Risk Factors of Venous Thromboembolic Events after Breast Cancer Surgeries; A Meta-Analysis of 166929 Patients

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 6-6
Author(s):  
A.M.E. Elkholy ◽  
A. Awadeen ◽  
I.H. Kabeil ◽  
A. Sokar
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Radical Mastectomy ◽  
Care Providers ◽  
Primary Reconstruction ◽  
Significant Difference ◽  
Venous Thromboembolic Events

Introduction: Venous thromboembolism (VTE) is the second most common cause of death among patients with breast cancer. In particular, VTE accounted for 20% of deaths after radical mastectomy. Owing to the devastating sequels associated with VTE and its financial impact, the current study was conducted to reveal the possible risk factors of VTE after breast cancer surgeries. Materials and Methods: Extensive systematic literature review, from inception up to 1 October 2019, was performed throughout 12 databases to reveal all clinical studies reported the risk factors of VTE after breast cancer surgeries. Pooled analysis was implemented using Review Manager. Results: This meta-analysis included 8 articles that encompassed an overall 166929 patients. There was no statistically significant difference between patients developed VTE and those not developed such condition regarding Caprini total score (SMD0.5;95%CI-0.58,1.57; P=0.36). Subsequently, patients developed VTE were elder than patients did not develop such complications (MD1.21;95%CI 1.06,1.35; P<0.001). Patients had pre-operative diabetes mellitus (OR 0.69;95%CI0.49,0.98; P=0.04) or pulmonary disease (OR1.43;95%CI1.09,1.88; P=0.01) were more susceptible to experience post-operative VTE, relative to other patients. Besides that, post-operative hospitalization stays were significantly longer among patients experienced VTE, relative to patients did not experience such complications (MD 2.6;95%CI 2.54,2.66; P<0.001). Patients subjected to radical mastectomy and primary reconstruction were more vulnerable to have VTE post-operatively (OR 2.66;95%CI 1.90,3.71; P<0.001). Similarly, patients received concurrent venous catheterization were more susceptible to develop VTE post-operatively (OR 2.13;95%CI 1.22,3.73; P<0.00=0.008). On the contrary, post-operative hormonal therapy, radiotherapy, or chemotherapy were not statistically significant risk factors of VTE after breast cancer surgeries. Conclusions: Elderly patients and those with pre-operative diabetes mellitus or pulmonary diseases and patients subordinated to primary reconstruction after radical mastectomy were more susceptible to develop VTE. Understanding these factors will aid health care providers to optimize the optimal preventive strategies of VTE after breast cancer surgeries.

scholarly journals Clinical profile and management of breast cancer in women in a rural based tertiary care hospital our experience

2017 ◽  
Vol 4 (2) ◽  
pp. 697
Author(s):  
Ambikavathy Mohan ◽  
Chandan Kumar
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Carcinoma ◽  
Health Care Providers ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Care Providers ◽  
Increased Risk ◽  
The Impact ◽  
Women In India

Background: Breast cancer is the second most common cancer among women in India and accounts for 7% of global burden of breast cancer and one-fifth of all cancers among women in India. The risk factors are related to lifestyle, early menarche, nulli parity, prolonged use of oral contraceptive pills, hormone replacement therapy, not breast‑feeding, alcohol, obesity, lack of exercise, and induced abortion. A woman who attains menopause after fifty five years of age has an increased risk of ovarian, breast, and uterine cancers. The risk is greater if a woman also began menstruating before twelve years of age. A longer exposure to estrogen increases a woman’s risk of breast cancers.Methods: This is a prospective observational study, conducted in the department of surgery, between December 2013 and June 2015(2 years). Patients diagnosed as breast carcinoma and admitted in surgical wards were included, Data pertaining to demography, clinical and pathological tumor profile, and treatment details were collected prospectively for each patient based on patient interviews and medical records. To analyse the Prevalence of breast cancer, clinical presentation, risk factors, diagnostic methods, treatment protocols, difference between pre and post‑menopausal breast cancer women regarding risk factors, assess the impact of treatment given and women’s knowledge about breast cancer.Results: A total number of 25 cases of breast carcinoma based on detailed history, clinical examination, Trucut biopsy, ultrasonography breast and axilla, ultrasound abdomen, mammogram and chest x-ray were analysed. All of them received three cycles of anterior chemotherapy consisting of 5- Fluorouracil 500 mg/m2,Adriamycin 50 mg/m2 Cyclophosphamide 80 mg/m2 (FAC regimen) administered intravenously followed by modified radical mastectomy. There were no recurrences seen on follow up till date.Conclusions: Late stage at presentation of breast cancer is a challenge to the health care providers. Cancer awareness programmes, multidisciplinary approach and evidence‑based strategies for early detection and effective management of the disease can go a long way in prevention.

