scholarly journals Thrombosis in Hodgkin Lymphoma Patients: Incidence, Time Points, Risk Factors and Impact of Stage and Treatment

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4151-4151
Author(s):  
Sven Borchmann ◽  
Ida Hude ◽  
Horst Müller ◽  
Heinz Haverkamp ◽  
Carolin Bürkle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Early Stage ◽  
Significant Risk ◽  
Incidence Rates ◽  
Comprehensive Analysis ◽  
Advanced Stage ◽  
Vein Thrombosis ◽  
Potential Risk Factors ◽  
Prophylactic Anticoagulation

Abstract Thrombotic events are regularly observed in patients receiving treatment for Hodgkin Lymphoma (HL). However, sound data on incidence and risk factors are not known. The aim of the present study was thus to provide a comprehensive analysis of thrombotic events after multimodality treatment for HL. A total of 5,773 patients ≤ 60 years treated within the German Hodgkin Study Group (GHSG) trials HD13-15 between January 2003 and December 2009 were included in this analysis. All reported venous and arterial thrombotic events occurring within 1 year after trial enrollment were evaluated and detailed information on patient characteristics, localizations, time of occurrence and risk factors were collected. We excluded thromboses of superficial veins and thrombophlebitis. Descriptive statistics and logistic regression were used for statistical analysis. A total of 193 thrombotic events occurred for an incidence of 3.3%; there were 11 events in early-favorable, 27 in early-unfavorable and 155 in advanced stage HL, resulting in incidence rates of 0.7%, 1.3% and 7.3%, respectively. The incidence in advanced stage HL was significantly higher than in early stage HL (p<0.001); 175 events were venous and 18 arterial. The most common venous events consisted of arm vein thrombosis in 49.1% (n=86), DVT in 29.1% (n=51), PE in 13.1% (n=23) and sinus vein thrombosis in 1.7% (n=3) of cases. The most common arterial events were MI in 55.6% (n=10), lower extremities arterial thromboembolism in 22.2% (n=4) and CVI in 16.7% (n=3) of cases. 30.6% (n=59) of events were associated with intravenous catheters, 8.8% (n=17) were likely due to tumor compression and 1.0% (n=2) occurred despite prophylactic anticoagulation. We found that 2.6% (n=5), 77.2% (n=149) and 20.2% (n=39) of cases occurred before, during and after chemotherapy respectively. In advanced HL patients treated with 8 x BEACOPPesc, 6 x BEACOPPesc or 8 x BEACOPP-14 , the incidence rates were 6.2% (n=44), 5.5% (n=39) and 10.1% (n=72) respectively. The incidence in patients treated with BEACOPP-14 was significantly higher than in patients treated with the other two regimens (p<0.01). Opposed to rather evenly distributed events during chemotherapy with BEACOPPesc, thromboses during treatment with BEACOPP-14 occurred more frequently at the beginning of chemotherapy. We then analyzed potential risk factors in advanced stage patients using logistic regression analysis, adjusting for treatment in order to identify a high-risk group for developing a thrombotic event. The well-established Khorana score was not associated with a higher risk of thrombosis (odds ratio (OR) per unit [95% confidence interval]: 0.91 [0.76-1.1], p=0.33). Additionally, we screened 21 potential risk factors, including the thrombocyte-to-lymphocyte ratio. Only age (OR per year: 1.02 [1.01-1.03], p=0.01) and smoking (OR: 1.61 [1.07-2.43], p=0.02) emerged as significant risk factors. None of the other following potential risk factors was prognostic: thrombocyte-to-lymphocyte ratio, thrombocytes, leukocytes, lymphocytes, hemoglobin, albumin, WHO activity index, erythropoietin treatment, sex, body mass index, B-symptoms, erythrocyte sedimentation rate, extranodal disease, large mediastinal mass, more than 2 affected areas or Ann Arbor stage (all p≥0.10). Yet, when only including venous events, which are potentially preventable by prophylactic anticoagulation, neither age nor smoking were significant risk factors anymore (p≥0.10). This study is the largest and most comprehensive analysis of thrombotic events in HL patients to date. Compared to both, early-favorable and early-unfavorable HL, advanced stage patients are at higher risk for thrombotic events. The most widely used Khorana score estimating thrombosis risk in cancer outpatients was not prognostic in the HL population investigated here. This is unsurprising considering the young age of the patient population investigated. Other risk factors were also not prognostic. This data does not imply a need for prophylactic anti-coagulation in outpatients treated for early-stage HL. In advanced-stage HL patients, routine prophylactic anticoagulation is not warranted. However, individual patients with additional risk factors that could not be evaluated such as history of thrombosis or reduced mobility might still benefit from prophylactic treatment. Disclosures Engert: Takeda, BMS: Consultancy, Honoraria, Research Funding.

