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Sample records for retrospective case-control analysis

  1. Pregnancy associated nasopharyngeal carcinoma: A retrospective case-control analysis of maternal survival outcomes

    International Nuclear Information System (INIS)

    Cheng, Yi-Kan; Zhang, Fan; Tang, Ling-Long; Chen, Lei; Zhou, Guan-Qun; Zeng, Mu-Sheng; Kang, Tie-Bang; Jia, Wei-Hua; Shao, Jian-Yong; Mai, Hai-Qiang; Guo, Ying; Ma, Jun

    2015-01-01

    Background: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. Methods: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010. Results: The median age of both groups was 30 years (range, 23–35 years); median follow-up for all patients was 70 months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p = 0.72), distant metastasis-free survival (79% vs. 76%, p = 0.77), loco-regional relapse-free survival (97% vs. 91%, p = 0.69) and disease-free survival (69% vs. 74%, p = 0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. Conclusion: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC

  2. Effectiveness of penicillin, dicloxacillin and cefuroxime for penicillin-susceptible Staphylococcus aureus bacteraemia: a retrospective, propensity-score-adjusted case-control and cohort analysis.

    Science.gov (United States)

    Nissen, Jette Lindbjerg; Skov, Robert; Knudsen, Jenny Dahl; Ostergaard, Christian; Schønheyder, Henrik Carl; Frimodt-Møller, Niels; Benfield, Thomas

    2013-08-01

    Penicillin-susceptible Staphylococcus aureus isolates account for a fifth of cases of S. aureus bacteraemia (SAB) in Denmark, but little is known about treatment outcomes with penicillins or other antimicrobials. Here we compare penicillin, dicloxacillin and cefuroxime as definitive treatments in relation to 30 day mortality. A retrospective chart review of 588 penicillin-susceptible S. aureus cases at five centres from January 1995 to December 2010. Data on demographics, antimicrobial treatment, clinical signs and symptoms, and mortality at day 30 were collected. Hazard ratios (HRs) with 95% CIs associated with mortality were modelled using propensity-score-adjusted Cox proportional hazards regression analysis. Propensity-score-matched case-control studies were carried out. Definitive therapy with cefuroxime was associated with an increased risk of 30 day mortality compared with penicillin (adjusted HR 2.54, 95% CI 1.49-4.32). Other variables that were statistically significantly associated with 30 day mortality included increasing age, disease severity and a primary respiratory focus. Osteomyelitis/arthritis was associated with a lower risk of death than were other secondary manifestations. Propensity-score-matched case-control studies confirmed an increased risk of 30 day mortality: cefuroxime treatment (39%) versus penicillin treatment (20%), P = 0.037; and cefuroxime treatment (38%) versus dicloxacillin treatment (10%), P = 0.004. Definitive therapy for penicillin-susceptible SAB with cefuroxime was associated with a significantly higher mortality than was seen with therapy with penicillin or dicloxacillin.

  3. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Science.gov (United States)

    Myles, Puja R; Nguyen-Van-Tam, Jonathan S; Lim, Wei Shen; Nicholson, Karl G; Brett, Stephen J; Enstone, Joanne E; McMenamin, James; Openshaw, Peter J M; Read, Robert C; Taylor, Bruce L; Bannister, Barbara; Semple, Malcolm G

    2012-01-01

    Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs), the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS); to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3) and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children) with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC), sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI): CATs 0.77 (0.73, 0.80); CURB-65 0.68 (0.64, 0.72); PMEWS 0.68 (0.64, 0.73), ptools for predicting need for higher levels of care and/or mortality in patients of all ages.

  4. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Directory of Open Access Journals (Sweden)

    Puja R Myles

    Full Text Available Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs, the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS; to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3 and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC, sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI: CATs 0.77 (0.73, 0.80; CURB-65 0.68 (0.64, 0.72; PMEWS 0.68 (0.64, 0.73, p<0.001] and children [AUROC: CATs 0.74 (0.68, 0.80; CURB-65 0.52 (0.46, 0.59; PMEWS 0.69 (0.62, 0.75, p<0.001]. CURB-65 and CATs were similar in predicting death in adults with both performing better than PMEWS; and CATs best predicted death in children. CATs were the best predictor of Level 2/3 care and/or death for both adults and children. CATs are potentially useful triage tools for predicting need for higher levels of care and/or mortality in patients of all ages.

  5. Anorexia nervosa versus bulimia nervosa : differences based on retrospective correlates in a case-control study

    NARCIS (Netherlands)

    Machado, Barbara C.; Goncalves, Sonia F.; Martins, Carla; Brandao, Isabel; Roma-Torres, Antonio; Hoek, Hans W.; Machado, Paulo P.

    This study is the result of two Portuguese case-control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN A

  6. Psychogenic nonepileptic seizures and chronic pain: a retrospective case-controlled study.

    Science.gov (United States)

    Gazzola, Deana M; Carlson, Chad; Rugino, Angela; Hirsch, Scott; Starner, Karen; Devinsky, Orrin

    2012-12-01

    Psychogenic nonepileptic seizures (PNES) can be challenging to diagnose, but certain clinical features can help to distinguish PNES from epileptic seizures. The purpose of this study is to assess chronic pain and prescribed pain medication use in PNES patients. A case-controlled, retrospective analysis was performed examining pain medication use in 85 PNES patients versus an active control group of 85 patients with idiopathic generalized epilepsy (IGE). Chronic pain was more frequent among PNES patients (N=40) than active controls (N=10) (pseizures raises the possibility of PNES. Among patients with PNES and chronic pain, a psychogenic etiology for pain and non-opiate pain management strategies should be considered. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. A retrospective likelihood approach for efficient integration of multiple omics factors in case-control association studies.

    Science.gov (United States)

    Balliu, Brunilda; Tsonaka, Roula; Boehringer, Stefan; Houwing-Duistermaat, Jeanine

    2015-03-01

    Integrative omics, the joint analysis of outcome and multiple types of omics data, such as genomics, epigenomics, and transcriptomics data, constitute a promising approach for powerful and biologically relevant association studies. These studies often employ a case-control design, and often include nonomics covariates, such as age and gender, that may modify the underlying omics risk factors. An open question is how to best integrate multiple omics and nonomics information to maximize statistical power in case-control studies that ascertain individuals based on the phenotype. Recent work on integrative omics have used prospective approaches, modeling case-control status conditional on omics, and nonomics risk factors. Compared to univariate approaches, jointly analyzing multiple risk factors with a prospective approach increases power in nonascertained cohorts. However, these prospective approaches often lose power in case-control studies. In this article, we propose a novel statistical method for integrating multiple omics and nonomics factors in case-control association studies. Our method is based on a retrospective likelihood function that models the joint distribution of omics and nonomics factors conditional on case-control status. The new method provides accurate control of Type I error rate and has increased efficiency over prospective approaches in both simulated and real data. © 2015 Wiley Periodicals, Inc.

  8. Anterior cervical spine surgery-associated complications in a retrospective case-control study

    OpenAIRE

    Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G.; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N.

    2017-01-01

    Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. ...

  9. Women with learning disabilities and access to cervical screening: retrospective cohort study using case control methods

    Science.gov (United States)

    Reynolds, Fiona; Stanistreet, Debbi; Elton, Peter

    2008-01-01

    Background Several studies in the UK have suggested that women with learning disabilities may be less likely to receive cervical screening tests and a previous local study in had found that GPs considered screening unnecessary for women with learning disabilities. This study set out to ascertain whether women with learning disabilities are more likely to be ceased from a cervical screening programme than women without; and to examine the reasons given for ceasing women with learning disabilities. It was carried out in Bury, Heywood-and-Middleton and Rochdale. Methods Carried out using retrospective cohort study methods, women with learning disabilities were identified by Read code; and their cervical screening records were compared with the Call-and-Recall records of women without learning disabilities in order to examine their screening histories. Analysis was carried out using case-control methods – 1:2 (women with learning disabilities: women without learning disabilities), calculating odds ratios. Results 267 women's records were compared with the records of 534 women without learning disabilities. Women with learning disabilities had an odds ratio (OR) of 0.48 (Confidence Interval (CI) 0.38 – 0.58; X2: 72.227; p.value learning disabilities. Conclusion The reasons given for ceasing and/or not screening suggest that merely being coded as having a learning disability is not the sole reason for these actions. There are training needs among smear takers regarding appropriate reasons not to screen and providing screening for women with learning disabilities. PMID:18218106

  10. Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control study.

    Science.gov (United States)

    Machado, Bárbara C; Gonçalves, Sónia F; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Hoek, Hans W; Machado, Paulo P

    2016-06-01

    This study is the result of two Portuguese case-control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN METHOD: A case-control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.

  11. Retrospective exposure assessment and quality control in an international multi-centre case-control study

    DEFF Research Database (Denmark)

    Tinnerberg, H; Heikkilä, P; Huici-Montagud, A

    2003-01-01

    The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...... country-specific differences, differences in information available to the home assessor and the others and misunderstandings or difficulties in translation of information. To ensure the consistency of exposure assessments in international retrospective case-control studies it is important to have a well...

  12. Women with learning disabilities and access to cervical screening: retrospective cohort study using case control methods

    Directory of Open Access Journals (Sweden)

    Stanistreet Debbi

    2008-01-01

    Full Text Available Abstract Background Several studies in the UK have suggested that women with learning disabilities may be less likely to receive cervical screening tests and a previous local study in had found that GPs considered screening unnecessary for women with learning disabilities. This study set out to ascertain whether women with learning disabilities are more likely to be ceased from a cervical screening programme than women without; and to examine the reasons given for ceasing women with learning disabilities. It was carried out in Bury, Heywood-and-Middleton and Rochdale. Methods Carried out using retrospective cohort study methods, women with learning disabilities were identified by Read code; and their cervical screening records were compared with the Call-and-Recall records of women without learning disabilities in order to examine their screening histories. Analysis was carried out using case-control methods – 1:2 (women with learning disabilities: women without learning disabilities, calculating odds ratios. Results 267 women's records were compared with the records of 534 women without learning disabilities. Women with learning disabilities had an odds ratio (OR of 0.48 (Confidence Interval (CI 0.38 – 0.58; X2: 72.227; p.value X2: 24.236; p.value X2: 286.341; p.value Conclusion The reasons given for ceasing and/or not screening suggest that merely being coded as having a learning disability is not the sole reason for these actions. There are training needs among smear takers regarding appropriate reasons not to screen and providing screening for women with learning disabilities.

  13. Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study.

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti

    Full Text Available In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.In this retrospective case-control study SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50 with those without severe sepsis (controls = 354. Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p<0.001. In logistic regression analysis after adjusting for potential confounders, lack of BCG vaccination, drowsiness, abdominal distension, acute kidney injury, and metabolic acidosis at admission remained as independent predicting factors for severe sepsis in pneumonic SAM children (p<0.05 for all comparisons.We noted a much higher case fatality among under-five SAM children with pneumonia and severe sepsis who required fluid resuscitation in addition to standard antibiotic and other supportive therapy compared to those without severe sepsis. Independent risk factors and outcome of the management of severe sepsis in our study children highlight the importance for defining optimal fluid resuscitation therapy aiming at reducing the case fatality in such children.

  14. The effect of marital status on pregnancy outcome in Israel: a retrospective case-control study.

    Science.gov (United States)

    Lurie, Samuel; Zalmanovitch, Anath; Golan, Abraham; Sadan, Oscar

    2010-12-01

    Previous studies have observed an association between unmarried status of the mother and adverse perinatal outcome such as increased rate of preterm deliveries, low birthweight and small-for-gestational-age infants. In Israel, attendance of prenatal care is imposed by the state and is not related to socioeconomic status; therefore, unmarried women are expected to have a similar prenatal care as married women. The objective of this study is to test the hypothesis that unmarried and married pregnant women have a similar perinatal outcome. In a retrospective case-control study, analysis of the records of women who gave birth at the delivery ward of Edith Wolfson Medical Center (a tertiary health care center) over a one-year period (2005) with respect to marital status was performed. The cases group included 304 unmarried women who were matched with 1:1 ratio for maternal age, parity, and number of fetuses in the current pregnancy. Unmarried women (n = 304) were more likely to smoke during pregnancy (35.2% vs 15.2%, P vs 54.4 ± 4.4 min, P vs 421.0 ± 25.3 min P unmarried women had similar length of gestation, preterm delivery rate, mode of delivery, low birthweight rates, low Apgar scores or meconium passage during labor as married women. In Israel, unmarried and married pregnant women may have almost similar pregnancy outcomes on length of gestation, mode of delivery and Apgar score. © 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

  15. The association between gall bladder mucoceles and hyperlipidaemia in dogs: a retrospective case control study.

    Science.gov (United States)

    Kutsunai, M; Kanemoto, H; Fukushima, K; Fujino, Y; Ohno, K; Tsujimoto, H

    2014-01-01

    The diagnosis of gall bladder mucoceles (GM) in dogs has become increasingly frequent in veterinary medicine. Primary breed-specific hyperlipidaemia is reported in Shetland Sheepdogs and Miniature Schnauzers, breeds in which GM are known to occur more frequently than in other breeds. The objective of this study was to evaluate the association between GM and hyperlipidaemia in dogs. The study design was a retrospective case control study. Medical records of dogs diagnosed with GM at the Veterinary Medical Centre of The University of Tokyo between 1 April 2007 and 31 March 2012, were reviewed. Fifty-eight dogs with GM and a record of either serum cholesterol, triglyceride, or glucose concentrations were included in the study. Hypercholesterolaemia (15/37 cases; odds ratio [OR]: 2.92; 95% confidence interval [CI]: 1.02-8.36) and hypertriglyceridaemia (13/24 cases; OR: 3.55; 95% CI:1.12-15.91) showed significant association with GM. Pomeranians (OR: 10.69), American Cocker Spaniels (OR: 8.94), Shetland Sheepdogs (OR: 6.21), Miniature Schnauzers (OR: 5.23), and Chihuahuas (OR: 3.06) were significantly predisposed to GM. Thirty-nine out of 58 cases had at least one concurrent disease, including pancreatitis (five cases), hyperadrenocorticism (two cases), and hypothyroidism (two cases). A significant association between GM and hyperlipidaemia was confirmed, suggesting that hyperlipidaemia may play a role in the pathogenesis of GM. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Intra- versus retroplacental hematomas: a retrospective case-control study on pregnancy outcomes.

    Science.gov (United States)

    Ott, Johannes; Pecnik, Philipp; Promberger, Regina; Pils, Sophie; Binder, Julia; Chalubinski, Kinga M

    2017-10-26

    Intrauterine hematomas are a common pregnancy complication. The literature lacks studies about outcomes based on hematoma localization. Thus, we aimed to compare pregnancies complicated by an intraplacental hematoma to cases with a retroplacental hematoma and to a control group. In a retrospective case-control study, 32 women with an intraplacental hematoma, 199 women with a retroplacental hematoma, and a control group consisting of 113 age-matched women with no signs of placental abnormalities were included. Main outcome measures were pregnancy complications. Second-trimester miscarriage was most common in the intraplacental hematoma group (9.4%), followed by women with a retroplacental hematoma (4.2%), and controls (0%; p = 0.007). The intraplacental hematoma group revealed the highest rates for placental insufficiency, intrauterine growth retardation, premature preterm rupture of membranes, preterm labor, preterm delivery hematoma group. When tested in multivariate models, intraplacental hematomas were independent predictors for placental insufficiency (ß = 4.19, p hematoma (p = 0.042). Intra- and retroplacental hematomas have different risk profiles for the affected pregnancy and act as independent risk factors.

  17. Outcomes for Women with Gestational Diabetes Treated with Metformin: A Retrospective, Case-Control Study

    Directory of Open Access Journals (Sweden)

    Rachel T. McGrath

    2018-03-01

    Full Text Available Metformin is increasingly being used a therapeutic option for the management of gestational diabetes mellitus (GDM. The aim of this study was to compare the maternal characteristics and perinatal outcomes of women with GDM treated with metformin (with or without supplemental insulin with those receiving other management approaches. A retrospective, case-control study was carried out and 83 women taking metformin were matched 1:1 with women receiving insulin or diet and lifestyle modification alone. Women managed with diet and lifestyle modification had a significantly lower fasting plasma glucose (p < 0.001 and HbA1c (p < 0.01 at diagnosis of GDM. Furthermore, women managed with metformin had a higher early pregnancy body mass index (BMI compared to those receiving insulin or diet and lifestyle modification (p < 0.001. There was no difference in mode of delivery, birth weight or incidence of large- or small-for-gestational-age neonates between groups. Women receiving glucose lowering therapies had a higher rate of neonatal hypoglycaemia (p < 0.05. The incidence of other adverse perinatal outcomes was similar between groups. Despite their greater BMI, women with metformin-treated GDM did not have an increased risk of adverse perinatal outcomes. Metformin is a useful alternative to insulin in the management of GDM.

  18. Analysis of single nucleotide polymorphisms in case-control studies.

    Science.gov (United States)

    Li, Yonghong; Shiffman, Dov; Oberbauer, Rainer

    2011-01-01

    Single nucleotide polymorphisms (SNPs) are the most common type of genetic variants in the human genome. SNPs are known to modify susceptibility to complex diseases. We describe and discuss methods used to identify SNPs associated with disease in case-control studies. An outline on study population selection, sample collection and genotyping platforms is presented, complemented by SNP selection, data preprocessing and analysis.

  19. Anterior cervical spine surgery-associated complications in a retrospective case-control study.

    Science.gov (United States)

    Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N

    2017-09-01

    Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded. The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF). Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

  20. Models for retrospective quantification of indoor radon exposure in case-control studies

    International Nuclear Information System (INIS)

    Gerken, M.; Kreienbrock, L.; Wellmann, J.; Kreuzer, M.; Wichmann, H.E.

    2000-01-01

    In epidemiologic studies on lung cancer risk due to indoor radon the quantification of individual radon exposure over a long time period is one of the main issues. Therefore, radon measurements in one or more dwellings, which in total have been inhabited by the participants for a sufficient time-period, are necessary as well as consideration of changes of building characteristics and ventilation habits, which influence radon concentration. Given data on 1-y alpha-track measurements and personal information from 6,000 participants of case-control studies in West and East Germany, and improved method is developed to assess individual radon exposure histories. Times spent in different rooms of the dwelling, which are known from a personal questionnaire, are taken into account. The time spent outside the house varies substantially among the participants. Therefore, assuming a substantially lower radon exposure outside the dwelling, the residence time constitutes an important aspect of total radon exposure. By means of an analysis of variance, important determinants of indoor radon are identified, namely constant conditions such as type of house, type of construction, year of construction, floor and type of basement, and changeable conditions such as heating system, window insulation, and airing habits. A correction of measurements in former dwellings by factors derived from the analysis is applied if current living conditions differ from those of the participants at the time when they were living in the particular dwellings. In rare cases the adjustment for changes leads to a correction of the measurements with a factor of about 1.4, but a reduction of 5% on average only. Exposure assessment can be improved by considering time at home and changes of building and ventilation conditions that affect radon concentration. The major concern that changes in ventilation habits and building conditions lead to substantial errors in exposure assessment cannot be confirmed in the

  1. Does comedy kill? A retrospective, longitudinal cohort, nested case-control study of humour and longevity in 53 British comedians.

    Science.gov (United States)

    Stewart, Simon; Thompson, David R

    2015-02-01

    This work aims to test the hypothesis that the funniest comedians are most at risk of a premature death and reduced longevity compared to their relatively less funny counterparts. A retrospective longitudinal cohort study with a nested case-control analysis of longevity of 53 male British comedians born between 1900 and 1954 was conducted. All comedians were given a subjective score from 1 (relatively funny) to 10 (hilariously funny) by the study investigators. The survival profile of all comedians was then examined adjusting for decade of birth, whether they worked in a comedy team and their comedy score. A nested case-control analysis examined the longevity of those comedians working in teams according to their pre-specified status within the team (straight/less funny versus funny team member). On an adjusted basis, there was no correlation between the decade of birth (HR 0.94, 95% 0.65 to 1.38 per incremental decade; p=0.763) and comedy team status (HR 1.13, 95% 0.51 to 2.48 versus independent comedian; p=0.761) with longevity. However, an increasingly funny comedy score was associated with increased mortality (HR 1.24, 95% CI 1.06 to 1.44 per unit funny score; p=0.006). Of the 23 comedians adjudged to be very funny (score 8-10), 18 (78%) had died versus 12 (40%) of the rest; mean age at death 63.3±12.2 versus 72.3±14.7 (p=0.079). Within comedy teams, those identified as the funnier member(s) of the partnership were, on an adjusted basis, more than three times more likely to die prematurely when compared to their more serious comedy partners (HR 3.52, 95% CI 1.22, 10.1; p=0.020). These data suggest that elite comedians are at increased risk of premature death compared to their less funny counterparts. Mental health issues and personality characteristics that help shape their comedic talent and success may well explain their reduced longevity and raises serious issues for identifying and mitigating their risk of a premature death. Copyright © 2014 Elsevier

  2. Burning mouth syndrome and associated factors: A case-control retrospective study.

    Science.gov (United States)

    Chimenos-Küstner, Eduardo; de Luca-Monasterios, Fiorella; Schemel-Suárez, Mayra; Rodríguez de Rivera-Campillo, María E; Pérez-Pérez, Alejandro M; López-López, José

    2017-02-23

    Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P=.003), parafunctional habits (P=.006), and oral hygiene (P=.012). There were neither statistically significant differences in BMS incidence between sex groups (P=.408) nor association of BMS with the pathogenic factors of substance abuse (P=.915), systemic pathology (P=.685), and dietary habits (P=.904). Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. Safety and Efficacy of Ferric Carboxymaltose in Anemic Pregnant Women: A Retrospective Case Control Study

    NARCIS (Netherlands)

    Pels, Anouk; Ganzevoort, Wessel

    2015-01-01

    Background. Anemia during pregnancy is commonly caused by iron deficiency and can have severe consequences for both the mother and the developing fetus. The aim of this retrospective study was to assess the safety and efficacy of intravenous ferric carboxymaltose (FCM) in pregnant women. Methods.

  4. Identifying protective and risk factors for injurious falls in patients hospitalized for acute care: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Emmanuel Aryee

    2017-11-01

    Full Text Available Abstract Background Admitted patients who fall and injure themselves during an acute hospitalization incur increased costs, morbidity, and mortality, but little research has been conducted on identifying inpatients at high risk to injure themselves in a fall. Falls risk assessment tools have been unsuccessful due to their low positive predictive value when applied broadly to entire hospital populations. We aimed to identify variables associated with the risk of or protection against injurious fall in the inpatient setting. We also aimed to test the variables in the ABCs mnemonic (Age > 85, Bones-orthopedic conditions, anti-Coagulation and recent surgery for correlation with injurious fall. Methods We performed a retrospective case-control study at an academic tertiary care center comparing admitted patients with injurious fall to admitted patients without fall. We collected data on the demographics, medical and fall history, outcomes, and discharge disposition of injured fallers and control patients. We performed multivariate analysis of potential risk factors for injurious fall with logistic regression to calculate adjusted odds ratios. Results We identified 117 injured fallers and 320 controls. There were no differences in age, anti-coagulation use or fragility fractures between cases and controls. In multivariate analysis, recent surgery (OR 0.46, p = 0.003 was protective; joint replacement (OR 5.58, P = 0.002, psychotropic agents (OR 2.23, p = 0.001, the male sex (OR 2.08, p = 0.003 and history of fall (OR 2.08, p = 0.02 were significantly associated with injurious fall. Conclusion In this study, the variables in the ABCs parameters were among the variables not useful for identifying inpatients at risk of injuring themselves in a fall, while other non-ABCs variables demonstrated a significant association with injurious fall. Recent surgery was a protective factor, and practices around the care of surgical patients could be

  5. Birth attendance and magnitude of obstetric complications in Western Kenya: a retrospective case-control study.

    Science.gov (United States)

    Liambila, Wilson N; Kuria, Shiphrah N

    2014-09-08

    Skilled birth attendance is critical in the provision of child birth related services. Yet, literature is scanty on the outcomes of child birth related complications in situations where majority of women deliver under the care of non-skilled birth attendants compared to those who are assisted by skilled providers. The study sought to assess the nature of childbirth related complications among the skilled and the non-skilled birth attendants in Western Kenya. A case-control study was conducted among women aged 15-49 years at the household. Controls were individually matched to cases on the basis of age and socio-economic status. A total of 294 cases and 291 controls were interviewed. Data were collected on various demographic and socio-economic characteristics and women's perception on the quality of care. All independent variables were analysed initially in bivariate models and those that were significantly associated with obstetric complications were included in multiple logistic regression model in order to control for confounding factors. Odds ratios (ORs), with 95% confidence intervals, were computed to show the association between the occurrence, magnitude and the extent to which child birth related complications were managed. Demographic and socio-economic characteristics of the cases and controls were similar. About 52% of the deliveries were assisted by skilled birth attendants while non-skilled providers attended to 48% of them. The odds of the occurrence of obstetric complications were greater among the women who were attended to by skilled providers in health facilities: adjusted odds ratio (AOR): 1.32 (CI 0.95, 1.84) than among those who were assisted by unskilled birth attendants, AOR 0.76 (CI 0.55, 1.06). Undignified care, high delivery and transport costs and fear of hospital procedures such as HIV tests and mishandling of the placenta were cited as some of the barriers to facility deliveries. Skilled birth attendants in facilities were associated

  6. Childhood risk factors in Korean women with anorexia nervosa: two sets of case-control studies with retrospective comparisons.

    Science.gov (United States)

    Kim, Youl-Ri; Heo, Si Young; Kang, Heechan; Song, Ki Jun; Treasure, Janet

    2010-11-01

    The aim of this study was to investigate the characteristics of the risk factors for anorexia nervosa (AN) in Korean women. Two sets of case-control comparisons were conducted, in which 52 women with lifetime AN from Seoul, S. Korea, were compared with 108 Korean healthy controls and also with 42 women with lifetime AN from the UK in terms of their childhood risk factors. A questionnaire designed to conduct a retrospective assessment of the childhood risk factors was administered to all participants. The Korean AN women were more likely to report premorbid anxiety, perfectionism, and emotional undereating and were less likely to report having supportive figures in their childhood than the Korean healthy controls. There were no overall differences in the childhood risk factors between the Korean and British women with AN. Premorbid anxiety, perfectionism, less social support, and emotional undereating merit attention as risk factors in Korean AN. The current results are informative, but an epidemiologically robust prospective case-control study would be needed to validate these findings. © 2009 by Wiley Periodicals, Inc.

