scholarly journals A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: An administrative population health study

2021 ◽  
Author(s):  
Jessica Stawski Jarmasz ◽  
Alexandrea ANDERSON ◽  
Margaret E. Bock ◽  
Yan Jin ◽  
Peter A. Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Insulin Treatment ◽  
Placental Lactogen ◽  
Health Study ◽  
Study Objective ◽  
Increased Risk ◽  
Significant Difference ◽  
Peripartum Depression ◽  
Lean Group ◽  
In Pregnancy

Abstract Background: Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however, they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Therefore, our study objective is to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD) among cohorts of women with and without obesity. Methods: Administrative health data (2002/03-2018/19) were used to identify a cohort of women (age 15+ years) who gave birth (N=250,746) and had no pre-existing mood/anxiety disorders or diabetes (N=222,863 excluded). Women were then divided into two groups: lean (N=17,975) and with obesity (N=9,908), which was identified by a recorded maternal weight of >38 - <65.6 kg and ≥85 - <186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery). Results: The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00 - 9.15) than in the lean group (6.93%; 95% CI 6.56 - 7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17-1.39; p<0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83-2.02; p=0.248). Conclusion: This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a possible preventative measure. However, the biological mechanism behind the observed positive effect of insulin on PPD rates remains to be investigated.

scholarly journals A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: an administrative population health study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica S. Jarmasz ◽  
Alexandrea Anderson ◽  
Margaret E. Bock ◽  
Yan Jin ◽  
Peter A. Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Insulin Treatment ◽  
Placental Lactogen ◽  
Health Study ◽  
Study Objective ◽  
Increased Risk ◽  
Significant Difference ◽  
Peripartum Depression ◽  
Lean Group ◽  
In Pregnancy

Abstract Background Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Therefore, our study objective is to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD) among cohorts of women with and without obesity. Methods Administrative health data (2002/03–2018/19) were used to identify a cohort of women (age 15+ years) who gave birth (N = 250,746) and had no pre-existing mood/anxiety disorders or diabetes (N = 222,863 excluded). Women were then divided into two groups: lean (N = 17,975) and with obesity (N = 9908), which was identified by a recorded maternal weight of > 38 to < 65.6 kg and ≥ 85 to < 186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery). Results The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00–9.15) than in the lean group (6.93%; 95% CI 6.56–7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17–1.39; p < 0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83–2.02; p = 0.248). Conclusion This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a possible preventative measure. However, the biological mechanism behind the observed positive effect of insulin on PPD rates remains to be investigated.

scholarly journals A potential role for insulin treatment during pregnancy in reducing postpartum psychological distress in maternal obesity: An administrative population health study

2020 ◽  
Author(s):  
Jessica Stawski Jarmasz ◽  
Alexandrea ANDERSON ◽  
Margaret E. Bock ◽  
Yan Jin ◽  
Peter A. Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Early Identification ◽  
Insulin Treatment ◽  
Placental Lactogen ◽  
Study Objective ◽  
Increased Risk ◽  
Significant Difference ◽  
Peripartum Depression ◽  
Lean Group ◽  
In Pregnancy

Abstract Background: Studies have found an association between obesity and an increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however, they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Therefore, our study objective is to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD) among cohorts of women with and without obesity.Methods: Administrative health data (2002/03-2018/19) were used to identify a cohort of women (age 15+ years) who gave birth (N=250,746) and had no pre-existing mood/anxiety disorders or diabetes (N=222,863 excluded). Women were then divided into two groups: lean (N=17,975) and with obesity (N=9,908), which was identified by a recorded maternal weight of >38 - <65.6 kg and ≥85 - <186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery).Results: The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00 - 9.15) than in the lean group (6.93%; 95% CI 6.56 - 7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17-1.39; p<0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83-2.02; p=0.248).Conclusion: This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a preventative measure, and further supporting placental lactogen levels as a potential marker for early identification.

scholarly journals A Potential Role for Insulin Treatment During Pregnancy in Reducing Postpartum Psychological Distress in Maternal Obesity: An Administrative Population Health Study

2020 ◽  
Author(s):  
Jessica Stawski Jarmasz ◽  
Alexandrea ANDERSON ◽  
Margaret E. Bock ◽  
Yan Jin ◽  
Peter A. Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Early Identification ◽  
Insulin Treatment ◽  
Placental Lactogen ◽  
Potential Marker ◽  
Increased Risk ◽  
Significant Difference ◽  
Peripartum Depression ◽  
Lean Group ◽  
In Pregnancy

