Levels of inflammatory markers and the development of the post-thrombotic syndrome

2009 ◽  
Vol 101 (03) ◽  
pp. 505-512 ◽  
Author(s):  
Hadia Shbaklo ◽  
Christina A. Holcroft ◽  
Susan R. Kahn
Keyword(s):  
Odds Ratio ◽  
Inflammatory Markers ◽  
Subsequent Development ◽  
Regression Analyses ◽  
Post Thrombotic Syndrome ◽  
Venous Valves ◽  
Markers Of Inflammation ◽  
Close Relationship ◽  
Study Population

SummaryThe post-thrombotic syndrome (PTS) occurs frequently after deep venous thrombosis (DVT) despite appropriate anticoagulant therapy. A close relationship between inflammation and thrombosis exists. While the inflammatory process at the time of DVT appears to improve thrombus resolution, it may promote destruction of venous valves, valvular reflux and subsequent development of PTS. We prospectively evaluated the association between levels of four cytokines (IL-6, IL-8, IL-10 and MCP-1), two adhesion molecules (ICAM-1 and VCAM-1) and the development of PTS in a well-defined cohort of patients with DVT. The study population consisted of 387 patients with objectively diagnosed symptomatic DVT who were followed for two years to determine the incidence of PTS. At the end of follow-up, plasma samples frozen at the four-month visit in 307 study patients were thawed and analyzed for the above inflammatory markers using the Luminex beads technology. Mean levels of IL-6 were significantly higher in patients with PTS compared to patients without PTS (7.35 pg/ml ± 14.26 [SD] vs. 4.60 pg/ml ± 4.90;p=0.03). Logistic regression analyses showed significant associations between PTS and levels above vs. below the median of IL-6 [odds ratio (OR) 1.66; 95% confidence interval (CI) 1.05, 2.62 (p=0.03)] and ICAM-1 [OR 1.63; 95% CI 1.03, 2.58 (p=0.04)]. None of the other markers showed any association with PTS. Our study suggests the presence of significant associations between markers of inflammation such as IL-6 and ICAM-1 and the development of PTS. Further work is needed to evaluate this relationship and to analyse other candidate markers that could be implicated etiologically in the association between DVT and PTS. If confirmed, this could lead to identification of new therapeutic targets for preventing PTS after DVT.

Levels of Inflammatory Markers and the Development of the Post Thrombotic Syndrome.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1810-1810
Author(s):  
Hadia Shbaklo ◽  
Christina A Holcroft ◽  
Susan R Kahn
Keyword(s):  
Inflammatory Markers ◽  
Subsequent Development ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Venous Valves ◽  
Markers Of Inflammation ◽  
Close Relationship ◽  
Study Population ◽  
Deep Vein

Abstract Background: The post-thrombotic syndrome (PTS) occurs frequently after deep vein thrombosis (DVT) despite appropriate anticoagulant therapy. A close relationship between inflammation and thrombosis exists. While the inflammatory process at the time of DVT appears to improve thrombus resolution, it may promote destruction of venous valves, valvular reflux and subsequent development of PTS. Objective: We prospectively evaluated the association between levels of four cytokines (IL-6, IL-8, IL-10 and MCP-1), two adhesion molecules (ICAM-1 and VCAM-1) and the development of PTS in a well-defined cohort of patients with DVT. Methods: The study population consisted of 387 patients with objectively diagnosed symptomatic DVT who participated in the Venous Thrombosis Outcomes (VETO) Study and were followed for two years to determine the incidence of PTS. For this substudy, plasma samples frozen at the 4 month visit in 307 study patients who consented to provide blood samples were thawed and analyzed for the above inflammatory markers using the Luminex beads technology. Associations between marker levels and development of the PTS during follow-up were evaluated. Results: Mean levels of IL-6 were significantly higher in patients with PTS compared to patients without PTS (7.35 pg/ml ± 14.26 vs. 4.60 pg/ml ± 4.90;p=0.03). Logistic regression analyses showed significant associations between PTS and levels above vs. below the median of IL-6 (OR 1.66; 95% CI 1.05, 2.62 (p=0.03)) and ICAM-1 (OR 1.63; 95% CI 1.03, 2.58 (p=0.04)). None of the other markers showed any association with PTS. Conclusion: Our study suggests the presence of significant associations between markers of inflammation such as IL-6 and ICAM-1 and the development of PTS. Further work is needed to evaluate this relationship and to analyze other candidate markers that could be implicated etiologically in the association between DVT and PTS. If confirmed, this could lead to identification of new therapeutic targets for preventing PTS after DVT.

