scholarly journals The role of secondary motor and language cortices in morbidity and mortality: a retrospective functional MRI study of surgical planning for patients with intracranial tumors

2013 ◽  
Vol 34 (4) ◽  
pp. E7 ◽  
Author(s):  
Jed Voss ◽  
Timothy B. Meier ◽  
Robert Freidel ◽  
Bornali Kundu ◽  
Veena A. Nair ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Functional Mri ◽  
Brain Regions ◽  
Motor Area ◽  
Morbidity And Mortality ◽  
Motor Deficits ◽  
Language Mapping ◽  
Language Deficits ◽  
The Impact ◽  
The Relationship

Object Functional MRI (fMRI) is commonly used by neurosurgeons preoperatively to identify brain regions associated with essential behaviors, such as language and motor abilities. In this study the authors investigated the relationship between patient morbidity and mortality and the distance from the tumor border area to functional activations in secondary motor and language cortices. Methods Patients with primary or metastatic brain tumors who underwent preoperative fMRI motor and language mapping were selected from a large database of patients with tumors. The lesion-to-activation distance (LAD) was measured in each patient relative to the supplementary motor area (SMA) for motor tasks and the presupplementary motor area (pSMA) for language tasks. The association between LAD and the incidence of deficits was investigated using the Fisher exact tests of significance. The impact of other variables, including age, handedness, sex, and tumor grade, was also investigated. In a subset of patients, logistic regression was performed to identify the likelihood of deficits based on the LAD to primary and secondary regions. Finally, Mantel-Cox log-rank tests were performed to determine whether survival time was significantly related to the LAD to secondary motor and language areas. Results A significant association was observed between the LAD to the SMA and the incidence of motor deficits, with the percentage of patients with deficits dropping for those in the LAD > 2 cm group. The relationship between the LAD to the pSMA and the incidence of language deficits was not significant. Logistic regression demonstrated that the LAD to primary sensorimotor cortex does affect the incidence of motor deficits, but that the LAD to SMA does not. Finally, the authors observed no relationship between the LAD to secondary regions and patient mortality rates. Conclusions These results demonstrate that the LAD to SMA structures does affect morbidity, although not to the extent of LAD to primary structures. In addition, motor deficits are significantly associated with LAD to secondary structures, but language deficits are not. This should be considered by neurosurgeons for patient consultation and preoperative planning.

scholarly journals Characterizing the relationship between functional MRI–derived measures and clinical outcomes in patients with vascular lesions

2013 ◽  
Vol 34 (4) ◽  
pp. E8 ◽  
Author(s):  
Thomas A. Gallagher ◽  
Veena A. Nair ◽  
Michael F. Regner ◽  
Brittany M. Young ◽  
Andrew Radtke ◽  
...  
Keyword(s):  
Functional Mri ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Sample Population ◽  
Relevant Parameter ◽  
Language Deficits ◽  
Lesion Type ◽  
The Impact ◽  
The Relationship

Object Functional MRI (fMRI) has proven to be an effective component of pretreatment planning in patients harboring a variety of different brain lesions. The authors have recently reported significant relationships concerning distances between brain tumor borders and areas of functional activation (lesion-to-activation distance; LAD) with regard to patient morbidity and mortality. This study further examines the relationship between LAD, focusing on a host of vascular lesions and pre- and posttreatment morbidity. Methods This study included a sample population of patients with vascular lesions (n = 106), primarily arteriovenous malformations (AVMs) and cavernomas. These patients underwent pretreatment fMRI-based motor mapping (n = 72) or language mapping (n = 84). The impact of LAD and other variables derived from the patient medical record were analyzed with respect to functional deficits in terms of morbidity (weakness and/or aphasia). Results In patients with no pretreatment deficits, there was trend for a significant relationship between the Wernicke area LAD and posttreatment language deficits. In patients with or without pretreatment deficits, a trend toward significance was observed between sensorimotor LAD and posttreatment motor deficits. Additionally, lesion type (AVMs or cavernomas) affected posttreatment deficits, with more patients with cavernomas showing posttreatment language deficits than patients with AVMs. However, this difference was not observed for posttreatment motor deficits. Conclusions These findings suggest that the proximity of a vascular lesion to sensorimotor and language areas is a relevant parameter in estimating patient prognosis in the perioperative period. Additionally, vascular lesion type and existence of pretreatment deficits play a significant role in outcomes.

