Risk factors for febrile neutropenia and the utilization of pegfilgrastim in patients receiving chemotherapy for gynecologic malignancies

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16063-16063
Author(s):  
T. M. Numnum ◽  
S. Bryant ◽  
E. Williams ◽  
L. Kilgore ◽  
J. M. Straughn
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Febrile Neutropenia ◽  
Factor Score ◽  
Primary Prophylaxis ◽  
Gynecologic Malignancies ◽  
Outpatient Chemotherapy ◽  
The Mean ◽  
Risk Factor Score ◽  
Mean Risk

16063 Background: Recently published gudelines for the use of granulocyte-colony stimulating factors define risk factors for the development of febrile neutropenia (FN) in patients receiveing chemotherapy. Our objective is to assess the risk factors associated with FN and the utilization of pegfilgrastim (G-CSF) for the prevention of FN in patients receiving chemotherapy for gynecologic malignancies. Methods: A computerized database identified all outpatient chemotherapy encounters over a 4 month period. Risk factors for FN (adapted from guidelines published by ASCO) were determined for each chemotherapy encounter and a risk factor score was calculated (1–17). Each chemotherapy encounter was analyzed to determine if G-CSF was administered and the reason for utilization. Dose delays/modifications were also determined. Statistical comparisons were performed using the χ2 test. Results: 692 chemotherapy encounters were identified in 209 patients. 77 % of patients had a diagnosis of ovarian cancer. The mean risk factor score was 3.9 (range 1–9). The most common risk factors were: female (100%), advanced cancer (81%), prior chemotherapy (54%), and age > 65 yo (46%). 276 of the 692 (40%) encounters utilized G-CSF. 135 patients (49%) received G-CSF as primary prophylaxis for the development of FN; 141 patients (51%) received G-CSF after an episode of Grade 3 or 4 neutropenia. The mean risk factor score was 4.3 in patients receiving primary prophylaxis. After primary prophylaxis, 1 dose delay/modification for neutropenia was experienced versus 14 dose delays/modifications without prophylaxis (p <0.01). There were 12 dose delays/modifications due to thrombocytopenia in patients receiving PP. There was only one episode of FN. 64% of patients receiving primary prophylaxis were treated with a docetaxel-containing regimen and 61% of patients were receiving primary chemotherapy. Conclusions: G-CSF is utilized in 40% of chemotherapy encounters and is commonly associated with docetaxel-containing regimens. Dose delays/modifications are uncommon after primary prophylaxis with G-CSF in patients receiving chemotherapy for gynecologic malignancies. No significant financial relationships to disclose.

scholarly journals Prevalence and outcome of young stroke patients with middle cerebral artery stenosis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenjuan Xu ◽  
Xiaoyu Zhang ◽  
Huan Chen ◽  
Zhangning Zhao ◽  
Meijia Zhu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Factor Score ◽  
Unfavorable Outcome ◽  
Stroke Patients ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Risk Factor Score ◽  
Stroke In Young

Abstract Background Etiologies of acute ischemic stroke in young adults are heterogeneous. Middle cerebral artery (MCA) stenosis is a common finding in Asians which may be an important cause of stroke in young adults. However, studies of stroke in young Asian populations are rare. Our study was to investigate the prevalence and outcome of young stroke patients with MCA stenosis in Chinese populations. Methods Young patients with MCA territory infarction between January 2013 and September 2018 were retrospectively recruited. Subjects were defined as stenosis group (MCA stenosis ≥50%) and no-stenosis group (MCA stenosis<50% or no stenosis) by their MCA stenosis. For patients in stenosis group, they were categorized as uni-MCA stenosis subgroup and multiple stenosis subgroup. Demographic data, risk factors, imaging feature and complications were compared between groups. Prevalence of MCA stenosis and risk factor score (score ≥ 2 or 3) in different age groups were investigated. Modified Rankin Scale (mRS) was used for evaluating functional outcome at discharge (unfavorable outcome: 3–6). Binary logistic regression was performed to determine independent risk factors of unfavorable outcome. Results Two hundred forty-nine young stroke patients were included in our study and 110 (44.2%) patients were defined as stenosis group. 55 (50%) patients were categorized as uni-MCA stenosis subgroup and 55 (50%) were multiple stenosis subgroup. The most common traditional vascular risk factors included hypertension, hyperlipemia, smoking, hyperhomocysteinemia and alcohol consumption. Prevalence of risk factor score ≥ 2 or 3 increased with age, but not incidence of MCA stenosis. By TOAST classification, the most common etiologies were large-artery atherosclerosis (41.0%) and small vessel disease (33.7%). Compared with no-stenosis group, patients in stenosis group were more likely to have large territorial infarct, develop complications and have unfavorable outcome. No significant difference was found between patients in uni-MCA stenosis and multiple stenosis subgroups except history of stroke/TIA, risk factor score ≥ 3 and silent infarct. By logistic regression, hypertension (OR = 3.561; 95%CI, 1.494 to 8.492; p = 0.004), NIHSS scores at admission (OR = 1.438; 95%CI, 1.276 to 1.620; p = 0,000) and infarct size (p = 0.015) independently predicted unfavorable outcome. Conclusions Forty-four point two percent young Chinese adults with MCA territory infarction had MCA stenosis. Prevalence of MCA stenosis did not increase with age. Patients with MCA stenosis had worse clinical outcome, however, only hypertension, NIHSS scores at admission and infarct size were independent predictors.

