scholarly journals Comparative Study of Superselective Intra-Arterial Chemoradiotherapy versus Radical Surgery on Distant Metastasis for Advanced Oral Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Wataru Kobayashi ◽  
Beng Gwan Teh ◽  
Norihiko Narita ◽  
Ryohei Ito ◽  
Yuki Saito ◽  
...  
Keyword(s):  
Surgical Management ◽  
Distant Metastasis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Oral Cancers ◽  
Significant Difference ◽  
N Classification ◽  
Neck Recurrence ◽  
T Classification ◽  
Classification And Treatment

Background. Distant metastasis is considerably more frequent in superselective intra-arterial chemoradiotherapy than other radical treatments for advanced oral cancers. However, there is no evidence supporting such claim. The purpose of this study was to report our experience in superselective intra-arterial chemoradiotherapy and conventional surgical management with particular focus on distant metastasis. Methods. One hundred seventy-two patients with oral squamous cell carcinoma in stages III and IV were included in this study. Retrospective analysis for DM rates and background between surgical management and superselective intra-arterial chemoradiotherapy was performed. Results. Distant metastasis developed clinically was detected in 24 out of 141 patients (17.0%) treated surgically and in 6 out of 31 patients (19.4%) treated with superselective intra-arterial chemoradiotherapy. There was no significant difference in the rate of distant metastasis between the 2 groups. Comparison of patients in both groups with and without distant metastasis revealed no differences in age, T classification, N classification, and treatment effect. Neck recurrence was the only significant risk factor for distant metastasis. Conclusion. No significant difference was found in the rate of distant metastasis between patients treated with surgical treatment and superselective intra-arterial chemoradiotherapy, and additional effort is needed to reduce the risk of distant metastasis.

scholarly journals The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

2021 ◽  
Vol 18 (2) ◽  
pp. 649
Author(s):  
Leah Shelef ◽  
Jessica M Rabbany ◽  
Peter M Gutierrez ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Military Service ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Severity Rating ◽  
Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

scholarly journals Venous Thromboprophylaxis in Gastrointestinal Bleeding

2015 ◽  
Vol 29 (3) ◽  
pp. 145-148 ◽  
Author(s):  
Neel Malhotra ◽  
Nilesh Chande
Keyword(s):  
Thrombotic Event ◽  
Antiplatelet Agent ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Primary Diagnosis ◽  
Gi Bleeding ◽  
Duration Of Treatment ◽  
Vte Prophylaxis ◽  
Significant Difference ◽  
Gi Bleed

OBJECTIVE: To study the use of venous thromboembolism (VTE) prophylaxis and the incidence of thrombotic events in patients with acute gastrointestinal (GI) bleeding.METHODS: Individuals admitted with a primary diagnosis of a GI bleed along with any endoscopically confirmed source (over a two-year period) were included. Patient comorbidity and data regarding anticoagulation or antiplatelet agent use before hospitalization were collected, in addition to type of VTE prophylaxis and duration of treatment. The primary end point was the development of VTE (deep vein thrombosis or pulmonary embolism) within one year of presentation.RESULTS: Data from 504 patients admitted with GI bleeding were eligible for review. The total number of VTE events was 20 (4%) while the mortality rate during hospitalization was 4.6%; 397 patients were not given VTE prophylaxis during their hospitalization. Of the patients who were given VTE prophylaxis, 68 received prophylactic heparin or heparin derivatives during their admission. One hundred sixty-five patients had at least one other significant risk factor for VTE including recent or subsequent surgery, past thrombotic event or malignancy. The incidence of thrombosis in those with significant risk factors for VTE was significantly higher than those without (8.5% versus 1.8%; P=0.0009). Overall, there was no significant difference in thrombotic events between individuals receiving pharmacological prophylaxis (1.2%) and those who did not (2.8%) (P=0.4).CONCLUSION: Overall, VTE prophylaxis did not significantly affect thrombotic events in patients admitted for an active GI bleed.

Postpartum Mental State of Mothers of Twins

2016 ◽  
Vol 11 (1) ◽  
pp. 1-12
Author(s):  
Éva Brantmüller ◽  
Mónika Gyúró ◽  
Kitti Galgán ◽  
Annamária Pakai
Keyword(s):  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Threshold Value ◽  
Primary Objective ◽  
Health Visitor ◽  
Maternal Mood ◽  
Significant Difference ◽  
Relevant Risk Factor ◽  
Convenience Sampling

