Effect of Lipid Abnormality on CKD Progression from Moderate to Severe Stage: Application of Flexible Parametric Proportional-Hazards and Proportional-Odds Models

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ali Ashraf Mozafari ◽  
Mohammad Ali Mansournia ◽  
Kourosh Sayehmiri ◽  
Bahareh Ghiasi ◽  
Mehdi Yaseri ◽  
...  
Keyword(s):  
Risk Factor ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Survival Models ◽  
Ckd Progression ◽  
Lipid Disorders ◽  
Cholesterol Levels ◽  
Severe Stage ◽  
Parametric Survival ◽  
The Impact

Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormalities in the progression of the disease remains mixed. Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease progression from moderate to severe stage using Flexible parametric survival models. Methods: This retrospective cohort study included 308 moderate CKD patients who received the nephrologist follow-up visits at the nephrology clinic, Ilam (Iran), from 2012 to 2019. The survival time was determined based on the time medically diagnosed with moderate stages (GFR = 59 - 55 mL/min per 1.73 m2) to the time of progression to the severe stage (GFR = 29 - 25 mL/min per 1.73 m2) hazard using flexible parametric survival models. Results: In univariate analysis, high levels of TG, LDL, and cholesterol were important risk factors which affect the CKD progression. The hazard of patients with TG > 200 mg/dL was 1.69 times higher than patients with desirable TG levels (P = 0.09). Moreover, for patients with LDL > 160 mg/dL, the hazard was 2.12 times higher than patients with desirable LDL levels (P = 0.01). The hazard of patients with total cholesterol levels > 240 mg/dL was 2.10 times higher than patients with desirable cholesterol levels (P = 0.003). The adjusted model was shown to better fit the PH model. Cholesterol levels > 240 mg/dL remains a significant risk factor for CKD progression (P = 0.03). Conclusions: Effective treatment programs should pay closer attention to screening and treatment of hyperlipidemia in patients diagnosed with moderate CKD.

Impact of Post-Remission Treatments in Patients Aged 65–70 Years with De Novo AML: A Comparison of Two Concomitant Randomized ALFA Trials with Overlapping Age Inclusion Criteria

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 557-557
Author(s):  
Raphael Itzykson ◽  
Claude Gardin ◽  
Cécile Pautas ◽  
Xavier Thomas ◽  
Pascal Turlure ◽  
...  
Keyword(s):  
Risk Factor ◽  
De Novo ◽  
Univariate Analysis ◽  
Significant Risk ◽  
High Dose ◽  
Inclusion Criteria ◽  
Aged Patients ◽  
Ambulatory Treatment ◽  
De Novo Aml ◽  
The Impact

