scholarly journals Factors associated with treatment interruption for hepatitis C

2014 ◽  
Vol 60 (1) ◽  
pp. 29-34
Author(s):  
Luciana Oliveira de Rezende Melo ◽  
Denise Leite Maia Monteiro ◽  
Nádia Cristina Pinheiro Rodrigues
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Cox Regression ◽  
Treatment Time ◽  
Outpatient Service ◽  
Treatment Interruption ◽  
Systemic Hypertension ◽  
Genotype 3 ◽  
Factors Associated

Objective To evaluate risk factors related to Hepatitis C treatment interruption. Methods Retrospective cohort of patients seen at the Hepatology outpatient service at Hospital dos Servidores do Estado do Rio de Janeiro, from 2001 to 2009. The factors investigated were: age, gender, genotype, degree of liver fibrosis, type of treatment, treatment time in weeks, diabetes mellitus, and systemic hypertension. Survival curves and bivariate and multivariate Cox regression models were used in the analyses. Results The risk of treatment interruption is six times greater in patients with more advanced degrees of liver fibrosis (F4) compared to those with less advanced degree (F2) in the period from 0 to 24 weeks of treatment. Genotype was found to be an important factor to explain therapy cessation after 24 weeks of treatment – the risk of stopping treatment was 2.5 times higher in patients with genotype 3 than in those with genotype 1. Conclusion Degree of liver fibrosis and genotype proved to be the main risk factors associated to treatment interruption.

scholarly journals Clinical and Pathological Risk Factors Associated with Liver Fibrosis and Steatosis in African-Americans with Chronic Hepatitis C

2017 ◽  
Vol 62 (8) ◽  
pp. 2159-2165 ◽  
Author(s):  
Ali Afsari ◽  
Edward Lee ◽  
Babak Shokrani ◽  
Tina Boortalary ◽  
Zaki A. Sherif ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
African Americans ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Factors Associated

scholarly journals Factors associated with psychiatric treatment dropout in a mental health reference center, Belo Horizonte

2005 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Ana Paula Souto Melo ◽  
Mark Drew Crosland Guimarães
Keyword(s):  
Mental Health ◽  
Cox Regression ◽  
Psychiatric Treatment ◽  
Treatment Interruption ◽  
Treatment Dropout ◽  
Factors Associated ◽  
Psychiatric Hospitalizations ◽  
History Of ◽  
Belo Horizonte ◽  
Social Demographic

OBJECTIVE: To characterize an outpatient public referral center for mental health and to assess factors associated with treatment dropout. METHODS: A non-concurrent prospective study was undertaken to review 295 patient files. Patients, whose first consultation took place between January and December 1997, were followed-up for at least four months until April 1998. Patients were considered as having abandoned their treatment when, following a recommendation for at least a second visit, they did not return within four months after the first consultation. Social, demographic and clinical variables were compared to verify possible factors associated with dropout of treatment. Statistical analysis was performed using relative hazard (RR) with 95% confidence interval (CI) estimated by the Cox Regression Model. RESULTS: Cumulative incidence of treatment dropout was 39.2% while multivariate analysis indicated that the following characteristics were statistically associated with treatment interruption: to live outside the referral area (RR = 1.95), no history of previous psychiatric hospitalizations (RR = 1.88), alcohol or drug use at admission (RR = 1.72), spontaneous demand to the service (RR = 2.12), lack of bus-passes (RR = 3.68) and to have less than four clinical appointments (RR = 7.31). CONCLUSIONS: Our findings suggest that services should be aware of the high incidence of treatment interruption, especially among those with no history of previous psychiatric hospitalizations and with less institutional bonds. This may indicate that mental health services should develop and implement public policies targeted at this population.

scholarly journals An unrecognized endocrinology emergency masquerading as a hypertensive emergency: A can’t miss diagnosis

