scholarly journals Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

2021 ◽  
Vol 10 (21) ◽  
pp. 5158
Author(s):  
Marek Czajkowski ◽  
Wojciech Jacheć ◽  
Anna Polewczyk ◽  
Jarosław Kosior ◽  
Dorota Nowosielecka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inverse Correlation ◽  
High Volume ◽  
Male Gender ◽  
Lead Extraction ◽  
Venous Obstruction ◽  
Vein Wall ◽  
Permanent Atrial Fibrillation ◽  
Related Risk

Background: our knowledge of lead-related venous stenosis/occlusion (LRVSO) remains limited and there is still controversy regarding the risk factors for LRVSO. Venography is mandatory before transvenous lead extraction (TLE). Methods: we performed a retrospective analysis of venograms in 2909 patients (39.43% females, average age 66.90 years) who underwent TLE between 2008 and 2021 at high-volume centers. Results: the severity of LRVSO was likely to be dependent on the number of leads in the system (OR = 1.345; p = 0.003), the number of abandoned leads (OR = 1.965; p < 0.001), the presence of coronary sinus leads (OR = 1.184; p = 0.056), male gender (OR = 1.349; p = 0.003) and patient age at first CIED implantation (OR = 1.008; p = 0.021). The presence of permanent atrial fibrillation (OR = 0.666; p < 0.001) and right ventricular diastolic diameter (OR = 0.978; p = 0.006) showed an inverse correlation with the degree of LRVSO. The combined three-model multivariate analysis provided better prediction of LRSVO using the above-mentioned factors than the CHA2DS2-VASc score. Conclusions: the severity of LRVSO is probably dependent on the mechanical impact of the implanted/abandoned leads on the vein wall, therefore the study has demonstrated the central role of system-/procedure-related risk factors. The thrombotic mechanism may be less important, especially long after implantation, and for this reason the combined prediction model for LRVSO in this study was more effective than the CHA2DS2-VASc score.

A prospective sonographic evaluation of peripheral intravenous catheter associated thrombophlebitis

2021 ◽  
pp. 112972982110090
Author(s):  
Nicholas Mielke ◽  
Steven Johnson ◽  
Patrick Karabon ◽  
Amit Bahl
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Assessment Tools ◽  
Vein Wall ◽  
True Incidence ◽  
Related Risk ◽  
Peripheral Intravenous Catheter ◽  
Catheter Tip ◽  
Catheter Size ◽  
Observational Cohort

Objective: Thrombophlebitis associated with peripheral intravenous catheters (PIVCs) is a poorly described complication in the literature. Given limited accuracy of current assessment tools and poor documentation in the medical record, the true incidence and relevance of this complication is misrepresented. We aimed to identify risk factors in the development of thrombophlebitis using an objective methodology coupling serial diagnostic ultrasound and clinical assessment. Methods: We conducted a single-site, prospective observational cohort study. Adult patients presenting to the emergency department that underwent traditionally placed PIVC insertion and were being hospitalized with an anticipated length of stay greater than 2 days were eligible participants. Using serial, daily ultrasound evaluations and clinical assessments via the phlebitis scale, we identified patients with asymptomatic and symptomatic thrombosis. The primary goal was to identify demographic, clinical, and IV related risk factors associated with thrombophlebitis. Univariate and multivariate analyses were employed to identify risk factors for thrombophlebitis. Results: A total of 62 PIVCs were included between July and August 2020. About 54 (87.10%) developed catheter-related thrombosis with 22 (40.74%) of the thrombosed catheters were characterized as symptomatic. Multivariate cox regression demonstrated that catheter diameter relative to vein diameter greater than one-third [AHR = 5.41 (1.91, 15.4) p = 0.0015] and angle of distal tip of catheter against vein wall ⩾5° [AHR = 4.39 (1.39, 13.8) p = 0.0116] were associated with increased likelihood of thrombophlebitis. Conclusions: Our study found that the increased proportion of catheter relative to vein size and steeper catheter tip angle increased the risk of thrombophlebitis. Catheter size relative to vein size is a modifiable factor that should be considered when inserting PIVCs. Additional larger prospective investigations using objective methodologies are needed to further characterize complications in PIVCs.