scholarly journals Prevention of diabetes type 2 by adjustment of lifestyle and diet

2018 ◽  
Vol 5 (9) ◽  
pp. 3697
Author(s):  
Alaa Noor Elahi ◽  
Fardus Almarghalani ◽  
Hussain Al-Ramadhan ◽  
Al Hassan Jalal ◽  
Haya Alnafisah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health Care Providers ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Diabetes Mellitus Type ◽  
Care Providers ◽  
The World

Type 2 diabetes mellitus is one of the most common chronic health conditions around the world and is a major challenge to health care providers. Its incidence across the world is increasing. There is long-term affection of pancreas before symptoms start, allowing for a large window for early detection and prevention of the disease. We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through March 2017. The following search terms were used: diabetes type 2, prevention diabetes type 2, effects of lifestyle on health, alcohol and diabetes, smoking and diabetes, preventive strategies for diabetes type 2. Our aim in this study is to understand the pathophysiology of diabetes mellitus type 2 with regards to the risk factors and how to prevent them. Diabetes mellitus type 2 is considered a preventable disease, therefore, studying its risk factors and trying to reduce them is very important. Even minor modifications in risk factors of the disease could achieve significant reduction in incidence and progression of diabetes. Weight loss, improved dietary intake, and increased exercise levels are the most important interventions that will lead to significant decrease in the occurrence of the disease.

scholarly journals Current Knowledge, Attitudes, and Practice among Health Care Providers in OSCC Awareness: Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4506
Author(s):  
Noemi Coppola ◽  
Michele Davide Mignogna ◽  
Immacolata Rivieccio ◽  
Andrea Blasi ◽  
Maria Eleonora Bizzoca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Sun Exposure ◽  
Care Providers ◽  
Screening Programs ◽  
Dental Practitioners ◽  
Significant Difference

OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What clinicians know and feel, and how they behave on OSCC is crucial to understand the feasibility and effectiveness of screening programs. The aim of this systematic review was to assess knowledge, attitudes, and practice (KAP) regarding OSCC among health care providers (HCPs). Therefore, a systematic review was conducted with SPIDER and PICO as major tools. A meta-analysis was structured through common items in two comparison groups of medical and dental practitioners. Descriptive statistics and a Mantel–Haenszel test were used to validate data. Sixty-six studies were selected for systematic review, eight of which are useful for meta-analysis. A statistically significant difference was recorded between dentists and medical practitioners for questions regarding: Alcohol (p < 0.001); Elderly (p < 0.012); Sun exposure (p < 0.0001); Erythroplakia (p < 0.019); Red patch (p < 0.010); White patch (p < 0.020); Tobacco consultation (p < 0.0001); Intraoral examination (p < 0.0001) and Up-to-date knowledge (p < 0.002). Overall, the incidence of OSCC screening is low. Most HCPs feel the need to increase KAP. Data confirmed gaps in KAP, highlighting the need for a more efficient pre- and post-graduation training, necessary to increase competence worldwide.

scholarly journals Prevalence, risk factors, and management practices of primary dysmenorrhea among young females

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samar Karout ◽  
Lama Soubra ◽  
Deema Rahme ◽  
Lina Karout ◽  
Hani M J Khojah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Mefenamic Acid ◽  
Management Practices ◽  
Hormonal Contraceptives ◽  
Primary Dysmenorrhea ◽  
Care Providers ◽  
Young Females ◽  
Significant Difference ◽  
History Of