  7. The effects of umbilical cord entanglement upon labor management and fetal health: retrospective case control study.

    Science.gov (United States)

    Buyukkayaci Duman, Nuriye; Topuz, Senay; Bostanci, Mehmet Omer; Gorkem, Umit; Yuksel Kocak, Derya; Togrul, Cihan; Gungor, Tayfun

    2018-03-01

    This retrospective study aimed at determining prognostic factors that paved the way for umbilical cord entanglement (UCE) and the effects of UCE upon labor management and fetal health. Sixty women who gave term birth with head presentation and received UCE diagnosis following birth composed the case group while another 60 women with the same characteristics who were selected with randomized sampling method and who did not develop UCE comprised the control group. The data obtained were processed with SPSS 22.0 statistical program. T test was used for comparing demographic and obstetric data and mean birth weight of babies in the case group and control group. For comparing data on active labor management and fetal health, numbers, percentages and chi-square test were used. Also for comparing values case: 58.3.0%; control: 21.7%), vacuum assisted vaginal delivery (case: 20.0%; control: 3.3%), forceps assisted vaginal delivery (case: 8.3%; control: 1.7%), fetal distress (case: 60.0%; control: 25.0%), amniotic fluid meconium (case: 58.3%; control: 21.7%), APGAR score less than 7 at the 1st minute (case: 58.3%; control: 21.7%) and APGAR score less than 7 at the 5th minute were higher in the women in the case group than the women in the control group (p < 0.05). UCE increased rates of interventional birth, emergent cesarean delivery, vacuum assisted vaginal delivery, forceps assisted vaginal delivery, amniotic fluid meconium and fetal distress.

  8. Diagnostic Performance and Utility of Quantitative EEG Analyses in Delirium: Confirmatory Results From a Large Retrospective Case-Control Study.

    Science.gov (United States)

    Fleischmann, Robert; Tränkner, Steffi; Bathe-Peters, Rouven; Rönnefarth, Maria; Schmidt, Sein; Schreiber, Stephan J; Brandt, Stephan A

    2018-03-01

    The lack of objective disease markers is a major cause of misdiagnosis and nonstandardized approaches in delirium. Recent studies conducted in well-selected patients and confined study environments suggest that quantitative electroencephalography (qEEG) can provide such markers. We hypothesize that qEEG helps remedy diagnostic uncertainty not only in well-defined study cohorts but also in a heterogeneous hospital population. In this retrospective case-control study, EEG power spectra of delirious patients and age-/gender-matched controls (n = 31 and n = 345, respectively) were fitted in a linear model to test their performance as binary classifiers. We subsequently evaluated the diagnostic performance of the best classifiers in control samples with normal EEGs (n = 534) and real-world samples including pathologic findings (n = 4294). Test reliability was estimated through split-half analyses. We found that the combination of spectral power at F3-P4 at 2 Hz (area under the curve [AUC] = .994) and C3-O1 at 19 Hz (AUC = .993) provided a sensitivity of 100% and a specificity of 99% to identify delirious patients among normal controls. These classifiers also yielded a false positive rate as low as 5% and increased the pretest probability of being delirious by 57% in an unselected real-world sample. Split-half reliabilities were .98 and .99, respectively. This retrospective study yielded preliminary evidence that qEEG provides excellent diagnostic performance to identify delirious patients even outside confined study environments. It furthermore revealed reduced beta power as a novel specific finding in delirium and that a normal EEG excludes delirium. Prospective studies including parameters of pretest probability and delirium severity are required to elaborate on these promising findings.

  9. Analysis of Case-Control Association Studies: SNPs, Imputation and Haplotypes

    KAUST Repository

    Chatterjee, Nilanjan

    2009-11-01

    Although prospective logistic regression is the standard method of analysis for case-control data, it has been recently noted that in genetic epidemiologic studies one can use the "retrospective" likelihood to gain major power by incorporating various population genetics model assumptions such as Hardy-Weinberg-Equilibrium (HWE), gene-gene and gene-environment independence. In this article we review these modern methods and contrast them with the more classical approaches through two types of applications (i) association tests for typed and untyped single nucleotide polymorphisms (SNPs) and (ii) estimation of haplotype effects and haplotype-environment interactions in the presence of haplotype-phase ambiguity. We provide novel insights to existing methods by construction of various score-tests and pseudo-likelihoods. In addition, we describe a novel two-stage method for analysis of untyped SNPs that can use any flexible external algorithm for genotype imputation followed by a powerful association test based on the retrospective likelihood. We illustrate applications of the methods using simulated and real data. © Institute of Mathematical Statistics, 2009.

  10. Analysis of Case-Control Association Studies: SNPs, Imputation and Haplotypes

    KAUST Repository

    Chatterjee, Nilanjan; Chen, Yi-Hau; Luo, Sheng; Carroll, Raymond J.

    2009-01-01

    Although prospective logistic regression is the standard method of analysis for case-control data, it has been recently noted that in genetic epidemiologic studies one can use the "retrospective" likelihood to gain major power by incorporating various population genetics model assumptions such as Hardy-Weinberg-Equilibrium (HWE), gene-gene and gene-environment independence. In this article we review these modern methods and contrast them with the more classical approaches through two types of applications (i) association tests for typed and untyped single nucleotide polymorphisms (SNPs) and (ii) estimation of haplotype effects and haplotype-environment interactions in the presence of haplotype-phase ambiguity. We provide novel insights to existing methods by construction of various score-tests and pseudo-likelihoods. In addition, we describe a novel two-stage method for analysis of untyped SNPs that can use any flexible external algorithm for genotype imputation followed by a powerful association test based on the retrospective likelihood. We illustrate applications of the methods using simulated and real data. © Institute of Mathematical Statistics, 2009.

  11. Efficacy of rasagiline and selegiline in Parkinson's disease: a head-to-head 3-year retrospective case-control study.

    Science.gov (United States)

    Cereda, Emanuele; Cilia, Roberto; Canesi, Margherita; Tesei, Silvana; Mariani, Claudio Bruno; Zecchinelli, Anna Lena; Pezzoli, Gianni

    2017-06-01

    Monoamine oxidase type B (MAO-B) inhibitors, such as selegiline and rasagiline, can be used as monotherapy or adjuvant therapy to levodopa in Parkinson's disease (PD). Data on long-term efficacy of MAO-B inhibitors are limited with no head-to-head comparison available to date. The aim of this case-control retrospective study was to analyze data from patients with PD attending the Parkinson Institute (Milan, Italy) over a 6-year period (2009-2015) and compare the effects of selegiline and rasagiline on levodopa treatment outcomes. Patients with PD treated with either selegiline (n = 85) or rasagiline (n = 85) for 3 years as well as a control group of patients (N = 170) who have never received MAO-B inhibitors, were matched for gender, disease duration (±1 year) and age (±1 year) at baseline assessment (ratio 1:1:2). The Unified PD Rating Scale and the Hoehn-Yahr staging system were used for clinical comparisons. At baseline, mean PD duration was 6.5 years and clinical features were comparable across all three groups. After a mean follow-up of approximately 37 months, no differences in clinical progression of motor and non-motor symptoms were observed between the three groups. However, MAO-B inhibitor use was associated with ~2-fold lower change in daily dose of levodopa (p rasagiline. Long-term use of MAO-B inhibitors resulted in a significant reduction in levodopa requirements and a lower frequency of dyskinesias in patients with PD. Selegiline and rasagiline had equal efficacy in controlling motor symptoms in PD patients on optimized therapy.

  12. Risk factors for incident delirium in an acute general medical setting: a retrospective case-control study.

    Science.gov (United States)

    Tomlinson, Emily Jane; Phillips, Nicole M; Mohebbi, Mohammadreza; Hutchinson, Alison M

    2017-03-01

    To determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission. Incident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients who are most susceptible to incident delirium. Retrospective case-control study with two controls per case. An audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data were collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1 January 2012 and 31 December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation. Identified using logistic regression modelling, predisposing risk factors for incident delirium were dementia, cognitive impairment, functional impairment, previous delirium and fracture on admission. Precipitating risk factors for incident delirium were use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission. Multiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation. Nurses and other healthcare professionals should be aware of patients who have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and

  13. Primary health care utilization prior to suicide: a retrospective case-control study among active-duty military personnel.

    Science.gov (United States)

    Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal

    2014-08-01

    About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.

  14. Identifying patterns in signs and symptoms preceding the clinical diagnosis of Alzheimer's disease: Retrospective medical record review study and a nested case -control design.

    Science.gov (United States)

    Bature, Fidelia; Pang, Dong; Robinson, Anthea; Polson, Norma; Pappas, Yannis; Guinn, Barbara

    2018-04-04

    Evidence suggests that individuals with Alzheimer's disease (AD) are often diagnosed in the later stages of their disease with a poor prognosis. This study aimed to identify patterns in signs and symptoms preceding the clinical diagnosis of AD to suggest a predictive model for earlier diagnosis of the disease in the primary care. A retrospective medical record review; nested case control design. Participants included one hundred and nine patients from three general practice (GP) surgeries in Milton Keynes and Luton Clinical Commissioning groups (CCG) (37 cases with AD and 72 controls without AD). A retrospective analysis using the logistic regression of the presence of signs and symptoms before the diagnosis of AD was attained. Identification of the timing and sequence of appearance of these presentations as first reported before the clinical diagnosis was measured. Episodic memory with an odds ratio of 1.85 was the most frequent presentation, documented in 1.38% of the controls and 75.6% in cases. Auditory disturbance with an odds ratio of 3.03, which has not previously been noted except in the form of auditory hallucination, could have a diagnostic value. Auditory disturbance, which occurred mostly in the Caucasian females, could discriminate individuals with AD from those without. The symptom, which presented up to 14.5 (mean time) years prior to clinical diagnosis, was identified in Caucasians and mixed race individuals only. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Benefit of an operating vehicle preventing peritonitis in peritoneal dialysis patients: a retrospective, case-controlled study.

    Science.gov (United States)

    Fang, Pan; Lu, Jia; Liu, Ying-Hong; Deng, Hong-Mei; Zhang, Lei; Zhang, Hong-Qing

    2018-06-01

    Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis. Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange. A single-center, retrospective, case-control study was undertaken to determine whether this operating vehicle has a protective role in preventing peritonitis. In total, 462 continuous ambulatory peritoneal dialysis patients were included in this study from October 2014 to March 2017. According to their personal will, these patients chose to use operating vehicle or traditional method during their bag exchange. The demographic, clinical and laboratory data of these patients in the two groups were collected, analyzed and compared. Of 462 patients with home dialysis, operating vehicle group consisted of 61 patients, and control group consisted of 401 patients. In the control group, over 677 patient-years, peritonitis occurred in 69 of 401 patients (17.2%), while in the operating vehicle group, over 60 patient-years, only 4 of 61 patients (6.6%) had episodes of peritonitis. The number of patients suffered from peritonitis was significantly decreased in the operating vehicle group (P = 0.034). Besides, there were a total of 99 episodes of peritonitis, and the rate was 1 episode every 7.2 patient-years in control group and 1 episode every 12 patient-years in the operating vehicle group. There was significant difference between the two groups (0.013). Positive dialysate cultures were obtained in majority of the peritonitis episodes (60.6%). Operating vehicle might help to reduce PD-related peritonitis by preventing contamination during bag

  16. On the Analysis of Case-Control Studies in Cluster-correlated Data Settings.

    Science.gov (United States)

    Haneuse, Sebastien; Rivera-Rodriguez, Claudia

    2018-01-01

    In resource-limited settings, long-term evaluation of national antiretroviral treatment (ART) programs often relies on aggregated data, the analysis of which may be subject to ecological bias. As researchers and policy makers consider evaluating individual-level outcomes such as treatment adherence or mortality, the well-known case-control design is appealing in that it provides efficiency gains over random sampling. In the context that motivates this article, valid estimation and inference requires acknowledging any clustering, although, to our knowledge, no statistical methods have been published for the analysis of case-control data for which the underlying population exhibits clustering. Furthermore, in the specific context of an ongoing collaboration in Malawi, rather than performing case-control sampling across all clinics, case-control sampling within clinics has been suggested as a more practical strategy. To our knowledge, although similar outcome-dependent sampling schemes have been described in the literature, a case-control design specific to correlated data settings is new. In this article, we describe this design, discuss balanced versus unbalanced sampling techniques, and provide a general approach to analyzing case-control studies in cluster-correlated settings based on inverse probability-weighted generalized estimating equations. Inference is based on a robust sandwich estimator with correlation parameters estimated to ensure appropriate accounting of the outcome-dependent sampling scheme. We conduct comprehensive simulations, based in part on real data on a sample of N = 78,155 program registrants in Malawi between 2005 and 2007, to evaluate small-sample operating characteristics and potential trade-offs associated with standard case-control sampling or when case-control sampling is performed within clusters.

  17. Bridging ImmunoGenomic Data Analysis Workflow Gaps (BIGDAWG): An integrated case-control analysis pipeline.

    Science.gov (United States)

    Pappas, Derek J; Marin, Wesley; Hollenbach, Jill A; Mack, Steven J

    2016-03-01

    Bridging ImmunoGenomic Data-Analysis Workflow Gaps (BIGDAWG) is an integrated data-analysis pipeline designed for the standardized analysis of highly-polymorphic genetic data, specifically for the HLA and KIR genetic systems. Most modern genetic analysis programs are designed for the analysis of single nucleotide polymorphisms, but the highly polymorphic nature of HLA and KIR data require specialized methods of data analysis. BIGDAWG performs case-control data analyses of highly polymorphic genotype data characteristic of the HLA and KIR loci. BIGDAWG performs tests for Hardy-Weinberg equilibrium, calculates allele frequencies and bins low-frequency alleles for k×2 and 2×2 chi-squared tests, and calculates odds ratios, confidence intervals and p-values for each allele. When multi-locus genotype data are available, BIGDAWG estimates user-specified haplotypes and performs the same binning and statistical calculations for each haplotype. For the HLA loci, BIGDAWG performs the same analyses at the individual amino-acid level. Finally, BIGDAWG generates figures and tables for each of these comparisons. BIGDAWG obviates the error-prone reformatting needed to traffic data between multiple programs, and streamlines and standardizes the data-analysis process for case-control studies of highly polymorphic data. BIGDAWG has been implemented as the bigdawg R package and as a free web application at bigdawg.immunogenomics.org. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  18. Case-control vaccine effectiveness studies: Data collection, analysis and reporting results.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    The case-control methodology is frequently used to evaluate vaccine effectiveness post-licensure. The results of such studies provide important insight into the level of protection afforded by vaccines in a 'real world' context, and are commonly used to guide vaccine policy decisions. However, the potential for bias and confounding are important limitations to this method, and the results of a poorly conducted or incorrectly interpreted case-control study can mislead policies. In 2012, a group of experts met to review recent experience with case-control studies evaluating vaccine effectiveness; we summarize the recommendations of that group regarding best practices for data collection, analysis, and presentation of the results of case-control vaccine effectiveness studies. Vaccination status is the primary exposure of interest, but can be challenging to assess accurately and with minimal bias. Investigators should understand factors associated with vaccination as well as the availability of documented vaccination status in the study context; case-control studies may not be a valid method for evaluating vaccine effectiveness in settings where many children lack a documented immunization history. To avoid bias, it is essential to use the same methods and effort gathering vaccination data from cases and controls. Variables that may confound the association between illness and vaccination are also important to capture as completely as possible, and where relevant, adjust for in the analysis according to the analytic plan. In presenting results from case-control vaccine effectiveness studies, investigators should describe enrollment among eligible cases and controls as well as the proportion with no documented vaccine history. Emphasis should be placed on confidence intervals, rather than point estimates, of vaccine effectiveness. Case-control studies are a useful approach for evaluating vaccine effectiveness; however careful attention must be paid to the collection

  19. Efficacy of rasagiline and selegiline in Parkinson?s disease: a head-to-head 3-year retrospective case?control study

    OpenAIRE

    Cereda, Emanuele; Cilia, Roberto; Canesi, Margherita; Tesei, Silvana; Mariani, Claudio Bruno; Zecchinelli, Anna Lena; Pezzoli, Gianni

    2017-01-01

    Monoamine oxidase type B (MAO-B) inhibitors, such as selegiline and rasagiline, can be used as monotherapy or adjuvant therapy to levodopa in Parkinson?s disease (PD). Data on long-term efficacy of MAO-B inhibitors are limited with no head-to-head comparison available to date. The aim of this case?control retrospective study was to analyze data from patients with PD attending the Parkinson Institute (Milan, Italy) over a 6-year period (2009?2015) and compare the effects of selegiline and rasa...

  20. A Note on Penalized Regression Spline Estimation in the Secondary Analysis of Case-Control Data

    KAUST Repository

    Gazioglu, Suzan; Wei, Jiawei; Jennings, Elizabeth M.; Carroll, Raymond J.

    2013-01-01

    Primary analysis of case-control studies focuses on the relationship between disease (D) and a set of covariates of interest (Y, X). A secondary application of the case-control study, often invoked in modern genetic epidemiologic association studies, is to investigate the interrelationship between the covariates themselves. The task is complicated due to the case-control sampling, and to avoid the biased sampling that arises from the design, it is typical to use the control data only. In this paper, we develop penalized regression spline methodology that uses all the data, and improves precision of estimation compared to using only the controls. A simulation study and an empirical example are used to illustrate the methodology.

  1. A Note on Penalized Regression Spline Estimation in the Secondary Analysis of Case-Control Data

    KAUST Repository

    Gazioglu, Suzan

    2013-05-25

    Primary analysis of case-control studies focuses on the relationship between disease (D) and a set of covariates of interest (Y, X). A secondary application of the case-control study, often invoked in modern genetic epidemiologic association studies, is to investigate the interrelationship between the covariates themselves. The task is complicated due to the case-control sampling, and to avoid the biased sampling that arises from the design, it is typical to use the control data only. In this paper, we develop penalized regression spline methodology that uses all the data, and improves precision of estimation compared to using only the controls. A simulation study and an empirical example are used to illustrate the methodology.

  2. Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study.

    Science.gov (United States)

    Petousis-Harris, Helen; Paynter, Janine; Morgan, Jane; Saxton, Peter; McArdle, Barbara; Goodyear-Smith, Felicity; Black, Steven

    2017-09-30

    Gonorrhoea is a major global public health problem that is exacerbated by drug resistance. Effective vaccine development has been unsuccessful, but surveillance data suggest that outer membrane vesicle meningococcal group B vaccines affect the incidence of gonorrhoea. We assessed vaccine effectiveness of the outer membrane vesicle meningococcal B vaccine (MeNZB) against gonorrhoea in young adults aged 15-30 years in New Zealand. We did a retrospective case-control study of patients at sexual health clinics aged 15-30 years who were born between Jan 1, 1984, and Dec 31, 1998, eligible to receive MeNZB, and diagnosed with gonorrhoea or chlamydia, or both. Demographic data, sexual health clinic data, and National Immunisation Register data were linked via patients' unique personal identifier. For primary analysis, cases were confirmed by laboratory isolation or detection of Neisseria gonorrhoeae only from a clinical specimen, and controls were individuals with a positive chlamydia test only. We estimated odds ratios (ORs) comparing disease outcomes in vaccinated versus unvaccinated participants via multivariable logistic regression. Vaccine effectiveness was calculated as 100×(1-OR). 11 of 24 clinics nationally provided records. There were 14 730 cases and controls for analyses: 1241 incidences of gonorrhoea, 12 487 incidences of chlamydia, and 1002 incidences of co-infection. Vaccinated individuals were significantly less likely to be cases than controls (511 [41%] vs 6424 [51%]; adjusted OR 0·69 [95% CI 0·61-0·79]; pvaccine effectiveness of MeNZB against gonorrhoea after adjustment for ethnicity, deprivation, geographical area, and sex was 31% (95% CI 21-39). Exposure to MeNZB was associated with reduced rates of gonorrhoea diagnosis, the first time a vaccine has shown any protection against gonorrhoea. These results provide a proof of principle that can inform prospective vaccine development not only for gonorrhoea but also for meningococcal vaccines. GSK

  3. There Is No Difference in IQ between Suicide and Non-Suicide Psychiatric Patients: A Retrospective Case-Control Study.

    Science.gov (United States)

    Park, Sung-Jin; Yi, Kikyoung; Lee, Joon Deuk; Hong, Jin Pyo

    2015-07-01

    The goal of this study was to examine the association between IQ and suicide in psychiatric patients. We conducted a nested case-control study using data obtained from psychiatric patients affiliated with a general hospital in Seoul, Korea. In a one-to-two ratio the psychiatric patients who died of suicide (Suicide Group; n=35) were matched to those who didn't (Non-suicide Group; n=70) by age, gender, psychiatric diagnosis and approximate time of first treatment. IQ was measured using the Korean version of the Wechsler Adult Intelligence Scale-Revised. There were no significant differences in any type of IQ between suicide patients and non-suicide patients. Logistic regression showed no evidence of an association between IQ and suicide. These results do not support the existence of an association between IQ and suicide.

  4. Retrospective case-control study of surgical treatment of stage IB-IIA cervical carcinomas after neoadjuvant radiotherapy

    International Nuclear Information System (INIS)

    Cigriejiene, V. M.; Kajenas, S.; Balnys, M.; Mikuckaite, L.

    2004-01-01

    To evaluate if preoperative radiotherapy influences course of operation (radical hysterectomy and lymphadenectomy) and postoperative period in series of stage IB-IIA cervical carcinomas. Retrospective comparative study was performed. During the study we analyzed 101 case histories of patients who underwent radical type II hysterectomy with lymphadenectomy in Kaunas University of Medicine Hospital and Kaunas Hospital of Oncology between 1995 and 2002. Mean operation time was shorter, hemoglobin and hematocrit values after operation were better, stay in hospital was longer, demand for narcotic analgetics was bigger, function of ovaries was maintained more rarely (p 0.05). In our study, preoperative radiotherapy did not seem to complicate course of radical hysterectomy. (author)

  5. Robust estimation for homoscedastic regression in the secondary analysis of case-control data

    KAUST Repository

    Wei, Jiawei

    2012-12-04

    Primary analysis of case-control studies focuses on the relationship between disease D and a set of covariates of interest (Y, X). A secondary application of the case-control study, which is often invoked in modern genetic epidemiologic association studies, is to investigate the interrelationship between the covariates themselves. The task is complicated owing to the case-control sampling, where the regression of Y on X is different from what it is in the population. Previous work has assumed a parametric distribution for Y given X and derived semiparametric efficient estimation and inference without any distributional assumptions about X. We take up the issue of estimation of a regression function when Y given X follows a homoscedastic regression model, but otherwise the distribution of Y is unspecified. The semiparametric efficient approaches can be used to construct semiparametric efficient estimates, but they suffer from a lack of robustness to the assumed model for Y given X. We take an entirely different approach. We show how to estimate the regression parameters consistently even if the assumed model for Y given X is incorrect, and thus the estimates are model robust. For this we make the assumption that the disease rate is known or well estimated. The assumption can be dropped when the disease is rare, which is typically so for most case-control studies, and the estimation algorithm simplifies. Simulations and empirical examples are used to illustrate the approach.

  6. Robust estimation for homoscedastic regression in the secondary analysis of case-control data

    KAUST Repository

    Wei, Jiawei; Carroll, Raymond J.; Mü ller, Ursula U.; Keilegom, Ingrid Van; Chatterjee, Nilanjan

    2012-01-01

    Primary analysis of case-control studies focuses on the relationship between disease D and a set of covariates of interest (Y, X). A secondary application of the case-control study, which is often invoked in modern genetic epidemiologic association studies, is to investigate the interrelationship between the covariates themselves. The task is complicated owing to the case-control sampling, where the regression of Y on X is different from what it is in the population. Previous work has assumed a parametric distribution for Y given X and derived semiparametric efficient estimation and inference without any distributional assumptions about X. We take up the issue of estimation of a regression function when Y given X follows a homoscedastic regression model, but otherwise the distribution of Y is unspecified. The semiparametric efficient approaches can be used to construct semiparametric efficient estimates, but they suffer from a lack of robustness to the assumed model for Y given X. We take an entirely different approach. We show how to estimate the regression parameters consistently even if the assumed model for Y given X is incorrect, and thus the estimates are model robust. For this we make the assumption that the disease rate is known or well estimated. The assumption can be dropped when the disease is rare, which is typically so for most case-control studies, and the estimation algorithm simplifies. Simulations and empirical examples are used to illustrate the approach.

  7. [High-grade pressure sores in frail older high-risk persons. A retrospective postmortem case-control-study].

    Science.gov (United States)

    Von Renteln-Kruse, W; Krause, T; Anders, J; Kühl, M; Heinemann, A; Püschel, K

    2004-04-01

    Some old persons at risk do develop, but others, at comparable risk, do not develop high-grade pressure sores. To evaluate potentially different risk factors, we performed a post mortem case-control study in old persons who developed high-grade pressure sores within six months until 14 days before death. Consecutive cases with pressure sores grade >/=3 and potential controls at comparably high risk for pressure sores were examined before cremation. After written informed consent had been obtained by the next relatives, all available nursing and medical records of the deceased were thoroughly evaluated. Cases and controls were matched according to age, gender, immobility, and cachexia.A total of 100 cases with 71 pressure sores grade 3 and 29 pressure sores grade 4 were compared to 100 controls with 27 pressure sores grade pressure sores in frail older high-risk persons. Sedative drug effects and impaired patient compliance with preventive and therapeutic measures may also be associated with the development of high-grade pressure sores in old persons at high risk.

  8. When should we test for voltage-gated potassium channel complex antibodies? A retrospective case control study.

    Science.gov (United States)

    O'Sullivan, B J; Steele, T; Ellul, M A; Kirby, E; Duale, A; Kier, G; Crooks, D; Jacob, A; Solomon, T; Michael, B D

    2016-11-01

    Patients with voltage-gated potassium channel (VGKC)-complex antibodies are increasingly recognized as having central, peripheral or combined phenotypes. With increasing awareness, more patients are tested and the clinical spectrum is expanding. Consequently, clinicians may be uncertain as to which patients should or should not be tested. Previous studies have identified common clinical features, but none has looked at the usefulness of these in predicting seropositive disease. We conducted a case-control study of patients tested for VGKC-complex antibodies over 10years at a regional tertiary neurology centre determining which clinical/biochemical features were associated with antibody-positive disease. We found a marked increase in the numbers tested, although the percentage positive remained low. Antibody titre was highest in central disease (pVGKC-disease (p=0.01). Seizures were present in 11 (69%) of those with VGKC-disease versus three (18%) without (odds ratio [OR] 10.3, 95% confidence interval [CI]: 2.0-52.7, p=0.005). There was an inverse correlation between the antibody titre and serum sodium. A multivariate model selected seizures and hyponatraemia as predictive of VGKC disease (sensitivity 75% and specificity 82%); faciobrachial dystonic movements were specific but insensitive. Interestingly serum alkaline phosphatase was higher in those with VGKC-disease (p=0.016) and highest in those with peripheral disease (p=0.015). An ALP>70u/L was strongly associated with antibody positivity (OR 4.11 95% CI: 1.43-11.8, p=0.007) with a sensitivity of 74.2%. The presence of seizures, faciobrachial movements, and hyponatraemia should raise suspicion of VGKC-disease; alkaline phosphatase may represent a novel biomarker, particularly in those with peripheral disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China.

