scholarly journals Maternal Characteristics, Pregnancy, and Neonatal Outome in Preeclampsia and HELLP Syndrome: a Comparative Study

2021 ◽  
Vol 9 (1) ◽  
pp. 7
Author(s):  
Ali Sungkar ◽  
Rima Irwinda ◽  
Raymond Surya ◽  
Andrew Pratama Kurniawan
Keyword(s):  
Risk Factor ◽  
Gestational Age ◽  
Hellp Syndrome ◽  
Neonatal Outcome ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Previous Pregnancy ◽  
Maternal Characteristics ◽  
Gestational Age At Delivery ◽  
History Of

HELLP syndrome is a complication in pregnancy which may increase maternal morbidity and mortality risk. This study aims to compare maternal characteristics, pregnancy and neonatal outcome between preeclampsia and HELLP syndrome. All preeclampsia without or with severe features and HELLP syndrome using ACOG criteria coming to dr. Cipto Mangunkusumo Hospital from January 2015 to December 2017 were recruited into this cross-sectional study. Demographic, clinical, laboratories parameters, and neonatal outcomes were compared between HELLP and preeclampsia patients. The SPSS 20 for Windows was used for all analyses. There were 676 deliveries which was complicated by preeclampsia without or with severe features and 113 patients with HELLP syndrome. Gestational age, history of hypertension systolic and diastolic blood pressure, hemoglobin, hematocrit, urea, creatinine, uric acid, and albumin are different significantly between HELLP and preeclampsia patients. History of hypertension in previous pregnancy is considered as a significant risk factor for HELLP syndrome (p=0.001); RR 2.33 (95% CI 1.41–3.9). Based on data of gestational age at delivery which lower in HELLP syndrome, it showed lower median birth weight in HELLP syndrome (1442.5 g) compared with preeclampsia (1442.5 g vs 2400 g, p=; 95%CI There is significant difference in gestational age at delivery, nullipara, blood pressure, and laboratory findings (urea, creatinine, uric acid, albumin) between preeclampsia and HELLP syndrome group. History of hypertension in previous pregnancy is a significant risk factor for HELLP syndrome. Regarding neonatal outcome, baby born from HELLP syndrome has lower median birth weight. Keywords: HELLP syndrome, preeclampsia, risk factor, neonatal outcome.   Karakteristik Maternal, Luaran Kehamilan, dan Neonatal pada Preeklamsia dan Sindrom HELLP: Studi Komparatif Abstrak Sindrom HELLP merupakan komplikasi kehamilan yang meningkatkan morbiditas dan mortalitas maternal. Studi ini bertujuan untuk mengetahui perbedaan karakteristik antara sindrom HELLP dan preeklamsia serta luaran neonatus. Studi potong lintang ini melibatkan seluruh pasien preeklamsia dengan atau tanpa perburukan dan sindrom HELLP berdasarkan kriteria ACOG yang datang ke RS dr. Cipto Mangunkusumo pada bulan Januari 2015 sampai Desember 2017. Analisis bivariat digunakan untuk mengetahui hubungan karakteristik demografi, klinis, laboratorium antara pasien HELLP dan preeklamsia sedangkan analisis multivariat untuk mengetahui karakteristik yang memengaruhi sindrom HELLP. Data dianalisis menggunakan SPSS 20. Terdapat 676 persalinan pada kelompok preeklamsia dengan atau tanpa perburukan dan 113 pasien dengan sindrom HELLP. Usia kehamilan, tekanan darah sistolik dan diastolik, hemoglobin, hematokrit, ureum, kreatinin, asam urat, dan albumin berbeda bermakna antara pasien sindrom HELLP dan preeklamsia. Riwayat hipertensi pada kehamilan sebelumnya dianggap sebagai faktor risiko terhadap sindrom HELLP (p=0,001); RR 2,33 (IK 95% 1,41-3,9). Berdasarkan usia kehamilan saat persalinan yang lebih awal dan bayi lahir lebih rendah pada sindrom HELLP (1442,5 g) dibandingkan preeklamsia (2400 g). Terdapat perbedaan bermakna pada usia kehamilan saat persalinan, tekanan darah, dan parameter laboratorium (ureum, kreatinin, asam urat, albumin) antara kelompok preeklamsia dan sindrom HELLP. Berdasarkan luaran neonatus, bayi dari sindrom HELLP lebih rendah berat lahirnya. Kata kunci: sindrom HELLP, preeklamsia, faktor risiko, luaran neonatus

