scholarly journals Potential Increased Risk of Trisomy 18 Observed After a Fertilizer Warehouse Fire in Brazos County and TX

2020 ◽  
Vol 17 (7) ◽  
pp. 2561
Author(s):  
Xiaohui Xu ◽  
Xiao Zhang ◽  
JeongWon Han ◽  
Yau Adamu ◽  
Bangning Zhang
Keyword(s):  
Observational Study ◽  
Confidence Interval ◽  
Trisomy 21 ◽  
Trisomy 18 ◽  
Chromosomal Anomalies ◽  
Live Births ◽  
Increased Risk ◽  
Significant Difference ◽  
Warehouse Fire ◽  
Fire Accident

Background: In this paper, we aimed to investigate the potential impacts of a fire accident in a fertilizer warehouse on chromosomal anomalies, including Trisomy 21 (T21) and Trisomy (T18) among pregnancies in Brazos County, Texas. We conducted an observational study in Brazos County, TX, with all patients of T18 and T21 cases in the live births in Brazos County between 2005–2014. The prevalence of T18 and T21 before, during, and after the accident in Brazos County were calculated and compared. The Standardized Morbidity Ratio (SMR) was applied to compare the prevalence of T18 and T21 in Brazos County to the statewide prevalence in Texas after adjusting for maternal race and age. Compared with statewide risk, the risk of T18 during the impacted years in Brazos county was found to be significantly higher (SMR = 5.0, 95% Confidence Interval(CI): 2.19–9.89), while there was no significant difference before (SMR = 0.77, 0.13–2.54) and after the accident (SMR = 0.71, 0.12–2.36). However, the prevalence of T21 during the impacted years was not significantly different from those before or after the accident. This study conclusively suggests that this fertilizer fire may be related to the increased prevalence of T18 in Brazos County, though the findings warrant further investigation.

scholarly journals Increased Risk of Trisomy 18 Observed after a Fertilizer Warehouse Fire in Brazos County, TX

2019 ◽  
Vol 3 ◽  
pp. 449
Author(s):  
Xu X ◽  
Zhang X ◽  
Han J ◽  
Adamu Y ◽  
Zhang B
Keyword(s):  
Trisomy 18 ◽  
Increased Risk ◽  
Warehouse Fire

Total amount of circulating human chorionic gonadotrophin α and β subunits in first trimester trisomies 21 and 18

1996 ◽  
Vol 148 (1) ◽  
pp. 27-31 ◽  
Author(s):  
E Jauniaux ◽  
K H Nicolaides ◽  
A-M Nagy ◽  
M Brizot ◽  
S Meuris
Keyword(s):  
Trisomy 21 ◽  
First Trimester ◽  
Maternal Serum ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Trisomy 18 ◽  
Serum Samples ◽  
Significant Difference ◽  
Common Unit ◽  
Α And Β Subunits

Abstract The aim of this study was to evaluate the variations in the balance between total (free and combined) circulating α and β subunits of human chorionic gonadotrophin (hCG) in trisomy 21 and 18. Maternal serum samples were collected at 10 and 11 weeks of gestation from 22 singleton pregnancies with trisomy 21 (n=17) and trisomy 18 (n=5) and 66 chromosomally normal controls, matched for gestational age. The hCG and free α and β subunits circulating levels were measured using specific immunoradiometric assays and converted in a common unit system obtained using calibration of the assays with intact and thermally dissociated purified hCG preparation. In trisomy 21, the only significant difference from controls was in the free βhCG level which was increased. In trisomy 18, intact hCG, free βhCG as well as total αhCG and total βhCG levels were significantly lower whereas the free αhCG level was significantly higher than in controls. The decrease in total βhCG was more pronounced than the decrease in total αhCG resulting in a significant increase in the total α- to βhCG subunit ratio in trisomy 18. These findings suggest some modifications in the biosynthesis and/or release rates of the hCG subunits in these trisomies. Journal of Endocrinology (1996) 148, 27–31

scholarly journals A cross sectional observational study to find the difference in occurrence of muscle related adverse effects of statins among geriatric and non-geriatric patients

2018 ◽  
Vol 7 (9) ◽  
pp. 1817
Author(s):  
Monica Aggarwal ◽  
Shivani Juneja ◽  
Muskan Goyal ◽  
Tariq Khurana
Keyword(s):  
Adverse Effects ◽  
Observational Study ◽  
Older People ◽  
Patient Information ◽  
Geriatric Patients ◽  
Creatine Phosphokinase ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference ◽  
The Difference

