Incidence and characteristics of cancer-associated thrombosis in a racially diverse population: A population-based study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13088-e13088
Author(s):  
Gary E. Raskob ◽  
Aaron M. Wendelboe ◽  
John Grady Heller ◽  
Kai Ding ◽  
Nimia L. Reyes ◽  
...  

e13088 Background: Venous thromboembolism (VTE) is a common complication in cancer patients, but contemporary data on the incidence and characteristics of cancer-associated VTE in different racial populations is limited. We sought to measure the incidence rate and characteristics of cancer-associated VTE in a racially diverse population. Methods: We performed a prospective, population–based cohort study of VTE in Oklahoma County, OK during April 1, 2012–March 31, 2014. Surveillance staff regularly visited all tertiary care and relevant outpatient facilities in the county and reviewed the text from all imaging results of chest computed tomography or magnetic resonance imaging, lung perfusion scans, and ultrasound of the extremities to identify cases of VTE. Data on patient characteristics were collected from the electronic medical record. VTE was considered cancer-associated if the patient had a history of cancer other than basal or squamous cell skin cancer. Cancer was defined as “active” if metastatic or diagnosed within 6 months prior to VTE. Associations and incidence were calculated using the chi-square test and Poisson regression, respectively. Results: Of 3,255 patients with ≥1 VTE event (deep-vein thrombosis and/or pulmonary embolism), 732 (23%) had a history of cancer, of whom 309 had active cancer. The types of cancer varied widely. The age-adjusted incidence of cancer-associated VTE was 648 per 100,000 adult population (age ≥ 18). Incidence increased with each decade of age. The racial/ethnic-specific incidence rates were as follows (each per 100,000): Whites non-hispanic (607), Blacks non-Hispanic (557), Native Americans (128), Asian/Pacific Islanders (113) and Hispanics (70). Risk factors for VTE among the 732 with cancer-associated VTE included previous VTE (19%), hospitalization (37%), surgery (33%), and central venous catheter (22%). Of those with a history of cancer ≥ 6 months previously, 32% had no other identifiable VTE risk factor. Conclusions: Cancer-associated VTE comprised about 20-25% of the total population burden of VTE. The incidence varied substantially by race/ethnicity. An appreciable proportion of those with a history of cancer ≥ 6 months previously subsequently developed VTE in the absence of other risk factors.

2021 ◽  
pp. postgradmedj-2021-141243
Author(s):  
Rahul Gupta ◽  
Satyam Singh Jayant ◽  
Ashu Rastogi ◽  
Sanjay K Bhadada ◽  
Anil Bhansali ◽  
...  

BackgroundDiabetes prevalence estimates suggest an increasing trend in South-East Asia region, but studies on its incidence are limited. The current study aims to estimate the incidence of type 2 diabetes and pre-diabetes in a population-based cohort from India.MethodsA subset of Chandigarh Urban Diabetes Study cohort (n=1878) with normoglycaemia or pre-diabetes at baseline was prospectively followed after a median of 11 (0.5–11) years. Diabetes and pre-diabetes were diagnosed as per WHO guidelines. The incidence with 95% CI was calculated in 1000 person-years and Cox proportional hazard model was used to find the association between the risk factors and progression to pre-diabetes and diabetes.ResultsThe incidence of diabetes, pre-diabetes and dysglycaemia (either pre-diabetes or diabetes) was 21.6 (17.8–26.1), 18.8 (14.8–23.4) and 31.7 (26.5–37.6) per 1000 person-years, respectively. Age (HR 1.02, 95% CI 1.01 to 1.04), family history of diabetes (HR 1.56, 95% CI 1.09 to 2.25) and sedentary lifestyle (HR 1.51, 95% CI 1.05 to 2.17) predicted conversion from normoglycaemia to dysglycaemia, while obesity (HR 2.43, 95% CI 1.21 to 4.89) predicted conversion from pre-diabetes to diabetes.ConclusionA high incidence of diabetes and pre-diabetes in Asian-Indians suggests a faster conversion rate to dysglycaemia, which is partly explained by sedentary lifestyle and consequent obesity in these individuals. The high incidence rates call for a pressing need for public health interventions targeting modifiable risk factors.


