Ramos ◽  
Beatriz Nery Nascimento ◽  
Gabriel Rossi Silva ◽  
Marcos Vinícius Ferreira Ramos ◽  
Barbara Cristina Ferreira Ramos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Multiple Logistic Regression Analysis ◽  
Diabetic Group ◽  
Postoperative Outcomes ◽  
Morbidity And Mortality ◽  
Systemic Hypertension ◽  
Surgical Time ◽  
Increased Risk

Abstract Background: Systemic hypertension (HTN) and diabetes mellitus (DM) are believed to be risk factors for adverse postoperative outcomes in patients undergoing surgical interventions, but evidence is lacking. This retrospective study evaluated the effects of HTN and DM, alone or in combination, on postoperative outcomes of elective noncardiac surgery in cancer patients. Methods: Patients (n = 844) with malignancies, who underwent elective surgery at a tertiary hospital, were categorised into healthy (group A, n = 339), hypertensive (group B, n = 357), diabetic (group C, n = 21), and hypertensive and diabetic (group D, n = 127) groups. Preoperatively, all patients had systolic blood pressure ≤ 160 mmHg and plasma glucose level ≤ 140 mg/dl. Postoperative in-hospital morbidity and mortality were compared among groups. Results: Postoperative complications occurred in 22 (6.5%), 21 (5.9%), 2 (9.5%), and 11 (8.7%) patients in groups A, B, C, and D, respectively (p = 0.712). HTN (p = 0.538), DM (p = 0.990), and HTN+DM (p = 0.135) did not impact the occurrence of adverse events. Patients with higher surgical risk (ASA III or IV) and those with longer surgical time had higher morbidity and mortality (p = 0.001, p < 0.001, respectively). In multiple logistic regression analysis, ASA status and surgical time were independent risk factors for postoperative complications (both p < 0.001). Conclusion: Cancer patients with preoperative comorbidities, such as HTN and DM, alone or in combination, regardless of other characteristics, do not have an increased risk of adverse postoperative outcomes.Trial registration: Retrospectively registered.

scholarly journals Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4086
Author(s):  
Judith Gecht ◽  
Ioannis Tsoukakis ◽  
Kim Kricheldorf ◽  
Frank Stegelmann ◽  
Martine Klausmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Arterial Hypertension ◽  
Estimated Glomerular Filtration Rate ◽  
Myeloproliferative Neoplasms ◽  
Multiple Logistic Regression Analysis ◽  
Study Group ◽  
Kidney Dysfunction ◽  
German Study ◽  
Increased Risk ◽  
History Of

Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m2)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.

scholarly journals Overweight and decreased baroreflex sensitivity as independent risk factors for hypertension in children, adolescents, and young adults

2008 ◽  
pp. 385-391
Author(s):  
K Krontorádová ◽  
N Honzíková ◽  
B Fišer ◽  
Z Nováková ◽  
E Závodná ◽  
...  
Keyword(s):  
Risk Factors ◽  
Baroreflex Sensitivity ◽  
Multiple Logistic Regression Analysis ◽  
Normal Weight ◽  
Receiver Operating Curve ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Sensitivity Specificity ◽  
The Relationship ◽  
Hypertension In Children

We studied the relationship between blood pressure (BP), body mass index (BMI, kg/m2) and baroreflex sensitivity (BRS, ms/mmHg) in adolescents. We examined 34 subjects aged 16.2±2.4 years who had repeatedly high causal BP (H) and 52 controls (C) aged 16.4±2.2 years. Forty-four C and 22 H were of normal weight (BMI between 19-23.9), and 8 C and 12 H were overweight (BMI between 24-30). Systolic BP was recorded beatto-beat for 5 min (Finapres, controlled breathing 0.33 Hz). BRS was determined by the cross-spectral method. The predicting power of BMI and BRS for hypertension was evaluated by sensitivity, specificity, and receiver operating curve (ROC - plot of sensitivity versus specificity). H compared with C had lower BRS (p<0.01) and higher BMI (p<0.05). Multiple logistic regression analysis (p<0.001) revealed that a decreased BRS (p<0.05) and an increased BMI (p<0.01) were independently associated with an increased risk of hypertension. No correlation between BMI and BRS was found either in H or in C. Following optimal critical values by ROC, the sensitivity, specificity and area under ROC were determined for: BMI - 22.2 kg/m2, 61.8 %, 69.2 %, 66.0 %; BRS - 7.1 ms/mmHg, 67.7 %, 69.2 %, 70.0 %; BMI and BRS - 0.439 a.u., 73.5 %, 82.7 %, and 77.3 %. Decreased BRS and overweight were found to be independent risk factors for hypertension.

Risk Factors for Surgical-Site Infections Following Cesarean Section

2001 ◽  
Vol 22 (10) ◽  
pp. 613-617 ◽  
Author(s):  
Carol A. Killian ◽  
Eileen M. Graffunder ◽  
Timothy J. Vinciguerra ◽  
Richard A. Venezia
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Logistic Regression Analysis ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Cesarean Sections ◽  
Increased Risk ◽  
Active Labor ◽  
Prenatal Visits

AbstractObjective:To identify risk factors associated with surgical-site infections (SSIs) following cesarean sections.Design:Prospective cohort study.Setting:High-risk obstetrics and neonatal tertiary-care center in upstate New York.Patients:Population-based sample of 765 patients who underwent cesarean sections at our facility during 6-month periods each year from 1996 through 1998.Methods:Prospective surgical-site surveillance was conducted using methodology of the National Nosocomial Infections Surveillance System. Infections were identified during admission, within 30 days following the cesarean section, by read-mission to the hospital or by a postdischarge survey.Results:Multiple logistic-regression analysis identified four factors independently associated with an increased risk of SSI following cesarean section: absence of antibiotic prophylaxis (odds ratio [OR], 2.63; 95% confidence interval [CI95], 1.50-4.6; P=.008); surgery time (OR, 1.01; CI95, 1.00-1.02; P=.04); <7 prenatal visits (OR, 3.99; CI95, 1.74-9.15; P=.001); and hours of ruptured membranes (OR, 1.02; CI95,1.01-1.03; P=.04).Patients given antibiotic prophylaxis had significantly lower infection rates than patients who did not receive antibiotic prophylaxis (F=02), whether or not active labor or ruptured membranes were present.Conclusion:Among the variables identified as risk factors for SSI, only two have the possibility to be changed through interventions. Antibiotic prophylaxis would benefit all cesarean patients regardless of active labor or ruptured membranes and would decrease morbidity and length of stay. Women's healthcare professionals also must continue to encourage pregnant women to start prenatal visits early in the pregnancy and to maintain scheduled visits throughout the pregnancy to prevent perinatal complications, including postoperative infection.

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