scholarly journals Gastric Xanthoma Is Related to the Rapid Growth of Gastric Cancer

2021 ◽  
Vol 10 (23) ◽  
pp. 5704
Author(s):  
Ko Miura ◽  
Tadayuki Oshima ◽  
Akio Tamura ◽  
Ken Hara ◽  
Takuya Okugawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Rapid Growth ◽  
Slow Growth ◽  
Univariate Analysis ◽  
Cancer Growth ◽  
Factors Associated ◽  
Gastric Cancers ◽  
History Of ◽  
Slow Growing ◽  
Periodic Check

Early detection of gastric cancer is important. However, rapid growth of gastric cancers that cannot be resected endoscopically occurs even with periodic check-ups. Accordingly, we assessed factors associated with the speed of gastric cancer growth by examining historical endoscopic images. A total of 1996 gastric cancer cases were screened, and characteristics of lesions with slow and rapid growth were assessed. A total of 114 lesions from 114 patients were included in the assessment. Sixty slow-growing and fifty-four rapidly growing gastric cancers were compared. Female sex and incidence of lesions in the lower part of the stomach were significantly less frequent in the rapid-growth group than in the slow-growth group. History of endoscopic treatment tended to be more frequent in the rapid-growth group. Age, body mass index, histology, Helicobacter pylori status, and medications did not differ significantly between groups. Xanthoma was significantly related to rapid growth of gastric cancer, and map-like redness tended to be more frequent in the rapid-growth group in univariate analysis. Xanthoma was significantly related to rapid growth of gastric cancer on multivariate analysis. Further studies are warranted to clarify the pathophysiological mechanisms involved in the speed of gastric cancer growth.

scholarly journals Risk Factors for Community Acquired Extended-Spectrum Β-lactamase (ESBL) Producing Enterobacteriaceae Urinary Tract Infections (UTIs)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S345-S345
Author(s):  
Dheeraj Goyal ◽  
Kristin Dascomb ◽  
Peter S Jones ◽  
Bert K Lopansri
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Catheter ◽  
Univariate Analysis ◽  
Prior History ◽  
Factors Associated ◽  
Extended Spectrum ◽  
History Of ◽  
Enterobacteriaceae Infections ◽  
Tract Infections

Abstract Background Community-acquired extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infections pose unique treatment challenges. Identifying risk factors associated with ESBL Enterobacteriaceae infections outside of prior colonization is important for empiric management in an era of antimicrobial stewardship. Methods We randomly selected 251 adult inpatients admitted to an Intermountain healthcare facility in Utah with an ESBL Enterobacteriaceae urinary tract infection (UTI) between January 1, 2001 and January 1, 2016. 1:1 matched controls had UTI at admission with Enterobacteriaceae but did not produce ESBL. UTI at admission was defined as urine culture positive for > 100,000 colony forming units per milliliter (cfu/mL) of Enterobacteriaceae and positive symptoms within 7 days prior or 2 days after admission. Repeated UTI was defined as more than 3 episodes of UTI within 12 months preceding index hospitalization. Cases with prior history of ESBL Enterobacteriaceae UTIs or another hospitalization three months preceding the index admission were excluded. Univariate and multiple logistic regression techniques were used to identify the risk factors associated with first episode of ESBL Enterobacteriaceae UTI at the time of hospitalization. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, presence of a urinary catheter at time of admission, and prior exposure to outpatient antibiotics within past one month were found to be significantly associated with ESBL Enterobacteriaceae UTIs. When controlling for age differences, severity of illness and co-morbid conditions, history of repeated UTIs (adjusted odds ratio (AOR) 6.76, 95% confidence interval (CI) 3.60–13.41), presence of a urinary catheter at admission (AOR 2.75, 95% CI 1.25 – 6.24) and prior antibiotic exposure (AOR: 8.50, 95% CI: 3.09 – 30.13) remained significantly associated with development of new ESBL Enterobacteriaceae UTIs. Conclusion Patients in the community with urinary catheters, history of recurrent UTIs, or recent antimicrobial use can develop de novo ESBL Enterobacteriaceae UTIs. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Wang ◽  
Anhua Huang ◽  
Min Jiang ◽  
Haidong Li ◽  
Wenqing Bao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Prospective Study ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Gallbladder Wall ◽  
Postoperative Recurrence ◽  
Factors Associated ◽  
History Of

