Early obesity and risk of cholangiocarcinoma in the United States.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 239-239
Author(s):  
Akram Shalaby ◽  
Milind M. Javle ◽  
Rachna T. Shroff ◽  
Ahmed OS Abousamra ◽  
Reham Abdel-Wahab ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Risk Model ◽  
Early Adulthood ◽  
Significant Risk ◽  
Public Health Problem ◽  
The United States ◽  
Cancer Center ◽  
History Of ◽  
Md Anderson

239 Background: In the United States, the incidence of intrahepatic cholangiocarcinoma (ICC) has been increasing over the last few decades. Despite the public health problem of obesity and the increasing incidence of ICC, the relationship between early adulthood obesity and ICC has never been examined in the American population. Methods: At the University of Texas MD Anderson Cancer Center we conducted a case-control study aimed at examining relationship between ICC and history of obesity after controlling for the potential confounding of several risk factors. Cases were patients with pathologically confirmed diagnosis of ICC. Controls were healthy subjects recruited from spouses of patients at MD Anderson who had cancers other than liver or gastrointestinal. Each case was frequency matched to 4 controls by age (± 5 years), sex, and race. Case patients and controls were interviewed for risk factors of liver cancer. A self-reported weight and body size pictogram at ages 20, 30, 40, 50, 60 was obtained from each participant. In 2016 we recruited 63 newly diagnosed patients with ICC who were compared to 252 healthy controls. Obesity was defined as body mass index (BMI) ≥ 30.0. Results: There was a significant 3 fold increase in ICC risk for obese individuals compared to those with normal weight. The estimated odds ratio (OR), 95%; confidence interval (CI) was 3.3 (1.3-9.1); P = .02. Obesity at the mid-20s, mid-30s, and mid- 40s was significantly associated with ICC risk; the estimated OR (95% CI) was 7.3 (2.8-19.7), 7 (2.4-20.9), and 4.8 (2-11.4), respectively. In addition, viral hepatitis, heavy alcohol use ( > 40 ml ethanol/day), and family history of cancer were significantly associated with ICC. Underlying radiological, pathological, or clinical evidence of steatosis, fibrosis, and cirrhosis was significantly observed in 25% ICC patients with early obesity. Conclusions: We concluded that early adulthood obesity is a significant risk factor for ICC in USA where underlying fatty liver diseases can be a significant factor for ICC progression. Integration of obesity with other ICC risk factors into a risk model may lead to identify high-risk individuals. Future collaboration with other US institutions is highly warranted to highlight the mechanism of obesity-induced ICC.

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

scholarly journals Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States

2021 ◽  
Vol 18 (16) ◽  
pp. 8821
Author(s):  
Athena K. Ramos ◽  
Suraj Adhikari ◽  
Aaron M. Yoder ◽  
Risto H. Rautiainen
Keyword(s):  
United States ◽  
Risk Factors ◽  
Occupational Injuries ◽  
Significant Risk ◽  
The United States ◽  
Safety Training ◽  
Structured Interviews ◽  
The Past ◽  
Risk Of Injury ◽  
Latino Immigrant

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Characterizing Husbandry Risk Factors Associated with Metastatic Soft Tissue Mineralization in Zoo-Housed Komodo Dragons (Varanus komodoensis) in the United States

2021 ◽  
Author(s):  
Dawn Zimmerman ◽  
Jennifer H. Yu ◽  
Willem Schaftenaar ◽  
Laura Debnar ◽  
Drury Reavill ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Soft Tissue ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
History Of ◽  
Univariate Analyses

Metastatic soft tissue mineralization has emerged as a major cause of death in captive Komodo dragons ( Varanus komodoensis ). A cross-sectional survey-based study was performed to evaluate husbandry-related risk factors for metastatic mineralization in zoo-housed Komodo dragons in the United States. Nineteen institutions participated, nine of which (47.4%) had a history of metastatic mineralization within their collections. Husbandry at participating institutions varied in temperature gradients, outdoor exposure, artificial lighting, and diet items offered. Differences in husbandry were tested between institutions with and without a history of mineralization using univariate analyses, and variables resulting in a significance level ≤0.10 were entered into a multinomial logistic regression model. The only variable demonstrating a significant difference during univariate analyses was the number of dragons per enclosure ( p =0.036), while the only significant predictive variable after modeling was humidity approximation. Zoos that approximated rather than measured humidity were 12.0 times as likely to have a history of mineralization in their Komodo dragons (OR 12.0, p =0.045). These variables likely reflect the under- or overestimation of exhibit humidity levels, and the tendency to house males and females together. Based on post-mortem findings for 27 dragon mortalities from these institutions, the presence of mineralization at necropsy was significantly associated with female dragons (OR 18.2, p =0.0044) and yolk coelomitis or embolism (OR 6.76, p =0.046). Although this study did not identify definitive links between husbandry and the prevalence of mineralization at the institutional level, the survey revealed high variation in husbandry conditions, and potential

