Is congenital bony stenosis of the cervical spine associated with lumbar spine stenosis? An anatomical study of 1072 human cadaveric specimens

2012 ◽  
Vol 17 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Navkirat S. Bajwa ◽  
Jason O. Toy ◽  
Ernest Y. Young ◽  
Nicholas U. Ahn
Keyword(s):  
Logistic Regression ◽  
Cervical Spine ◽  
Lumbar Spine ◽  
Linear Regression Analysis ◽  
Large Population ◽  
Positive Association ◽  
Anatomical Study ◽  
Lumbar Stenosis ◽  
Increased Risk ◽  
Tandem Stenosis

Object Congenital cervical and lumbar stenosis occurs when the bony anatomy of the spinal canal is smaller than expected, predisposing an individual to symptomatic neural compression. While tandem stenosis is known to occur in 5%–25% of individuals, it is not known whether this relationship is due to an increased risk of degenerative disease in these individuals or whether this finding is due to the tandem presence of a congenitally small cervical and lumbar canal. The purpose of the present study was to determine if the presence of congenital cervical stenosis is associated with congenital lumbar stenosis. Methods One thousand seventy-two adult skeletal specimens from the Hamann-Todd Collection in the Cleveland Museum of Natural History were selected. The canal area at each level was calculated using a formula that was verified by computerized measurements. Values that were 2 standard deviations below the mean were considered to represent congenitally stenotic regions. Linear regression analysis was used to determine the association between the sum of canal areas at all levels in the cervical and lumbar spine. Logistic regression was used to calculate odds ratios for congenital stenosis in one area if congenital stenosis was present in the other. Results A positive association was found between the additive area of all cervical (that is, the sum of C3–7) and lumbar (that is, the sum of L1–5) levels (p < 0.01). A positive association was also found between the number of cervical and lumbar levels affected by congenital stenosis (p < 0.01). Logistic regression also demonstrated a significant association between congenital stenosis in the cervical and lumbar spine, with an odds ratio of 0.2 (p < 0.05). Conclusions Based on the authors' findings in a large population of adult skeletal specimens, it appears that congenital stenosis of the cervical spine is associated with congenital stenosis of the lumbar spine. Thus, the presence of tandem stenosis appears to be, at least in part, related to the tandem presence of a congenitally small cervical and lumbar canal.

scholarly journals Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2254
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Luigi Tarantini ◽  
Alessandro Navazio ◽  
Giovanni Corrao
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Adjuvant Therapy ◽  
Large Population ◽  
Positive Association ◽  
Population Based ◽  
Study Cohort ◽  
Increased Risk ◽  
Post Menopausal ◽  
New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

scholarly journals Association of recurrent common infections and subclinical cardiovascular disease in Mexican women

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246047
Author(s):  
Priscilla Espinosa-Tamez ◽  
Martin Lajous ◽  
Carlos Cantú-Brito ◽  
Ruy Lopez-Ridaura ◽  
Adriana Monge ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Cardiovascular Risk ◽  
Linear Regression Analysis ◽  
Atheromatous Plaque ◽  
Low Grade ◽  
Adult Women ◽  
Recurrent Infections ◽  
Increased Risk ◽  
Subclinical Cardiovascular Disease

Background Acute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD). Methods In a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers’ Cohort. Through 2012–2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors. Results Among participants (50±5 years) 13% reported no infections, 20% one infection and 67% three or more episodes. Overall prevalence of sCVD was 12%(n = 240). Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of sCVD (OR 1.91; 95%CI 1.16, 3.13) compared to women without infections (p-trend:0.015). Sub-analyses by type of infection resulted not significant. Linear regression analysis did not show a significant association between mean IMT and recurrent infections. Conclusions Recurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease.