2016 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Yanerys Agosto Vargas ◽  
Sharon Velez Maymi ◽  
Paola Mansilla Letelier ◽  
Luis Raul Hernandez-Vazquez ◽  
Samayra Miranda Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Mortality Rate ◽  
Pituitary Gland ◽  
Pituitary Apoplexy ◽  
Systemic Hypertension ◽  
Pituitary Macroadenoma ◽  
Rare Entity ◽  
Factors Associated ◽  
Multiple Risk Factors

Pituitary apoplexy secondary to sellar tumors is a rare entity that carries a high mortality rate. It could be secondary to infarction or hemorrhage of the pituitary gland. The incidence remains unclear, most are reported in men between the ages of 50 to 60. In the majority of times, apoplexy is idiopathic in nature, without a clear discernible cause. However, there are multiple risk factors associated with this entity, such as systemic hypertension, among others. There are few cases of pituitary apoplexy caused by infarction of a pituitary macroadenoma. We present this case of pituitary apoplexy secondary to infarction of a nonfunctional pituitary adenoma in a young woman, with a fortunate resolution.

scholarly journals Liver Metastases in Newly Diagnosed Pancreatic Ductal Adenocarcinoma: A Population Based Analysis

2020 ◽  
Author(s):  
Guoyi Wu ◽  
Xiaoben Pan ◽  
Baohua Wang ◽  
Xiaolei Zhu ◽  
Jing Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Metastases ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Cox Regression ◽  
Population Based ◽  
The Body ◽  
Ductal Adenocarcinoma ◽  
Rank Test ◽  
Factors Associated

Abstract Background Estimates of the incidence and prognosis of developing liver metastases at the pancreatic ductal adenocarcinoma (PDAC) diagnosis are lacking.Methods In this study, we analyzed the association of liver metastases and the PDAC patients outcome. The risk factors associated with liver metastases in PDAC patients were analyzed using multivariable logistic regression analysis. The overall survival (OS) was estimated using Kaplan-Meier curves and log-rank test. Cox regression was performed to identify factors associated with OS.Results Patients with primary PDAC in the tail of the pancreas had a higher incidence of liver metastases (62.2%) than those with PDAC in the head (28.6%). Female gender, younger age, primary PDAC in the body or tail of the pancreas, and larger primary PDAC tumor size were positively associated with the occurrence of liver metastases. The median survival of patients with liver metastases was significantly shorter than that of patients without liver metastases. Older age, unmarried status, primary PDAC in the tail of the pancreas, and tumor size ≥4 cm were risk factors for OS in the liver metastases cohort.Conclusions Population-based estimates of the incidence and prognosis of PDAC with liver metastases may help decide whether diffusion-weighted magnetic resonance imaging should be performed in patients with primary PDAC in the tail or body of the pancreas. The location of primary PDAC should be considered during the diagnosis and treatment of primary PDAC.

scholarly journals 346. Factors Associated with Hypertension in Young Adults with Perinatally-Acquired HIV Infection: a Case–Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S184-S184
Author(s):  
Patrick O’Neil ◽  
Patrick Ryscavage ◽  
Kristen A Stafford
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Family History ◽  
Case Control Study ◽  
Case Control ◽  
Systemic Hypertension ◽  
Early Management ◽  
Factors Associated ◽  
History Of ◽  
Control Study

