scholarly journals Components of metabolic syndrome in patients with multiple myeloma and smoldering multiple myeloma

2020 ◽  
Author(s):  
Efrat Markus ◽  
Svetlana Trestman ◽  
Yael Cohen ◽  
Yoel Angel ◽  
Yael Sofer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Multiple Myeloma ◽  
Regression Analysis ◽  
Cox Regression ◽  
Healthy Controls ◽  
Cox Regression Analysis ◽  
Smoldering Multiple Myeloma ◽  
Metabolic Syndrome Components

Abstract Background: The prevalences of diabetes mellitus and hypertension, both of which are components of metabolic syndrome, are known to be increased among patients with multiple myeloma (MM), but remain undetermined among patients with smoldering MM (SMM). Methods: Changes in various components of metabolic syndrome were investigated during the follow-up of patients with either MM or SMM compared to healthy controls. The data of 153 patients (105 with MM and 48 with SMM) and 138 controls were accessed from our medical center’s records between 2008-2015. We analyzed the patients’ data at diagnosis (baseline) and after 1, 3, and 5 years of follow-up. Results: Patients with SMM had a significantly higher prevalence of diabetes, hypertension, and dyslipidemia at baseline compared to controls. A multivariate Cox regression analysis revealed a higher risk to develop dyslipidemia after 1, 3, and 5 years of follow-up among the SMM patients. The MM patients had a higher risk to develop diabetes after 1 year, hypertension after 5 years, and dyslipidemia after 1, 3, and 5 years of follow-up. Conclusions: These data demonstrate that patients with SMM and those with MM are more prone to develop various components of metabolic syndrome, and they stress the importance of following-up metabolic syndrome components in both groups of patients.

scholarly journals Components of metabolic syndrome in patients with multiple myeloma and smoldering multiple myeloma

2019 ◽  
Author(s):  
Efrat Markus ◽  
Svetlana Trestman ◽  
Yael Cohen ◽  
Yoel Angel ◽  
Yael Sofer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Multiple Myeloma ◽  
Regression Analysis ◽  
Cox Regression ◽  
Healthy Controls ◽  
Cox Regression Analysis ◽  
Smoldering Multiple Myeloma ◽  
Metabolic Syndrome Components

Abstract Background: The prevalences of diabetes mellitus and hypertension, both of which are components of metabolic syndrome, are known to be increased among patients with multiple myeloma (MM), but remain undetermined among patients with smoldering MM (SMM). Methods: Changes in various components of metabolic syndrome were investigated during the follow-up of patients with either MM or SMM compared to healthy controls. The data of 153 patients (105 with MM and 48 with SMM) and 138 controls were accessed from our medical center’s records between 2008-2015. We analyzed the patients’ data at diagnosis (baseline) and after 1, 3, and 5 years of follow-up. Results: Patients with SMM had a significantly higher prevalence of diabetes, hypertension, and dyslipidemia at baseline compared to controls. A multivariate Cox regression analysis revealed a higher risk to develop dyslipidemia after 1, 3, and 5 years of follow-up among the SMM patients. The MM patients had a higher risk to develop diabetes after 1 year, hypertension after 5 years, and dyslipidemia after 1, 3, and 5 years of follow-up. Conclusions: These data demonstrate that patients with SMM and those with MM are more prone to develop various components of metabolic syndrome, and they stress the importance of following-up metabolic syndrome components in both groups of patients.

scholarly journals Components of metabolic syndrome in patients with multiple myeloma and smoldering multiple myeloma

2020 ◽  
Author(s):  
Efrat Markus ◽  
Svetlana Trestman ◽  
Yael Cohen ◽  
Yoel Angel ◽  
Yael Sofer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Multiple Myeloma ◽  
Regression Analysis ◽  
Cox Regression ◽  
Healthy Controls ◽  
Cox Regression Analysis ◽  
Smoldering Multiple Myeloma ◽  
Metabolic Syndrome Components