scholarly journals Relationship between serum leptin levels, non-cardiovascular risk factors and mortality in hemodialysis patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ivona Risovic ◽  
Vlastimir Vlatkovic ◽  
Snjezana Popovicpejicic ◽  
Gabrijela Malešević
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Survival Rates ◽  
Inverse Correlation ◽  
Study Groups ◽  
Mineral And Bone Disorder ◽  
Serum Leptin ◽  
Significant Difference

Abstract Introduction. Hemodialysis (HD) patients have higher mortality rate than the general population. Recent studies indicate a significant role of non-cardiovascular risk factors in for mortality in HD patients. Leptin is protein hormone and may indicate malnutrition in HD patients. Its role in mortality in these patients is being examined. This study aimed to investigate the correlation between serum leptin levels and non-cardiovascular risk factors and relationship between leptin level and mortality in HD patients. Methods The prospective study included 93 patients on maintenance HD and follow-up period was 12 months. We measured leptin level and evaluated non-cardiovascular risk factors: nutritional status, anemia, volemia, parameters of mineral and bone disorder. Results. Out of 93 patients 9 died during study and 1 underwent kidney transplantation. Malnutrition and hypervolemia were two main non-cardiovascular risk factors among deceased subjects. Leptin showed a significant direct correlation with nutritional BMI (r = 0.72, P <0.001), fat tissue index (r = 0.74, P <0.001) and statistically significant inverse correlation with leantissue index (r = -0.349, P <0.05) and inverse correlation with volemic parameters (overhydration / extracellular water ratio (r = -0.38, P <0.001), but no association with anemia and mineral bone parameters was observed. Elevated leptin levels were associated with better survival. However, no statistically significant difference in survival rates was observed between the study groups (Log-Rank P =0.214, Breslow P =0.211, Tarone-Ware P=0.212). Conclusion: Deceased patients had significantly lower leptin values. Leptin was associated with two non-cardiovascular risk factors for mortality: malnutrition and hypervolemia.

scholarly journals Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

2022 ◽  
Vol 8 ◽  
Author(s):  
Han Zhang ◽  
Yingying Wu ◽  
Yuqing He ◽  
Xingyuan Liu ◽  
Mingqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Population Based ◽  
Male Gender ◽  
Poor Correlation ◽  
Age Related ◽  
Related Risk ◽  
Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p &lt; 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p &lt; 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p &lt; 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p &lt; 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p &lt; 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p &lt; 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged &lt;40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p &lt; 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p &lt; 0.001) were significantly associated with higher odds of death. For patients aged &gt;80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p &lt; 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

scholarly journals Risk factors for bad obstetric history in Kirkuk women, Iraq

2013 ◽  
Vol 2 (3) ◽  
pp. 70-77 ◽  
Author(s):  
ZKM Aljumaily ◽  
AM Alsamarai
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Inverse Correlation ◽  
Normal Pregnancy ◽  
Obstetric History ◽  
Iraqi Women ◽  
Mother Education ◽  
Animal Exposure ◽  
Microbial Agents

