scholarly journals Predicting the risk of severe menopausal syndrome in perimenopausal women with hypothyroidism

2021 ◽  
Vol 17 (3) ◽  
pp. 219-225
Author(s):  
N.V. Pasechko ◽  
O.O. Chukur ◽  
A.O. Bob ◽  
A.S. Sverstiuk
Keyword(s):  
Mathematical Model ◽  
Regression Analysis ◽  
Risk Factor ◽  
High Risk ◽  
High Risk Group ◽  
Coefficient Of Determination ◽  
Endocrine Disorders ◽  
Average Risk ◽  
Menopausal Syndrome ◽  
Perimenopausal Women

Background. Every year the number of menopausal women increases. At this age, the prevalence of hypothyroidism (HT) reaches its peak. The problem of menopausal syndrome (MS) is relevant for patients with HT, concomitant endocrine disorders create a background for combination with dyshormonal factors. The purpose of the study: to propose an approach to predicting the risk of severe MS in perimenopausal women with HT according to the developed algorithm and mathematical model. Materials and methods. To predict the development of MS, 146 perimenopausal women with autoimmune HT were surveyed. ­Using multiple regression analysis, a prognostic model of the risk of severe MS was created. Results. Logistic regression analysis revealed the following most significant multicollinear risk factors for MS: smoking, alcohol consumption, adverse environmental conditions, physical activity, history of stress and anxiety, thyroid disease. A correlation matrix with calculation of regression coefficients and coefficient of determination was constructed, a mathematical model was created to determine the risk factor for the progression of MS. The predicted value of the risk factor for severe MS with a high degree of probability was determined in 72 (49.32 %) women, with an average probability — in 58 (39.73 %), and with a low probability — in 16 women (10.95 %) with HT. The correspondence of the predicted results with the theoretically expected ones in the high-risk group was recorded in 104.37 %, in the average-risk — in 94.73 %, and in the low-risk — in 89.65 % of cases. Conclusions. The developed algorithm and mathematical model for predicting severe MS on the background of HT are highly informative and allow determining in advance the group of women at high risk of severe MS for the timely implementation of appropriate preventive measures.

scholarly journals Risk factors and prognosis of metabolic syndrome in perimenopausal women with hypothyroidism

2021 ◽  
pp. 28-34
Author(s):  
N. V. Pasyechko ◽  
O. O. Chukur
Keyword(s):  
Risk Factors ◽  
Mathematical Model ◽  
Metabolic Syndrome ◽  
Regression Analysis ◽  
Predictive Accuracy ◽  
Thyroid Stimulating Hormone ◽  
Coefficient Of Determination ◽  
Endocrine Disorders ◽  
The Metabolic Syndrome ◽  
Perimenopausal Women

One of the main problems is that the metabolic syndrome (MS) is not clinically manifested until thesignificant carbohydrate and lipid metabolism violations, that initiate a pathological range of symptoms, leading to cardiovascular disease, diabetes mellitus, non-alcoholic steatohepatosis, impairment of reproductive function and other diseases. Conco­mitant endocrine disorders create a background on which dyshormonal and metabolic factors are superimposed. Therefore, an urgent and important task is the correct, and most importantly timely, interpretation of existing risk factors for metabolic disorders in women of perimenopausal age with concomitant hypothyroidism (HT), purposed on their correction to prevent or slowdown the development of complications.Aim — to develop a mathematical model for assessing the prognostic value of risk factors for investigation ofMSdevelopment and progression in perimenopausal women with HT.Materials and methods. 146 perimenopausal women with HT were examined to predict the MS development. Multiple regression analysis was used to construct prognostic model of MS risk.Results. With the help of logistic regression analysis, the following significant multicollinear risk factors for MS have been identified: triglycerides, thyroid-stimulating hormone, vitamin D, and waist circumference. A correlation matrix with the calculation of regression coefficients and coefficient of determination was constructed, and mathematical model was created to determine the coefficient of the MSprogression. The developed mathematical model for predicting of MSdevelopment had a high predictive accuracy, which confirms the compliance of the predicted results with the theoretically expected. The probability that patients will develop MS with a previously predicted risk of MS was 96.1 % (p < 0.05).Conclusions. The developed mathematical model of the predictionof metabolic syndromedevelopment against the background of hypothyroidism is highly informative and allows to determine in advance the contingent of women with high probability of MS development for the timely implementation of appropriate preventive measures.