AbstractTwin birth is a relevant risk factor for postnatal depression (PND). The primary objective of our study is to reveal the prevalence of suspected cases of depression and to identify some background factors among mothers of twins. We applied convenience sampling method within a retrospective, quantitative study among mothers given birth to twins for six months, but, at least, three years. The participants completed the self-administered, modular questionnaire and the standard EPDS questionnaire anonymously. 35% of mothers of twins reached or exceeded the threshold value for depression following the first six months after delivery. No significant difference was found in the prevalence of the suspected cases among the primipara and multipara (p=1.000). At the same time, artificial conception proved to be a significant risk factor (p= 0.019). Distraught family life (p=0.001) and unfavorable changes in a domestic partnership (p=0.009) increased the prevalence of the suspected cases of depression significantly. The health visitor is the only person who knows the hierarchy of families with their weaknesses and strengths in the Hungarian primary health care; therefore, her role is unquestionable in the recognition of maternal mood disorders. The health visitor compares the scores of the EPDS questionnaire with the experiences during family visits, and with all of these facts, she refers the person in need to a specialist.

scholarly journals A study to determine risk factors for renal scarring as detected by dimercaptosuccinic acid scan in children with urinary tract infection

2021 ◽  
Author(s):  
Nisha Jacob Arackal Jacob ◽  
Seshagiri Koripadu ◽  
Harishchandra Venkata Yanamandala
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Renal Scarring ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Positive Group ◽  
Recurrent Uti ◽  
Significant Difference ◽  
Dimercaptosuccinic Acid Scan ◽  
Dmsa Scan

Background: The aim of the study was to determine the risk factors for renal scarring detected by DMSA (dimercaptosuccinic acid) scan in children with culture-proven urinary tract infection (UTI).Methods: A hospital based observational case-control study was conducted from 2018 June to 2020 June in children aged between 1 month to 5 years who underwent a DMSA scan following culture-proven UTI (N=72). Of the children fulfilling the criteria, 43 had renal scarring in the DMSA scan as a case group and the remaining 29 children who had no renal scarring were taken as a control group.Results: Of the total 72 cases with culture-positive UTI, 59% of patients had renal scarring and the rest and 40% were scar negative. There was no significant difference in the renal scarring observed with respect to age in the two groups. There was significant (p<0.05) the association noted between renal scarring and VUR (vesicoureteric reflux). A significant difference was observed in the renal scarring between the two groups regarding the presence of recurrent UTI (p=0.000). Although most cases (97.7%) had a fever in the DMSA positive group, this was not a significant risk factor for scarring (p>0.05). In DMSA positive group, circumcision was not a significant risk factor for scarring.Conclusions: VUR and recurrent UTI were significant risk factors for renal scarring in children with culture-proven UTI as detected by DMSA scan. The other risk factors like age, sex, fever, leucocytosis and circumcision were not found to be significant. 

Thyroid Autoimmunity and Metabolic Syndrome: A Nationwide Population-Based Study

2021 ◽  
Author(s):  
Hye Jeong Kim ◽  
Sang Joon Park ◽  
Hyeong Kyu Park ◽  
Dong Won Byun ◽  
Kyoil Suh ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Autoimmunity ◽  
Significant Risk ◽  
Density Lipoprotein ◽  
Significant Risk Factor ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Walking Activity ◽  
Significant Difference

Objective Recent studies have reported that thyroid hormone levels are associated with metabolic syndrome (MetS) even in euthyroid subjects. However, the association between thyroid autoimmunity and MetS is uncertain. We aimed to investigate the relationship between thyroid autoimmunity and MetS in a large cohort study of euthyroid subjects. Methods A total of 4,775 participants aged ≥19 years from the Korea National Health and Nutrition Examination Survey VI (2013-2015) with anti-thyroid peroxidase antibody (TPOAb) results and normal thyroid functions were included in this study. Subjects were grouped according to thyroid autoimmunity (positivity of TPOAb). We estimated the odds ratios (ORs) for MetS according to TPOAb positivity using logistic regression models, adjusted for potential confounders. Results Among the study subjects, 25% (n=1,206) were diagnosed with MetS. Subjects with MetS showed higher median TPOAb levels (6.3 vs 6.8 IU/mL, p<0.001) and higher positivity of TPOAb (5 vs 7%, p=0.002) than those without MetS. There was a significant difference in prevalence of MetS depending on the TPOAb positivity (25% vs 33%, p=0.002). Subjects with TPOAb positive had a significantly greater risk of abdominal obesity [OR 1.675, 95% confidence interval (CI) 1.302-2.154, p<0.001], low high-density lipoprotein cholesterol (OR 1.603, 95% CI 1.244-2.066, p<0.001) and elevated blood pressure (OR 1.418, 95% CI 1.099-1.829, p=0.007), as compared to those with TPOAb negative. Positivity of TPOAb was a significant risk factor for MetS even after adjusting for confounding variables including age, sex, household income, education, smoking, alcohol consumption, walking activity, thyroid-stimulating hormone and free thyroxine (OR 1.389, 95% CI 1.048-1.841, p=0.022). Conclusion In euthyroid subjects, thyroid autoimmunity is associated with MetS. Further large longitudinal studies are needed to clarify causality.