scholarly journals National Reporting Trend for HO-MRSA Bacteremia LabID Events, 2010–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s68-s69
Author(s):  
Karen Jones ◽  
Yi Mu ◽  
Qunna Li ◽  
Allan Nkwata ◽  
Minn Soe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Fixed Effects ◽  
Current Trend ◽  
Significant Risk ◽  
Interrupted Time Series ◽  
Incidence Rates ◽  
Surveillance Systems ◽  
Quality Reporting ◽  
Potential Risk Factors

Background: The Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) has included surveillance of laboratory-identified (LabID) methicillin-resistant Staphylococcus aureus (MRSA) bacteremia events since 2009. In 2013, the Centers for Medicare & Medicaid Services (CMS) began requiring acute-care hospitals (ACHs) that participate in the CMS Inpatient Quality Reporting program to report MRSA LabID events to the NHSN and, in 2015, ACHs were required to report MRSA LabID events from emergency departments (EDs) and/or 24-hour observation locations. Prior studies observed a decline in hospital-onset MRSA (HO-MRSA) rates in national studies over shorter periods or other surveillance systems. In this analysis, we review the national reporting trend for HO-MRSA bacteremia LabID events, 2010–2018. Method: This analysis was limited to MRSA bacteremia LabID event data reported by ACHs that follow NHSN surveillance protocols. The data were restricted to events reported for overall inpatient facility-wide and, if applicable, EDs and 24-hour observation locations. MRSA events were classified as HO (collected >3 days after admission) or inpatient or outpatient community onset (CO, collected ≤3 days after admission). An interrupted time series random-effects generalized linear model was used to examine the relationship between HO-MRSA incidence rates (per 1,000 patient days) and time (year) while controlling for potential risk factors as fixed effects. The following potential risk factors were evaluated: facility’s annual survey data (facility type, medical affiliation, length of facility stay, number of beds, and number of intensive care unit beds) and quarterly summary data (inpatient and outpatient CO prevalence rates). Result: The number of reporting ACHs increased during this period, from 473 in 2010 to 3,651 in 2018. The crude HO-MRSA incidence rates (per 1,000 patient days) have declined over time, from a high of 0.067 in 2011 to 0.052 in 2018 (Table 1). Compared to 2014, the adjusted annual incidence rate increased in 2015 by 16.38%, (95% confidence interval [CI], 10.26%–22.84%; P < .0001). After controlling for all significant risk factors, the estimated annual HO-MRSA incidence rates declined by 5.98% (95% CI, 5.17%–6.78%; P < .0001) (Table 2). Conclusions: HO-MRSA bacteremia incidence rates have decreased over the past 9 years, despite a slight increase in 2015. This national trend analysis reviewed a longer period while analyzing potential risk factors. The decline in HO-MRSA incidence rates has been gradual; however, given the current trend, it is not likely to meet the Healthy People 2020 objectives. This analysis suggests the need for hospitals to continue and/or enhance HO-MRSA infection prevention efforts to reduce rates further.Funding: NoneDisclosures: None

Prevalence of Human Cystic Echinococcosis in Rio Negro Province, Argentina and Direct Risk Factors for Infection

2021 ◽  
Author(s):  
Leonardo Uchiumi ◽  
Guillermo Mujica ◽  
Daniel Araya ◽  
Juan Carlos Salvitti ◽  
Mariano Sobrino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Rural Areas ◽  
Cystic Echinococcosis ◽  
Significant Risk ◽  
Prevalence Ratio ◽  
Bivariate Analysis ◽  
Rio Negro ◽  
Potential Risk Factors ◽  
Current Address

Abstract Background: Cystic echinococcosis (CE) is a parasitic zoonosis caused by infection with the larval stage of Echinococcus granulosus sensu lato This study investigated the prevalence and potential risk factors associated with human CE in the towns and rural areas of Ñorquinco and Ramos Mexia, Rio Negro province, Argentina. Methods: In order to detect abdominal CE cysts, we screened 892 volunteers by ultrasound and investigated potential risk factors for CE using a standardized questionnaire. Bivariate and multivariate analyses were used to estimate the Prevalence Ratio (PR) and their 95% CIs of the association between CE and the factors investigated. Results: Abdominal CE was detected in 42/892 screened volunteers (4.7%, CI 3.2-6.1), only two of who being under 15 years of age. Thirteen CE (30.9%) cases had 25 cysts in active stages (CE1, CE2, CE3) The most relevant risk factors identified in the bivariate analysis included: live in rural area (p=0.003), age >40 years (p=0.000), drinking always water of natural source (p=0.007), residing in rural areas during first five years of life (p=0.000) and live more than 20 years at your current address (p=0.013). In the multivariate model, statistically significant risk factors were: frequently touch dogs (p=0.012), residing in rural areas during first five years of life (p=0.004), smoking (p=0.000), age > 60 years (p­­=0.002) and live in rural areas (p=0.017).Conclusions: our results point toward infection with CE being acquired since childhood and with constant exposure throughout life, especially in rural areas with a general environmental contamination