Risk Factors for Silent Cerebral Infarcts in a Pediatric Sickle Cell Anemia (SCA) Cohort

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2487-2487 ◽  
Author(s):  
Francoise Bernaudin ◽  
Suzanne Verlhac ◽  
Annie Kamdem ◽  
Cécile Arnaud ◽  
Lena Coïc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Logistic Regression Analysis ◽  
G6pd Deficiency ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
History Of ◽  
Independent Risk Factors

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 (< 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<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<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<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.

scholarly journals History of miscarriage as a risk factor for hepatitis C virus infection in pregnant Iraqi women

2002 ◽  
Vol 8 (2-3) ◽  
pp. 239-244
Author(s):  
W. A. Al Kubaisy ◽  
A. D. Niazi ◽  
K. Kubba
Keyword(s):  
Risk Factor ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hepatitis C Virus Infection ◽  
History Of ◽  
Iraqi Women ◽  
Hcv Genotyping

Sera from 3491 pregnant women were screened for the presence of HCV antibodies [anti-HCV]. HCV genotyping was also performed on the sera of 94 women. The overall anti-HCV seroprevalence was 3.21%. Anti-HCV seroprevalence was significantly positively correlated with the number of miscarriages. Miscarriage was a significant risk factor for the acquisition of HCV infection from the first miscarriage up to the fifth, the risk increasing with increasing number of miscarriages. A higher proportion of women with a history of miscarriage harboured HCV-1b compared to those with no miscarriage.

Abstract 13889: The Influence of Depression on Dementia Risk in Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
T Jared Bunch ◽  
Tami L Bair ◽  
Stacey Knight ◽  
Benjamin A Steinberg ◽  
Jeffrey L Anderson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Population Based ◽  
Late Life Depression ◽  
Adjusted Risk ◽  
Relative Risks ◽  
History Of ◽  
History Of Depression

Background: Atrial Fibrillation (AF) is a significant risk factor for multiple forms of dementia. Although late-life depression may be a manifestation of dementia, earlier-life depression is a risk factor for dementia. The influence of earlier-life depression in patients with AF as a risk factor for dementia is unknown. Methods: AF patients (January 1, 1990-August 8, 2016) with no history of dementia and at least 3 years of follow-up derived from the Intermountain Healthcare Registry were included. Patients were compared by the presence or absence of depression at baseline. The primary endpoints were the development of dementia (total)imer’s disease. Results: Among 132,703 AF patients, 19,757 (14.9%) had a history of depression. Of these, 10,044 (50.8%) had SSRI use prior to AF diagnosis. The mean time from depression diagnosis to AF diagnosis was 5.0±4.8 years. AF patients with a history of depression were younger, more often female, and had higher rates of hypertension, diabetes, and heart failure. Patients with depression had a significantly higher multivariable-adjusted risk of dementia at 3 years (HR: 1.74 (1.59, 1.90), p<0.0001) and 5 years (HR: 1.73 (1.61, 1.86), p<0.0001), independent of the length of time between depression and AF diagnosis. Landmark analysis showed patients with depression and AF have much higher rates of dementia after 3 years (HR 1.51 (1.40, 1.63), p<0.0001) and after 5 years (HR 1.47 (1.34, 1.61), p<0.0001), Figure. These relative risks with depression are greater than composite risks of AF and dementia alone (HR 1.36) derived from multiple population-based studies. Conclusions: Patients with a history of depression prior to AF diagnosis have much higher rates of dementia after the onset of the arrhythmia. The presence of earlier-life depression should be recognized as an important risk factor for dementia in AF patients and may represent a therapeutic target to lower risk of cognitive decline.