Abstract Background: The prevalences of diabetes mellitus and hypertension, both of which are components of metabolic syndrome, are known to be increased among patients with multiple myeloma (MM), but remain undetermined among patients with smoldering MM (SMM). Methods: Changes in various components of metabolic syndrome were investigated during the follow-up of patients with either MM or SMM compared to healthy controls. The data of 153 patients (105 with MM and 48 with SMM) and 138 controls were accessed from our medical center’s records between 2008-2015. We analyzed the patients’ data at diagnosis (baseline) and after 1, 3, and 5 years of follow-up. Results: Patients with SMM had a significantly higher prevalence of diabetes, hypertension, and dyslipidemia at baseline compared to controls. A multivariate Cox regression analysis revealed a higher risk to develop dyslipidemia after 1, 3, and 5 years of follow-up among the SMM patients. The MM patients had a higher risk to develop diabetes after 1 year, hypertension after 5 years, and dyslipidemia after 1, 3, and 5 years of follow-up. Conclusions: These data demonstrate that patients with SMM and those with MM are more prone to develop various components of metabolic syndrome, and they stress the importance of following-up metabolic syndrome components in both groups of patients.

scholarly journals Components of metabolic syndrome in patients with multiple myeloma and smoldering multiple myeloma

2020 ◽  
Author(s):  
Efrat Markus ◽  
Svetlana Trestman ◽  
Yael Cohen ◽  
Yoel Angel ◽  
Yael Sofer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Multiple Myeloma ◽  
Regression Analysis ◽  
Cox Regression ◽  
Healthy Controls ◽  
Cox Regression Analysis ◽  
Smoldering Multiple Myeloma ◽  
Metabolic Syndrome Components

Abstract Background: The prevalences of diabetes mellitus and hypertension, both of which are components of metabolic syndrome, are known to be increased among patients with multiple myeloma (MM), but remain undetermined among patients with smoldering MM (SMM). Methods: Changes in various components of metabolic syndrome were investigated during the follow-up of patients with either MM or SMM compared to healthy controls. The data of 153 patients (105 with MM and 48 with SMM) and 138 controls were accessed from our medical center’s records between 2008-2015. We analyzed the patients’ data at diagnosis (baseline) and after 1, 3, and 5 years of follow-up. Results: Patients with SMM had a significantly higher prevalence of diabetes, hypertension, and dyslipidemia at baseline compared to controls. A multivariate Cox regression analysis revealed a higher risk to develop dyslipidemia after 1, 3, and 5 years of follow-up among the SMM patients. The MM patients had a higher risk to develop diabetes after 1 year, hypertension after 5 years, and dyslipidemia after 1, 3, and 5 years of follow-up. Conclusions: These data demonstrate that patients with SMM and those with MM are more prone to develop various components of metabolic syndrome, and they stress the importance of following-up metabolic syndrome components in both groups of patients.