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals Intensive Multiagent Therapy, Including Dose-Compressed Cycles of Ifosfamide/Etoposide and Vincristine/Doxorubicin/Cyclophosphamide, Irinotecan, and Radiation, in Patients With High-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group

2016 ◽  
Vol 34 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Brenda J. Weigel ◽  
Elizabeth Lyden ◽  
James R. Anderson ◽  
William H. Meyer ◽  
David M. Parham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Bone Marrow Involvement ◽  
High Risk Group ◽  
Historical Cohort ◽  
Dismal Prognosis ◽  
Risk Patients ◽  
Metastatic Sites

Purpose Patients with metastatic rhabdomyosarcoma (RMS), except those younger than 10 years with embryonal RMS, have an estimated long-term event-free survival (EFS) of less than 20%. The main goal of this study was to improve outcome of patients with metastatic RMS by dose intensification with interval compression, use of the most active agents determined in phase II window studies, and use of irinotecan as a radiation sensitizer. Patients and Methods Patients with metastatic RMS received 54 weeks of therapy: blocks of therapy with vincristine/irinotecan (weeks 1 to 6, 20 to 25, and 47 to 52), interval compression with vincristine/doxorubicin/cyclophosphamide alternating with etoposide/ifosfamide (weeks 7 to 19 and 26 to 34), and vincristine/dactinomycin/cyclophosphamide (weeks 38 to 46). Radiation therapy occurred at weeks 20 to 25 (primary) but was also permitted at weeks 1 to 6 (for intracranial or paraspinal extension) and weeks 47 to 52 (for extensive metastatic sites). Results One hundred nine eligible patients were enrolled, with a median follow-up of surviving patients of 3.8 years (3-year EFS for all patients, 38% [95% CI, 29% to 48%]; survival, 56% [95% CI, 46% to 66%]). Patients with one or no Oberlin risk factor (age > 10 years or < 1 year, unfavorable primary site of disease, ≥ three metastatic sites, and bone or bone marrow involvement) had a 3-year EFS of 69% (95% CI, 52% to 82%); high-risk patients with two or more risk factors had a 3-year EFS of 20% (95% CI, 11% to 30%). Toxicity was similar to that on prior RMS studies. Conclusion Patients with metastatic RMS with one or no Oberlin risk factor had an improved 3-year EFS of 69% on ARST0431 compared with an historical cohort from pooled European and US studies; those with two or more risk factors have a dismal prognosis, and new approaches are needed for this very-high-risk group.

scholarly journals A Risk Signature of Nine Autophagy-Related Genes Associated With Immune Microenvironment and Clinical Prognosis in Wilms Tumor

2021 ◽  
Author(s):  
Shaopei Ye ◽  
Wenbin Tang ◽  
Ke Huang
Keyword(s):  
Regression Analysis ◽  
High Risk ◽  
Risk Score ◽  
Cox Regression ◽  
Wilms Tumor ◽  
Risk Group ◽  
High Risk Group ◽  
Differentially Expressed ◽  
Clinical Prognosis ◽  
Cox Regression Analysis

Abstract Background: Autophagy is a biological process to eliminate dysfunctional organelles, aggregates or even long-lived proteins. . Nevertheless, the potential function and prognostic values of autophagy in Wilms Tumor (WT) are complex and remain to be clarifed. Therefore, we proposed to systematically examine the roles of autophagy-associated genes (ARGs) in WT.Methods: Here, we obtained differentially expressed autophagy-related genes (ARGs) between healthy and Wilms tumor from Therapeutically Applicable Research To Generate Effective Treatments(TARGET) and The Cancer Genome Atlas (TCGA) database. The functionalities of the differentially expressed ARGs were analyzed using Gene Ontology. Then univariate COX regression analysis and multivariate COX regression analysis were performed to acquire nine autophagy genes related to WT patients’ survival. According to the risk score, the patients were divided into high-risk and low-risk groups. The Kaplan-Meier curve demonstrated that patients with a high-risk score tend to have a poor prognosis.Results: Eighteen DEARGs were identifed, and nine ARGs were fnally utilized to establish the FAGs based signature in the TCGA cohort. we found that patients in the high-risk group were associated with mutations in TP53. We further conducted CIBERSORT analysis, and found that the infiltration of Macrophage M1 was increased in the high-risk group. Finally, the expression levels of crucial ARGs were verifed by the experiment, which were consistent with our bioinformatics analysis.Conclusions: we emphasized the clinical significance of autophagy in WT, established a prediction system based on autophagy, and identified a promising therapeutic target of autophagy for WT.