Greek Registry Of Essential Thrombocythemia: Baseline Characteristics and Therapeutic Strategy

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4084-4084
Author(s):  
Damianos Sotiropoulos ◽  
Argiris Symeonidis ◽  
Vassilios K Papadopoulos ◽  
Panagiotis Tsirigotis ◽  
Maria Pagoni ◽  
...  
Keyword(s):  
Risk Factor ◽  
Significant Risk ◽  
Jak2 V617f ◽  
Significant Risk Factor ◽  
First Line ◽  
Platelet Counts ◽  
First Line Therapy ◽  
Line Therapy ◽  
History Of

Abstract The Greek Registry of Essential Thrombocythemia (ET) is implemented under the auspices of the Acute Leukemias and Myeloproliferative Neoplasms Study Group of the Hellenic Society of Haematology. Hereby, we present results after four years of retrospective data collection. The total number of patients included is 1078, from 14 Greek sites; ET was diagnosed between 1982 and 2012. The male to female ratio is 1:1.19. Median age at diagnosis is 63 years, median platelet counts (PLT) 826x109/L, hemoglobin (Hb) 13.6 g/dL, white blood cell counts (WBC) 9.4x109/L. The presenting symptoms were a thrombotic event in 6.8%, a hemorrhagic event in 1.5% of patients. In 79.8% of the patients the diagnosis was made after incidental finding of elevated platelet counts on routine laboratory investigation. Molecular studies were performed in 677 patients and 42.8% of them were positive for the JAK2-V617F mutation. The presence of JAK2-V617F mutation (mutant vs wild type allele) was associated with baseline platelet counts (757.5 vs 882 x109/L) and hemoglobin levels (14.4 vs 13.4 g/dL), p<0.001 (Mann-Whitney U-test). A history of thrombosis or hemorrhage was present in 18.6% and 6.6% of patients respectively. Chi-square test was performed to assess whether platelet counts at diagnosis (<600, 600-800, >800 x109/L), Hb<13.8g/dL, WBC>9.5x109/L, or splenomegaly are associated with thrombotic or hemorrhagic events in the past medical history or during the follow-up of ET patients. The only statistically significant difference was observed in the occurrence of thrombosis during the follow up: 10.1% of those with PLT between 600-800 x109/L, 4.5% in PLT<600 and 5.6% in PLT>800 x109/L. To assess for possible confounders the multivariable logistic regression model was used, with independent variables the PLT at diagnosis, age >60 years, history of thrombosis and first line therapy. The history of thrombosis was the only statistically significant risk factor with odds ratio (OR) 3.9 (p=0.0005), while PLT was not a statistically significant risk factor (OR=2.5, p=0.074). Antiplatelet therapy was offered in 80% of patients (aspirin in 59.1%, clopidogrel in 4.7%, and combination therapy in 6.5%); anticoagulants (low molecular weight heparin or warfarin) were given in 2.3%, while the remaining 17.8% of patients did not receive any antithrombotic therapy. During the first six months post diagnosis, 31.6% of patients did not need any cytoreductive therapy. The rest 68.4% of the patients received first line therapy (hydroxyurea 80.6%, anagrelide 11.4% and interferon 5.4%). The response rates were 89.9%, 82.1% and 85.7%, respectively. Second-line therapy was received by 25.8% of the patients (hydroxyurea 23%, anagrelide 44.6%, interferon 9.5%), while the off-label combination of hydroxyurea and anagrelide was administered to 21.2% of the patients. Of the 852 patients treated with hydroxyurea as first line therapy, 12.1% switched to anagrelide and 1.2% to interferon. Of those initially treated with anagrelide, 27.6% switched to hydroxyurea and 8.2% to interferon. During the follow up phase, secondary solid tumor occurred in 4% and hematological malignancy in 2.7% of the patients. The aim of the registry and the subsequent data analysis is to convey the practice of managing the disease. Moreover, useful conclusions can be reached regarding to the patients’ responsiveness to therapy and the minimization of thrombotic and hemorrhagic adverse events. Disclosures: Spanoudakis: Genesis Hellas: Honoraria. Kotsianidis:Genesis Hellas: Honoraria, Research Funding.