scholarly journals Antiplatelet Premedication for Stent-Assisted Coil Embolization of Intracranial Aneurysms: Low-Dose Prasugrel vs Clopidogrel

Neurosurgery ◽  
2017 ◽  
Vol 83 (5) ◽  
pp. 981-988 ◽  
Author(s):  
Hyun Ho Choi ◽  
Jung Jun Lee ◽  
Young Dae Cho ◽  
Moon Hee Han ◽  
Won-Sang Cho ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Low Dose ◽  
Significant Risk ◽  
Cerebral Aneurysms ◽  
Significant Risk Factor ◽  
Thromboembolic Events ◽  
Antiplatelet Medication ◽  
Unruptured Intracranial Aneurysms ◽  
Significant Difference

Abstract BACKGROUND The use of antiplatelet medications to prevent thrombosis in the treatment of cerebral aneurysms with stents has become widely emphasized. OBJECTIVE To compare low-dose prasugrel with clopidogrel in stent-assisted coil embolization of intracranial aneurysms. METHODS This is a retrospective review of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil embolization of unruptured intracranial aneurysm between November 2014 and March 2017. Thromboembolic and hemorrhagic adverse events were compared between 207 patients who received low-dose prasugrel (PSG group) and 90 patients who received clopidogrel (CPG group). RESULTS P2Y12 reaction unit (PRU) values were significantly lower in the PSG group (PSG group vs CPG group, 132.3 ± 76.9 vs 238.1 ± 69.1; P &lt; .001); the percentage of inhibition was also statistically higher in the PSG group (54.0 ± 26.0% vs 20.8 ± 18.6%; P &lt; .001). Thromboembolic events occurred less frequently in the PSG group than in the CPG group (0.9% vs 6.4%; P = .01), whereas there was no significant difference in the percentage of hemorrhagic complications (0.5% vs 2.2%; P = .22). In the multivariate analysis, clopidogrel as the antiplatelet medication was the sole significant risk factor for thromboembolism in this series of patients undergoing stent-assisted coil embolization. CONCLUSION Use of low-dose PSG as an antiplatelet premedication is quick, effective, and safe for stent-assisted coil embolization of unruptured intracranial aneurysms. Prasugrel premedication significantly lowered the frequency of thromboembolic events without increasing the risk of hemorrhage.

scholarly journals Posterior Sagging After Cephalomedullary Nailing for Intertrochanteric Femur Fracture is Associated with a Separation of the Greater Trochanter

2020 ◽  
Vol 11 ◽  
pp. 215145932094601
Author(s):  
Keong-Hwan Kim ◽  
Michael Seungcheol Kang ◽  
Eic Ju Lim ◽  
Mi Lan Park ◽  
Jung Jae Kim
Keyword(s):  
Risk Factor ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Significant Risk Factor ◽  
Proximal Fragment ◽  
Intertrochanteric Fractures ◽  
Greater Trochanter ◽  
Ambulatory Ability ◽  
Significant Difference ◽  
Cephalomedullary Nailing

Introduction: Cephalomedullary nailing presents several biomechanical benefits for treatment of intertrochanteric fractures, but posterior sagging (PS) of the proximal fragment occurs postoperatively in some patients despite intraoperative achievement of an adequate reduction. We investigated the risk factors for PS in those patients, with specific attention to posterior split fragment involving the greater trochanter (GT separation) as a possible significant risk factor. Methods: We retrospectively reviewed 50 (12 males, 38 females) patients ≥50 years old at diagnosis of an intertrochanteric fracture after low-energy trauma who underwent cephalomedullary nailing between April 2015 and February 2017 and were not lost to follow-up within 12 months postoperatively. Results: Thirteen (26%) patients experienced PS postoperatively. Average time to bone union was significantly longer in the PS (9.5 months) than in the non-PS (4.8 months) groups ( P = .002). Three patients in the PS group experienced nonunion compared to none in the non-PS group ( P = .015). Significant difference was found in postoperative level of ambulatory ability (Koval score) and deterioration of the score after the injury between 2 groups (4.2 vs 2.8, P = .043 and 2.5 vs 0.8, P = .005). On multivariate logistic regression analysis, GT separation ( P = .010) was a significant risk factor for PS. Discussion and Conclusion: The presence of GT separation in cases of intertrochanteric fractures seems to weaken posterior stability in the proximal fragment, thus showing poor clinical outcomes.

scholarly journals Socio-demographic characteristics, breast feeding practices and household sanitation as risk factors for diarrhoeal illness in under five children

2020 ◽  
Vol 7 (3) ◽  
pp. 635
Author(s):  
Amita U. Surana ◽  
Dorothy S. Sengupta ◽  
Harshal R. Chauhan ◽  
Hetal P. Budh ◽  
Toral Gandhi
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Breast Feeding ◽  
Significant Risk ◽  
Feeding Practices ◽  
Significant Risk Factor ◽  
Bottle Feeding ◽  
Immunization Status ◽  
Route Of Transmission ◽  
Significant Difference