Abstract 3734: Presurgical fMRI and Morbidity Outcomes in Patients with Vascular Lesions

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andrew C Radtke ◽  
Joshua Pankratz ◽  
Ryan Holdsworth ◽  
Dovile Baniulis ◽  
Nicole Kornder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preoperative Planning ◽  
Binary Logistic Regression ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Binary Logistic Regression Analysis ◽  
Language Mapping ◽  
Motor Mapping ◽  
The Relationship

Background fMRI is being increasingly used as an adjunct imaging technique for preoperative planning for patients with various brain lesions. The proximity of the lesion to eloquent cortex is a major factor in guiding surgical planning. Our group has previously reported significant association between the distance between brain tumor periphery and area of fMRI activation (Lesion-Activation Distance; LAD) and morbidity and mortality outcomes. This study investigated the relationship between vascular lesion LAD and morbidity. Methods This study was a retrospective analysis of data from patients with vascular lesions [arteriovenous malformations (AVMs) (n=49), and cavernomas (n=57)], who had received fMRI as part of their preoperative planning. The preoperative fMRI included motor mapping (n=87) and/or language mapping (n=102). The fMRI paradigms were chosen based on observed preoperative weakness (aphasia, paresis) and anticipated functional areas of the brain that may be affected by treatment. Results Multiple logistic regression analyses showed that a model that combines Age and Language LAD was a significant predictor of postoperative deficits (p= 0.04). Broca’s LAD(1-2 cm) X Age was a significant predictor of postoperative deficits (change in odds ratio (OR) =0.82, CI:0.68-0.98). The relationship between Brocas’s LAD and postoperative aphasia and Broca’s LAD and pre and postoperative aphasia trended towards significance (p = .08 and p =.07 respectively). Wernicke’s LAD, independently or combined with Age, was not a significant predictor of postoperative deficits. Binary logistic regression analysis for SMC LAD and postop deficits did not reach significance (p =.10). There were no significant differences in postoperative language or motor deficits as a function of gender or handedness. Conclusions These results suggest that both age and the proximity of a vascular lesion to language LAD are factors that can help predict postoperative outcomes, especially for Broca’s LAD. The lack of similar results when investigating the relationship between Wernicke’s LAD and postoperative deficits suggests potential brain reorganization and/or robustness of this brain region. These results have implications for the potential use of fMRI as a presurgical tool for language mapping in patients with vascular lesions.

Trust in police as an influencing factor on trust in government: 2SLS analysis using perception of safety

2020 ◽  
Vol 43 (4) ◽  
pp. 541-558
Author(s):  
Jisu Jeong ◽  
Seunghui Han
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Trust In Government ◽  
Content Type ◽  
Perception Of Safety ◽  
Ordered Logistic Regression ◽  
The Impact ◽  
The Relationship ◽  
Trust In Police

PurposeCitizen trust in police is important in terms of citizen consent to government policies and of police achieving their organizational goals. In the previous study, improvements in police policy, organizational operation and policing activities were developed to clarify which factors influence trust in police and how trust can be improved. This research raises the question, would changes in trust in police have an impact on trust in government? In this paper, this research question is discussed theoretically and the causal relationship analyzed empirically by applying OLS, ordered logistic, 2SLS and logistic regressions.Design/methodology/approachThe basic analysis methods are to apply the OLS and the ordered logistic regression. OLS regression analysis is an analytical method that minimizes an error range of a regression line. The assumptions for OLS are: linearity, independence, equilibrium, extrapolation and multicollinearity issues. These problems were statistically verified and analyzed, in order to confirm the robustness of the analysis results by comparing the results of the ordered logistic regression because of the sequence characteristic of the dependent variable. The data to be used in this study is the Asia Barometer Survey in 2013.FindingsTrust in police and citizen perception of safety are analyzed as important factors to increase trust in the government. The effects of trust in police are more significant than the effects of control variables, and the direction and strength of the results are stable. The effect of trust in police on trust in government is strengthened by the perception of safety (IV). In addition, OLS, ordered logistic regression analysis, which analyzed trust in central government and local government, and logistic regression analysis categorized by trust and distrust show the stability.Research limitations/implicationsThis paper has implications in terms of theoretical and empirical analysis of the relationship between trust in police and trust in government. In addition, the impact of perception of safety on trust in police can be provided to police officers, policymakers and governors who are seeking to increase trust in government. This paper is also meaningful in that it is the microscopic research based on the citizens' survey. One of the limitations of macroscopic research is that it does not consider the individual perceptions of citizens.Practical implicationsThe results of this paper can confirm the relationship of the virtuous cycle, which is perception of safety – trust in police – trust in government. The police will need to provide security services to improve citizens' perception of safety and make great efforts to create safer communities and society. Trust in police formed through this process can be an important component of trust in government. By making citizens feel safer and achieving trust in police, ultimately, trust in government will be improved.Originality/valueThe police perform one of the essential roles of government and are one of the major components of trust in government, but the police sector has been neglected compared to the roles of the economic and political sectors. These influences of macro factors are too abstract to allow specific policy directions to be suggested. If we consider trust in police, and factors that can improve trust in government, we can suggest practical policy alternatives.