    Science.gov (United States)

    Fang, Chengqing; Mao, Jianhua; Dai, Yuwen; Xia, Yonghui; Fu, Haidong; Chen, Yifang; Wang, Yaping; Liu, Aimin

    2010-06-01

    To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, Pdehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.

  10. Circulating folate levels and colorectal adenoma: a case-control study and a meta-analysis.

    Science.gov (United States)

    Park, Yeong Mi; Youn, Jiyoung; Cho, Chang Ho; Kim, Sung Hi; Lee, Jung Eun

    2017-10-01

    The relationship between folate and colorectal neoplasia remains controversial. We examined the association between serum folate concentrations and colorectal adenomas in a case-control study of Korean adults and conducted a meta-analysis. Our case-control study included 113 pairs of case and control who underwent colonoscopy and provided blood samples. We used multivariable conditional logistic regression models to obtain the odds ratios and 95% confidence interval (CIs). For meta-analysis, we identified the relevant studies by searching the PubMed database up to February 2017, included our case-control study and combined the study-specific relative risks (RRs) using a random-effects model. In this case-control study, we included 58 men and 55 women with colorectal adenomas and sex and fasting status matched the controls. We did not find any significant association between the serum folate levels and colorectal adenomas in either men or women. For meta-analysis, a total of eleven studies were included in our analysis and classified into two groups; polyp clearance group (PC) for the studies that included participants who underwent endoscopies and had their polyps removed at baseline; and no polyp clearance group (NPC) for the studies that included participants whose histories of endoscopies were unknown or who underwent their first endoscopies. Four PC (1,311 cases and 1,672 non-cases) and eight NPC studies (3,501 cases and 11,347 non-cases) were included. The combined RRs (95% CIs) comparing the bottom with the top categories of circulating folate levels were 1.07 (0.97-1.18) for the NPC group but 1.45 (1.16-1.74) for the PC group. Low circulating folate levels were associated with new adenoma formation.

  11. Asbestos: a hidden player behind the cholangiocarcinoma increase? Findings from a case?control analysis

    OpenAIRE

    Brandi, Giovanni; Di Girolamo, Stefania; Farioli, Andrea; de Rosa, Francesco; Curti, Stefania; Pinna, Antonio Daniele; Ercolani, Giorgio; Violante, Francesco Saverio; Biasco, Guido; Mattioli, Stefano

    2013-01-01

    Purposes We conducted a case?control analysis to explore the association between occupational exposure to asbestos and cholangiocarcinoma (CC). Methods The study was based on historical data from 155 consecutive patients with CC [69 intrahepatic CC (ICC) and 86 extrahepatic CC (ECC)] referred to Sant?Orsola-Malpighi University Hospital between 2006 and 2010. The cases were individually matched by calendar period of birth, sex, and region of residence to historical hospital and population cont...

  12. Behavioral risk factors of breast cancer in Bangui of Central African Republic: A retrospective case-control study.

    Directory of Open Access Journals (Sweden)

    Augustin Balekouzou

    Full Text Available Breast cancer is recognized as a major public health problem in developing countries; however, there is very little evidence of behavioral factors associated with breast cancer risk. This study was conducted to identify lifestyles as risk factors for breast cancer among Central African women. A case-control study was conducted with 174 cases confirmed histologically by the pathology unit of the National Laboratory and 348 age-matched controls. Data collection tools included a questionnaire with interviews and medical records of patients. Data were analyzed using SPSS software version 20. Odd ratio (OR and 95% confidence intervals (95% CI were obtained by unconditional logistic regression. In total, 522 women were studied with a mean age of 45.8 (SD = 13.4 years. By unconditional logistic regression model, women with breast cancer were more likely to have attained illiterate and elementary education level [11.23 (95% CI, 4.65-27.14 and 2.40 (95% CI, 1.15-4.99], married [2.09 (95% CI, 1.18-3.71], positive family history [2.31 (95% CI, 1.36-3.91], radiation exposure [8.21 (95% CI, 5.04-13.38], consumption charcuterie [10.82 (95% CI, 2.39-48.90], fresh fish consumption [4.26 (95% CI, 1.56-11.65], groundnut consumption [6.46 (95% CI, 2.57-16.27], soybean consumption [16.74 (95% CI, 8.03-39.84], alcohol [2.53 (95% CI, 1.39-4.60], habit of keeping money in bras[3.57 (95% CI, 2.24-5.69], overweight [5.36 (95% CI, 4.46-24.57] and obesity [3.11(95% CI, 2.39-20.42]. However, decreased risk of breast cancer was associated with being employed [0.32 (95% CI, 0.19-0.56], urban residence [0.16 (95% CI, 0.07-0.37], groundnut oil consumption [0.05 (95% CI, 0.02-0.14], wine consumption [0.16 (95% CI, 0.09-0.26], non habit of keeping cell phone in bras [0.56 (95% CI, 0.35-0.89] and physical activity [0.71(95% CI, 0.14-0.84]. The study showed that little or no education, marriage, positive family history of cancer, radiation exposure, charcuterie, fresh fish

  13. Effect of Metabolic Syndrome on the Functional Outcome of Corticosteroid Injection for Lateral Epicondylitis: Retrospective Matched Case-Control Study.

    Science.gov (United States)

    Roh, Young Hak; Oh, Minjoon; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

    2017-09-07

    Both obesity and diabetes mellitus are well-known risk factors for tendinopathies. We retrospectively compared the efficacy of single corticosteroid injections in treating lateral epicondylitis in patients with and without metabolic syndrome (MetS). Fifty-one patients with lateral epicondylitis and MetS were age- and sex-matched with 51 controls without MetS. Pain severity, Disability of the Arm, Shoulder, and Hand score, and grip strength were assessed at base line and at 6, 12 and 24 weeks post-injection. The pain scores in the MetS group were greater than those in the control group at 6 and 12 weeks. The disability scores and grip strength in the MetS group were significantly worse than those of the control group at 6 weeks. However, there were no significant differences at 24 weeks between the groups in terms of pain, disability scores and grip strengths. After 24 weeks, three patients (6%) in the control group and five patients (10%) in the MetS group had surgical decompression (p = 0.46). Patients with MetS are at risk for poor functional outcome after corticosteroid injection for lateral epicondylitis in the short term, but in the long term there was no difference in outcomes of steroid injection in patients with and without MetS.

  14. Should adrenaline be used in patients with hemodynamically stable anaphylaxis? Incident case control study nested within a retrospective cohort study.

    Science.gov (United States)

    Ko, Byuk Sung; Kim, Ji Yeon; Seo, Dong-Woo; Kim, Won Young; Lee, Jae Ho; Sheikh, Aziz; Bates, David W

    2016-02-03

    Although adrenaline (epinephrine) is a cornerstone of initial anaphylaxis treatment, it is not often used. We sought to assess whether use of adrenaline in hemodynamically stable patients with anaphylaxis could prevent the development of hypotension. We conducted a retrospective cohort study of 761 adult patients with anaphylaxis presenting to the emergency department (ED) of a tertiary care hospital over a 10-year period. We divided the patients into two groups according to the occurrence of hypotension and compared demographic characteristics, clinical features, treatments and outcomes. Of the 340 patients with anaphylaxis who were normotensive at first presentation, 40 patients experienced hypotension during their ED stay. The ED stay of the hypotension group was significantly longer than that of patients who did not experience hypotension (496 min vs 253 min, P = 0.000). Adrenaline use in hemodynamically stable anaphylaxis patient was independently associated with a lower risk of developing in-hospital occurrence of hypotension: OR, 0.254 [95% CI, 0.091-0.706]. Adrenaline use in hemodynamically stable anaphylaxis patients was associated with a reduced risk of developing in-hospital occurrence of hypotension. Adverse events induced by adrenaline were rare when the intramuscular route was used.

  15. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Roggeri DP

    2016-08-01

    Full Text Available Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Salvatore Cataudella,2 Nello Martini,3 1ProCure Solutions, Nembro, Bergamo, 2CINECA Interuniversity Consortium, Bologna, 3Accademia Nazionale di Medicina, Rome, Italy Purpose: Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods: Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3 with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures. Results: Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively. The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in

  16. Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

    Science.gov (United States)

    Paliwoda, Michelle; New, Karen; Bogossian, Fiona

    2016-09-01

    All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of

  17. Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths.

    Science.gov (United States)

    Zaridze, David; Brennan, Paul; Boreham, Jillian; Boroda, Alex; Karpov, Rostislav; Lazarev, Alexander; Konobeevskaya, Irina; Igitov, Vladimir; Terechova, Tatiana; Boffetta, Paolo; Peto, Richard

    2009-06-27

    Alcohol is an important determinant of the high and fluctuating adult mortality rates in Russia, but cause-specific detail is lacking. Our case-control study investigated the effects of alcohol consumption on male and female cause-specific mortality. In three Russian industrial cities with typical 1990s mortality patterns (Tomsk, Barnaul, Biysk), the addresses of 60,416 residents who had died at ages 15-74 years in 1990-2001 were visited in 2001-05. Family members were present for 50,066 decedents; for 48,557 (97%), the family gave proxy information on the decedents' past alcohol use and on potentially confounding factors. Cases (n=43,082) were those certified as dying from causes we judged beforehand might be substantially affected by alcohol or tobacco; controls were the other 5475 decedents. Case versus control relative risks (RRs; calculated as odds ratios by confounder-adjusted logistic regression) were calculated in ever-drinkers, defining the reference category by two criteria: usual weekly consumption always less than 0.5 half-litre bottles of vodka (or equivalent in total alcohol content) and maximum consumption of spirits in 1 day always less than 0.5 half-litre bottles. Other ever-drinkers were classified by usual weekly consumption into three categories: less than one, one to less than three, and three or more (mean 5.4 [SD 1.4]) bottles of vodka or equivalent. In men, the three causes accounting for the most alcohol-associated deaths were accidents and violence (RR 5.94, 95% CI 5.35-6.59, in the highest consumption category), alcohol poisoning (21.68, 17.94-26.20), and acute ischaemic heart disease other than myocardial infarction (3.04, 2.73-3.39), which includes some misclassified alcohol poisoning. There were significant excesses of upper aerodigestive tract cancer (3.48, 2.84-4.27) and liver cancer (2.11, 1.64-2.70). Another five disease groups had RRs of more than 3.00 in the highest alcohol category: tuberculosis (4.14, 3.44-4.98), pneumonia (3

  18. Acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus: a retrospective case-control study

    International Nuclear Information System (INIS)

    Patel, Ajaykumar B; Hallemeier, Christopher L; Petersen, Ivy A; Jensen, Ashley W; Osborn, Thomas G; Miller, Robert C

    2012-01-01

    The purpose of this study was to evaluate acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus (DLE). A retrospective review was performed of patients with DLE who received radiotherapy at our institution between 1980 and 2005. Patients with other connective tissue disorders were excluded. Control patients were matched 2:1 with the DLE treatment courses based on age, cancer diagnosis, year of treatment, radiotherapy dose, and sex. Acute (within 30 days from the completion of radiotherapy) and late toxicities were evaluated for each treatment course using the Common Terminology Criteria for Adverse Events Version 3.0. Twelve patients with DLE received a total of 15 radiotherapy courses. The median follow-up time was 2.6 years (range, 0.0-15.2 years). Acute toxicity of any organ was observed in 10 (67%) treatment courses, of which 2 (13%) were Grade 3 or higher. Acute Grade 1 or 2 dermatologic toxicity was observed in 8 courses (53%). Late toxicity of any organ was observed in 7 of 12 (58%) evaluable treatment courses, of which 3 (23%) were grade 3 or higher. Late grade 1 or 2 dermatologic toxicity was observed in 5 (42%) courses. No patient experienced acute or late Grade 3 or higher dermatologic toxicity. The rates of any organ or dermatologic acute and late toxicity were not significantly different between DLE and control treatment courses. Our findings do not suggest an increased risk of toxicity to the skin or other organs in patients with DLE receiving radiotherapy

  19. Acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Patel Ajaykumar B

    2012-02-01

    Full Text Available Abstract Background The purpose of this study was to evaluate acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus (DLE. Methods A retrospective review was performed of patients with DLE who received radiotherapy at our institution between 1980 and 2005. Patients with other connective tissue disorders were excluded. Control patients were matched 2:1 with the DLE treatment courses based on age, cancer diagnosis, year of treatment, radiotherapy dose, and sex. Acute (within 30 days from the completion of radiotherapy and late toxicities were evaluated for each treatment course using the Common Terminology Criteria for Adverse Events Version 3.0. Results Twelve patients with DLE received a total of 15 radiotherapy courses. The median follow-up time was 2.6 years (range, 0.0-15.2 years. Acute toxicity of any organ was observed in 10 (67% treatment courses, of which 2 (13% were Grade 3 or higher. Acute Grade 1 or 2 dermatologic toxicity was observed in 8 courses (53%. Late toxicity of any organ was observed in 7 of 12 (58% evaluable treatment courses, of which 3 (23% were grade 3 or higher. Late grade 1 or 2 dermatologic toxicity was observed in 5 (42% courses. No patient experienced acute or late Grade 3 or higher dermatologic toxicity. The rates of any organ or dermatologic acute and late toxicity were not significantly different between DLE and control treatment courses. Conclusions Our findings do not suggest an increased risk of toxicity to the skin or other organs in patients with DLE receiving radiotherapy.

  20. Profitability and Market Value of Orphan Drug Companies: A Retrospective, Propensity-Matched Case-Control Study.

    Science.gov (United States)

    Hughes, Dyfrig A; Poletti-Hughes, Jannine

    2016-01-01

    Concerns about the high cost of orphan drugs has led to questions being asked about the generosity of the incentives for development, and associated company profits. We conducted a retrospective, propensity score matched study of publicly-listed orphan companies. Cases were defined as holders of orphan drug market authorisation in Europe or the USA between 2000-12. Control companies were selected based on their propensity for being orphan drug market authorisation holders. We applied system General Method of Moments to test whether companies with orphan drug market authorization are valued higher, as measured by the Tobin's Q and market to book value ratios, and are more profitable based on return on assets, than non-orphan drug companies. 86 companies with orphan drug approvals in European (4), USA (61) or both (21) markets were matched with 258 controls. Following adjustment, orphan drug market authorization holders have a 9.6% (95% confidence interval, 0.6% to 18.7%) higher return on assets than non-orphan drug companies; Tobin's Q was higher by 9.9% (1.0% to 19.7%); market to book value by 15.7% (3.1% to 30.0%) and operating profit by 516% (CI 19.8% to 1011%). For each additional orphan drug sold, return on assets increased by 11.1% (0.6% to 21.3%), Tobin's Q by 2.7% (0.2% to 5.2%), and market to book value ratio by 5.8% (0.7% to 10.9%). Publicly listed pharmaceutical companies that are orphan drug market authorization holders are associated with higher market value and greater profits than companies not producing treatments for rare diseases.

  1. The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

    Directory of Open Access Journals (Sweden)

    Cai Z

    2016-05-01

    Full Text Available Zhiyou Cai,1 Wenbo He,1 Chuan-yong Peng,2 Jin Zhou,2 Qi-lan Xu,2 Zong-shan Wu2 1Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, 2The Examination Center of Magnetic Resonance Imaging, the Lu’an Affiliated Hospital of Anhui Medical University, Lu’an People’s Hospital, Lu’an, Anhui Province, People’s Republic of China Background and purpose: Lacunar infarct (LI is well known as a heterogeneous primary disorder of cerebral small vessel. Compelling results have demonstrated that age is a risk factor to the prevalence of LI. However, the relationship between age and the prevalence of LI remains obscure. It is essential to note the relationship between age and the prevalence of LI through more clinical data. Methods: A total of 3,500 patients were included in the case-controlled study. All data were collected from the Examination Center of Magnetic Resonance Imaging, Lu’an People’s Hospital from January 2014 to December 2015. A primary discharge diagnosis of LI was done, and all subjects were evaluated as retrospective data. The relationship between the risk factors and the prevalence of diabetes and the relationship between age and the prevalence of diabetes was analyzed. A chi-square test was used to analyze the associations between different variables. A one-way analysis of variance was used to test the equality of three or more means at one time by using variances. Statistical significance was defined as a P-value of <0.05. Results: The one-way analysis of variance demonstrated that the prevalence of LI increased with age before 60 years and decreased with age after 69 years. The same results were found in both the male and the female subjects. These results showed that the age-related risk factors (hypertension, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking have no relationship with the prevalence of LI on the basis of age. There is

  2. Incidence and risk factors for postoperative lingual neuropraxia following airway instrumentation: A retrospective matched case-control study.

    Directory of Open Access Journals (Sweden)

    Yi-Kai Su

    Full Text Available Lingual nerve injury or neuropraxia is a rare but potentially serious perioperative complication following airway instrumentation during general anesthesia. This study explored the the incidence and perioperative risk factors for lingual nerve injury in patients receiving laryngeal mask (LMA or endotracheal (ETGA general anesthesia in a single center experience.All surgical patients in our hospital who received LMA or ETGA from 2009 to 2013 were included, and potential perioperative risk factors were compared. Matched controls were randomly selected (in 1:5 ratio from the same database in non-case patients. A total of 36 patients in the records had reported experiencing tongue numbness after anesthesia in this study. Compared with the non-case surgical population (n = 54314, patients with tongue numbness were significantly younger (52.2±19.5 vs 42.0±14.5; P = 0.002 and reported lower ASA physical statuses (2.3±0.7 vs 1.6±0.6; P<0.001. Patient gender, anesthesia technique used, and airway device type (LMA or ETGA did not differ significantly across the two groups. A significantly higher proportion of patients underwent operations of the head-and-neck region (38.9 vs 15.6%; P = 0.002 developed tongue numbness after anesthesia. Multivariate logistic regression analysis indicated that head-and-neck operations remained the most significant independent risk factor for postoperative lingual nerve injury (AOR 7.63; 95% CI 2.03-28.70.The overall incidence rate of postoperative lingual neuropraxy was 0.066% in patients receiving general anesthesia with airway device in place. Young and generally healthy patients receiving head-and-neck operation are at higher risk in developing postoperative lingual neuropraxy. Attention should be particularly exercised to reduce the pressure of endotracheal tube or laryngeal mask on the tongue during head-and-neck operation to avert the occurrence of postoperative lingual neuropraxy.

  3. The use of the bootstrap in the analysis of case-control studies with missing data

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Johansen, Christoffer

    2004-01-01

    nonparametric bootstrap, bootstrap confidence intervals, missing values, multiple imputation, matched case-control study......nonparametric bootstrap, bootstrap confidence intervals, missing values, multiple imputation, matched case-control study...

  4. Risk Factor Associated with Negative Spouse HIV Seroconversion among Sero-Different Couples: A Nested Case-Control Retrospective Survey Study in 30 Counties in Rural China.

    Directory of Open Access Journals (Sweden)

    Houlin Tang

    Full Text Available Antiretroviral therapy (ART and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV sero-different couples in rural China.An open cohort of HIV sero-different couples enrolled in 30 counties in China between October 1, 2010, and September 30, 2012, and followed-up to December 31, 2012, was constructed retrospectively. A nested case-control study of risk factors of HIV seroconversion among sero-different couples was conducted in April and May of 2013, based on the open cohort. Sero-different couples with the HIV-negative spouse seroconverting at least 3 months after the previous negative diagnosis during cohort observation period were labeled as "case couples". The "control couples" were selected randomly from the same cohort that did not have the HIV-negative spouse seroconversion during the same period. The "case couples" and "control couples" were matched on gender, age, and region of residence. Sexual behaviors among HIV sero-different couples before and after the index spouses notifying their HIV infection status to their HIV-negative spouses were collected via face-to-face interview. Univariate and multivariate logistic regression models were used to assess factors associated with HIV seroconversion among HIV sero-different couples.Of 4481 HIV sero-different couples, a total of 53 seroconversions were observed within 5218 person-years of follow-up. The incidence rate was 1.02 (95%CI: 0.76-1.33 per 100 person-years. Forty "case couples" confirmed HIV-negative spouse seroconversions infected via marital sexual transmission, were matched to 80 "control couples". Of the 120 couples, 81(67.5% were receiving ART, and 70 (58.3% reported consistently used condoms during intercourse after the index

  5. Risk Factor Associated with Negative Spouse HIV Seroconversion among Sero-Different Couples: A Nested Case-Control Retrospective Survey Study in 30 Counties in Rural China.

    Science.gov (United States)

    Tang, Houlin; Wu, Zunyou; Mao, Yurong; Cepeda, Javier; Morano, Jamie

    2016-01-01

    Antiretroviral therapy (ART) and condom use have been proven to reduce the risk of sexual transmission of human immunodeficiency virus (HIV) among HIV sero-different couples, but its full implementation remains a challenge. This study aims to assess HIV seroconversion rate of HIV-negative spouse and its associated risk factors among HIV sero-different couples in rural China. An open cohort of HIV sero-different couples enrolled in 30 counties in China between October 1, 2010, and September 30, 2012, and followed-up to December 31, 2012, was constructed retrospectively. A nested case-control study of risk factors of HIV seroconversion among sero-different couples was conducted in April and May of 2013, based on the open cohort. Sero-different couples with the HIV-negative spouse seroconverting at least 3 months after the previous negative diagnosis during cohort observation period were labeled as "case couples". The "control couples" were selected randomly from the same cohort that did not have the HIV-negative spouse seroconversion during the same period. The "case couples" and "control couples" were matched on gender, age, and region of residence. Sexual behaviors among HIV sero-different couples before and after the index spouses notifying their HIV infection status to their HIV-negative spouses were collected via face-to-face interview. Univariate and multivariate logistic regression models were used to assess factors associated with HIV seroconversion among HIV sero-different couples. Of 4481 HIV sero-different couples, a total of 53 seroconversions were observed within 5218 person-years of follow-up. The incidence rate was 1.02 (95%CI: 0.76-1.33) per 100 person-years. Forty "case couples" confirmed HIV-negative spouse seroconversions infected via marital sexual transmission, were matched to 80 "control couples". Of the 120 couples, 81(67.5%) were receiving ART, and 70 (58.3%) reported consistently used condoms during intercourse after the index spouse was

  6. Traumatic diaphragmatic hernias: Retrospective analysis

    Directory of Open Access Journals (Sweden)

    J.P.A. Sousa

    2006-05-01

    Full Text Available Aims: This study classifies cases of traumatic diaphragmatic hernias (TDH in patients admitted to the Intensive Care Unit (ICU of the Coimbra University Hospitals (HUC from 1990 to 2004. Methods: Retrospective analysis of 34 cases of TDH, studying anatomical location, place and time of diagnosis, complementary tests aiding diagnosis, herniated organs, associated traumatism, morbidity and mortality. Results: Twenty-eight male and six female patients with an average age of 40.5 years ± 20.5, average SAPS score 38.8. Average lenght of stay was 19.1 ± 13.6 days, all suffered from closed traumatism and were put on artificial ventilation. The left-side diaphragm was more frequently affected (94.1% then the right. Diagnosis in 19 cases was made up in the first six hours following the diagnosis of traumatism, in four cases within 12 hours and in the remaining cases between 48 hours and 16 years after traumatism. In 13 patients the diagnosis was established intra-operatively. The stomach was typically one of the herniated organs. The most frequently associated lesions at the thoracic level were pulmonary contusion, haemothorax and pneumothorax, and at the abdominal level, haemoperitoneum and splenic lesion. The rates for complications and mortality were 55.8% and 11.7% respectively. Conclusions: TDH mainly occurs on the left side through closed thoraco-abdominal trauma following road traffic accidents. This group of patients, on average younger than others admitted to ICU, presents a longer average hospitalisation period, but has lower rates of mortality and lower SAPS severity scores. The most commonly herniated organ was the stomach and the most frequently encountered lesions were cranial-encephalic, splenic and pleural traumatisms. Pre-operative diagnosis of diaphragmatic injuries is difficult and a high index of clinical suspicion is needed after thoracoabdominal trauma. This diagnosis should always be considered a possibility in

  7. Hand infections: a retrospective analysis

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    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  8. Effectiveness of Japanese encephalitis SA 14-14-2 live attenuated vaccine among Indian children: Retrospective 1:4 matched case-control study.

    Science.gov (United States)

    Tandale, Babasaheb V; Khan, Siraj A; Kushwaha, Komal P; Rahman, Helina; Gore, Milind M

    2018-04-24

    We estimate the effectiveness of Japanese encephalitis (JE) SA 14-14-2 live-attenuated vaccination single dose campaign among children aged 1-15 years in India during 2006-07. Acute encephalitis syndrome (AES) cases hospitalized following vaccination campaigns during the years 2006-08 were investigated retrospectively. The laboratory-confirmed JE cases were detected from the surveillance laboratories based on anti-JE IgM antibody by ELISA or viral RNA detection by RT-PCR in sera or cerebrospinal fluid. Consent was sought from parents or guardians. Four community controls were chosen randomly per case during house-to-house survey employing individual matching on age, gender and residence during the risk period. Vaccination history was enquired from the child's guardian and verified from vaccination card at home or records at health centre. Conditional logistic regression was conducted on matched case-control sets. We studied 149 cases and matched 596 controls. Vaccination effectiveness was 43.8% (95% CI, 1.9-67.8) based on vaccination card or record. However, effectiveness was 72.2% (95% CI, 56.2-82.4) based on parental history or card/record. Vaccination effectiveness in Assam state was higher than in Uttar Pradesh state. We concluded that the single subcutaneous dose of SA 14-14-2 JE vaccine provided moderate effectiveness in Indian children. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Sporadic occurrence of completely lateralized vertex sharp transients of sleep is a normal phenomenon: a retrospective, blinded, case-control study.

    Science.gov (United States)

    Brenton, J Nicholas; Mytinger, John R

    2015-04-01

    Vertex sharp transients (VSTs) of sleep often lateralize to the left or right frontocentral regions and can be mistaken as epileptiform. The aim of this study was to determine the prevalence of completely lateralized VSTs in pediatric-aged individuals and to assess their significance by comparing cohorts with and without epilepsy. The authors hypothesized that completely lateralized VSTs are normal and occur with similar frequencies in patients with and without epilepsy. The authors conducted a retrospective, blinded, case-control study comparing completely lateralized VSTs within a 5-minute EEG sleep epoch between cohorts of 100 patients with epilepsy and 100 age- and gender-matched controls. The number of patients with completely lateralized VSTs was not significantly different between cases (62%) and controls (65%) (P = 0.66). The median number of completely lateralized VSTs was small but not significantly different between cases (median 3) and controls (median 4) (P = 0.11). The presence of completely lateralized VSTs in cases (generalized vs. focal epilepsy) was not significantly different (P > 0.95). This is the first systematic study of the prevalence and significance of completely lateralized VSTs of sleep. This study provides class III evidence that completely lateralized VSTs, occurring in a sporadic fashion, are a normal phenomenon and should not be confused with epileptiform discharges.