Abstract Background: Obesity in pregnancy carries significant risks on mother and child. Studies have found an association between obesity and increased risk for peripartum depression, which has also been linked to decreased placental lactogen levels. In addition, women with obesity treated for gestational diabetes with insulin were found to have increased levels of placental lactogen. Treatment options exist for perinatal and postpartum depression however, they pose a risk to the developing offspring. Thus, prevention as well as markers for early identification of peripartum depression are needed. Methods: Administrative health data (2002/03-2018/19) housed at the Manitoba Centre for Health Policy were used to identify the association between insulin treatment in pregnancy and the risk of postpartum psychological distress (abbreviated here as PPD). This was effectuated in a cohort of women (age 15+ years) who gave birth (N=250,746) and had no pre-existing mood/anxiety disorders or diabetes (N=222,863 excluded). Women were then divided into two groups: lean (N=17,975) and with obesity (N=9,908), which was identified by a recorded maternal weight of >38 - <65.6 kg and ≥85 - <186 kg (respectively). The risk of PPD within one year after delivery with and without insulin treatment was assessed by Poisson regression analysis. Models were adjusted for maternal age group (at pregnancy start date) and area-level income (at delivery). Results: The unadjusted risk of PPD was higher in the obesity group (8.56%; 95% CI 8.00 - 9.15) than in the lean group (6.93%; 95% CI 6.56 - 7.33). When no insulin treatment was given during pregnancy, mothers with obesity had a significantly higher risk of PPD than the lean group (aRR 1.27; 95% CI 1.17-1.39; p<0.0001). However, when women with obesity and insulin treatment were compared to the lean group with no insulin treatment, no significant difference in the risk of PPD was observed between the groups (aRR 1.30; 95% CI 0.83-2.02; p=0.248). Conclusion: This is the first study to demonstrate a positive association between insulin treatment in pregnancy among women with obesity and reduced PPD rates, suggesting insulin as a preventative measure, and further supporting placental lactogen levels as a potential marker for early identification.

scholarly journals SAT-014 Insulin Treatment in Human Pregnancy Mitigates an Increased Risk of Postpartum Psychological Distress with Maternal Obesity in the Absence of a Pre-Existing Mood and Anxiety Disorder

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jessica S Jarmasz ◽  
Alexandrea Anderson ◽  
Margaret E Bock ◽  
Yan Jin ◽  
Peter A Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Placental Lactogen ◽  
Mood And Anxiety Disorders ◽  
Increased Risk ◽  
Significant Difference ◽  
In Pregnancy

Abstract BACKGROUND: Pregnant women with obesity are at increased risk for peripartum depression. Maternal obesity is also associated with reduced human placental lactogen (hPL) levels, and decreased hPL transcripts were reported in women with clinical depression. In addition, hPL production may be rescued in women with obesity that were subsequently diagnosed with gestational diabetes and treated with insulin (INS). Objective: Study the effect of INS treatment in pregnancy on the risk for postpartum psychological distress (PPD) in women with and without obesity. Study Design: Using data housed at the Manitoba Centre for Health Policy (2002–2017), cohorts of women (ages 15+) with a single live birth with and without obesity were developed using weight (≥85 and &lt;65.6 kg, respectively) and an average (1.63 m) height. Pre-existing mood and anxiety disorders within 5 years preceding delivery as well as gestational hypertension were excluded. After randomly selecting 1 birth per mother, cohorts were stratified by INS treatment during the gestational period. The risk of PPD within 1 year of delivery was assessed by Poisson regression analysis. Models were adjusted for maternal age and area-level income at delivery. Results: The risk of PPD was 27% greater among women with obesity versus without (adjusted rate ratio (aRR)=1.27, 95% CI 1.16–1.4, p&lt;0.0001). However, women with obesity treated with INS did not have a significantly different risk of PPD compared to women without obesity whether treated with INS (aRR=0.99, 95%CI 0.48–2.02, p=0.974) or not (aRR=1.16, 95%CI 0.86–1.56, p=0.328). This suggests that the risk of PPD among women with obesity may be reduced by INS treatment; however, our ability to detect a significant difference may be limited by small cohort numbers (46 women with obesity received INS in pregnancy) or confounders for receiving INS in pregnancy. Direct comparison of INS treatment within weight groups faced the same limitations but trended toward a reduction in women with obesity who received INS (aRR=0.91, 95%CI 0.68–1.22, p=0.531). The positive association between INS treatment in pregnancy and decreased risk of PPD in women with obesity was lost when pre-existing mood and anxiety disorder was not excluded. Inclusion of pre-existing diabetes in the adjusted models did not improve model fit or contribute significantly to the differences in PPD rates. Conclusions: Maternal obesity increases the risk for PPD but this risk may be reduced by gestational INS treatment in the absence of a pre-existing mood and anxiety disorders. This correlates with the decrease and increase in hPL levels reported previously with maternal obesity without and with INS treatment (for diabetes) in pregnancy, respectively. Thus, hPL levels may serve as a possible indicator of PPD risk and a potential target for gestational INS treatment.