Drp1 widely, yet heterogeneously distributes in mice central nervous system

2020 ◽  
Author(s):  
Ting-Ting Luo ◽  
Chun-Qiu Dai ◽  
Jia-Qi Wang ◽  
Zheng-Mei Wang ◽  
Yi Yang ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Malignant Glioma ◽  
Expression Patterns ◽  
Brain Regions ◽  
Inhibitory Neurons ◽  
Heterogeneous Distribution ◽  
Human Malignant Glioma ◽  
The Impact ◽  
The Relationship

Abstract Objectives: Drp1 is wildly expressed and plays a role in inducing mitochondrial fission process. It is confirmed that many diseases are associated with Drp1 and mitochondria. However, since the exact Drp1 is not specifically distributed, it is hard to determine the impact of anti-Drp1 molecules on human body and where the Drp1 inhibitor functions. Methods: We visualized distribution of Drp1 in different brain regions, and explicated the relationship between Drp1 and mitochondria. GAD67-GFP knock-in mice were utilized to detect the expression patterns of Drp1 on the GABAergic neurons. And we further analyzed Drp1 expression in human malignant glioma tissue. Results: Drp1 widely but heterogeneously distributed in central nervous system. Further observation indicated that Drp1 was highly and heterogeneously expressed in inhibitory neurons. Under transmission electron microscope, Drp1 distribution in dendrites was higher than other areas in neurons and only a small amount of Drp1 was located on mitochondria. In human malignant glioma, Drp1 fluorescence intensity increased from grade I-III, while grade IV showed the descending trend. Conclusion: In this study, we observed Drp1 widely yet heterogeneously distributed in central nervous system. Drp1 heterogeneous distribution may be related with the occurrence and development of neurologic disease. We hope that the relationship between Drp1 and mitochondria may give the therapeutic guidance.

Cytokine Profile Changes In 309 Myelofibrosis Patients: Comparison Of JAK1/JAK2 Inhibitor Therapy Vs. Placebo – Correlative Analysis From The Comfort-I Trial

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4074-4074 ◽  
Author(s):  
Amylou C. Dueck ◽  
Charles S. Cleeland ◽  
Robert Dantzer ◽  
Jeff Sloan ◽  
Srdan Verstovsek ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Limit Of Detection ◽  
Inhibitor Therapy ◽  
Phase Iii ◽  
Jak2 Inhibitor ◽  
Combining Data ◽  
Cytokine Levels ◽  
The Impact ◽  
The Relationship ◽  
Over Time

