Safety of pediatric cerebral angiography

OBJECTIVE Catheter-based cerebral angiography is commonly used for neurovascular diagnosis in children. In this work, the authors aimed to quantify the complication rate of cerebral angiography in children, characterize these complications, and identify risk factors for complications. METHODS Relevant clinical data were retrospectively obtained for 587 consecutive cerebral angiography procedures performed in 390 children from March 2002 to March 2020. Complications were categorized as neurological or nonneurological, and severity was graded using a standard schema. Incidences of complications were reported as point estimates. Associations between risk factors and complications were characterized in univariate analysis using the two-tailed Fisher exact test and in multivariate analysis using multiple logistic regression with bidirectional elimination based on the Akaike information criterion. In both univariate and multivariate analyses, statistical significance was corrected for multiple comparisons using the Benjamini-Hochberg method. RESULTS Complications occurred in 6.5% of procedures, including neurological complications in 1.9% and nonneurological complications in 4.8%. Permanent deficits occurred in only 0.2% of cases. Overall, 0.5% of procedures resulted in major complications, while 6.0% resulted in minor complications. Female sex and a history of hypertension or ischemic stroke were associated with an increased risk of complications, while femoral artery access was associated with a decreased risk of complications. CONCLUSIONS Pediatric cerebral angiography was shown to have a low rate of major or permanent complications. Children who were female and those with a history of hypertension or ischemic stroke were shown to be at higher risk of complications, while the use of femoral access carried a lower risk of complications.

Download Full-text

THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.321 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Mukesh Kumar Sharma ◽

Pradeep Kurmi ◽

Deepak Ameta ◽

Chandra Bhanu Chandan

Keyword(s):

Risk Factors ◽

Contrast Media ◽

Statistical Significance ◽

Univariate Analysis ◽

Kidney Injury ◽

Coronary Intervention ◽

Contrast Induced Nephropathy ◽

Absolute Increase ◽

Increased Risk ◽

Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine >1.5mg/dl] and increased contrast volume were associated with increased risk of CIN whereas, gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

Download Full-text

Incidence and Risk Factors for Bilateral Nephrolithiasis: A Large Case-retrospective Study

10.21203/rs.3.rs-414196/v1 ◽

2021 ◽

Author(s):

Xiong Yang ◽

Zhi Li ◽

Shiyong Qi ◽

Linguo Xie ◽

Qiduo Shi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Multivariate Analysis ◽

Kidney Stones ◽

Statistical Significance ◽

Univariate Analysis ◽

Renal Stones ◽

Urinary Stones ◽

Preoperative Imaging ◽

History Of

Abstract To determine the incidence and risk factors of bilateral kidney stones. Utilized the retrospective analysis method on demographic characteristics and clinical data of patients with renal stones in the Second Hospital of Tianjin Medical University. Grouped patients into unilateral and bilateral renal stones according to preoperative imaging and ultrasound examination. Univariate and multivariate analysis methods were used to evaluate the factors that may cause bilateral stones. The study included 7587 patients with kidney stones in total, of whom 4983 had unilateral kidney stones (including 2719 left stones and 2264 right stones), and 2604 had bilateral kidney stones (34.3%). By comparing the unilateral stones group with the bilateral stones group, the univariate analysis demonstrated that weight, body mass index (BMI), history of nephrolithiasis, diabetes mellitus (DM), hypertension, gout, and the maximal stone diameter had statistical significance. Binary logistic regression multivariate analysis demonstrated that BMI, history of nephrolithiasis, diabetes mellitus, hypertension, gout, and the maximal stone diameter were independent risk factors for bilateral urinary stones. This study shows that 34.3% of patients with kidney stones were diagnosed as having bilateral kidney stones; BMI and the maximal stone diameter are positively correlated with the incidence of bilateral kidney stones; Patients with a history of nephrolithiasis, diabetes, hypertension, and gout have a significantly higher risk of having bilateral kidney stones.