Physicians’ Choice in Using Internet and Fax for Patient Recruitment and Follow-up in a Randomized Controlled Trial

2004 ◽  
Vol 43 (03) ◽  
pp. 268-272 ◽  
Author(s):  
S. Morita ◽  
T. Fukui ◽  
J. Sakamoto ◽  
M. Rahman
Keyword(s):  
Randomized Controlled Trial ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Data Entry ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Web Based ◽  
Randomized Controlled ◽  
The Web

Summary Objective: To examine the physicians’ preference between Web and fax-based remote data entry (RDE) system for an ongoing randomized controlled trial (RCT) in Japan. Methods: We conducted a survey among all the collaborating physicians (n = 512) of the CASE-J (Candesartan Antihypertensive Survival Evaluation in Japan) trial, who have been recruiting patients and sending follow-up data using the Web or a fax-based RDE system. The survey instrument assessed physicians’ choice between Web and fax-based RDE systems, their practice pattern, and attitudes towards these two modalities. Results: A total of 448 (87.5%) responses were received. The proportions of physicians who used Web, fax, and the combination of these two were 45.9%, 33.3% and 20.8%, respectively. Multivariate logistic regression analyses revealed that physicians 55 years or younger [odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.3] and regular users of computers (OR = 4.2, 95% CI = 2.1-8.2) were more likely to use the Web-based RDE system. Conclusions: This information would be useful in designing an RCT with a Web-based RDE system in Japan and abroad.

Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings

2021 ◽  
Author(s):  
Brian L Block ◽  
Thomas M Martin ◽  
W John Boscardin ◽  
Kenneth E Covinsky ◽  
Michele Mourad ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hospital Death ◽  
Hospital Level ◽  
Large Variability ◽  
Large Sample ◽  
Number Of Patients ◽  
Study Population

Some hospitals have faced a surge of patients with COVID-19, while others have not. We assessed whether COVID-19 burden (number of patients with COVID-19 admitted during April 2020 divided by hospital certified bed count) was associated with mortality in a large sample of US hospitals. Our study population included 14,226 patients with COVID-19 (median age 66 years, 45.2% women) at 117 hospitals, of whom 20.9% had died at 5 weeks of follow-up. At the hospital level, the observed mortality ranged from 0% to 44.4%. After adjustment for age, sex, and comorbidities, the adjusted odds ratio for in-hospital death in the highest quintile of burden was 1.46 (95% CI, 1.07-2.00) compared to all other quintiles. Still, there was large variability in outcomes, even among hospitals with a similar level of COVID-19 burden and after adjusting for age, sex, and comorbidities.

scholarly journals A Longitudinal Study of the Association Between Persistent Pathogens and Incident Depression Among Older U.S. Latinos

2018 ◽  
Vol 74 (5) ◽  
pp. 634-641 ◽  
Author(s):  
Amanda M Simanek ◽  
Cheng Zheng ◽  
Robert Yolken ◽  
Mary Haan ◽  
Allison E Aiello
Keyword(s):  
Odds Ratio ◽  
Inflammatory Markers ◽  
Total Sample ◽  
C Reactive Protein ◽  
Varicella Zoster ◽  
Reactive Protein ◽  
Severity Of Depression ◽  
Simplex Virus ◽  
Persistent Pathogens