Abstract Background Inflammatory deregulation may be a major factor in cancer related symptoms (Dantzer Nature Rev Clin Oncol 2012). Improved symptoms in myelofibrosis (MF) patients treated with single arm ruxolitinib (JAK1/JAK2 inhibitor) studies has been correlated with normalization of selected cytokines increased pre-therapy (c-reactive protein, IL-1ra, MIP-1b, TNF-a, and IL-6; Verstovsek NEJM 2010). We sought to assess the impact of JAK1/JAK2 inhibitor therapy on cytokine levels and the relationship between cytokine levels and symptoms prior to and during JAK1/JAK2 inhibitor therapy in the phase III placebo controlled COMFORT-I trial (Verstovsek NEJM 2012). Methods Cytokine levels (89 cytokines measured at baseline and at weeks 4 and 24) and MF symptoms (assessed by MFSAF 2.0 – Mesa JCO 2013) were collected during the blinded phase of COMFORT-I. Patients were randomized to ruxolitinib vs. placebo. Plasma was used for the measurement of cytokines using Rules-Based Medicine, Inc. (Austin, TX) Human MAP panel. Associations between the MFSAF total symptom score (TSS) and log2-transformed cytokine data were investigated at baseline using Spearman correlations and linear regression. Mixed models were used to assess cytokine and TSS changes over time within each arm and overall. Logistic regression was used to assess the relationship between baseline cytokines and TSS response (>/=50% reduction from baseline) at week 24, and between week 4 cytokine changes and TSS response (>/=50% reduction from baseline) at week 24 within each arm and overall. Mixed and logistic regression models combining data across arms also included terms for visit, arm, and visit-by-arm interaction. All models also included age, gender, and body mass index (BMI). Given the large number of cytokines being investigated, p<0.001 was considered statistically significant. Cytokine values below the limit of detection were set at the lowest limit of detection and 25 cytokines were excluded from statistical analysis due to having more than 30% of data missing or below the limit of detection. Results Patients: 309 subjects were randomized in COMFORT-I with median age 68 (range 40-91), 46% female, 50% primary myelofibrosis, and 61% high risk. All 309 subjects had cytokines measured at one or more of the three visits included in this analysis, with 308 having cytokine values paired with a TSS score at the same visit. Cytokines at Baseline: At baseline, the highest Spearman correlations with symptomatic burden (as assessed by the TSS) were observed for APOA1 (rho=-.21) and FERRITIN (rho=-.20), followed by INTLK5, MIP1A, MMP3, INTLK2, MGB, INTLK1A, and INTLK7 with correlations between -.15 and -.17 (all p<0.01). After adjusting for age, sex, and BMI, VCAM1 and APOA1 were significantly associated with TSS at baseline. Cytokine and Symptom changes during trial: Changing levels of 5 cytokines were significantly associated with change of TSS over time beyond the change due to visit, arm, visit-by-arm interaction, age, sex and BMI including VCAM1, LEPTIN, TIMP1, B2MICG, and TNFRII. Within the placebo arm, only 5 cytokines significantly changed over time compared to 46 cytokines in the ruxolitinib arm (visit-by-arm interaction was significant for 43 in the overall models). VCAM1, B2MICG, and TNFRII were among the 5 cytokines which changed in the placebo arm, and VCAM1, LEPTIN, TIMP1, B2MICG, and TNFRII were among the 46 cytokines which changed in the ruxolitinib arm. No baseline cytokines and no changes in cytokines at week 4 univariately predicted week 24 TSS response within either arm at the p<0.001 level. Conclusions In the first serial assessment of MF symptoms and plasma cytokine levels in the conduct of a placebo controlled trial we found 5 cytokines in which improved levels correlated with decreased MF symptom burden in ruxolitinib treated patients. Development of a multivariate model for predicting symptom response, correlations with splenic response and impact on survival benefit of therapy is ongoing. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Long-term consequences of childhood maltreatment: Altered amygdala functional connectivity

2015 ◽  
Vol 27 (4pt2) ◽  
pp. 1577-1589 ◽  
Author(s):  
Kelly Jedd ◽  
Ruskin H. Hunt ◽  
Dante Cicchetti ◽  
Emily Hunt ◽  
Raquel A. Cowell ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Functional Connectivity ◽  
Childhood Maltreatment ◽  
Brain Regions ◽  
Healthy Development ◽  
Early Stress ◽  
History Of ◽  
The Impact ◽  
The Relationship