Download Full-text

Abstract P402: Serum Magnesium and the Risk of Ischemic Stroke among Women

Circulation ◽

10.1161/circ.127.suppl_12.ap402 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Sally N Akarolo-Anthony ◽

Monik C Jimenez ◽

Stephanie E Chivue ◽

Walter C Willett ◽

Kathryn M Rexrode

Keyword(s):

Ischemic Stroke ◽

Serum Magnesium ◽

Glycosylated Hemoglobin ◽

Univariate Analysis ◽

Effect Modification ◽

Control Analysis ◽

Blood Draw ◽

Low Magnesium ◽

Increased Risk ◽

History Of

Background: Low magnesium levels may be associated with higher blood pressure as well as endothelial dysfunction. Results from studies examining the association between serum magnesium and risk of stroke are inconsistent, with some studies suggesting a protective association with higher levels. Methods: Among 32,826 participants in the Nurses’ Health Study who provided blood samples in 1989-1990, ischemic strokes were identified and confirmed by medical records through 2006. We conducted a nested case-control analysis of 460 cases, matched to controls (1:1) on age, menopausal status, use of postmenopausal hormones, ancestry, date of blood draw, fasting status and smoking status. Magnesium quintiles were created based on the distribution of serum magnesium levels among controls, and a dichotomous variable was also created, based on prior data: low magnesium (<2.0 mg/dL) and high magnesium (≥ 2.0 mg/dL). Conditional logistic regression models were used to estimate the multivariable adjusted association of serum magnesium and the risk of ischemic stroke and unconditional analyses were used to assess effect modification. Results: In univariate analysis, median magnesium levels did not differ between stroke cases and controls (median=2.1 in each, p-value=0.16). Conditional on matching factors, women in the lowest magnesium quintile had a relative risk (RR) of 1.34 (95% confidence interval [CI]: 0.85-2.09) for ischemic stroke, compared to those in the highest quintile. Additional adjustment for potential confounders (alcohol intake, body mass index [BMI], physical activity, aspirin use, thiazide diuretic use, history of diabetes, history of coronary heart disease, glycosylated hemoglobin and the ratio of total to HDL-cholesterol) did not substantially alter the risk estimates (RR=1.34; 95% CI: 0.82-2.17). However, women with magnesium levels <2.0mg/dL had a significant increase in the risk of ischemic stroke, compared to women with magnesium levels ≥2.0 (RR= 1.66; 95% CI: 1.18 - 2.34. Controlling for potential confounders (as above) did not significantly alter this risk (RR= 1.63; 95% CI: 1.13 - 2.36). No significant effect modification was observed by age, BMI, hypertension or diabetes. Conclusions: Serum magnesium levels <2.0 are associated with increased risk of ischemic stroke among this population of women.

Download Full-text

P09.06 Risk factors associated with Meningioma in a Cohort of 2 Million Israeli Adolescents

Neuro-Oncology ◽

10.1093/neuonc/noz126.138 ◽

2019 ◽

Vol 21 (Supplement_3) ◽

pp. iii39-iii40

Author(s):

S Yust-Katz ◽

E Derzane ◽

L Keinan ◽

A Amiel ◽

A Honig ◽

...

Keyword(s):

Risk Factors ◽

Autoimmune Diseases ◽

Cancer Registry ◽

Large Population ◽

Univariate Analysis ◽

Hazard Ratios ◽

Increased Risk ◽

Potential Risk Factors ◽

History Of ◽

Cox Proportional Hazard Models

Abstract Background: Meningiomas are the most common primary central nervous system tumors. Risk factors including- obesity, height, history of allergy/atopy or autoimmune diseases, have been assessed with conflicting results. In this study, we reviewed the database of a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas. Methods: This study analyzed a cohort of 2,035,915 Jewish men and women who underwent compulsory physical examination as part of screening for army drafting between the age of 16 to 19 from 1948 to 1991. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according the several risk factors including sex, BMI, height, history of allergic and autoimmune disease. Results: Linkage of the adolescent military database with the Israeli cancer registry revealed 480 cases of meningioma. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only gender (female) and height were significantly associated with the risk of meningioma for the whole study population (p<0.01 for both variables). When analyzed separately for gender- height was significant only for men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI was not associated with an elevated risk of meningioma even when analyzed separately for gender. Past medical history including asthma, diabetes, and other atopic and autoimmune diseases were not found to be associated with the risk of meningioma. Conclusion: In this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of meningioma.