Abstract Background: The outcome of older patients with AML treated with intensive chemotherapy remains poor. No standard of treatment for post-remission therapy been demonstrated in these patients, and repeated high-dose cytarabine (AraC) post-remission courses have only been shown of benefit in patients aged of 50 years or less. Objective: To compare the overall outcome and the impact of post-remission strategies in patients with newly-diagnosed AML aged 65 to 70 years and enrolled during the same period (12/1999 to 10/2006) in two concomitant randomized ALFA trials with overlapping age inclusion criteria. The ALFA-9803 study (Gardin et al, Blood, 2007) was designed for elderly patients (65y+ with de novo or post-MDS AML) while the ALFA-9801 trial was designed for middle-aged patients (50–70y with de novo AML) (Pautas et al. ASH 2007 #162). All other inclusion criteria were similar among the two trials. Patients and Treatments: Analysis was restricted to the 211 patients aged 65–70y with de novo AML. A frontline randomization between idarubicin (IDA) and daunorubicin (DNR) was included in the two trials, with a total IDA/DNR dose of 36/180 mg and 36–48/240 mg during induction, for the 9803 and 9801 trial respectively. After induction, both trials essentially differed by the post-remission chemotherapy, which comprised two intermediate-dose cytarabine (IDAC) cycles in the 9801 trial and a second randomization between one repeated 3+7 like cycle and six 1+5 anthracycline-based ambulatory consolidations in the 9803 trial. Only two patients received a stem cell transplantation in first CR (1 allogeneic, 1 autologous). In both studies, the initial randomization between IDA and DNR had no impact on OS. Nevertheless, all analyses were stratified on IDA/DNR randomization arm. Results: Seventy-six patients were treated in the 9801 trial and 135 in the 9803 trial. Median age was 67 years and M/F sex ratio was 110/101. Median WBC was 7.4 G/L. Cytogenetic risk was favorable in 9 (4%), intermediate in 118 (56%) and unfavorable in 54 (26%) patients, respectively. Ninety-five and 116 patients were randomized to receive DNR and IDA, respectively. Aside from median age (67 vs 68 years in 9801 and 9803, respectively; P<.001), patient characteristics were similar between the two protocol subgroups, in terms of inclusion date, sex, PS, FAB, cytogenetics, and WBC. The overall CR rate was 62%. In univariate analysis, there was a trend for a higher CR rate in the younger 9801 trial (70 vs 57%; p=.17). As expected, cytogenetics was identified as the sole significant risk factor for CR achievement (89% in favorable, 68% in intermediate, and 44% in unfavorable-risk; p=0.03). Median follow-up, OS, RFS, and EFS were 35, 14, 12 and 6.5 months, respectively. In univariate analysis, the trial did not influence OS (3-year OS, 20 vs 17% in the 9801 and 9803 trial, respectively; p=.71), RFS or EFS. Again, the only identified risk factor for OS and EFS was high-risk cytogenetics. After CR achievement, 44 9801-patients (58%) received the planned IDAC consolidation, while 30 (22%) and 33 (24%) 9803-patients received the planned 3+7 like or ambulatory consolidation, respectively. In these patients, no significant differences in CR duration (median CR duration: 12.4, 14.8 and 11.9 months with IDAC, 3+7 like, and ambulatory consolidation, respectively; p=0.57) was observed among these three different post-remission strategies. In multivariate analysis, only unfavorable cytogenetics affected OS (HR=1.8 [95% CI 1.3–2.6], p=10-3) and EFS (HR=2.0 [1.4–2.8], p<10-4), with a trend for adverse RFS (HR=1.6 [.99–2.7], p=.055). Conclusion: In patients aged 65–70 years with de novo AML, more intensive post-remission therapy containing IDAC does not appear to significantly improve EFS, RFS, or OS, as compared to less intensive consolidation or even repeated anthracyclin-based ambulatory treatment. The poor early outcome of those with unfavorable cytogenetics justifies the evaluation of new global therapeutic approaches in this patient subset.

scholarly journals Maternal Obesity and Rectovaginal Group B Streptococcus Colonization at Term

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shelby M. Kleweis ◽  
Alison G. Cahill ◽  
Anthony O. Odibo ◽  
Methodius G. Tuuli
Keyword(s):  
Risk Factor ◽  
Maternal Obesity ◽  
Management Strategies ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Positive Culture ◽  
Significant Risk Factor ◽  
Entire Cohort ◽  
Group B ◽  
The Impact

Objective. To test the hypothesis that maternal obesity is an independent risk factor for rectovaginal group B streptococcus (GBS) colonization at term.Study Design. Retrospective cohort study of consecutive women with singleton term pregnancies admitted in labor at Barnes-Jewish Hospital (2004–2008). Maternal BMI ≥ 30 Kg/m2(obese) or <30 Kg/m2(nonobese) defined the two comparison groups. The outcome of interest was GBS colonization from a positive culture. Baseline characteristics were compared using Student’st-test and Chi-squared or Fisher’s exact test. The association between obesity and GBS colonization was assessed using univariable and multivariable analyses.Results. Of the 10,564 women eligible, 7,711 met inclusion criteria. The prevalence of GBS colonization in the entire cohort was relatively high (25.8%). Obese gravidas were significantly more likely to be colonized by GBS when compared with nonobese gravidas (28.4% versus 22.2%,P<0.001). Obese gravidas were still 35% more likely than nonobese women to test positive for GBS after adjusting for race, parity, smoking, and diabetes (adjusted OR 1.35 [95% CI 1.21–1.50]).Conclusion. Maternal obesity is a significant risk factor for GBS colonization at term. Further research is needed to evaluate the impact of this finding on risk-based management strategies.

