scholarly journals Assessment of risk factors for the development of simple and complex non-atypical endometrial hyperplasia

2020 ◽  
Vol 24 (4) ◽  
pp. 584-588
Author(s):  
N. A. Bykova

Annotation. Goal – to identify and assess the most significant risk factors for the development of simple non-atypical endometrial hyperplasia (SNAEH) and complex non-atypical endometrial hyperplasia (CNAEH) in women. Retrospective analysis of anamnestic data of 58 case histories of patients with SNAEH, 35 case histories of patients with CNAEH and data of 30 women of the control group, which allowed to identify risk factors for hyperproliferative processes of the endometrium (HPE) for research, the statistical significance of which was further assessed by calculating odds ratio (OR). The main feature associated with the risk of SNAEH is heredity – OR = 49.73 (95% CI 2.90–852.32). Significantly increases the risk of developing SNAEH in the presence of thyroid gland lesion (TGL) – OR = 34.97 (95% CI 2.03–601.20). The third in the hierarchical sequence is the polycystic ovary syndrome factor; OR = 25.72 (95% CI 1.488–444.59). Heredity occupies the top of the hierarchical structure in the group of patients with CNAEH. OR is 80.67 (95% CI 4.56–1424.76). A high probability of developing CNAEH is also observed for women over the age of 50 (OR = 32.44 (95% CI 1.82–576.56). In third place – the presence of TGL, which significantly increases the risk of developing CNAEH; OR = 28.63 (95% CI 1.60–510.56) Identification of statistically significant risk factors for the development of HPE will help to identify risk groups among the population, to carry out preventive measures among them (lifestyle adjustments, treatment of concomitant diseases) and decrease the incidence of the HPE.

Author(s):  
T. A. Irinyenikan

Background. The inability of couples to achieve pregnancy is a major cause of psycho-social problems in family relationship that could lead to marital disharmony. Objective. The aim of this study was to find out the possible risk factors for female infertility. Methods. A case-control design and a sample size of 400 (200 cases of infertility and 200 controls) were used in the study. Cases and controls were selected at random at the infertility and family planning clinic of the University of Medical Sciences Teaching Hospital Complex, Akure and were subjected to a predesigned interviewer administered questionnaire to collect the data. The cases were classified into primary and secondary infertility; binary and stepwise logistic regressions were used to generate the Odds ratio and 95% confidence interval of the possible risk factors and the level of significance was set at P<0.05. Results. The mean age of the women with infertility was 28.5±5.43 years and the mean age of those in the control group was 29.1±5.62 years. Among the cases, 155 (77.5%) had secondary infertility, while 45 (22.5%) had primary infertility. Significant risk factors for female infertility included presence of fibroids, having had fibroid operation, multiple sexual partners, previous abortion, polycystic ovary syndrome (PCOS), sexually transmitted infection (STI) and post abortion sepsis. Conclusion. The study showed that secondary infertility is still the most prevalent and the risk factors were multi factorial. Efforts should be intensified to reduce infertility due to preventable causes.


2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.


2016 ◽  
Vol 56 (3) ◽  
pp. 129
Author(s):  
Nadya Arafuri ◽  
Pudjo Hagung Widjajanto ◽  
Ekawaty L. Haksari

Background Albumin transfusion for the treatment of neonatal hypoalbuminemia may reduce morbidity. In conditions with disrupted endothelial integrity (e.g., sepsis and critical illness), the administered albumin may leak into the interstitial space, hence, serum albumin levels may fall below expected levels after transfusion. To date, few studies have been done to evaluate the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Objectives To determine the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Methods We performed a case-control study in the Neonatal Ward of Dr. Sardjito Hospital from 2007 to 2012. Normal albumin level was defined as above 3 g/dL. The case group included neonates with post-transfusion albumin levels <3 g/dL and the control group included those with post-transfusion albumin ≥3 g/dL. Subjects received intravenous transfusions of 25% or 20% albumin according to the clinical standard of the Neonatal Ward of Dr. Sardjito Hospital. Neonates with very low birth weight, severe birth trauma, burn injuries, severe bleeding, or incomplete medical records were excluded. The data were analyzed with logistic regression test.Results From January 2007 to December 2012, 124 neonates were enrolled in the study. Multivariate analysis showed that low albumin levels before transfusion (OR 12.27; 95%CI 2.17 to 69.30), presence of critical illness (OR 4.01; 95%CI 1.49 to 10.79), diagnosis of sepsis (OR 3.56; 95%CI 1.36 to 9.32), and the >24-hour interval between albumin examination and transfusion (OR 0.06; 95%CI 0.01 to 0.37) were significant risk factors affecting the failure to achieve normal albumin levels.Conclusions Failure to achieve normal albumin levels after transfusion in neonates was significantly associated with low albumin level prior to transfusion, critical illness, sepsis, and >24-hour interval between transfusion and post-transfusion albumin examination.[Paediatr Indones. 2016;56:129-33.].


Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 474 ◽  
Author(s):  
Luca Giannella ◽  
Giovanni Delli Carpini ◽  
Francesco Sopracordevole ◽  
Maria Papiccio ◽  
Matteo Serri ◽  
...  

Background: Up to 40% of women with atypical endometrial hyperplasia (AEH) can reveal endometrial cancer (EC) at hysterectomy. The pre-operative endometrial sampling method (ESM) and some independent cancer predictors may affect this outcome. The present study aimed to compare the rate of EC at hysterectomy in women with AEH undergoing dilation and curettage (D&C), hysteroscopically-guided biopsy (HSC-bio), or hysteroscopic endometrial resection (HSC-res). The secondary outcome was to compare the reliability of ESMs in women showing independent variables associated with EC. Methods: Two-hundred-and-eight consecutive women with AEH and undergoing hysterectomy between January 2000 and December 2017 were analyzed retrospectively. Based on pre- and post-test probability analysis for EC, three ESMs were compared: D&C, HSC-bio, and HSC-res. Univariate and multivariate analyses were performed to assess risk factors predicting cancer on final histology. Finally, the patient’s characteristics were compared between the three ESM groups. Results: D&C and HSC-bio included 75 women in each group, while HSC-res included 58 women. Forty-nine women (23.6%) revealed cancer at hysterectomy (pre-test probability). Post-test probability analysis showed that HSC-res had the lowest percentage of EC underestimation: HSC-res = 11.6%; HSC-bio = 19.5%; D&C = 35.3%. Patient characteristics showed no significant differences between the three ESMs. Multivariate analysis showed that body mass index ≥40 (Odds Ratio (OR) = 19.75; Confidence Intervals (CI) 2.193–177.829), and age (criterion > 60 years) (OR = 1.055, CI 1.002–1.111) associated significantly with EC. In women with one or both risk factors, post-test probability analysis showed that HSC-res was the only method with a lower EC rate at hysterectomy compared to a pre-test probability of 44.2%: HSC-res = 19.96%; HSC-bio = 53.81%; D&C = 63.12%. Conclusions: HSC-res provided the lowest rate of EC underestimation in AEH, also in women showing EC predictors. These data may be considered for better diagnostic and therapeutic planning of AEH.


2018 ◽  
Vol 51 (01) ◽  
pp. 54-61 ◽  
Author(s):  
Justyna Kuliczkowska-Plaksej ◽  
Renato Pasquali ◽  
Andrzej Milewicz ◽  
Felicja Lwow ◽  
Diana Jedrzejuk ◽  
...  

AbstractThe objective of the study was to measure the levels of 25-hydroxyvitamin D [25(OH)D] and vitamin D binding protein (VDBP) and assess their relationships with cardiovascular risk factors in women with the polycystic ovary syndrome (PCOS). A group of 267 women, aged 20–35 years (24.7 ± 4.9): 167 with PCOS and 100 healthy women were divided according to body mass index. Biochemical and hormonal parameters were measured. Free and bioavailable 25(OH)D were calculated using the mathematical equations. The percentage of body fat and visceral fat deposit were assessed by DXA. In the normal weight control group total, free, bioavailable 25(OH)D (p<0.001 for all) were significantly higher than in its overweight/obese counterpart, while VDBP levels were comparable. In PCOS women total 25(OH)D (p<0.001), and VDBP (p –0.006) were lower in the overweight/obese subgroups than in the normal weight ones. In both groups serum VDBP levels correlated negatively with serum insulin and positively with sex hormone binding globulin. In PCOS group, in contrast to control group, VDPB was negatively correlated with abdominal fat deposit, BMI, fasting glucose and positively with HDL. Despite lower total 25(OH)D in obese PCOS women, all women with PCOS (lean and obese) had comparable free and bioavailable 25(OH)D, which might be a result of concomitantly lowered serum VDBP levels in obese PCOS women. VDBP might play important role in the regulation of availability of active fractions of 25(OH)D in PCOS women. VDBP seems to be associated with cardiovascular risk factors such as BMI, waist circumference, visceral fat, and fasting serum insulin in women with PCOS.


