Glucocorticoids Increase Fracture Risk and Fracture Prevalence Independently from Bone Mineral Density and Clinical Risk Factors: Results from the Gliwice Osteoporosis (GO) Study

The aim of the study was to establish the influence of glucocorticoids (GC) on fracture risk, probability, and prevalence. A set of 1548 postmenopausal women were divided into study group – treated with GC (n=114, age 66.48±7.6 years) and controls (n=1434, age 66.46±6.83 years). Data on clinical risk factors for osteoporosis and fractures were collected. Hip bone densitometry was performed using a device Prodigy (GE, USA). Fracture probability was established by FRAX, and fracture risk by Garvan algorithm and POL-RISK. Fracture risk and fracture probability were significantly greater for GC-treated women in comparison to controls. In the study group, there were 24, 3, 24, and 6 fractures noted at spine, hip, forearm, and arm, respectively. The respective numbers of fractures reported in controls at those skeletal sites were: 186, 23, 240, and 25. The use of GCs increased significantly prevalence of all major, spine and arm fractures. Also the number of all fractures was affected by GC use. Following factors significantly increased fracture probability: age (OR 1.04 per each year; 95% CI: 1.03–1.06), GC use (OR 1.54; 95% CI: 1.03–2.31), falls (OR 2.09; 95% CI: 1.60–2.73), and FN T-score (OR 0.62 per each unit; 95% CI: 0.54–0.71). In conclusion, in patients treated with GCs the fracture risk, probability, and prevalence were increased. This effect was evident regardless of whether GC therapy is included in the algorithm as a risk factor (FRAX, POL-RISK) or not taken into consideration (Garvan nomogram).

Studying safety and risk management in the gas transmission system using GIS technology

In this current research, the combination of gas transportation system in line with analytical process was applied to conduct an assessment on the risk management of gas transferring pipe lines. By this process, classification and qualification of the numerous types of transportation risks would be accessible. Index and transportation index indicate risk probability and risk severity, respectively. In this regard, total risk is calculated based on the multiplication of all risk probability using geographical information systems (GIS) classified risks that have been throughout the pipeline route using attributive information. This information also gave database alternative monitoring of gas transportation.

Characteristics of the Wells Score and Associated Factors of Pulmonary Embolisms in Inpatients with Deep Venous Thrombosis

Objective: To evaluate the characteristics of the Wells score and associated factors of acute pulmonary embolisms (PE) in surgical-based inpatients’ with acute deep venous thrombosis (DVT), at Songklanagarind Hospital.Material and Methods: Acute DVT inpatients in the departments of surgery, obstetrics-gynecology and orthopedics; from 2010 to 2016, were extracted from medical records, and retrospectively reviewed. The Wells score was calculated for risk stratification in terms of low, moderate, and high probability. Finally, the associated factors of acute PE were assessed.Results: There were 278 inpatients diagnosed with acute DVT in the surgery (n=142), obstetrics-gynecology (n=101, and orthopedics (n=35) wards. The numbers of low, moderate and high risk probability were 4 (1.0%), 141 (51.0%) and 133 (48.0%), respectively. We identified four factors that were significantly different between the three specialties comprising of: “paralysis, paresis, or recent plaster immobilization of the lower extremities”, “recently bedridden or underwent a major surgical procedure”, “leg edema” and “active cancer”. Regarding the surgery service, patients with acute PE experienced a higher rate of bilateral DVT than those who did not—28.0% and 8.0%, respectively.Conclusion: The low-risk probability determined by Wells score had low incidence of acute DVT in in-patient department settings. Acute bilateral DVT was more significantly associated with acute PE in the surgery service.

MSC 2021 Virtual E-Abstract

1. A Cluster-Randomised Controlled Trial Evaluating The Effectiveness Of Stroke Riskometer In Improving Stroke Risk Probability In Adults: A Preliminary Analysis.2. Ph-Weighted Amide Proton Transfer Magnetic Resonance Imaging (APT MRI) Better Delineates The Acidotic Ischemic Penumbra.

The Effectiveness of Stroke Riskometer™ in Improving Stroke Risk Awareness in Malaysia: A Study Protocol of a Cluster-Randomized Controlled Trial