Abstract Depression is estimated to affect more than 6.5 million Americans 65 years of age and older and compared with non-Latino whites older U.S. Latinos have a greater incidence and severity of depression, warranting further investigation of novel risk factors for depression onset among this population. We used data on 771/1,789 individuals ≥60 years of age from the Sacramento Area Latino Study on Aging (1998–2008) who were tested for cytomegalovirus (CMV), herpes simplex virus, varicella zoster, Helicobacter pylori, Toxoplasma gondii, and C-reactive protein (CRP) and interleukin-6 (IL-6) level. Among those without elevated depressive symptoms at baseline, we examined the association between each pathogen, inflammatory markers and incident depression over up to nearly 10 years of follow-up using discrete-time logistic regression. We found that only CMV seropositivity was statistically significantly associated with increased odds of incident depression (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.00–1.90) in the total sample as well as among women only (OR: 1.70, 95% CI: 1.01–2.86). These associations were not mediated by CRP or IL-6 levels. Our findings suggest that CMV seropositivity may serve as an important risk factor for the onset of depression among older U.S. Latinos, but act outside of inflammatory pathways.

scholarly journals Neighborhood Mobility and Unmet Physical Activity Need in Old Age: A 2-Year Follow-Up

2020 ◽  
Vol 28 (3) ◽  
pp. 442-447
Author(s):  
Lotta Palmberg ◽  
Erja Portegijs ◽  
Taina Rantanen ◽  
Eeva Aartolahti ◽  
Anne Viljanen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Lower Risk ◽  
Community Dwelling ◽  
Regression Analyses ◽  
Old People ◽  
Step Counts ◽  
Lower Baseline

Background: Many older people report a willingness to increase outdoor physical activity (PA), but no opportunities for it, a situation termed as unmet PA need. The authors studied whether lower neighborhood mobility and PA precede the development of unmet PA need. Methods: Community-dwelling 75- to 90-year-old people (n = 700) were interviewed annually for 2 years. Unmet PA need, neighborhood mobility, and PA were self-reported. In addition, accelerometer-based step counts were assessed among a subgroup (n = 156). Results: Logistic regression analyses revealed that lower baseline neighborhood mobility (odds ratio 3.02, 95% confidence interval [1.86, 4.90] vs. daily) and PA (odds ratio 4.37, 95% confidence interval [2.62, 7.29] vs. high) were associated with the development of unmet PA need over 2 years. The participants with higher step counts had a lower risk for unmet PA need (odds ratio 0.68, 95% confidence interval, [0.54, 0.87]). Conclusion: Maintaining higher PA levels and finding solutions for daily outdoor mobility, especially for those with declines in health, may protect from the development of unmet PA need.

scholarly journals Association of serum IGF1 with endothelial function: results from the population-based study of health in Pomerania

2010 ◽  
Vol 163 (4) ◽  
pp. 617-623 ◽  
Author(s):  
Klaus Empen ◽  
Roberto Lorbeer ◽  
Henry Völzke ◽  
Daniel M Robinson ◽  
Nele Friedrich ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Odds Ratio ◽  
Population Based ◽  
Flow Mediated Dilation ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Population Based Study ◽  
Igf Binding ◽  
Study Population ◽  
Igf Binding Protein

ObjectiveIGF1 mediates multiple physiological and pathophysiological responses in the cardiovascular system. The aim of this study was to analyze the association between serum IGF1 as well as IGF-binding protein 3 (IGFBP3) levels and endothelial function measured by flow-mediated dilation (FMD).DesignCross-sectional population-based observational study.MethodsThe study population comprised 1482 subjects (736 women) aged 25–85 years from the Study of Health in Pomerania. Serum IGF1 and IGFBP3 levels were determined by chemiluminescence immunoassays. FMD measurements were performed using standardized ultrasound techniques. FMD values below the sex-specific median were considered low.ResultsIn males, logistic regression analyses revealed an odds ratio (OR) of 1.27 (95% confidence interval (CI) 1.07–1.51;P=0.008) for decreased FMD for each decrement of IGF1s.d.after adjustment for major cardiovascular confounders. In females, no significant relationship between serum IGF1 and FMD was found (OR 0.88, CI 0.74–1.05;P=0.147). After exclusion of subjects with the current use of antihypertensive medication, these findings were similar (males: OR 1.40, CI 1.12–1.75;P=0.003; females: OR 0.95, CI 0.77–1.16;P=0.595). There was no association between serum IGFBP3 levels and FMD in both sexes.ConclusionsLow serum IGF1 levels are associated with impaired endothelial function in males. In women, serum IGF1 is not associated with endothelial function.