scholarly journals Homicide in the Canadian Prairies: Elderly and Nonelderly Killings

2002 ◽  
Vol 47 (9) ◽  
pp. 875-879 ◽  
Author(s):  
AG Ahmed ◽  
Robin PD Menzies
Keyword(s):  
Risk Factor ◽  
Social Isolation ◽  
Clinical Characteristics ◽  
Psychiatric Treatment ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Canadian Prairies ◽  
Elderly Individuals ◽  
Male Perpetrators ◽  
History Of

Objective: To examine the psychosocial and clinical characteristics of male perpetrators of elderly and nonelderly homicides in the Canadian Prairies. Method: We examined data drawn from a study of 901 adult homicide offenders who were incarcerated or on parole between 1988 and 1992 in Alberta, Saskatchewan, and Manitoba. Results: Of those studied, 67 men were convicted of homicide involving 79 elderly victims, and 671 were convicted of homicide involving 675 nonelderly victims. Most perpetrators were single and engaged in irregular patterns of employment at the time of their index offence. Fourteen (20.8%) offenders with elderly victims had a history of psychiatric treatment, compared with 98 (14.6%) offenders with nonelderly victims; however, this difference was not statistically significant. Approximately 30% of both groups were diagnosed with personality disorders. A comparison of the index-offence characteristics showed no significant differences between the 2 groups. Conclusion: Our findings suggest that elderly individuals are more likely to be killed in their own homes by strangers. Social isolation appears to be a significant risk factor in cases of elderly homicide.

scholarly journals Treatment Trends in Dry Eye Disease and Factors Associated with Ophthalmic Follow-up Discontinuation in Japan

2019 ◽  
Vol 8 (8) ◽  
pp. 1120 ◽  
Author(s):  
Miki Uchino ◽  
Norihiko Yokoi ◽  
Motoko Kawashima ◽  
Yamanishi Ryutaro ◽  
Yuichi Uchino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Dry Eye ◽  
Past History ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
History Of

Despite the importance of dry eye disease (DED) treatment, the rate of DED treatment discontinuation, especially discontinuation of ophthalmic follow-up, remains unknown. This study aimed to assess the prevalence and risk factors of ophthalmic follow-up discontinuation for DED. A cross-sectional survey of 1030 participants was conducted using a self-administered web-survey instrument. We collected lifestyle information, history of DED diagnosis, types of treatment, frequency of eye-drop usage, symptoms, and the reasons for discontinuing treatment. Statistical analyses including logistic regression were used to evaluate the risk factors of discontinuing ophthalmic follow-up for DED. A past history of clinical DED diagnosis was reported by 155 (15.0%) subjects. Of those, 130 had persistent DED, and 88 (67.7%) of the subjects reported discontinuation of ophthalmic follow-up for DED. The most prevalent reasons for ophthalmic follow-up discontinuation were time restrictions, followed by dissatisfaction with the DED treatment. Duration after DED diagnosis was the only significant risk factor for discontinuing ophthalmic follow-up after adjusting for age and sex (odds ratio = 1.09, 95% confidence interval = 1.02–1.17, p = 0.009). In conclusion, longer DED duration after diagnosis was a significant risk factor for discontinuing ophthalmic follow-up for DED. This study showed that DED ophthalmic follow-up discontinuation involves both medical and non-medical reasons. Clinicians need to be aware of them, and preventative effort is needed to avoid discontinuation.

scholarly journals Impact of comorbid asthma on severity of coronavirus disease (COVID-19)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sang Chul Lee ◽  
Kang Ju Son ◽  
Chang Hoon Han ◽  
Ji Ye Jung ◽  
Seon Cheol Park
Keyword(s):  
Risk Factor ◽  
Respiratory Failure ◽  
Acute Exacerbation ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Asthma Patients ◽  
Charlson Comorbidity Score ◽  
History Of ◽  
Male Sex ◽  
Related Mortality