Abstract Background Primary dysmenorrhea (PD) is one of the most common gynecological conditions among young females, which has a significant negative impact on health-related quality of life and productivity. Despite its high prevalence, the evidence is limited regarding the management-seeking practices and its perceived effectiveness among females with PD. Methods This is a cross-sectional study conducted among 550 female students in six universities across Lebanon. The prevalence of PD, associated risk factors, and management-seeking practices were assessed using a self-administered questionnaire. Results The prevalence of PD was 80.9%. Most of the females with PD described their menstrual pain as moderate (56%) to severe (34.6%), which significantly affected their daily activities and studying ability (P < 0.001). The major risk factors associated with PD included heavy menstrual flow (adjusted odds ratio [AOR] = 10.28), family history of PD (AOR = 2.52), history of weight loss attempt (AOR = 2.05), and medical specialization (AOR = 1.663). Only 36.9% of females with PD sought formal medical advice. Most dysmenorrheic females (76.4%) received medications for the management of PD, and remarkably none of them took hormonal contraceptives. Drugs commonly used for PD were mefenamic acid (26.2%), ibuprofen (25%), and paracetamol (11.5%), which were administered when the pain started (58.2%). All medications were significantly effective in reducing the pain score (P = 0.001), and most NSAIDs were more potent than paracetamol in managing PD (P = 0.001). However, no significant difference in adverse effects among medications was revealed. Moreover, no superiority of any individual NSAID for pain relief was established. Nevertheless, mefenamic acid was associated with the lowest risk of abdominal pain (OR: 0.03, P = 0.005) and the highest risk of flank pain (OR = 12, P = 0.02). Conclusions Suboptimal management of PD is practiced among university students in Lebanon. Therefore, health care providers should educate dysmenorrheic females to optimize the self-management support of PD. Furthermore, future research is required to investigate females’ misconceptions about hormonal contraceptives in the management of PD, aiming to raise awareness and correct misconceptions.

scholarly journals Conventional cardiac risk factors associated with Trastuzumab induced cardio-toxicity in breast cancer: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
G Koulaouzidis ◽  
D Charisopoulou
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Family History ◽  
Meta Analysis ◽  
Previous History ◽  
Prophylactic Therapy ◽  
History Of ◽  
Positive Breast Cancer

Abstract Funding Acknowledgements Type of funding sources: None. Background Trastuzumab has had a major impact on the treatment of human epidermal growth factor receptor 2(HER-2) positive breast cancer patients. However, it is associated with cardiotoxicity, expressed as an asymptomatic decrease in LVEF and less often as clinical HF. Published studies have tried to identify risk factors predisposing to cardiotoxicity but the results are not uniform.  The aim of this meta-analysis is to identify the association of the conventional cardiovascular risk factors:age, smoking, hypertension, hyperlipidaemia, obesity, diabetes mellitus, family history of cardiac disease and the previous history of coronary artery disease (CAD), with the development of Trastuzumab induced cardiotoxicity (TIC). Methods A literature search of PubMed was conducted to identify studies examining the association between cardiovascular risk factors and TIC. The primary outcome of interest was the development of cardiotoxicity manifested as heart failure or deterioration in LVEF based on the criteria presented within each study. We included prospective and retrospective studies of patients with HER2 positive breast cancer who were treated with Trastuzumab. Data were extracted and pooled odds ratios (ORs) with 95% confidence intervals (Cis) were calculated examining the odds of developing TIC for each of the risk factors. Results A total of 35 studies were included in the analysis. Age &gt; 60 years old (OR: 0.7; 95% CI: 0.318-1.09; p = 0.0004), hypertension (OR: 0.69; 95% CI: 0.26-1.12; p = 0.001), smoking (OR: 0.35; 95% CI: 0.01- 0.69; p = 0.038), diabetes mellitus (OR: 0.44; 95% CI: 0.24- 0.68; p = 0.0001) and family history of CAD (OR: 5.51, 95%CI 1.76-17.25; p&lt; 0.00001) were significantly associated with the development of cardiotoxicity. Known history of CAD (OR: 3.72; 95%CI 2.11-6.57; p = 0.0005) was also associated with the development of TIC. On the other hand, obesity (OR: 2.47; 95% CI: 0.93- 6.55; p= 0.07) and hyperlipidaemia (OR: 1.32, 95% CI: 0.71- 2.46; p = 0.38) did not meet statistical significance for association with TIC. Conclusion Identifying women at risk for TIC have several important potential applications. Clinicians may decide to assess LVEF more frequently in patients at highest risk for TIC in order to detect LV systolic dysfunction earlier. Identifying high risk patients may play a role for recognition which individuals would obtain the most benefit from prophylactic therapy for preventing TIC.  this could help identify patients who would benefit most from prophylactic therapy for preventing TIC. Finally, these factors could in the future form the basis of a risk model for TIC.