INTRODUCTION: Microbial agents such as Toxoplasma, rubella, CMV and HSV are important cause of infections during pregnancy, which mainly are asymptomatic. However, the infection during pregnancy may result in serious foetal side effects. Objective was to determine the risk factors that enhance the development of bad obstetric history (BOH) due to TORCH infections in Iraqi women. MATERIALS AND METHODS: A 538 women were included in the study, of them 293 (54.5%) were with BOH, and 245 (45.5%) were with normal pregnancy history. In the BOH group, 144 (49.1%) women were pregnant, while in the normal pregnancy group, 117 (47.7%) were pregnant. Logistic regression analysis was used to determine the risk factors that may play a role in development of BOH. RESULTS: Multifactorial analysis indicated that Toxoplasma gondi IgM, rubella IgM, rubella IgG, CMV IgM, HSV -2 IgG and animal exposure were risk factors that lead to BOH development. However, Toxoplasma IgG seropositivity had inverse correlation to BOH development. Mother education was a significant protective (OR=0.614, P=0.000) factor that reduce development of BOH. Residence, education, occupation and family size influenced the role of TORCH in induction of BOH. CONCLUSIONS: This study indicated that Toxoplasma gondi IgM, rubella IgM, rubella IgG, CMV IgM, HSV-2 IgG and animal exposure were risk factors that lead to BOH development. Mother education was a significant protective factor that reduce development of BOH. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8121   Int J Infect Microbiol 2013;2(3):70-77

scholarly journals EVALUATION OF ENVIRONMENTAL AND SOCIOECONOMIC FACTORS CONTRIBUTING TO FRAGILITY FRACTURES IN INDIANS

2020 ◽  
Author(s):  
Vaibhav Singh ◽  
Ananda Kisor Pal ◽  
Dibyendu Biswas ◽  
Alakendu Ghosh ◽  
Brijesh P Singh
Keyword(s):  
Risk Factors ◽  
Endocrine System ◽  
Fragility Fractures ◽  
Conventional Farming ◽  
Mineral Density ◽  
Related Risk ◽  
Endocrine Disrupting ◽  
History Of ◽  
Control Study

ABSTRACTObjectiveOsteoporosis causes fragility fractures that also occur in patients with bone mineral density (BMD) in the normal or osteopenic range, suggesting role of risk factors that are unrelated or partially related to BMD. The study aims at highlighting the link between 3 conditions, that are environment and occupation related risk factors and that are widely prevalent in India, and development of fragility fractures.MethodsA Case Control study was done by recruiting 110 Cases with history of recent fragility fractures and 84 Controls with no history of recent fractures. 3 study parameters, village dwelling, conventional farming, and poverty, were chosen the presence or absence of which were documented in participants. This was followed by an ODDS ratio analysis.ResultsThe Odds of village dwellers, conventional farmers, and socioeconomically poor individuals to develop fragility fractures were both significant and large.ConclusionUrbanization is a risk in the development of fragility fractures. However, this study points that village dwelling in India is associated with the development of fragility fractures. Similarly, Odds of farmers exposed to pesticides and agrochemicals to develop fragility fractures is large and significant. Pesticides and agrochemicals act as endocrine disruptors and bone health is closely linked to endocrine system. Fragility fractures among farmers may be due to endocrine disrupting properties of pesticides and agrochemicals. Socioeconomic deprivation is a known risk in the development of osteoporosis. This study too highlights that the odds of individuals living in poverty to develop fragility fractures is significant and large.

scholarly journals ENDOSCOPIC PIECEMEAL RESECTION OF LARGE BENIGN COLORECTAL NEOPLASIA: RESULTS OF A RUSSIAN MULTICENTER STUDY

2020 ◽  
Vol 19 (1) ◽  
pp. 73-79
Author(s):  
D. V. Zavyalov ◽  
S. V. Kashin ◽  
E. R. Olevskaya ◽  
S. V. Molchanov ◽  
E. A. Fedorova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Tumor Recurrence ◽  
Colorectal Neoplasia ◽  
Postoperative Bleeding ◽  
Significant Risk ◽  
Inverse Correlation ◽  
Male Gender ◽  
Intraoperative Bleeding ◽  
Piecemeal Resection