  10. Reduced Risk of Barrett's Esophagus in Statin Users: Case-Control Study and Meta-Analysis.

    Science.gov (United States)

    Beales, Ian L P; Dearman, Leanne; Vardi, Inna; Loke, Yoon

    2016-01-01

    Use of statins has been associated with a reduced incidence of esophageal adenocarcinoma in population-based studies. However there are few studies examining statin use and the development of Barrett's esophagus. The purpose of this study was to examine the association between statin use and the presence of Barrett's esophagus in patients having their first gastroscopy. We have performed a case-control study comparing statin use between patients with, and without, an incident diagnosis of non-dysplastic Barrett's esophagus. Male Barrett's cases (134) were compared to 268 male age-matched controls in each of two control groups (erosive gastro-esophageal reflux and dyspepsia without significant upper gastrointestinal disease). Risk factor and drug exposure were established using standardised interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. We performed a meta-analysis pooling our results with three other case-control studies. Regular statin use was associated with a significantly lower incidence of Barrett's esophagus compared to the combined control groups [adjusted OR 0.62 (95 % confidence intervals 0.37-0.93)]. This effect was more marked in combined statin plus aspirin users [adjusted OR 0.43 (95 % CI 0.21-0.89)]. The inverse association between statin or statin plus aspirin use and risk of Barrett's was significantly greater with longer duration of use. Meta-analysis of pooled data (1098 Barrett's, 2085 controls) showed that statin use was significantly associated with a reduced risk of Barrett's esophagus [pooled adjusted OR 0.63 (95 % CI 0.51-0.77)]. Statin use is associated with a reduced incidence of a new diagnosis of Barrett's esophagus.

  11. Sympathetic skin response in multiple sclerosis: a meta-analysis of case-control studies.

    Science.gov (United States)

    Margaritella, Nicolò; Mendozzi, Laura; Garegnani, Massimo; Gilardi, Elisabetta; Nemni, Raffaello; Pugnetti, Luigi

    2018-01-01

    The usefulness of sympathetic skin responses (SSR) in multiple sclerosis (MS) has been advocated by several studies in the last 20 years; however, due to a great heterogeneity of findings, a comprehensive meta-analysis of case-control studies is in order to pinpoint consistencies and investigate the causes of discrepancies. We searched MEDLINE, EMBASE and Cochrane databases for case-control studies comparing SSR absence frequency and latency between patients with MS and healthy controls. Thirteen eligible studies including 415 MS patients and 331 healthy controls were identified. The pooled analysis showed that SSR can be always obtained in healthy controls while 34% of patients had absent SSRs in at least one limb (95% CI 22-47%; p studies (I 2  = 90.3%). Patients' age explained 22% of the overall variability and positive correlations were found with Expanded Disability Status Scale and disease duration. The pooled mean difference of SSR latency showed a significant increase in patients on both upper (193 ms; 95% CI 120-270 ms) and lower (350 ms; 95% CI 190-510 ms) extremities. We tested the discriminatory value of SSR latency thresholds defined as the 95% confidence interval (CI) upper bound of the healthy controls, and validated the results on a new dataset. The lower limb threshold of 1.964 s produces the best results in terms of sensitivity 0.86, specificity 0.67, positive predicted value 0.75 and negative predicted value 0.80. Despite a considerable heterogeneity of findings, there is evidence that SSR is a useful tool in MS.

  12. Association between Myocardial Infarction and Periodontitis: a Meta-Analysis of Case-Control Studies

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    Quan Shi

    2016-11-01

    Full Text Available AbstractBackground and Objective: Many clinical researches have been carried out to investigate the relationship between myocardial infarction (MI and periodontitis. Despite most of them indicated that the periodontitis may be associated with an increased risk of MI, the findings and study types of these studies have been inconsistent. The goal of this meta-analysis was to critically assess the strength of the association between MI and periodontitis in case-control studies.Methods: PubMed and the Cochrane Library were searched for eligible case-control studies reporting relevant parameters that compared periodontal status between MI and control subjects. The odds ratios (ORs and 95% confidence intervals (CIs from each study were pooled to estimate the strength of the association between MI and periodontitis. The mean differences and 95% CIs for periodontal-related parameters were calculated to determine their overall effects.Results: Seventeen studies including a total of 3456 MI patients and 3875 non-MI control subjects were included. The pooled OR for the association between MI and periodontitis was 2.531 (95% CI: 1.927-3.324. The mean differences (95% CIs for clinical attachment loss, probing depth, bleeding on probing, plaque index, and the number of missing teeth were 1.000 (0.726-1.247, 1.209 (0.538-1.880, 0.342 (0.129-0.555, 0.383 (0.205-0.560, and 4.122 (2.012-6.232, respectively. Conclusion: With the current evidence, the results support the presence of a significant association between MI and periodontitis. Moreover, MI patients had worse periodontal and oral hygiene status and fewer teeth than did control subjects. More high-quality and well-designed studies focusing on the casual relationship between MI and periodontitis should be conducted in the future.

  13. Risk of radiation-induced malignancy with heterotopic ossification prophylaxis: a case-control analysis.

    Science.gov (United States)

    Sheybani, Arshin; TenNapel, Mindi J; Lack, William D; Clerkin, Patrick; Hyer, Daniel E; Sun, Wenqing; Jacobson, Geraldine M

    2014-07-01

    To determine the risk of radiation-induced malignancy after prophylactic treatment for heterotopic ossification (HO). A matched case-control study was conducted within a population-based cohort of 3489 patients treated either for acetabular fractures with acetabular open reduction internal fixation or who underwent total hip arthroplasty from 1990 to 2009. Record-linkage techniques identified patients who were diagnosed with a malignancy from our state health registry. Patients with a prior history of malignancy were excluded from the cohort. For each documented case of cancer, 2 controls were selected by stratified random sampling from the cohort that did not develop a malignancy. Matching factors were sex, age at time of hip treatment, and duration of follow-up. A total of 243 patients were diagnosed with a malignancy after hip treatment. Five patients were excluded owing to inadequate follow-up time in the corresponding control cohort. A cohort of 238 cases (control, 476 patients) was included. Mean follow-up was 10 years, 12 years in the control group. In the cancer cohort, 4% of patients had radiation therapy (RT), compared with 7% in the control group. Of the 9 patients diagnosed with cancer after RT, none occurred within the field. The mean latency period was 5.9 years in the patients who received RT and 6.6 years in the patients who did not. Median (range) age at time of cancer diagnosis in patients who received RT was 62 (43-75) years, compared with 70 (32-92) years in the non-RT patients. An ad hoc analysis was subsequently performed in all 2749 patients who were not matched and found neither an increased incidence of malignancy nor a difference in distribution of type of malignancy. We were unable to demonstrate an increased risk of malignancy in patients who were treated with RT for HO prophylaxis compared with those who were not. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. A retrospective, case-control study on traditional environmental risk factors in inflammatory bowel disease in Vukovar-Srijem County, north-eastern Croatia, 2010.

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    Vcev, Aleksandar; Pezerovic, Davorin; Jovanovic, Zeljko; Nakic, Darko; Vcev, Ivan; Majnarić, Ljiljana

    2015-05-01

    Traditional environmental risk factors in inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD), were examined as part of the retrospective epidemiologic study conducted in Vukovar-Srijem County, north-eastern Croatia in 2010. The geographical variations in the frequency of IBD in Croatia have been observed, which is also the trend in the Central Eastern European region and Europe as a whole, indicating the influence of environmental and lifestyle factors. However, the data on the spread of environmental IBD risk factors are still limited. The purpose of this study was to analyse the traditional environmental risk factors in IBD on our cohort sample, including measles virus infection and vaccination (MMR vaccine-Mumps, Measles, Rubella), tonsillectomy, appendectomy, current and former cigarette smoking and use of oral contraceptives in women. This retrospective, case-control study was performed as a part of a wider epidemiologic study aimed at assessing the incidence, prevalence and clinical expression of IBD, in Vukovar-Srijem County (population: 204,768; 2001), which is a lesser developed part of the continental Croatia that experienced deep demographic changes in the recent past. IBD patients were identified according to the hospital's patient records. There were 119 UC patients and 31 CD patients of a total of 150 patients in the cohort. A total of 150 individuals, volunteers, not having a diagnosis of IBD, age- and sex-matched, were used as the control group. Information on examined risk factors were obtained from all subjects in a previously conducted interview. Patients were contacted personally or by phone and interviewed by a gastroenterologist. There were no differences in the number of smokers, former smokers and non-smokers, between UC and CD patients and the controls, nor in the duration of smoking (years), in current smokers and ex-smokers. Only marginally significant longer time of non-smoking, in ex-smokers was found in

  15. Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.

    Science.gov (United States)

    Ray, Paula; Hayward, Jean; Michelson, David; Lewis, Edwin; Schwalbe, Joan; Black, Steve; Shinefield, Henry; Marcy, Michael; Huff, Ken; Ward, Joel; Mullooly, John; Chen, Robert; Davis, Robert

    2006-09-01

    Whole-cell pertussis (wP) and measles vaccines are effective in preventing disease but have also been suspected of increasing the risk of encephalopathy or encephalitis. Although many countries now use acellular pertussis vaccines, wP vaccine is still widely used in the developing world. It is therefore important to evaluate whether wP vaccine increases the risk of neurologic disorders. A retrospective case-control study was performed at 4 health maintenance organizations. Records from January 1, 1981, through December 31, 1995, were examined to identify children aged 0 to 6 years old hospitalized with encephalopathy or related conditions. The cause of the encephalopathy was categorized as known, unknown or suspected but unconfirmed. Up to 3 controls were matched to each case. Conditional logistic regression was used to analyze the relative risk of encephalopathy after vaccination with diphtheria-tetanus-pertussis (DTP) or measles-mumps-rubella (MMR) vaccines in the 90 days before disease onset as defined by chart review compared with an equivalent period among controls indexed by matching on case onset date. Four-hundred fifty-two cases were identified. Cases were no more likely than controls to have received either vaccine during the 90 days before disease onset. When encephalopathies of known etiology were excluded, the odds ratio for case children having received DTP within 7 days before onset of disease was 1.22 (95% confidence interval [CI] = 0.45-3.31, P = 0.693) compared with control children. For MMR in the 90 days before onset of encephalopathy, the odds ratio was 1.23 (95% confidence interval = 0.51-2.98, P = 0.647). In this study of more than 2 million children, DTP and MMR vaccines were not associated with an increased risk of encephalopathy after vaccination.

  16. A retrospective analysis of acute organophosphorus poisoning ...

    African Journals Online (AJOL)

    A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. ... Young adult males were more commonly involved than females (M:F 2.5:1). The mean age of the patients was 28 years (range 2-72 years, SD ± 14.3 years). Mean time to receive treatment ...

  17. Comparison of UHPLC and HPLC in benzodiazepines analysis of postmortem samples: a case-control study.

    Science.gov (United States)

    Behnoush, Behnam; Sheikhazadi, Ardeshir; Bazmi, Elham; Fattahi, Akbar; Sheikhazadi, Elham; Saberi Anary, Seyed Hossein

    2015-04-01

    The aim of this study was to compare system efficiency and analysis duration regarding the solvent consumption and system maintenance in high-pressure liquid chromatography (HPLC) and ultra high-pressure liquid chromatography (UHPLC). In a case-control study, standard solutions of 7 benzodiazepines (BZs) and 73 biological samples such as urine, tissue, stomach content, and bile that screened positive for BZs were analyzed by HPLC and UHPLC in laboratory of forensic toxicology during 2012 to 2013. HPLC analysis was performed using a Knauer by 100-5 C-18 column (250 mm × 4.6 mm) and Knauer photodiode array detector (PAD). UHPLC analysis was performed using Knauer PAD detector with cooling autosampler and Eurospher II 100-3 C-18 column (100 mm × 3 mm) and also 2 pumps. The mean retention time, standard deviation, flow rate, and repeatability of analytical results were compared by using 2 methods. Routine runtimes in HPLC and UHPLC took 40 and 15 minutes, respectively. Changes in mobile phase composition of the 2 methods were not required. Flow rate and solvent consumption in UHPLC decreased. Diazepam and flurazepam were detected more frequently in biological samples. In UHPLC, small particle size and short length of column cause effective separation of BZs in a very short time. Reduced flow rate, solvent consumption, and injection volume cause more efficiency and less analysis costs. Thus, in the detection of BZs, UHPLC is an accurate, sensitive, and fast method with less cost of analysis.

  18. Analysis of the Risk Factors for Aerobic Vaginitis: A Case-Control Study.

    Science.gov (United States)

    Geng, Nv; Wu, Wenjuan; Fan, Aiping; Han, Cha; Wang, Chen; Wang, Yingmei; Xue, Fengxia

    2015-06-09

    Aerobic vaginitis (AV) is a newly defined clinical entity which may interfere with women's reproductive health and have negative effects on pregnancy. This study was to identify the risk factors for AV. Participants in this case-control study included healthy women and women with AV. All participants completed a standardized questionnaire covering sociodemographic factors, sexual behaviors, personal hygiene habits and health behaviors. Uni- and multivariate logistic regression analyses were used for statistical evaluation. A total of 290 women of reproductive age were enrolled. In the multivariate analysis, unmarried status (odds ratio [OR] 2.606, 95% confidence interval [CI] 1.257-5.402), use of an intrauterine device (OR 4.989, 95% CI 1.922-12.952), long-term use of antibiotics (OR 11.176, 95% CI 1.363-91.666) and frequent vaginal douching (OR 4.689, 95% CI 1.363-16.135) were independent risk factors for AV. On the contrary, consistent condom use (OR 0.546, 95% CI 0.301-0.991) and college-level education or above (OR 0.255, 95% CI 0.131-0.497) were independent protective factors. Measures that may be considered to prevent AV include enhancing education to improve women's knowledge related to reproductive health, especially unmarried women, encouraging them to consistently use condoms as a contraceptive method, to avoid long-term use of antibiotics and to stop frequent vaginal douching. © 2015 S. Karger AG, Basel.

  19. Statin use and risk of cholecystectomy - A case-control analysis using Swiss claims data.

    Science.gov (United States)

    Biétry, Fabienne A; Reich, Oliver; Schwenkglenks, Matthias; Meier, Christoph R

    2016-12-01

    Using claims data from the Helsana Group, a large Swiss health insurance provider, we examined the association between statin use and the risk of cholecystectomy in a case-control analysis. We identified 2,200 cholecystectomy cases between 2013 and 2014 and matched 4 controls to each case on age, sex, index date and canton. We categorized statin users into current or past users (last prescription ≤ 180 or > 180 days before the index date, respectively) and classified medication use by duration based on number of prescriptions before the index date. We applied conditional logistic regression analyses to calculate odds ratios (ORs) with 95% confidence intervals (CIs) and adjusted the analyses for history of cardiovascular diseases and for use of estrogens, fibrates and other lipid-lowering agents. The adjusted OR (aOR) for cholecystectomy was 0.85 (95% CI: 0.74, 0.99) for current statin users compared to non-users. Long-term current statin use (5-19 prescriptions) was associated with a reduced OR (aOR 0.77, 95% CI: 0.65, 0.92). However, neither short-term current use nor past statin use affected the risk of cholecystectomy. The study supports the previously raised hypothesis that long-term statin use reduces the risk of cholecystectomy.

  20. Impact of psoriasis on patients' work and productivity: a retrospective, matched case-control analysis.

    Science.gov (United States)

    Wu, Ying; Mills, Douglas; Bala, Mohan

    2009-01-01

    Psoriasis negatively impacts patient quality of life; however, the impact on work and productivity is not well known. To determine the impact of psoriasis on work and productivity using data from the National Health and Wellness Survey (NHWS). Data collected from 40 730 adults who completed the NHWS between 1 May and 30 June 2004, of whom 1127 had psoriasis, were analyzed. Psoriasis patients and a matched cohort of non-psoriasis patients were identified to assess the impact of psoriasis on work and productivity. Psoriasis patients were more likely to have missed work for health-related reasons (p work productivity impairment (p work impairment (p work (p work productivity.

  1. Efficacy of tranexamic acid in reducing blood loss in posterior lumbar spine surgery for degenerative spinal stenosis with instability: a retrospective case control study

    Directory of Open Access Journals (Sweden)

    Endres Stefan

    2011-11-01

    Full Text Available Abstract Background Degenerative spinal stenosis and instability requiring multilevel spine surgery has been associated with large blood losses. Factors that affect perioperative blood loss include time of surgery, surgical procedure, patient height, combined anterior/posterior approaches, number of levels fused, blood salvage techniques, and the use of anti-fibrinolytic medications. This study was done to evaluate the efficacy of tranexamic acid in reducing blood loss in spine surgery. Methods This retrospective case control study includes 97 patients who had to undergo surgery because of degenerative lumbar spinal stenosis and instability. All operations included spinal decompression, interbody fusion and posterior instrumentation (4-5 segments. Forty-six patients received 1 g tranexamic acid intravenous, preoperative and six hours and twelve hours postoperative; 51 patients without tranexamic acid administration were evaluated as a control group. Based on the records, the intra- and postoperative blood losses were measured by evaluating the drainage and cell saver systems 6, 12 and 24 hours post operation. Additionally, hemoglobin concentration and platelet concentration were reviewed. Furthermore, the number of red cell transfusions given and complications associated with tranexamic acid were assessed. Results The postoperative hemoglobin concentration demonstrated a statistically significant difference with a p value of 0.0130 showing superiority for tranexamic acid use (tranexamic acid group: 11.08 g/dl, SD: 1.68; control group: 10.29 g/dl, SD: 1.39. The intraoperative cell saver volume and drainage volume after 24 h demonstrated a significant difference as well, which indicates a less blood loss in the tranexamic acid group than the control group. The postoperative drainage volume at12 hours showed no significant differences; nor did the platelet concentration Allogenic blood transfusion (two red cell units was needed for eight patients

  2. The impact of "Be Clear on Cancer" campaign on breast care services provided by a specialist oncoplastic unit - A retrospective case control study.

    Science.gov (United States)

    Mazari, Fayyaz Ali Khan; Holt, Stephen; Azmy, Iman A

    2017-11-01

    "Be Clear on Cancer" (BCOC) was a national campaign to raise awareness of breast cancer in women over seventy years old. Cancer Research UK conducted this campaign from 03 February 2014 to 15 March 2014. This study assesses its impact on breast care services. BCOC campaign guidelines for hospital trusts were used as standard comparator for this retrospective case-control study. All new patients referred to breast clinic over four months from February 2014 were included, and compared to the same period in 2013. Information was recorded for referrals, biopsy rates and pathological diagnoses. Intra & inter-group comparisons were performed. 1646 patients were included. An increase of 25.2%(n = 184) was observed in referrals in 2014(n = 915) compared to 2013(n = 731). Cancer detection rates went down significantly (P = 0.002,Chi-square) in 2014 (5.1%,n = 47) compared to 2013 (9.0%,n = 66) due to the increase in number of referrals. In the over 70s group, a higher than predicted increase of 64.2%(n = 52) in all referrals, and 8%(n = 44) in two-week wait referrals was observed. The number of biopsies and cancers detected remained stable although the proportions undergoing biopsies (2014-29.3%,n = 39/133 versus 2013-38.3%,n = 31/81) or being diagnosed with cancer (2014-19.5%,n = 26/133 versus 2013-30.9%,n = 25/81) declined significantly (P = 0.001,McNemar) during the campaign due to an inflation in the number of referrals. Despite the overall reduction, cancer detection rate for biopsies performed remained significantly high in the over 70s (66.7%,n = 26/39) when compared with the under 70s (23.9%,n = 21/88) during the campaign. Although "Be Clear on Cancer" campaign resulted in a significant increase in breast cancer referrals, it did not translate into an increase in biopsy rates or cancer detection rates. The amount of work generated for the hospital because of this campaign was far greater than the predicted increase from campaign pilots

  3. Team care to cure adolescents with braces (avoiding low quality of life, pain and bad compliance): a case-control retrospective study. 2011 SOSORT Award winner.

    Science.gov (United States)

    Tavernaro, Marta; Pellegrini, Anna; Tessadri, Fabrizio; Zaina, Fabio; Zonta, Andrea; Negrini, Stefano

    2012-09-20

    Bracing could be efficacious, given good compliance and quality of braces. Recently the SOSORT Brace TREATMENT Management Guidelines (SBTMG) have highlighted the perceived importance of the professional teams surrounding braced patients. To verify the impact of a complete rehabilitation team in the adolescent patient with bracing. Design. Initial cross-sectional study, followed by a retrospective case-control study. Thirty-eight patients (15.8 ± 1.6 years; 26 females; 10 hyperkyphosis, 28 scoliosis of 29.2 ± 7.9° Cobb) extracted from a single orthotist database (between January 1, 2008 and September 1, 2009) and treated by the same physician; brace wearing at least 15 hours/day for a minimum of 6 months; age 10 or more. Braces: Sforzesco, Sibilla, Lapadula or Maguelone. Exercises: SEAS. Two questionnaires filled in blindly by patients: SRS-22 and one especially developed and validated with 25 questions on adherence to treatment. Groups (main risk factor): TEAM (private institute: satisfied 44/44 SOSORT criteria; grade of teamwork, "excellent") included 13 patients and NOT 25 (National Health Service Rehabilitation Department: 35/44 SOSORT criteria respected; grade, "insufficient"). TEAM was more compliant to bracing than NOT (97 ± 6% vs. 80 ± 24%) and performed nearly double the exercises (38 ± 12 vs. 20 ± 13 minutes/session). The self-reduction of bracing was significant in NOT (from 16.8 ± 3.7 to 14.8 ± 4.9 hours/day, , Pversus 7% of TEAM (P < 0.05). The populations did not differ at the baseline studied outcomes. The absence of a good team surrounding the patient increases by five times the risk of reduced compliance to bracing (odds ratio OR 5.5 - 95% confidence interval 95CI 3.6-7.4), along with more than 15 times that of QoL problems (OR 15.7 - 95CI 13.6-17.9) and pain (OR 16.8 - 95CI 14.5-19.1). Provided the limits of this first study on the topic, the SBTMG seems to be important for brace treatment

  4. Retrospective multicenter matched case-control study on the risk factors for narcolepsy with special focus on vaccinations (including pandemic influenza vaccination) and infections in Germany.

    Science.gov (United States)

    Oberle, Doris; Pavel, Jutta; Mayer, Geert; Geisler, Peter; Keller-Stanislawski, Brigitte

    2017-06-01

    Studies associate pandemic influenza vaccination with narcolepsy. In Germany, a retrospective, multicenter, matched case-control study was performed to identify risk factors for narcolepsy, particularly regarding vaccinations (seasonal and pandemic influenza vaccination) and infections (seasonal and pandemic influenza) and to quantify the detected risks. Patients with excessive daytime sleepiness who had been referred to a sleep center between April 2009 and December 2012 for multiple sleep latency test (MSLT) were eligible. Case report forms were validated according to the criteria for narcolepsy defined by the Brighton Collaboration (BC). Confirmed cases of narcolepsy (BC level of diagnostic certainty 1-4a) were matched with population-based controls by year of birth, gender, and place of residence. A second control group was established including patients in whom narcolepsy was definitely excluded (test-negative controls). A total of 103 validated cases of narcolepsy were matched with 264 population-based controls. The second control group included 29 test-negative controls. A significantly increased odd ratio (OR) to develop narcolepsy (crude OR [cOR] = 3.9, 95% confidence interval [CI] = 1.8-8.5; adjusted OR [aOR] = 4.5, 95% CI = 2.0-9.9) was detected in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset as compared to nonvaccinated individuals. Using test-negative controls, in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset, a nonsignificantly increased OR of narcolepsy was detected when compared to nonvaccinated individuals (whole study population, BC levels 1-4a: cOR = 1.9, 95% CI = 0.5-6.9; aOR = 1.8, 95% CI = 0.3-10.1). The findings of this study support an increased risk for narcolepsy after immunization with pandemic influenza A/H1N1/v vaccine. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-07-01

    The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

  6. A combined analysis of North American case-control studies of residential radon and lung cancer.

    Science.gov (United States)

    Krewski, Daniel; Lubin, Jay H; Zielinski, Jan M; Alavanja, Michael; Catalan, Vanessa S; Field, R William; Klotz, Judith B; Létourneau, Ernest G; Lynch, Charles F; Lyon, Joseph L; Sandler, Dale P; Schoenberg, Janet B; Steck, Daniel J; Stolwijk, Jan A; Weinberg, Clarice; Wilcox, Homer B

    2006-04-01

    Cohort studies have consistently shown underground miners exposed to high levels of radon to be at excess risk of lung cancer, and extrapolations based on those results indicate that residential radon may be responsible for nearly 10-15% of all lung cancer deaths per year in the United States. However, case-control studies of residential radon and lung cancer have provided ambiguous evidence of radon lung cancer risks. Regardless, alpha-particle emissions from the short-lived radioactive radon decay products can damage cellular DNA. The possibility that a demonstrated lung carcinogen may be present in large numbers of homes raises a serious public health concern. Thus, a systematic analysis of pooled data from all North American residential radon studies was undertaken to provide a more direct characterization of the public health risk posed by prolonged radon exposure. To evaluate the risk associated with prolonged residential radon exposure, a combined analysis of the primary data from seven large scale case-control studies of residential radon and lung cancer risk was conducted. The combined data set included a total of 4081 cases and 5281 controls, representing the largest aggregation of data on residential radon and lung cancer conducted to date. Residential radon concentrations were determined primarily by a-track detectors placed in the living areas of homes of the study subjects in order to obtain an integrated 1-yr average radon concentration in indoor air. Conditional likelihood regression was used to estimate the excess risk of lung cancer due to residential radon exposure, with adjustment for attained age, sex, study, smoking factors, residential mobility, and completeness of radon measurements. Although the main analyses were based on the combined data set as a whole, we also considered subsets of the data considered to have more accurate radon dosimetry. This included a subset of the data involving 3662 cases and 4966 controls with a-track radon

  7. Salivary creatinine and urea analysis in patients with chronic kidney disease: a case control study.

    Science.gov (United States)

    Lasisi, Taye Jemilat; Raji, Yemi Raheem; Salako, Babatunde Lawal

    2016-01-16

    Many metabolic changes develop in patients with chronic kidney disease which often necessitate frequent biochemical analysis of blood. Saliva analysis as an alternative to blood has many advantages. The aims of this study were to evaluate levels of salivary creatinine and urea in patients with chronic kidney disease in comparison to healthy individuals; to determine correlation between salivary creatinine/urea and blood creatinine/urea and to evaluate the diagnostic potential of saliva. A case control study, involving 50 patients with late stage chronic kidney disease and 49 healthy individuals as control. Blood and saliva samples were analyzed for urea and creatinine levels. Data are presented as median with interquartile range and compared using Independent Samples Mann Whitney U test. Correlation between plasma and salivary creatinine as well as urea was determined using Spearman's correlation test. Receiver operating characteristics (ROC) analysis was done to determine the diagnostic ability of salivary creatinine and urea and cut-off values were established. Median salivary creatinine levels were 2.60 mg/dl and 0.20 mg/dl while median salivary urea levels were 92.00 mg/dl and 20.50 mg/dl in patients with chronic kidney disease and controls respectively. Salivary levels of creatinine and urea were significantly elevated in chronic kidney disease patients (p creatinine as well as urea levels. Total areas under the curve for salivary creatinine and urea were 0.97 and 0.89 respectively. Cut-off values for salivary creatinine and urea were 0.55 mg/dl and 27.50 mg/dl respectively which gave sensitivity and specificity of 94 % and 85 % for creatinine; as well as 86 % and 93 % for urea. Findings of this study suggest that analysis of salivary creatinine and urea in patients with chronic kidney disease reflects their levels in blood. Hence, salivary creatinine and urea could be used as diagnostic biomarkers of chronic kidney disease.