scholarly journals Trends in the co-occurrence of cardiovascular risk factors by education in Finland, 1997–2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Paalanen ◽  
T Härkänen ◽  
J Kontto ◽  
H Tolonen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Factor Score ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Education Group ◽  
Educational Differences ◽  
Risk Factor Score ◽  
Education Groups ◽  
Over Time

Abstract Background Understanding on sociodemographic variation of the co-occurrence of cardiovascular disease (CVD) risk factors is crucial for planning public health policy and future prevention strategies. We aimed at examining 1) the co-occurrence of smoking, hypertension, elevated cholesterol and obesity by education, and 2) the trends in educational differences in the co-occurrence of these risk factors in Finland. Methods We used cross-sectional health examination surveys carried out every five years among the general adult population: for 1997-2012 the National FINRISK Study and for 2017 the FinHealth 2017 Survey. Respondents aged 25-64 years were included in the analyses (n = 25,036). Current smoking, obesity (BMI≥30 kg/m2), hypertension (≥140/≥90 mmHg or medication) and elevated serum total cholesterol (≥5.0 mmol/l or medication) were used for the risk factor accumulation score with categories 1) zero, 2) one, 3) two, and 4) three or four elevated risk factors. Multinomial logistic regression was used to estimate predicted probabilities for each category. Results Overall, the risk factor score was more favourable among women than men, and among high education groups than low education groups in both sexes. The lowest risk factor score class became more prevalent in all education groups in both sexes over time. The change in educational differences was not significant. However, the intermediate education group approached the highest education group over time. Conclusions Our data indicate an overall transition towards a more favourable risk factor score in Finland, in 1997-2017. The score among the intermediate education group approached that among the highest education group. The tendency of risk factor accumulation among those with least education remained during the study period, which raises a need to develop and implement interventions and public health policies that would be effective in decreasing the risk factor burden particularly in this group. Key messages Overall, a favourable trend of diminishing risk factor prevalence was seen. The tendency of accumulation of major CVD risk factors among the least educated subjects remained from 1997 to 2017.

Associations of Leisure Time, Commuting, and Occupational Physical Activity With Physical Fitness and Cardiovascular Risk Factors in Young Men

2014 ◽  
Vol 11 (8) ◽  
pp. 1482-1491 ◽  
Author(s):  
Jani P. Vaara ◽  
Heikki Kyröläinen ◽  
Mikael Fogelholm ◽  
Matti Santtila ◽  
Arja Häkkinen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Physical Fitness ◽  
Cardiovascular Risk Factors ◽  
Leisure Time ◽  
Factor Score ◽  
Cvd Risk ◽  
Risk Factor Score

Background:The aim was to study the relationships between different domains of physical activity and cardiovascular risk factors and physical fitness.Methods:781 young men participated. Self-reported leisure-time (LTPA), commuting (CPA) and occupational (OPA) activity were determined. Blood pressure, s-HDL-cholesterol, s-triglycerides and s-LDL-cholesterol, and glucose were measured. The continuous cardiovascular disease (CVD) risk factor score was calculated from the z-score mean of each cardiovascular risk factor. The cutpoint was defined as 1 standard deviation above the mean. Cardiorespiratory and muscular fitness were measured.Results:The likelihood of CVD risk factor score was higher in moderate [OR 1.99 (95% CI 1.21–3.28)] and low [1.87 (1.16–3.02)] CPA groups compared with the high group, whereas neither low nor moderate LTPA or OPA groups showed similar associations after adjustments. Low OPA combined either with low LTPA [2.01 (1.08–3.74)] or low CPA [1.90 (1.05–3.44)] had a higher likelihood for CVD risk factor compared with combined moderate-high categories after adjustments. LTPA was positively associated with all physical fitness parameters, CPA with cardiorespiratory fitness and muscular endurance, and OPA with grip strength.Conclusion:The results emphasize the beneficial role of CPA regarding CVD risk factor score and stress the avoidance of low physical activity in its different domains.

scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

Influence of Concomitant Polypharmacy on Docetaxel-induced Febrile Neutropenia

2021 ◽  
Vol 1 (3) ◽  
pp. 135-141
Author(s):  
KATSUYA MAKIHARA ◽  
YUKA SHIMEDA ◽  
TOMOKAZU MATSUMURA
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Febrile Neutropenia ◽  
Confidence Interval ◽  
Cytochromes P450 ◽  
Cyp3a4 Activity ◽  
Factors Associated ◽  
Cyp3a4 Inhibitors ◽  
Concomitant Medications ◽  
Main Factor

Background/Aim: Docetaxel (DTX) is metabolized by liver cytochromes P450 (CYP) 3A4 (CYP3A4) and 3A5 (CYP3A5) CYP3A4 activity is considered the main factor affecting the effectiveness in DTX clearance. We, therefore, explored the association between DTX-induced febrile neutropenia (FN) and concomitant polypharmacy involving CYP3A4 inhibitors in cancer patients. Patients and Methods: Among patients who received docetaxel, we compared the number of concomitant medications between patients with and without FN, and risk factors associated with FN were identified. Results: The total number of concomitant CYP3A4 inhibitors and substrates used was significantly higher in patients with FN [mean: 2.1 (95% confidence interval (CI)=1.5-2.9)] than in those without FN [mean: 1.4 (95% CI=1.0-1.8)] (p=0.01). The only risk factor for FN was the use of ≥2 concomitant CYP3A4 inhibitors and substrates in total (OR=4.82, 95% CI=1.77-14.1; p=0.002). Conclusion: Polypharmacy involving CYP3A4 inhibitors and substrates increases the risk of DTX-induced FN.

scholarly journals Predicting COVID-19 Severity with a Specific Nucleocapsid Antibody plus Disease Risk Factor Score

mSphere ◽  
2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Sanjana R. Sen ◽  
Emily C. Sanders ◽  
Kristin N. Gabriel ◽  
Brian M. Miller ◽  
Hariny M. Isoda ◽  
...  
Keyword(s):  
Risk Factor ◽  
Factor Score ◽  
Disease Risk ◽  
Severe Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Disease Risk Factor ◽  
Disease States ◽  
Wide Range ◽  
Risk Factor Score ◽  
Prognostic Prediction

ABSTRACT Effective methods for predicting COVID-19 disease trajectories are urgently needed. Here, enzyme-linked immunosorbent assay (ELISA) and coronavirus antigen microarray (COVAM) analysis mapped antibody epitopes in the plasma of COVID-19 patients (n = 86) experiencing a wide range of disease states. The experiments identified antibodies to a 21-residue epitope from nucleocapsid (termed Ep9) associated with severe disease, including admission to the intensive care unit (ICU), requirement for ventilators, or death. Importantly, anti-Ep9 antibodies can be detected within 6 days post-symptom onset and sometimes within 1 day. Furthermore, anti-Ep9 antibodies correlate with various comorbidities and hallmarks of immune hyperactivity. We introduce a simple-to-calculate, disease risk factor score to quantitate each patient’s comorbidities and age. For patients with anti-Ep9 antibodies, scores above 3.0 predict more severe disease outcomes with a 13.42 likelihood ratio (96.7% specificity). The results lay the groundwork for a new type of COVID-19 prognostic to allow early identification and triage of high-risk patients. Such information could guide more effective therapeutic intervention. IMPORTANCE The COVID-19 pandemic has resulted in over two million deaths worldwide. Despite efforts to fight the virus, the disease continues to overwhelm hospitals with severely ill patients. Diagnosis of COVID-19 is readily accomplished through a multitude of reliable testing platforms; however, prognostic prediction remains elusive. To this end, we identified a short epitope from the SARS-CoV-2 nucleocapsid protein and also a disease risk factor score based upon comorbidities and age. The presence of antibodies specifically binding to this epitope plus a score cutoff can predict severe COVID-19 outcomes with 96.7% specificity.

