Testicular cancer in two brothers of a quadruplet: a case report and a review of literature

Introduction. Testicular cancer and a multiple birth are both rare events, and the risk of testicular cancer is increased in twins. In Lithuania, only five quadruplets have been recorded since the middle of the 20th century. In this report, we present two rare events in one family: testicular cancer in two brothers of a quadruplet (three brothers and a sister). Case description. Both patients were diagnosed at 21 years of age and died within two years from the diagnosis despite treatment. The third symptomless brother did not have testicular pathology. We also review the risk factors associated with testicular cancer, and the proposed hypotheses how a multiple birth results in an increased risk. The most consistent risk factors for testicular cancer are cryptorchidism, prior history of testicular cancer, and a positive familial history. According to different studies, the risk of testicular cancer in twins is higher from 22% to 30%, compared to the general population. Conclusions. To our knowledge, we have presented the first case of testicular teratoblastoma in brothers of a quadruplet.

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Abstract 27: Statin use and risk of hemorrhagic stroke in a community-based cohort of aging women: The Women’s Health Initiative

Circulation ◽

10.1161/circ.129.suppl_1.27 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Elena Salmoirago-Blotcher ◽

Kathleen M Hovey ◽

Judith K Ockene ◽

Chris A Andrews ◽

Jennifer Robinson ◽

...

Keyword(s):

Risk Factors ◽

Women's Health ◽

Hemorrhagic Stroke ◽

Extension Study ◽

Prior History ◽

Health Initiative ◽

Increased Risk ◽

History Of ◽

Statin Use ◽

The Women’S Health Initiative

Background: Statin therapy is recommended for treatment of hypercholesterolemia and prevention of cardiovascular events. Concerns have been raised about a potentially higher risk of hemorrhagic stroke in statin users; however, there is limited information in women and in older populations. We evaluated whether statin treatment was associated with increased risk of hemorrhagic stroke among women enrolled in the Women’s Health Initiative (WHI). Methods: This secondary data analysis was conducted among 68,132 women enrolled in the WHI Clinical Trials (CTs). Participants were 50 to 79 yrs old; postmenopausal; and were followed through 2005 (parent study) and for an additional 5 yrs (through September 30, 2010) in the WHI extension study. Statin use was assessed at baseline and at follow-up (FU) visits at 1, 3, 6, and 9 years. Women brought all medications in original containers for inventory. Strokes were self-reported annually and adjudicated by medical record review. Risk of hemorrhagic stroke by statin use (modeled as a time-varying covariate, with the “no use” category as the referent) was estimated from Cox proportional hazard regression models adjusted for age (model 1); risk factors for hemorrhagic stroke (model 2); and possible confounders by indication (model 3). All models adjusted for enrollment in the different CTs and in the extension study. Participants were censored at the date of last contact or loss to FU. Pre-specified subgroup analyses were conducted according to use or non-use of antiplatelet medications (including aspirin) or anticoagulants, and prior history of stroke. Results: Final models included 67,882 women (mean age at baseline 63 ± 7 yrs). Over a mean FU of 12 yrs, incidence rates of hemorrhagic stroke were 6.4/10,000 person-years among women on statins and 5.0/10,000 person-years among women not taking statins. The unadjusted risk of hemorrhagic stroke in statin users vs. non-users was 1.21 (CI: 0.96, 1.53). The HR was attenuated to 0.98 (CI: 0.76, 1.26) after adjusting for age, hypertension, and other risk factors for hemorrhagic stroke. Planned subgroups analyses showed that women taking both statins and antiplatelet agents had a higher risk of hemorrhagic stroke than women taking antiplatelet medications without statins (HR: 1.59; CI: 1.02, 2.46), whereas women not taking antiplatelet medications had no risk elevation with statins (HR=0.79; CI: 0.58-1.08); P for interaction = .01. No significant interactions were found for anticoagulant use or prior history of stroke, but the statistical power for these analyses was low. Conclusion: Statin use was not associated with an overall increased risk of hemorrhagic stroke among older community-dwelling women. However, women taking statins in conjunction with antiplatelet medications had elevated risk; a finding that warrants further study and potential incorporation into clinical decision making.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.827 ◽

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.