scholarly journals Global, regional, and national prevalence of diabetes mellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Minmin Li ◽  
Tao Chen ◽  
Zhongqiu Hua ◽  
Ni Zhu ◽  
Duolao Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Pulmonary Tuberculosis ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Eastern Mediterranean Region ◽  
Original Research ◽  
Care Providers ◽  
National Prevalence ◽  
Prevalence Of Diabetes Mellitus

Abstract Background. The concept that people with pulmonary tuberculosis are at risk of developing diabetes mellitus has been raised. However, the prevalence of diabetes mellitus in patients with pulmonary tuberculosis have not been well established. We aim to estimate the global, regional, and national prevalence of diabetes mellitus in population with pulmonary tuberculosis. Methods. In this systematic review and meta-analysis, we assessed observational studies of diabetes mellitus in people with pulmonary tuberculosis, using PubMed and Embase electronic bibliographic databases in English language, to identify articles published until August 31, 2018. We included original research studies published in a peer-reviewed journal and reported the prevalence of diabetes mellitus or had enough data to compute these estimates. Studies were excluded if they did not provide primary data or were case studies and reviews. Independent extraction of articles and collected detailed information by 2 authors using predefined questionnaire, including study quality indicators. The country-specific random-effects meta-analyses for countries with two or more available studies and a fractional response regression model to predict individual studies prevalence of diabetes mellitus in patients with pulmonary tuberculosis for countries with one or no study. The study is registered with PROSPERO, registration number CRD42018101989. Results. We identified 18042 studies, and 127 were retained for data extraction across 46 countries. The global prevalence of diabetes mellitus in patients with pulmonary tuberculosis were estimated to be 12.07% (95%CI: 10.43-14.85). The prevalence of diabetes mellitus in patients with pulmonary tuberculosis was 13.38% (95%CI: 11.16-16.05) in region of Americas, 13.34% (95%CI: 12.82-14.61) in European region, 12.68% (95%CI: 9.15-16.37) in South-East Asia, 12.56% (95%CI: 11.79-22.70) in Western Pacific region, 10.95% (95%CI: 9.04-17.83) in Eastern Mediterranean region and 7.54% (95%CI: 6.51-8.77)in African region. The country with the highest estimated prevalence of pulmonary tuberculosis combined diabetes mellitus were Mauritius (39.65%, 95%CI: 4.22-90.74). Conclusion. Our findings suggest that pulmonary tuberculosis combined diabetes mellitus is still prevalent. As such, diabetes mellitus deserves more attention from PTB health-care providers, researchers, policy makers, and stakeholders for improved detection, overall proper management, and efficient control of diabetes mellitus in people with pulmonary tuberculosis.