2016 ◽  
Vol 32 (1) ◽  
pp. 34-38
Author(s):  
Biplob Kumar Das ◽  
Kanak Jyoti Mondal

Stroke is one of the foremost causes of morbidity, mortality and is a socioeconomic challenge. This is particularly true for developing countries like Bangladesh, where health support system including the rehabilitation system is not within the reach of common people. Hypertriglycerademia has an effective influence in the pathogenesis of Ischaemic Stroke (IS). So, the focus of this study was to evaluate and assess the association of serum triglyceride level in patients of IS. This case control study was carried out in the Department of Neurology in collaboration with Department of Biochemistry, BSMMU, Dhaka from July 2011 to June 2013. In this study, 60 diagnosed cases of ischaemic stroke patients and 60 age and sex matched healthy controls were enrolled. Risk factors of Ischemic Stroke (IS) patients were assessed ( adjusted Odds Ratio) in comparison with healthy adults. In this study, being married [OR. 1.95, 95% CI (0.40-9.42), p=0.409] , smoker [OR.1.65, 95% CI (0.57 - 4.82),p= 0.357], DM [OR. 1.48, 95% CI (0.36-6.06), p=0.582 ], IHD [OR. 1.51, 95% CI (0.29 – 7.89), p=0.624] , HTN [OR. 3.66, 95% CI (1.11–12.12), p=0.033] , overweight [OR.2.31, 95% CI (0.77 – 6.91), 0.135] and obesity [OR. 16.19, 95% CI (1.31–200.6), p=0.030] , increased level of serum TC [OR.8.24, 95% CI (2.07 – 32.83), p=0.003], TG [OR. 9.40, 95% CI (1.17 -75.86), p=0.035], LDL [OR. 0.45, 95% CI (0.10–2.05), p=0.308],and decreased level of HDL [OR. 3.37, 95% CI (1.03 - 12.25), p=0.045] were found as risk factors in developing IS. Independent t-test was done to find out the statistically significant differences of continuous variables like serum lipid profile between case and control group. The mean (SD) value of TG which is focus of this study, was found 237.67 (61.74) in case group, and 169.97 (26.95) in control group which was highly statistically significant (p < 0.0001). All of the significant variables were entered into stepwise logistic regression analysis model. From the logistic regression model, it can be finally concluded that hypertension, obesity, increased level of TC, increased level of TG and decreased level of HDL were statistically significant risk factors for development of IS. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 34-38


2015 ◽  
Vol 49 (4) ◽  
pp. 155-158 ◽  
Author(s):  
David Humphries ◽  
John Orchard ◽  
Alex Kountouris

ABSTRACT Background Injuries to the abdominal wall, particularly muscular injuries, are relatively common in professional cricketers. The Cricket Australia injury database holds data on these injuries over a 20 years span. Methods This study is a combination of (1) a descriptive outline of the parameters associated with side strains and abdominal wall injuries in elite male cricketers, based on deidentified data extraction from the Cricket Australia database from 1995 to 1996 and 2014 to 2015; (2) multivariate regression analysis of risk factors for abdominal wall strains, taking into account the risk factors of player position, player age and previous abdominal wall injury history. Results There were 183 injuries recorded over a 20 years period at Australian state or national player level. Significant risk factors in logistic regression analysis were: being a Pace Bowler RR 10.0 (95% CI 3.1—32.1) and being 24 years old or younger RR 3.4 (95% CI 1.7—6.8). Surprisingly, there was only minimal risk increase, not reaching statistical significance, for recent injury in the same season (p = 0.18) and no association at all with past injury in previous season (p = 0.99). Discussion The internal oblique muscle is reported the most commonly injured component of the abdominal wall, the injuries are overwhelmingly sustained by pace bowlers and the peak incidence of the injury is in the early part of the cricket season. Younger fast bowlers are more likely to be injured than older ones. A history of abdominal wall strain in either the recent or distant past does not increase or decrease future risk of strain, which is in contrast to other muscle strains. How to cite this article Humphries D, Orchard J, Kountouris A. Abdominal Wall Injuries at the Elite Level in Australian Male Professional Cricketers. J Postgrad Med Edu Res 2015;49(4): 155-158.