AbstractThe severity of the coronavirus disease (COVID-19) is associated with various comorbidities. However, no studies have yet demonstrated the potential risk of respiratory failure and mortality in COVID-19 patients with pre-existing asthma. We selected 7272 adult COVID-19 patients from the Korean Health Insurance Review and Assessment COVID-19 database for this nationwide retrospective cohort study. Among these, 686 patients with asthma were assessed by their severities and evaluated by the clinical outcome of COVID-19 compared to patients without asthma. Of 7272 adult COVID-19 patients, 686 with asthma and 6586 without asthma were compared. Asthma was not a significant risk factor for respiratory failure or mortality among all COVID-19 patients (odds ratio [OR] = 0.99, P = 0.997 and OR = 1.06, P = 0.759) after adjusting for age, sex, and the Charlson comorbidity score. However, a history of acute exacerbation (OR = 2.63, P = 0.043) was significant risk factors for death among COVID-19 patients with asthma. Asthma is not a risk factor for poor prognosis of COVID-19. However, asthma patients who had any experience of acute exacerbation in the previous year before COVID-19 showed higher COVID-19-related mortality, especially in case of old age and male sex.

Sulcal and ventricular trajectories in stereotactic surgery

2009 ◽  
Vol 110 (2) ◽  
pp. 201-207 ◽  
Author(s):  
W. Jeff Elias ◽  
Charles A. Sansur ◽  
Robert C. Frysinger
Keyword(s):  
Risk Factor ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cerebrovascular Complications ◽  
Thalamic Infarction ◽  
Deep Brain Stimulation Electrode ◽  
History Of ◽  
Deep Brain

Object The authors analyzed deep brain stimulation electrode trajectories on MR images to identify risks of cerebrovascular complications associated with the number of electrode insertions, traversal of a sulcus, and penetration of the ventricle. Methods Pre- and postoperative MR volumes were fused to determine the proximity of electrodes to a sulcus or ventricle and whether there were cortical, subcortical, or intraventricular complications. Complications were further classified as hemorrhagic or nonhemorrhagic and symptomatic or asymptomatic. The authors examined 258 electrode implantation for deep brain stimulation. There were 4 symptomatic events (1.6% incidence): 3 hemorrhagic and 1 nonhemorrhagic, all within the cortex. Asymptomatic events included cortical hemorrhage in 1 patient, nonhemorrhagic cortical changes in 6, pallidal hemorrhage in 1, thalamic infarction in 1, and intraventricular hemorrhage (IVH) in 5 patients. Results Proximity to a sulcus was a significant risk factor for hemorrhagic and nonhemorrhagic cortical complications (p = 0.001). There was a complication rate of 10.1% within the trajectories penetrating or adjacent to a sulcus, and a 0.7% rate with trajectories clearly positioned within the gyrus. Asymptomatic IVH was observed in 5% of ventricular penetrations. A history of hypertension was a risk factor for cortical hemorrhage (p = 0.019), but not for cortical ischemic/edematous events (p = 0.605). The number of electrode penetrations did not differ between patients with and without complications (p = 0.868), and the sequence of electrode insertions was not a risk factor in bilateral surgeries. Conclusions Symptomatic cortical complications occur when electrodes traverse close to a sulcus. Asymptomatic IVH occurs infrequently with ventricular penetration. Despite intraoperative efforts to avoid cortical sulci, a higher than expected incidence of electrode proximity to the sulci was identified on careful postoperative trajectory analysis. This finding emphasizes the importance of assiduously planning trajectories and reviewing cases with thorough MR analysis.

Personal history of breast cancer as a significant risk factor for endometrial serous carcinoma in women aged 55 years old or younger

2010 ◽  
Vol 128 (4) ◽  
pp. 763-770 ◽  
Author(s):  
Sharon X. Liang ◽  
Micheal Pearl ◽  
Shu Liang ◽  
Li Xiang ◽  
Lin Jia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Personal History ◽  
Serous Carcinoma ◽  
History Of
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