  8. Maternal age and Alzheimer's disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group

    NARCIS (Netherlands)

    W.A. Rocca; C.M. van Duijn (Cornelia); D.G. Clayton (David); V. Chandra; L. Fratiglioni (Laura); A.B. Graves; A. Heyman; A.F. Jorm; E. Kokmen (Emre); K. Kondo; J.A. Mortimer; S.L. Shalat; H. Soininen; A. Hofman (Albert)

    1991-01-01

    textabstractTo investigate the possible association between Alzheimer's disease and late maternal age at index birth, we conducted a collaborative re-analysis of existing case-control data sets. Of the 11 studies participating in the EURODEM project, four were included in the analyses regarding

  9. A nested case-control study of influenza vaccination was a cost-effective alternative to a full cohort analysis

    NARCIS (Netherlands)

    Hak, E; Wei, F; Grobbee, D E; Nichol, K L

    OBJECTIVE: In the absence of trial results that are applicable to the target population, nested case-control studies might be an alternative to full-cohort analysis. We compared relative and absolute estimates of associations in an influenza vaccine study using both designs. STUDY DESIGN AND

  10. Association between Herpesviruses and Chronic Periodontitis: A Meta-Analysis Based on Case-Control Studies.

    Science.gov (United States)

    Zhu, Ce; Li, Fei; Wong, May Chun Mei; Feng, Xi-Ping; Lu, Hai-Xia; Xu, Wei

    2015-01-01

    Numerous studies have investigated the associations between herpesviruses and chronic periodontitis; however, the results remain controversial. To derive a more precise estimation, a meta-analysis on all available studies was performed to identify the association between herpesviruses and chronic periodontitis. A computerized literature search was conducted in December 2014 to identify eligible case-control studies from the PUBMED and EMBASE databases according to inclusion and exclusion criteria. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were used to assess the association between herpesviruses and risk of chronic periodontitis. A fixed or random effects model was determined based on a heterogeneity test. Sensitivity analysis was conducted to investigate stability and reliability. Publication bias was investigated using the Begg rank correlation test and Egger's funnel plot. Ten eligible studies were included to investigate the association between Epstein-Barr virus (EBV) and chronic periodontitis. The results showed that EBV has a significant association with chronic periodontitis compared with periodontally healthy group (OR = 5.74, 95% CI = 2.53-13.00, Pchronic periodontitis was analyzed in 10 studies. The pooled result showed that HCMV also has a significant association with chronic periodontitis (OR = 3.59, 95% CI = 1.41-9.16, P = 0.007). Similar results were found in the sensitivity analyses. No significant publication bias was observed. Two eligible studies were included to investigate the association between herpes simplex virus (HSV) and chronic periodontitis risk. The association between HSV and chronic periodontitis was inconclusive (OR = 2.81 95% CI = 0.95-8.27, P = 0.06). Only one included study investigated the association between human herpesvirus 7 (HHV-7) and chronic periodontitis risk (OR = 1.00, 95% CI = 0.21-4.86). The findings of this meta-analysis suggest that two members of the herpesvirus family, EBV

  11. ABO blood group and esophageal carcinoma risk: from a case-control study in Chinese population to meta-analysis.

    Science.gov (United States)

    Wang, Wei; Liu, Lei; Wang, Zhiwei; Lu, Xiaopeng; Wei, Min; Lin, Tianlong; Zhang, Yixin; Jiang, Songqi; Wang, Qiang; Cao, Ziang; Shi, Minxin

    2014-10-01

    The association between ABO blood group and the risk of esophageal carcinoma (EC) in previously published studies is uncertain and conflicting. The aim of the current study was to determine the correlation of ABO blood group with EC risk via a case-control study and meta-analysis. We performed a population-based case-control study of 3,595 cases and 41,788 controls in Chinese population to evaluate the association between ABO blood group and EC risk. Then, a comprehensive meta-analysis combining our original data and previously published data was conducted to clearly discern the real relationship. The strength of association was measured by odds ratios (ORs) with 95% confidence intervals (CI). In our case-control study, the risk of EC in blood group B was significantly higher than that in non-B groups (A, O, and AB) (OR = 1.15, 95% CI 1.09-1.21). Compared with non-O groups (A, B, and AB), individuals with blood group O demonstrated a reduced risk of EC (OR = 0.90, 95% CI 0.85-0.94). The meta-analysis also indicated that blood group B was associated with significantly higher EC risk (OR = 1.20, 95% CI 1.10-1.31), and people with blood group O had a decreased EC risk (OR = 0.94, 95% CI 0.90-0.99). Neither the case-control study nor the meta-analysis produced any significant association of blood group A or AB with EC risk. Results from our case-control study and the followed meta-analysis confirmed that there was an increased risk of EC in blood group B individuals, whereas a decreased risk of EC was observed in blood group O individuals.

  12. A detailed radiobiological and dosimetric analysis of biochemical outcomes in a case-control study of permanent prostate brachytherapy patients

    International Nuclear Information System (INIS)

    Butler, Wayne M.; Stewart, Renee R.; Merrick, Gregory S.

    2009-01-01

    generalized EUD. In this case-control study of prostate brachytherapy biochemical failures and nonfailures, there were no radiobiological parameters derived from detailed DVH-based analysis that predicted for biochemical control. This may indicate that in our approach, implant dosimetry is at or near the limits of clinically effective dose escalation.

  13. Retrospective analysis of the Spitak earthquake

    Directory of Open Access Journals (Sweden)

    A. K. Tovmassian

    1995-06-01

    Full Text Available Based on the retrospective analysis of numerous data and studies of the Spitak earthquake the present work at- tempts to shed light on different aspects of that catastrophic seismic event which occurred in Northern Arme- nia on December 7, 1988. The authors follow a chronological order of presentation, namely: changes in geo- sphere, atmosphere, biosphere during the preparation of the Spitak earthquake, foreshocks, main shock, after- shocks, focal mechanisms, historical seismicity; seismotectonic position of the source, strong motion records, site effects; the macroseismic effect, collapse of buildings and structures; rescue activities; earthquake conse- quences; and the lessons of the Spitak earthquake.

  14. Meta-analysis of thirty-two case-control and two ecological radon studies of lung cancer.

    Science.gov (United States)

    Dobrzynski, Ludwik; Fornalski, Krzysztof W; Reszczynska, Joanna

    2018-03-01

    A re-analysis has been carried out of thirty-two case-control and two ecological studies concerning the influence of radon, a radioactive gas, on the risk of lung cancer. Three mathematically simplest dose-response relationships (models) were tested: constant (zero health effect), linear, and parabolic (linear-quadratic). Health effect end-points reported in the analysed studies are odds ratios or relative risk ratios, related either to morbidity or mortality. In our preliminary analysis, we show that the results of dose-response fitting are qualitatively (within uncertainties, given as error bars) the same, whichever of these health effect end-points are applied. Therefore, we deemed it reasonable to aggregate all response data into the so-called Relative Health Factor and jointly analysed such mixed data, to obtain better statistical power. In the second part of our analysis, robust Bayesian and classical methods of analysis were applied to this combined dataset. In this part of our analysis, we selected different subranges of radon concentrations. In view of substantial differences between the methodology used by the authors of case-control and ecological studies, the mathematical relationships (models) were applied mainly to the thirty-two case-control studies. The degree to which the two ecological studies, analysed separately, affect the overall results when combined with the thirty-two case-control studies, has also been evaluated. In all, as a result of our meta-analysis of the combined cohort, we conclude that the analysed data concerning radon concentrations below ~1000 Bq/m3 (~20 mSv/year of effective dose to the whole body) do not support the thesis that radon may be a cause of any statistically significant increase in lung cancer incidence.

  15. Polymorphisms of VEGF and VEGF receptors are associated with the occurrence of ovarian hyperstimulation syndrome (OHSS)-a retrospective case-control study.

    Science.gov (United States)

    Nouri, Kazem; Haslinger, Peter; Szabo, Ladislaus; Sator, Michael; Schreiber, Martin; Schneeberger, Christian; Pietrowski, Detlef

    2014-01-01

    Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of IVF/ICSI therapy. The pathophysiology and etiology of the disease is still not fully clarified. To assess whether polymorphisms of the VEGF/VEGF-receptor system contribute to the occurrence of ovarian hyperstimulation syndrome (OHSS), we performed a retrospective analysis of 116 OHSS patients, and 124 female controls. The following SNPs were genotyped: Rs2071559 (VEGFR2-604); rs2305948 (VEGFR2-1192); rs1870377 (VEGFR2-1719); rs2010963 (VEGF-405); and rs111458691 (VEGFR1-519). Odds ratios (ORs) were estimated with a 95% confidence interval (CI). Linkage disequilibrium (LD) analysis was performed in the three loci of the VEGFR2 gene. We found an overrepresentation of the T allele of the VEGFR1-519 polymorphism in OHSS patients (P = 0.02, OR: 3.62, CI: 1.16 - 11.27). By genotype modeling, we found that polymorphism of VEGFR1-519 and VEGF-405 showed significant differences in patients and controls (p = 0.02, OR: 3.79 CI: 1.98 - 11.97 and p = 0.000005, OR: 0.29, CI: 0.17 - 0.50). LD analysis revealed significant linkage disequilibrium in VEGFR2. Polymorphisms in the VEGFR2 gene and in the VEGF gene are associated with the occurrence of OHSS. This strengthens the evidence for an important role of the VEGF/VEGF- receptor system in the occurrence of OHSS.

  16. Vitamin E Intake and Risk of Renal Cell Carcinoma: A Meta-Analysis of 7 Case-Control Studies.

    Science.gov (United States)

    Shang, Yonggang; Yi, Shanhong; Cui, Dong; Han, Guangwei; Liu, Chengcheng

    2015-07-01

    Vitamin E intake may reduce the risk of renal cell carcinoma, but the results were inconsistent. Hence, we conducted a meta-analysis to assess the association between dietary vitamin E intake and the risk of renal cell carcinoma. We searched PubMed to identify the relevant case-control studies up to June 2014. Reference lists of retrieved articles were also reviewed. Odds ratios and corresponding 95% confidence intervals were used to estimate the association between dietary vitamin E intake and the risk of renal cell carcinoma. We identified 7 case-control studies regarding dietary vitamin E intake and risk of renal cell carcinoma, involving 5789 cases and 14866 controls. The odds ratio of renal cell carcinoma for the highest compared with the lowest dietary vitamin E intake was 0.75 (95% confidence interval: 0.59-0.91), and heterogeneity was observed across studies. The association between dietary vitamin E intake and the risk of renal cell carcinoma was not significantly differed by gender, but this association were inconsistent in the North American and European populations. Our study provided a evidence that there was a significant inverse association of dietary vitamin E intake with risk of renal cell carcinoma. However, this finding was based on the case-control studies, more well-designed cohort studies are needed. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Chronic urinary tract infection and bladder carcinoma risk: a meta-analysis of case-control and cohort studies.

    Science.gov (United States)

    Akhtar, Saeed; Al-Shammari, Ahmad; Al-Abkal, Jarrah

    2018-02-05

    This meta-analysis of published case-control and cohort studies sought to quantify the magnitude and direction of association between chronic UTI (defined as the infection of the urinary tract that either does not respond to treatment or keeps recurring) and risk of bladder carcinoma (BCa) (i.e., including mainly urothelial carcinoma, squamous cell carcinoma or adenocarcinoma). A literature search was conducted using Medline, Embase, Ovid, Web of Science, Science Direct and Cochrane Library, which was supplemented with manual search of reference lists of the identified articles. Case-control and cohort studies examining UTI as a predictor of BCa risk published through June 2016 were eligible. Using random-effects models, odds ratios (OR) or relative risks (RR) from eligible studies were combined to synthesize summary effect estimates. The included studies were assessed for methodological quality and potential publication bias. Heterogeneity by study characteristics was examined by sub-group and meta-regression analyses. Eighteen case-control and three cohort studies published between 1963 and 2016 were eligible. Random-effects models showed that UTI was significantly associated with an increased BCa risk both in case-control studies (summary OR RE  = 2.33; 95% CI 1.86, 2.92) and cohort studies (summary RR RE  = 2.88; 95% CI 1.20, 6.89). The observed relationship of UTI with an increased BCa risk was independent of the study characteristics considered. No significant publication bias was detected. Chronic UTI was significantly and independently associated with an increased BCa risk. However, due to the presence of high between-study heterogeneity and inconsistent patterns of adjusted confounding effects, more data are needed to clarify the role of chronic UTI in causation of BCa and if established, prompt and effective treatment of UTI may minimize a substantial proportion of BCa risk.

  18. Opium consumption and risk of bladder cancer: A case-control analysis.

    Science.gov (United States)

    Hosseini, Seyyed Yousof; Safarinejad, Mohammad Reza; Amini, Erfan; Hooshyar, Hassan

    2010-01-01

    We evaluated the relationship between opium consumption and bladder cancer (BC) in a case-control study of an Iranian population. In a hospital-based case-control study of 179 patients with BC and 179 cancer-free controls frequency-matched by age, sex, and smoking status, we investigated the relationship between opium consumption and BC. A comprehensive epidemiologic interview was conducted on all participants to collect personal information, such as demographics and smoking status. Overall, we found significant age, sex, cigarette smoking adjusted association between BC risk and opium consumption, [odds ratio (OR) = 4.60; 95% confidence interval (CI) = 3.53-6.28]. The elevated risk was more evident in older individuals (OR = 5.42; 95% CI, 4.12-7.28) than younger individuals (OR = 3.65; 95% CI, 2.76-4.76) (P = 0.01). Heavy smokers with the opium consumption exhibited a 6-fold elevated risk for BC (OR = 6.16; 95% CI, 3.34-8.32) (P = 0.0001). When stratified according to different grades of BC, a 3.4-fold increased risk was associated with the opium consumption in grade III with an OR of 3.44 (95% CI, 2.82-8.28) (P = 0.001). A similar but slightly higher risk was also seen in case of grade IV tumors (OR = 3.86; 95% CI, 2.14-10.16) (P = 0.001). Invasive bladder tumors were more common among the opiates users (OR = 2.6; 95% CI, 1.44-5.42) (P = 0.01). Cumulative risk of BC in women with opium consumption (OR = 4.10 95% CI, 3.54-5.88) (P = 0.001) was slightly less than in men (OR = 5.10 95% CI, 3.54-5.88) (P = 0.0001). Based on Pearson correlations, the risk of BC significantly correlated with opium dependence duration (r = 0.74, P = 0.001), type of opiate used (r = 0.65, P = 0.001), and simultaneous cigarette smoking (r = 0.74, P = 0.0001). The results indicated that there is about 5-fold increase in risk of developing this cancer in the presence of opium consumption. Further research is needed to investigate the functional implications of the opium consumption in BC

  19. Fish intake and ovarian cancer risk: a meta-analysis of 15 case-control and cohort studies.

    Directory of Open Access Journals (Sweden)

    Pei-yue Jiang

    Full Text Available BACKGROUND: Previous epidemiological studies have shown that fish consumption may modify the risk of ovarian cancer. However, these studies yielded controversial results. The present meta-analysis was undertaken to evaluate the relationship between fish intake and ovarian cancer risk. METHODS: A literature search was carried out using Pubmed, Embase, and Cochrane Library Central database for all relevant studies up to August 2013. We pooled the relative risks (RR from individual studies using fixed-effect or random-effect model, and carried out heterogeneity and publication bias analyses. RESULTS: A total of 15 (ten case-control, and five cohort studies were included in the present meta-analysis, representing data for 889,033 female subjects and 6,087 ovarian cancer cases. We found that total fish intake was not significantly associated with the risk of ovarian cancer among cohort studies (RR = 1.04 95% CI [0.89, 1.22] as well as case-control studies (RR = 0.90, 95% CI [0.73,1.12]. There was no evidence of publication bias as suggested by Begg's test (P = 0.55 and Egger's test(P = 0.29. CONCLUSIONS: The present meta-analysis showed that total fish consumption was not significantly associated with the risk of ovarian cancer. Further analysis on different fish species and food preparation methods should be conducted in future studies.

  20. Ultrasound analysis of mental artery flow in elderly patients: a case-control study.

    Science.gov (United States)

    Baladi, Marina G; Tucunduva Neto, Raul R C M; Cortes, Arthur R G; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

    2015-01-01

    Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. This case-control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86-15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height.

  1. Expert Coaching in Weight Loss: Retrospective Analysis.

    Science.gov (United States)

    Painter, Stefanie Lynn; Ahmed, Rezwan; Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-03-13

    Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Participant's one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. ©Stefanie Lynn Painter, Rezwan Ahmed, Robert F Kushner, James O Hill, Richard Lindquist, Scott

  2. Expert Coaching in Weight Loss: Retrospective Analysis

    Science.gov (United States)

    Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-01-01

    Background Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. Objective The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. Methods A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Conclusions Participant’s one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. PMID:29535082

  3. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  4. Effect of a Multidisciplinary Outpatient Model of Care on Health Outcomes in Older Patients with Multimorbidity: A Retrospective Case Control Study.

    Directory of Open Access Journals (Sweden)

    Sepehr Shakib

    Full Text Available To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital.A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital. Controls were matched in a 4:1 ratio with cases for age, gender, index admission diagnosis and length of stay.Non-elective readmission rates, total readmission length of stay and overall survival.A total of 252 cases and 1008 control patients were included in the study. Despite the patients referred to the multidisciplinary model of care had slightly more comorbid conditions, significantly higher total length of hospital stay in the previous 12 months and increased prevalence of diabetes and heart failure by comparison to those who received usual care, they had significantly improved survival (adjusted hazard ratio 0.70 95% CI 0.51-0.96, p = 0.029 and no excess in the number of hospitalisations observed.Following discharge from hospital, holistic multidisciplinary outpatient management is associated with improved survival in older patients with multimorbidity. The findings of this study warrant further examination in randomised and cost-effectiveness trials.

  5. Non-corticosteroid risk factors of symptomatic avascular necrosis of bone in systemic lupus erythematosus: A retrospective case-control study.

    Science.gov (United States)

    Faezi, Seyedeh Tahereh; Hoseinian, Azam Sadat; Paragomi, Pedram; Akbarian, Mahmood; Esfahanian, Fatemeh; Gharibdoost, Farhad; Akhlaghi, Maassoumeh; Nadji, Abdolhadi; Jamshidi, Ahmad Reza; Shahram, Farhad; Nejadhosseinian, Mohammad; Davatchi, Fereydoun

    2015-07-01

    Avascular necrosis of bone (AVN) is an important complication of systemic lupus erythematosus (SLE). Corticosteroid therapy has been underlined as a main risk factor for osteonecrosis. However, AVN development in patients who have never received corticosteroid and the absence of AVN in the majority of the patients, who received corticosteroid, propose a role for non-corticosteroid risk factors in AVN development. This case-control study included two subsets: oral corticosteroid (66 AVN and 248 non-AVN patients) and pulse-therapy subset (39 AVN and 312 non-AVN patients) who have attended our Lupus clinic from 1979 to 2009. Patients received similar cumulative dose corticosteroid, equal maximum dose and 1-year maximum dose of corticosteroid. The demographic data (including sex, age of disease onset, age at the diagnosis of AVN), organs involvement, SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology-Damage index (SLICC/ACR-DI), number of disease flare ups were compared between two subsets. The mean age of SLE onset was younger (P value = 0.04) in the AVN patients. In oral corticosteroid subset, malar rash (P value AVN patients, whereas psychosis (P value = 0.03) was significantly more prevalent AVN subset in oral corticosteroid subset. In corticosteroid pulse subset, no significant difference in clinical features was noted. In oral corticosteroid subset, younger age of disease onset and psychosis were significantly associated with AVN, whereas malar rash and oral ulcer showed negative association AVN.

  6. Thyroid cancer among children and adolescents in Russia following the Chernobyl accident. Retrospective estimation of thyroid doses and case - control study

    International Nuclear Information System (INIS)

    Ivanov, V.K.; Pitkevich, V.A.; Chekin, S.Yu.

    2000-01-01

    residing of the population for determining the dynamic contamination of milk and greens; (4) multichamber model of the dairy for the 'Russian' cow adjusted on direct experimental data; (5) standard age dependent multichamber ICRP model of the man; (6) the data from the special questionnaire about changes of his (her) diet, origination of the meal and his (her) migration during May - July 1986; (7) results of reconstruction on the basis of direct thyroid radiometry for 28229 persons in Kaluga oblast and for 2967 persons in Bryansk oblast. The results of Odds Ratio, Relative Risk and Excess Relative Risk evaluations are discussed for the 1:2 matched case-control study and for the 1:4 matched case- control study. These two methods allow for different information on person's residence at the time of Chernobyl accident and bring out different results for risk evaluation. (author)

  7. The association between osteoporotic hip fractures and actinic lesions as a biomarker for cumulative sun exposure in older people-a retrospective case-control study in Argentina.

    Science.gov (United States)

    Perroud, H A; Dagatti, M S; Amigot, B; Levit, G P; Tomat, M F; Morosano, M E; Masoni, A M; Pezzotto, S M

    2017-05-01

    The aim of this study was to analyze the association between the presence of actinic lesions (solar keratosis and non-melanoma skin cancer) and osteoporotic hip fractures in older patients. Both pathologies are common conditions in this age group. Since cumulative sun exposure is difficult to quantify, the presence of actinic lesions can be used to indirectly analyze the association between ultraviolet radiation and osteoporotic hip fractures. This was an observational case-control study. We reviewed the centralized medical records of patients with hip fracture (cases, n = 51) and patients with other diseases hospitalized in the same institution and period (controls, n = 59). The mean age of the patients was 80 ± 8.3 years (range 50-103 years). Differences in maternal hip fracture history were found between cases and controls (14.8 and 8 %, respectively; p = 0.047). Falls history in the past year was higher in cases than in controls (p < 0.0001). Actinic lesions were observed in 32.7 % of patients (prevalence rate 23.5 % in cases, 40.7 % in controls; p = 0.04). When considering patients with actinic lesions, controls have a higher FRAX score compared with cases. Although sun exposure is recommended for bone health, it represents a risk factor for actinic lesions. The presence of actinic lesions may indicate a lower osteoporotic hip fracture risk. A balance between adequate lifetime sun exposure and protection against its adverse effects is required for each patient, in the context of geographic location.

  8. Analysis of the joint effects of radon exposure and smoking on lung cancer risk in three nested case-control studies in Europe

    International Nuclear Information System (INIS)

    Leuraud, Klervi; Laurier, Dominique; Schnelzer, Maria; Grosche, Bernd; Tomasek, Ladislav

    2008-01-01

    Full text: Objectives: Three case-control studies nested in the French (Fr), German (Ge) and Czech (Cz) cohorts of uranium miners were conducted in the frame of a European research Project, named Alpha-Risk, on the quantification of risks associated with multiple radiation exposures. These case-control studies aimed at assessing the effect of protracted radon exposure on lung cancer risk taking into account individual tobacco consumption. Material and methods: In the three case-control studies, cases were miners of the corresponding cohort who died of lung cancer (100, 704, 672 cases for the Fr, Ge and Cz study, respectively). For each case, controls were randomly matched on birth period and attained age at the time of death of the corresponding case (500, 1398 and 1491 controls for the Fr, Ge and Cz study, respectively). Cumulated radon exposure during employment was obtained from ambient and individual measurements for the Fr and Cz studies, and from a job exposure matrix for the Ge study. Smoking habits were retrospectively determined from medical archives and questionnaires applied in face-to-face interviews, phone calls or mailings. Analysis was performed by conditional logistic regression using a linear excess relative risk (ERR) model. A multiplicative model was fitted to assess the joint effect of radon exposure and smoking on lung cancer risk. Results: Smoking status was established for 62, 421, and 672 cases and 320, 620, and 1491 controls for the Fr, Ge, and Cz study, respectively. Two categories ('ever smokers' vs. 'never smokers') were defined. The percentages of 'ever-smokers' were 90%, 95%, and 92% for the cases and 73%, 75%, and 73% for the controls, for the Fr, Ge and Cz study, respectively. Mean five-year lagged cumulated radon exposures were 115, 717 and 174 working level months (WLM) for the cases, and 71, 505 and 118 WLM for the controls, for the Fr, Ge and Cz study, respectively. The excess relative risk per WLM (ERR/WLM) was 0.98% with a 95

  9. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Outcome in acromegaly: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2012-01-01

    Full Text Available Introduction: Many of the treatment modalities recommended for acromegaly are either too expensive or not available in large parts of India. There is a dearth of treatment and outcome data in Indian patients. Aims and Objectives: The purpose of this study was to analyze the treatment modalities used and the respective outcomes which include remission, recurrence, hypopituitarism, other complications, and mortality. Materials and Methods: This is a retrospective data analysis of 15 acromegaly patients treated at a tertiary care hospital in eastern India. A remission criteria of nadir growth hormone level <1 μg/dl after Oral Glucose tolerance test (OGTT and normal age related IGF-1 levels was used. Results: All patients (100% had macroadenomas. Surgery could not be done in five (33%; three (19.8% refused, two (13.2% had comorbidities. Transsphenoidal surgery (TSS achieved remission in four out of ten (40%. Conventional radiotherapy (CRT failed in all five patients and caused hypopituitarisn in three (60%. Cabergoline (CAB either alone or following surgery achieved remission in one out of four (25% though symptomatic relief and tolerability were remarkable. One patient (7% had pituitary apoplexy with remission, two patients (14.3% died due to CVA. Conclusions: TSS remains the treatment of choice in acromegaly, though in macroadenomas the success is limited. A sizeable proportion of patients refuse or are unfit for surgery. As most of the recommended options are very costly or unavailable, alternative treatment options generally used are CRT or CAB which have limited efficacy. Incidence of hypopituitarism, following CRT is very high.

  11. The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study.

    Science.gov (United States)

    Verzi, Anna Eliza; Quan, Victor L; Walton, Kara E; Martini, Mary C; Marghoob, Ashfaq A; Garfield, Erin M; Kong, Betty Y; Isales, Maria Cristina; VandenBoom, Timothy; Zhang, Bin; West, Dennis P; Gerami, Pedram

    2018-05-01

    Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi. We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions. Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) (P < .001). The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively. Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%. Focal central and peripheral SWSs were comparable in diagnostic significance. The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon. Diffuse SWSs correlated with greater breadth of deep fibroplasia than focal SWSs (P = .009), and SWSs correlated with greater Breslow depth among melanomas (P = .007). This study was retrospective. Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Retrospective Morphometric Analysis of the Infraorbital Foramen ...