Incidence and risk factors of thromboembolism (TE) in advanced gastric cancer (AGC) receiving chemotherapy: A prospective observational study (NCT01047618).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 31-31
Author(s):  
Baek-Yeol Ryoo ◽  
Min-Hee Ryu ◽  
Sook Ryun Park ◽  
Myoung Joo Kang ◽  
Kwon-Oh Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Incidence Rate ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Limited Information ◽  
Vein Thrombosis ◽  
Gastric Cancer Patients ◽  
D Dimer

31 Background: The incidence of TE in gastric cancer patients (pts) is known to be high. But because the previous reports were retrospectively analyzed in heterogeneous population, they give us only limited information. We therefore conducted a prospective study to investigate the incidence of TE and prognostic factors related with TE in AGC pts receiving chemotherapy. Methods: We checked D-dimer and coagulation battery at the start of chemotherapy and every 3 months thereafter. If there developed symptoms or signs of TE, or if D-dimer elevated 5 μg/mL or more we checked imaging studies to detect TE. The chemotherapy regimen mainly included fluoropyrimidine plus platinum-based for 1st-line, taxane-based for 2nd-line, and irinotecan-based for 3rd-line chemotherapy. Results: Between Nov 2009 and Apr 2012, 241 pts were analyzed. They received median 9 (range 1 - 42) cycles of chemotherapy. During the median observational duration of 16.7 months, 32 events (13.3%, 95% CI; 8.9 - 17.7%) of TE were detected. The types of TE were as follows; deep vein thrombosis (DVT) only in 18 (56.3%), pulmonary embolism (PE) only in 4 (12.5%), DVT and PE in 5 (15.6%), cerebral infarction in 4 (12.5%), and intra-abdominal arterial thrombosis 1 (3.1%) pts. The 1-year and 2-year cumulative incidences of TE were 15.0% (95% CI, 9.6 - 20.0%) and 20.0% (95% CI, 12.1 - 26.9%), respectively. The incidence rate of TE was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. In univariate analysis, the previous gastrectomy history, baseline CA72-4 level and baseline D-dimer level were statistically significant risk factor related with TE development. But in multivariate analysis, baseline D-dimer level was the only independent risk factor associated with TE development (Hazard ratio 2.46 [95% CI, 1.08 - 5.63], P= 0.033). Among 32 pts with baseline D-dimer 5.0 μg/mL or higher, 8 pts (25.0%) developed TE, while for pts whose baseline D-dimer was lower than 5.0 μg/mL, 24 out of 209 pts (11.5%) developed TE. Conclusions: The incidence rate of TE in AGC pts receiving chemotherapy was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. D-dimer was an important prognostic factor related with TE development. Clinical trial information: NCT01047618.

scholarly journals Marker Chromosomes Are a New Cytogenetic Adverse Risk Factor in AML after Allo-HCT

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5260-5260
Author(s):  
Kyoko Fuse ◽  
Tomoyuki Tanaka ◽  
Shun Uemura ◽  
Tatsuya Suwabe ◽  
Takayuki Katagiri ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Median Survival ◽  
Poor Prognosis ◽  
Conflicts Of Interest ◽  
Univariate Analysis ◽  
Marker Chromosome ◽  
Disease Stage ◽  
Poor Prognostic Factor ◽  
The Impact