scholarly journals Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gordon S. K. Yau ◽  
Jacky W. Y. Lee ◽  
Victor T. Y. Tam ◽  
Stan Yip ◽  
Edith Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Very Low Birth Weight ◽  
Significant Risk ◽  
The Mean ◽  
Record Review ◽  
Chinese Twins ◽  
Retrospective Medical Record Review

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.

scholarly journals METABOLIC SYNDROME - AN EMERGING RISK FACTOR FOR CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 11 (6) ◽  
pp. 212
Author(s):  
Ashwini Shenai ◽  
Savitha G
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Healthy Individuals ◽  
Serum Urea ◽  
The Mean

Objective: Metabolic syndrome (MetS) is a common health problem worldwide. According to third national health and nutrition examination survey criteria, about 47 million people have MetS. It is defined as having three or more of the following five risk factors including abdominal obesity, increased triglyceride levels, low-density lipoprotein cholesterol level, elevated blood pressure, and elevated fasting glucose levels. These components of MetS are major risk factors for the development of chronic kidney disease (CKD) also. CKD is a major public problem and it is a major risk factor for the development of cardiovascular disease. Hence, the aim of the current study was to evaluate the association between MetS and CKD.Methods: A total of 50 patients reporting to Saveetha Dental College and Hospitals were enrolled into the study which includes 25 patients with MetS and 25 healthy individuals. 5 mL of venous blood was collected and centrifuged. Then, it is analyzed for fasting blood sugar (FBS), serum triglycerides, serum urea, and creatinine using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software.Results: The mean body mass index, FBS, serum creatinine, and triglyceride levels were higher in MetS patients in comparison to healthy individuals. The mean body mass index (BMI), FBS, serum urea, serum creatinine, and triglyceride levels in the control group and MetS group were 27.75±3.67, 84.8±12.5, 17.52±5.2, 0.91±0.17, and 96.5±60.13 and 35.14±4.25, 108.8±34.69, 21.4±5.9, 1.0±0.14, and 239.76±51.21, respectively. There was a significant difference in the mean BMI, FBS, urea, creatinine, and triglyceride levels of the above group.Conclusion: Serum urea and creatinine levels were significantly higher in MetS individuals. Hence, MetS could be a one of the risk factors for the development of CKD.

scholarly journals Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis?

2019 ◽  
Vol 5 (4) ◽  
pp. 205521731988176
Author(s):  
Claudia H Marck ◽  
Zoe Aitken ◽  
Steve Simpson ◽  
Tracey J Weiland ◽  
George A Jelinek
Keyword(s):  
Multiple Sclerosis ◽  
Risk Factor ◽  
Factor Score ◽  
Modifiable Risk Factor ◽  
Risk Factor Score

Cycling to School and Cardiovascular Risk Factors: A Longitudinal Study

2011 ◽  
Vol 8 (8) ◽  
pp. 1025-1033 ◽  
Author(s):  
Lars Bo Andersen ◽  
Niels Wedderkopp ◽  
Peter Kristensen ◽  
Niels Christian Moller ◽  
Karsten Froberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Activity Level ◽  
Disease Rate ◽  
Cvd Risk ◽  
Risk Factor Profile ◽  
Risk Factor Score

Background:Cycling to school may potentially increase physical activity level in sedentary children. Transport to school occur twice a day and could improve cardiovascular health in children. Commuter cycling is associated with lower mortality and cardiovascular disease rate in adults, but limited evidence exists in children.Methods:Participants were 334 children (age 9.7 ± 0.5 years) who were followed up 6 years later. Mode of travel to school was investigated by questionnaire. Cardiovascular (CVD) risk factors were compared by mode of travel to school both at baseline and at follow up and for subjects who changed mode of transportation. No difference was found between walkers and passive travelers, and these groups were merged in the analysis.Results:A consistent pattern of better CVD risk factor profile in commuter cyclists compared with children using other means of transport was found. Participants, who did not cycle to school at baseline, and who had changed to cycling at follow up, were fitter, had better cholesterol/HDL ratio, better glucose metabolism, and a lower composite CVD risk factor score than those who did not cycle at either time point.Conclusion:Cycling to school may contribute to a better cardiovascular risk factor profile in young people.

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