Abstract 14185: Targeting Lower Oxygen Saturation Parameters in Premature Infants Does Not Increase Incidence of Pulmonary Hypertension in the Neonatal Intensive Care Unit

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Maria Niccum ◽  
Fotios Spyropoulos ◽  
Jonathan Levin ◽  
Carter Petty ◽  
Mary P Mullen ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Birth Weight ◽  
Oxygen Saturation ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Positive Association ◽  
Increased Risk ◽  
Significant Difference ◽  
Lower Oxygen

Introduction: Lower oxygen saturation targets in preterm infants have been associated with decreased incidence of bronchopulmonary dysplasia (BPD) but increased risk of pulmonary hypertension (PH). Studies have shown that targets of <90% are associated with higher incidence of PH, however data on the optimal saturation target >90% are lacking. In this study, we compared the rate of BPD and PH in two cohorts with saturation targets of 94-98% and 92-97%. We hypothesized that BPD rate would be lower and PH rate would be unchanged at the lower saturation target. Methods: We performed a retrospective cohort study comparing PH and BPD rates among two cohorts of infants born at ≤32 weeks gestation at Brigham and Women’s Hospital: cohort 1 with saturation target of 94-98% (n = 129, July 2017-July 2018), cohort 2 with saturation target of 92-97% (n = 124, July 2018-July 2019). PH was defined by echocardiographic evidence of systolic septal flattening or right ventricular pressure ≥35 mmHg (estimated by tricuspid regurgitant jet velocity or shunt velocity) at gestational age (GA) ≥36 weeks. Comparisons between groups were carried out by Chi-square test, t-test, and multivariable logistic regression. Results: Subjects had a GA of 23-32 weeks; 46% were female. Groups did not differ with respect to GA, sex, or birth weight. There was no difference in rate of PH (2.4% vs. 4.2%, p = 0.12) or BPD (25% vs. 20%, p = 0.31) between cohort 1 and cohort 2. Other clinical parameters were not different between groups, including presence of patent ductus arteriosus, presence of atrial septal defect, use of diuretics, or use of steroids. After controlling for GA, birth weight, sex, and diagnosis of BPD using logistic regression, there was no difference in rate of PH between groups (p = 0.47), but there was a positive association of BPD with PH (OR 3.45; 95% CI, 1.18-10.09; p = 0.02). Conclusions: A lower oxygen saturation target was not associated with a higher rate of PH or lower rate of BPD in preterm infants. The overall rate of PH was much lower than rates previously reported at saturation targets <90%. Given our low incidence of PH, and the lack of a significant difference in rate of PH between groups, a saturation target of 92-97% may be safe while also minimizing need for supplemental oxygen in this population.

scholarly journals Association between serum uric acid and obesity in Chinese adults: a 9-year longitudinal data analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041919
Author(s):  
Jie Zeng ◽  
Wayne R Lawrence ◽  
Jun Yang ◽  
Junzhang Tian ◽  
Cheng Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Repeated Measures ◽  
Positive Association ◽  
Chinese Adults ◽  
High Quality Research ◽  
Increased Risk ◽  
Gender And Age ◽  
Subgroup Analyses

ObjectivesHyperuricaemia has been reported to be significantly associated with risk of obesity. However, previous studies on the association between serum uric acid (SUA) and body mass index (BMI) yielded conflicting results. The present study examined the relationship between SUA and obesity among Chinese adults.MethodsData were collected at Guangdong Second Provincial General Hospital in Guangzhou City, China, between January 2010 and December 2018. Participants with ≥2 medical check-up times were included in our analyses. Physical examinations and laboratory measurement variables were obtained from the medical check-up system. The high SUA level group was classified as participants with hyperuricaemia, and obesity was defined as BMI ≥28 kg/m2. Logistic regression model was performed for data at baseline. For all participants, generalised estimation equation (GEE) model was used to assess the association between SUA and obesity, where the data were repeatedly measured over the 9-year study period. Subgroup analyses were performed by gender and age group. We calculated the cut-off values for SUA of obesity using the receiver operating characteristic curves (ROC) technique.ResultsA total of 15 959 participants (10 023 men and 5936 women) were included in this study, with an average age of 37.38 years (SD: 13.27) and average SUA of 367.05 μmol/L (SD: 97.97) at baseline, respectively. Finally, 1078 participants developed obesity over the 9-year period. The prevalence of obesity was approximately 14.2% for high SUA level. In logistic regression analysis at baseline, we observed a positive association between SUA and risk of obesity: OR=1.84 (95% CI: 1.77 to 1.90) for per-SD increase in SUA. Considering repeated measures over 9 year for all participants in the GEE model, the per-SD OR was 1.85 (95% CI: 1.77 to 1.91) for SUA and the increased risk of obesity were greater for men (OR=1.45) and elderly participants (OR=1.01). In subgroup analyses by gender and age, we observed significant associations between SUA and obesity with higher risk in women (OR=2.35) and young participants (OR=1.87) when compared with men (OR=1.70) and elderly participants (OR=1.48). The SUA cut-off points for risk of obesity using ROC curves were approximately consistent with the international standard.ConclusionsOur study observed higher SUA level was associated with increased risk of obesity. More high-quality research is needed to further support these findings.