AbstractChildhood maltreatment is a serious individual, familial, and societal threat that compromises healthy development and is associated with lasting alterations to emotion perception, processing, and regulation (Cicchetti & Curtis, 2005; Pollak, Cicchetti, Hornung, & Reed, 2000; Pollak & Tolley-Schell, 2003). Individuals with a history of maltreatment show altered structural and functional brain development in both frontal and limbic structures (Hart & Rubia, 2012). In particular, previous research has identified hyperactive amygdala responsivity associated with childhood maltreatment (e.g., Dannlowski et al., 2012). However, less is known about the impact of maltreatment on the relationship between the amygdala and other brain regions. The present study employed an emotion processing functional magnetic resonance imaging task to examine task-based activation and functional connectivity in adults who experienced maltreatment as children. The sample included adults with a history of substantiated childhood maltreatment (n = 33) and comparison adults (n = 38) who were well matched on demographic variables, all of whom have been studied prospectively since childhood. The maltreated group exhibited greater activation than comparison participants in the prefrontal cortex and basal ganglia. In addition, maltreated adults showed increased amygdala connectivity with the hippocampus and prefrontal cortex. The results suggest that the intense early stress of childhood maltreatment is associated with lasting alterations to frontolimbic circuitry.

scholarly journals Subjective executive function deficits in hazardous alcohol drinkers

2021 ◽  
pp. 026988112110326
Author(s):  
Anna Powell ◽  
Harry Sumnall ◽  
Cecil Kullu ◽  
Lynn Owens ◽  
Catharine Montgomery
Keyword(s):  
Alcohol Use ◽  
Recovery Of Function ◽  
Brain Regions ◽  
Future Research ◽  
Hazardous Alcohol Use ◽  
Cross Sectional ◽  
Hazardous Alcohol ◽  
The Impact ◽  
The Relationship ◽  
Alcohol Related Problems

Background: Dependent alcohol drinkers exhibit differences in the structure and function of the brain, and impairments in cognitive function, including executive functions (EFs). Less is known about the impact of non-dependent but hazardous use (that which raises the risk of harm), and it is also unclear to what extent executive impairments in this cohort affect real-world function. The current study examines the relationship between alcohol use, EF and alcohol-related problems, in the general population. Methods: A between-groups cross-sectional design assessed EF across two levels of drinking; hazardous (Alcohol Use Disorders Identification Test (AUDIT) score of ⩾8) and non-hazardous. Alcohol drinkers ( n = 666; 136 male; 524 female; six not disclosed; aged 28.02 ± 10.40 years) completed validated questionnaires online assessing subjective EF, alcohol use and alcohol-related problems. Results: Organisation, Strategic Planning, Impulse Control and overall function were significantly impaired in hazardous drinkers. Furthermore, the effect of alcohol on EF, partially mediated the relationship between alcohol use and alcohol-related problems. Conclusion: Hazardous drinking was associated with lower subjective EF, and this mediated the effect of alcohol on alcohol-related problems. This may be due to changes in prefrontal brain regions, which could indicate greater risk for the development of alcohol dependence (AD). Future research should use additional means to assess EF in hazardous drinkers, including recovery of function, development of AD and the relationship between cognition and alcohol-related daily problems.

