scholarly journals Le ulcere flebostatiche recidive degli arti inferiori: analisi di un’esperienza/Recurrent venous leg ulcers: clinical analysis of an experience

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Alberto Garavello ◽  
Margherita Lo Ponte ◽  
Stefania Gilardi ◽  
Paola Fiamma ◽  
Massimo Tozzi
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Wound Care ◽  
Lower Limbs ◽  
Orthopedic Procedures ◽  
Ulcer Recurrence ◽  
Venous Ulcers ◽  
Potential Risk Factors ◽  
Fattori Di Rischio

Nonostante i recenti progressi in tema di wound care, le ulcere varicose degli arti inferiori restano un problema frequente, con un alto tasso di recidiva. In questo lavoro abbiamo esaminato la storia clinica, la storia chirurgica e le patologie associate di 133 pazienti affetti da ulcera varicosa degli arti inferiori, di cui 56 da ulcera recidiva o plurirecidiva. L’analisi dei fattori di rischio potenziale per recidiva ha evidenziato come la presenza di varici recidive, una pregressa trombosi venosa profonda, problemi ortopedici, interventi ortopedici, l’obesità e un’età inferiore a 60 anni siano fattori di rischio potenziale per una recidiva dell’ulcera. La combinazione di uno più fattori di rischio assume significatività per la possibilità di una recidiva; si passa dal 22,7% in assenza di fattori di rischio al 33% per i pazienti che ne presentano due, fino al 57,5% in presenza di tre fattori di rischio e all’81,3% per quattro o più. L’ulcera varicosa richiede un follow-up stretto del paziente e una terapia elastocompressiva continua, che deve vedere una stretta collaborazione del paziente e un’attenzione specifica ai fattori di rischio. Despite recent advances in wound care, varicose ulcers of lower limbs remain frequent and display a high rate of recurrence. In this paper, we examined the clinical, surgical histories and associated diseases of 133 patients with venous ulcers of the lower limbs, which were recurrent in 56 cases. The analysis of potential risk factors for recurrence showed that the presence of recurrent varicose veins, a previous deep venous thrombosis, orthopedic problems, previous orthopedic procedures, obesity and age lower than 60 are potential risk factors for ulcer recurrence. Furthermore, the association of one or more risk factors increased the likelihood of relapse, from 22.7% with no risk factors to 33% with 2 risk factors, up to 57.5% with 3 risk factors, and up to 81.3% with 4 risk factors or more. Venous ulcers require close follow-up and continuous elastic compression, close collaboration by the patient and specific focus on risk factors.

Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

2022 ◽  
pp. 153473462110659
Author(s):  
Michele Neves Brajão Rocha ◽  
Carol Viviana Serna Gonzalez ◽  
Eline Lima Borges ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Soraia Assad Nasbine Rabeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Onset Time ◽  
Venous Ulcer ◽  
High Recurrence Rate ◽  
Ulcer Recurrence ◽  
Clinical Approach ◽  
Historical Cohort ◽  
Venous Ulcers

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

scholarly journals Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12786
Author(s):  
Franziska Dinah Welzel ◽  
Melanie Luppa ◽  
Alexander Pabst ◽  
Michael Pentzek ◽  
Angela Fuchs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Potential Risk ◽  
Oldest Old ◽  
Anxiety Symptoms ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Potential Risk Factors

Research on anxiety in oldest-old individuals is scarce. Specifically, incidence studies based on large community samples are lacking. The objective of this study is to assess age- and gender-specific incidence rates in a large sample of oldest-old individuals and to identify potential risk factors. The study included data from N = 702 adults aged 81 to 97 years. Anxiety symptoms were identified using the short form of the Geriatric Anxiety Inventory (GAI-SF). Associations of potential risk factors with anxiety incidence were analyzed using Cox proportional hazard models. Out of the N = 702 older adults, N = 77 individuals developed anxiety symptoms during the follow-up period. The incidence rate was 51.3 (95% CI: 41.2–64.1) per 1000 person-years in the overall sample, compared to 58.5 (95% CI: 43.2–72.4) in women and 37.3 (95% CI: 23.6–58.3) in men. Multivariable analysis showed an association of subjective memory complaints (HR: 2.03, 95% CI: 1.16–3.57) and depressive symptoms (HR: 3.20, 95% CI: 1.46–7.01) with incident anxiety in the follow-up. Incident anxiety is highly common in late life. Depressive symptoms and subjective memory complaints are major risk factors of new episodes. Incident anxiety appears to be a response to subjective memory complaints independent of depressive symptoms.