Objective: For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones.Methods: The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression.Results: In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones (P < 0.05).Conclusion: The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

scholarly journals Clinical and Histopathological Features of Early Gastric Cancer With Unclear Lateral Demarcation

2021 ◽  
Author(s):  
Kengo Nagai ◽  
Yoshito Hayashi ◽  
Ryotaro Uema ◽  
Takanori Inoue ◽  
Keiichi Kimura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Narrow Band Imaging ◽  
Ki 67 ◽  
Histopathological Features ◽  
Gastric Cancers ◽  
Antibody Staining ◽  
Gastric Phenotype ◽  
History Of ◽  
Superficial Epithelium

Abstract Background Magnifying-endoscopy with narrow band imaging (M-NBI) is useful to determine lateral demarcation of early gastric cancers, but determining the lateral demarcation is sometimes difficult. Features related to the unclear lateral demarcation remain unknown. We evaluated the clinical and histopathological features of early gastric cancers with unclear lateral demarcation by M-NBI. Methods This single-center retrospective cohort study analyzed early gastric cancer treated by endoscopic submucosal dissection (ESD) from January 2013 to August 2015. We evaluated clinicopathological and immunohistochemical features using anti-p53, -Ki-67, -MUC5AC, -MUC6, -MUC2, and -CD10 antibody staining. We compared the lateral demarcation between the demarcation clear (DC) and demarcation unclear (DU) lesions by using M-NBI. Results A total of 224 differentiated adenocarcinomas (DU group: 18 lesions; DC group: 206 lesions) were analyzed. The history of successful Helicobacter pylori eradication was significantly more frequent in the DU group (p = 0.001). We examined tissues of 72 lesions immunohistochemically, including 18 lesions in the DU group and 54 randomly selected lesions in the DC group. Non-neoplastic superficial epithelium is more frequently observed in the DU group (p = 0.0058). Additionally, the DU group showed a significantly higher expression of gastric phenotype marker (p = 0.023), lower p53 score (p = 0.0002), and lower Ki-67 labeling index (p = 0.0293). The non-neoplastic superficial epithelium and low p53 score were significant independent variables associated with unclear lateral demarcation by M-NBI in the multivariate analysis. Conclusions Non-neoplastic superficial epithelium and low p53 score were associated with the difficultly in determining lateral demarcation in early gastric cancers by M-NBI.

scholarly journals T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: a cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kentaro Matsuo ◽  
Sang-Woong Lee ◽  
Ryo Tanaka ◽  
Yoshiro Imai ◽  
Kotaro Honda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Venous Invasion ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Associated ◽  
T Stage ◽  
History Of

Abstract Background The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we investigated the clinicopathological factors associated with the long-term outcomes of RGC. Methods We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical and Pharmaceutical University Hospital, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival. Results No significant differences were noted in the survival rate based on clinical factors (age, body mass index, diabetes mellitus, hypertension, cardiovascular disease, pulmonary complications, liver disease, diet, history of alcohol drinking, and history of smoking) or the type of remnant gastrectomy. Significant differences were noted in the survival rate based on pathological factors and surgical characteristics (intraoperative blood loss, operation time, and the number of positive lymph nodes). Multivariate analysis revealed that the T stage (hazard ratio, 5.593; 95% confidence interval [CI], 1.183–26.452; p = 0.030) and venous invasion (hazard ratio, 3.351; 95% CI, 1.030–10.903; p = 0.045) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC. Conclusions T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be keys to managing and identifying therapeutic strategies for improving prognosis in RGC.

scholarly journals Factors Associated with Unsuccessful Recanalization in Mechanical Thrombectomy for Acute Ischemic Stroke

2019 ◽  
Vol 9 (3) ◽  
pp. 107-113 ◽  
Author(s):  
Toshiaki Goda ◽  
Naoki Oyama ◽  
Takaya Kitano ◽  
Takanori Iwamoto ◽  
Shinji Yamashita ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Univariate Analysis ◽  
Single Center ◽  
Patient Factors ◽  
Anterior Circulation ◽  
Factors Associated ◽  
Female Sex ◽  
History Of