scholarly journals Insulin Treatment May Increase Adverse Outcomes in Patients With COVID-19 and Diabetes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yan Yang ◽  
Zixin Cai ◽  
Jingjing Zhang
Keyword(s):  
Hospital Admission ◽  
Insulin Therapy ◽  
Large Scale ◽  
Insulin Treatment ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Hospitalization Time ◽  
Increased Risk ◽  
Significant Difference

Background and ObjectiveRecently, insulin treatment has been found to be associated with increased mortality and other adverse outcomes in patients with coronavirus disease 2019 (COVID-19) and diabetes, but the results remain unclear and controversial, therefore, we conducted this meta-analysis.MethodsFour databases, namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify all studies concerning insulin treatment and the adverse effects of COVID-19, including mortality, incidence of severe/critical complications, in-hospital admission and hospitalization time. To assess publication bias, funnel plots, Begg’s tests and Egger’s tests were used. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to access the effect of insulin therapy on mortality, severe/critical complications and in-hospital admission. The association between insulin treatment and hospitalization time was calculated by the standardized mean difference (SMD) with 95% CIs.ResultsEighteen articles, involving a total of 12277 patients with COVID-19 and diabetes were included. Insulin treatment was significantly associated with an increased risk of mortality (OR=2.10; 95% CI, 1.51-2.93) and incidence of severe/critical COVID-19 complications (OR=2.56; 95% CI, 1.18-5.55). Moreover, insulin therapy may increase in-hospital admission in patients with COVID-19 and diabetes (OR=1.31; 95% CI, 1.06-1.61). However, there was no significant difference in the hospitalization time according to insulin treatment (SMD=0.21 95% CI, -0.02-0.45).ConclusionsInsulin treatment may increase mortality and severe/critical complications in patients with COVID-19 and diabetes, but more large-scale studies are needed to confirm and explore the exact mechanism.

scholarly journals Intelligence and neuroticism in relation to depression and psychological distress: Evidence from two large population cohorts

2017 ◽  
Vol 43 ◽  
pp. 58-65 ◽  
Author(s):  
L.B. Navrady ◽  
S.J. Ritchie ◽  
S.W.Y. Chan ◽  
D.M. Kerr ◽  
M.J. Adams ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Protective Factor ◽  
Short Form ◽  
Large Population ◽  
Family Health ◽  
Population Based ◽  
Health Study ◽  
Increased Risk ◽  
Ability Tests ◽  
Risk For Depression

AbstractBackground:Neuroticism is a risk factor for selected mental and physical illnesses and is inversely associated with intelligence. Intelligence appears to interact with neuroticism and mitigate its detrimental effects on physical health and mortality. However, the inter-relationships of neuroticism and intelligence for major depressive disorder (MDD) and psychological distress has not been well examined.Methods:Associations and interactions between neuroticism and general intelligence (g) on MDD, self-reported depression, and psychological distress were examined in two population-based cohorts: Generation Scotland: Scottish Family Health Study (GS:SFHS, n = 19,200) and UK Biobank (n = 90,529). The Eysenck Personality Scale Short Form-Revised measured neuroticism and g was extracted from multiple cognitive ability tests in each cohort. Family structure was adjusted for in GS:SFHS.Results:Neuroticism was strongly associated with increased risk for depression and higher psychological distress in both samples. Although intelligence conferred no consistent independent effects on depression, it did increase the risk for depression across samples once neuroticism was adjusted for. Results suggest that higher intelligence may ameliorate the association between neuroticism and self-reported depression although no significant interaction was found for clinical MDD. Intelligence was inversely associated with psychological distress across cohorts. A small interaction was found across samples such that lower psychological distress associates with higher intelligence and lower neuroticism, although effect sizes were small.Conclusions:From two large cohort studies, our findings suggest intelligence acts a protective factor in mitigating the effects of neuroticism on psychological distress. Intelligence does not confer protection against diagnosis of depression in those high in neuroticism.