Background: Acute diarrhoeal disease among children under 5 years remains a major cause of morbidity and mortality. In India, diarrhoea attributes to 13% of under-5 mortality. As most diarrhoeal diseases have feco-oral route of transmission, the source of water supply, sanitary measures and personal hygiene are important factors in prevention of same. This study aims to determine various risk factors for diarrhoeal illnesses.Methods: A descriptive cross-sectional observational case-control study done among under-5 children hospitalized during rainy months in paediatric ward of tertiary care centre. Information regarding participant’s age, sex, immunization status and breast feeding practices collected from the mother or caregiver of the child using a structured questionnaire.Results: Out of 55 cases and 55 controls enrolled, there was no significant difference in birth weight, gender, immunization status, socio economic profile, hygiene practices and sanitation facility between two groups. Statistically significant difference (p 0.01717) was seen in wasting associated with cases and controls however no difference in proportion of stunting was noted. The cases showed early age of start of complimentary feeding (5.86± 1.38m) and less duration of total breast feeding (15.94±4.09m) as compared to controls. Bottle feeding was seen in 69% cases as compared to 53% controls.Conclusions: In socio economically and environmentally similar conditions, faulty feeding is a significant risk factor for diarrhoeal illness in under 5 children. Wasting is also a significant risk factor associated with the same.

scholarly journals Serosurvey of hepatitis A virus and E virus infection among municipal sweepers working in the largest city in the south of Iran

2021 ◽  
Author(s):  
Jamal Sarvari ◽  
Seyed Younes Hosseini ◽  
Negar Joharinia ◽  
Seyed Ali Hosseini ◽  
Saeed Firoozi Ghahestani ◽  
...  
Keyword(s):  
Work Experience ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Normal Population ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Personal Hygiene ◽  
The South ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background Given the importance of Hepatitis A (HAV) and Hepatitis E (HEV) infection in careers like street sweeping, this study was conducted to determine the exposure rate in urban solid waste collectors/sweepers in the south of Iran. Materials and methods In this cross-sectional study, the sera samples of 385 waste collectors/sweepers from all districts of Shiraz, southern Iran, were collected. A questionnaire was used to gather data on their demographic and occupational characteristics, as well as their awareness of viral hepatitis disease. The rate of HAV and HEV sero-prevalence was determined by commercial ELISA kits. Results All partisans were male with a mean age of 41 ± 8 years. ELISA assay showed that all of participants were positive for anti-HAV Ab. Moreover, 62out of 385 (16.1%) subjects were positive for anti-HEV IgG Ab. Also, statistical analysis showed that the frequency of IgG Ab against HEV among the age group of 20–30, 31–40, 41–50 and over 50 years old was 4.5%, 10.1%, 17.4%, and 36.7% that was statistically significant (P < 0.001). Based on the work experience, current and previous jobs, residency, personal hygiene and knowledge status of hepatitis disease and transmission, the results showed that there was no statistically significant difference between anti-HEV positive and negative sweepers (p˃0.05). Conclusion Our results indicated that the frequency of anti-HAV and HEV IgG among sweepers is slightly higher than the normal population; it does not seem that garbage collecting/sweeping career could be a significant risk factor for HAV and HEV infection.

scholarly journals Difference of Vertical Transmission in HIV-Infected Women with Complete and Incomplete PMTCT

2016 ◽  
Author(s):  
Sitti Fausihar ◽  
Yudianto B Saroyo
Keyword(s):  
Vertical Transmission ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hiv Positive ◽  
Pmtct Program ◽  
Factors Affecting ◽  
Keywords Hiv ◽  
Significant Difference

Objective: To analyze any differences on vertical transmission in groups with complete and incomplete program as well as the factors influencing completion. Method: This was a retrospective cohort study performed by data collection from medical records and/or interviews from January 2010 to February 2012. The variables analyzed subject characteristics, applied PMTCT program and risk factors affecting transmission. Result: Seventy-five pregnant women who were HIV-positive were initially recruited, but 21 subjects were excluded due to incomplete medical records. In the first group (n=27) who received complete PMTCT, no vertical transmission was identified, while in the second group (n=27) with incomplete PMTCT, seven children were found to be HIV-positive. Rupture of membrane for more than 4 hours was the only significant risk factor for vertical transmission (p=0.001, RR=64.5, 95% CI=6.14-677.6). Conclusion: There was a significant difference in the occurrence of vertical transmission between complete and incomplete PMTCT program. Complete PMTCT program may provide protective effect against the occurrence of vertical transmission by 25.9%. Keywords: HIV, PMTCT, vertical transmission

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