scholarly journals POS0772 PREVALENCE AND RISK FACTORS FOR HERPES ZOSTER REACTIVATION IN 1542 PATIENTS WITH RHEUMATIC DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 640.1-640
Author(s):  
C. C. Mok ◽  
L. Y. Ho ◽  
S. M. Tse ◽  
K. L. Chan ◽  
C. H. To
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Regression Analysis ◽  
Herpes Zoster ◽  
Rheumatic Diseases ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Objectives:To study the prevalence and risk factors of herpes zoster (HZ) infection in patients with rheumatic diseases.Methods:Medical records of patients with rheumatic diseases who attended our out-patient rheumatology clinics between 2019 March and 2019 August were retrospectively reviewed. Patients who were using biological or targeted DMARDs were excluded. Episodes of HZ infection since disease diagnosis were identified and the prevalence over time was calculated. Laboratory parameters (total white cell count, neutrophil-to-lymphocyte ratio, serum albumin, globulin & creatinine), history of diabetes mellitus and the highest doses of immunosuppressive medications within 6 months of the first episode of HZ infection were compared with those within 6 months of last follow-up in patients who did not have HZ infection. Cox regression analysis was performed to identify factors associated with the first HZ infection in all patients.Results:1542 patients were studied (88% women, age 46.4±15.0 years). The underlying diseases were systemic lupus erythematosus (SLE) (38%), rheumatoid arthritis (26%) and other rheumatic diseases (36%). After a total follow-up of 11,515 patient-years since diagnosis (7.5±7.0 years), 122 (7.9%) patients developed 146 episodes of HZ infection, giving an overall prevalence of 1.27/100-patient years. The prevalence rates of HZ in SLE, RA and non-SLE/RA patients were 1.70, 0.64 and 0.76 per 100 patient-years, respectively. Patients who experienced HZ reactivation were younger (41.6±14.7 vs 46.8±15.0 years; p<0.001), more likely to have SLE (74% vs 35%; p<0.001) and diabetes mellitus (17% vs 7.3%; p=0.01), and had a significantly lower albumin (38.6±5.6 vs 41.3±3.5; p<0.001) and higher neutrophil-to-lymphocyte ratio (4.9±6.2 vs 2.8±2.6; p<0.001). More patients with HZ reactivation were treated with prednisolone (54% vs 22%; p<0.001), azathioprine (20% vs 8%; p<0.001), mycophenolate mofetil [MMF] (21% vs 12%; p=0.006), cyclophosphamide [CYC] (4.9% vs 0.1%; p<0.001) and hydroxychloroquine (48% vs 34%; p=0.002) in the preceding 6 months compared with those who did not have HZ infection. Among those using immunosuppressive drugs, the doses of MMF (1.42±0.64 vs 1.02±0.31g; p=0.005) and prednisolone (15.6±15.9 vs 5.5±4.5mg; p<0.001) were significantly higher in those with HZ infection. The cumulative risk of having HZ reactivation in SLE patients at 24 and 48 months since diagnosis was 5.9% and 8.6%, respectively, which was significantly higher than that in non-SLE patients (1.9% and 2.5%, respectively; p<0.001 by log rank test). Cox regression analysis revealed that having a diagnosis of SLE (HR 1.97 [1.17-3.31]), albumin level (HR 0.93 [0.90-0.97] per g/L; p=0.001), serum creatinine (HR 0.995 [0.990-1.00] per umol/L), higher neutrophil/lymphocyte ratio (HR 1.08 [1.05-1.11]) and the use of CYC (HR 6.69 [2.56-17.5]) and prednisolone (HR 1.61 [1.02-2.45]) in the preceding 6 months were independently associated with the development of HZ infection.Conclusion:Reactivation of HZ is fairly common in patients with rheumatic diseases. Underlying SLE, prednisolone/cyclophosphamide therapy and the neutrophil/lymphocyte ratio, but not age, sex or other laboratory parameters, are the major risk factors for HZ reactivation.Disclosure of Interests:None declared

Red Blood Cell Indices in Relation to Post-stroke Psychiatric Disorders: A Longitudinal Study in a Follow-up Stroke Clinic

2020 ◽  
Vol 17 (3) ◽  
pp. 218-223
Author(s):  
Haichao Wang ◽  
Li Gong ◽  
Xiaomei Xia ◽  
Qiong Dong ◽  
Aiping Jin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Cox Regression ◽  
Depression And Anxiety ◽  
Cox Regression Analysis ◽  
Post Stroke ◽  
Rbc Indices ◽  
Post Stroke Depression

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.

scholarly journals The Role of Hydraulic Silicate Cements on Long-Term Properties and Biocompatibility of Partial Pulpotomy in Permanent Teeth

Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 305
Author(s):  
Chung-Min Kang ◽  
Saemi Seong ◽  
Je Seon Song ◽  
Yooseok Shin
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Antimicrobial Properties ◽  
Permanent Teeth ◽  
Success Rates ◽  
Pulp Tissue ◽  
Cox Regression Analysis ◽  
Clinical Variables

The use of hydraulic silicate cements (HSCs) for vital pulp therapy has been found to release calcium and hydroxyl ions promoting pulp tissue healing and mineralized tissue formation. The present study investigated whether HSCs such as mineral trioxide aggregate (MTA) affect their biological and antimicrobial properties when used as long-term pulp protection materials. The effect of variables on treatment outcomes of three HSCs (ProRoot MTA, OrthoMTA, and RetroMTA) was evaluated clinically and radiographically over a 48–78 month follow-up period. Survival analysis was performed using Kaplan–Meier survival curves. Fisher’s exact test and Cox regression analysis were used to determine hazard ratios of clinical variables. The overall success rate of MTA partial pulpotomy was 89.3%; Cumulative success rates of the three HSCs were not statistically different when analyzed by Cox proportional hazard regression analysis. None of the investigated clinical variables affected success rates significantly. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long-term follow-up, with no statistical differences between clinical factors.

scholarly journals Tocilizumab improves survival in severe COVID-19 pneumonia with persistent hypoxia: A retrospective cohort study with follow-up from Mumbai, India

