scholarly journals Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

2018 ◽  
Vol 31 (1) ◽  
pp. 22 ◽  
Author(s):  
Mariana Lima ◽  
Sofia Dutra ◽  
Filipe Veloso Gomes ◽  
Tiago Bilhim ◽  
Élia Coimbra
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Descriptive Analysis ◽  
Female Gender ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Significant Relation ◽  
Potential Risk Factors ◽  
Postembolization Syndrome

Introduction: Hepatic transarterial chemoembolization is a widely used technique for the treatment of hepatocellular carcinoma. The most common complication of this procedure is postembolization syndrome. The main objective of this study was to assess risk factors for the development of postembolization syndrome.Material and Methods: Single-centre retrospective analysis of 563 hepatic transarterial chemoembolization procedures from January 1st, 2014 – December 31st, 2015. Hepatic transarterial chemoembolization was performed with ½ - 2 vials of 100 - 300 μm microspheres loaded with doxorubicin. Patients who experienced postembolization syndrome were identified based on prolongation of hospitalization due to pain, fever, nausea and/or vomiting. A control group with the patients who did not have postembolization syndrome was randomly created (three controls for one case). Descriptive analysis and multivariate logistic regression were performed.Results: The overall prevalence of postembolization syndrome was 6.2%. Hepatic transarterial chemoembolization with doxorubicin dosage above 75 mg (more than one vial), the size of the largest nodule and female gender had statistically significant relation with development of postembolization syndrome (p = 0.030, p = 0.046 and p = 0.037, respectively). Discussion: Doxorrubicin dosage above 75 mg is associated with a higher risk of postembolization syndrome. This result can be helpful for decision-making in clinical practice, whenever it is possible to avoid a higher dose without compromising the efficacy of the treatment. The size of the largest nodule and female gender also constitute risk factors for postembolization syndrome. The other variables studied were not related to the development of postembolization syndrome.Conclusion: The dose of doxorrubicin, the size of the largest nodule treated and female gender are potential risk factors for the development of postembolization syndrome after hepatic transarterial chemoembolization for hepatocellular carcinoma.

scholarly journals Good Clinical Middle-term Outcomes of the Reduction of Posterior Cruciate Ligament Avulsion Fracture in Cruciate Retaining Total Knee Arthroplasty

2020 ◽  
Author(s):  
Wei Lin ◽  
Jinghui Niu ◽  
Yike Dai ◽  
Huaxing Zhang ◽  
Jing Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Female Gender ◽  
Control Group ◽  
Middle Term ◽  
Cruciate Retaining ◽  
Potential Risk Factors ◽  
Total Knee ◽  
Pcl Avulsion

Abstract Background Intraoperative posterior cruciate ligament (PCL) avulsion fracture of tibial is an uncommon but serious complication during primary cruciate retaining (CR) total knee arthroplasty (TKA). However, the clinical outcomes and patient-reported outcome (PRO) of the reduction of PCL avulsion fracture of tibial have rarely been informed. The objective of this research was to investigate the prevalence and middle-term clinical outcomes of this kind of fracture during primary CR TKA and to identify the potential risk factors. Methods A retrospective cohort study from January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibial and intraoperative reduction during primary CR TKA as PCL avulsion group, matched in a 4:1 ratio of 224 patients who underwent primary CR TKA as control group for comparison. All patients were followed up at least 4 years. Patients’ demographics, before surgery and last follow-up after surgery including range of motion (ROM), Knee Society Score (KSS), Forgotten joint score (FJS) were assessed in the two groups, Logistic regression to identify the potential risk factors. Results In our series of 1216 patients who underwent CR TKA during the retrospective period, 56 patients (4.6%) experienced PCL avulsion fracture of tibial. There were no noteworthy differences in demographic, ROM, KSS, FJS scores of the patients between the two groups. In PCL avulsion fracture group, no patients experienced revision due to the knee instability. Logistic regression analysis showed that older age (P = 0.032) and female gender (P = 0.041) were the risk factors of PCL avulsion fracture of tibial. Conclusions The incidence of PCL avulsion fracture of tibial is 4.6%, older patients and female gender may be the two risk factors of PCL avulsion fracture. The reduction of PCL avulsion fracture during CR TKA can achieve an excellent middle-term clinical and PRO outcomes compared with the control group, and without increased the risk of complications.

scholarly journals Factors affecting the incidence of postoperative periprosthetic fractures following primary and revision hip arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christos Bissias ◽  
Angelos Kaspiris ◽  
Athanasios Kalogeropoulos ◽  
Konstantinos Papoutsis ◽  
Nikolaos Natsioulas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Revision Arthroplasty ◽  
Female Gender ◽  
Periprosthetic Fractures ◽  
Factors Affecting ◽  
Potential Risk Factors ◽  
Grade 3

Abstract Objectives The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. Methods A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words “risk factor,” “periprosthetic fracture,” and “hip replacement or arthroplasty.” Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. Results Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (− 57%), cement application (− 59%), and insertion of Biomet (− 68%) or Thompson’s prosthesis (− 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. Conclusion This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.