Hand ◽  
2020 ◽  
pp. 155894472096387
Author(s):  
Kevin H. Kim ◽  
Bryan Duell ◽  
Swapna Munnangi ◽  
Mitchell Long ◽  
Elizabeth Morrison

Background Delayed-onset carpal tunnel syndrome (DCTS) can develop weeks and months after distal radius fracture (DRFx). A better understanding of the risk factors of DCTS can guide surgeon’s decision making regarding the management of DRFx and also provides another discussion point to be had with elderly patients when discussing outcomes of nonoperative management. Methods We reviewed 216 nonoperatively managed DRFx between June 2015 and January 2019 at a single level 1 trauma center and senior author’s office. We identified 26 patients who developed DCTS at a minimum of 6 weeks after DRFx, which constituted our case group. The remaining 190 patients served as the control group (non–carpal tunnel syndrome [CTS]). Differences between case and control group were evaluated through univariate and multivariate analyses. Results The prevalence of DCTS among nonoperatively managed DRFx was 12%. In univariate analysis, volar tilt (VT) and teardrop angle (TDA) were significant independent predictors of development of DCTS. Multivariate logistic regression analysis determined that the odds of developing CTS increased by 12% and 24% for each degree of decrease in VT and TDA, respectively. No other significant risk factors were identified. Conclusions Decreasing VT and TDA are the most significant risk factors associated with DCTS in nonoperatively managed DRFx. These are simple and reliable radiographic measurements that provide significant prognostic value. These parameters can be used to guide surgeon decision making regarding management of DRFx in the elderly while aiding patient expectations and outcomes following nonoperative management of DRFx.


2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 


2009 ◽  
Vol 21 (1) ◽  
pp. 165
Author(s):  
M. A. Velazquez ◽  
H. Niemann

It has been hypothesized that high non-physiological IGF-1 levels are partially responsible for the recurrent pregnancy loss observed in women with the polycystic ovary syndrome (Eng GS et al. 2007 Diabetes 56, 2228–2234). The aim of this study was to determine the effect of supraphysiological concentrations of IGF-1 on blastocyst production and the occurrence of apoptosis in bovine embryos, which are a good model for human embryo development (Baumann CG et al. 2007 Mol. Reprod. Dev. 74, 1345–1353). COC obtained by slicing from abattoir ovaries were matured (TCM-199, Sigma) for 24 h and fertilized (Fert-TALP) for 18 h (Day 0) in vitro. Two different IGF-1 (Recombinant human IGF-1, R&D Systems GmbH, Wiesbaden, Germany) concentrations (supraphysiological = 1000 ng mL–1 and physiological = 100 ng mL–1) were added to the culture media (Synthetic oviduct fluid/BSA) and compared with a control group (no IGF-1 supplementation). On Day 8, blastocyst rates (22 replicates) were recorded and DNA degradation was detected in blastocyst nuclei using a cell death detection kit (Roche Diagnostics GmbH, Mannheim, Germany) based on the terminal deoxinucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) principle. Embryos (n = 27 [control], n = 29 [both IGF-1 groups]) from 4 replicates were examined by confocal laser scanning microscopy. Data were analyzed by ANOVA and the Fisher exact test using the SigmaStat 2.0 software package (Jandel Scientific, San Rafael, CA). Cleavage was numerically improved by both, 1000 (59.1 ± 1.8) and 100 (58.2 ± 2.8) ng IGF-1 over controls (53.5 ± 2.2), but the differences did not reach statistical significance (P = 0.22). The proportion of hatched blastocysts was enhanced by 100 (5.8 ± 1.0, P = 0.03) and 1000 (5.1 ± 0.7, P = 0.03) ng IGF-1 compared to controls (2.8 ± 0.6). Total blastocyst rate was increased by 100 ng IGF-1 (34.4 ± 1.9, P = 0.02) over controls (28.3 ± 1.7), but not by 1000 ng IGF-1 (29.1 ± 1.6 P = 0.75). The 100 ng IGF-1 group (38.5 ± 3.7) had fewer degenerated embryos (P = 0.01) compared to 1000 ng IGF-1 (49.7 ± 3.3). The proportion of embryos displaying at least one apoptotic cell was greater in the 1000 ng IGF-1 group over controls (96% v. 77% P = 0.04). The number of blastomeres with TUNEL-positive nuclei per embryo was higher in the supraphysiological group (5.5 ± 0.6, P < 0.001) compared with the control (2.3 ± 0.4) and the physiological group (2.5 ± 0.3). There were no significant differences between the control and the 100 ng IGF-1 group in this regard (P = 0.49). In conclusion, supraphysiological concentrations of IGF-1 do not increase blastocyst production but increase levels of apoptosis in bovine embryos produced in vitro. M. A. V. is in the PhD program of the University of Veterinary medicine, Hannover, Germany, and is supported by the German Academic Exchange Service (DAAD)


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