    African Journals Online (AJOL)

    Objective: The aim of our study is to examine the morphometric characteristics of the infraorbital foramen (IOF) and its anatomic localization by using conebeam computerized tomography (CBCT). Materials and Methods: In our study, the anatomic characteristics of the IOF were identified by studying retrospectively the CBCT ...

  13. A retrospective case-control study of modifiable risk factors and cutaneous markers in Indian patients with young coronary artery disease

    Directory of Open Access Journals (Sweden)

    Amitesh Aggarwal

    2012-06-01

    Full Text Available Objective Indians have the highest risk rates for coronary artery disease (CAD among all ethnic groups. There is a paucity of data on the risk factors and clinical markers associated with premature CAD. We aimed to determine whether young CAD is due to preventable lifestyle-related factors and cutaneous clinical markers are useful in identifying at-risk patients. Design Single-centre retrospective study. Setting Tertiary care center. Participants A total of 292 patients (age ≤40 years who presented with acute CAD between January 2005 and June 2009 and 92 age, and gender-matched controls. Major outcome measures Details of smoking, family history of premature CAD, waist size, blood sugar and lipid profile. Clinical evidence of arcus juvenilis, premature greying of hair and premature baldness sought. Results Dyslipidaemia (91%, smoking (74.3%, low high-density lipoprotein cholesterol (HDL-C (68.9%, central obesity (47.7% and greying of hair (34.9% were the most commonly associated factors. Compared with male patients, females had greater prevalence of dyslipidaemia, low HDL-C, central obesity, hypertension, diabetes and family history of premature CAD. The presence of cutaneous markers was significantly associated with premature CAD. Conclusions CAD in young Indian people is multifactorial; dyslipidaemia, low HDL-C, smoking, hypertension, central obesity and family history of premature CAD are the most common risk factors. Smoking in men and central obesity in women are the most prevalent factors. Clinicians should be highly suspicious of patients with presence of cutaneous markers, and they should be followed intensively for lifestyle modifications.

  14. Regularized rare variant enrichment analysis for case-control exome sequencing data.

    Science.gov (United States)

    Larson, Nicholas B; Schaid, Daniel J

    2014-02-01

    Rare variants have recently garnered an immense amount of attention in genetic association analysis. However, unlike methods traditionally used for single marker analysis in GWAS, rare variant analysis often requires some method of aggregation, since single marker approaches are poorly powered for typical sequencing study sample sizes. Advancements in sequencing technologies have rendered next-generation sequencing platforms a realistic alternative to traditional genotyping arrays. Exome sequencing in particular not only provides base-level resolution of genetic coding regions, but also a natural paradigm for aggregation via genes and exons. Here, we propose the use of penalized regression in combination with variant aggregation measures to identify rare variant enrichment in exome sequencing data. In contrast to marginal gene-level testing, we simultaneously evaluate the effects of rare variants in multiple genes, focusing on gene-based least absolute shrinkage and selection operator (LASSO) and exon-based sparse group LASSO models. By using gene membership as a grouping variable, the sparse group LASSO can be used as a gene-centric analysis of rare variants while also providing a penalized approach toward identifying specific regions of interest. We apply extensive simulations to evaluate the performance of these approaches with respect to specificity and sensitivity, comparing these results to multiple competing marginal testing methods. Finally, we discuss our findings and outline future research. © 2013 WILEY PERIODICALS, INC.

  15. Diabetes an inducing factor for dental caries: A case control analysis in Jammu.

    Science.gov (United States)

    Singh, Iqbal; Singh, Paramjeet; Singh, Amarpreet; Singh, Tara; Kour, Robindera

    2016-01-01

    Diabetes mellitus (DM) is a common chronic disease and it has emerged as a major health-care problem. There are more chances of dentinal caries among diabetics than nondiabetics. DM is responsible for causing ascendancy in the proportion and activity of saliva that impacts the oral health. The objective of the present study is to evaluate the impact of various factors present in saliva on tooth decay amid type-II DM in Jammu. The subjects in our analysis comprises of 50 patients with type-II DM and 50 controls within the age group of 30-60 years. Diabetic status was assessed by estimating random blood glucose levels. Dental findings were recorded using modified World Health Organization (WHO) Oral health survey-basic method 2013. Salivary samples from all the subjects were collected and sent to the laboratory for interpretation of pH, flow rate, and salivary calcium. The analysis of salivary components decayed tooth was carried using analysis of variance (ANOVA) and Pearson's correlation test. All the parameters were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 20.0. The results have shown a significantly lower values of salivary pH, flow rate, and calcium levels in diabetics than in nondiabetics. Within the limits of the present study, the results indicated that patients with type-II DM have high rate of dental caries and are at high risk of caries development. The decline in the salivary components will reduce capability of supporting the mineral compartment of tooth structure to resist the demineralization process by cariogenic potentials thereby creating a favorable environment for caries progression.

  16. Statin treatment and functional outcome after ischemic stroke: case-control and meta-analysis.

    Science.gov (United States)

    Biffi, Alessandro; Devan, William J; Anderson, Christopher D; Cortellini, Lynelle; Furie, Karen L; Rosand, Jonathan; Rost, Natalia S

    2011-05-01

    Multiple studies suggest that statin use before acute ischemic stroke is associated with improved functional outcome. However, available evidence is conflicting, and several published reports are limited by small sample sizes. We therefore investigated the effect of antecedent use of statins on stroke outcome by performing a meta-analysis of all results from published studies as well as our own unpublished data. We performed a systematic literature search and meta-analysis of studies investigating the association between prestroke statin use and clinical outcome and included additional data from 126 prestroke statin users and 767 nonusers enrolled at our institution. A total of 12 studies, comprising 2013 statin users and 9682 nonusers, was meta-analyzed using a random effects model. We also meta-analyzed results for individual Trial of ORG 10172 in Acute Stroke Treatment stroke subtypes to determine whether the effect of statin use differed across subtypes using the Breslow-Day test. Meta-analysis of all available data identified an association between prestroke statin use and improved functional outcome (OR, 1.62; 95% CI, 1.39 to 1.88), but we uncovered evidence of publication bias. The effect of statin use on functional outcome was found to be larger for small vessel strokes compared with other subtypes (Breslow-Day P=0.008). Antecedent use of statins is associated with improved outcome in patients with acute ischemic stroke. This association appears to be stronger in patients with small vessel stroke subtype. However, evidence of publication bias in the existing literature suggests these findings should be interpreted with caution.

  17. Wellness coaching and health-related quality of life: a case-control difference-in-differences analysis.

    Science.gov (United States)

    Menon, Jyothi; Paulet, Mindy; Thomas, Joseph

    2012-10-01

    Association between wellness coaching and changes in health-related quality of life over 1 year and 2 years was assessed. Difference-in-differences analysis of covariance assessed association between coaching and change in 8-item short-form health survey (SF-8) summary scores. Ordered logistic models assessed coaching and change in SF-8 individual domain scores. This was a case-control study. Participants in at least one coaching program were more likely to have increases in social functioning after 1 year and less likely to have increases in role physical after 2 years. Participants in nutrition coaching had more positive change in mental component summary scores after 1 year. Participants in stress management had more negative change in mental component summary scores after 1 year and after 2 years and had more negative change in physical component summary scores after 2 years. Findings were mixed regarding association between coaching and change in health-related quality of life.

  18. Retinal Nerve Fiber Layer Thickness Changes in the Pseudoexfoliation Syndrome: A Meta-Analysis of Case-Control Studies.

    Science.gov (United States)

    Yu, Ji-Guo; Huang, Qing; Zhou, Xiao-Fang; Ding, Yi; Li, Jing; Xiang, Yi

    2018-01-01

    To evaluate and compare changes in retinal nerve fiber layer (RNFL) thickness in patients with the pseudoexfoliation syndrome (PXS) and healthy controls. Case-control studies were selected through an electronic search of the Cochrane Controlled Trials Register, PubMed, and Embase. Results were reviewed to ensure that the included studies met prespecified inclusion/exclusion criteria, and the quality of each study was assessed using the Newcastle-Ottawa Scale. All included studies measured average and 4-quadrant (temporal, superior, nasal, and inferior) RNFL thickness using optical coherence tomography (OCT). For the continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence intervals (CIs). Eight case-control studies were included in this meta-analysis involving 225 eyes of PXS patients and 208 eyes of healthy controls in total. Statistical analysis revealed that the average RNFL thickness in PXS patients was significantly reduced compared to healthy controls (WMD = -6.91, 95% CI: -9.99 to -3.82, p < 0.0001). Additionally, differences in RNFL thickness in the superior quadrant (WMD = -10.68, 95% CI: -16.40 to -4.95, p = 0.0003), inferior quadrant (WMD = -8.20, 95% CI: -10.85 to -5.55, p < 0.00001), nasal quadrant (WMD = -3.05, 95% CI: -5.21 to -0.90, p = 0.005), and temporal quadrant (WMD = -6.39, 95% CI: -9.98 to -2.80, p = 0.0005) were all significant between the two groups. These results suggest that it is important to evaluate RNFL thickness and the optic nerve head through OCT in patients with PXS in order to determine early glaucomatous damage and start timely intervention prior to visual field loss. © 2017 S. Karger AG, Basel.

  19. High Spicy Food Intake and Risk of Cancer: A Meta-analysis of Case-control Studies.

    Science.gov (United States)

    Chen, Yu-Heng; Zou, Xiao-Nong; Zheng, Tong-Zhang; Zhou, Qi; Qiu, Hui; Chen, Yuan-Li; He, Mei; Du, Jia; Lei, Hai-Ke; Zhao, Ping

    2017-09-20

    Studies on the association between spicy food intake and cancer risk have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies. PubMed, EMBASE, and the Cochrane Library were searched for eligible publications. Combined odds ratios (OR s) with their 95% confidence interval (CI) were calculated using a random- or fixed-effects model. The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale (NOS). All data were analyzed using STATA 11.0 software (version 11.0; StataCorp., College Station, TX, USA). Subgroup analyses were also performed with stratification by region, sex, number of cases, cancer subtype, source of the control group, and NOS score. A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis (7884 patients with cancer and 10,142 controls). Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 (95% CI = 1.35-2.29) in spite of significant heterogeneity (P cases, different sources of the control group, and high-quality articles (NOS score of ≥ 7). However, no statistically significant association was observed for women, esophageal cancer, gallbladder cancer, or low-quality articles (NOS score of case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity. More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.

  20. Can statistic adjustment of OR minimize the potential confounding bias for meta-analysis of case-control study? A secondary data analysis.

    Science.gov (United States)

    Liu, Tianyi; Nie, Xiaolu; Wu, Zehao; Zhang, Ying; Feng, Guoshuang; Cai, Siyu; Lv, Yaqi; Peng, Xiaoxia

    2017-12-29

    Different confounder adjustment strategies were used to estimate odds ratios (ORs) in case-control study, i.e. how many confounders original studies adjusted and what the variables are. This secondary data analysis is aimed to detect whether there are potential biases caused by difference of confounding factor adjustment strategies in case-control study, and whether such bias would impact the summary effect size of meta-analysis. We included all meta-analyses that focused on the association between breast cancer and passive smoking among non-smoking women, as well as each original case-control studies included in these meta-analyses. The relative deviations (RDs) of each original study were calculated to detect how magnitude the adjustment would impact the estimation of ORs, compared with crude ORs. At the same time, a scatter diagram was sketched to describe the distribution of adjusted ORs with different number of adjusted confounders. Substantial inconsistency existed in meta-analysis of case-control studies, which would influence the precision of the summary effect size. First, mixed unadjusted and adjusted ORs were used to combine individual OR in majority of meta-analysis. Second, original studies with different adjustment strategies of confounders were combined, i.e. the number of adjusted confounders and different factors being adjusted in each original study. Third, adjustment did not make the effect size of original studies trend to constringency, which suggested that model fitting might have failed to correct the systematic error caused by confounding. The heterogeneity of confounder adjustment strategies in case-control studies may lead to further bias for summary effect size in meta-analyses, especially for weak or medium associations so that the direction of causal inference would be even reversed. Therefore, further methodological researches are needed, referring to the assessment of confounder adjustment strategies, as well as how to take this kind

  1. Reduced Serum Level of Interleukin-10 is Associated with Cerebral Infarction: A Case-Control and Meta-Analysis Study.

    Science.gov (United States)

    Zhu, Yifei; Yang, Haiqing; Diao, Zengyan; Li, Yi; Yan, Chuanzhu

    2016-05-01

    IL-10 expression limits inflammation and restricts the size of CNS damage from stroke. In this study, we examined the correlation between cerebral infarction (CI) and serum levels of interleukin-10 (IL-10) using a combination of case-control study and meta-analysis of published data, with an aim of understanding the relevance of serum IL-10 levels to CI development. This study enrolled a total of 169 CI patients admitted to the Second Hospital of Hebei Medical University between May 2011 and November 2014. During the same period, a group of 145 individuals were recruited at the same hospital as healthy controls after thorough physical examination. Serum IL-10 levels were measured by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 (IBM, 2010, Chicago, IL, USA) and Comprehensive Meta-Analysis 2.0 (CMA 2.0) software were used for data analysis. Serum levels of IL-10 (pg/mL) were significantly lower in CI patients when compared to healthy controls (15.36 ± 3.21 vs. 21.64 ± 5.17, t = 13.12, P 0.05). Logistic regression analysis indicated that, with the exception of triglyceride (TG) and uric acid (UA) levels (both P > 0.05), the other seven parameters, including fasting blood glucose (FPG), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), creatinine (Cr), systolic blood pressure (SBP), and diastolic blood pressure (DBP), strongly correlated with CI development (all P analysis of pooled data from nine case-control studies revealed an inverse correlation between the serum IL-10 levels and CI (SMD = 1.797, 95% CI 0.785~2.810, P = 0.001). Subgroup analysis based on country showed that low serum levels of IL-10 may be the major risk factor for CI in Croatia (SMD = 2.961, 95% CI 2.480~3.443, P analysis based on ethnicity showed that IL-10 serum levels and CI displayed negative relationship in Asians (SMD = 2.522, 95% CI 0.468~4.576, P = 0.016) but not in Caucasians (P > 0.05). Our study provided convincing evidence that the patients

  2. [Retrospective analysis of 44 childhood drowning accidents].

    Science.gov (United States)

    Brüning, Caroline; Siekmeyer, Werner; Siekmeyer, Manuela; Merkenschlager, Andreas; Kiess, Wieland

    2010-07-01

    Worldwide, drowning is the second leading cause of unintentional death and the leading cause of cardiovascular failure for children [1-3]. The number of near-drownings, where the incident is survived for at least 24 hours, is assumed to be four times as high [5]. In the years 1994 until 2008 there were 44 cases of drowning treated at the children's department of the University of Leipzig. This number shows that even in a medical centre drowning incidents are only occasional incidents. Therefore it is important to know the sequelae and handlings to be able to react in case of an emergency. A total of 44 children suffering a drowning accident within the last 48 hours who were treated during the period of 01.01.1994 through 30.06.2008 at the Children's Centre at the University of Leipzig. A retrospective analysis using a structured questionnaire was done. Social demographic data, accident progress, clinical results and progress as well as outcome of the cases were investigated. During the analysed period in the median three children were treated each year after drowning incidents. Clustering in the summer and winter months and on the weekends was recognizable. The median age was 3.33 years and the group of high risk were children aged 1-3 years, especially boys. Sixty percent of the children came from stable social backgrounds. Half of the children suffered from drowning in created swimming pools or ponds, the rest in natural waters, public pools and sources of water in the household. The median submersion lasted 2 minutes. Correlation of submersions below 1 minute with a good, and submersions above 10 minutes with a negative outcome was shown. A Glasgow Coma Scale (GCS) of 3 points (n = 15) and pupils without light reaction (n = 14) were associated with a lethal outcome or residual neurological deficits. Looking at the laboratory values, correlation between severe acidotic pH-values with a very low base excess, high blood sugar as well as high lactate values and a

  3. Space-Time Analysis of Testicular Cancer Clusters Using Residential Histories: A Case-Control Study in Denmark

    Science.gov (United States)

    Sloan, Chantel D.; Nordsborg, Rikke B.; Jacquez, Geoffrey M.; Raaschou-Nielsen, Ole; Meliker, Jaymie R.

    2015-01-01

    Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population. PMID

  4. Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

    Directory of Open Access Journals (Sweden)

    Chantel D Sloan

    Full Text Available Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297 were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs. Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish

  5. Space-time analysis of testicular cancer clusters using residential histories: a case-control study in Denmark.

    Science.gov (United States)

    Sloan, Chantel D; Nordsborg, Rikke B; Jacquez, Geoffrey M; Raaschou-Nielsen, Ole; Meliker, Jaymie R

    2015-01-01

    Though the etiology is largely unknown, testicular cancer incidence has seen recent significant increases in northern Europe and throughout many Western regions. The most common cancer in males under age 40, age period cohort models have posited exposures in the in utero environment or in early childhood as possible causes of increased risk of testicular cancer. Some of these factors may be tied to geography through being associated with behavioral, cultural, sociodemographic or built environment characteristics. If so, this could result in detectable geographic clusters of cases that could lead to hypotheses regarding environmental targets for intervention. Given a latency period between exposure to an environmental carcinogen and testicular cancer diagnosis, mobility histories are beneficial for spatial cluster analyses. Nearest-neighbor based Q-statistics allow for the incorporation of changes in residency in spatial disease cluster detection. Using these methods, a space-time cluster analysis was conducted on a population-wide case-control population selected from the Danish Cancer Registry with mobility histories since 1971 extracted from the Danish Civil Registration System. Cases (N=3297) were diagnosed between 1991 and 2003, and two sets of controls (N=3297 for each set) matched on sex and date of birth were included in the study. We also examined spatial patterns in maternal residential history for those cases and controls born in 1971 or later (N= 589 case-control pairs). Several small clusters were detected when aligning individuals by year prior to diagnosis, age at diagnosis and calendar year of diagnosis. However, the largest of these clusters contained only 2 statistically significant individuals at their center, and were not replicated in SaTScan spatial-only analyses which are less susceptible to multiple testing bias. We found little evidence of local clusters in residential histories of testicular cancer cases in this Danish population.

  6. Operative outcome of liver resections for hepatocellular carcinoma: Retrospective case control study of a twelve-years pioneer experience in the Sudan

    Directory of Open Access Journals (Sweden)

    Osama Mohamed Elsanousi

    Full Text Available Introduction: Modern liver surgery in the Sudan started at our institution, The National Ribat University Hospital, in 2002. This study aimed to assess the perioperative events of hepatocellular carcinoma (HCC resection in our institution during the period January 2002 to December 2013 compared to hepatectomies for benign liver pathologies. Methods: The medical records of 114 patients subjected to hepatectomy were divided into the HCC group (cases, and benign group (controls. The characteristics and perioperative events of both groups were assessed and compared. Results: The mean age of the HCC patients was 58.6 ± 7.7 years. The majority of liver resections in the HCC group were minor (72.7%. The mean intraoperative blood loss was 918.8 ml in the HCC group and 720 ml in benign resections group and the difference between them was not significant, p = 0.129. The mean operative duration of HCC resection was 4 hours. The major postoperative complications were encountered in 16 patients (36.4% in the HCC group. HCC group thirty-day postoperative mortality was 9.1%, (n = 4 patients while no patient of the benign group (n = 60 died within that duration, p = .030. Logistic regression multivariate analysis revealed massive bleeding as an independent predictor for major postoperative morbidity, Odds ratio [OR] = 5.899, 95%, Confidence Interval [95% CI], 1.129–30.830, p = .035. Discussion: Our results revealed outcome parameters comparable with the international reports. Conclusion: Further improvements in hepatic surgery in general, and HCC in particular is inevitable. Keywords: Outcomes, Hepatocellular carcinoma, Liver

  7. Epstein-Barr virus is associated with periodontal diseases: A meta-analysis based on 21 case-control studies.

    Science.gov (United States)

    Gao, Zilong; Lv, Juan; Wang, Min

    2017-02-01

    Some controversies still exist between the detection of Epstein-Barr virus (EBV)'s DNA and risks of periodontal diseases. Hence, a comprehensive meta-analysis on all available literatures was performed to clarify the relationship between EBV and preidontitis.A comprehensive search was conducted within the PUBMED, EMBASE, and WANFANG databases up to October 10th, 2016 according to inclusion and exclusion criteria and finally 21 case-control literatures were obtained. The outcomes including odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. Publication bias was determined by Begg or Egger test. Sensitivity analysis was used to investigate reliability and stability of the results.According to the data from included trials, the association between overall increased risks of periodontitis and the detection of EBV was significant (OR = 6.199, 95% CI = 3.119-12.319, P disease-type analysis, the pooled ORs for chronic periodontitis and aggressive periodontitis were 6.586 (95% CI = 3.042-14.262, P diseases. SgP and tissue are available for detecting EBV in patients of periodontitis. At last, our results suggest that detecting EBV of samples in =5 (6) mm sites of periodontal pockets are more sensitive than in ≤3-mm sites.

  8. A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study.

    Science.gov (United States)

    Johal, Ama; Chaggar, Amrit; Zou, Li Fong

    2018-03-01

    The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. Significant detectable differences were found in the surface facial features of developing Class III subjects.

  9. The RTEL1 rs6010620 polymorphism and glioma risk: a meta-analysis based on 12 case-control studies.

    Science.gov (United States)

    Du, Shu-Li; Geng, Ting-Ting; Feng, Tian; Chen, Cui-Ping; Jin, Tian-Bo; Chen, Chao

    2014-01-01

    The association between the RTEL1 rs6010620 single nucleotide polymorphism (SNP) and glioma risk has been extensively studied. However, the results remain inconclusive. To further examine this association, we performed a meta-analysis. A computerized search of the PubMed and Embase databases for publications regarding the RTEL1 rs6010620 polymorphism and glioma cancer risk was performed. Genotype data were analyzed in a meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess the association. Sensitivity analyses, tests of heterogeneity, cumulative meta-analyses, and assessments of bias were performed in our meta-analysis. Our meta-analysis confirmed that risk with allele A is lower than with allele G for glioma. The A allele of rs6010620 in RTEL1 decreased the risk of developing glioma in the 12 case-control studies for all genetic models: the allele model (OR=0.752, 95%CI: 0.715-0.792), the dominant model (OR=0.729, 95%CI: 0.685-0.776), the recessive model (OR=0.647, 95%CI: 0.569-0.734), the homozygote comparison (OR=0.528, 95%CI: 0.456-0.612), and the heterozygote comparison (OR=0.761, 95%CI: 0.713-0.812). In all genetic models, the association between the RTEL1 rs6010620 polymorphism and glioma risk was significant. This meta-analysis suggests that the RTEL1 rs6010620 polymorphism may be a risk factor for glioma. Further functional studies evaluating this polymorphism and glioma risk are warranted.

  10. Falls from height: A retrospective analysis.

    Science.gov (United States)

    Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Güven, Taner; Gür, Ali; Gürbüz, Sükrü

    2018-01-01

    Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

  11. Occupational exposures to solvents and lead as risk factors for Alzheimer's disease: A collaborative re-analysis of case-control studies

    NARCIS (Netherlands)

    A.B. Graves; C.M. van Duijn (Cornelia); V. Chandra; L. Fratiglioni (Laura); A. Heyman; A.F. Jorm; E. Kokmen (Emre); K. Kondo; J.A. Mortimer; W.A. Rocca; S.L. Shalat; H. Soininen; A. Hofman (Albert)

    1991-01-01

    textabstractA meta-analysis, involving the secondary analysis of original data from 11 case-control studies of Alzheimer's disease, is presented for occupational exposures to solvents and lead. Three studies had data on occupational exposure to solvents. Among cases, 21.3% were reported to have been

  12. The association of lifetime physical inactivity with head and neck cancer: a hospital-based case-control analysis.

    Science.gov (United States)

    Platek, Alexis J; Cannioto, Rikki A; Etter, John Lewis; Kim, Jae; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; Callahan, Emily; Khachatryan, Edgar; Nagy, Ryan; Minlikeeva, Albina; Brian Szender, J; Singh, Anurag K; Danziger, Iris; Moysich, Kirsten B

    2017-10-01

    Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR = 2.73, 95% CI 1.87-3.99, p physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.

  13. Analysis of new lactotransferrin gene variants in a case-control study related to periodontal disease in dog.

    Science.gov (United States)

    Morinha, Francisco; Albuquerque, Carlos; Requicha, João; Dias, Isabel; Leitão, José; Gut, Ivo; Guedes-Pinto, Henrique; Viegas, Carlos; Bastos, Estela

    2012-04-01

    The molecular and genetic research has contributed to a better understanding of the periodontal disease (PD) in humans and has shown that many genes play a role in the predisposition and progression of this complex disease. Variations in human lactotransferrin (LTF) gene appear to affect anti-microbial functions of this molecule, influencing the PD susceptibility. PD is also a major health problem in small animal practice, being the most common inflammatory disease found in dogs. Nevertheless, the research in genetic predisposition to PD is an unexplored subject in this species. This work aims to contribute to the characterization of the genetic basis of canine PD. In order to identify genetic variations and verify its association with PD, was performed a molecular analysis of LTF gene in a case-control approach, including 40 dogs in the PD cases group and 50 dogs in the control group. In this study were detected and characterized eight new single nucleotide variations in the dog LTF gene. Genotype and allele frequencies of these variations showed no statistically significant differences between the control and PD cases groups. Our data do not give evidence for the contribution of these LTF variations to the genetic background of canine PD. Nevertheless, the sequence variant L/15_g.411C > T leads to an aminoacid change (Proline to Leucine) and was predicted to be possibly damaging to the LTF protein. Further investigations would be of extreme value to clarify the biological importance of these new findings.

  14. Neurocysticercosis in Nepal: a retrospective clinical analysis

    Directory of Open Access Journals (Sweden)

    Rajeev Ojha

    2015-01-01

    Full Text Available Aim: The prevalence of epilepsy is higher in Nepal. This study was conducted to analyze the clinical manifestations of neurocysticercosis (NCC among seizure patients admitted to our center. Methods: We retrospectively studied all the NCC patients admitted to Neurology Department, Bir Hospital, Kathmandu, Nepal from April 2012 to February 2014. Computer tomography/magnetic resonance imaging (CT/MRI head, clinical profile, lab investigations and exclusion of other causes were the basis of the NCC diagnosis. Chi-square and Student′s t-test were used for comparison of variables. Results: Out of 131 seizure patients admitted, 21 patients were diagnosed with NCC (mean age: 33.95 ± 16.41; male: 15 (71.4%, female: 6 (28.6%. Generalized tonic clonic seizure was the most common seizure type in NCC patients (18 patients; 85.7%, two of them had status epilepticus during presentation in Emergency Department. Three patients had focal seizure, one with epilepsia partialis continua. Neuroimaging showed multiple NCC lesions in 8 (38.1% and a single NCC lesion in 13 (61.9% patients. Seven of them (33.3% sought traditional healers before being presented to our center. Eight patients (38.1% were treated with antiepileptics in local health-post without neuroimaging studies done. Calcified stage of NCC was the most frequent CT/MRI findings (12 patients; 57.1%. Phenytoin was preferred both by physicians and patients due to its low cost. Conclusion: NCC is a common finding among seizure patients in Nepal. Poor economic status, illiteracy and underdeveloped rural society are the major challenges in prevention and treatment of NCC.