scholarly journals The Impact of Preoperative Risk on the Association between Hypotension and Mortality after Cardiac Surgery: An Observational Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2057
Author(s):  
Vanja Ristovic ◽  
Sophie de Roock ◽  
Thierry G. Mesana ◽  
Sean van Diepen ◽  
Louise Y. Sun
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
High Risk ◽  
Hospital Mortality ◽  
Risk Group ◽  
High Risk Group ◽  
Group Care ◽  
Intermediate Risk ◽  
Intraoperative Hypotension ◽  
The Impact

Background: Despite steady improvements in cardiac surgery-related outcomes, our understanding of the physiologic mechanisms leading to perioperative mortality remains incomplete. Intraoperative hypotension is an important risk factor for mortality after noncardiac surgery but remains relatively unexplored in the context of cardiac surgery. We examined whether the association between intraoperative hypotension and in-hospital mortality varied by patient and procedure characteristics, as defined by the validated Cardiac Anesthesia Risk Evaluation (CARE) mortality risk score. Methods: We conducted a retrospective cohort study of consecutive adult patients who underwent cardiac surgery requiring cardiopulmonary bypass (CPB) from November 2009–March 2015. Those who underwent off-pump, thoracic aorta, transplant and ventricular assist device procedures were excluded. The primary outcome was in-hospital mortality. Hypotension was categorized by mean arterial pressure (MAP) of <55 and between 55–64 mmHg before, during and after CPB. The relationship between hypotension and death was modeled using multivariable logistic regression in the intermediate and high-risk groups. Results: Among 6627 included patients, 131 (2%) died in-hospital. In-hospital mortality in patients with CARE scores of 1, 2, 3, 4 and 5 was 0 (0%), 7 (0.3%), 35 (1.3%), 41 (4.6%) and 48 (13.6%), respectively. In the intermediate-risk group (CARE = 3–4), MAP < 65 mmHg post-CPB was associated with increased odds of death in a dose-dependent fashion (adjusted OR 1.30, 95% CI 1.13–1.49, per 10 min exposure to MAP < 55 mmHg, p = 0.002; adjusted OR 1.18 [1.07–1.30] per 10 min exposure to MAP 55–64 mmHg, p = 0.001). We did not observe an association between hypotension and mortality in the high-risk group (CARE = 5). Conclusions: Post-CPB hypotension is a potentially modifiable risk factor for mortality in intermediate-risk patients. Our findings provide impetus for clinical trials to determine if hemodynamic goal-directed therapies could improve survival in these patients.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea

2017 ◽  
Vol 58 (1) ◽  
pp. 16-24
Author(s):  
Insook Kim ◽  
Seonae Won ◽  
Mijin Lee ◽  
Won Lee
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Environmental Factors ◽  
Fall Prevention ◽  
Systems Approach ◽  
Risk Group ◽  
Past History ◽  
High Risk Group ◽  
Fall Injuries

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

scholarly journals Association of ABO Blood Types and Clinicopathological Features of Prostate Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fang-Ming Wang ◽  
Yan Zhang ◽  
Gui-Ming Zhang ◽  
Ya-Nan Liu ◽  
Li-Jiang Sun ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Regression Analysis ◽  
High Risk ◽  
Gleason Score ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
High Risk Group ◽  
Blood Type ◽  
Blood Types ◽  
Significant Difference

Purpose. To investigate the association between ABO blood types and clinicopathological characteristics in patients with prostate cancer (PC). Methods. A total of 237 pathologically diagnosed PC patients were enrolled. All patients were classified as low–middle or high-risk group. The correlation of ABO blood types with high-risk PC was determined by univariate and multivariate regression analysis. Results. Data indicated 144 (85.7%) patients were stratified as high risk in the non-O group, while 50 (72.5%) patients in the O group (p=0.025). However, there was no significant difference regarding PSA, Gleason score, stage, or metastasis between O and non-O group (p>0.05). Univariate logistic regression analyses revealed PSA, Gleason score, and blood type non-O were all correlated with high-risk PC (OR = 1.139, p<0.001; OR = 9.465, p<0.001; OR = 2.280, p=0.018, resp.). In the stepwise multivariate regression analysis, the association between blood type non-O and high-risk PC remained significant (OR = 33.066, 95% CI 2.391–457.323, and p=0.009) after adjusting for confounding factors as well as PSA and Gleason score. Conclusion. The present study firstly demonstrated that non-O blood type was at higher risk of aggressive PC compared with O type, suggesting that PC patients with non-O blood type should receive more attention in clinical practice.