Background: Statins are effectively used for the treatment of dyslipidemias in geriatric patients. The geriatric patients are more vulnerable to experience consequences of drug intensification leading to the manifestation of adverse effects, such as muscle related adverse effects (MRAE) with statins use. The main objective was to find the difference in the occurrence of MRAE of statins among geriatric and non-geriatric users.Methods: This was a cross-sectional, observational comparative study in which MRAE associated with statins and relevant patient information was noted. Creatine phosphokinase (CPK) levels which are considered as a marker for statin induced muscle damage were obtained for all patients. The different parameters were compared among geriatric and non-geriatric statin users.Results: Sixty one patients, 28 geriatric (≥60 years) and 33 non-geriatric (<60 years) statin users were enrolled in this study. Ten (38%) geriatric statin users as compared to 6 (20%) non-geriatric statin users were found to have MRAE (P = 0.207). No significant difference in the occurrence of MRAE among geriatric and non-geriatric statin users was found.Conclusions: The results obtained from the present study suggest that statins are relatively safe, even in older people. There was no evidence to suggest an increased risk of MRAE in geriatric patients receiving statin therapy as compared to non- geriatric patients.

scholarly journals Atrioventricular septal defects among infants in Europe: a population-based study of prevalence, associated anomalies, and survival

2012 ◽  
Vol 23 (4) ◽  
pp. 560-567 ◽  
Author(s):  
Nikolas Christensen ◽  
Helle Andersen ◽  
Ester Garne ◽  
Diana Wellesley ◽  
Marie-Claude Addor ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Coarctation Of The Aorta ◽  
Population Based ◽  
Chromosomal Anomalies ◽  
Population Based Study ◽  
Live Births ◽  
Atrioventricular Septal Defects ◽  
Septal Defects ◽  
Total Prevalence ◽  
Cardiac Lesions

AbstractObjectiveTo describe the epidemiology of chromosomal and non-chromosomal cases of atrioventricular septal defects in Europe.MethodsData were obtained from EUROCAT, a European network of population-based registries collecting data on congenital anomalies. Data from 13 registries for the period 2000–2008 were included.ResultsThere was a total of 993 cases of atrioventricular septal defects, with a total prevalence of 5.3 per 10,000 births (95% confidence interval 4.1 to 6.5). Of the total cases, 250 were isolated cardiac lesions, 583 were chromosomal cases, 79 had multiple anomalies, 58 had heterotaxia sequence, and 23 had a monogenic syndrome. The total prevalence of chromosomal cases was 3.1 per 10,000 (95% confidence interval 1.9 to 4.3), with a large variation between registers. Of the 993 cases, 639 cases were live births, 45 were stillbirths, and 309 were terminations of pregnancy owing to foetal anomaly. Among the groups, additional associated cardiac anomalies were most frequent in heterotaxia cases (38%) and least frequent in chromosomal cases (8%). Coarctation of the aorta was the most common associated cardiac defect. The 1-week survival rate for live births was 94%.ConclusionOf all cases, three-quarters were associated with other anomalies, both chromosomal and non-chromosomal. For infants with atrioventricular septal defects and no chromosomal anomalies, cardiac defects were often more complex compared with infants with atrioventricular septal defects and a chromosomal anomaly. Clinical outcomes for atrioventricular septal defects varied between regions. The proportion of termination of pregnancy for foetal anomaly was higher for cases with multiple anomalies, chromosomal anomalies, and heterotaxia sequence.

scholarly journals Current understanding of bleeding with ibrutinib use: a systematic review and meta-analysis

2017 ◽  
Vol 1 (12) ◽  
pp. 772-778 ◽  
Author(s):  
François Caron ◽  
Darryl P. Leong ◽  
Christopher Hillis ◽  
Graeme Fraser ◽  
Deborah Siegal
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Confidence Interval ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Allocation Concealment ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Significant Difference ◽  
Event Rates

