Comparison of Outcomes After Primary Laparoscopic Versus Open Approach for T1b/T2 Gallbladder Cancer

ObjectivesThe primary laparoscopic approach (PLA) for T1b/T2 gallbladder cancer (GBC) remains contradicted. We aimed to compare the perioperative and long-term outcomes after PLA versus open approach (OA) for T1b/T2 GBC.MethodsPatients with resected T1b/T2 GBC were selected from our hospital between January 2011 and August 2018. Overall survival (OS), disease-free survival (DFS), and several secondary outcomes were used to evaluate safety and effectiveness. Subgroup analyses were performed to identify significant risk factors for OS/DFS in GBC patients undergoing PLA/OA.ResultsA total of 114 patients who underwent OA (n = 61) or PLA (n = 53) were included in the study. The percent of PLA cases was increased over time from 40.0% in 2011 to 70.0% in 2018 (p < 0.05). There was no significant difference in OS [hazard ratio (HR), 1.572; 95% confidence interval (CI), 0.866–2.855; p = 0.13] and DFS (HR, 1.225; 95% CI, 0.677–2.218; p = 0.49). No significance was found for intraoperative drainage placement (p = 0.253), intraoperative blood loss (p = 0.497), operation time (p = 0.105), postoperative hospitalization (p = 0.797), positive LNs (p = 0.494), total harvested LNs (p = 0.067), and recurrence rates (P = 0.334). Subgroup analyses demonstrated no significance of conversion rates after PLA (all p > 0.05). Patients undergoing PLA with good/poor OS would have similar recurrence rates (p = 0.402). Positive LNs (p = 0.032) and tumor differentiation (p = 0.048) were identified as risk factors for OS after PLA, while positive LNs (p = 0.005) was identified for OS after OA. Moreover, age (p = 0.013), gallbladder stone (p = 0.008), tumor size (p = 0.028), and positive LNs (p = 0.044) were potential risk factors for DFS after OA.ConclusionsPLA for T1b/T2 GBC was comparable to OA in terms of perioperative and long-term outcomes. Less positive LNs and well-differentiated tumors were independent predictors for better OS after PLA, and less positive LNs were also identified for better OS after OA. Additionally, younger age, without gallbladder stone, smaller tumor size, and less positive LNs were potential risk factors for better DFS after OA.

Download Full-text

Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors

Diagnostics ◽

10.3390/diagnostics11081303 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1303

Author(s):

Khairunnisa’ Md Yusof ◽

Kelly A. Avery-Kiejda ◽

Shafinah Ahmad Suhaimi ◽

Najwa Ahmad Zamri ◽

Muhammad Ehsan Fitri Rusli ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Potential Risk ◽

Breast Cancer Survivors ◽

Ultrasound Examination ◽

Arm Circumference ◽

Potential Risk Factors ◽

Breast Cancer Related Lymphedema

Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients.

Download Full-text

Clinical Risk Factors for Long-term Hospital Stay in Common Patients with coronavirus disease 2019(COVID-19)

10.21203/rs.3.rs-34982/v1 ◽

2020 ◽

Author(s):

Wei Lu ◽

Junjie Fang ◽

Bin Chen ◽

Dan Wu ◽

Chunyao Yu ◽

...

Keyword(s):

Risk Factors ◽

Hospital Stay ◽

Potential Risk ◽

Clinical Laboratory ◽

Short Term ◽

Factors Associated ◽

Regression Methods ◽

Potential Risk Factors ◽

Multivariable Regression

Abstract Background This study aimed to investigate the potential risk factors associated with hospital stay in mild patients with COVID-19. Methods A total of 109 laboratory-confirmed COVID patients with initial common subtype diseased by real-time RT-PCR that meet discharge standards were retrospectively included from January 16 to March 15 of 2020. Baseline demographic, clinical, laboratory examination was extracted from electronic medical records at the first day of admission and compared between short-term hospital stay and long-term hospital stay. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with hospital stay. Results Of 109 COVID-19 patients, 61 patients were short-term stay (≤ 10 days) and 48 patients were long-term stay (> 10 days). The average age of patients in short-term stay were younger than those long-term stay(P = 0.01). Hypertension was the most common comorbidity (34%, 21/61), followed by diabetes (15%,9/61) and Cardiopathy (8%, 5/61). Fever and cough were the typical clinical manifestation in two group. Decreased WBC, Hemoglobin and increased Monocyte, MLR (Monocyte Lymphocyte ratio) and Hypersensitive CRP showed a long-term stay (all P < 0.05). The treatment of Resochin and Human immunoglobulin had a shorter hospital stay. Multivariable regression showed that MLR and CRP on admission were risk factors for predicting the hospital stay, with the HR (hazard ratio 2.03, 1.02–5.39; P = 0.022) and (1.32,1.05–3.24, P = 0.045) respectively. Conclusions The potential risk factors of MLR and CRP may help clinicians to predict the hospital stay of COVID-19 patients.