scholarly journals Configuration of Primary and Recurrent Aggressive Fibromatosis on Contrast-Enhanced MRI with an Evaluation of Potential Risk Factors for Recurrences in MRI Follow-Up

2019 ◽  
Vol 192 (05) ◽  
pp. 448-457
Author(s):  
Sam Sedaghat ◽  
Alexey Surov ◽  
Sebastian Krohn ◽  
Maya Sedaghat ◽  
Benjamin Reichardt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Contrast Enhancement ◽  
Potential Risk ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Aggressive Fibromatosis ◽  
Primary Tumor Resection ◽  
Potential Risk Factors ◽  
Muscle Edema

Purpose To analyze the appearance of primary and recurrent aggressive fibromatosis (AF) on MRI with a focus on configuration and to determine potential risk factors for recurrences detected on MRI follow-up scans. Methods From 79 consecutive patients with histologically proven diagnosis of AF, 39 patients underwent a minimum of four 1.5 T MRI follow-up scans after resection of primary AF between 2008 and 2018. The primary and recurrent tumors were radiographically examined for configuration, limitation and extent on MRI. Epidemiological data and loco-regional subcutaneous edema, muscle edema and post-operative seroma were included. Results The mean age of the patients was 39 ± 2.6 years. Primary and recurrent AF most often occurred in the thigh. The main appearance of primary AF was significantly most often fascicular (p = 0.001–0.01) with heterogeneous and marked contrast enhancement. 21 % (n = 8) of the patients developed recurrences of AF. A fascicular configuration with homogeneous/heterogeneous contrast enhancement was the main appearance of recurrent AF, but recurrent AF appeared nodular, polycyclic, ovoid or streaky/flat as well. Recurrent AF significantly most often occurred within the first 9 months after primary tumor resection (p = 0.009), especially in patients up to 25 years of age (RR = 6.1; 95 % CI: 1.8–20.9; p = 0.004). The cases of recurrent AF were altogether significantly smaller than the primary tumors (p = 0.001). Post-treatment subcutaneous and muscle edema were present in 77 % and 56 %, respectively. Patients with muscle edema after primary tumor resection had a significantly higher risk for AF recurrences (relative risk ratio (RR) = 1.8; 95 % CI: 1.16–2.8; p = 0.0096). There was no significant difference detected in patients with complete or incomplete resection of the primary tumor. Conclusion Primary and recurrent aggressive fibromatosis has a mostly fascicular configuration, but may appear ovoid, nodular, streaky/flat or polycyclic as well. High risks for tumor recurrences are detected for patients up to 25 years of age, patients within the first 9 post-operative months and patients with muscle edema after primary tumor resection. Key points:  Citation Format

Risk factors for significant prostate cancer in radical cystoprostatectomy specimen: A retrospective analysis.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 136-136
Author(s):  
Andrea Katharina Thissen ◽  
Daniel Porres ◽  
David J. K. P. Pfister ◽  
Axel Heidenreich
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Bladder Cancer ◽  
Retrospective Analysis ◽  
Potential Risk ◽  
Common Finding ◽  
Considerable Proportion ◽  
Radical Cystoprostatectomy ◽  
Potential Risk Factors