AIM: to assess the safety of endoscopic piecemeal mucosal resection (EPMR) of large epithelial colorectal lesions and to identify risk factors for tumor recurrence.PATIENTS AND METHODS: results of EPMR were evaluated in retrospective study, which was carried out in five regional endoscopic centers. The criterion for inclusion in the study was benign colorectal lesion of 20 mm and larger.RESULTS: we found that complications of EPMR occurred in 13% of cases. In 9.2% it was intraoperative bleeding, which was stopped endoscopically. Postoperative bleeding was detected in 1.2% of patients, perforation – in 2.4%. Tumor recurrence developed in 12%. We have revealed a direct correlation between tumor recurrence and intraoperative bleeding (p=0.013) and a size of lesion >4 cm (p=0.012); the inverse correlation between the tumor recurrence and the fullness of the lifting during the removal (p=0.008) and the male gender of the patient (p=0.043).CONCLUSION: significant risk factors of tumor recurrence after endoscopic piecemeal resection of large benign colorectal neoplasia were identified before the procedure (gender and tumor size) and intraoperatively (completeness of lifting and the intraoperative bleeding).

scholarly journals Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

2020 ◽  
Vol 9 (2) ◽  
pp. 361 ◽  
Author(s):  
Wojciech Jacheć ◽  
Anna Polewczyk ◽  
Maciej Polewczyk ◽  
Andrzej Tomasik ◽  
Andrzej Kutarski
Keyword(s):  
Young Patients ◽  
High Volume ◽  
Female Gender ◽  
Lead Extraction ◽  
Factors Associated ◽  
Major Complications ◽  
Proper Patient Selection ◽  
Related Risk ◽  
Risk Patients ◽  
Selection For

Background: To ensure the safety and efficacy of the increasing number of transvenous lead extractions (TLEs), it is necessary to adequately assess the procedure-related risk. Methods: We analyzed potential clinical and procedural risk factors associated with 2049 TLE procedures. The TLEs were performed between 2006 and 2016 using only simple tools for lead extraction. Logistic regression analysis was used to develop a risk prediction scoring system for TLEs. Results: Multivariate analysis showed that the sum of lead dwell times, anemia, female gender, the number of procedures preceding TLE, and removal of leads implanted in patients under the age of 30 had a significant influence on the occurrence of major complications during a TLE. This information served as a basis for developing a predictive SAFeTY TLE score, where: S = sum of lead dwell times, A = anemia, Fe = female, T = treatment (previous procedures), Y = young patients, and TLE = transvenous lead extraction. In order to facilitate the use of the SAFeTY TLE Score, a simple calculator was constructed. Conclusion: The SAFeTY TLE score is easy to calculate and predicts the potential occurrence of procedure-related major complications. High-risk patients (scoring more than 10 on the SAFeTY TLE scale) must be treated at high-volume centers with surgical backup.

scholarly journals COVID-19 and psychological distress in Norway: The role of trust in the healthcare system

2020 ◽  
pp. 140349482097151
Author(s):  
Samantha M. Harris ◽  
Gro M. Sandal
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Linear Regression ◽  
Healthcare System ◽  
Mental Healthcare ◽  
Female Gender ◽  
Moderation Analysis ◽  
Immigrant Background ◽  
Related Risk

Aim: The study aims to examine groups at risk for psychological distress in connection with the COVID-19 outbreak, and the role of trust in the healthcare system as a possible moderator. Methods: Data were collected from a large sample of the Norwegian population ( n = 4008) through the Norwegian Citizen Panel (NCP). A linear regression was conducted to examine the effects of COVID-19 related risk factors on psychological distress, using the 10-item Hopkins Symptom Checklist (HSCL-10). Finally, we conducted a moderation analysis to examine the interaction of trust in the healthcare system and COVID-19 related risk factors. Results: A linear regression showed that female gender, younger age, lower level of education, being infected with COVID-19, being medically vulnerable, working in the healthcare system, being in voluntary quarantine and having an immigrant background predicted mean HSCL-10 scores. The moderation analysis revealed that people in the medically vulnerable group, those below 61, and those in quarantine reported higher psychological distress when they also had lower trust in the healthcare system. Conclusions: Findings indicate important groups to take into consideration in mental healthcare strategies and policies. However, most participants in the current study reported psychological distress levels that were below the clinical cut-off, suggesting that the majority may have coped relatively well in the early stages of the pandemic.