The Relationship Between D-Dimer Level, Venous Valvular Reflux and Development of the Post-Thrombotic Syndrome after Deep Venous Thrombosis.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1821-1821 ◽  
Author(s):  
Jennifer Latella ◽  
Sylvie Desmarais ◽  
Susan Kahn ◽  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Subsequent Development ◽  
Standardized Assessments ◽  
Post Thrombotic Syndrome ◽  
Ultrasound Assessment ◽  
Recurrent Vte ◽  
The Relationship ◽  
D Dimer

Abstract Background: The pathophysiology of the post-thrombotic syndrome (PTS) is postulated to involve persistent venous thrombosis and valvular reflux. We prospectively studied if d-dimer levels or valvular reflux were associated with subsequent development of the PTS after objectively confirmed deep venous thrombosis (DVT). Methods: Consecutive patients with objectively diagnosed acute symptomatic DVT were recruited at 8 hospital centres in Quebec and Ontario, Canada. Patients attended study visits at Baseline, 1, 4, 8, 12, and 24 months. Blood was taken to measure d-dimer (VIDAS d-dimer; cut off <500 ug/L) at the 4 month visit. A standardized ultrasound assessment for popliteal venous valvular reflux was performed at the 12 month visit. Standardized assessments for PTS (using Villalta scale) were performed at each follow-up visit. Subjects were classified as having developed PTS if the ipsilateral Villalta score was >5 on at least 2 visits starting at the 4 month visit or later or was >5 at the final follow-up visit. Statistical analyses assessed associations between d-dimer level, ipsilateral reflux and PTS. Results: 387 patients were recruited and followed. Mean age was 56 years and 51% were male. PTS developed in 45% of patients. Mean d-dimer was significantly higher in patients who developed PTS compared with those who did not (712.0 vs. 444.0 ug/L; p= 0.02). In logistic regression analyses adjusted for age and warfarin use at the time of d-dimer determination, d-dimer levels significantly predicted PTS (p=0.03). Ipsilateral venous valvular reflux was more frequent in patients with moderate/severe PTS than in patients with no PTS or mild PTS (65% vs. 40% vs. 43%, respectively; p=0.013). Finally, mean d-dimer was higher in patients who developed recurrent VTE during follow-up (n=31) than in those who did not (1126.8 vs. 514.9 ug/L; p=0.05), and d-dimer was an independent predictor of recurrent VTE (p=0.04) after adjustment for other known predictors of recurrence. Conclusion: D-dimer levels measured 4 months after DVT are associated with subsequent development of PTS and are predictive of VTE recurrence. Venous valvular reflux was associated with moderate/severe PTS. Further studies are required to assess whether d-dimer or valvular reflux may be useful in determining which patients are most at risk of developing PTS or severe PTS and who may thus benefit from preventive strategies.

Severe Head Injury linked to Subsequent Development of Malignant Brain Tumour within a Short Period- A Case Report

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Head Injury ◽  
Brain Tumour ◽  
Severe Head Injury ◽  
Case Reports ◽  
Subsequent Development ◽  
Malignant Brain Tumour ◽  
Tumour Development ◽  
Short Period ◽  
The Brain

There have been a few case reports of head injury leading to brain tumour development in the same region as the brain injury. Here we report a case where the patient suffered a severe head injury with contusion. He recovered clinically with conservative management. Follow up Computed Tomography scan of the brain a month later showed complete resolution of the lesion. He subsequently developed malignant brain tumour in the same region as the original contusion within a very short period of 15 months. Head injury patients need close follow up especially when severe. The link between severity of head injury and malignant brain tumour development needs further evaluation. Role of anti-inflammatory agents for prevention of post traumatic brain tumours needs further exploration.

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

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