Blood Transfusion, Anesthesia, Surgery and Risk of Non-Hodgkin Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4697-4697
Author(s):  
James R. Cerhan ◽  
Eric Engels ◽  
Wendy Cozen ◽  
Scott Davis ◽  
Richard K. Severson ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Blood Transfusion ◽  
Hodgkin Lymphoma ◽  
Regional Anesthesia ◽  
Statistical Significance ◽  
Positive Association ◽  
Blood Transfusions ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
History Of

Abstract Background. The incidence of non-Hodgkin lymphoma (NHL) has increased dramatically since at least the 1950s, and only a fraction of this increase can be explained by established risk factors. During this timeframe, there has been a major increase in the use of blood transfusions, anesthesia, and invasive surgical procedures, all of which can impact immune function. Methods. We conducted a population-based case-control study from 1998–2000 using SEER cancer registries in Detroit, Iowa, Los Angeles and Seattle. NHL cases (N=759) were newly diagnosed, HIV-negative, and aged 20–74 years. Controls (N=589) were identified through random digit dialing (<65 years old) and Medicare files (age 65 years and older), and were frequency matched to cases on sex, age, race, and study site. Data on history of blood transfusions, anesthetics (general and regional), and surgeries (type, frequency, and age for 21 anatomic regions) >1 year before diagnosis (or date of enrollment for controls) were collected during in-person interviews. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for the matching factors. NHL subtypes (follicular and diffuse) were designated according to SEER cancer registry pathology reports, and risk of each subtype was estimated using polychotomous logistic regression. Results. History of blood transfusion was weakly associated with increased risk of NHL (OR=1.26; 95% CI 0.91–1.73), and the elevated risk was specific to transfusions first given 5 to 29 years before diagnosis (OR=1.69; 95% CI 1.08–2.62). Risk was also specific to blood transfusions given for a medical indication (OR=2.09; 95% CI 1.03–4.26), while transfusions given for trauma, obstetric or surgical indications were not associated with risk. Exposure to general or regional anesthesia (OR=1.35 for 24+ times compared to 0–6; 95% CI 0.91–2.02) and total number of surgeries (OR=1.22 for 7+ surgeries compared to 0; 95% CI 0.77–1.93) were weakly and positively associated with risk of NHL, although neither association achieved statistical significance. Results were similar for general versus regional anesthesia. In analysis of surgeries at specific anatomic sites, there were no associations with NHL risk, except for a suggestive positive association for surgery involving the appendix, stomach or bowel (OR=1.24; 95% CI 0.98–1.58). When blood transfusion, anesthesia, and total number of surgeries were included in the same model, ORs for time since first transfusion and total number of surgeries remained unchanged, while the association for anesthesia weakened. These results were generally similar for both diffuse and follicular subtypes, with the exception that total number of surgeries showed a suggestive positive association with follicular (OR=1.61 for 7+ surgeries compared to 0; 95% CI 0.74–3.51) but not diffuse NHL. Conclusion: History of blood transfusion was associated with an increased risk of NHL. Total number of surgeries, type of surgery, and use of anesthesia were only weakly associated with risk, although the suggestive positive association for number of surgeries with follicular lymphoma warrants further investigation.