  15. Association between polymorphism within interleukin related genes and Graves' disease: a meta-analysis of 22 case-control studies

    Science.gov (United States)

    Zeng, Tianshu; Cai, Xiong; Kong, Wen

    2017-01-01

    Graves’ disease (GD) is a common autoimmune disorder with a genetic predisposition. There is strong evidence to suggest that both Th1 and Th2 circulating cytokines are involved in the development of GD. In this study, we conducted a meta-analysis to assess the impact of seven variations of five IL-related genes on the susceptibility to GD. A total of 22 case-control studies involving 5338 GD patients and 6446 healthy controls were included. The results showed that only one SNP rs1800795 in IL-6 was significantly associated with GD in homozygous model (CC vs. GG: OR = 2.714, 95% CI = 1.047–7.039, p = 0.04), heterozygous model (CG vs. GG: OR = 1.295, 95% CI = 1.013–1.655, p = 0.039), dominant model (CC+CG vs. GG: OR = 1.418, 95% CI = 1.122–1.793, p = 0.003) and additive model (C vs. G: OR = 1.432, 95% CI = 1.087–1.886, p = 0.011).To explain the heterogeneity, we performed the subgroup analysis by ethnicity. The ethnicity stratification revealed that the association between rs1800795 and GD tended to be much stronger for Asian than European population in homozygous, dominant, recessive, and additive models. The remaining 6 SNPs in 4 genes did not show any significant association with GD in any genetic models. Together, our data support that rs1800795 within the IL-6 gene confers genetic susceptibility for GD. Future large-scale studies are required to validate the associations between IL-6 and others IL-related genes and GD. PMID:29228744

  16. Association of functional MMP-2 gene variant with intracranial aneurysms: case-control genetic association study and meta-analysis.

    Science.gov (United States)

    Alg, Varinder S; Ke, Xiayi; Grieve, Joan; Bonner, Stephen; Walsh, Daniel C; Bulters, Diederik; Kitchen, Neil; Houlden, Henry; Werring, David J

    2018-01-15

    Abnormalities in Matrix Metalloproteinase (MMP) genes, which are important in extracellular matrix (ECM) maintenance and therefore arterial wall integrity are a plausible underlying mechanism of intracranial aneurysm (IA) formation, growth and subsequent rupture. We investigated whether the rs243865 C > T SNP (single nucleotide polymorphism) within the MMP-2 gene (which influences gene transcription) is associated with IA compared to matched controls. We conducted a case-control genetic association study, adjusted for known IA risk factors (smoking and hypertension), in a UK Caucasian population of 1409 patients with intracranial aneurysms (IA), and 1290 matched controls, to determine the association of the rs243865 C > T functional MMP-2 gene SNP with IA (overall, and classified as ruptured and unruptured). We also undertook a meta-analysis of two previous studies examining this SNP. The rs243865 T allele was associated with IA presence in univariate (OR 1.18 [95% CI 1.04-1.33], p = .01) and in multi-variable analyses adjusted for smoking and hypertension status (OR 1.16 [95% CI 1.01-1.35], p = .042). Subgroup analysis demonstrated an association of the rs243865 SNP with ruptured IA (OR 1.18 [95% CI 1.03-1.34] p = .017), but, not unruptured IA (OR 1.17 [95% CI 0.97-1.42], p = .11). Our study demonstrated an association between the functional MMP-2 rs243865 variant and IAs. Our findings suggest a genetic role for altered extracellular matrix integrity in the pathogenesis of IA development and rupture.

  17. Case-control studies on the relationship between onchocerciasis and epilepsy: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Christoph Kaiser

    Full Text Available OBJECTIVE: A systematic review and meta-analysis of all available case-control studies on the relationship between onchocerciasis and epilepsy. Because age and level of onchocerciasis endemicity in the area of residence are major determinants for infection, an additional analysis was performed, restricted to studies achieving control of these confounding factors. DATA SOURCES: Medical databases, the "African Neurology Database, Institute of Neuroepidemiology and Tropical Neurology, Limoges," reference lists of relevant articles, commercial search engines, up to May 2012. METHODS: We searched for studies examining infection status with Onchocerca volvulus in persons with epilepsy (PWE and without epilepsy (PWOE providing data suitable for the calculation of pooled odds ratios (ORp and/or standardized mean differences (SMD using random-effects models. RESULTS: Eleven studies providing data of qualitative skin biopsies for diagnosis of onchocerciasis were identified. Combined analysis on the total sample of 876 PWE and 4712 PWOE resulted in an ORp of 2.49 (95% confidence interval (95%CI: 1.61-3.86, p<0.001. When this analysis was restricted to those studies achieving control for age, residence and sex (367 PWE, 624 PWOE, an ORp of 1.29 (95% CI: 0.93-1.79; p = 0.139 was found. Presence of nodules for diagnosis of onchocerciasis was analyzed in four studies (225 PWE, 189 PWOE; ORp 1.74; 95%CI: 0.94-3.20; p<0.076, including two studies of the restricted analysis (106 PWE, 106 PWOE; ORp 2.81; 95%CI: 1.57-5.00; p<0.001. One study examined quantitative microfilariae counts in patients without preceding microfilaricidal treatment and demonstrated significantly higher counts in PWE than in PWOE. INTERPRETATION: Our results strengthen the hypothesis that, in onchocerciasis foci, epilepsy and infection with O. volvulus are associated. Analysis of indicators giving information on infection intensity, namely nodule palpation and quantitative microfilaria

  18. A case-control analysis on the association between erectile dysfunction and sudden sensorineural hearing loss in Taiwan.

    Science.gov (United States)

    Keller, Joseph J; Chen, Yi-Kuang; Lin, Herng-Ching

    2012-05-01

    Although the cause of sudden sensorineural hearing loss (SSNHL) is yet to be elucidated, many theories have been proposed regarding potentially contributory etiologies. One increasingly well-supported theory purports an underlying vascular pathomechanism. If this is the case, SSNHL may also associate with conditions comorbid with vascular diseases, such as erectile dysfunction (ED). However, no studies to date have investigated the association between ED and SSNHL. This study set out to estimate a putative association between ED and having been previously diagnosed with SSNHL using a population-based dataset with a case-control design. This study used administrative claim data from the Taiwan National Health Insurance program. We identified 4,504 patients with ED as the study group and randomly selected 22,520 patients as the comparison group. Conditional logistic regression was used to examine the association between ED and having previously received a diagnosis of SSNHL. The prevalence and risk of SSNHL between cases and controls were calculated. Of the sampled patients, 41 (0.15%) had been diagnosed with SSNHL before the index date; 22 (0.49% of the cases) were from the study group and 19 (0.08% of controls) were from the control group. Conditional logistic regression analysis revealed that after adjusting for the patient's monthly income, geographic location, hypertension, diabetes, hyperlipidemia, coronary heart disease, obesity, and alcohol abuse/alcohol dependence syndrome status, patients with ED were more likely than controls to have been diagnosed with SSNHL before the index date (odds ratio = 6.06, 95% confidence interval = 3.25-11.29). There was an association between ED and prior SSNHL. The results of this study add to the evidence supporting an underlying vascular pathomechanism regarding the development of SSNHL and highlight a need for clinicians dealing with SSNHL patients to be alert to the development of ED. © 2012 International Society for

  19. Risk analysis of leukaemia incidence among people living along the Techa River: a nested case-control study

    International Nuclear Information System (INIS)

    Ostroumova, E; Gagniere, B; Laurier, D; Gudkova, N; Krestinina, L; Verger, P; Hubert, P; Bard, D; Akleyev, A; Tirmarche, M; Kossenko, M

    2006-01-01

    Large quantities of radioactive materials released over time from the Mayak nuclear weapons facility caused significant internal and external exposure for people living along the banks of the Techa River (Southern Urals, Russia). We conducted a nested case-control study in the Extended Techa River Cohort to determine whether the risk of leukaemia incidence increased with protracted exposure to ionising radiation or with other non-radiation risk factors. The study included 83 cases identified over 47 years of follow-up and 415 controls matched for sex, age at diagnosis, age (within a 5 year age group), and date of initial residence in the riverside area. External and internal doses have been calculated using the Techa River Dosimetry System 1996 (TRDS96). Conditional logistic regression was used to calculate odds ratios per Gray (OR/Gy) and 95% confidence intervals (95% CI). After excluding cases of chronic lymphoid leukaemia, the OR/Gy of total, external, and internal doses were 4.6 (95% CI: 1.7-12.3), 7.2 (95%CI: 1.7-30.0) and 5.4 (95%CI: 1.1-27.2), respectively. A history of solid tumour, either malignant or benign, before the leukaemia diagnosis was associated with a 2.5-fold increase in the leukaemia risk (95% CI: 1.1-5.9). Even though the analysis of confounders was less useful than expected because of missing data, multivariate analyses that took the exposure dose into account confirmed the association between leukaemia incidence and tumour history

  20. Familial aggregation of Alzheimer's disease and related disorders: A collaborative re-analysis of case-control studies

    NARCIS (Netherlands)

    C.M. van Duijn (Cornelia); D.G. Clayton (David); V. Chandra; L. Fratiglioni (Laura); A.B. Graves; A. Heyman; A.F. Jorm; E. Kokmen (Emre); K. Kondo; J.A. Mortimer; W.A. Rocca; S.L. Shalat; H. Soininen; A. Hofman (Albert)

    1991-01-01

    textabstractCase-control studies of Alzheimer's disease were re-analysed to examine the association of Alzheimer's disease with family history in first degree relatives of dementia, Down's syndrome and Parkinson's disease. Overall, the relative risk of Alzheimer's disease for those with at least one

  1. Risk factors for Alzheimer's disease: Overview of the EURODEM collaborative re-analysis of case-control studies

    NARCIS (Netherlands)

    C.M. van Duijn (Cornelia); Th. Stijnen (Theo); A. Hofman (Albert)

    1991-01-01

    textabstractStudies of risk factors for Alzheimer's disease have been hampered by low statistical power. The data from 11 case-control studies were pooled and re-analysed to evaluate the evidence for the association of Alzheimer's disease with family history of dementia and related disorders,

  2. Source attribution of human salmonellosis using a meta-analysis of case-control studies of sporadic infections

    DEFF Research Database (Denmark)

    Coutinho Calado Domingues, Ana Rita; Pires, Sara Monteiro; Hisham Beshara Halasa, Tariq

    2012-01-01

    Salmonella is an important cause of human illness. Disease is frequently associated with foodborne transmission, but other routes of exposure are recognized. Identifying sources of disease is essential for prioritizing public health interventions. Numerous case-control studies of sporadic salmone...

  3. Risk factors for campylobacteriosis of chicken, ruminant, and environmental origin: a combined case-control and source attribution analysis

    NARCIS (Netherlands)

    Mughini Gras, L.|info:eu-repo/dai/nl/413306046; Smid, J.H.|info:eu-repo/dai/nl/313996458; Wagenaar, J.A.|info:eu-repo/dai/nl/126613354; de Boer, A.G.; Havelaar, A.H.|info:eu-repo/dai/nl/072306122; Friesema, I.H.M.; French, N.P.; Busani, L.; van Pelt, W.

    2012-01-01

    BACKGROUND Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs

  4. Risk Factors for Campylobacteriosis of Chicken, Ruminant, and Environmental Origin: A Combined Case-Control and Source Attribution Analysis

    NARCIS (Netherlands)

    Gras, L.M.; Smid, J.H.; Wagenaar, J.A.; Boer, de A.G.; Havelaar, A.H.; Friesema, I.H.M.; French, N.P.; Busani, L.; Pelt, van W.

    2012-01-01

    Background: Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs

  5. Interleukin 1 beta gene and risk of schizophrenia: detailed case-control and family-based studies and an updated meta-analysis.

    Science.gov (United States)

    Shibuya, Masako; Watanabe, Yuichiro; Nunokawa, Ayako; Egawa, Jun; Kaneko, Naoshi; Igeta, Hirofumi; Someya, Toshiyuki

    2014-01-01

    Interleukin-1 beta (IL-1β) has been implicated in the pathophysiology of schizophrenia. To assess whether the IL1B gene confers increased susceptibility to schizophrenia, we conducted case-control and family-based studies and an updated meta-analysis. We tested the association between IL1B and schizophrenia in 1229 case-control and 112 trio samples using 12 markers, including common tagging single nucleotide variations (SNVs) and a rare non-synonymous variation detected by resequencing the coding regions. We also performed a meta-analysis of rs16944 using a total of 8724 case-control and 201 trio samples from 16 independent populations. We found no significant associations between any of the 12 SNVs examined and schizophrenia in either case-control or trio samples. Moreover, our meta-analysis results showed no significant association between the common SNV, rs16944, and schizophrenia. The present study does not support a role for IL1B in schizophrenia susceptibility.

  6. VIM-positive Pseudomonas aeruginosa in a large tertiary care hospital: matched case-control studies and a network analysis.

    Science.gov (United States)

    Voor In 't Holt, Anne F; Severin, Juliëtte A; Hagenaars, Margot B H; de Goeij, Inge; Gommers, Diederik; Vos, Margreet C

    2018-01-01

    Emergence of multidrug-resistant Pseudomonas aeruginosa is of global concern. We aimed to identify epidemiological relationships, the most common way of transmission, and risk factors for presence of Verona Integron-encoded Metallo-β-lactamase (VIM)-positive P. aeruginosa (VIM-PA). We conducted a network analysis and matched case-control studies (1:2:2). Controls were hospital-based and matched with cases for ward, day of admission (control group 1 and 2) and time between admission and the identification of VIM-PA (control group 1). The network was visualized using Cytoscape, and risk factors were determined using conditional logistic regression. Between August 2003 and April 2015, 144 case patients and 576 control patients were recruited. We identified 307 relationships in 114 out of these 144 patients, with most relationships (84.7%) identified at the same department ratio [OR] = 4.40, 95% confidence interval [CI] = 2.00 to 9.65 and OR = 2.47; 95% CI = 1.12 to 5.49), > 10 day use of selective digestive tract decontamination (SDD) (OR = 2.97; 95% CI = 1.02 to 8.68 and OR = 4.61; 95% CI = 1.22 to 17.37), and use of quinolones (OR = 3.29; 95% CI = 1.34 to 8.10 and OR = 3.95; 95% CI = 1.13 to 13.83 and OR = 4.47; 95% CI = 1.75 to 11.43) were identified as risk factors when using both control groups. The network analysis indicated that the majority of transmissions occurred on the wards, but through unidentified and presumably persistent sources, which are most likely in the innate hospital environment. Previous use of certain antibiotic regimens made patients prone to VIM-PA carriage. Additionally, gastroscopy could be considered as a high-risk procedure in patients with risk factors. Our results add to the growing body of evidence that infection control measures targeting VIM-PA should be focused on reducing antibiotics and eliminating sources in the environment.

  7. Xeroderma pigmentosum group D polymorphisms and esophageal cancer susceptibility: a meta-analysis based on case-control studies.

    Science.gov (United States)

    Yang, Rong; Zhang, Chong; Malik, Armah; Shen, Zhi-Da; Hu, Jian; Wu, Yi-He

    2014-11-28

    To clarify the effects of the xeroderma pigmentosum group D (XPD) Asp312Asn and Lys751Gln gene polymorphisms on the risk of esophageal cancer (EC). A computerised literature search was conducted to identify the relevant studies from the PUBMED and EMBASE databases, reviews, and reference lists of relevant articles. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the associations between the XPD Asp312Asn and/or Lys751Gln polymorphisms and EC susceptibility. Statistical analyses were performed using the software Stata 12.0. A fixed or random effects model was selected based on a heterogeneity test. Publication bias was estimated using funnel plots and Egger's linear regression method. Subgroup analyses were performed based on histological type and ethnicity. Thirteen case-control studies with a total of 10 comparisons for the Asp312Asn polymorphism, including 2373 cases and 3175 controls, and 15 comparisons for the Lys751Gln polymorphism, including 3226 cases and 5237 controls, were recruited for the meta-analysis. In terms of the XPD Asp312Asn polymorphism, significantly increased EC risks were identified in the Asp/Asn vs Asp/Asp comparison (OR = 1.17, 95%CI: 1.02-1.33, P = 0.03) and in the dominant-model comparison (Asn/Asn+Asp/Asn vs Asp/Asp: OR = 1.18, 95%CI: 1.04-1.34, P = 0.01). However, no significant associations were found in the Asn/Asn vs Asp/Asp comparison (OR = 1.30, 95%CI: 1.00-1.70, P = 0.05) or in the recessive-model comparison (Asn/Asn vs Asp/Asn + Asp/Asp: OR = 1.17, 95%CI: 0.91-1.50, P = 0.22). In terms of the XPD Lys751Gln polymorphism, a significant association with EC susceptibility was found under the recessive model (Gln/Gln vs Lys/Gln+Lys/Lys: OR = 1.21, 95%CI: 1.02-1.43, P = 0.03). However, no associations were identified in the other comparisons (co-dominant model: Lys/Gln vs Lys/Lys: OR = 1.11, 95%CI: 0.94-1.31, P = 0.20; Gln/Gln vs Lys/Lys: OR = 1.31, 95%CI: 0.98-1.75, P = 0.07; dominant model: OR = 1.14, 95%CI

  8. 69-74 A Retrospective Analysis of Prescribing Prac

    African Journals Online (AJOL)

    user

    A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four. Selected Hospitals of West ... Key words: World Health Organization, prescribing indicators, rational drug use. INTRODUCTION. Indicators of ... factors, the risk of irrational prescribing could raise several folds. Irrational use of ...

  9. Prevalence of breast tuberculosis: Retrospective analysis of 65 ...

    African Journals Online (AJOL)

    Prevalence of breast tuberculosis: Retrospective analysis of 65 patients attending a tertiary hospital in Durban, South Africa. ... Breast tuberculosis (BTB) is uncommon, but not rare. Knowledge of the ways in which it can ... Fine-needle aspiration cytology had sensitivity of only 28% compared with 94% for histology. Of those ...

  10. A retrospective analysis of ultrasound-guided large core needle ...

    African Journals Online (AJOL)

    A retrospective analysis of ultrasound-guided large core needle biopsies of breast lesions at a regional public hospital in Durban, KwaZulu-Natal, South Africa. ... Objective: To assess the influence of technical variables on the diagnostic yield of breast specimens obtained by using US-LCNB, and the sensitivity of detecting ...

  11. Breast cancer metastasis to thyroid: a retrospective analysis.

    African Journals Online (AJOL)

    Objective: Retrospective analysis of data from breast cancer patients with thyroid metastasis (TM). Methods: The ... parenchyma with gathering of calcification that reduced in size, revealing the sensitiveness of TM to chemotherapy. Conclusion: US ..... patients.16-18. Most common sites of primary tumors are renal cell car-.

  12. A retrospective analysis of blood gases with two different insulin ...

    African Journals Online (AJOL)

    A retrospective analysis of blood gases with two different insulin infusion protocols in patients undergoing cardiovascular surgery. ... In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb). Materials and Methods: We collected data from ...

  13. Foliar nutrient analysis of sugar maple decline: retrospective vector diagnosis

    Science.gov (United States)

    Victor R. Timmer; Yuanxin Teng

    1999-01-01

    Accuracy of traditional foiiar analysis of nutrient disorders in sugar maple (Acer saccharum Marsh) is limited by lack of validation and confounding by nutrient interactions. Vector nutrient diagnosis is relatively free of these problems. The technique is demonstrated retrospectively on four case studies. Diagnostic interpretations consistently...

  14. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis.

    Science.gov (United States)

    Marty, Francisco M; Ostrosky-Zeichner, Luis; Cornely, Oliver A; Mullane, Kathleen M; Perfect, John R; Thompson, George R; Alangaden, George J; Brown, Janice M; Fredricks, David N; Heinz, Werner J; Herbrecht, Raoul; Klimko, Nikolai; Klyasova, Galina; Maertens, Johan A; Melinkeri, Sameer R; Oren, Ilana; Pappas, Peter G; Ráčil, Zdeněk; Rahav, Galia; Santos, Rodrigo; Schwartz, Stefan; Vehreschild, J Janne; Young, Jo-Anne H; Chetchotisakd, Ploenchan; Jaruratanasirikul, Sutep; Kanj, Souha S; Engelhardt, Marc; Kaufhold, Achim; Ito, Masanori; Lee, Misun; Sasse, Carolyn; Maher, Rochelle M; Zeiher, Bernhardt; Vehreschild, Maria J G T

    2016-07-01

    Mucormycosis is an uncommon invasive fungal disease with high mortality and few treatment options. Isavuconazole is a triazole active in vitro and in animal models against moulds of the order Mucorales. We assessed the efficacy and safety of isavuconazole for treatment of mucormycosis and compared its efficacy with amphotericin B in a matched case-control analysis. In a single-arm open-label trial (VITAL study), adult patients (≥18 years) with invasive fungal disease caused by rare fungi, including mucormycosis, were recruited from 34 centres worldwide. Patients were given isavuconazole 200 mg (as its intravenous or oral water-soluble prodrug, isavuconazonium sulfate) three times daily for six doses, followed by 200 mg/day until invasive fungal disease resolution, failure, or for 180 days or more. The primary endpoint was independent data review committee-determined overall response-ie, complete or partial response (treatment success) or stable or progressive disease (treatment failure)-according to prespecified criteria. Mucormycosis cases treated with isavuconazole as primary treatment were matched with controls from the FungiScope Registry, recruited from 17 centres worldwide, who received primary amphotericin B-based treatment, and were analysed for day-42 all-cause mortality. VITAL is registered with ClinicalTrials.gov, number NCT00634049. FungiScope is registered with ClinicalTrials.gov, number NCT01731353. Within the VITAL study, from April 22, 2008, to June 21, 2013, 37 patients with mucormycosis received isavuconazole for a median of 84 days (IQR 19-179, range 2-882). By day 42, four patients (11%) had a partial response, 16 (43%) had stable invasive fungal disease, one (3%) had invasive fungal disease progression, three (8%) had missing assessments, and 13 (35%) had died. 35 patients (95%) had adverse events (28 [76%] serious). Day-42 crude all-cause mortality in seven (33%) of 21 primary-treatment isavuconazole cases was similar to 13 (39%) of 33

  15. Occupational Lifting Tasks and Retinal Detachment in Non-Myopics and Myopics: Extended Analysis of a Case-control Study

    OpenAIRE

    Mattioli, Stefano; Curti, Stefania; De Fazio, Rocco; Cooke, Robin Mt; Zanardi, Francesca; Bonfiglioli, Roberta; Farioli, Andrea; Violante, Francesco S.

    2012-01-01

    Objectives: Lifting heavy weights involves the Valsalva manoeuvre, which leads to intraocular pressure spikes. We used data from a case-control study to further investigate the hypothesis that occupational lifting is a risk factor for retinal detachment. Methods: The study population included 48 cases (patients operated for retinal detachment) and 84 controls (outpatients attending an eye clinic). The odds ratios (OR) of idiopathic retinal detachment were estimated with a logistic regressi...

  16. Higher blood 25(OHD level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies.

    Directory of Open Access Journals (Sweden)

    Peizhan Chen

    Full Text Available Experimental data suggest a protective effect of vitamin D on breast cancer; however, epidemiologic results remain inclusive. With a Chinese population-based case-control study and meta-analysis of the observational studies, we here systematically evaluated the association of blood 25(OHD level and breast cancer risk. With 593 breast cancer cases and 580 cancer-free controls from Shanghai, China, we found that 80% of the normal women had severe vitamin D deficiency (less than 20 ng/mL and 15.2% had mild deficiency (20 to 30 ng/mL and only 4.8% of women had sufficient vitamin D level (>30 ng/mL while the proportion was 96.1%, 3.2% and 0.7% respectively for the breast cancer patients. Compared to those with the lowest quartile of plasma 25(OHD level, women with highest quartile 25(OHD level showed a significant decreased breast cancer risk (Q4 vs.Q1: OR = 0.10, 95% CI = 0.06-0.15 and every 1 ng/ml increment of plasma 25(OHD level led to a 16% lower odds of breast cancer (OR = 0.84, 95% CI = 0.81-0.87; P<0.001. From the meta-analysis of the observational studies, we found that women with highest quantile of blood 25(OHD level was associated with a significantly reduced breast cancer risk compared to those with lowest quantile of blood 25(OHD level for the 11 nested case-control and retrospective studies (pooled OR = 0.86, 95% CI = 0.75-1.00 and 10 case-control studies (7 population based, OR = 0.35, 95% CI = 0.24-0.52; 3 hospital based, OR = 0.08, 95% CI = 0.02-0.33. These results suggest that vitamin D may have a chemo-preventive effect against breast cancer.

  17. Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Corbella, Stefano; Taschieri, Silvio; Francetti, Luca; De Siena, Francesca; Del Fabbro, Massimo

    2012-07-01

    Periodontal disease is a highly prevalent group of illnesses of microbial etiology, whose consequence is a severe breakdown of tooth-supporting structures. A link between periodontal infection and several systemic conditions, among which adverse pregnancy outcomes, has been suggested in the recent years. The aim of this review based on case-control studies was to evaluate if periodontal disease could be considered as a risk factor for preterm birth, low birth-weight and preterm low birth-weight. An electronic search (via Pubmed) was performed for case-control studies investigating the relationship between periodontal disease and adverse pregnancy outcomes. From the initially retrieved 417 articles, 17 case-control studies, accounting for a total of 10,148 patients, were included in the review and in the meta-analysis. The estimated odds ratio was 1.78 (CI 95%: 1.58, 2.01) for preterm birth, 1.82 (CI 95%: 1.51, 1.20) for low birth-weight and 3.00 (CI 95%: 1.93, 4.68) for preterm low birth-weight. Despite the results of the analysis of pooled data suggested a link between periodontal diseases and adverse pregnancy outcomes, the presence of important confounders, whose effect could not be addressed, prevents a validation of the meta-analysis outcomes. Further more accurate investigations based on individual data analysis could give a better insight into the topic of the present review.

  18. Cost analysis of iliac stenting performed in the operating room and the catheterization lab: A case-control study.

    Science.gov (United States)

    Kim, Sooyeon; Kramer, Sage P; Dugan, Adam J; Minion, David J; Gurley, John C; Davenport, Daniel L; Ferraris, Victor A; Saha, Sibu P

    2016-12-01

    Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures. Immediate and two-year outcomes were observed. Patient demographics, perioperative details, physician billings, and hospital costs were recorded. Multivariable regression was used to adjust costs by patient and perioperative cost drivers. Fifty-one procedures (49%) were performed in the OR and 54 (51%) in the CL. Mean age was 57, and 44% were female. Severe cases were more often performed in the OR (RC ≥ 4; 42% vs. 11%, P costs (P costs (P costs but was associated with increased professional fees. Same-stay (5%) and post-discharge reintervention (33%) did not vary by location. The OR was associated with increased length of stay, more ICU admissions, and increased total costs. However, OR patients had more severe disease and therefore often required more aggressive intervention. After controlling for these differences, procedure venue per se was not associated with increased costs, but OR cases incurred increased professional fees due to dual-provider charges. Given the similar clinical results between venues, it seems reasonable to perform most stenting in the CL or utilize conscious sedation in the OR. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Association of atrial fibrillation and cancer: Analysis from two large population-based case-control studies.