Abstract [Background] Chromosome analysis is indispensable for the diagnosis and risk classification of acute myeloid leukemia (AML). A marker chromosome (MC) is a fragmented chromosome that cannot be identified as originating from an existing autosomal or sex chromosome. Although often observed, the significance of MC in hematological malignancies is unknown. Recently, MC was found to be the result of chromothripsis (CT). CT is a catastrophic phenomenon by which chromosomes are shattered into tens to hundreds of fragments. Half of all CT cases are related to TP53 mutation. In addition to MC, complex karyotype (CK), monosomal karyotype (MK) and existing sub-clone (SC) have also been noted as the result of CT. Previous studies reported that MC was a poor prognostic factor in AML. These studies included AML patients who underwent allogeneic hematopoietic cell transplantation (allo-HCT). However, the influence of MC on AML after allo-HCT was not clarified. [Purpose] In this study, we evaluated the impact of MC on the outcome of AML patients after allo-HCT. [Method] This retrospective analysis included 166 AML patients who received allo-HCT at Niigata University Hospital (n=129) or Nagaoka Red Cross Hospital (n=37) between 1990 and 2017. The median age of patients at allo-HCT was 38 years old (range 14-67 y). The median follow-up period was 2.0 y (range 0.0-22.2 y). According to the revised Medical Research Council (rMRC) criteria for cytogenetic risk categories, 26 (15.7%), 104 (62.7%) and 36 (21.7%) patients were categorized as favorable, intermediate and adverse-risk, respectively. Myeloablative conditioning was used for 128 (77.1%) and reduced-intensity was used for 38 (22.9%) patients. Donors were related for 83 (59.3%) and unrelated for 57 (40.7%) patients. The Kaplan-Meier method (log-rank test) and Gray's test were used to estimate the probabilities of overall survival (OS) and cumulated incidence of relapse (CIR). The impact of several variables was assessed by multivariate analysis using a Cox regression model and Fine-Gray test with backward stepwise selection based on the p-value. For the comparison of clinical phenotypes, category variables were evaluated by Fisher's exact test. [Results] MC was detected in 14 (8.4%) of 166 patients. Eleven (78.6%) were grouped as adverse-risk by rMRC criteria. CK, MK and SC were observed in 26 (16.3%), 20 (12.0%) and 23 (13.9%) patients, respectively. The median age of AML/MC+ (n=14) and AML/MC-(n=152) patients were similar (38.5 y, range 19-64 y vs 38 y, range 14-64 y, P=0.812). Twelve AML/MC+ patients (85.7%) received allo-HCT at the advanced stage (³3 CR or non-remission) and 10 (71.4%) had primary induction failure (PIF). Compared with AML/MC- patients, those with AML/MC+ had a higher incidence of MK (78.6% vs. 5.9%, p<0.001), sub-clone (64.3% vs. 9.2%, p<0.001) and CK (85.7% vs. 9.9%, p<0.001). On univariate analysis, the 2-y OS and median survival period of AML/MC+ patients were shorter than those of AML/MC- patients (26.8% vs. 61.3% and 0.78 y vs. 4.9 y, p=0.0126). The 2-y CIR of AML/MC+ patients was higher than that of AML/MC- patients (80.4% vs. 37.2%, p<0.01). To further investigate the impact of MC on the outcome, we compared AML patients with/without MC who had the cytogenetic adverse-risk karyotype. The 2-y OS of adverse-risk AML/MC+ patients (n=11) was shorter than that of adverse-risk AML/MC- patients (n=25) (9.1% vs 58.3%, p=0.003). The median survival periods were 0.58 y and 4.0 y, and the 2-y CIR was 89.6% and 44.7% (p=0.002), respectively. The 2-y OS based on the other risk factors in adverse-risk AML patients were as follows: CK+ 33.2%, MK+ 26.9% and SC+ 34.7%. As these results suggested MC to be a poorer risk factor, we performed multivariate analysis for confirmation. In the multivariate analysis adjusted for CK, MK, SC, donor, conditioning and disease stage before allo-HCT, only MC was an independent poor risk factor for OS (HR 3.547, 95%CI: 1.46-8.63, p=0.005) and CIR (HR 3.90, 95%CI: 1.47-10.33, p=0.006) among adverse-risk AML patients using the rMRC criteria. [Conclusion] It is very difficult for AML/MC+ patients to achieve complete remission, leading to a markedly poor prognosis after allo-HCT. The outcome for AML/MC+ was inferior to that for AML with CK, MK, SC or the current adverse-risk karyotype by rMRC. This analysis revealed MC as a new independent factor that further indicates a poor prognosis after allo-HCT, especially in high-risk AML patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Short- and Long-Term Safety and Efficacy of Self-Expandable Leo Stents Used Alone or with Coiling for Ruptured and Unruptured Intracranial Aneurysms: A Retrospective Observational Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4541
Author(s):  
François Lebeaupin ◽  
Pierre-Olivier Comby ◽  
Marc Lenfant ◽  
Pierre Thouant ◽  
Brivaël Lemogne ◽  
...  
Keyword(s):  
Risk Factor ◽  
Success Rate ◽  
Intracranial Aneurysms ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Unruptured Intracranial Aneurysms ◽  
Intracranial Complications ◽  
Procedural Success

