scholarly journals Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

2020 ◽  
Author(s):  
Qiuxia Xie ◽  
Haoling Qin ◽  
Ling Lin ◽  
Jian Guan ◽  
Xuhui Zhou

Abstract Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.

2020 ◽  
Author(s):  
Qiuxia Xie ◽  
Haoling Qin ◽  
Ling Lin ◽  
Jian Guan ◽  
Xuhui Zhou

Abstract Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.


2019 ◽  
Author(s):  
Qiuxia Xie ◽  
Haoling Qin ◽  
Ling Lin ◽  
Jian Guan ◽  
Xuhui Zhou

Abstract Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. HPS is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of hepatopulmonary syndrome (HPS) patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as case group. 36 Normal people were considerate as control group. Demographic data, treatment methods, AD related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of maximum diameter of ascending aorta (mm), aortic dissection range, and main branch of aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis were used in this study. Results: CCI value and the branches of the brachiocephalus in case group were significant higher than that in control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalus were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalus was an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalus were an independent risk factor for HPS.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S64-S65
Author(s):  
David Gustafson ◽  
Osvaldo Padilla

Abstract Introduction Gallbladder adenocarcinoma (GBC) is a rare malignancy. Frequency of incidental adenocarcinoma of the gallbladder in the literature is approximately 0.2% to 3%. Typically, GBC is the most common type and is discovered late, not until significant symptoms develop. Common symptoms include right upper quadrant pain, nausea, anorexia, and jaundice. A number of risk factors in the literature are noted for GBC. These risk factors are also more prevalent in Hispanic populations. This study sought to compare patients with incidental gallbladder adenocarcinomas (IGBC) to those with high preoperative suspicion for GBC. Predictor variables included age, sex, ethnicity, radiologic wall thickening, gross pathology characteristics (wall thickness, stone size, stone number, and tumor size), histologic grade, and staging. Methods Cases of GBC were retrospectively analyzed from 2009 through 2017, yielding 21 cases. Data were collected via Cerner EMR of predictor variables noted above. Statistical analysis utilized conditional logistic regression analysis. Results The majority of patients were female (n = 20) and Hispanic (n = 19). There were 14 IGBCs and 7 nonincidental GBCs. In contrast with previous research, exact conditional logistic regression analysis revealed no statistically significant findings. For every one-unit increase in AJCC TNM staging, there was a nonsignificant 73% reduction in odds (OR = 0.27) of an incidental finding of gallbladder carcinoma. Conclusion This study is important in that it attempts to expand existing literature regarding a rare type of cancer in a unique population, one particularly affected by gallbladder disease. Further studies are needed to increase predictive knowledge of this cancer. Longer studies are needed to examine how predictive power affects patient outcomes. This study reinforces the need for routine pathologic examination of cholecystectomy specimens for cholelithiasis.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15171-e15171
Author(s):  
Kiyofumi Shimoji ◽  
Takeshi Masuda ◽  
Yu Nakanishi ◽  
Kakuhiro Yamaguchi ◽  
Shinjiro Sakamoto ◽  
...  

e15171 Background: Immune check point inhibitor (ICI) induced interstitial lung disease (ICI-ILD) is a clinically serious and life-threatening toxicity. Pre-existing ILD has been reported to be a risk factor for ICI-ILD in patients with non-small cell lung cancer (NSCLC). In addition, we have previously reported that interstitial lung abnormality (ILA) is also a risk factor for the ICI-ILD. Therefore, we investigated whether any patient characteristics, including ILA, were risk factors for ICI-ILD in patients with non-NSCLC cancers. Methods: Head and neck cancer, malignant melanoma, oral cavity cancer, renal cell carcinoma or gastric cancer patients who received anti PD-1 antibody (Nivolumab or Pembrolizumab) at Hiroshima University Hospital from December 2015 to May 2019 were enrolled. Information on patient characteristics before anti-PD-1 antibody administration, including chest CT findings and laboratory data, were obtained. Results: Two hundred patients were enrolled, and 20 (10%) developed ICI-ILD. Grade1 was observed in 15 patients, grade2 in 3, and grade3 and 5 in 1. There was no significant difference in the background factors between patients with and without ICI-ILD. On the other hand, the proportion of patients with ILA was significantly higher in the patients with ICI-ILD than those without (P < 0.01). Furthermore, univariate logistic regression analysis revealed ILA was the risk factor for ICI-ILD (p < 0.01), and multivariate logistic regression analysis showed that GGA or reticulation in ILA was an independent risk factor for ICI-ILD (p = 0.016, 0.011). Conclusions: Pre-existing ILA is a risk factor for ICI-ILD, and GGA or reticulation in ILA is an independent risk factor for ICI-ILD in patients with non-NSCLC cancers. Therefore, we should pay more attention to the development of ICI-ILD in patients with ILA, especially GGA or reticulation.


2020 ◽  
Vol 51 (5) ◽  
pp. 529-539
Author(s):  
Tingting Zeng ◽  
Liming Tan ◽  
Yang Wu ◽  
Jianlin Yu

Abstract Background Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). Methods We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. Results Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116–2.025; P &lt;.01). Conclusions Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2487-2487 ◽  
Author(s):  
Francoise Bernaudin ◽  
Suzanne Verlhac ◽  
Annie Kamdem ◽  
Cécile Arnaud ◽  
Lena Coïc ◽  
...  