P692Chemoradiation therapy to patients with lung cancer exacerbates thoracic aortic calcification

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Miki ◽  
T Miyoshi ◽  
K Ichikawa ◽  
S Miyauchi ◽  
J Soh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Cardiovascular Events ◽  
Multivariate Logistic Regression Analysis ◽  
Aortic Calcification ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Annual Percent Change ◽  
Percent Change ◽  
Thoracic Aortic Calcification

Abstract Introduction Development of chemoradiation therapy (CRT) has improved mortality in patients with cancer. Whereas, it is emerging problem that cancer-survivors suffer from cardiovascular diseases, and the association between modern CRT and the increase in future cardiovascular events is suggested. Meanwhile, previous studies showed that thoracic aortic calcification (TAC) detected by computed tomography (CT), a marker of atherosclerosis, was associated with all-cause mortality and cardiovascular events. However, the influence of CRT on TAC progression remains unclear. Purpose The purpose of this study was to evaluate whether CRT would exacerbate TAC. Methods A total of 68 patients who treated lung cancer at our hospital between 2011 and 2015 were retrospectively analyzed (mean 62 year-old, male 78%): 35 patients underwent surgical treatment after induction CRT (CRT group) and 33 patients underwent surgical treatment alone (control group), extracted by propensity score matching by age, sex, smoking status, and diseased side. The volume of TAC between 2nd and 12th thoracic vertebrae was quantitatively measured with CT imaging, at baseline and at 1 year follow-up. The annual percent change in TAC was compared between the CRT and the control group. Moreover, the independent relationship between implementation of CRT and the progression of TAC was assessed by multivariate logistic regression analysis, adjusting for age, gender, conventional atherosclerotic risk factors and baseline aortic calcification volume. Results Patients in the CRT group received radiation (mean 47.3±4.0 Gy) and chemotherapy: 2 courses of cisplatin with docetaxel (34 cases) or vinorelbine (1 case). The prevalence of dyslipidemia, taking statins and diabetes drugs were significantly higher in the control groups (17% vs. 39%; p=0.041, 11% vs. 33%; p=0.029, 3% vs. 18%; p=0.044, respectively). Baseline C-reactive protein level was significantly higher in the CRT group (0.255 vs. 0.115; p=0.034). In univariate analysis, the annual percent change in TAC volume was significantly increased in the CRT group compared with the control group (37.6% vs. 23.3%; p=0.006). Multivariate logistic regression analysis demonstrated that CRT was an independent factor associated with the progression of TAC volume, even after adjustment for baseline calcification volume and coronary risk factors (OR, 3.90; 95% CI, 1.32–11.47; p=0.014). Conclusion CRT to patients with lung cancer exacerbates thoracic aortic calcification, which may result in future cardiovascular events.

scholarly journals Risk factors for mortality in children with Wilms tumor

2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Wilms Tumor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Stage Iii ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Potential Risk Factors

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 

scholarly journals The Effect of Transarterial Chemoembolization in Combination With Kang’ai Injection on Patients With Intermediate Stage Hepatocellular Carcinoma: A Prospective Study

2017 ◽  
Vol 17 (2) ◽  
pp. 477-485 ◽  
Author(s):  
Yue-Meng Wan ◽  
Yu-Hua Li ◽  
Zhi-Yuan Xu ◽  
Hua-Mei Wu ◽  
Ying Xu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Size ◽  
Transarterial Chemoembolization ◽  
Intermediate Stage ◽  
Primary Endpoints ◽  
Tumor Number ◽  
Tace Group ◽  
Extrahepatic Metastases ◽  
A Prospective Study ◽  
Postembolization Syndrome

Background: The outcome of patients with intermediate stage hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) remains poor. Search for a more effective therapy is still necessary. Objective: This study aimed to investigate the effect of combining TACE with Kang’ai (KA) injection for treating patients with intermediate stage HCC. Methods: A total of 89 patients with intermediate stage HCC were enrolled and divided into TACE +KA group (n = 48) receiving repeated TACE plus KA injection, and TACE group (n = 41) receiving repeated TACE alone. All patients were prospectively studied. Primary endpoints were overall survival (OS) and time to radiologic progression (TTP). Results: The TACE + KA group had significantly longer median OS (27.0 vs 21.0 months, P = .038) and TTP (12.0 vs 10.0 months, P = .028) than TACE group. The 1-, 2-, and 3-year OS rates in the TACE + KA group were markedly higher than in TACE group (88.5%, 58.8%, and 20.8% vs 81.3%, 44.9%, and 6.7%, respectively, P = .038), while the 1- and 2-year TTP rates in the TACE + KA group were significantly lower than in TACE group (49.3% and 86.9% vs 75.3% and 100%, P = .028). TACE + KA group displayed significantly lower incidences of intrahepatic and extrahepatic metastases, as well as postembolization syndrome than TACE group ( P < .05). Multivariate analyses revealed group ( P = .023), maximum tumor size ( P = .019), and tumor number ( P = .034) as significant predictors for OS, and group ( P = .046), maximum tumor size ( P = .002) and α-fetoprotein level ( P = .020) as significant predictors for TTP. Both TACE and KA injection were well tolerated. Conclusion: TACE plus KA injection is more effective than TACE alone for treating patients with intermediate stage HCC in this nonrandomized study. Further research is warranted.