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Risk factors for pre-eclampsia among women at antenatal booking in Kano, Northern Nigeria

Healthcare in Low-resource Settings ◽

10.4081/hls.2013.e12 ◽

2013 ◽

Vol 1 (1) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Ibrahim A. Yakasai ◽

Imran O. Morhason-Bello

Keyword(s):

Risk Factors ◽

Early Onset ◽

Multiple Logistic Regression Analysis ◽

Control Group ◽

Northern Nigeria ◽

Degree Relative ◽

Factors Associated ◽

Increased Risk ◽

History Of ◽

At Home

Pre-eclampsia (PE) is an important cause of maternal mortality. There have been several studies on risk factors assessment with conflicting reports across the globe on this disease; however, rigorous recent evaluation of these factors is uncommon in this region. The aim of the present study was to determine the risks factors in the early-onset PE in Aminu Kano Teaching Hospital (AKTH), Kano (Northern Nigeria). We conducted a case-control study in Nigeria between April 2009 and January 2010 to identify the risk factors associated with the early-onset PE in women attending antenatal clinic in AKTH. Information on socio-cultural characteristics, medical history, previous obstetrics history, level of stress at home, and type of family were obtained and recorded in a proforma designed for the study. Multiple logistic regression analysis was used to determine the risk factors for PE at 95% confidence level. Pregnant women with early-onset PE (150 in each case and control group). Risk factors associated with increased risk of early-onset PE were: history of pre-eclampsia/eclampsia (PE/E) in a previous pregnancy [adjusted odds ratio (AOR) 2.09]; exposure to passive smoking (AOR 1.34); inadequate antenatal supervision (AOR 15.21); family history of hypertension in one or more 1st-degree relative (AOR 8.92); living in a joint family (AOR 6.93); overweight (120% to 150% of pre-pregnancy ideal body weight, AOR 4.65). Risk factors among women in Northern Nigeria are similar to those reported from other studies. Good antenatal cares, early detection, reduction of stressful conditions at home are the most important preventive measures of early-onset severe PE among these women.

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Factors Associated with Depression and Anxiety in the Adult Population of Qatar in the First Year of the COVID-19 pandemic: Results from an Online Survey

10.21203/rs.3.rs-729213/v1 ◽

2021 ◽

Author(s):

Salma M. Khaled ◽

Iman Amro ◽

Lina Bader ◽

Peter Woodruff ◽

Majid A Alabdulla ◽

...

Keyword(s):

Risk Factors ◽

Online Survey ◽

Adult Population ◽

Prior History ◽

First Year ◽

Depression And Anxiety ◽

Cross Sectional ◽

Factors Associated ◽

Potential Risk Factors ◽

History Of

Abstract Background: There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, COVID-19 infection and mortality rates.Aim: To identify factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic.Method: We conducted a cross-sectional online survey in Qatar between July and December 2020 after the first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Results: Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=2.04, p < 0.001 (versus married), prior history of psychiatric disorder (versus no history) (OR=1.76, p=0.039), increased worries due to social media use for COVID-related news/updates (OR=1.72, p=0.003), those with a history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). These associations also pertained in the reduced model, with exception of religiosity which was only marginally statistically significant (OR=0.97, p=0.055).Conclusions: The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar crises, and assist with early intervention to treat sufferers.

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P628 Risk Factors Associated with Extraintestinal Manifestations in Patients with Inflammatory Bowel Diseases

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.748 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S566-S566

Author(s):

C Liava ◽

E Sinakos ◽

T Dimitroulas ◽

C Navrozidou ◽

E Akriviadis

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Aphthous Stomatitis ◽

Perianal Disease ◽

Extraintestinal Manifestations ◽

Factors Associated ◽

Increased Risk ◽

History Of ◽

Inflammatory Bowel

Abstract Background Risk factors associated with extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) have been evaluated mainly in retrospective studies. We aimed to determine risk factors associated with EIMs and to compare the frequency of EIMs between ulcerative colitis (UC) and Crohn’s disease (CD), based on retrospectively-prospectively collected data of a cohort of IBD patients followed in daily clinical practice. Methods Patients with biopsy-confirmed IBD aged 10–80 years old were included in the study. A comprehensive questionnaire was used to collect data on each site visit from July 2018 until March 2020. Logistic regression analysis and multivariable-adjusted models were used to examine risk factors associated with EIMs and chi-squared test was used to compare the frequency of EIMs between patients with UC and CD. Results 300 patients with IBD (180 with CD, 113 with UC, and 7 with indeterminate colitis) were evaluated. EIMs were observed in 49% of patients, with a 2-fold increased risk in CD (OR 2.31; 95% CI:1.37–3.89; P<.005). The musculoskeletal system was affected in 38% (43% in CD vs 29% in UC, OR 1.86; 95% CI:1.08–3.20; P<.05) with peripheral arthropathy being the most common manifestation (33% in CD vs 23% in UC, P=.095), followed by dermatological manifestations (13%), with a 4-fold increased risk of erythema nodosum in CD (11% vs 3% in UC, OR 3.95; 95% CI:1.12–13.93; P<.05). On univariate logistic regression analysis history of hospitalization for IBD, history of surgery for IBD, aphthous stomatitis, perianal disease, thyroiditis Hashimoto, age, use of thiopurines, and/or anti-TNF in the past were associated with increased risk of developing EIMs. A trend for increased risk of EIMs was found for family history of IBD in first-degree relatives (OR 2.47; 95% CI:0.91–6.74; P=.078) and fecal calprotectin above 250 μg/g (OR 2.22; 95% CI:0.90–5.47; P<.084). On multivariate analysis only aphthous stomatitis (OR 4.60; 95% CI:2.32–9.13; P<.001), perianal disease (OR 2.30; 95% CI:1.17–4.50; P<.05), thyroiditis Hashimoto (OR 2.82; 95% CI:1.03–7.74; P<.05) and age (2% increase in risk per year, OR 1.02; 95% CI:1.01–1.03; P<.05) were significant for EIMs. Conclusion In this retrospective/prospective study 49% of IBD patients developed EIMs with a 2-fold increased risk in CD. Musculoskeletal and dermatological manifestations were the most frequent EIMs. Aphthous stomatitis, perianal disease, thyroiditis Hashimoto and age were associated with increased risk of EIMs.