Download Full-text

Diagnostic Lobectomy for Bethesda III Thyroid Nodules: Pathological Outcomes and Risk Factors for Malignancy

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489421993976 ◽

2021 ◽

pp. 000348942199397

Author(s):

Benjamin K. Walters ◽

Samuel L. Garrett ◽

James K. Aden ◽

Grant M. Williams ◽

Samantha L. Butler-Garcia ◽

...

Keyword(s):

Risk Factors ◽

Thyroid Nodules ◽

Medical Center ◽

Statistical Significance ◽

Retrospective Chart Review ◽

Needle Aspiration ◽

Chi Square ◽

Increased Risk ◽

Risk Of Malignancy ◽

History Of

Objective: An indeterminate thyroid nodule fine-needle aspiration (FNA) presents a unique dilemma. We evaluated our institution’s experience with Bethesda III thyroid nodules, including the risk of malignancy (ROM) of these nodules removed for diagnostic lobectomy and radiologic and clinical risk factors for malignancy. Study design: Retrospective chart review. Setting: San Antonio Military Medical Center (SAMMC; 483 bed Military Treatment Facility and Level 1 Trauma Center). Methods: We identified all patients with a Bethesda III thyroid FNA at our institution from 2010 to 2018 and determined which nodules were removed. The final histological diagnosis was recorded. Whether or not age, gender, body mass index (BMI), race, nodule size, margin regularity, rate of nodule growth, vascularity, internal calcifications, family history of thyroid cancer, personal history of radiation, and history of repeated AUS/FLUS on FNA had a significant impact on malignancy risk was evaluated with chi square and rank sum Wilcoxon tests. Results: 492 patients had 1 or more AUS result. 52% (258/492) underwent repeat FNA. This resulted in Bethesda II or III in 90% (232/258). In 10% (26/258), the repeat FNA resulted in a higher Bethesda grade. 183 lobectomies were performed on the side containing an AUS nodule. The malignancy percentage was 38.3% (70/183). Age less than 30 was the only variable showing statistical significance for increased risk of malignancy ( P = .04). Conclusion: The ROM of nodules characterized as AUS/FLUS on FNA may be higher than expected. Age may be a better predictor of malignancy than repeat FNA.

Download Full-text

EPID-02. HEIGHT AND THE RISK OF MENINGIOMA

Neuro-Oncology ◽

10.1093/neuonc/noz175.302 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi74-vi74

Author(s):

Shlomit Yust-Katz ◽

Alexandra Amiel ◽

Ramiz Abu Shkara ◽

Tali Siegal ◽

Gilad Twig

Keyword(s):

Risk Factors ◽

Autoimmune Diseases ◽

Cancer Registry ◽

Large Population ◽

Univariate Analysis ◽

Significant Risk ◽

Female Gender ◽

Total Study Population ◽

Increased Risk ◽

History Of

Abstract BACKGROUND Meningiomas are the most common primary central nervous system tumors. Risk factors for meningiomas including obesity, height, history of allergy/atopy or autoimmune diseases, have been previously assessed with conflicting results. We reviewed a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas. METHODS This study analyzed a cohort of 2,035,915 Jewish men and women who underwent obligatory physical examination when aged 16 to 19 years, from 1967 to 2011. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according to sex, body mass index (BMI), height, history of allergic and autoimmune disease. RESULTS Linkage of the adolescent military database with the Israeli cancer registry identified 480 cases (152 males and 328 females) of meningioma during a follow up of 40,304,078-person years. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only female gender (p< 0.01) and height (p< 0.01) were associated with risk for meningioma in the total study population. When stratified by gender, height remained a significant risk factor only in men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI, past medical history including asthma, diabetes, and atopic and autoimmune diseases, were not associated with meningioma risk. CONCLUSION in this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of adult meningioma.