Abstract Ibrutinib therapy was associated with an increased risk of bleeding in previous trials. In this systematic review and meta-analysis of published trials including patients treated with ibrutinib, the relative risk (95% confidence interval [CI]) of overall bleeding was significantly higher in ibrutinib recipients (2.72 [1.62-6.58]), but major bleeding did not show a significant difference (1.66 [0.96-2.85]). The incidences (95% CI) of major bleeding and any bleeding were 3.0 (2.3-3.7) and 20.8 (19.1-22.1) per 100 patient-years, respectively. This analysis is limited by reporting bias from variable ascertainment of bleeding and lack of allocation concealment in some studies and differing exposures between groups, leading to potential overestimation of event rates in the ibrutinib group.

scholarly journals P112 Teriparatide versus anti-resorptive treatment in rheumatoid arthritis patients with severe osteoporosis: an observational study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Barbara Hauser ◽  
Kathryn M Berg ◽  
Justine A Lambert ◽  
Stuart H Ralston
Keyword(s):  
Rheumatoid Arthritis ◽  
Observational Study ◽  
P Value ◽  
T Score ◽  
Increased Risk ◽  
Anabolic Treatment ◽  
Significant Difference ◽  
Hip Bmd ◽  
History Of ◽  
Osteoporosis Clinic

Abstract Background/Aims  Patients with rheumatoid arthritis (RA) are at increased risk of developing osteoporosis (OP) and have a twofold increased risk of vertebral fracture compared with the general population. There is increasing evidence that teriparatide (TPTD) is superior to anti-resorptive medication in patients with severe spinal OP.The aim of this study was to compare the efficacy of TPTD with anti-resorptive treatment (ART) in RA patients with severe spinal OP. Methods  Observational study of RA patients and controls with severe OP who were referred to a specialist osteoporosis clinic. Patients with a history of two vertebral fractures or a spinal BMD Tscore &lt; -4 were offered either TPTD or standard care with either oral or parenteral ART. After completion of TPTD treatment patients were advised to commence ART. DEXA re-evaluation was usually performed after 1, 2 and 5 years. Results  We studied 59 postmenopausal women with RA who had severe spinal OP. In the RA group 29 patients received TPTD treatment and 30 patients were started on ART (12 Zoledronic acid, 11 Alendronate, 3 Risedronate, 2 Denosumab, 1 Etidronate and 1 unknown).RA patients who were started on TPTD were on average 5 years younger (65.4 ±10.6) than patients who were started on ART (70.6±8.2; p = 0.041). Slightly more than half of TPTD RA patients (55.2%) had previously received bisphosphonates and 10.3% received low dose Prednisolone (mean± SD dose = 5.5 ± 3.3 mg). Baseline lumbar spine T-score was -4.25±0.57 in the RA TPTD group. Patients with RA who elected to have ART as opposed to TPTD had higher BMD values as compared with those who chose to have TPTD (T-score = -3.39±1.09; p = 0.001, from RA TPTD group).We found that increase in BMD with TPTD treatment was superior to ART in the RA group at increasing spine BMD after 2 years (+17.59% ± 9.63% vs 3.19 % ± 4.99% , p value&lt;0.001). Assessment after 5 years following commencement of ART showed that spine BMD remained higher in the RA TPTD group than in the RA ART group alone (18.0% ± 11.6% vs 6.36 % ± 8.95%; p = 0.019). However, there was no significant difference between TPTD and ART on hip BMD change at 2 years (+ 3.6% ± 12.2 % vs -0.57% ± 5.96%, p = 0.237) or 5 years (+1.0% ± 10.9% vs -0.3% vs ± 7.8%, p = 0.724). Conclusion  This real-world study confirms that TPTD treatment is more effective in treating severe spinal OP in RA patients than antiresorptive medication alone. Despite the fact that the majority of RA patients had been pre-treated with bisphosphonates the TPTD treatment effect in RA patients was robust. Anabolic treatment with TPTD is a good option for RA patients with severe spinal OP. Disclosure  B. Hauser: Other; Dr Hauser has received fees for a promotional article from Gedeon Richter. K.M. Berg: None. J.A. Lambert: None. S.H. Ralston: Grants/research support; Prof Ralston has received grant funding from Lilly for an observational study and donation of Teriparatide for the TOPAZ trial in Osteogenesis Imperfecta.

scholarly journals Hemorrhage in patients with polycythemia vera receiving aspirin with an anticoagulant: a prospective, observational study