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Blastomycosis in Missouri: epidemiology and risk factors for endemic disease

Epidemiology and Infection ◽

10.1017/s0950268803008987 ◽

2003 ◽

Vol 131 (2) ◽

pp. 907-914 ◽

Cited By ~ 44

Author(s):

M. V. CANO ◽

G. F. PONCE-DE-LEON ◽

S. TIPPEN ◽

M. D. LINDSLEY ◽

M. WARWICK ◽

...

Keyword(s):

Risk Factors ◽

Genetic Factors ◽

Case Control Study ◽

Case Control ◽

Prior History ◽

Black Race ◽

Increased Risk ◽

History Of ◽

Independent Risk Factors ◽

Control Study

Between 1992 and 1999, 93 cases of blastomycosis, including 25 laboratory confirmed cases, were identified in Missouri (annual incidence, 0·2/100000 population). Mississippi County in southeastern Missouri had the highest incidence (12/100000) with a much higher rate among blacks than whites in this county (43·2/100000). The mortality rate, 44% was also higher among blacks. To determine risk factors for endemic blastomycosis, a case-control study was conducted among southeastern Missouri residents. Independent risk factors for blastomycosis were black race and a prior history of pneumonia. No environmental exposures or socioeconomic factors were significantly associated with increased risk. The increased risk among blacks may possibly be related to genetic factors, but further studies are needed to clarify this. However, heightened awareness of the disease and a better understanding of the risk factors are important and may lead to earlier diagnosis and start of treatment, possibly improving outcome.

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Factors Associated with Metabolic Syndrome Among Middle-Aged Women in Their 50s: Based on National Health Screening Data

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093008 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3008 ◽

Cited By ~ 1

Author(s):

HyungSeon Kim ◽

YeonHee Cho

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

National Health ◽

Working Women ◽

Middle Aged ◽

Family History Of Diabetes ◽

Factors Associated ◽

The Metabolic Syndrome ◽

Increased Risk ◽

History Of

This study aimed to identify the risk factors associated with metabolic syndrome among middle-aged women in their 50s to provide a strategy for managing the metabolic syndrome of those whose prevalence is rapidly increasing. Secondary data from the 2012 Korean National Health Insurance Service Medical check-up cohort database were analyzed. Participants included 36,582 middle-aged women in their 50s from the cohort who received a general medical check-up. The risk factors were estimated using logistic regression analysis. Metabolic syndrome was identified in 14.6% of the surveyed persons among middle-aged women in their 50s. Working women, low household income levels, country residents, high body mass index (BMI), total cholesterol of over 240 mg/dL, non-drinker, non-exerciser, history of diabetes or hypertension, and family history of diabetes were associated with increased risk of metabolic syndrome. It is necessary to prepare a strategy to increase access to health care services so that socioeconomic vulnerability does not lead to negative health behavior such as obesity and lack of physical activity. In particular, we recommend active interventions at workplaces for the working women who have a higher risk of metabolic syndrome.