Epidemiology of prostate cancer

2017 ◽  
Author(s):  
Timothy J. Key ◽  
Alison J. Price
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Potential Risk ◽  
African Ancestry ◽  
Prostate Cancer Risk ◽  
Positive Association ◽  
Incidence Rates ◽  
Nutritional Factors ◽  
Incidence And Mortality ◽  
Potential Risk Factors

Prostate cancer is the second most common malignancy and the sixth most common cause of cancer death for men worldwide. The highest incidence and mortality rates are in populations that originated in Africa, such as African Americans. Rates are also high in Western countries and generally low in East and South Asia. Incidence rates are increasing in some countries which until recently had low rates, but are not changing much in countries which already have high rates. The only well-established risk factors are increasing age, African ancestry, family history of the disease, and certain genetic factors, none of which is modifiable. Many potential risk factors have been investigated in epidemiological studies and randomized trials. Observational studies have shown that prostate cancer risk is positively associated with the plasma concentration of insulin-like growth factor-I, but is not strongly associated with testosterone or other sex hormones. Studies of nutritional factors suggest that risk may be higher in men with a high intake of animal foods and dairy products, but this relationship is not clear enough to be considered as established. Some studies of other nutritional factors such as fat, lycopene and other carotenoids, vitamin D, vitamin E and selenium have suggested possible associations, but overall do not show any clear relationships. Research on other possible risk factors has shown a small positive association of risk with height, but little association with obesity, smoking or alcohol intake, and evidence on sexual behaviour and sexually transmitted infections is inconclusive. Further research is needed, particularly to determine whether potential risk factors may be related more to aggressive than to indolent prostate cancer.

33. Gradually decreasing anal cancer incidence in the HIV+ population in the Netherlands after a decade of cART

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 586
Author(s):  
O. Richel ◽  
R. P. Van der Zee ◽  
C. Smit ◽  
H. J. C. De Vries ◽  
J. M. Prins
Keyword(s):  
Risk Factors ◽  
Alcohol Abuse ◽  
Anal Cancer ◽  
Cancer Incidence ◽  
Potential Risk ◽  
Incidence Rates ◽  
Hiv Patients ◽  
Hazard Ratios ◽  
Potential Risk Factors ◽  
Sex With Men

Background Anal cancer incidence has been increasing in the combined antiretroviral therapy (cART) era in HIV+ patients. In this study we surveyed trends in anal cancer incidence between 1995 and 2012, and analysed a range of potential risk factors. Methods: We retrieved data for all patients diagnosed with anal cancer from the Dutch HIV observational cohort (ATHENA) database. Incidence rates were calculated per 100 000 person-years of follow-up (FU), for the whole period of 18 years, and per 2-year blocks. Potential risk factors were analysed in a uni- and multivariable Cox proportional hazard model. Results: For all HIV+ patients, men who have sex with men (MSM), and heterosexual men and women, respectively, the incidence of anal cancer was 83 (95% CI 70–99), 116 (95% CI 95–140), 44 (95% CI 21–83) and 12 (95% 3–30) per 100 000 person-years of FU. In 2005–2006, a peak in incidence rates was observed of 114 (95% CI 74–169) in the total HIV population and 168 (95% CI 103–259) among HIV+ MSM, followed by a decrease to 72 (95% CI 42–113) and 100 (95% CI 56–164), respectively, in 2011–2012. Low nadir CD4 (<110), alcohol abuse and smoking were significantly associated with anal cancer in MSM, with hazard ratios (HR) of 2.41 (95%CI 1.5–3.89), 2.23 (95% CI 1.28–3.89) and 1.60 (95% CI 1.07–2.41), respectively. Conclusions: Anal cancer remains a serious problem in predominantly HIV+ MSM; however, it seems that incidence rates are levelling off. A low nadir CD4 count, alcohol abuse and smoking are risk factors for the development of anal cancer.

scholarly journals Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards

2020 ◽  
pp. jech-2020-214297 ◽  
Author(s):  
Saman Khalatbari-Soltani ◽  
Robert G Cumming ◽  
Cyrille Delpierre ◽  
Michelle Kelly-Irving
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Early Stage ◽  
Severe Disease ◽  
Vulnerable Groups ◽  
Prevention Measures ◽  
Occupational Position ◽  
Socioeconomic Characteristics ◽  
Socioeconomic Determinants ◽  
Potential Risk Factors