Abstract P382: Association of Recurrent Common Infections and Subclinical Cardiovascular Disease in Mexican Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Priscilla Espinosa-Tamez ◽  
Andres Catzin-Kuhlmann ◽  
Adriana Monge ◽  
Elsa Yunes ◽  
Carlos Cantú-Brito ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Cardiovascular Risk ◽  
Linear Regression Analysis ◽  
Low Grade ◽  
Recurrent Infections ◽  
Vaginal Infections ◽  
Cross Sectional ◽  
Increased Risk ◽  
Subclinical Cvd

Introduction: Both acute and agent specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections and cardiovascular disease (CVD) is limited. Hypothesis: Women with greater exposure to uncomplicated common infectious events have an increased risk of subclinical CVD (sCVD) compared to women with no events. Methods: In a cross-sectional study we assessed the relationship of recurrent infections and carotid artery intima-media thickness (IMT) in 1,945 disease-free women from the Mexican Teachers’ Cohort. Through 2012-2016, participants answered questions on respiratory, urinary tract and vaginal infections during the previous year and IMT was measured using ultrasound by standardized neurologists and log-transformed. Total infectious episodes were categorized as “0”, “1 or 2” and “3 or more”. We defined sCVD as mean right and left IMT≥0.8mm or plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors. Results: Among participants (50 ±5 years of age) 14% (278 of 1945) reported no infections, 41% (800 of 1945) 1 or 2 infections, and 45% (867 of 1945) 3 or more. Overall prevalence of sCVD was 12% (242 of 1945). Adjusted models for logistic regression showed that women with 3 or more infections had 80% higher odds of subclinical CVD (95% CI 1.1, 2.9) compared to women without infections (p-trend: 0.019). Sub-analyses by type of infection were not significantly associated with sCVD (Image 1). Linear regression analysis did not show a significant association between mean IMT and recurrent infections. Conclusion: Recurrent infectious events in women are associated with greater sCVD, which supports the hypothesis of low grade chronic inflammation in CVD.

scholarly journals Search for early pancreatic cancer blood biomarkers in five European prospective population biobanks using metabolomics

2019 ◽  
Author(s):  
Jesse Fest ◽  
Lisanne S. Vijfhuizen ◽  
Jelle J. Goeman ◽  
Olga Veth ◽  
Anni Joensuu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Logistic Regression ◽  
Predictive Value ◽  
Early Stage ◽  
Smoking Status ◽  
Large Population ◽  
Predictive Biomarkers ◽  
Increased Risk ◽  
Diabetes Mellitus Status ◽  
And Gender

AbstractBackground and aimMost patients with pancreatic cancer present with advanced disease and die within the first year after diagnosis. Predictive biomarkers that signal the presence of pancreatic cancer in an early stage are desperately needed. We aimed to identify new and validate previously found plasma metabolomic biomarkers associated with early stages of pancreatic cancer.MethodsThe low incidence rate complicates prospective biomarker studies. Here, we took advantage of the availability of biobanked samples from five large population cohorts (HUNT2, HUNT3, FINRISK, Estonian biobank, Rotterdam Study) and identified prediagnostic blood samples from individuals who were to receive a diagnosis of pancreatic cancer between one month and seventeen years after blood sampling, and compared these with age- and gender-matched controls from the same cohorts. We applied1H-NMR-based metabolomics on the Nightingale platform on these samples and applied logistic regression to assess the predictive value of individual metabolite concentrations, with gender, age, body mass index, smoking status, type 2 diabetes mellitus status, fasting status, and cohort as covariates.ResultsAfter quality assessment, we retained 356 cases and 887 controls. We identified two interesting hits, glutamine (p=0.011) and histidine (p=0.012), and obtained Westfall-Young family-wise error rate adjusted p-values of 0.43 for both. Stratification in quintiles showed a 1.5x elevated risk for the lowest 20% of glutamine and a 2.2x increased risk for the lowest 20% of histidine. Stratification by time to diagnosis (<2 years, 2-5 years, >5 years) suggested glutamine to be involved in an earlier process, tapering out closer to onset, and histidine in a process closer to the actual onset. Lasso-penalized logistic regression showed a slight improvement of the area under the Receiver Operator Curves when including glutamine and histidine in the model. Finally, our data did not support the earlier identified branched-chain amino acids as potential biomarkers for pancreatic cancer in several American cohorts.ConclusionWhile identifying glutamine and histidine as early biomarkers of potential biological interest, our results imply that a study at this scale does not yield metabolomic biomarkers with sufficient predictive value to be clinically usefulper seas prognostic biomarkers.

