Abstract 126: Importance of Untreated Hypertension for Intracerebral Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kyle B Walsh ◽  
Opeolu Adeoye ◽  
Padmini Sekar ◽  
Jennifer Osborne ◽  
Charles J Moomaw ◽  
...  

Introduction: Hypertension (HTN), particularly untreated HTN, has been found to be a significant risk factor for ICH in predominately white ICH populations. We evaluated the risk of treated and untreated HTN on ICH in a multi-ethnic case-control study. Hypothesis: Treated and untreated HTN confer variable risk for ICH by race/ethnicity. Methods: The Ethnic/Racial Variations of ICH (ERICH) study is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics. Cases were enrolled from 42 recruitment centers using hot-pursuit. Controls matched to cases 1:1 by age (±5 years), sex, race/ethnicity, and metropolitan area were recruited by random-digit dialing. Subjects were interviewed to determine whether they had a history of HTN and if they took medications to reduce blood pressure. Results: Between 9/2010 and 6/2015, 891 white, 833 black, and 599 Hispanic case/control pairs were enrolled. Higher proportions of black and Hispanic ICH with HTN were untreated, compared with whites (43.3% and 48.3% vs. 33.2%; p=.0002 and p<.0001, respectively). When adjusted for medical insurance status, a significant difference persisted for whites vs. Hispanics (p=.002), but not whites vs. blacks (p=.197). In multivariate analyses adjusted for alcohol use, anticoagulation, hypercholesterolemia, education, and insurance status, treated HTN was a significant risk factor for ICH in whites (OR=1.72, 95% CI 1.33-2.22, p<.0001), blacks (3.04, 2.13-4.34, <.0001), and Hispanics (2.57, 1.64-4.00, <.0001). Untreated HTN was a substantially greater risk factor for ICH for all three racial/ethnic groups: whites (9.53, 5.88-15.45, <.0001), blacks (11.10, 7.06-17.47, <.0001), Hispanics (9.65, 5.49-16.95, <.0001). In the subtype analyses of deep, lobar, and infratentorial ICH, untreated HTN resulted in ORs of 3.50 to 24.81, with statistical significance for all subtypes and ethnic groups. Conclusion: Treatment of HTN reduces the risk of ICH conferred by HTN markedly, but not completely. Untreated hypertension, which is significantly more prevalent among black and Hispanic ICH cases than among white cases, confers at least a 9-fold risk of ICH regardless of race. Treatment of hypertension is expected to have substantial impact on risk of ICH.

2003 ◽  
Vol 130 (3) ◽  
pp. 353-366 ◽  
Author(s):  
J. NEIMANN ◽  
J. ENGBERG ◽  
K. MØLBAK ◽  
H. C. WEGENER

A case control study comprising 282 cases and 319 matched controls was conducted in Denmark during 1996–7. Two estimates of the odds ratio (OR) were determined for each risk factor with and without ‘protective factors’ fitted into the final model. Consumption of undercooked poultry (OR 4·5; 8·2), consumption of red meat at a barbecue (OR 2·3; 4·1), consumption of grapes (OR 1·6; 2·8) and drinking unpasteurized milk (OR 2·3; 11·8) were identified as risk factors in both models. Frequent consumption of pork chops (OR 4·4) and daily contact with domestic animals and pets were identified as risk factors in one of the two models only. Finally, foreign travel was found to be a significant risk factor (OR 2·5). Seasonal and regional interaction was observed for several risk factors and the time elapsed from interviewing of cases to interviewing of controls seemed to influence the effect of certain seasonal dependent risk factors.


2000 ◽  
Vol 21 (12) ◽  
pp. 761-764 ◽  
Author(s):  
Klaus Weist ◽  
Constanze Wendt ◽  
Lyle R. Petersen ◽  
Hans Versmold ◽  
Henning Rüden

Objective:To investigate an outbreak of methicillin-susceptibleStaphylococcus aureus(MSSA); infections in a neonatal clinic.Design:Prospective chart review, environmental sampling, and genotyping by two independent methods: pulsed-field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). A case-control study was performed with 31 controls from the same clinic.Setting:A German 1,350-bed tertiary-care teaching university hospital.Results:There was a significant increase in the incidence of pyodermas with MSSA 10 neonates in good physical condition with no infection immediately after birth developed pyodermas. A shared spatula and ultrasound gel were the only identified infection sources. The gel contained MSSA and was used for hip-joint sonographies in all neonates. PFGE and RAPD-PCR patterns from 6 neonates and from the gel were indistinguishable and thus genetically related clones. The case-control study revealed no significant risk factor with the exception of cesarean section (P=.006). The attack rate by days of hip-joint sonography between April 15 and April 27, 1994, was 11.8% to 40%.Conclusions:Inappropriate hygienic measures in connection with lubricants during routine ultrasound scanning may lead to nosocomialS aureusinfections of the skin. To our knowledge this source ofS aureusinfections has not previously been described.