<b><i>Background:</i></b> Stroke is considered the second leading cause of mortality and disability worldwide. The increasing burden of stroke is strong evidence that currently used primary prevention strategies are not sufficiently effective. The Stroke Riskometer^™ application (app) represents a new stroke prevention strategy distinctly different from the conventional high-cardiovascular disease risk approach. <b><i>Objective:</i></b> This proposed study aims to evaluate the effectiveness of the Stroke Riskometer^™ app in improving stroke awareness and stroke risk probability amongst the adult population in Malaysia. <b><i>Methods:</i></b> A non-blinded, parallel-group cluster-randomized controlled trial with a 1:1 allocation ratio will be implemented in Kelantan, Malaysia. Two groups with a sample size of 66 in each group will be recruited. The intervention group will be equipped with the Stroke Riskometer^™ app and informational leaflets, while the control group will be provided with standard management, including information leaflets only. The Stroke Riskometer^™ app was developed according to the self-management model of chronic diseases based on self-regulation and social cognitive theories. Data collection will be conducted at baseline and on the third week, sixth week, and sixth month follow-up via telephone interview or online questionnaire survey. The primary outcome measure is stroke risk awareness, including the domains of knowledge, perception, and intention to change. The secondary outcome measure is stroke risk probability within 5 and 10 years adjusted to each participant’s socio-demographic and/or socio-economic status. An intention-to-treat approach will be used to evaluate these measures. Pearson’s χ² or independent <i>t</i> test will be used to examine differences between the intervention and control groups. The generalized estimating equation and the linear mixed-effects model will be employed to test the overall effectiveness of the intervention. <b><i>Conclusion:</i></b> This study will evaluate the effect of Stroke Riskometer^™ app on stroke awareness and stroke probability and briefly evaluate participant engagement to a pre-specified trial protocol. The findings from this will inform physicians and public health professionals of the benefit of mobile technology intervention and encourage more active mobile phone-based disease prevention apps. <b><i>Trial Registration:</i></b> ClinicalTrials.gov Identifier NCT04529681.

Pesticide Residue Behavior and Risk Assessment in Celery after Se Nanoparticles Application

This study investigates pesticide levels in celery, and compares their degradation, dissipation, distribution, and dietary risk after spraying with selenium (Se) nanoparticles. Abamectin, imidacloprid, acetamiprid, thiamethoxam, and lambda-cyhalothrin were sprayed at 1.6, 6.8, 2.0, 1.0, and 0.7 g a.i. ha−1 followed by a 2 g·ha−1 Se nanoparticle application during the growing period. Thiamethoxam, abamectin, imidacloprid, lambda-cyhalothrin, and acetamiprid in celery degraded following a first order kinetic model after 2 g·ha−1 Se nanoparticles application. With the exception of acetamiprid, the half-lives of thiamethoxam, abamectin, imidacloprid, and lambda-cyhalothrin were reduced from 2.4, 0.5, 1.2, 4.2 days without Se nanoparticles application to 1.4, 0.2, 0.9, 3.7 days with the addition of Se nanoparticles (2 g·ha−1), respectively. The chronic dietary exposure risk probability (RQc) and the acute dietary exposure risk probability (RQa) of celery after Se nanoparticles application were within acceptable limits for consumption except for abamectin.

Risk Occurred Probability and Influencing Factors of Stroke in Followed-Up Hypertension Patients

Objective To explore the risk occurred probability and influencing factors of stroke in followed-up hypertension (HP) patients through the analysis of long-term followed-up cohort data. Methods The method of followed-up observation cohort was used to collect the information of 168417 followed-up hypertension patients from 2002 to 2020 in Jiading district in Shanghai. Kaplan-Meier method was used to analyze the risk occurred probability of stroke complications in long-term followed-up HP patients, and the influencing factors were analyzed by Cox proportional risk model. Results Among 168417 followed-up hypertension patients, 11143 cases had occurred stroke, and the cumulative occurrence rate of stroke was 6.62% (male was 6.87%, female was 6.37%). With the extension of the years of hypertension, the cumulative risk occurred probability of stroke in HP patients would continue to increasing, and the interval was not equidistant. The total cumulative risk probability of stroke in HP patients was 78.9% (male was 91.0%, female was 70.7%). During the period of hypertension, the risk occurred probability of stroke was not fixed, but fluctuates. There were 4 onset peaks, which were in 8 years (peak value 4.2%), 15 years (peak value 14.0%), 22 years (peak value 6.0%) and 26 years (peak value 13.9%). The highest risk probability of male patients was in 26 years (peak value 23.1%), and the second peak was in 15 years (peak value 15.6%). The highest risk probability of female patients was in 15 years (peak value 12.9%), and the second peak was in 26 years (peak value 8.7%). The risk probability of different sex, BP grad and BMI was different, male was higher than female, grade 3 HP higher than grade 1 and grad 2 HP, thin higher than normal weight. The major influencing factors of stroke complications were age (RR = 2.917, p < 0.001), body mass index (RR = 1.450, p < 0.001), family history of stroke (RR = 1.386, p < 0.001), blood pressure grad (RR = 1.148, p < 0.001), registry age (RR = 1.071, P < 0.001 and family history of hypertension (RR = 1.051, P < 0.001). Conclusion The risk occurred probability of stroke among hypertension would continue to increase disproportionately during period of hypertension, and the total cumulative risk probability could finally reach 78.9%. Male was higher than female. Age, BMI, family history (stroke and HP), blood pressure grad and duration of HP were related to the occurrence of stroke complications.