Download Full-text

Long-term Clinical Evaluation of Tapered Multi-threaded Implants: Results and Influences of Potential Risk Factors

Journal of Oral Implantology ◽

10.1563/0.830.1 ◽

2006 ◽

Vol 32 (6) ◽

pp. 300-307 ◽

Cited By ~ 17

Author(s):

Zeev Ormianer ◽

Ady Palti

Keyword(s):

Risk Factors ◽

Bone Loss ◽

Potential Risk ◽

Survival Rates ◽

Marginal Bone Loss ◽

Wide Diameter ◽

Clinical Complications ◽

Bone Changes ◽

Potential Risk Factors

Abstract This prospective study evaluated the long-term performance of tapered screw implants placed in patients with a variety of potentially compromising clinical variables. Sixty patients were treated with 218 implants; each case included one or more potential risk factors associated with increased rates of implant failure, peri-implant bone loss or clinical complications in the dental literature: short implants (23%), comorbid conditions (25%), maxillary implants (61%), immediate loading (88.5%), placement into extraction sockets (91%), and partial edentulism (97%). The implants were restored with a variety of prostheses. Marginal bone changes were calculated utilizing periapical radiographs taken at placement and at all subsequent appointments utilizing a standardized paralleling device and a 1-mm measurement grid. Mean clinical follow-up was 67.5 (range: 1–94) months for implants and 60 (range: 15–74) months for prostheses. Four implants failed to integrate and were immediately replaced by wide-diameter implants. Eight prostheses sustained porcelain fracture (n = 7) or cement failure (n = 1) and were replaced. No peri-implant marginal bone loss was observed for 98% of the implants; the remaining 2% exhibited 1 mm of bone loss. Cumulative survival rates were 98.2% for implants and 96.3% for prostheses after 5 years of clinical loading. Concerns that tapered implant designs may be more prone to crestal bone loss than cylinder designs are unsupported by the results of this study. Tapered implants maintained integration and marginal bone levels despite the presence of one or more potentially compromising variables.

Download Full-text

The Artificial Urinary Sphincter (AUS) in male non-neurogenic incontinence: Long-term analysis of the functional and subjective outcomes and potential risk factors for failure

European Urology ◽

10.1016/s0302-2838(21)00505-4 ◽

2021 ◽

Vol 79 ◽

pp. S161

Author(s):

C. Schillebeeckx ◽

Y. Deruyver ◽

G. Tasso ◽

E. Beels ◽

D. De Ridder ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Artificial Urinary Sphincter ◽

Urinary Sphincter ◽

Potential Risk Factors ◽

Subjective Outcomes ◽

Term Analysis

Download Full-text

Nephrogenic metaplasia: long-term haemodialysis and anuria as potential risk factors and reversibility with renal transplantation

Nephrology Dialysis Transplantation ◽

10.1093/ndt/10.11.2101 ◽

1995 ◽

Keyword(s):

Risk Factors ◽

Renal Transplantation ◽

Potential Risk ◽

Potential Risk Factors ◽

Nephrogenic Metaplasia

Download Full-text

Long-term Ultraviolet Flux, Other Potential Risk Factors, and Skin Cancer Risk: A Cohort Study

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-13-0821 ◽

2014 ◽

Vol 23 (6) ◽

pp. 1080-1089 ◽

Cited By ~ 83

Author(s):

Shaowei Wu ◽

Jiali Han ◽

Francine Laden ◽

Abrar A. Qureshi

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Skin Cancer ◽

Cancer Risk ◽

Potential Risk ◽

Skin Cancer Risk ◽

Potential Risk Factors

Download Full-text

Mood Disorders in Late-Life

University of Toronto Journal of Public Health ◽

10.33137/utjph.v1i1.33826 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Rachel Strauss ◽

Paul Kurdyak ◽

Richard H Glazier

Keyword(s):

Risk Factors ◽

Substance Use ◽

Food Insecurity ◽

Mood Disorder ◽

Mood Disorders ◽

Potential Risk ◽

Late Life ◽

Term Care ◽

Potential Risk Factors

Background: Mental health concerns in late-life is a growing public health challenge as the population aged 65 and older rapidly increases locally and worldwide. An updated understanding of the causes of mood disorders in late-life and their consequences could guide interventions for this underrecognized and undertreated problem. We undertook a population-based analysis to quantify the prevalence of mood disorders in late-life in Ontario, Canada and to identify potential risk factors, and consequences. Methods: Individuals aged 65 or older participating in 4 cycles of a nationally-representative survey were included. A self-reported diagnosis of a mood disorder was used to classify individuals with mood disorders. Using linked administrative data, we quantified associations between potential risk factors, such as demographic/socioeconomic factors, substance use, and morbidity, and mood disorder. We also determined associations between mood disorders and outcomes (health service utilization and mortality) 5 years after the index interview date. Findings: The overall prevalence of mood disorders was 6.1% (4.9% among males,7.1% among females). The proportion of individuals with a mood disorder was higher among females for all potential risk factors. Statistically significant associations with mood disorder included age, sex, food insecurity, chronic opioid use, smoking, and morbidity. Individuals with mood disorders had increased odds of all long-term consequences, including hospitalization (adjusted OR [odds ratio]=1.55 95% CI [confidence interval]: 1.31-1.83); admission to long-term care (adjusted OR=2.28 95% CI: 1.71-3.02); and death (adjusted OR=1.35 95% CI: 1.13-1.63). Interpretation: Mood disorders in late-life were strongly correlated with demographic and social/behavioural factors as well as long-term health utilization outcomes. The understanding of correlations between potential risk factors for mood disorders in late-life provides a basis for potential interventions to reduce their occurrence and consequences. Interventions that target females, younger age groups, those with food insecurity or substance use, and individuals with co-morbidities may be promising.

Download Full-text