136 Background: Prostate cancer (Pca) has been found incidentally in radical cystoprostatectomy (RCP) specimens in 27-70%. We evaluated histopathological features and clinical outcome of patients with incidental Pca undergoing RCP for urothelial bladder cancer and identified potential risk factors for the presence of significant Pca, being defined as Gleason Score ≥7b, primary tumor ≥T2c or Pca volume ≥0.5cm3. Methods: A retrospective analysis of patients who underwent RCP between 01/2005-03/2015 was performed with regard to clinical data and pathohistological features. Whole mount serial sections of specimens were examined in the same urological and pathological institution. Pca grade, p-stage, cancer volume and surgical margins were recorded. Preoperative PSA values and follow-up were analysed. Results: We identified 71 patients with incidental Pca with a mean age of 71.7 years (47-84 years). 33/71 patients (46.5%) had significant Pca (28.2% ≥T2c, 4.2% GS ≥7b [+≥T2c], 14.1% cancer volume ≥0.5cm3[+≥T2c]). Other features were as follows: pT2a, n=36 (50.7%); pT2b, n=2 (2.8%); GS 6, n=50 (70.4%); GS 7a, n=18 (25,3%). All patients were R0 and N0 for Pca. Mean preoperative PSA level was 2.7ng/ml. None of the patients developed biochemical recurrence (median follow-up: 29.5 [1-124 months]). Patients with significant Pca were older than those with insignificant Pca (median age 71.2 years vs 70.1 years) and had higher preoperative PSA levels: 90% of patients with a PSA level of 4-10ng/ml had a ≥T2c Pca, while 81.5% of patients with PSA levels of 0-1ng/ml had a pT2a Pca. P-stages in patients with PSA values between 1-4ng/ml were found to be equally distributed between pT2a-pT2c. Conclusions: The occurence of incidental Pca is a common finding in patients undergoing RCP, with a considerable proportion having the characteristics of significant Pca. Potential risk factors for significant Pca are older age and PSA levels >4ng/ml. However, none of the patients experienced biochemical relapse or Pca-related death during the follow-up. In line with published data, incidental Pca does not impact on the oncological outcome of patients undergoing RCP. The prognosis is primarily determined by bladder cancer.

Risk Factors for Healing and Recurrence of Chronic Venous Leg Ulcers

2000 ◽  
Vol 15 (2) ◽  
pp. 49-52 ◽  
Author(s):  
J. R. Barwell ◽  
A. S. K. Ghauri ◽  
M. Taylor ◽  
J. Deacon ◽  
C. Wakely ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Leg Ulcer ◽  
Ulcer Recurrence ◽  
Leg Ulcers ◽  
Venous Reflux ◽  
Venous Leg Ulcers ◽  
Duplex Imaging ◽  
Delayed Healing ◽  
Potential Risk Factors

Objective: To identify independent risk factors for delayed healing and increased recurrence of chronic venous leg ulcers. Design: Prospective study. Setting: Community-based leg ulcer service. Patients: Six hundred and thirty-three limbs in 587 consecutive patients with an ankle-brachial pressure index (ABPI) ≥0.85. Method: Potential risk factors were initially assessed in a one-stop clinic incorporating clinical evaluation, ABPI and venous duplex imaging. Limbs were treated within a defined protocol. Twenty-four-week healing and 3-year ulcer recurrence rates were determined. Results: Of 12 potential risk factors age ( p< 0.001), ulcer chronicity ( p< 0.001) and popliteal vein reflux ( p< 0.005) were independent risks for delayed healing. Of 13 potential risk factors rheumatoid arthritis ( p<0.005) and healing time ( p < 0.05) were independent risks for ulcer recurrence. Isolated superficial venous reflux treated by saphenous vein surgery predicted reduced ulcer recurrence ( p< 0.005). Conclusion: Targeting in primary care of ulcer patients with specific characteristics might encourage earlier referral and appropriate resource management. Leg ulcer patients with superficial venous reflux might benefit from surgical correction.

scholarly journals The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty: a multi-center study of more than 260 patients