Abstract Background The incidence of systemic hypertension (HTN) among perinatally-HIV-infected (PHIV) patients appears to increase as they enter adulthood. Among non-perinatally HIV-infected adults both traditional and HIV-associated risk factors have been found to contribute to HTN. Whether these same factors contribute to HTN in PHIV is unknown. The purpose of this study was to determine the socio-demographic, clinical, virologic, and immunologic factors associated with HTN among a cohort of PHIV adolescents and young adults, aged ≥18 years. Methods We conducted a case–control study among a population of 160 PHIV adults with and without HTN who were receiving care at the University of Maryland and aged 18–35 years as of December 31, 2017. Covariates assessed included traditional risk factors such as age, family history of HTN, and smoking, as well as HIV- and antiretroviral-associated covariates. Results We identified 49 HTN cases (30.6%) and 111 (69.4%) controls. There were no significant differences in the odds of most traditional (age, gender, race, family history of HTN, tobacco, alcohol, and/or other drug use) or HIV-associated (CD4 nadir <100 cells/mm3, individual ART exposure, ART interruption) risk factors among PHIV adults with HTN compared with those with no diagnosis of HTN. Cases had lower odds of a history of treatment with lopinavir/ritonavir (LPV/r). Cases had 3.7 (95% CI 1.11, 12.56) times the odds of a prior diagnosis of chronic kidney disease (CKD) compared with controls after controlling for CD4 nadir and ARV treatment history. Conclusion The results of this study suggest that most traditional and HIV-related risk factors do not appear to increase the odds of having HTN in this PHIV cohort. However, HTN among PHIV may be driven in part by CKD, and a focus on the prevention and early management of CKD in this group may be necessary to prevent the development of HTN. Additionally, there may be as yet unidentified risk factors for HTN among PHIV which require further exploration. Given the large and growing population of PHIV entering adulthood worldwide, it is imperative to explore risk factors for and effects of HTN in large, diverse PHIV populations. Disclosures All authors: No reported disclosures.

scholarly journals P140 Factors associated with development of NAFLD in patients with inflammatory bowel disease: a 5-year retrospective study on 225 patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S207-S208
Author(s):  
V Domislović ◽  
I Knežević-Štromar ◽  
M Premužić ◽  
M Brinar ◽  
D Vranešić Bender ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Obese Patients ◽  
Logrank Test ◽  
Factors Associated ◽  
Advanced Liver Fibrosis ◽  
Disease Specific

Abstract Background Patients with IBD are at higher risk for non-alcoholic fatty liver disease (NAFLD) comparing to general population. Complex pathogenesis of NAFLD in IBD may be related to disease-specific risk factors such as chronic inflammation, steroid exposure, drug induced hepatotoxicity, malnutrition and alteration of gut microbiota, which is emerging as a major factor in the pathogenesis of NAFLD. The goal of the study was to investigate factors associated with NADLF and advanced liver fibrosis (ALF) in patients with CD and UC. Methods This is a retrospective study on IBD patients without extraintestinal manifestations and known liver disease. NAFLD was defined as Hepatic Steatosis Index (HSI) ≥ 36, and ALF was defined as FIB-4 ≥ 2.67. Predictors of NAFLD development were analysed using Kaplan–Meier and Cox regression analyses. Results In this retrospective study, we have included 225 IBD patients; 72.4% (n = 163) patients with CD and 27.6% (n = 62) patients with UC (median age 41.2 yr, 53.7% males) which were observed for a median of 4.6 years. There were 63.1% (n = 142) patients with normal BMI, 27.6% (n = 62) overweight and 9.3% (n = 21) obese patients. Obese patients had the highest HIS score 43.9 ± 5.9, following with overweight 37.8 ± 5.7 and normal BMI 30 ± 4.3 kg/m2, p &lt; 0.001. During the follow-up obese and overweight patients had higher risk of developing NAFLD comparing to patients with normal BMI (obese HR = 11.1 95% CI 4.3–28.3 and overweight HR = 5.55 95% CI 3.4–9.1, Logrank test p &lt; 0.001) (Figure 1). Regarding FIB-4 score there, was no difference among different BMI categories (p = 0.192), and there was no difference in ALF development in the follow-up period (Logrank test p = 0.91). In Cox proportional-hazards regression significant predictors for NAFLD development were dyslipidaemia HR=2.11, 95% CI 1.2–3.7, overweight HR=6 95% CI 3.6–10, and obesity HR=13.4, 95% CI 7–35. Conclusion NAFLD is frequent comorbidity in patients with CD and UC, which can lead to development of advanced liver fibrosis. Our results show that patients with IBD have a high risk of NAFLD development, whereas the increased risk for ALF was not observed. Overweight and obese patients and those with dyslipidemia should be closer monitored due to significantly higher risk of NAFLD. This study points out the complexity disease-specific risk factors and importance of better stratifying IBD patients at risk of NAFLD and advanced liver fibrosis.

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