2020 ◽  
Author(s):  
YOJANA Gokhale ◽  
Rakshita Mehta ◽  
Uday Kulkarni ◽  
Nitin Karnik ◽  
Sushant Gokhale B.Tech ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Virus Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Supplemental Oxygen ◽  
Cytokine Storm ◽  
Cox Regression Analysis

Abstract Background: Cytokine storm triggered by Severe Corona Virus Disease 2019 (COVID-19) is associated with high mortality. With high ‘Interlukin -6’ (IL-6) levels reported in COVID-19 deaths in China1, IL-6 is considered to be the key player in COVID-19 cytokine storm. Tocilizumab, a monoclonal antibody against IL-6 receptor, is used on compassionate grounds for treatment of COVID-19 cytokine storm. Aim of this study was to assess effect of tocilizumab on mortality due to COVID-19 cytokine storm.Method: This retrospective, observational study included patients of severe COVID-19 pneumonia with persistent hypoxia (defined as saturation 94% or less on supplemental Oxygen of 15 L per minute through non-rebreathing mask or PaO2/FiO2 ratio of less than 200) who were admitted to tertiary care center in Mumbai, India, between 31st March to 5th July 2020. In addition to standard care, single Inj. Tocilizumab 400mg was given intravenously to 151 consecutive COVID-19 patients with persistent hypoxia from 13th May to 5th July 2020. These 151 patients were retrospectively analysed and compared with historic controls i.e consecutive COVID-19 patients with persistent hypoxia, defined as above (N=118, from our first COVID-19 admission on 31st March to 12th May 2020 ie till tocilizumab was available in hospital). Univariate and multivariate Cox regression analysis was performed for identifying predictors of survival. Statistical analysis was performed using IBM SPSS version 26.Results: On multivariate Cox regression analysis, independent predictors of survival were use of tocilizumab (HR 0.621, 95% CI 0.427-0.903, P 0.013) and higher oxygen saturation.Conclusion: Tocilizumab improved survival in severe COVID-19 pneumonia with persistent hypoxia

scholarly journals Role of Disease Modifying Treatment in the Risk of Alloimmunization in Transfused Patients with Myelodysplastic Syndromes: A Population-Based Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4253-4253
Author(s):  
Hanne Rozema ◽  
Robby Kibbelaar ◽  
Nic Veeger ◽  
Mels Hoogendoorn ◽  
Eric van Roon
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Population Based ◽  
Incidence Rates ◽  
Blood Products ◽  
Cox Regression Analysis ◽  
In The Beginning ◽  
Observation Period

The majority of patients with myelodysplastic syndromes (MDS) require regular red blood cell (RBC) transfusions. Alloimmunization (AI) against blood products is an adverse event, causing time-consuming RBC compatibility testing. The reported incidence of AI in MDS patients varies greatly. Even though different studies on AI in MDS patients have been performed, there are still knowledge gaps. Current literature has not yet fully identified the risk factors and dynamics of AI in individual patients, nor has the influence of disease modifying treatment (DMT) been explored. Therefore, we performed this study to evaluate the effect of DMT on AI. An observational, population-based study, using the HemoBase registry, was performed including all newly diagnosed MDS patients between 2005 and 2017 in Friesland, a province of the Netherlands. All available information about treatment and transfusions, including transfusion dates, types, and treatment regimens, was collected from the electronic health records and laboratory systems. Follow-up occurred through March 2019. For our patient cohort, blood products were matched for AB0 and RhD, and transfused per the 'type and screen' policy (i.e. electronic matching of blood group phenotype between patient and donor). After a positive antibody screening, antibody identification and Rh/K phenotyping was performed and subsequent blood products were (cross)matched accordingly. The observation period was counted from first transfusion until last transfusion or first AI event. Univariate analyses and cumulative frequency distributions were performed to study possible risk factors and dynamics of AI. DMT was defined as hypomethylating agents, lenalidomide, chemotherapy and monoclonal antibodies. The effect of DMT as a temporary risk period on the risk of AI was estimated with incidence rates, relative risks (RR) and hazard ratios (HR) using a cox regression analysis. Follow-up was limited to 24 months for the cox regression analysis to avoid possible bias by survival differences. Statistical analyses were performed using IBM SPSS 24 and SAS 9.4. Out of 292 MDS patients, 236 patients received transfusions and were included in this study, covering 463 years of follow-up. AI occurred in 24 patients (10%). AI occurred mostly in the beginning of the observation period: Eighteen patients (75%) were alloimmunized after receiving 20 units of RBCs, whereas 22 patients (92%) showed AI after 45 units of RBCs (Figure 1). We found no significant risk factors for AI in MDS patients at baseline. DMT was given to 67 patients (28%) during the observation period. Patients on DMT received more RBC transfusions than patients that did not receive DMT (median of 33 (range: 3-154) and 11 (range: 0-322) RBC units respectively, p<0,001). Four AI events (6%) occurred in patients on DMT and 20 AI events (12%) occurred in patients not on DMT. Cox regression analysis of the first 24 months of follow-up showed an HR of 0.30 (95% CI: 0.07-1.31; p=0.11). The incidence rates per 100 person-years were 3.19 and 5.92 respectively. The corresponding RR was 0.54 (95% CI: 0.16-1.48; p=0.26). Based on our results, we conclude that the incidence of AI in an unselected, real world MDS population receiving RBC transfusions is 10% and predominantly occurred in the beginning of follow-up. Risk factors for AI at baseline could not be identified. Our data showed that patients on DMT received significantly more RBC transfusions but were less susceptible to AI. Therefore, extensive matching of blood products may not be necessary for patients on DMT. Larger studies are needed to confirm the protective effect of DMT on AI. Disclosures Rozema: Celgene: Other: Financial support for visiting MDS Foundation conference.