scholarly journals Dr Effects of Adiponectin, Plasma D-Dimer, Inflammation and Tumor Markers on Clinical Characteristics and Prognosis of Patients with Ovarian Cancer

2021 ◽  
Author(s):  
Hui Li
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Tumor Markers ◽  
Inflammatory Factors ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Factors Affecting ◽  
Serum Tumor Markers ◽  
Related Risk ◽  
Hs Crp

 [Abstract] Objective: To investigate the effects of adiponectin (ADPN), plasma D-dimer (D-D), inflammation and tumor markers on clinical characteristics and prognosis of patients with ovarian cancer. Methods: A total of 80 patients with ovarian cancer treated in our hospital from April 2017 to November 2019 were enrolled as study subjects and evenly divided into observation group (patients with ovarian cancer) and control group (patients with benign ovarian tumor) based on the results of postoperative pathological biopsy. The levels of ADPN, plasma D-D, inflammatory factors and serum tumor markers [carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4) and risk of ovarian malignancy algorithm (ROMA)] were compared between the two groups. The diagnostic value of serum tumor markers CA125, HE4 and ROMA in ovarian cancer was explored. The correlations of the changes of ROMA with the changes in the levels of ADPN, plasma D-D, high-sensitivity C-reactive protein (hs-CRP), CA125 and HE4 were analyzed. Additionally, the related risk factors affecting the development of ovarian cancer were subjected to univariate and multivariate logistic regression analyses. Results: In comparison with control group, observation group exhibited a lowered ADPN level (p<0.05), notably raised levels of plasma D-D, inflammatory factors hs-CRP and interleukin-6 (IL-6) and serum tumor markers CA125 and HE4 and an evidently increased ROMA (p<0.05). Besides, the detection of serum ROMA showed the highest specificity and sensitivity and low false positive rate and false negative rate. The changes of ROMA were positively correlated with the changes in the levels of plasma D-D, hs-CRP, CA125 and HE4 (p<0.05), and negatively associated with the changes in ADPN level (p<0.05). The results of univariate analysis showed that abnormal ADPN, D-D, hs-CRP, IL-6, CA125 and HE4 levels were related risk factors affecting the development of ovarian cancer. It was found through multivariate logistic regression analysis that decreased ADPN level and increased D-D, hs-CRP, IL-6, CA125 and HE4 levels were independent risk factors affecting the development of ovarian cancer. Conclusion: In the case of ovarian cancer, the ADPN level declines, while the levels of plasma D-D, inflammatory factors, and serum tumor markers CA125, HE4 and ROMA rise obviously. Besides, the ROMA level displays a positive relation to the content of CA125, HE4, plasma D-D and inflammatory factors and a negative association with ADPN level.

scholarly journals Evaluation of Ischemic Heart Disease in the Young Population of Georgia

2021 ◽  
Vol 17 (18) ◽  
Author(s):  
Gogishvili Giorgi
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Young People ◽  
Ischemic Heart Disease ◽  
Night Shift ◽  
Young Patients ◽  
Female Gender ◽  
Ischemic Heart ◽  
Control Group ◽  
Ischemic Disease

Objective: Study of risk factors (RF) for ischemic heart disease (IHD) in young people is a significant problem in cardiology. Aims: Study and prognosis of ischemic heart disease in Georgian population under 45 years of age. Methods: The study included 107 young patients with coronary heart disease (from 18 to 44 years old), who were treated in the cardiology department of the St. John the Merciful Private Clinic. The average age was (34.68 ± 6.2) years. The control group consisted of 199 healthy volunteers without cardiovascular diseases at the age from 18 to 44 years, the average age was (35.9 ± 5.2) years. In all patients, traditional risk factors were assessed. Results: Regression analysis has shown that it increases the risk of ischemic heart disease: living in the city - OR=6.90(95%CI:1.28-37.18); sleep disturbance - OR=45.62(95%CI:3.52-590.64); obesity -OR=24.56(95%CI:4.14-145.66); hypertension - OR=40.76(95%CI:8.07-205.92); excess intake of saturated fats - OR=79.94(95%CI:10.93-584.43); night shift - OR=39.01(95%CI:3.75-405.75); early detection of ischemic disease in grade I-II relatives - OR=44.22(95%CI:8.07-242.17); decrease - female gender - OR=0.14 (95%CI:0.03-0.70) and married - OR=0.01(95%CI:0.00-0.08); Conclusion: The ability to predict the risk of developing IHD in young people on the basis of traditional RFs, most of which are modifiable, as well as the study of "new" RFs opens up new perspectives in the formation of a strategic approach to the management of young patients in the presence of high risk.

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