Risk Factors and Individual Probabilities of Melanoma for Whites

2005 ◽  
Vol 23 (12) ◽  
pp. 2669-2675 ◽  
Author(s):  
Eunyoung Cho ◽  
Bernard A. Rosner ◽  
Diane Feskanich ◽  
Graham A. Colditz
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Risk Model ◽  
Fold Increase ◽  
The United States ◽  
Hair Color ◽  
Discriminatory Accuracy ◽  
Incidence And Mortality ◽  
History Of ◽  
Incident Cases

Purpose Incidence and mortality of cutaneous melanoma is rising rapidly in the United States; therefore, identifying risk factors for melanoma and integrating them into a clinical and population risk estimation tool may help guide prevention efforts and identify participants for preventive interventions. Methods We examined risk factors for melanoma in three large prospective studies of women and men. We observed 152,949 women and 25,206 men free of cancer at baseline for up to 14 years. Results A total of 535 incident cases of invasive melanoma (444 women and 91 men) were included in the analysis. We combined the three studies to examine risk factors and to build a risk model to calculate melanoma risk score. Older age, male sex, family history of melanoma, higher number of nevi, history of severe sunburn, and light hair color were each associated with significantly elevated risk of melanoma and were included in the final risk prediction. Participants at the highest decile of risk had a more than three-fold increase in risk of melanoma compared with those in the lowest decile (observed relative risk, 3.61; expected relative risk, 4.20). The measure of discriminatory accuracy as summarized by an age-and sex-adjusted concordance statistic of 0.62 (95% CI, 0.58 to 0.65) indicated that the model had reasonable ability to differentiate those who will develop melanoma and those who will remain free from the disease. Conclusion We identified several risk factors for melanoma and developed statistical models with adequate performance and discriminatory accuracy.

Incidence and progression of diabetic retinopathy in a multi-ethnic US cohort: the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
pp. bjophthalmol-2021-318992
Author(s):  
Ning Cheung ◽  
Miao Li Chee ◽  
Ronald Klein ◽  
Barbara E K Klein ◽  
Steven Shea ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Significant Risk ◽  
The United States ◽  
Glycosylated Haemoglobin ◽  
Retinal Images ◽  
Ethnic Population ◽  
Ethnic Study ◽  
Factors Associated

AimTo provide contemporary longitudinal data on the incidence and progression of diabetic retinopathy (DR) in a multi-ethnic population of whites, African Americans, Chinese and Hispanics in the United States.MethodsA prospective, multi-region, multi-ethnic population-based cohort study that included 498 participants with diabetes, aged 45–84 years at baseline, from the Multi-Ethnic Study of Atherosclerosis with retinal images obtained twice, on average 8 years apart. Presence and severity of DR were graded from these retinal images according to the modified Airlie House classification system. Main outcome measures were 8-year incidence, progression and improvement of DR, and their associated risk factors.ResultsOver the 8 years, the cumulative rates were 19.2% for incident DR, 17.3% for DR progression, 23.3% for DR improvement, 2.7% for incident vision-threatening DR, 1.8% for incident proliferative DR and 2.2% for incident macular oedema. In multivariate analysis, significant risk factors associated with incident DR were higher glycosylated haemoglobin (relative risk (RR) 1.28; 95% CI: 1.16 to 1.41) and higher systolic blood pressure (RR 1.14; 95% CI: 1.04 to 1.25). Significant factors associated with DR progression were higher glycosylated haemoglobin (RR 1.20; 95% CI: 1.00 to 1.43) and higher low-density lipoprotein cholesterol (RR 1.01; 95% CI: 1.00 to 1.03).ConclusionOver an 8-year period, approximately one in five participants with diabetes developed DR, while almost a quarter of those with DR at baseline showed improvement, possibly reflecting the positive impact of clinical and public health efforts in improving diabetes care in the United States over the last two decades.

scholarly journals Is ESR Important for Predicting Post-ERCP Pancreatitis?