Download Full-text

Emergence of Vancomycin Resistance after Treatment of Enterococcus: Risk Factors for Subsequent Pathogen Resistance

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.754 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s211-s212

Author(s):

Zachary Shepard ◽

Robert Woods ◽

Twisha Patel

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Descriptive Analysis ◽

Univariate Analysis ◽

Pathogen Resistance ◽

Fisher Exact Test ◽

Retrospective Case ◽

Exact Test ◽

Increased Risk

Background: Vancomycin-resistant Enterococcus (VRE) is a leading cause of nosocomial infections that carries an increased risk of mortality when compared to vancomycin-sensitive Enterococcus (VSE). Data on the frequency of conversion between VSE and VRE in patients are scarce. Among patients presenting with VSE infections, little is known about the subsequent risk of conversion to VRE in the initial treatment period. Methods: A descriptive analysis of VSE to VRE conversion and a retrospective case-control study were performed examining cases of VSE that had subsequent cultures positive for VRE within 90 days within a quaternary healthcare system. Cases were obtained from June 2013 through December 2018. Controls were patients who had VSE culture followed by another VSE culture and were matched by organism (E. faecalis or E. faecium), time between cultures, and initial culture site. Age, gender, healthcare, antibiotic, Clostridiodes difficile, proton pump inhibitor (PPI) exposure, and H2 blocker exposures, and prior VRE infection or colonization were abstracted from the electronic medical record. A univariate analysis with the Fisher exact test was performed with significance considered for P < .05. Results: In total, 8,913 cases of E. faecalis and 2,322 cases of E. faecium were included in the study. Of 8,913 cases of E. faecalis, 51 of 8,503 (0.6%) cultured VRE after VSE, and 47 of 403 (11.7%) cultured VSE after initial VRE. Of E. faecium, 51 of 783 (6.5%) cultured VRE after VSE, and 76 of 1,532 (5.0%) cultured VSE after initial VRE. In total, 76 cases were matched with 99 controls. Patients converting from VSE to VRE were more likely to have prior admission to an intensive care unit (P = .0207), prior positive swab or culture for VRE (P = .0114), previous C. difficile infection (P = .0155), prior vancomycin (P = .0022) and cefepime (P = .0089) exposure. Patients receiving vancomycin after initial VSE culture were more likely to have subsequent cultures positive for VRE (P = .0053). There was no difference in age (P = .966) or male sex (P = .7588). Conclusions: Conversion from VSE to VRE is common, and E. faecium is more likely to become resistant than E. faecalis. Reversion to a vancomycin-sensitive phenotype is also common, and E. faecalis is more likely to show subsequent sensitivity than E. faecium. Previous admission to an intensive care unit, prior colonization or infection with VRE, prior C. difficile infection, and exposure to vancomycin and cefepime are risk factors for emergence of VRE after treatment for vancomycin-sensitive Enterococcus.Funding: NoneDisclosures: None

Download Full-text

Abstract 2733: The Comparative Importance of `Shared' Risk Factors for Ischemic Stroke and Intracerebral Hemorrhage in Patients with Atrial Fibrillation

Stroke ◽

10.1161/str.43.suppl_1.a2733 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Emer R McGrath ◽