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Acute neurotoxicity following vincristine due to Charcot–Marie–Tooth disease in a young child with medulloblastoma

Neuro-Oncology Practice ◽

10.1093/nop/npz002 ◽

2019 ◽

Vol 6 (3) ◽

pp. 179-184

Author(s):

Trisha Kissoon ◽

Sridharan Gururangan ◽

John Sladky

Keyword(s):

Risk Factors ◽

Young Child ◽

Prior History ◽

Hereditary Neuropathy ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Asymptomatic Patients ◽

Increased Risk ◽

History Of ◽

Tooth Disease

Abstract Vincristine (VCR), a microtubule inhibitor that arrests the cell cycle by blocking metaphase of mitosis, is unique among the vinca alkaloids for causing polyneuropathy. Patients with increased risk of VCR neurotoxicity include the elderly and those with prior history of neuropathy-prone medical conditions. Identifying such risk factors prior to the development of neurotoxicity should be a goal prior to VCR administration. Clinicians should obtain a thorough medical and family history of neuropathies in any child scheduled to receive neurotoxic medications to avoid exacerbating an underlying disorder. We report a case of a young child with newly diagnosed medulloblastoma who started treatment on a VCR-containing chemotherapy regimen following surgery and craniospinal radiation. She subsequently developed severe peripheral polyneuropathy and new enhancement of the cranial and nerve roots following a relatively low cumulative dose of VCR and was diagnosed with previously unidentified Charcot–Marie–Tooth disease (CMTD) Type 1A. This case highlights that an evaluation of risk factors should be completed prior to initiation of neurotoxic chemotherapies and advocates for testing for inherited neuropathies such as CMTD even in asymptomatic patients when hereditary neuropathy is suspected.

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Risk Factors Associated with the Occurrence of Autoimmune Diseases in Adult Coeliac Patients

Gastroenterology Research and Practice ◽

10.1155/2018/3049286 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Laura Conti ◽

Edith Lahner ◽

Gloria Galli ◽

Gianluca Esposito ◽

Marilia Carabotti ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Autoimmune Diseases ◽

Type I Diabetes ◽

Type I ◽

Factors Associated ◽

Specific Risk ◽

Increased Risk ◽

History Of ◽

Control Study

Objectives. Autoimmune diseases (AD) may be associated with coeliac disease (CD), but specific risk factors have been poorly investigated. The aim of this study was to assess the spectrum of AD and its specific risk factors associated in a series of adult coeliac patients. Materials and Methods. We performed a single-center case-control study including adult newly diagnosed CD patients. To evaluate the risk factors of the association between AD and CD, 341 coeliac patients included were categorized on the basis of AD presence: 91 cases with at least one AD and 250 controls without AD were compared for clinical, serological, and histological features. Eighty-seven cases were age-gender-matched with 87 controls. Results. Among 341 CD patients, 26.6% of CD patients had at least one AD. Endocrine and dermatological diseases were the most prevalent AD encountered: autoimmune thyroiditis was present in 48.4% of cases, psoriasis in 17.6%, and type I diabetes and dermatitis herpetiformis in 11%, respectively. At logistic regression, factors associated with AD were a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93–7), a body mass index ≥ 25 kg/m2 at CD diagnosis (OR 2.95%, CI 1.1–3.8), and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1–3.7). Analysis on age-gender-matched patients confirmed these results. Conclusions. CD patients with family history of AD, overweight at CD diagnosis, and a delay of CD diagnosis had an increased risk of having another AD. The benefit of CD screening in these specific subsets of patients with AD awaits further investigation.

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Factors associated with depression and anxiety in the adult population of Qatar after the first COVID-19 wave: a cross-sectional study

Discover Psychology ◽

10.1007/s44202-021-00009-z ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Salma Mawfek Khaled ◽

Iman Amro ◽

Lina Bader ◽

Peter Woodruff ◽

Majid A. Alabdulla ◽

...

Keyword(s):

Risk Factors ◽

Online Survey ◽

Adult Population ◽

Depression Scale ◽

Cross Sectional Study ◽

Prior History ◽

Depression And Anxiety ◽

Cross Sectional ◽

Factors Associated ◽

History Of

AbstractThere is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. The main purpose of the study is to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the Patient Health Questionnaire-Anxiety Depression Scale (PHQ-ADS). Of 1138 participants, 71.0% were female, 69.0% Arabs, 70.0% Non-Qataris, and 77.0% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with moderate-to-severe levels of depression or anxiety on the PHQ-ADS; Arab ethnicity (OR = 1.67, p = 0.026), never married versus married (OR = 1.69, p = 0.015), prior history of psychiatric disorder versus no history (OR = 1.80, p = 0.009), increased worries due to social media use for COVID-related news/updates (OR = 1.72, p = 0.003), a history of COVID-19 (OR = 1.76, p = 0.039), loneliness (OR = 1.91, p < 0.001), and lower levels of religiosity (OR = 0.96, p = 0.039). These associations also pertained in the reduced model, with the exception of religiosity which was only marginally statistically significant (OR = 0.97, p = 0.055). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar national events, and assist with early intervention to treat sufferers.

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