Abstract Background Silent infarcts are associated with impaired cognitive functioning and have been shown to be predictors of stroke (Miller ST J Pediatr 2001). Until now, reported risk factors for silent infarcts were low pain event rate, history of seizures, high leukocyte count and Sen bS haplotype (Kinney TR Pediatrics 1999). Here, we seek to define the prevalence and risk factors of silent infarcts in the Créteil SCA pediatric cohort comprising patients assessed at least yearly by transcranial doppler (TCD) since 1992, and by MRI/MRA. Methods This study retrospectively analyzed data from the Créteil cohort stroke-free SS/Sb0 children (280; 134 F, 146 M), according to institutional review board. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities (&lt; 170 cm/sec) and normal MRA on TP, although TP was re-initiated in case of abnormal velocities recurrence. Patients with “conditional” velocities (170–199 cm/sec) were assessed by TCD 4 times yearly. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF, LDH levels; MCV; SpO2) were obtained a minimum of 3 months away from a transfusion, one month from a painful episode, after 12 months of age, before the first TCD, and always before therapy intensification. Results. Patients were followed for a total of 2139 patient-years. Alpha-Thal was present in 114/254 patients (45%) and 27/241 (11.2%) had G6PD deficiency. Beta genotype, available in 240 patients, was BaBa in 102 (42.5%), BeBe in 54 (22.5%), SeSe in 19 (7.9%) and “other” in 65 (27.1%); TCD was abnormal in 52 of 280 patients (18.6%). MRA showed stenoses in 30 of 226 evaluated patients (13.3%) while MRI demonstrated presence of silent infarcts in 81/280 patients (28.9%). Abnormal TCD (p&lt;0.001), G6PD deficiency (p=0.008), high LDH (p=0.03), and low Hb (p=0.026) were significant risk factors for stenoses by univariate analysis while multivariate analysis retained only abnormal TCD as a significant risk factor for stenoses ([OR= 10.6, 95% CI (4.6–24.4)]; p&lt;0.001). Univariate logistic regression analysis showed that the risk of silent infarcts was not related to alpha-Thal, beta genotype, abnormal TCD, WBC, PMN, platelets, reticulocyte counts, MCV, LDH level, HbF %, pain or ACS rates but was significantly associated with stenoses detected by MRA (p&lt;0.001), gender (male; p=0.04), G6PD deficiency (p=0.05), low Hb (p=0.016) and Hct (p=0.012). Multivariate logistic regression analysis showed that gender ([OR= 2.1, 95% CI (1.03–4.27)]; p=0.042), low Hb ([OR= 1.4, 95% CI (1.0–1.1)]; p=0.05) and stenoses ([OR= 4.8, 95% CI (1.88–12.28)]; p=0.001) were all significant independent risk factors for silent infarcts. The presence of stenoses was the only significant risk factor for silent infarcts in patients with a history of abnormal TCD ([OR= 5.9, 95% CI (1.6–21.7)]; p=0.008). Conclusion We recently showed that G6PD deficiency, absence of alpha-Thal, and hemolysis are independent significant risk factors for abnormal TCD in stroke-free SCA patients (Bernaudin et al, Blood, 2008, in press). Here, we report that an abnormal TCD is the most significant risk factor for stenoses and, expanding previous studies, we demonstrate that stenoses, low Hb and gender are significant independent risk factors for silent infarcts.


2006 ◽  
Vol 52 (11) ◽  
pp. 2021-2027 ◽  
Author(s):  
Hillary H Hegener ◽  
I-Min Lee ◽  
Nancy R Cook ◽  
Paul M Ridker ◽  
Robert YL Zee

Abstract Background: Adiponectin (ADIPOQ) gene variations are associated with risk of cardiovascular disease in patients with diabetes. No prospective data are available, however, on the risk of atherothrombotic disorders in persons with ADIPOQ variations who do not have diabetes. Methods: From a group of DNA samples collected at baseline in a prospective cohort of 14 916 initially healthy American men, we assessed the presence of 5 ADIPOQ genetic variants (rs266729, rs182052, rs822396, rs2241766, and rs1501299) in samples from 600 Caucasian men who subsequently suffered an atherothrombotic event (incident myocardial infarction or ischemic stroke) and from 600 age- and smoking-matched Caucasian men who remained free of reported vascular disease during follow-up (controls). Results: Genotype distributions for the variations tested were in Hardy-Weinberg equilibrium. Marker-by-marker conditional logistic regression analysis, adjusted for potential risk factors, showed an association of rs266729 [recessive: odds ratio (OR), 0.26; 95% confidence interval (CI), 0.10–0.64; P = 0.004] and rs182052 (recessive: OR, 0.40; 95% CI, 0.21–0.76; P = 0.006) with decreased risk of ischemic stroke. These findings remained significant after Bonferroni correction. Haplotype-based (constituted by rs266729, rs182052, and rs822396) conditional logistic regression analysis, adjusted for the same potential risk factors, showed an association of haplotype G-A-G (OR, 0.28; 95% CI, 0.09–0.87; P = 0.03) with decreased risk of ischemic stroke. Prespecified analysis limited to participants without baseline diabetes showed similar significant findings. Conclusions: The present prospective investigation provides further evidence for a protective role of adiponectin gene variation in the risk of ischemic stroke that was independent of the presence of diabetes.