Rheumatology ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 1281-1287 ◽  
Author(s):  
David Armstrong ◽  
Alex Dregan ◽  
Mark Ashworth ◽  
Patrick White ◽  
Chris McGee ◽  
...  

Abstract Objectives To test the hypothesis that prior antibiotics influences the risk of developing RA. Methods A case–control study was conducted over 15 years using the UK’s Royal College of General Practitioners Research and Surveillance Centre database. The frequency and type of antibiotic prescription for patients who subsequently developed RA were compared with antibiotic prescriptions in a control group of patients who remained free of RA. Cases, defined as patients with a new diagnosis of RA made between 2006 and 2018, were matched with up to four RA-free controls on practice, age, gender and date of diagnosis. Exposure was measured by the number and type of prescriptions for antibiotics prior to the RA diagnosis or to the index date in controls. Results A total of 8482 patients with a new diagnosis of RA between 2006 and 2018 were compared with 22 661 controls. There was a higher likelihood of an RA diagnosis after antibiotic prescriptions within 1 year, 5 years and ever with a strong dose–response. Patients receiving &gt;10 antibiotics in a 5 year period were more than twice as likely to receive an RA diagnosis as controls [adjusted odds ratio 2.65 (CI 2.40, 2.93)]. Conclusion Exposure to antibiotics prior to the diagnosis was a significant risk factor for RA. This could reflect an immunological response to a compromised microbiome. Alternatively, patients with pre-symptomatic or early undiagnosed RA may have been more likely to present to their general practitioner with infections due to an unrecognized effect of RA.


2020 ◽  
Author(s):  
Guannan Xi ◽  
Qian Ying ◽  
Xuefeng Wang ◽  
Fei Luo ◽  
Chengqiu Lu ◽  
...  

Abstract Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, as antenatal examinations have improved, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of well-managed gestational diabetes with morbidity and complications of RDS. Method This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes. RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (1.9) weeks, which was similar to that of the non-RDS infants (35.7 (±1.3) weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups. CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. With regards to most GDM, diet and exercise are sufficient for maintaining an HbA1c below 6.5%


2014 ◽  
Vol 143 (1) ◽  
pp. 178-183 ◽  
Author(s):  
M. A. ASENCIO ◽  
M. HUERTAS ◽  
R. CARRANZA ◽  
J. M. TENIAS ◽  
J. CELIS ◽  
...  

SUMMARYA retrospective case-control study of patients who had undergone cataract extraction at a Spanish hospital over a 13-year period was conducted to identify the risk factors for developing post-operative endophthalmitis (POE). During the study period, the type of antibiotic prophylaxis was changed from subconjunctival gentamicin to the addition of both vancomycin and gentamicin to the irrigating solution. The overall incidence of POE was 0·19% (35 cases/18 287 operations). For the period prior to the change in antibiotic prophylaxis, the incidence rate of POE was 3·4 cases/1000 operations while in the latter period the incidence rate decreased to 0·34 cases/1000 operations. All patients who presented a virulent microorganism had a final visual acuity worse than 20/200. The only significant risk factor identified was the type of prophylaxis used (odds ratio 1·97, 95% confidence interval 0·94–4·14, P = 0·07). There were no significant differences between cases and controls although choice of surgeon approached significance.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1699
Author(s):  
Zainab Akhter ◽  
Nicola Heslehurst ◽  
Dries Ceulemans ◽  
Judith Rankin ◽  
Roger Ackroyd ◽  
...  

Bariatric surgery prior to pregnancy is a significant risk factor for small for gestational age (SGA) babies. This case-control study investigated differences between mothers delivering an SGA baby following bariatric surgery, compared to those delivering an appropriate for gestational age (AGA) baby. Out of 129 babies born to mothers in the AURORA cohort study, 25 were SGA (<10th percentile) and 97 were AGA (10th–90th percentile). Higher gestational weight gain (GWG) was significantly associated with decreased odds of SGA (aOR per kg 0.92, 95% CI 0.85–0.99). According to the Institute of Medicine GWG guidelines, 44% of SGA mothers had ‘inadequate’ GWG compared to 17% of AGA mothers. Nearly half of the mothers had ‘excessive’ GWG yet still gave birth to an SGA or AGA baby. Mothers of SGA babies lost more weight following bariatric surgery (45.6 ± 14.4 kg vs. 39.0 ± 17.9 kg). Women who reported receiving nutritional advice following bariatric surgery were significantly less likely to have an SGA baby (aOR 0.15, 95% CI 0.0.4–0.55). Women with a history of bariatric surgery should be provided with specialized support before and during pregnancy to encourage adequate nutritional intake and weight gain to support healthy fetal growth.


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