2019 ◽  
pp. 81-92
Author(s):  
Agnieszka Kwaśniewska ◽  
Aleksandra Wawrzeńczyk ◽  
Katarzyna Brus-Sawczuk ◽  
Ewa Ganowicz ◽  
Izabela Strużycka

INTRODUCTION. Oral cancer is a significant problem among global population. In Poland a few thousands of new incidents are reported annually. Prophylaxis and early detection help decreasing the incidence rate. Screening programmes are a tool that enable to achieve that goal. OBJECTIVES. The aim of this study was to evaluate prevalence of selected risk factors and pathological lesions of oral mucosa in adult population. MATERIAL AND METHODS. The study group consisted of 253 patients. After undertaking a medical history in a form of a questionnaire, a conventional intraoral soft tissue examination was performed. This was followed by use of cool white light (Microlux DL Addent). RESULTS. Among patients following risk factors were frequently found: tobacco smoking - 20.9% patients, alcohol consumption - 2/3 of patients drink occasionally, 8.7% drink on regular basis. Over 80% patients were sexually active. 3 patients suffered from oral cancer, 21 patients gave a history of cancer in other locations, 54.2% reported a family history of cancer. Screened patients declare quite healthy diet, although level of grilled and fried meat consumption is fairly high. 37.8% patients were alarmed by the condition of the oral mucosa but only half of them reported it to their dentist. Most of the lesions were found on the buccal mucosa (88 patients, 34.8%), retromandibular triangle and palate and most of lesions were white lesions, categorized as traumatic. CONCLUSIONS. This preliminary study showed, that the incidence of oral cancer risk factors is high in this population. The incidence of pathological lesions of oral mucosa was also high. The study showed low awareness of oral cancer prevention, risk factors and symptoms.


Author(s):  
Shib Sekhar Datta ◽  
R. Rupesh Kanna ◽  
Surendar Rangaswamy ◽  
Rajkumar S.

Background: Suicide is one of the major public health problems in low and middle income countries. However, information about causes and risk factors are insufficient. Objectives of the study were to find out prevalence of suicidal ideation and attempt among young and adult population in rural Pondicherry and to analyse the risk factors qualitatively.Methods: Community based cross-sectional study was conducted among 18-44 years’ population in rural Pondicherry during January to June 2012. Total 200 subjects were interviewed by house to house visit. Information on socio-demographic characteristics, concurrent illness, family and personal history were obtained. Factors contributing to suicidal ideation and attempt were collected through FGDs, free listing and pile sorting exercise. Quantitative data was analyzed using SPSS version 17.0. Qualitative data analyzed using Anthropac 4.98.1/X software.Results: 8% subjects had ever attempted and 7.5% had ideas of suicide. Suicidal ideation/ attempt were more among males and 36-45 years group. Physical disability, infertility/sterility and chronic illness were significantly associated with suicidal ideation or attempt. Family dispute, history of beaten by spouse and family history of suicide/attempt was significantly associated with ideation. Alcoholism, failed relationship, physical abuses were strongly associated with ideas of suicide or attempt. Risk factors for males include failed relationships, more than one wife, family dispute, alcoholism etc. Risk factors for females include failed relationship, poor performance in exam, quarrel with friends, unemployment, alcoholic husband, pressure for dowry, extramarital relationship by husband etc.Conclusions: Suicidal attempt and ideation rates were high in study area and demand population based mental health interventions to reduce population suicide rates.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.


Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Arisara Poosari ◽  
Thitima Nutravong ◽  
Prakasit Sa-ngiamwibool ◽  
Wises Namwat ◽  
Supaporn Chatrchaiwiwatana ◽  
...  

Abstract Background Previous studies have shown the association between Campylobacter species infection and that environmental factors, poor oral hygiene in particular, are linked to an increased risk of esophageal cancer (EC). However, no study has reported on these factors in Thailand. Thus, this study’s objective was to evaluate the impact of the relationship between Campylobacter infection and environmental factors on EC incidence in the population of Thailand. Methods Data from a case–control study were collected from 105 newly diagnosed EC cases and 105 controls recruited from 2007 to 2017. Infection with Campylobacter spp. was detected in the formalin-fixed paraffin-embedded (FFPE) tissue of EC taken from gastroesophageal biopsy specimens obtained from the participants, and evaluated using TaqMan® real-time PCR. Multivariable logistic regression was performed to calculate the odds ratios (ORs) and perform data analysis. Results Smoking, alcohol use, a family history of cancer, history of gastroesophageal reflux disease, poor oral hygiene and Campylobacter spp. infection were shown to be significant risk factors for EC (p  <  0.05). The combination of poor oral hygiene and infection with Campylobacter spp. constituted significant risk for EC (p  <  0.001). In addition, the risk of EC in subjects co-infected with C. rectus and C. concisus that practiced poor oral hygiene was even higher and was significant (ORadj  =  4.7; 95% CI 2.41–9.98; p  =  0.003). Conclusions In Thailand, the major risk factors for EC are smoking status, alcohol drinking, family history of cancer, GERD, poor oral hygiene and Campylobacter spp. infection. This study found Campylobacter spp. prevalence to be associated with EC and appears to be enhanced by poor oral hygiene, suggesting that a combination of poor oral hygiene and Campylobacter species infection may together act as an important etiological risk factor for EC.