2015 ◽  
Vol 8 ◽  
pp. CGast.S18938
Author(s):  
Amir Houshang Mohammad Alizadeh ◽  
Esmaeil Shamsi Afzali ◽  
Catherine Behzad ◽  
Mirhadi Mousavi ◽  
Dariush Mirsattari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Model ◽  
Significant Risk ◽  
Female Gender ◽  
The Elderly ◽  
Tertiary Center ◽  
Significant Difference ◽  
Close Observation ◽  
Potential Risk Factors ◽  
History Of

Background Pancreatitis remains the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), resulting in substantial morbidity and occasional mortality. There are notable controversies and conflicting reports about risk factors of post-ERCP pancreatitis (PEP). Aim To evaluate the potential risk factors for PEP at a referral tertiary center, as a sample of the Iranian population. Materials and Methods Baseline characteristics and clinical as well as paraclinical information of 780 patients undergoing diagnostic and therapeutic ERCP at Taleghani hospital in Tehran between 2008 and 2012 were reviewed. Data were collected prior to the ERCP, at the time of the procedure, and 24-72 hours after discharge. PEP was diagnosed according to consensus criteria. Results Of the 780 patients who underwent diagnostic ERCP, pancreatitis developed in 26 patients (3.3%). In the multivariable risk model, significant risk factors with adjusted odds ratios (ORs) were age <65 years (OR = 10.647, P = 0.023) and erythrocyte sedimentation rate (ESR) >30 (OR = 6.414, P < 0.001). Female gender, history of recurrent pancreatitis, pre-ERCP hyperamylasemia, and difficult or failed cannulation could not predict PEP. There was no significant difference in the rate of PEP in wire-guided cannulation versus biliary cannulation using a sphincterotome and contrast injection as the conventional method. Conclusions Performing ERCP may be safer in the elderly. Patients with high ESR may be at greater risk of PEP, which warrants close observation of these patients for signs of pancreatitis after ERCP.

scholarly journals Prevalence of and Risk Factors for Anal High-grade Squamous Intraepithelial Lesions in Women Living with Human Immunodeficiency Virus

2019 ◽  
Vol 70 (8) ◽  
pp. 1701-1707 ◽  
Author(s):  
Elizabeth A Stier ◽  
Shelly Y Lensing ◽  
Teresa M Darragh ◽  
Ashish A Deshmukh ◽  
Mark H Einstein ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
High Resolution ◽  
The United States ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Intraepithelial Lesions

Abstract Background Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking. Methods The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort. Eligible participants were WLHIV aged ≥18 years with no history of anal HSIL. Study participants had an examination including collection of cervical/vaginal and anal specimens, followed by high-resolution anoscopy with biopsy. Results We enrolled 256 women with evaluable anal pathology. The mean age was 49.4 years, 64% women were non-Hispanic black, 67% were former or current smokers, and 56% reported ever having anal sex with a man. The median CD4 T-cell count was 664 cells/μL. The prevalence of anal histologic HSIL (hHSIL) was 27% (95% confidence interval [CI], 22%–33%). There was a strong concordance (240/254) between local and consensus pathologists for hHSIL vs less than hHSIL (κ = 0.86 [95% CI, .79–.93]). Current CD4 count of ≤200 cells/μL was the strongest predictor of consensus anal hHSIL diagnosis (adjusted odds ratio [aOR], 10.34 [95% CI, 3.47–30.87]). History of anoreceptive intercourse was also associated with hHSIL (aOR, 2.44 [95% CI, 1.22–4.76]). Conclusions The prevalence of anal hHSIL in WLHIV in the United States was 27% in this study where all participants received high-resolution anoscopy and biopsy.

“You’re Ganja Have a Good Time”: Investigating the Roots of Blunt Use Among a National Sample of Hispanic Adults

2019 ◽  
Vol 18 (1) ◽  
pp. 20-26
Author(s):  
R. Andrew Yockey ◽  
Keith A. King ◽  
Rebecca A. Vidourek
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Significant Risk ◽  
Public Health Problem ◽  
The United States ◽  
Good Time ◽  
Assistance Program ◽  
Factors Associated ◽  
Increased Risk ◽  
Hispanic Adults

Blunt use is a pressing public health problem in the United States. While most studies have focused on African American youth, there remains a paucity of research examining blunt use among Hispanic individuals. Previous findings, which are quite limited, suggest mixed results, thus warranting further investigation regarding the prevalence of blunt use among Hispanic individuals and factors associated with such use. In accord with Jessor’s problem behavior theory, we hypothesized that prior use of illicit substances and certain psychosocial risk factors pose an increased risk for blunt use among Hispanic adults. A secondary analysis examined prior substance use and psychosocial factors of 10,216 Hispanic lifetime blunt users participating in the 2017 National Survey on Drug Use and Health. Findings revealed that one in five (20.5%) Hispanic individuals reported lifetime blunt use. Significant risk factors associated with blunt use were age (18+ years or older), participation in a government assistance program, prior illicit substance use, and changes in appetite or weight. Additional research on other risk factors, prevention mechanisms, and treatment interventions for Hispanic individuals who use blunts is warranted.