Disadvantaged socioeconomic position (SEP) is widely associated with disease and mortality, and there is no reason to think this will not be the case for the newly emerged coronavirus disease 2019 (COVID-19) that has reached a pandemic level. Individuals with a more disadvantaged SEP are more likely to be affected by most of the known risk factors of COVID-19. SEP has been previously established as a potential determinant of infectious diseases in general. We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of comorbidities and immune functioning. However, the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes is not yet known and is subject to scrutiny and investigation. Here we briefly review the extent to which SEP has been considered as one of the potential risk factors of COVID-19. From 29 eligible studies that reported the characteristics of patients with COVID-19 and their potential risk factors, only one study reported the occupational position of patients with mild or severe disease. This brief overview of the literature highlights that important socioeconomic characteristics are being overlooked when data are collected. As COVID-19 spreads worldwide, it is crucial to collect and report data on socioeconomic determinants as well as race/ethnicity to identify high-risk populations. A systematic recording of socioeconomic characteristics of patients with COVID-19 will be beneficial to identify most vulnerable groups, to identify how SEP relates to COVID-19 and to develop equitable public health prevention measures, guidelines and interventions.

scholarly journals Analyzing risk factors for lumpy skin disease by a geographic information system (GIS) in Turkey

2020 ◽  
Vol 70 (4) ◽  
pp. 1797
Author(s):  
O.B. INCE ◽  
T. TÜRK
Keyword(s):  
Risk Factors ◽  
Information System ◽  
Geographic Information System ◽  
Potential Risk ◽  
Skin Disease ◽  
Significant Risk ◽  
Geographic Information ◽  
Morbidity Rate ◽  
Lumpy Skin Disease ◽  
Potential Risk Factors

Lumpy skin disease (LSD) is caused by the virus of the same name and has major economic impacts on cattle breeding. In Turkey, frequent cases of cattle LSD have been reported over the last years. The present study aimed to analyze potential risk factors for LSD and provide information for controlling the spread of infectious diseases by a geographic information system (GIS). The research included cross-sectional and retrospective studies with active disease follow-up and semi-structured interviews (SSI) from August 2013 to December 2014 in Turkey. Potential risk factors for LSD were evaluated based on environmental conditions and provincial demographic and epidemiological data. Of the total of 562 observed animals, 27.22% and 2.67% of cattle were sick and died due to LSD, respectively. The morbidity rate was 26.04% in mixed and 38.18% in local breeds. The animal-level prevalence significantly differed among animals of different age, sex, and with different vaccination status (P<0.05). It was more serious in younger animals and females and during drier weather conditions. A trend of seasonality was observed in LSD occurrence. Significant risk factors affecting the prevalence of LSD were proximity to the southern border of Turkey, animal movements, and animal markets. In this process, geographical query, analysis, and thematic map production were performed by GIS.

scholarly journals Risk factors for Barrett’s esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center

2019 ◽  
Vol 12 ◽  
pp. 175628481985311 ◽  
Author(s):  
Pin-Chieh Wu ◽  
Yan-Hua Chen ◽  
Fu-Zong Wu ◽  
Kung-Hung Lin ◽  
Chiao-Lin Hsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Potential Risk ◽  
Gastrointestinal Endoscopy ◽  
Significant Risk ◽  
Upper Gastrointestinal Endoscopy ◽  
Potential Risk Factors ◽  
Male Sex ◽  
Gerd Symptoms ◽  
Upper Gastrointestinal

Background: Barrett’s esophagus (BE) is a premalignant condition with increased incidence worldwide both in old and young individuals. However, the role of certain potential risk factors remains unclear in young adults (< 50 years). We aimed to determine the risk factors of BE in young adults. Methods: A total of 4943 young adults who underwent upper gastrointestinal endoscopy at our health check-up center were enrolled. The diagnosis of BE was based on histological confirmation. We analyzed demographic factors, laboratory data, potential risk factors such as smoking, alcohol consumption, presence of gastroesophageal reflux disease (GERD) symptoms, and metabolic syndrome for the risk of BE by using binary logistic regression analysis. Results: The prevalence of BE was 1.8% (88/4943). Male sex, the presence of GERD symptoms, and smoking were three significant risk factors related to BE. Furthermore, participants who had smoked for 10 pack-years or more had increased risk of BE with dose-dependent phenomenon ( p trend < 0.001). The proportion of BE in male participants with both GERD symptoms and a smoking history of 10 pack-years or more was as high as 10.3% (16/155). Conclusions: Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking.

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