scholarly journals Fatty liver index as a predictive marker for the development of diabetes: A retrospective cohort study using Japanese health check-up data

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257352
Author(s):  
Atsushi Kitazawa ◽  
Shotaro Maeda ◽  
Yoshiharu Fukuda
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Fatty Liver ◽  
Risk Group ◽  
High Risk Group ◽  
Health Check ◽  
Incident Diabetes ◽  
Standard Group ◽  
Fatty Liver Index

Background & aims Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population. Methods This was a retrospective study using the Japanese health check-up database of one health insurance from FY2015 to FY2018. This study included 28,991 individuals with prediabetes. First, we stratified all participants into two groups: “high-risk,” comprising patients with HbA1c >6.0%, and “standard,” comprising the rest. Subsequently, we divided them into four groups according to FLI (<30 or not) and obesity (BMI <25 kg/m2 or not). Subsequently, the incidence rate of diabetes was compared among the groups after 3 years of follow-up using multiple logistic regression models after adjusting for potential confounders. Results After 3 years of follow-up, 1,547 new cases of diabetes were found, and the cumulative incidence was 2.96% for the standard group and 26.1% for the high-risk group. In non-obese individuals, odds ratios (95% confidence interval) for FLI ≥30 versus FLI <30 were: 1.44 (1.09–1.92) for the standard group and 1.42 (0.99–2.03) for the high-risk group. In the high-risk group, obesity (BMI ≥25 kg/m2) but FLI <30 was not a risk factor for developing diabetes. Conclusion Although high FLI is generally considered to be a risk factor for developing diabetes, obesity might have been a confounding factor. However, the present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals. Our results include suggestion to develop a screening tool to effectively identify people at high risk of developing diabetes from the population (especially non-obese prediabetes) who are apparently at low health risk and are unlikely to be targeted for health guidance.

scholarly journals A Novel Signature to Predict Thyroid Cancer Prognosis and Immune Landscape Using Immune-Related LncRNA Pairs

2021 ◽  
Author(s):  
BO SONG ◽  
Lijun Tian ◽  
Fan Zhang ◽  
Zheyu Lin ◽  
Boshen Gong ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Cancer ◽  
High Risk ◽  
Small Molecule ◽  
Immune Cell ◽  
Cox Regression ◽  
Risk Group ◽  
High Risk Group ◽  
Immune Cell Infiltration ◽  
Cox Regression Analysis

Abstract Background: Thyroid cancer (TC) is the most common endocrine malignancy worldwide. The incidence of TC is high and increasing worldwide due to continuous improvements in diagnostic technology. TC is still often overtreated due to a lack of reliable diagnostic biomarkers. Therefore, determining accurate prognostic predictions to stratify TC patients is important.Methods: Raw data were downloaded from the TCGA database, and pairwise comparisons were applied to identify differentially expressed immune-related lncRNA (DEirlncRNA) pairs. Then, we used univariate Cox regression analysis and a modified Lasso algorithm on these pairs to construct a risk assessment model for TC. Next, TC patients were assigned to high- and low-risk groups based on the optimal cutoff score of the model for the 1-year ROC curve. We evaluated the signature in terms of prognostic independence, predictive value, immune cell infiltration, ICI-related molecules and small-molecule inhibitor efficacy. Results: We identified 30 DEirlncRNA pairs through Lasso regression, and 14 pairs served as the novel predictive signature. The high-risk group had a significantly poorer prognosis than the low-risk group. Cox regression analysis revealed that this immune-related signature can predict prognosis independently and reliably for TC. With the CIBERSORT algorithm, we found an association between the signature and immune cell infiltration. Additionally, several immune checkpoint inhibitor (ICI)-related molecules, such as PD-1 and PD-L1, showed a negative correlation with the high-risk group. We further found that some commonly used small-molecule inhibitors, such as sunitinib, were related to this new signature. Conclusions: We constructed a prognostic immune-related lncRNA signature that can predict TC patient survival without considering the technical bias of different platforms, and this signature also sheds light on TC overall prognosis and novel clinical treatments, such as ICB therapy and small molecular inhibitors.

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