Introduction: Mechanical thrombectomy (MT) for acute ischemic stroke has become a standard therapy, and the recanalization rate has significantly improved. However, some cases of unsuccessful recanalization still occur. We aimed to clarify patient factors associated with unsuccessful recanalization after MT for acute ischemic stroke. Methods: This was a single-center, retrospective study of 119 consecutive patients with anterior circulation acute ischemic stroke who underwent MT at our hospital between April 2015 and March 2019. Successful recanalization after MT was defined as modified Treatment in Cerebral Ischemia (mTICI) grade 2b or 3, and unsuccessful recanalization was defined as mTICI grades 0–2a. Several factors were analyzed to assess their effect on recanalization rates. Results: Successful recanalization was achieved in 88 patients (73.9%). The univariate analysis showed that female sex (38.6 vs. 67.7%, p = 0.007), a history of hypertension (53.4 vs. 83.9%, p = 0.003), and a longer time from groin puncture to recanalization (median 75 vs. 124 min, p < 0.001) were significantly associated with unsuccessful recanalization. The multivariate analysis confirmed that female sex (OR 3.18; 95% CI 1.12–9.02, p = 0.030), a history of hypertension (OR 4.84; 95% CI 1.32–17.8, p = 0.018), M2–3 occlusion (OR 4.26; 95% CI 1.36–13.3, p = 0.013), and the time from groin puncture to recanalization (per 10-min increase, OR 1.22; 95% CI 1.09–1.37, p < 0.001) were independently associated with unsuccessful recanalization. Conclusion: Female sex and a history of hypertension might be predictors of unsuccessful recanalization after MT for anterior circulation acute ischemic stroke. Further studies are needed to fully evaluate predictors of recanalization.

scholarly journals Growth Rate Analysis of an Untreated Glomus Vagale on MRI

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jeffrey Tzu-Yu Wang ◽  
Allen Yu-Yu Wang ◽  
Sheila Cheng ◽  
Lavier Gomes ◽  
Melville Da Cruz
Keyword(s):  
Growth Rate ◽  
Head And Neck ◽  
Slow Growth ◽  
Rate Analysis ◽  
Mri Scans ◽  
History Of ◽  
Slow Growing ◽  
Serial Mri ◽  
Head And Neck Paragangliomas

Paragangliomas are slow growing, hypervascular neuroendocrine tumors that develop in the extra-adrenal paraganglion tissues. Paraganglioma involving the vagus nerve ganglia is termed glomus vagale. The slow growth of head and neck paragangliomas especially in the absence of symptom may obviate the necessity for any active intervention, in which case, a “wait and scan” policy is implemented involving long-term clinical and radiologic follow-ups. We present a case of a 71-year-old female with an untreated left glomus vagale who underwent a conservative “wait and rescan” plan of management and the tumor was observed with 8 serial MRI scans over a period of 7.4 years. A growth rate analysis was conducted which demonstrated a slow growth. A literature review of radiologic studies examining the natural history of head and neck paragangliomas was also performed.

Factors associated with diagnosis and operability of chronic thromboembolic pulmonary hypertension

2013 ◽  
Vol 110 (07) ◽  
pp. 83-91 ◽  
Author(s):  
Gérald Simonneau ◽  
Joanna Pepke-Zaba ◽  
Eckhard Mayer ◽  
David Ambrož ◽  
Isabel Blanco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Venous Thromboembolism ◽  
Univariate Analysis ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Factors Associated ◽  
Thromboembolic Pulmonary Hypertension ◽  
History Of ◽  
Acute Venous Thromboembolism

SummaryChronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary hypertension (IPAH) share a similar clinical presentation, and a differential diagnosis requires a thorough workup. Once CTEPH is confirmed, patients who can be safely operated have to be identified. We investigated risk factors associated with CTEPH and IPAH, and the criteria for the selection of operable CTEPH patients. This case-control study included 436 consecutive patients with CTEPH and 158 with IPAH in eight European centres, between 2006 and 2010. Conditions identified as risk factors for CTEPH included history of acute venous thromboembolism (p < 0.0001), large size of previous pulmonary embolism (p = 0.0040 in univariate analysis), blood groups non-O (p < 0.0001 in univariate analysis), and older age (p = 0.0198), whereas diabetes mellitus (p = 0.0006), female gender (p = 0.0197) and higher mean pulmonary artery pressure (p = 0.0103) were associated with increased likelihood for an IPAH diagnosis. Operability of CTEPH patients was associated with younger age (p = 0.0108), proximal lesions (p ≤ 0.0001), and pulmonary vascular resistance below 1200 dyn.s.cm-5 (p = 0.0080). Non-operable CTEPH patients tended to be less differentiable from IPAH patients by risk factor analysis than operable patients. This study confirmed the association of CTEPH with history of acute venous thromboembolism and blood groups non-O, and identified diabetes mellitus and higher mean pulmonary artery pressure as factors suggesting an IPAH diagnosis. Non-operable CTEPH is more similar to IPAH than operable CTEPH regarding risk factors.

Preliminary analysis of risk factors associated with peritoneal carcinomatosis (PC) after prophylactic bilateral salpingoophorectomy (PBSO) in patients with a BRCA mutation.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1509-1509
Author(s):  
Neda Stjepanovic ◽  
Estela Carrasco ◽  
Neus Gadea ◽  
Antonio Gil ◽  
M. Assumpcio Perez ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Brca2 Mutation ◽  
Univariate Analysis ◽  
Bilateral Breast Cancer ◽  
Pathological Examination ◽  
Molecular Characteristics ◽  
Factors Associated ◽  
P53 Signature ◽  
History Of

1509 Background: Women with a BRCA1 or BRCA2 mutation are at high risk of developing ovarian carcinoma (OC) and a residual risk of PC after PBSO has been reported. We aimed to analyze the incidence of PC after PBSO and the clinical, pathological and molecular risk factors associated to PC in our series. Methods: Between April 2005 and December 2012, 100 patients with BRCA1 or BRCA2 mutation (50 each) underwent PBSO and were followed in the High Risk Clinics for the development of PC. PBSO pieces were submitted to pathological examination for presence of pathological and molecular risk factors like in situ or invasive Fallopian Tube Carcinoma (isFTC, inFTC) and p53 signature. Patients’ medical charts included in the High Risk Clinics Database were revised retrospectively for clinical, pathological and molecular characteristics. We analyzed the incidence of PC and the odds ratio (OR) for PC after PBSO in univariate analysis. Results: Overall, 2 patients (2%, 1 BRCA1, 1 BRCA2) were found to have isFTC, while 5 out 34 had a positive p53 signature (15%, 1 BRCA1, 4 BRCA2). With a median follow-up of 40 months (1-90) since PBSO, 2 patients developed PC (2%, both BRCA2). They underwent PBSO at age of 63 and 64 years and developed the PC 2 and 9 years after. One had a history of isFTC with p53 signature and 5 children, while the other had a prior history of bilateral breast cancer and no children. None had a family history of OC. Performing PBSO at an age older than 50 years was associated with an OR 8.56 (3.29-22.27) of PC. Conclusions: Fifteen and 2% percent of our patients had a positive p53 signature or an occult isFTC in the PBSO piece. Our analysis suggests that delaying PBSO to women older than 50 years may be associated with a higher risk of PC. Further analysis in a larger cohort is warranted.

scholarly journals NCOG-35. PREDICTORS OF POSTOPERATIVE SEIZURES IN PATIENTS WITH GLIOBLASTOMA MULTIFORME

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii136-ii137
Author(s):  
Yue Zhang ◽  
Alper Dincer ◽  
Noah Feld ◽  
Matthew Carr ◽  
Lily Zhang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
Neurocognitive Deficits ◽  
Clinical Tool ◽  
Related Factors ◽  
Factors Associated ◽  
History Of ◽  
Postoperative Seizure ◽  
Overall Risk