Peculiarities of hormonal balance and metabolic profile in pregnant women with different obesity types

2020 ◽  
pp. 67-72
Author(s):  
К. Tyshko ◽  
◽  
О. Gnatko ◽  
Keyword(s):  
Adipose Tissue ◽  
Pregnant Women ◽  
Metabolic Profile ◽  
Free Testosterone ◽  
Placental Lactogen ◽  
Control Group ◽  
Homa Index ◽  
Increased Risk ◽  
Significant Difference ◽  
Hormonal Balance

Maternal obesity has become one of the main factors influencing obstetric and perinatal outcomes. Obesity in pregnant women increases the risk of complications during pregnancy, childbirth and the postpartum period. The newborns of obese women also have higher rates of perinatal morbidity and an increased risk of long-term health problems. The objective: to learn hormonal and metabolic peculiarities in pregnant women with different obesity types during full-term pregnancy. Materials and methods. We examined 61 pregnant women with android type and 57 pregnant women with gynoid type of obesity at 39.6–40.6 weeks of gestation and 57 pregnant women without obesity and overweight. The concentration of estradiol, free estriol, insulin, placental lactogen, free testosterone, cortisol, dehydroepialdosterone sulfate (DHEA sulfate), and serum progesterone by enzyme-linked immunosorbent method and glucose rate by glucose-oxydase method were determined. The HOMA index was determined. Results. In pregnant women with gynoid obesity type, the level of progesterone was 41.15 (34.6–48) ng/ml, with android type – 35.7 (32.6–40.6) ng/ml and with physiological body weight 35.4 (33.2–40) ng/ml (p<0.05). While determining the concentration of placental lactogen in three groups there were no significant differences. There was a decrease (p<0,05) in the level of free estriol in groups of pregnant women with android and gynoid type of obesity in comparison with the control group, respectively 13.9 (13.1–14.9) ng/ml, 13.6 (12, 4–15.4) ng/ml and 14.7 (13.6–15.8) ng/ml. The concentration of estradiol in second group was 24 925.3 (20 206.6–30 400.5) pg/ml, which is 1.2 times (p<0.05) higher as in the control group and 1.4 times higher as in first group. In pregnant women with android-type obesity, estradiol levels were 1.2 times lower (p<0.05) compared with the control group. The concentration of cortisol in pregnant women with android type was 812.1 (599–1235.15) nmol/l, which is 2.7 times higher (p<0.05) compared to the women with gynoid type of obesity and 1.5 times higher (p<0.05) than in the control group. In pregnant women with gynoid type of obesity, 1.7 times lower (p<0.05) cortisol levels were observed in comparison with control group. The level of free testosterone was 2.4 (1.7–3.1) nmol/l in pregnant women of first group, what was higher (p<0.05) than in second group and in control group, respectively 1 (0.8–1.5) nmol/l and 1.9 (1.6–2.3) nmol/l. Pregnant women in group 1 had 2.4 times higher (p<0.05) testosterone levels compared to group 2 and 1.2 times higher (p<0.05) than in control group. In women with android type, the concentration of DHEA sulfate was 2.4 times higher (p<0.05) than in pregnant women with gynoid type and 2.1 times higher (p<0.05) compared with the control group. Pregnant women with android type of obesity have a significantly higher (p<0.05) serum insulin concentration of 67 (40–94.5) μIU / ml compared to women with gynoid type of obesity 33.3 (25.6–43) μIU/ml. When determining the glucose concentration no significant difference between three groups was found. The HOMA index in pregnant women with android type of obesity was 2.1 times higher than in pregnant women with gynoid type and 2.3 times higher than in control group (p<0.05). Conclusions. The results of a study indicate that the type of distribution of adipose tissue is important during pregnancy and childbirth because the hormonal and metabolic activity of adipose tissue in android and gynoid obesity types are different. Keywords: android type of obesity, pregnancy, gynoid type of obesity, hormonal balance, metabolic profile.