Knowledge and Attitudes of Hispanic Women and Their Health Care Providers about Breast Cancer Risk Factors and Screening

2002 ◽  
Vol 5 (4) ◽  
pp. 222-231 ◽  
Author(s):  
Michelle N. Strecker ◽  
Aimee J. Williams ◽  
Melissa Bondy ◽  
Dennis A. Johnston ◽  
Hope Northrup
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Health Care ◽  
Breast Cancer Risk ◽  
Health Care Providers ◽  
Hispanic Women ◽  
Care Providers ◽  
Cancer Risk Factors ◽  
Knowledge And Attitudes ◽  
Breast Cancer Risk Factors

The Prevalence of Gestational Diabetes Mellitus in Pregnant Women Referred to Amir al-Mu'minin Hospital of Gerash City, Fars Province, Iran

2021 ◽  
Author(s):  
Elham Rezaee ◽  
Fariba Mohammadi ◽  
Mohammad Javad Boozhmehrani ◽  
Parisa Bagheri
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Adverse Outcomes ◽  
Screening Tests ◽  
Fars Province ◽  
Care Providers ◽  
Significant Difference

Background and Aims: The increasing number of pregnant women being diagnosed as having gestational diabetes mellitus (GDM) and  lead health care providers to develop reliable screening protocols and know the exact worldwide epidemiology of the disease. This study seeks to obtain data that will help to improve the epidemiologic knowledge about this disease. Materials and Methods: This cross-sectional study was performed on 953 pregnant women seeking routine prenatal screening tests. Participants participate with using Carpenter-Coustan criteria in the study. Statistical analysis was performed using SPSS software. Results and Conclusions: Among 953 pregnant women , 38 participants (4%) were detected to have GDM . Fifty percent of patients in the study were overweight .The data showed a significant difference in the mean age between the diabetic and non-diabetic groups. The high prevalence of GDM in young Iranian pregnant women may emphasize the need for early diagnosis and treatment to avoid adverse outcomes associated with GDM.

scholarly journals SP8.1.1 Ultrasonic versus electrocautery dissection in modified radical mastectomy for breast cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Amna Suliman ◽  
Ahmed Latif ◽  
Ilaria Giono ◽  
Sudeendra Doddi ◽  
MIchal Uhercik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Operative Blood Loss ◽  
Significant Difference ◽  
Operative Drainage

Abstract Aims Electrocautery (EC) remains the dominant dissection tool in modified radical mastectomy (MRM) for breast cancer. However, ultrasonic dissection devices (UDD) have emerged as popular alternatives on the basis that their mechanism of action limits tissue damage resulting in decreased blood loss, seroma formation and post-operative drainage. A systematic review and meta-analysis was performed to compare surgical outcomes for EC versus UDD in MRM surgery. Methods MEDLINE, EMBASE, PubMed and the Cochrane Database were searched and a comprehensive systematic review and meta-analysis performed according to PRISMA guidelines, comparing EC versus UDD in MRM for breast cancer. Outcomes of interest were post-operative drainage, incidence of seroma, intra-operative blood loss and operative time. Meta-analysis was performed using a random effects model to aggregate the data. Odds ratios (OR) were used as the summary statistic for dichotomous data and mean difference (MD) for continuous data. Data heterogeneity was assessed using the I2 statistic. Results Nineteen eligible peer-reviewed studies were analysed involving 1501 patients, UDD:744 EC:757. We demonstrated that in MRM, UDD significantly reduced post-operative drainage (MD = 312.26, 95% confidence interval (CI): 102.59-521.93, p = 0.004); seroma (OR = 0.51, 95% CI: 0.39-0.68, p &lt; 0.00001) and intra-operative blood loss (MD = 111.68, 95% CI: 84.56-138.8, p &lt; 0.00001) with no significant difference in operative time between the two techniques (MD = 0.32 (11.3-11.94), p = 0.96. Conclusion Using UDD in MRM for breast cancer presents significant advantages in decreasing post-operative drainage, seroma and intra-operative blood loss, without lengthening operating time compared to EC. It therefore appears favourable, however further cost-effectiveness analysis would be beneficial to guide selection.

Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 27 (37) ◽  
pp. 6373-6383 ◽  
Author(s):  
Leila Jouybari ◽  
Faezeh Kiani ◽  
Farhad Islami ◽  
Akram Sanagoo ◽  
Fatemeh Sayehmiri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Tissue ◽  
Reference Lists ◽  
Meta Analysis ◽  
Cancer Risks ◽  
Hair Samples ◽  
Significant Difference ◽  
Mean Differences ◽  
Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

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