Family Environment and Its Correlation with Anxiety and Depression: A Study on Heart Patients

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Meena Jain ◽  
Saloni Chandalia
Keyword(s):  
Heart Disease ◽  
Family Environment ◽  
Heart Attack ◽  
Psychiatric Symptoms ◽  
Disease Risk ◽  
Positive Association ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Increased Risk ◽  
Artery Disease

This research paper deals with the Family Environment and its Correlation with Anxiety and Depression level among persons with Heart Disease. There had been a number of researches that investigated that ischemic heart disease patients who suffer significant anxiety have close to a 5-fold increased risk of experiencing frequent angina and those with depression have more than a 3-fold increased risk for these episodes. This observed link between psychiatric symptoms and angina underlines the importance of treating anxiety and depression in cardiac patients, according to study co author Dr Mark D Sullivan (University of Washington School of Medicine, Seattle). To gather the needed data, Hamilton Anxiety Scale and Becks Depression Inventory were used. As stated from literatures, for people with heart dysfunction, depression and anxiety can increase the risk of an adverse cardiac event such as a heart attack or blood clots. For people who do not have heart disease, depression and anxiety can also increase the risk of a heart attack and development of coronary artery disease. Researchers have also emphasized on the role of family psychosocial environment and its positive association with the Coronary Heart Disease risk.

scholarly journals 22. Description of Hospitalized Patients with Influenza Vaccine Failure

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Joanna Kimball ◽  
Yuwei Zhu ◽  
Dayna Wyatt ◽  
Helen Talbot
Keyword(s):  
Logistic Regression ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Older Patients ◽  
Influenza A ◽  
Influenza Season ◽  
Hospitalized Patients ◽  
Vaccine Failure ◽  
Increased Risk ◽  
Immunosuppressed Patients

Abstract Background Despite influenza vaccination, some patients develop illness and require hospitalization. Many factors contribute to vaccine failure, including mismatch of the vaccine and circulating strains, waning immunity, timing of influenza season, age and patient comorbidities such as immune function. This study compared vaccinated, hospitalized patients with and without influenza. Methods This study used 2015–2019 Tennessee data from the US Hospitalized Adult Influenza Vaccine Effectiveness Network database. Enrolled patients were ≥ 18 years vaccinated for the current influenza season and admitted with an acute respiratory illness. Patient or surrogate interviews and medical chart abstractions were performed, and influenza vaccinations were confirmed by vaccine providers. Influenza PCR testing was performed in a research lab. Statistical analyses were performed with STATA and R using Pearson’s chi-squared, Kruskal-Wallis and Wilcoxon rank-sum tests and multivariate logistic regression. Results 1236 patients met study criteria, and 235 (19%) tested positive for influenza. Demographics, vaccines and comorbidities were similar between the two groups (Table 1) except for morbid obesity, which was more common in influenza negative patients (13% vs 8%, p = 0.04), and immunosuppression, which was more common in the influenza positive (63% vs 54%, p = 0.01). Logistic regression analysis demonstrated older patients (OR 1.47, 95% CI 1.03–2.10) and immunosuppressed patients (OR 1.56, 1.15–2.12) were at increased risk for influenza (Table 2 and Figure 1). Immunosuppression also increased the risk for influenza A/H3N2 (OR 1.86, 95% CI 1.25–2.75). A sensitivity analysis was performed on patients who self-reported influenza vaccination for the current season without vaccine verification and demonstrated increased risk of influenza in older adults (OR 1.66, 95% CI 1.16–2.39). Table 1: Demographics of influenza positive versus influenza negative patients in influenza vaccinated, hospitalized patients. Table 2: Logistic regression analyses of vaccinated, hospitalized influenza positive patients; vaccinated, hospitalized patients with influenza A subtypes and self-reported vaccinated, hospitalized influenza positive patients. Figure 1: Predicted Probability of Hospitalization with Influenza, Influenza A/H1N1 and Influenza A/H3N2 in Vaccinated Patients by Age. Conclusion Our study demonstrated an increased risk of influenza vaccine failure in older patients and immunosuppressed patients. These groups are also at increased risk for influenza complications. To improve protection of these patients against future influenza illnesses, more effective vaccines are needed, and more research on ring vaccination should be pursued. Disclosures All Authors: No reported disclosures

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