To assess the efficacy and safety of the Leo stent used alone or with coiling to treat complex intracranial aneurysms (IAs) not eligible for simple or balloon-assisted coiling, this single-center retrospective study included consecutive adults with ruptured or unruptured IAs treated in 2011–2018 by stenting with or without coiling. The indication for stenting was IA complexity precluding simple or balloon-assisted coiling. Extensive data on the patients, IAs, antiplatelet treatments, procedures, and outcomes over the first 36 months were collected. Risk factors for early complications (univariate analysis) and delayed ischemia (multivariate analysis) were sought. We include 64 patients with 66 IAs. The procedural success rate was 65/66 (98.5%). Obliteration was Raymond Roy class I or II for 85% of IAs. Six patients died including four of the 12 patients presenting with subarachnoid hemorrhage, which was the only significant risk factor for early major complications. At 1 month, 45/64 (69%) had no disabilities. No rebleeding was reported. Ischemia was detected by routine MRI in 20 (35%) of the 57 patients with long-term data and was asymptomatic in 14. The stent-within-a-stent configuration was the only independent risk factor for ischemia. The Leo stent used alone or with coils to manage challenging IAs was associated with a high procedural success rate and complete or nearly complete IA obliteration of 85% of IAs. The high frequency of ischemia is ascribable to our use of routine serial MRI. In patients with bleeding, the Leo stent was associated with an excess risk of early, major, intracranial complications, as compared to patients without bleeding. Long-term follow-up was marked by the occurrence of ischemic events in the vascular territory of the stent, mostly silent.

Abstract 15869: Off-Pump Coronary Artery Bypass Grafting is Associated With Higher Rate of Percutaneous Coronary Intervention at 8-Year Follow-Up

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Fabio Barili ◽  
Stefano Rosato ◽  
Paola D’Errigo ◽  
Alessandro Parolari ◽  
Lorenzo Menicanti ◽  
...  
Keyword(s):  
Risk Factor ◽  
Univariate Analysis ◽  
Hazard Ratio ◽  
P Value ◽  
Term Survival ◽  
Off Pump ◽  
Pump Cabg ◽  
The Impact

Introduction: The debate on the advantages and limitations of off-pump (OPCAB) vs on pump CABG has not still arrived to a conclusion and concerns still exist on graft patency. This study was designed to compare the impact on mortality and morbidity of OPCAB and on-pump CABG, with a specific focus on mid-term need for percutaneous cardiac intervention (PCI). Methods: The PRIORITY project was designed to evaluate the mid-long term outcomes of 2 large prospective multicenter cohort studies on CABG conducted between 2002-2004 and 2007-2008. Data on isolated CABG performed both on-pump and off-pump were derived from clinical dataset and linked to 2 administrative datasets. Time-to event analyses were performed in a competing risk framework to evaluate the potential role of surgical techniques on outcomes. Results: The population consisted of 11020 patients who underwent isolated CABG (27.2% OPCAB). Several risk factor but surgical technique independently affected in-hospital mortality. The incidence of postoperative PCI was significantly higher in OPCAB group (p<0.05) and the multivariate logistic regression demonstrated that on-pump CABG was the only factor that protects from PCI after surgery (OR 0.61). Although unadjusted long-term survival was significantly worst for OPCAB (Log-rank p-value 0.00), the adjustment for factors found significant in the univariate analysis did not confirm OPCAB as a risk factor for mortality (hazard ratio was 0.96 ± 0.05, p-value 0.407). On the contrary, the significantly better cumulative incidence function of hospitalization for PCI at follow-up (Gray test p-value 0.00) in the on-pump group was confirmed even by the adjustment for confounding factors (p-value 0.00, adjusted hazard ratio 0.70 ± 0.07) and hence OPCAB was demonstrated to be an independent risk factor for PCI with an hazard that is 42% higher than on-pump CABG. Conclusions: This study demonstrated that OPCAB did not affect short and long-term mortality. Nonetheless, it was a risk factor for re-hospitalization for PCI.

scholarly journals The relationship between circulating vitamin D3 and subclinical atherosclerosis in an elderly Asian population

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ya-Wen Lu ◽  
Ruey-Hsing Chou ◽  
Li-Kuo Liu ◽  
Liang-Kung Chen ◽  
Po-Hsun Huang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Vitamin D3 ◽  
Large Scale ◽  
Subclinical Atherosclerosis ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Asian Population ◽  
Current Evidence ◽  
The Relationship