2021 ◽  
Author(s):  
Andreas B. Imhoff ◽  
Eva Bartsch ◽  
Christoph Becher ◽  
Peter Behrens ◽  
Gerrit Bode ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Potential Risk ◽  
Young Patients ◽  
Womac Score ◽  
Potential Risk Factors ◽  
Multi Center Study ◽  
Center Study

Abstract Purpose To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction. Pre- and perioperative risk factors were compared among failures and non-failures to determine potential risk factors. Results A total of 263 patients (85% follow-up rate) could be enrolled. The mean age at the time of index surgery was 49 ± 12 years with a mean postoperative follow-up of 45 ± 18 months. The overall failure rate was 11% (28 patients), of which 18% (5 patients) were patients with patella resurfacing at index surgery and 82% (23 patients) were patients without initial patella resurfacing. At final follow-up, 93% of the patients who did not fail were satisfied with the procedure with a mean transformed WOMAC Score of 84.5 ± 14.5 points, a mean KOOS Score of 73.3 ± 17.1 points, a mean Tegner Score of 3.4 ± 1.4 points and a mean VAS pain of 2.4 ± 2.0 points. An increased BMI was significantly correlated with a worse postoperative outcome. Concomitant procedures addressing patellofemoral instability or malalignment, the lack of patellofemoral resurfacing at the index surgery and a high BMI were significantly correlated with failure in our patient cohort. Conclusion Patellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure. Level of evidence Retrospective case series, Level IV.

scholarly journals High-Risk Indicators of Renal Involvement in Primary Sjogren’s Syndrome: A Clinical Study of 1002 Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Jing Luo ◽  
Yu-Wei Huo ◽  
Jian-Wu Wang ◽  
Hui Guo
Keyword(s):  
Risk Factors ◽  
Interstitial Nephritis ◽  
Renal Tubular Acidosis ◽  
Potential Risk ◽  
Renal Damage ◽  
Renal Involvement ◽  
Primary Sjögren’S Syndrome ◽  
Lower Limbs ◽  
Potential Risk Factors ◽  
Renal Tubular

Objective. A retrospective analysis of clinical characteristics and immunological manifestations of primary Sjogren’s syndrome (pSS) patients with or without renal involvement was conducted in order to elucidate the potential risk factors of renal damage in pSS and evaluate the condition. Methods. A total of 1002 patients, who fulfilled the 2002 classification criteria for pSS from the Second Affiliated Hospital of Shanxi Medical University, were enrolled in the cross-sectional study. Clinical, immunological, and histological characteristics were compared between pSS patients with and without renal involvement, and potential risk factors of renal involvements in pSS patients were examined by multivariate analysis. Results. Among these pSS patients, there were 162 cases (16.17%) with and 840 cases (83.83%) without renal damage. Serious edema of both lower limbs, interstitial nephritis, and renal tubular acidosis were found in the pSS with renal damage group. Compared with simple pSS patients, the levels of creatinine, cystatin C, and alpha-1-microglobulin (α1-MG) in the pSS with renal damage group were significantly increased. The difference between the two groups was statistically significant (P<0.05). The AUC of the combination of creatinine and α1-MG and creatinine, α1-MG, and creatinine was statistically larger than that of creatinine, and the biomarker of the biggest AUC is the combination of creatinine and α1-MG. Conclusion. The main clinical manifestations of pSS with renal damage were edema of the lower limbs, interstitial nephritis, and renal tubular acidosis. Creatinine and α1-MG are effective indicators for renal function in pSS, which may provide a better understanding for clinical decision-making.

scholarly journals Potential risk factors for reactive arthritis and persistence of symptoms at 2 years: a case-control study with longitudinal follow-up

2017 ◽  
Vol 37 (2) ◽  
pp. 415-422 ◽  
Author(s):  
Helga Raquel Garcia Ferrer ◽  
Alexander Azan ◽  
Isa Iraheta ◽  
Joan Von Feldt ◽  
Luis R. Espinoza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Reactive Arthritis ◽  
Case Control Study ◽  
Case Control ◽  
Potential Risk Factors ◽  
Control Study

Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite

2009 ◽  
Vol 137 (11) ◽  
pp. 1655-1663 ◽  
Author(s):  
C. R. STENSVOLD ◽  
H. C. LEWIS ◽  
A. M. HAMMERUM ◽  
L. J. PORSBO ◽  
S. S. NIELSEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Irritable Bowel Syndrome ◽  
General Population ◽  
Clinical Significance ◽  
Potential Risk ◽  
Factors Associated ◽  
Potential Risk Factors ◽  
Intestinal Symptoms ◽  
Irritable Bowel

SUMMARYTwo independent studies were conducted to describe symptoms and potential risk factors associated withBlastocystisinfection. Isolates were subtyped by molecular analysis. In the NORMAT study (126 individuals randomly sampled from the general population) 24 (19%) were positive forBlastocystis.Blastocystiswas associated with irritable bowel syndrome (P=0·04), contact with pigs (P<0·01) and poultry (P=0·03). In the Follow-up (FU) study (follow-up of 92Blastocystis-positive patients), reports on bloating were associated with subtype (ST) 2 (P<0·01), and blood in stool to mixed subtype infection (P=0·06). ST1 was more common in FU individuals (32%) than in NORMAT individuals (8%), whereas single subtype infections due to ST3 or ST4 were seen in 63% of the NORMAT cases and 28% of the FU cases. Only FU individuals hosted ST7, and ST6/7 infections due to ST7 or ST9 were characterized by multiple intestinal symptoms. The data indicate subtype-dependent differences in the clinical significance ofBlastocystis.

scholarly journals Clinical profiles of neonates born to mothers with COVID-19

2021 ◽  
Vol 61 (5) ◽  
pp. 277-82
Author(s):  
Ambili Susan Jacob ◽  
Mohammed MTP ◽  
Reetha Gopinath ◽  
Binoo Divakaran ◽  
Tariq Harris
Keyword(s):  
Risk Factors ◽  
Vertical Transmission ◽  
Potential Risk ◽  
Disease Transmission ◽  
Horizontal Transmission ◽  
Tertiary Care ◽  
Increased Risk ◽  
Hygiene Measures ◽  
Potential Risk Factors

Background The risk of congenital infections in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mothers and those breastfed by infected mothers remains largely unknown. Objective To describe the outcomes and clinical features of neonates born to mothers infected with SARS-CoV-2 during pregnancy, to follow up neonates who were positive for SARS-CoV-2 at the time of delivery for a period of 1 month, and to identify potential risk factors associated with disease transmission. Methods This prospective observational study on neonates born to SARS-CoV-2-infected mothers between June 2020 and January 2021 was carried out after getting written informed consent in a tertiary care government hospital (Government Medical college Kannur, North Kerala, India). The clinical and demographic characteristics of infected mothers were reviewed. Neonates were tested for SARS-CoV-2 infection within 24 hours of birth, with repeat testing on day 5 for those who were negative at birth.  The demographic and clinical characteristics as well as potential risk factors for disease transmission in these neonates were evaluated. Results A total of 342 neonates (95.3%) were tested for SARS-CoV-2 infection at birth. Rooming-in and breastfeeding was practiced in 75% of at-risk neonates. Fifty neonates tested positive for SARS-CoV-2 infection at birth (14.3%); 293 neonates who tested negative at birth remained so on day 5, except one baby isolated with a caretaker who also tested positive, indicating postnatal infection. There was no statistically significant increased risk of infection in neonates born to SARS-CoV-2-positive mothers compared to those born to mothers who had already become negative at delivery. Mild symptoms were present in 8% of positive neonates. On one-month follow up, all neonates were well and gaining weight. Conclusion Vertical transmission, in particular transplacental, may be possible in SARS-CoV-2-infected mothers. Maternal infection at the time of delivery is not a predictor for increased vertical transmission compared to mothers whose infections had resolved prior to delivery. Breastfeeding with appropriate hygiene measures is not a risk factor for horizontal transmission.

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