Moira K Kapral ◽

Jiming Fang ◽

Martin J O'Donnell ◽

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Ischemic Stroke ◽

Renal Impairment ◽

Intracerebral Hemorrhage ◽

Vascular Disease ◽

Multivariable Analysis ◽

Increased Risk ◽

History Of ◽

Shared Risk

Background: Optimal prescribing of oral anticoagulants, for the prevention of stroke in patients with atrial fibrillation, requires clinicians to estimate the competing risk of ischemic stroke and intracerebral hemorrhage (ICH). However, a number of risk factors increase the risk of both ischemic stroke and ICH (e.g. age, hypertension and chronic renal disease), and it is unclear how these ‘shared’ risk factors should influence decisions on antithrombotic therapy. Objective: To determine the comparative importance of risk factors for ischemic stroke and ICH in patients with atrial fibrillation, focusing primarily on risk factors included in the CHA2DS2VASC (risk of ischemic stroke) and HAS-BLED (risk of major bleeding) scores. Methods: Prospective registry of 3,197 patients admitted with acute ischemic stroke or ICH and atrial fibrillation included in the Registry of the Canadian Stroke Network (Jul 03-Mar 08; 11 Regional Stroke Centers in Ontario, Canada). Multivariable analysis was used to determine the association between baseline risk factors (age, sex, history of hypertension, previous stroke or transient ischemic attack, history of congestive heart failure, history of vascular disease, hepatic impairment, current alcohol intake, history of diabetes mellitus, history of gastro-intestinal bleeding, renal impairment, admission INR and antiplatelet therapy) and risk of ischemic stroke versus ICH. Results: Of 3,197 patients with atrial fibrillation and acute stroke, 2,806 (87.8%) presented with an ischemic stroke and 391 (12.2%) presented with an ICH. Of the ‘shared’ risk factors, age (OR 1.17; 95% CI 1.04-1.31 per decade) and previous history of stroke (OR 1.40; 95% CI 1.09-1.81) were associated with an increased risk of ischemic stroke relative to ICH, while a history of hypertension (OR 0.90; 95% CI 0.69-1.18) and renal impairment (OR 1.29; 0.96-1.72) were not associated with either stroke subtype, on multivariable analyses. Of the ‘non-shared’ risk factors, alcohol consumption of <2 units/day vs. no consumption (OR 1.61; 95% CI 1.24-2.09), female sex (OR 1.53; 95% CI 1.20-1.96) and a history of vascular disease (OR 1.73; 95% CI 1.30- 2.30) were associated with an increased risk of ischemic stroke relative to ICH. Elevated INR at the time of admission was a significant predictor of ICH, relative to ischemic stroke. Conclusion: None of the ‘shared’ risk factors were stronger predictors of ICH compared to ischemic stroke, which has obvious implications for clinical practice. In particular, older age was more strongly associated with ischemic stroke than ICH in patients with atrial fibrillation, and therefore, should be considered as a factor favoring a decision to commence anticoagulant therapy.

Download Full-text

Abstract TP66: Laboratory Factors Predisposing to Risk of Intracerebral Hemorrhage After IV Thrombolysis for Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.tp66 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Haris Kamal ◽

Navdeep Lail ◽

Katelyn Kavak ◽

Aurangzeb Memon ◽

Amit Kandel ◽

...

Keyword(s):