Haematologica ◽  
2021 ◽  
Author(s):  
Jeffrey I. Zwicker ◽  
Dilan Paranagama ◽  
David S. Lessen ◽  
Philomena M. Colucci ◽  
Michael R. Grunwald
Keyword(s):  
United States ◽  
Observational Study ◽  
Confidence Interval ◽  
Polycythemia Vera ◽  
Prospective Observational Study ◽  
The United States ◽  
Increased Risk ◽  
Adjusted Rate ◽  
Risk Of Hemorrhage

Polycythemia vera (PV) is associated with increased risk of thrombosis and hemorrhage. Aspirin, recommended for primary thromboprophylaxis, is often combined with anticoagulants during management of acute thrombotic events. The safety of dual antiplatelet and anticoagulant therapy is not established in PV. In a prospective, observational study, 2510 patients with PV were enrolled at 227 sites in the United States. Patients were monitored for the development of hemorrhage and thrombosis after enrollment. A total of 1602 patients with PV received aspirin with median (range) follow-up of 2.4 (0-3.6) years. The exposure-adjusted rate of all hemorrhages in patients receiving aspirin alone was 1.40 per 100 patient-years (95% confidence interval [CI]: 0.99-1.82). The combination of aspirin plus anticoagulant was associated with an incidence of hemorrhage of 6.75 per 100 patient-years (95% CI: 3.04-10.46). The risk of hemorrhage was significantly greater in patients receiving the combination of aspirin and anticoagulant compared with aspirin alone (total hemorrhages, hazard ratio [HR]: 5.83; 95% CI: 3.36-10.11; P

scholarly journals Age is a predictor for the recurrence of syncope in vasovagal syncope patients with a positive head-up tilt test

2019 ◽  
Author(s):  
Yongjuan Guo ◽  
Xiaomin Chen ◽  
Tianze Zeng ◽  
Lin Wang ◽  
Lvwei Cen
Keyword(s):  
Confidence Interval ◽  
Vasovagal Syncope ◽  
Predictive Performance ◽  
Tilt Test ◽  
Logistics Regression ◽  
Increased Risk ◽  
Significant Difference ◽  
Valid Predictor ◽  
Head Up Tilt ◽  
Head Up Tilt Test

Abstract BACKROUND Valid predictors of the recurrence of syncope in vasovagal syncope(VVS) patients with a positive head-up tilt test (HUTT) are currently lacking. The goal of this study was to identify the predictive performance of age for the recurrence of syncope in VVS patients with a positive HUTT.METHODS in total, 175 VVS patients with a positive HUTT were followed for 6 to 32 months, and ≥1 syncope episodes during follow-up was considered the recurrence of syncope. The study population was divided into 2 groups, namely, a recurrence of syncope group (44 patients) and a no recurrence of syncope group (131 patients). The baseline clinical data, hemodynamic parameters and classification of the vasovagal syncope on the HUTT were analyzed. Logistics regression was used to analyze the effect size and confidence interval of age. A receiver operating characteristic(ROC) analysis was used to assess the predictive performance and investigate the predictive value of age by the area under the curve (AUC).RESULTS The age of recurrence of syncope group 60.0 (47.8, 66.0) years was older than that of no recurrence of syncope group 53.0 (43.0, 62.0) years, and there was a significant difference between the two groups (P < 0.05). The trend of syncope recurrence changed with age and the logistics regression model adjusted by sex showed that the elder was an increased risk of syncope recurrence in VVS with positive HUTT [OR value: 1.03, 95% confidence interval(CI) 1.008 to 1.061 p < 0.05].Age was a valid predictor for the recurrence of syncope in VVS patients with a positive HUTT (AUC: 0.688; 95%CI 0.598 to 0.777 p < 0.05). The cut-off value was 53.5 years, and the sensitivity and specificity were 72.7% and 52.7%, respectively. CONCLUSIONS Age may be a valid predictor for recurrence of syncope in VVS patients with positive HUTT. The rate of recurrence of syncope increased with increasing age, especially in old female.

scholarly journals Early-onset group BStreptococcus(EOGBS) infection subsequent to cessation of screening-based intrapartum prophylaxis: findings of an observational study in West London, UK

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018795 ◽  
Author(s):  
Guduru Gopal Rao ◽  
Jane Townsend ◽  
Daniel Stevenson ◽  
Grace Nartey ◽  
Stephen Hiles ◽  
...  
Keyword(s):  
Observational Study ◽  
Early Onset ◽  
Antimicrobial Prophylaxis ◽  
Mode Of Delivery ◽  
Healthcare Organisation ◽  
Live Births ◽  
Significant Difference ◽  
The Impact ◽  
Onset Group ◽  
Early Onset Group