Abstract 19123: Elevated Growth and Differentiation Factor 15 (GDF15) Levels Predict Outcome in Patients With Severe Aortic Stenosis Undergoing Tavi

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Nora Krau ◽  
Sandra Freitag-Wolf ◽  
Doreen Brehm ◽  
Rainer Petzina ◽  
Georg Lutter ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Aortic Valve ◽  
Risk Stratification ◽  
Transforming Growth Factor ◽  
Cox Regression ◽  
Severe Aortic Stenosis ◽  
Statistical Significance ◽  
Cox Regression Analysis ◽  
Negative Outcome

Background: GDF15 belongs to the transforming growth factor superfamily and has a significant role in regulating inflammatory and apoptotic pathways. GDF15 is an emerging biomarker for risk stratification in cardiovascular disease. Here we analyze its prognostic value in patients with severe symptomatic aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). Methods and Results: We prospectively enrolled 217 patients undergoing TAVI (using Edwards Sapien XT prostheses) at our institution over a continuous period of 35 month (2/2011-12/2013). All patients were available for complete follow up. Clinical parameters were determined before the procedure, biomarkers (GDF15 & NTproBNP) were measured before, 3 and 7 days after TAVI. The primary endpoint was survival time, all available prognostic factors were studied by Cox regression analysis with backward selection based on the likelihood ratio criteria. At median follow-up of 349 d (Q1-Q3 106-660d), a total of n=66 deaths occurred. 30d mortality was 6.9%. Mean age was 81.8 years (± 6.0 y) and 55.8% were females. Mean log. Euroscore (ES) was 25.4% (± 17.2%). Median preprocedural GDF15 values were 2256 pg/ml (Q1-Q3 1585.5-3082.0). In univariate analyses, increased GDF15 levels (upper quartile compared to lower three quartiles) revealed a HR of 2.4 (CI 1.5-3.9, p<0.001) for adverse outcome. In addition, also log. ES (p= 0.001), log. ES II (p=0.018), STS-Score (p=0.019), NTproBNP (p=0.037) and atrial fibrillation (p=0.02) demonstrated statistical significance for negative outcome. A multivariate Cox regression analysis including these factors and postprocedural aortic regurgitation, demonstrated that elevated GDF15 had a HR of 2.104 (CI 1.3-3.5; p=0.003) for negative outcome in patients undergoing TAVI, while elevated NTproBNP had HR of 1.412 (CI 0.8-2.4; p=0.212). Moreover, this analysis also revealed the log. ES as an independent risk factor (HR of 2.211, CI 1.3-3.7; p= 0.002). Conclusion: Increased GDF15 levels are associated with a poor prognosis in patients undergoing TAVI. Furthermore, GDF15 showed to be superior to the established biomarker NTproBNP in risk stratification of patients undergoing TAVI providing additional prognostic information.

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