scholarly journals The Influence of Lead-Related Venous Obstruction on the Complexity and Outcomes of Transvenous Lead Extraction

2021 ◽  
Vol 18 (18) ◽  
pp. 9634
Author(s):  
Marek Czajkowski ◽  
Wojciech Jacheć ◽  
Anna Polewczyk ◽  
Jarosław Kosior ◽  
Dorota Nowosielecka ◽  
...  
Keyword(s):  
Clinical Success ◽  
Technical Difficulty ◽  
High Volume ◽  
Lead Extraction ◽  
Short Term ◽  
Term Survival ◽  
Major Complications ◽  
Related Risk ◽  
Short Term Mortality

Background: Little is known about lead-related venous stenosis/occlusion (LRVSO), and the influence of LRVSO on the complexity and outcomes of transvenous lead extraction (TLE) is debated in the literature. Methods: We performed a retrospective analysis of venograms from 2909 patients who underwent TLE between 2008 and 2021 at a high-volume center. Results: Advanced LRVSO was more common in elderly men with a high Charlson comorbidity index. Procedure duration, extraction of superfluous leads, occurrence of any technical difficulty, lead-to-lead binding, fracture of the lead being extracted, need to use alternative approach and lasso catheters or metal sheaths were found to be associated with LRVSO. The presence of LRVSO had no impact on the number of major complications including TLE-related tricuspid valve damage. The achievement of complete procedural or clinical success did not depend on the presence of LRVSO. Long-term mortality, in contrast to periprocedural and short-term mortality, was significantly worse in the groups with LRSVO. Conclusions: LRVSO can be considered as an additional TLE-related risk factor. The effect of LRVSO on major complications including periprocedural mortality and on short-term mortality has not been established. However, LRVSO has been associated with poor long-term survival.

scholarly journals Male gender and obesity are risk factors of gallbladder polyps in a large northwest Chinese population

2021 ◽  
Author(s):  
Yao Liu ◽  
Jiajing Yin ◽  
Shen Qu
Keyword(s):  
Risk Factors ◽  
Chinese Population ◽  
Blood Lipids ◽  
Demographic Characteristic ◽  
Northwest China ◽  
Serum Biochemistry ◽  
Male Gender ◽  
Chinese People ◽  
Gallbladder Polyps ◽  
Related Risk

Abstract Objectives The aim of this study was to determine the prevalence and related risk factors of gallbladder polyps in a northwest Chinese population. Methods A retrospective investigation was conducted on the prevalence and risk factors of gallbladder polyps among subjects who underwent physical examination in Shanxi Harmony Healthy Examination Center, from January 2016 to December 2020. Demographic, serum biochemistry, and ultrasonography data were collected from all patients. The correlations between the prevalence of gallbladder polyps and sex, age, body mass index (BMI), serum biochemistry, liver viral markers were calculated for all patients. Results A total of 67438 people aged from 18 to 75 years were enrolled in the study. Overall prevalence of gallbladder polyps in northwest China was approximately 7.8% and with the highest prevalence among middle-aged men. Analysis risk factors for increased odds ratios (ORs) of gallbladder polyps development were female (OR = 0.746; 95%CI, 0.624–0.891, P = 0.001) and BMI(25-27.5kg/m2) (OR = 1.243; 95%CI, 1.035–1.494, P = 0.020), BMI(≥ 27.5 kg/m2) (OR = 1.274; 95%CI, 1.038–1.562, P = 0.020). Other demographic characteristic and serum biochemistry parameters, including blood pressure, blood lipids, liver and renal function, liver viral markers did not correlate with the prevalence of gallbladder polyps. Conclusions Prevalence of gallbladder polyps among northwest Chinese people are a little higher to those reported for other populations. Male gender and BMI were strong risk factors for gallbladder polyps formation.

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