scholarly journals NEURAL TUBE DEFECTS (NTDS);

2017 ◽  
Vol 24 (12) ◽  
pp. 1878-1883
Author(s):  
Nadeem Shahzad ◽  
Afshan Riaz ◽  
Uzma Ameer ◽  
Daniyal Nadeem
Keyword(s):  
United States ◽  
Risk Factors ◽  
Family History ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Previous History ◽  
The United States ◽  
Control Group ◽  
Positive History ◽  
History Of

Background: The most common congenital malformations are Neural tubedefects (NTDs) occurring in 0.6 per 1,000 live births in the United States, and almost 4000pregnancies are recorded of babies with neural tube defects, among them anencephalyand Spina bifida are the most common and their annual incidence is 2,500 to 3,000 births inthe United States. The etiology of NTDs is still an enigma, however, in the past few decadesvaluable advances has been made in understanding the causation and measures to preventNTDs and many risk factors are indentified which are associated with it. Objectives: This studywas designed to determine the risk factors and their association with neural tube defects. StudyDesign: Case control study. Place and Duration of Study: This study was conducted at unit111 Lady Willingdon Hospital Lahore and duration was one year from 1.1.2016 to 31.12.2016.Methodology: A total of 120 mothers were included in the study, of which 30 were having ofbabies delivered with NTDs, matched with 90 mothers delivered babies without NTDs (Threecontrols for each NTD case). Informations were collected on special Performa, data was analyzedon SPSS version 20. Results: Majority of the patients in both groups were found between 31-40 years of age, 43.33 %( n13) in patients with NTD group and 56.67 %( n51) in controls whileonly 16.67% (n5) in NTD and 17.78 % (n16) were found between 21-30 years. The mean agewas recorded as 33.06+1.21 and 32.12+ 0.89 respectively. Regarding parity, 23.33% (n7) werefound between P1-2, 26.67% (n11) were P2-3 while 40% (n12) with Parity >4 in the NTD group,while 21.11% (n19) were p1-2, 37.77% (n 34) with P 3-4 and 41.12% (n37) were P >4 in controlgroup. 86.67% (n 26) were found with poor economic status and 13.33% (n4) were found withrich status in NTDs, while 18.89% (n17) were found with poor and 81.11% (n73) with rich statusin control group. Distribution of fetuses according to their gender revealed that 20% (n6) weremales, and 80% (n24) were females in NTDs while 47.77 %( n43) were found males and 52.23%(n47) were females in controls. Regarding family history 80% (n24) with positive history of NTDsin patients of NTD group and 20% (n6) with no history while 4.44% (n4) had positive history and95.56% (n86) had no familial history of NTD in control cases. About previous history of NTDs,93.33% (n28) were found with positive previous history of NTDs and only 6.67% (n2)with noprevious history of NTDs in NTD group, while only 5.56% (n5) were found with positive previoushistory of NTDs and 94.44%(n85) with no previous history in controls. Conclusions: Poor socioeconomic status, family history and previous history of a baby with Neural tube defects are themajor risk factors.

scholarly journals Concussion Among Children in the United States General Population: Incidence and Risk Factors

2021 ◽  
Vol 12 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson
Keyword(s):  
United States ◽  
Risk Factors ◽  
General Population ◽  
The United States ◽  
Health History ◽  
The Us ◽  
History Of ◽  
Concussion History ◽  
Current Sample

The objective of this study was to examine the incidence of concussion and risk factors for sustaining concussion among children from the United States general population. This prospective cohort study used data from the Adolescent Brain Cognitive Development (ABCD) Study®. Children were recruited from schools across the US, sampled to reflect the sociodemographic variation of the US population. The current sample includes 11,013 children aged 9 to 10 years old (47.6% girls; 65.5% White) who were prospectively followed for an average of 1 year (mean = 367.9 days, SD = 40.8, range 249–601). The primary outcome was caregiver-reported concussion during a 1 year follow-up period. Logistic regression was used to determine which potential clinical, health history, and behavioral characteristics (assessed at baseline) were prospectively associated with concussion. In the 1 year follow-up period between ages 10 and 11, 1 in 100 children (n = 123, 1.1%) sustained a concussion. In univariate models, three baseline predictors (ADHD, prior concussion, and accident proneness) were significantly associated with sustaining a concussion. In a multivariate model, controlling for all other predictors, only prior concussion remained significantly associated with the occurrence of a concussion during the observation period (Odds Ratio = 5.49, 95% CI: 3.40–8.87). The most robust and only independent prospective predictor of sustaining a concussion was history of a prior concussion. History of concussion is associated with 5.5 times greater odds of sustaining concussion between ages 10 and 11 among children from the general US population.

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