Abstract The current evidence regarding the association between vitamin D deficiency and cardiovascular diseases/metabolic disorders is contradictory and inconclusive. In this large-scale observational study, we investigated the relationship between the serum 25-hydroxy vitamin D3 [25(OH)D] concentration and subclinical atherosclerosis in an elderly Asian population. In the I-Lan longitudinal study (ILAS), 1798 elderly, aged 50 and older, were enrolled. For each subject, serum 25-hydroxy vitamin D3 [25(OH)D] concentration and demographic data were recorded. The participants were divided into two groups according to their serum 25(OH)D level (sufficient, > 20 ng/mL and deficient, ≤ 20 ng/mL). Carotid intima-media thickness (cIMT) was measured at bilateral common carotid arteries. Subclinical atherosclerosis was defined as a mean cIMT > 0.81 mm. The mean subject age was 64 ± 9 years old, and 604 (33.6%) were identified as having serum 25(OH)D level ≤ 20 ng/mL. Subjects with serum 25(OH)D level ≤ 20 ng/mL were younger, more likely to be female and smoker, and had a higher incidence of hypertension, dyslipidemia, and metabolic syndrome, compared to those with serum 25(OH)D level > 20 ng/mL. Additionally, patients with serum 25(OH)D level ≤ 20 ng/mL were associated with a lower risk of subclinical atherosclerosis (crude OR: 0.63, 95% CI 0.50–0.81, p < 0.001), according to univariate analysis. However, after adjusting for gender and age, serum 25(OH)D level ≤ 20 ng/mL was not a significant risk factor for subclinical atherosclerosis. Serum 25(OH)D level ≤ 20 ng/mL was not an independent risk factor for subclinical atherosclerosis in this large elderly Asian population. Association observed in the univariate analysis may be confounded by gender or comorbidities.

Exercise, Nutrition, and Homocysteine

2006 ◽  
Vol 16 (4) ◽  
pp. 341-361 ◽  
Author(s):  
Lanae M. Joubert ◽  
Melinda M. Manore
Keyword(s):  
Physical Activity ◽  
Risk Factor ◽  
Blood Cholesterol ◽  
Cvd Risk ◽  
Total Blood ◽  
Individual Fitness ◽  
Cholesterol Levels ◽  
Confounding Variables ◽  
The Impact

Homocysteine is an independent cardiovascular disease (CVD) risk factor modi-fable by nutrition and possibly exercise. While individuals participating in regular physical activity can modify CVD risk factors, such as total blood cholesterol levels, the impact physical activity has on blood homocysteine concentrations is unclear. This review examines the influence of nutrition and exercise on blood homocysteine levels, the mechanisms of how physical activity may alter homocys-teine levels, the role of homocysteine in CVD, evidence to support homocysteine as an independent risk factor for CVD, mechanisms of how homocysteine increases CVD risk, and cut-off values for homocysteinemia. Research examining the impact of physical activity on blood homocysteine levels is equivocal, which is partially due to a lack of control for confounding variables that impact homocysteine. Duration, intensity, and mode of exercise appear to impact blood homocysteine levels differently, and may be dependent on individual fitness levels.

scholarly journals Risk for Occurrence of Laryngeal Cancer Among Current Cigarette Smokers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 13s-13s ◽  
Author(s):  
I. Pavlovska ◽  
B. Taushanova ◽  
B. Zafirova
Keyword(s):  
Risk Factor ◽  
Cigarette Smoking ◽  
Laryngeal Cancer ◽  
Malignant Tumors ◽  
Smoking Habit ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Control Group