Abstract INTRODUCTION Seizures are a major cause of morbidity in patients with GBM, resulting in neurocognitive deficits and reduced QOL. There are limited studies on the predictors of postoperative seizures in these patients. Furthermore, there is no consensus among neurosurgeons on the timing of perioperative use of antiepileptic drugs (AEDs). The objective of this study is to determine patient- and tumor-related factors associated with postoperative seizures in GBM patients who undergo surgical resection. METHODS Our patient data registry was queried for adult patients treated for GBM at VCU from 2005 to 2014. Univariate and multivariable logistic regression analyses were performed to identify patient and tumor factors associated with postoperative seizure within a 12 month period. Cox proportional hazards regression analysis was used to evaluate the overall risk of postoperative seizure. RESULTS 146 patients met the criteria for the study. Of these, 39 patients (27%) experienced a postoperative seizure within 12 months. On univariate analysis, factors significantly associated with postoperative seizure within 12-months included percent (%) of FLAIR volume resected (OR: .81; CI: 0.65-0.99; p=.046), history of AED use (OR: 2.51; CI: 1.20-5.25; p = 0.015), and history of seizure (OR: 2.26, CI: 1.07-4.76; p=0.033). On multivariate analysis, % FLAIR resection maintained significance. (OR of 0.79; CI: .63-.99; p = 0.044). The increased overall risk of postoperative seizure was associated with preoperative seizure &lt; 30 days before surgery. (HR:6.65, CI: 1.02-43.36, p=0.048). DISCUSSION Our study found that the increased extent of resection of FLAIR volume correlates with decreased odds of seizure occurrence in the 12-month postoperative period. Epileptogenesis of GBM seizures within this time period may be due to tumor-related edema or infiltrative tumor cells. Evaluation of FLAIR imaging postoperatively may be a useful clinical tool to guide AED management in high-risk patients.

scholarly journals Risk factors for cefotaxime resistance in children with pneumonia

2012 ◽  
Vol 52 (5) ◽  
pp. 255
Author(s):  
Anak Agung Made Sucipta ◽  
Ida Bagus Subanada ◽  
Samik Wahab
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Control Group ◽  
Case Group ◽  
Antimicrobial Use ◽  
Factors Associated ◽  
History Of ◽  
Culture Positive ◽  
Control Study

Background Pneumonia is a health problem in developingcountries, often caused by bacterial agents. The 'Widespreaduse of cefotaxime, a third􀁒generation of cephalosporin, may leadto increased incidence of resistance to this antibiotic. Severalstudies have reported on risk factors associated v.ith resistanceto cefotaxime.Objective To identify risk factors for cefotaxime resistance inchildren 'With pneumonia.Methods We performed a case􀁒control study at Sanglah Hospitalbetween January 2006􀁒December 2010. The case group includedchildren with blood culture􀁒positive pneumonia and resistanceto cefotaxime by sensitivity test. The control group was selectedfrom the same population as the case group, but the bacteriaisolated from these subjects were sensitive to cefotaxime. Wetested the folloMng risk factors for resistance to cefotaxime:age :53 years, microorganism species, history of antimicrobialuse, and history of hospitalization within the prior 3 months.Chi square test and logistic regression analysis were performedto determine any associations between the four potential riskfactors and resistance to cefotaxime. A P<0.05 was consideredto be statistically significant.Results Univariate analysis showed that the risk factors forresistance to cefotaxime were history of antimicrobial use in theprior 3 months (OR 2.79; 95%CI 1.40 to 5.55; P􀁓O.OOI) andhistory of hospitalization Mthin the prior 3 months (OR 5.57;95%CI 1.95 to 15.87; P=<O.OOOl). By multivariate analysis,risk factors associated Mth resistance to cefotaxime were historyof antimicrobial use in the prior 3 months (OR 2.4; 95%CI 1.18to 4.86; P=0.015), history of hospitalization within the prior 3months (OR 4.7; 95%CI 1.62 to 13.85; P􀁓0.004), and historyof breast feeding for less than 2 months (OR 2.3; 95%CI 1.0 to5.4; P􀁓0.042).Conclusion History of antimicrobial use and history ofhospitalization within the prior 3 monthsweresignificantrisk factors for resistance to cefotaxime in children Mth pneumonia.[Paediatr Indanes. 2012;52:255-9].

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