Ischemic Stroke ◽

Blood Glucose ◽

Acute Ischemic Stroke ◽

Total Cholesterol ◽

Univariate Analysis ◽

Laboratory Data ◽

Significant Group ◽

Lipid Panel ◽

Increased Risk ◽

History Of

Background: Laboratory factors associated with hemorrhagic conversion (HC) after Intravenous thrombolysis with rtPA (IVT) for Acute Ischemic Stroke(AIS) remain nebulous despite advances in our knowledge of AIS. This study aimed to investigate laboratory factors predisposing to HC in AIS patients receiving IVT or IAT. Methods: We retrospectively reviewed the medical records of patients who received IV tPA for AIS at our comprehensive stroke center from 01/2006 till 07/2015. Besides age, gender, NIHSS, history of DM, history of atrial fibrillation (Afib), we gathered their laboratory data including INR, lipid panel, serum albumin, serum creatinine, hemoglobin A1c, and admission blood glucose. Post-thrombolysis brain imaging was reviewed to evaluate for any symptomatic ICH (sICH). The mean values of above mentioned laboratory data were compared between the group with sICH and non-bleeders. Univariate and multivariate logistic regression were performed to evaluate the association of the laboratory findings with presence of sICH. sICH was defined as ICH causing an increase in NIHSS ≥4. Results: Of the 794 subjects in this study 51 (6.4%) had sICH. In univariate analysis, patients who had sICH had significantly higher NIHSS on admission (14.2±5.4 vs 11.2±6.5, p<.001), LDL (113.3 mg/dl ±36.9 vs. 101.8±38.2, p=.032), HbA1c (6.9 %±2.3 vs. 6.1±1.3, p=.003) and lower levels of Albumin (3.5 mg/dl ±0.4 vs. 3.9±0.5, p<.001) compared to subjects with non-bleeders. Furthermore, a higher prevalence of history of DM (34.8% vs. 22.2%, p=.020) and Afib (19.7% vs. 10.7%, p=.028) was found in subjects presenting with sICH. There were no significant group differences regarding age, sex, total cholesterol, blood glucose on admission, Creatinine or INR levels ( p>.05). After adjusting for covariates , Lower Albumin levels, higher LDL, higher total Cholesterol and higher HbA1c were significantly associated with an increased risk for sICH development. Chance of sICH decreased by 77% for every increase by 1mg/dl towards a normal albumin level (p<0.05). Conclusion: Multiple laboratory factors including lower endogenous albumin levels and higher HbA1C have shown to predispose to a higher risk of HC after IV thrombolysis and might be good predictor of of sICH post IV thrombolysis.

Download Full-text

Risk factors for latex sensitization in young children with myelomeningocele

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.4.peds08364 ◽

2009 ◽

Vol 4 (3) ◽

pp. 285-288 ◽

Cited By ~ 6

Author(s):

Masoud Majed ◽

Farideh Nejat ◽

Mostafa El Khashab ◽

Parvin Tajik ◽

Mohammad Gharagozloo ◽

...

Keyword(s):

Risk Factors ◽

Barium Enema ◽

Univariate Analysis ◽

Young Patients ◽

Diagnostic Procedures ◽

Specific Ige ◽

Increased Risk ◽

History Of ◽

Skin Prick Tests ◽

Low Prevalence

Object Patients with myelomeningoceles (MMCs) are at increased risk of latex allergy and sensitization. Number of surgeries and history of atopy are known risk factors. The object of this study was to evaluate the role of diagnostic procedures and nonsurgical treatments in latex sensitization in young patients with MMC. Methods Seventy-three children with MMC were included in the study. For each child a questionnaire was administered and serum determination of IgE was performed, and 62 children underwent skin prick tests (SPTs), 60 of which had reliable results. Multivariate logistic regression modeling was performed, using latex sensitization as the dependent variable. Results The mean age of the 73 patients was 3.8 years. The SPT results were positive in 30.6%, whereas results of testing for latex-specific IgE were positive in only 8.2%. In univariate analysis, history of untethering, barium enema, and number of clean intermittent catheterizations (CICs) per day were significantly associated with positive results on the SPT. Although the number of surgical procedures was significantly higher in patients who had shunts, no significant relationship between the presence of a shunt and latex sensitization was seen. Conclusions The young age of the patients in this study may account for the low prevalence of latex sensitization that was found. In young patients with MMC, the numbers of CICs per day, a history of untethering, circumcision, and a barium enema performed without latex-free equipment could be risk factors for latex sensitization. The use of latex-free gloves in all procedures performed in these cases, nonlatex polyvinyl chloride catheters in CIC, and ordinary nonballoon tips in barium enemas could decrease the risk of sensitization.

Download Full-text