Pregnancy-Related RBC Alloimmunization in Sickle Cell Trait Patients; A Single-Center Experience

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Mohammad Barouqa ◽  
Carlos Castrodad-Rodriguez ◽  
Morayma Reyes Gil ◽  
Randin Nelson ◽  
James Szymanski ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Globin Gene ◽  
Autosomal Recessive Disorder ◽  
Transfusion Therapy ◽  
Single Center Experience ◽  
Clinical Complications ◽  
Increased Risk ◽  
Significant Difference ◽  
In Pregnancy

Abstract Background Sickle Cell Disease (SCD) is an autosomal recessive disorder, which results from a point mutation in the β-globin gene. The production of mutant Hb S (V6E) leads to hemolytic anemia and numerous clinical complications. Patients homozygous for HbS gene (SS) typically rely on life-long transfusion therapy. Alloimmunization to foreign RBC antigens in multiply transfused patients is significantly more frequent in SS patients (observed in 7–47%) compared to patients with HbA (AA), and can pose a significant hurdle in finding compatible RBCs. However, the mechanism for enhanced alloimmunization in SS patients has not yet been elucidated. Patients heterozygous for HbS (SA) have a no distinct clinical phenotype and do not typically require transfusions. We investigated the rate of RBC antigen alloimmunization and specificity in SA patients. Aim The aim of this study was to determine and compare the rate and specificities of RBC antigen pregnancy-related alloimmunization in SA and AA patients. Methods In our retrospective study, we identified females who delivered a newborn between January 2014 to October 2019, for whom prenatal hemoglobin electrophoresis testing, and prenatal and perinatal antibody screening and identification was performed. R (V.3.6.2) statistical computing program was used for analysis. Results A total of 41735 subjects were identified: 40058 (AA) and 1677 (SA). African Americans were more prevalent in the SA compared to the AA group (55.8% vs 29.4%, P&lt;0.01)and were more likely to have received ≥ 1 transfusion during pregnancy (4.5% vs 3.3%, P&lt;0.01). A total number of 267 alloantibodies were detected in 246 patients (0.6% of the studied population) during pregnancy, 228 patients (0.6%) in the AA group and 18 patients (1.1%) in the SA group.229/246 (93%) of patients with antibodies did not receive transfusion during pregnancy, and thus antibodies were considered to represent pregnancy-related alloimmunization. In non-transfused subjects the SA group were more likely to have developed alloantibodies in pregnancy compared to the AA group [OR= 1.94, P=0.015]. The median age of patients with antibodies in the SA was older [33.5 vs 27 (p=0.008)] as compared to those in the AA group [29 vs 27 (p=0.002)]. The most common antibody identified was anti-E (SA 42% vs AA 28%), anti-Lea (SA 21% vs AA 13%) and anti-C (SA 5% vs AA 12%). Subjects with pre-existing alloantibodies had a 5.4x increased risk of forming a new allo-antibody. However only 0.1% of subjects had a history of prior allo-antibodies, with no significant difference identified between AA and SA. Conclusions SA patients were found to have an increased rate of pregnancy-related alloimmunization (OR 1.75, P=0.02) after adjusting for the effects of increasing age, RH type, ethnicity, number of previously existing antibodies and number of transfusions in pregnancy.

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

Interpersonal Violence and Substance Use Among Female Sexual Minorities

2019 ◽  
Author(s):  
Cort M. Dorn-Medeiros ◽  
Cass Dykeman ◽  
Timothy Bergquist
Keyword(s):  
New York ◽  
Tobacco Use ◽  
Interpersonal Violence ◽  
Sexual Minorities ◽  
Sample Population ◽  
Life Outcomes ◽  
City Community ◽  
Increased Risk ◽  
Significant Difference ◽  
Community Health Survey

This archived data study used results from the New York City Community Health Survey to explore the relationship between interpersonal violence among female sexual minorities (FSM) and their levels of alcohol and tobacco use. A total of 92 FSM were included in the sample population. There was a significant difference in the mean number of alcoholic drinks consumed between FSM who reported past experience of interpersonal violence and those who did not. No difference was found in levels of tobacco use between FSM who reported interpersonal violence and those who did not. Results of the present study support current research indicating FSM may be at increased risk for elevated alcohol use and respective negative life outcomes related to the experience of interpersonal violence.

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