2020 ◽  
Vol 19 (03) ◽  
pp. 120-125
Author(s):  
Fatikhatul Mabruroh ◽  
Syahrizal Syarif

Penyakit Jantung koroner menjadi masalah kesehatan global baik pada negara maju ataupunberkembang. Stres sebagai salah satu faktor risiko penyakit jantung koroner masih kurangmendapatkan perhatian. Tujuan penelitian ini untuk mengetahui hubungan stres terhadap penyakit jantungkoroner di Kota Bogor tahun 2015. Disain studi yang digunakan dalam penelitian ini adalah nestesd-case control menggunakan data kohort yang dikumpulkan oleh Badan Penelitian dan Pengembangan Kesehatan. Jumlah sampel yang diambil pada penelitian in adalah 1.078 dengan perbandingan kelompok kasus dan kontrol 1:5. Jenis analisis yang digunakan adalah conditional logistic regression analysis. Hasil analisis menunjukkan risiko stres dan variabel lainnya, stres (OR adjusted 1,07 CI 95% 0,49 – 2,33), HDL (OR adjusted 0,8 CI 95% 0,55 – 1,17) , Usia (OR adjusted 1,77 CI 95% 1,07 – 2, 92), LDL (OR adjusted 2,34 CI 95% 1,38 – 3,95), dan kolesterol total (OR adjusted 0,55 CI 95% 0,32 – 0,94) tidak berhubungan secara signifikan pada terjadinya penyakit jantung koroner. Diharapkan terdapat penelitian lainnya menggunakan alat ukur yang lebih spesifik agar dapat meminimalisir adanya misklarifikasi pada melihat asosiasi stres terhadap penyakit jantung koroner.


2012 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Digna Niken Purwaningrum ◽  
Hamam Hadi ◽  
I Made Alit Gunawan

Background: Food insecurity is associated with allocation of income for high energy density food consumption that may cause obesity in poor family. In addition, low physical activity may lead to obesity, particularly in individual living in disadvantaged situation.Objective: To identify risk factors of obesity among poor housewives in Yogyakarta.Method: This was a case control study, case group was obese housewives and the control group was non obese housewives. The locations of the study were Bumijo and Pringgokusuman which have high population density. The samples were taken purposively. Each group consisted of 70 housewives (1:1) and were matched according to age. Mc.Nemar test and conditional logistic regression were used to identify the risk factors of obesity.Results: There was no difference in characteristics between the two groups. Food insecurity reached 91,43% in the control group, proportion of excessive energy intake reached 37.86% in the case group, higher than in control group (24.29%). Excessive fat intake in the case group reached 30% whereas in the control group was 28.57%. Low physical activity reached 40% in the case group, and 10% in the control group. The result of Mc.Nemar test showed that food insecurity, energy and fat intake had no significant association with obesity (p>0.05). While physical activity was associated with obesity (p=0.0001). The result of conditional logistic regression showed physical activity was dominant risk factor for obesity among poor housewives (R2=0.1916).Conclusion: Food security status was not a risk factor for obesity in poor families; energy intake and fat intake contributed to the prevalence of obesity though the influence was smaller than physical activity.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248810
Author(s):  
Il-Jae Wang ◽  
Byung-Kwan Bae ◽  
Young Mo Cho ◽  
Suck Ju Cho ◽  
Seok-Ran Yeom ◽  
...  

Background The effect of alcohol on the outcome and fibrinolysis phenotype in trauma patients remains unclear. Hence, we performed this study to determine whether alcohol is a risk factor for mortality and fibrinolysis shutdown in trauma patients. Materials and methods A total of 686 patients who presented to our trauma center and underwent rotational thromboelastometry were included in the study. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to determine whether alcohol was an independent risk factor for in-hospital mortality and fibrinolysis shutdown. Results The rate of in-hospital mortality was 13.8% and blood alcohol was detected in 27.7% of the patients among our study population. The patients in the alcohol-positive group had higher mortality rate, higher clotting time, and lower maximum lysis, more fibrinolysis shutdown, and hyperfibrinolysis than those in the alcohol-negative group. In logistic regression analysis, blood alcohol was independently associated with in-hospital mortality (odds ratio [OR] 2.578; 95% confidence interval [CI], 1.550–4.288) and fibrinolysis shutdown (OR 1.883 [95% CI, 1.286–2.758]). Within the fibrinolysis shutdown group, blood alcohol was an independent predictor of mortality (OR 2.168 [95% CI, 1.030–4.562]). Conclusions Alcohol is an independent risk factor for mortality and fibrinolysis shutdown in trauma patients. Further, alcohol is an independent risk factor for mortality among patients who experienced fibrinolysis shutdown.


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