Background: Cancer is a leading cause of death worldwide. It is on the second place as a death cause in developed countries and among the three leading death causes in adults in developing countries. Every year, worldwide, approximately 10 million persons have been diagnosed with malignant tumors (in every locations), and more than 6 million of these people die. According to many studies, several risk factors are brought in connection with laryngeal cancer (LarC). The most significant and generally accepted is alcohol consumption and the habit of cigarette smoking. Cigarette smoking habit caused about 30% of all cancers, due to which it represents the most significant risk factor for occurrence of these disorders in humans. Aim: Aim of the study was to determine the existence of the eventual causal associations among the cigarette smoking and development and distribution of the laryngeal cancer. Methods: This study is an analytical type of case-control study. It elaborated 185 patients, suffering from laryngeal cancer and the same number of persons without malignant disease (control group-CG). Risk analyses were done using unconditional logistic regression, which provides results in the form of adjusted odds ratio. The odds ratios and their 95% confidence intervals (CI) were computed. Results: Among patients were 79% of current smokers (CS), 18.3% of former smokers (FS) and only 2.7% of never smokers (NS), compared with 40.5% of CS, 28.7% of FS and 30.8% of NS among controls. More than a half of the CS has been smoking 21-40 cigarettes per day (c/day) (54.8%), while in CG members this percent was 29.3%. Group of so called “heavy” smokers (> 40c/day), includes 13.7% of patients, and only 4% from CG. Majority of CS with LarC had smoking length, ranging from 31-45 years (56.2%). CS had 16.03 (95% CI, 6.25-41.12), times significantly higher risk to become ill from LarC, compared with NS. CS who were smoking < 20 c/day had 10.49 (95% CI, 3.87-28.45), while those who were smoking > 20 c/day, had 45.6 (95% CI, 16.55-125.67), times significantly higher risk to become ill, compared with NS. Univariate analysis in CS showed significantly higher risk for the persons to become ill, who were smoking > 40 years, compared with those who were smoking < 40 years (OR=3.73; 95% CI 2.03-6.84). The risk of occurring LarC has been four times (95% CI, 2.35-7.88), significantly higher in the CS who are smoking > 20 years, > 20 c/day, compared with those, who in the same time period, smoke < 20 c/day. Conclusion: Cigarette smoking is by far the most important risk factor for laryngeal cancer. Concerted control of smoking appears to be an urgent priority in LarC prevention, including efforts to prevent adolescents from starting to smoke.

scholarly journals Prevalence of carotid artery disease in patients with metabolic syndrome

2020 ◽  
Vol 12 ◽  
Author(s):  
Tatjana Deleva-Stoshevska
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Significant Risk ◽  
Adequate Treatment ◽  
Effective Prevention ◽  
Linear Probe ◽  
Artery Disease ◽  
The Impact

There is a growing body of scientific evidence on the impact of metabolic syndrome (MetS) on the progression of atherosclerosis, imposing the need for research of the association of MetS with carotid artery disease (CAD) as a significant risk factor for cerebrovascular insult (CVI) and transient ischemic attack (TIA). The aim of the study was to determine the prevalence of CAD as a risk factor for CVI and TIA in subjects with MetS. Material and methods: A cross-sectional study was performed including a total of 118 subjects, 65 men, 53 women, with MetS according to NCEP ATP III criteria that were analyzed clinically, biochemically and ultrasonographically in the City General Hospital "8th September" - Skopje in the period from January 2017 to January 2018. Waist circumference, blood pressure, glycemia, triglycerides, and HDL cholesterol were determined according to standard routine protocols. The evaluation of the extracranial carotid trunk was done with a Color Doppler Duplex sonography with a linear probe of 7.5MHz. CAD assessment was performed using Ultrasound Consensus Criteria for Carotid Stenosis. An objective neurological assessment of the existence of CVI and TIA was performed by a standard protocol for neurological examination and brain CT results from medical history were reviewed. Results: The prevalence of CAD in this study was 77 subjects (65.25%), of which 35 subjects (29.66%) had symptomatic CAD, 17 subjects (48.57%) had CVI, 18 subjects (51.43%) had TIA. Regarding the degree of carotid artery stenosis (CAS) in the total number of subjects with MetS and CAD, no subjects with normal findings were registered, 16 subjects had stenosis <50% , 29 subjects had stenosis 50-69% , 23 subjects had stenosis 70-99% , while 9 subjects had occlusion. Conclusion: The results obtained in this study have shown that asymptomatic CAD is dominant in patients with MetS, which further imposed the need for timely extracranial ultrasonographic evaluation of the carotid trunk. This would achieve both effective prevention and adequate treatment of CVI and TIA, thereby reducing morbidity and mortality from cerebrovascular events which has a great health and socioeconomic significance.

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