scholarly journals AB0136 ASSESSING THE RELATIONSHIP AMONG OBESITY, GENETIC POLYMORPHISM, AND CLINICAL PARAMETERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1096.1-1096
Author(s):  
K. Yoshida ◽  
S. Hatachi ◽  
S. Takahashi ◽  
N. Amano ◽  
M. Katayama ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Genetic Polymorphism ◽  
Gene Mutation ◽  
Nucleotide Polymorphisms ◽  
Laboratory Parameters ◽  
Methotrexate Dose ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Background:Several study suggested body mass index(BMI) may influence development of rheumatoid arthritis(RA). There are conflicting reports concerning the impact of high BMI on development of RA, but several reports of obese on drug resistance and functional impairment. The relationship of genetic polymorphism on obesity is unclear in RA.Objectives:To examine the relationship among BMI, genetic polymorphism of obesity, disease activity of RA, laboratory parameters, and therapeutic agent of RA.Methods:We have carried out a retrospective observational study by systematically analyzing medical records of total 289 patients diagnosed with RA in Shinko Hospital between March 2016 and December 2019. We also conducted genotyping single nucleotide polymorphisms (SNPs) including FTO (rs1558902 and rs9939609), UCP1 (rs1800592), ADR2(rs1042713) and ADR3(rs4994) after informed consent. Obesity was defined as BMI over than 25 and patients were divided between obese (“Ob”) and non-obese (“non-Ob”). These SNPs, DAS28CRP, laboratory parameters, methotrexate dose, use of biological DMARDs were compared between Ob and non-Ob patients.Results:Of these 289 patients, 82.7% was female, mean age was 61.9 years and BMI was 22.4. Univariate logistic regression showed differences (p<0.1) between Ob and non Ob groups in UCP1 gene mutation(63.6% vs 78%, P=0.018), DAS(2.24 vs 1.99, P=0.033),triglyceride abnormality(23.8% vs 9.3%, P=0.021), HDL(56 vs 71, P=0.00009), HbA1c abnormality(26.5% vs 12.1%, P=0.019),γGTP(32 vs 21, P=0.00037), ALP (253 vs 230, P=0.0058), ALT (26.5 vs 20, P=0.029),and MTX dose(6 vs 8, P=0.066). Multivariate logistic regression showed that Ob group was significantly associated with HDL(OR=0.976, 95%CI 0.958 to 0.995), UCP1 gene mutation(OR=0.446, 95%CI 0.202 to 0.984), γGTP(OR=2.321, 95%CI 1.269 to 4.245), and MTX dose(OR=0.866, 0.784 to 0.957).Conclusion:Obesity in patients with RA had significant positive correlation with γGTP, and negative correlation with HDL, UCP gene mutation and MTX dose.Disclosure of Interests:None declared

scholarly journals Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sidra Arif ◽  
Hina Khan ◽  
Muhammad Aslam ◽  
Muhammad Farooq
Keyword(s):  
Logistic Regression ◽  
Survival Analysis ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Binary Logistic Regression ◽  
World Health ◽  
Breastfeeding Duration ◽  
The Impact ◽  
The Relationship

Abstract Background Breastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant’s protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan. Methods The data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017–18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables. Results We use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable. Conclusions The results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.

Are allergies, asthma or hypersensitivity to NSAIDs equally a risk factor for the development of a specific CRS phenotype?

2019 ◽  
Vol 73 (4) ◽  
pp. 1-5
Author(s):  
Grażyna Stryjewska-Makuch ◽  
Małgorzata Janik ◽  
Bogdan Kolebacz ◽  
Wojciech Ścierski ◽  
Grażeyna Lisowska
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Bronchial Asthma ◽  
Systemic Disease ◽  
Caucasian Population ◽  
Inflammation Markers ◽  
Th2 Inflammation ◽  
The Impact ◽  
The Relationship ◽  
Extensive Surgery

Introduction: CRS is a complex systemic disease affecting more than 10% of the population. There are two main types of CRS phenotypes: CRSwNP and CRSsNP. In the Caucasian population, the prevalence of inflammation markers typical of the Th1 profile is observed in CRSsNP, whereas Th2 and Th17 in CRSwNP. Th2 inflammation is observed in the CRSwNP phenotype with concomitant allergies, asthma or hypersensitivity to NSAIDs. Objectives: The aim of the study was to evaluate, based on the authors' own material, whether allergies, asthma or hypersensitivity to NSAIDs was a risk factor for the development of a specific CRS phenotype. An attempt was also made to investigate the effect of comorbidities on the extent of sinus endoscopic procedures, which depended on the severity of inflammation. Methods: In the years 2006–2015, ESS was performed on 2217 patients with different CRS phenotypes. Patients with an allergy, bronchial asthma and hypersensitivity to NSAIDs were subjected to analysis. Results: Based on logistic regression, it has been found that among the comorbidities, only asthma (p < 0.0001) and hypersensitivity to NSAIDs (p = 0.0007) significantly affect the occurrence of the phenotype with polyps, whereas the impact of allergies is statistically insignificant (p = 0.1909). The relationship between the type of ESS and CRS phenotypes is statistically significant (p < 0.0001). Conclusions: Bronchial asthma and hypersensitivity to NSAIDs have a statistically significant effect on the occurrence of the CRSwNP phenotype. This effect has not been observed in the case of allergies. The impact of allergies, asthma and hypersensitivity on the phenotype has been observed in the group of patients subjected to the most extensive surgery (ESS 4).

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