ObjectivesTo describe the impact on early-onset group BStreptococcus(EOGBS) infection rates following reversion from screening-based to risk-based intrapartum antimicrobial prophylaxis (IAP) for prevention.SettingMaternity services provided by secondary healthcare organisation in North West London.ParticipantsAll women who gave birth in the healthcare organisation between April 2016 and March 2017. There were no exclusions.DesignObservational study comparing EOGBS rates in the postscreening period (2016–2017) with prescreening (2009–2013) and screening periods (2014–2015).MethodsLocal guidelines for risk-based IAP were reintroduced in April 2016. Compliance with guidelines was audited. Gestational age, mode of delivery, maternal demographics and EOGBS rates in three time periods were compared using Poisson regression analysis. EOGBS was defined through GBS being cultured from blood, cerebrospinal fluid or other sterile fluids within 6 days of birth.Primary outcomeEOGBS rates/1000 live births in prescreening, screening and postscreening periodsResultsIncremental changes in maternity population were observed throughout the study period (2009 onwards), in particular the ethnic profile of mothers. Of the 5033 live births in postscreening period, 9 babies developed EOGBS infection. Only one of the mothers of affected babies had a risk factor indicating use of IAP. Comparison of postscreening period with screening period showed a fivefold increase in EOGBS rates after adjustment for ethnicity (1.79 vs 0.33/1000 live births; risk ratio =5.67, p=0.009). There was no significant difference between prescreening and postscreening periods with rates of infection reverting to their prescreening level.ConclusionsThis study provides further evidence of efficacy of screening-based IAP compared with risk-based IAP in prevention of EOGBS in newborns in an area of high incidence.

Cardiac toxicity associated with dose and gender in patients undergoing chemoradiation for esophageal carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 112-112 ◽  
Author(s):  
Lauren Marie Tait ◽  
Joshua E. Meyer ◽  
Erin McSpadden ◽  
Jonathan D. Cheng ◽  
Philip Agop Philip ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Esophageal Carcinoma ◽  
Cardiac Toxicity ◽  
Tumor Location ◽  
T Test ◽  
Heart Volume ◽  
Female Patients ◽  
Dose Volume ◽  
Increased Risk ◽  
Significant Difference

112 Background: The purpose of this study was to identify factors associated with symptomatic cardiac toxicity in patients treated with chemoradiotherapy (CRT) for esophageal carcinoma. Methods: One-hundred and forty-four patients with adenocarcinoma or squamous cell carcinoma were treated from 7/2002 - 6/2011 at 2 academic institutions with pre-operative, definitive or palliative CRT. Chemotherapy and radiation therapy was administered at the discretion of the treating oncologist. Altogether, 120 patients had sufficient dose volume histogram (DVH) data for analysis and ≥3 month follow up from treatment completion. Association of cardiac toxicity with a number of variables was investigated, including heart disease, cardiac bypass/angioplasty, diabetes, insulin use, smoking, and tumor location (upper/middle vs. lower/GE junction). T-test assessed risk of cardiac toxicity secondary to age. Percentage of heart volume receiving >20, 30, 40, and 50 Gy (V20-V50) and its association with cardiac toxicity was evaluated for each patient. Fisher’s exact test was used to test for an association between dose volume parameters and cardiac toxicity. Results: Patient population included 93 males and 27 females with a mean age of 63 years. Any cardiac toxicity occurred in 27 patients, 8 of which were symptomatic. T-test comparing age to toxicity was not significant; however, female patients were 3.57 times more likely to have cardiac toxicity ([95% Confidence Interval 1.42-9.01], p=0.005). A significant difference in V40 existed between patients with cardiac toxicity and those without (p=0.05). Patients above the median cut-off for V40 (54%) had 2.48 increased odds of developing cardiac toxicity ([95% Confidence Interval 1.02-6.02], p=0.04). None of the other investigated variables were associated with an increased risk of developing cardiac toxicity. Conclusions: Female patients were found to have an increased risk of cardiac toxicity subsequent to receiving CRT for esophageal carcinoma. V40 greater than 54% was associated with increased cardiac toxicity. These data suggest exercising increased care when designing radiation fields in women undergoing CRT for esophageal carcinoma.

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