2021 ◽  
Vol 15 (9) ◽  
pp. 2451-2453
Author(s):  
Shahid Iqbal ◽  
Muhammad Fareed Khan ◽  
Raja Imtiaz Ahmed ◽  
Shahab Saidullah ◽  
Nisar Ahmed ◽  
...  

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Robert J Stanton ◽  
Eleni Antzoulatos ◽  
Elisheva R Coleman ◽  
Felipe De Los Rios La Rosa ◽  
Stacie L Demel ◽  
...  

Background: Hemorrhagic transformation (HT) of ischemic stroke can have devastating consequences, leading to longer hospitalizations, increased morbidity and mortality. We sought to identify the rate of HT in stroke patients not treated with tPA within a large, biracial population. Methods: The GCNKSS is a population-based stroke epidemiology study from five counties in the Greater Cincinnati region. During 2015, we captured all hospitalized strokes by screening ICD-9 codes 430-436 and ICD-10 codes I60-I68, and G45-46. Study nurses abstracted all potential cases and physicians adjudicated cases, including classifying the degree of HT. Patients treated with thrombolytics were excluded. Incidence rates per 100,000 and associated 95% confidence intervals (CI) were estimated for HT cases, age and sex adjusted to the 2000 US population. Multiple logistic regression was used to examine risk factors associated with HT. Results: In 2015, there were 2301 ischemic strokes included in the analysis. Of these 104 (4.5%) had HT; 23 (22.1%) symptomatic, 55 (52.9%) asymptomatic and 26 (25%) unknown. Documented reasons for not receiving tPA in these patients were: time (71, 68.3%), anticoagulant use (1, 1.0%), other (18,17.3%) and unknown (14, 13.5%), which were not significantly different compared to those without HT. Only 29/104 (18.3%) had HT classified as PH-1 or PH-2. The age, sex and race-adjusted rate of HT was 9.8 (7.9, 11.6) per 100,000. The table shows rates of potential risk factors and the adjusted odds of developing HT. 90 day all-cause case fatality for patients with HT was significantly higher, 27.9% vs. 15.7%, p<0.0001. Conclusion: We found that 4.5% of non-tPA treated IS patients had HT. These patients had more severe strokes, were more likely to have abnormal coagulation tests or anticoagulant use, and were more likely to die within 90 days. We also report the first population-based incidence rate of HT in non-tPA treated of 9.8/100,000, a rate similar to the incidence of SAH.


Author(s):  
J. Skov Neergaard ◽  
K. Dragsbæk ◽  
C. Christiansen ◽  
M. Asser Karsdal ◽  
S. Brix ◽  
...  

Background: Identification of subjects with a progressive disease phenotype is an urgent need in the pharmaceutical industry where most of the recent clinical trials in Alzheimer’s disease have failed. Objectives: The objective of this study was to identify subgroups of individuals with objective cognitive impairment (OCI), who were most likely to progress to dementia and to identify the risk factors associated with progression. Design: Prospective cohort study. Setting: Population-based. Participants: 5,380 elderly women from Denmark. Measurements: The Short Blessed Test and a category fluency test with animal naming, was used to assess cognitive function, and to classify them into different groups of OCI. Results: OCI was identified in 852 subjects at baseline. The risk of dementia was elevated for OCI subjects as compared to subjects with normal cognition (HR 1.46[1.19-1.79]). The courses of OCI were studied in a sub-cohort who completed the cognitive assessment at both the baseline and the follow-up visit (n = 1,933). Of these subjects 203 had OCI at baseline. The multi-domain subtypes of OCI were associated with progressive OCI. Subjects most likely to progress were older, physically inactive, had a higher level of total cholesterol (>6.5 mmol/L) and had a history of depression as compared to subjects with a non-progressive course of OCI. Conclusions: In this cohort we identified a risk profile associated with progression from OCI in older women. The degree of impairment at baseline was an important predictor of conversion to dementia, additionally several modifiable risk factors were associated with progression.


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