    Science.gov (United States)

    Saliba, Walid; Rennert, Hedy S; Gronich, Naomi; Gruber, Stephen B; Rennert, Gad

    2018-01-01

    An association between atrial fibrillation (AF) and risk of cancer has been suggested in several studies, including prospective cohort studies. However, the magnitude and the temporal nature of this association remain unclear. Data from two large prospective population-based case-control studies, the Molecular Epidemiology of Colorectal Cancer (MECC, n = 8,383) and the Breast Cancer in Northern Israel Study (BCINIS, n = 11,608), were used to better understand the nature and temporality of a possible association between cancer diagnosis and AF events before and after cancer diagnosis. A case-control study approach was employed to study prior AF as a risk factor for cancer, and a cohort study approach was employed to study incident cancer as a risk factor for AF. AF was associated with a significant reduced odds of cancer as reflected in the case-control approach, with an adjusted OR = 0.77 (95% CI, 0.65-0.91), while cancer was not found to be significantly associated with elevated risk of AF in the cohort approach, with an adjusted HR = 1.10 (0.98-1.23). The immediate period (90 days) after an AF event was associated with a 1.85 times increased risk of cancer, and the immediate period after the diagnosis of cancer was associated with a 3.4 fold increased risk of AF. These findings probably reflect both the effect of acute transient conditions associated with new cancer diagnosis and detection bias. Similar results were identified with colorectal and breast cancer cases. Atrial fibrillation of longer than 90 days duration is associated with reduced odds of new cancer diagnosis. The results of this study suggest that an association observed in prior research may be due to instances related to cancer diagnosis and detection bias rather than a causal relationship. However, there may be bias in the sampling and residual confounding that distort the associations.

  20. Survival benefit of TIPS versus serial paracentesis in patients with refractory ascites: a single institution case-control propensity score analysis

    International Nuclear Information System (INIS)

    Gaba, R.C.; Parvinian, A.; Casadaban, L.C.; Couture, P.M.; Zivin, S.P.; Lakhoo, J.; Minocha, J.; Ray, C.E.; Knuttinen, M.G.; Bui, J.T.

    2015-01-01

    Aim: To compare the impact of covered stent-graft transjugular intrahepatic portosystemic shunt (TIPS) versus serial paracentesis on survival of patients with medically refractory ascites. Materials and methods: In this retrospective study, cirrhotic patients who underwent covered stent-graft TIPS for refractory ascites from 2003–2013 were compared with similar patients who underwent serial paracentesis during 2009–2013. Demographic and liver disease data, Model for End-Stage Liver Disease (MELD) scores, and survival outcomes were obtained from hospital electronic medical records and the social security death index. After propensity score weighting to match study group characteristics, survival outcomes were compared using Kaplan–Meier statistics with log-rank analysis. Results: Seventy TIPS (70% men, mean age 55.7 years, mean MELD 15.1) and 80 paracentesis (58% men, mean age 53.5 years, mean MELD 22.5) patients were compared. The TIPS haemodynamic success rate was 100% (mean portosystemic pressure gradient reduction 13 mmHg). Paracentesis patients underwent a mean of 7.9 procedures. After propensity score weighting to balance group features, TIPS patients showed a trend toward enhanced survival compared with paracentesis patients (median survival 1037 versus 262 days, p = 0.074). TIPS conferred a significant increase or trend toward improved survival compared with paracentesis at 1 (66% versus 44%, p = 0.018), 2 (56% versus 38%, p = 0.057), and 3 year (49% versus 32%, p = 0.077) time points. Thirty and 90 day mortality rates were not statistically increased by TIPS. Conclusion: Covered stent-graft TIPS improves intermediate- to long-term survival without significantly increasing short-term mortality of ascites patients, and suggests a greater potential role for TIPS in properly selected ascitic patients when medical management fails. - Highlights: • The survival benefit of TIPS for patients with refractory ascites remains unproven. • A case-control

  1. Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis.

    Science.gov (United States)

    Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

    2015-03-01

    Between April and June, 2012, a reactive cholera vaccination campaign was done in Haiti with an oral inactivated bivalent whole-cell vaccine. We aimed to assess the effectiveness of the vaccine in a case-control study and to assess the likelihood of bias in that study in a bias-indicator study. Residents of Bocozel or Grand Saline who were eligible for the vaccination campaign (ie, age ≥12 months, not pregnant, and living in the region at the time of the vaccine campaign) were included. In the primary case-control study, cases had acute watery diarrhoea, sought treatment at one of three participating cholera treatment units, and had a stool sample positive for cholera by culture. For each case, four control individuals who did not seek treatment for acute watery diarrhoea were matched by location of residence, enrolment time (within 2 weeks of the case), and age (1-4 years, 5-15 years, and >15 years). Cases in the bias-indicator study were individuals with acute watery diarrhoea with a negative stool sample for cholera. Controls were selected in the same manner as in the primary case-control study. Trained staff used standard laboratory procedures to do rapid tests and stool cultures from study cases. Participants were interviewed to collect data on sociodemographic characteristics, risk factors for cholera, and self-reported vaccination. Data were analysed by conditional logistic regression, adjusting for matching factors. From Oct 24, 2012, to March 9, 2014, 114 eligible individuals presented with acute watery diarrhoea and were enrolled, 25 of whom were subsequently excluded. 47 participants were analysed as cases in the vaccine effectiveness case-control study and 42 as cases in the bias-indicator study. 33 (70%) of 47 cholera cases self-reported vaccination versus 167 (89%) of 188 controls (vaccine effectiveness 63%, 95% CI 8-85). 27 (57%) of 47 cases had certified vaccination versus 147 (78%) of 188 controls (vaccine effectiveness 58%, 13-80). Neither self

  2. Volumetric changes and peri-implant health at implant sites with or without soft tissue grafting in the esthetic zone, a retrospective case-control study with a 5-year follow-up.

    Science.gov (United States)

    Bienz, Stefan P; Jung, Ronald E; Sapata, Vitor M; Hämmerle, Christoph H F; Hüsler, Jürg; Thoma, Daniel S

    2017-11-01

    To evaluate the volumetric changes and peri-implant health at implant sites with and without previous soft tissue grafting over a 5-year observation period. In 18 partially edentulous patients, dental implants were placed in the esthetic zone (15-25) with simultaneous guided bone regeneration, followed by submerged healing. During the healing phase, eight patients (test) received a subepithelial connective tissue graft, whereas 10 patients (control) did not receive any soft tissue augmentation. Subsequently, abutment connection was performed and final reconstructions were inserted. Impressions were taken 1 week after crown insertion and at 5 years. Obtained casts were scanned and superimposed for volumetric and linear measurements. The mean distance (MD) in the mid-buccal area between the two surfaces and the differences in buccal marginal mucosal level (bMML change ) and in ridge width (RW change ) were evaluated. Peri-implant health was assessed using probing pocket depth (PPD) values, plaque index (PlI) and bleeding on probing (BOP). At a median follow-up time of 60.5 months a median MD of -0.38 mm (Min: -0.94; Max: -0.03) (test) and of -0.51 mm (Min: -0.76; Max: 0.05) (control) was calculated. The level of the margo mucosae (bMML change ) demonstrated a median loss of -0.42 mm (Min: -1.1; Max: -0.01) (test) and of -0.33 mm (Min: -1.02; Max: 0.00) (control). The median RW change ranged between -0.44 mm and -0.73 mm (test) and between -0.49 mm and -0.54 mm (control). Mean PPD values slightly increased, whereas PlI and BOP remained stable over time in both groups. None of the comparisons between the groups revealed statistically significant differences (P > 0.35). A small sample size must be considered, however. Limited by a retrospective case-control study design, implant sites with and without soft tissue grafting on the buccal side revealed only minimal volumetric and linear changes and stability of peri-implant parameters over 5 years. © 2017

  3. Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

    Science.gov (United States)

    Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

    2015-01-01

    Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

  4. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  5. Risk Factors for Campylobacteriosis of Chicken, Ruminant, and Environmental Origin: A Combined Case-Control and Source Attribution Analysis

    Science.gov (United States)

    Wagenaar, Jaap A.; de Boer, Albert G.; Havelaar, Arie H.; Friesema, Ingrid H. M.; French, Nigel P.; Busani, Luca; van Pelt, Wilfrid

    2012-01-01

    Background Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs because of cross-contamination. Human Campylobacter infections can be attributed to specific reservoirs by estimating the extent of subtype sharing between strains from humans and reservoirs using multilocus sequence typing (MLST). Methodology/Principal Findings We investigated risk factors for human campylobacteriosis caused by Campylobacter strains attributed to different reservoirs. Sequence types (STs) were determined for 696 C. jejuni and 41 C. coli strains from endemic human cases included in a case-control study. The asymmetric island model, a population genetics approach for modeling Campylobacter evolution and transmission, attributed these cases to four putative animal reservoirs (chicken, cattle, sheep, pig) and to the environment (water, sand, wild birds) considered as a proxy for other unidentified reservoirs. Most cases were attributed to chicken (66%) and cattle (21%), identified as the main reservoirs in The Netherlands. Consuming chicken was a risk factor for campylobacteriosis caused by chicken-associated STs, whereas consuming beef and pork were protective. Risk factors for campylobacteriosis caused by ruminant-associated STs were contact with animals, barbecuing in non-urban areas, consumption of tripe, and never/seldom chicken consumption. Consuming game and swimming in a domestic swimming pool during springtime were risk factors for campylobacteriosis caused by environment-associated STs. Infections with chicken- and ruminant-associated STs were only partially explained by food-borne transmission; direct contact and environmental pathways were also important. Conclusion/Significance This is the first case-control study in which risk factors for

  6. Risk factors for campylobacteriosis of chicken, ruminant, and environmental origin: a combined case-control and source attribution analysis.

    Directory of Open Access Journals (Sweden)

    Lapo Mughini Gras

    Full Text Available BACKGROUND: Campylobacteriosis contributes strongly to the disease burden of food-borne pathogens. Case-control studies are limited in attributing human infections to the different reservoirs because they can only trace back to the points of exposure, which may not point to the original reservoirs because of cross-contamination. Human Campylobacter infections can be attributed to specific reservoirs by estimating the extent of subtype sharing between strains from humans and reservoirs using multilocus sequence typing (MLST. METHODOLOGY/PRINCIPAL FINDINGS: We investigated risk factors for human campylobacteriosis caused by Campylobacter strains attributed to different reservoirs. Sequence types (STs were determined for 696 C. jejuni and 41 C. coli strains from endemic human cases included in a case-control study. The asymmetric island model, a population genetics approach for modeling Campylobacter evolution and transmission, attributed these cases to four putative animal reservoirs (chicken, cattle, sheep, pig and to the environment (water, sand, wild birds considered as a proxy for other unidentified reservoirs. Most cases were attributed to chicken (66% and cattle (21%, identified as the main reservoirs in The Netherlands. Consuming chicken was a risk factor for campylobacteriosis caused by chicken-associated STs, whereas consuming beef and pork were protective. Risk factors for campylobacteriosis caused by ruminant-associated STs were contact with animals, barbecuing in non-urban areas, consumption of tripe, and never/seldom chicken consumption. Consuming game and swimming in a domestic swimming pool during springtime were risk factors for campylobacteriosis caused by environment-associated STs. Infections with chicken- and ruminant-associated STs were only partially explained by food-borne transmission; direct contact and environmental pathways were also important. CONCLUSION/SIGNIFICANCE: This is the first case-control study in which risk

  7. The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis.

    Science.gov (United States)

    Cannioto, Rikki; Etter, John Lewis; Guterman, Lauren Beryl; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; LaMonte, Michael J; Nagy, Ryan; Minlikeeva, Albina; Szender, James Brian; Moysich, Kirsten B

    2017-08-01

    Recreational physical inactivity has been gaining recognition as an independent epidemiological exposure of interest in relation to cancer endpoints due to evidence suggesting that it may associate with cancer independent of obesity. In the current analyses, we examined the associations of lifetime recreational physical inactivity with renal and bladder cancer risk. In this hospital-based case-control study, we identified N=160 renal cancer patients, N=208 bladder cancer patients, and N=766 age frequency-matched controls without cancer. Participants self-reporting never participating in any regular/weekly recreational physical activity throughout their lifetime were classified as physically inactive. Utilizing unconditional multivariable logistic regression analyses, we estimated odds ratios and 95% confidence intervals to represent the associations between lifetime physical inactivity and renal and bladder cancer risk. In multivariable logistic regression models, we observed significant positive associations between lifetime recreational physical inactivity and renal cancer and bladder cancer risk: odds ratio=1.77 (95% CI: 1.10-2.85) and odds ratio=1.73 (95% CI: 1.13-2.63), respectively. Similar associations also persisted among individuals who were not obese for both renal and bladder cancer: odds ratio=1.75 (95% CI: 1.03-2.98) and odds ratio=1.70 (95% CI: 1.08-2.69), respectively. In this case-control study, we observed evidence of a positive association between renal and bladder cancer with lifetime recreational physical inactivity. These data add to the growing body of evidence suggesting that physical inactivity may be an important independent risk factor for cancer. However, additional studies using a larger sample and prospectively collected data are needed to substantiate the current findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Retrospective Analysis of Studying Psychological Nature of Creativity

    Directory of Open Access Journals (Sweden)

    N V Artjushkina

    2013-12-01

    Full Text Available The creativity phenomenon analysis in the works of the domestic and foreign scientists is presented in this article. The authors focus their special attention on the factors of creativity manifestation during the various periods of ontogenesis and on the characteristic of the conditions necessary for the formation of a creative personality. On the basis of the retrospective analysis and the synthesis of the conceptual approaches to studying the parameters of creativity, the criteria by which it is possible to determine the level of the development of the creative personality are revealed.

  9. Is intravesical instillation of hyaluronic acid and chondroitin sulfate useful in preventing recurrent bacterial cystitis? A multicenter case control analysis

    OpenAIRE

    Giorgio Gugliotta; Gloria Calagna; Giorgio Adile; Salvatore Polito; Salvatore Saitta; Patrizia Speciale; Stefano Palomba; Antonino Perino; Roberta Granese; Biagio Adile

    2015-01-01

    Objective: Urinary tract infections (UTIs) are common in the female population and, over a lifetime, about half of women have at least one episode of UTI requiring antibiotic therapy. The aim of the current study was to compare two different strategies for preventing recurrent bacterial cystitis: intravesical instillation of hyaluronic acid (HA) plus chondroitin sulfate (CS), and antibiotic prophylaxis with sulfamethoxazole plus trimethoprim. Materials and methods: This was a retrospective...

  10. Update on the effect of exogenous hormone use on glioma risk in women: a meta-analysis of case-control and cohort studies.

    Science.gov (United States)

    Lan, Yu-Long; Wang, Xun; Lou, Jia-Cheng; Ma, Bin-Bin; Xing, Jin-Shan; Zou, Shuang; Zhang, Bo

    2018-04-01

    Various studies have confirmed the important roles of endogenous hormones in the development of gliomas, while the roles of exogenous hormones remain controversial. Based on case-control studies and cohort studies, a meta-analysis was exerted to explore the effect of two exogenous hormones use (HRT: hormone replacement therapy; OC: oral contraceptives) on glioma risk. 16 eligible studies, including 11 case-control studies and 5 cohort studies, containing 8055027 women, were included in our study. All included studies have reported the relative risks (RRs) or odds ratios (ORs), and 95% confidence intervals (CIs). We use the fixed-effects model to calculate the estimated overall risk. In case-control studies, the risk of glioma was lower in women who had ever been treated with an exogenous hormone than in the control group (HRT: OR 0.91, 95% CI 0.84-0.99; OC: OR 0.99, 95% CI 0.91-1.07). In research of cohort studies, similar results have been obtained (HRT: RR 0.95, 95% CI 0.83-1.08; OC: RR 0.75, 95% CI 0.66-0.84). Our study further confirmed that the use of exogenous hormones has an important impact on the risk of glioma in women. However, more prospective studies are needed to further confirm this conclusion.

  11. Lack of association between NADPH quinone oxidoreductase 1 (NQO1 gene C609T polymorphism and lung cancer: a case-control study and a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Shujie Guo

    Full Text Available BACKGROUND: The association between NAD(PH:quinone oxidoreductase 1 (NQO1 gene C609T polymorphism (rs1800566 and lung cancer has been widely evaluated, and a definitive answer so far is lacking. We first conducted a case-control study to assess this association in northeastern Han Chinese, and then performed a meta-analysis to further address this issue. METHODOLOGY/PRINCIPAL FINDINGS: This case-control study involved 684 patients clinically diagnosed as lung cancer and 602 age-matched cancer-free controls from Harbin city, Heilongjiang province, China. Genotyping was conducted using the PCR-LDR (ligase detection reactions method. Meta-analysis was managed by STATA software. Data and study quality were assessed in duplicate. Our case-control association study indicated no significant difference in the genotype and allele distributions of C609T polymorphism between lung cancer patients and controls, consistent with the results of the further meta-analysis involving 7286 patients and 9167 controls under both allelic (odds ratio (OR = 0.99; 95% confidence interval (CI: 0.92-1.06; P = 0.692 and dominant (OR = 0.98; 95% CI: 0.89-1.08; P = 0.637 models. However, there was moderate evidence of between-study heterogeneity and low probability of publication bias. Further subgroup analyses by ethnicity, source of controls and sample size detected no positive associations in this meta-analysis. CONCLUSIONS: Our study in northeastern Han Chinese, along with the meta-analysis, failed to confirm the association of NQO1 gene C609T polymorphism with lung cancer risk, even across different ethnic populations.

  12. Fluid balance and chloride load in the first 24h of ICU admission and its relation with renal replacement therapies through a multicentre, retrospective, case-control study paired by APACHE-II.

    Science.gov (United States)

    González-Castro, A; Ortiz-Lasa, M; Leizaola, O; Salgado, E; Irriguible, T; Sánchez-Satorra, M; Lomas-Fernández, C; Barral-Segade, P; Cordero-Vallejo, M; Rodrigo-Calabia, E; Dierssen-Sotos, T

    2017-05-01

    To analyse the association between water balance during the first 24h of admission to ICU and the variables related to chloride levels (chloride loading, type of fluid administered, hyperchloraemia), with the development of acute kidney injury renal replacement therapy (AKI-RRT) during patients' admission to ICU. Multicentre case-control study. Hospital-based, national, carried out in 6 ICUs. Cases were patients older than 18 years who developed an AKI-RRT. Controls were patients older than 18 years admitted to the same institutions during the study period, who did not develop AKI-RRT during ICU admission. Pairing was done by APACHE-II. An analysis of unconditional logistic regression adjusted for age, sex, APACHE-II and water balance (in evaluating the type of fluid). We analysed the variables of 430 patients: 215 cases and 215 controls. An increase of 10% of the possibility of developing AKI-RRT per 500ml of positive water balance was evident (OR: 1.09 [95% CI: 1.05 to 1.14]; P<.001). The study of mean values of chloride load administered did not show differences between the group of cases and controls (299.35±254.91 vs. 301.67±234.63; P=.92). The water balance in the first 24h of ICU admission relates to the development of IRA-TRR, regardless of chloraemia. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Allergies and risk of pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium.

    Science.gov (United States)

    Olson, Sara H; Hsu, Meier; Satagopan, Jaya M; Maisonneuve, Patrick; Silverman, Debra T; Lucenteforte, Ersilia; Anderson, Kristin E; Borgida, Ayelet; Bracci, Paige M; Bueno-de-Mesquita, H Bas; Cotterchio, Michelle; Dai, Qi; Duell, Eric J; Fontham, Elizabeth H; Gallinger, Steven; Holly, Elizabeth A; Ji, Bu-Tian; Kurtz, Robert C; La Vecchia, Carlo; Lowenfels, Albert B; Luckett, Brian; Ludwig, Emmy; Petersen, Gloria M; Polesel, Jerry; Seminara, Daniela; Strayer, Lori; Talamini, Renato

    2013-09-01

    In order to quantify the risk of pancreatic cancer associated with history of any allergy and specific allergies, to investigate differences in the association with risk according to age, gender, smoking status, or body mass index, and to study the influence of age at onset, we pooled data from 10 case-control studies. In total, there were 3,567 cases and 9,145 controls. Study-specific odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression adjusted for age, gender, smoking status, and body mass index. Between-study heterogeneity was assessed by using the Cochran Q statistic. Study-specific odds ratios were pooled by using a random-effects model. The odds ratio for any allergy was 0.79 (95% confidence interval (CI): 0.62, 1.00) with heterogeneity among studies (P allergies or asthma. There were no major differences among subgroups defined by age, gender, smoking status, or body mass index. Older age at onset of allergies was slightly more protective than earlier age.

  14. Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Antunes Willemann

    2014-01-01

    Full Text Available Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

  15. Recreational Physical Activity and Differentiated Thyroid Cancer Risk: A Pooled Analysis of Two Case-Control Studies

    Science.gov (United States)

    Xhaard, Constance; Lence-Anta, Juan J.; Ren, Yan; Borson-Chazot, Françoise; Sassolas, Geneviève; Schvartz, Claire; Colonna, Marc; Lacour, Brigitte; Danzon, Arlette; Velten, Michel; Clero, Enora; Maillard, Stéphane; Marrer, Emilie; Bailly, Laurent; Mariné Barjoan, Eugènia; Schlumberger, Martin; Orgiazzi, Jacques; Adjadj, Elisabeth; Pereda, Celia M.; Turcios, Silvia; Velasco, Milagros; Chappe, Mae; Infante, Idalmis; Bustillo, Marlene; García, Anabel; Salazar, Sirced; Rodriguez, Regla; Benadjaoud, Mohamed Amine; Ortiz, Rosa M.; Rubino, Carole; de Vathaire, Florent

    2016-01-01

    Purpose Physical activity has been hypothesized to influence cancer occurrence through several mechanisms. To date, its relation with thyroid cancer risk has been examined in relatively few studies. We pooled 2 case-control studies conducted in Cuba and Eastern France to assess the relationship between self-reported practice of recreational physical activity since childhood and thyroid cancer risk. Methods This pooled study included 1,008 cases of differentiated thyroid cancer (DTC) matched with 1,088 controls (age range 9-35 and 17-60 years in the French and Cuban studies, respectively). Risk factors associated with the practice of recreational physical activity were estimated using OR and 95% CI. Logistic regressions were stratified by age class, country, and gender and were adjusted for ethnic group, level of education, number of pregnancies for women, height, BMI, and smoking status. Results Overall, the risk of thyroid cancer was slightly reduced among subjects who reported recreational physical activity (OR = 0.8; 95% CI 0.5-1.0). The weekly frequency (i.e. h/week) seems to be more relevant than the duration (years). Conclusion Long-term recreational physical activity, practiced since childhood, may reduce the DTC risk. However, the mechanisms whereby the DTC risk decreases are not yet entirely clear. PMID:27493888

  16. FOXO3 variants are beneficial for longevity in Southern Chinese living in the Red River Basin: A case-control study and meta-analysis.

    Science.gov (United States)

    Sun, Liang; Hu, Caiyou; Zheng, Chenguang; Qian, Yu; Liang, Qinghua; Lv, Zeping; Huang, Zezhi; Qi, KeYan; Gong, Huan; Zhang, Zheng; Huang, Jin; Zhou, Qin; Yang, Ze

    2015-04-27

    Forkhead box class O (FOXO) transcription factors play a crucial role in longevity across species. Several polymorphisms in FOXO3 were previously reported to be associated with human longevity. However, only one Chinese replication study has been performed so far. To verify the role of FOXO3 in southern Chinese in the Red River Basin, a community-based case-control study was conducted, and seven polymorphisms were genotyped in 1336 participants, followed by a meta-analysis of eight case-control studies that included 5327 longevity cases and 4608 controls. In our case-control study, we found rs2802288*A and rs2802292*G were beneficial to longevity after Bonferroni correction (pallele = 0.005, OR = 1.266; pallele = 0.026, OR = 1.207). In addition, in the longevity group, carriers with rs2802288*A and rs2802292*G presented reduced HbA1c (p = 0.001), and homozygotes of rs2802292*GG presented improved HOMA-IR (p = 0.014). The meta-analysis further revealed the overall contribution of rs2802288*A and rs2802292*G to longevity. However, our stratified analysis revealed that rs2802292*G might act more strongly in Asians than Europeans, for enhancement of longevity. In conclusion, our study provides convincing evidence for a significant association between the rs2802288*A and rs2802292*G gene variants in FOXO3 and human longevity, and adds the Southern Chinese in the Red River Basin to the growing number of human replication populations.

  17. FOXO3 variants are beneficial for longevity in Southern Chinese living in the Red River Basin: A case-control study and meta-analysis

    OpenAIRE

    Sun, Liang; Hu, Caiyou; Zheng, Chenguang; Qian, Yu; Liang, Qinghua; Lv, Zeping; Huang, Zezhi; Qi, KeYan; Gong, Huan; Zhang, Zheng; Huang, Jin; Zhou, Qin; Yang, Ze

    2015-01-01

    Forkhead box class O (FOXO) transcription factors play a crucial role in longevity across species. Several polymorphisms in FOXO3 were previously reported to be associated with human longevity. However, only one Chinese replication study has been performed so far. To verify the role of FOXO3 in southern Chinese in the Red River Basin, a community-based case-control study was conducted, and seven polymorphisms were genotyped in 1336 participants, followed by a meta-analysis of eight case-contr...

  18. Irradiation-induced telomerase activity and gastric cancer risk: a case-control analysis in a Chinese Han population

    International Nuclear Information System (INIS)

    He, Xianli; Qiao, Qing; Ge, Naijian; Nan, Jing; Shen, Shuqun; Wang, Zizhong; Yang, Yefa; Bao, Guoqiang

    2010-01-01

    Telomerase expression is one of the characteristics of gastric cancer (GC) cells and telomerase activity is frequently up-regulated by a variety of mechanisms during GC development. Therefore, we hypothesized that elevated levels of activated telomerase might enhance GC risk due to increased propagation of cells with DNA damage, such as induced by γ-radiation. To explore this hypothesis, 246 GC cases and 246 matched controls were recruited in our case-control study. TRAP-ELISA was used to assess the levels of telomerase activity at baseline and after γ-radiation and the γ-radiation-induced telomerase activity (defined as after γ-irradiation/baseline) in cultured peripheral blood lymphocytes (PBLs). Our data showed that there was no significant difference for the baseline telomerase activity between GC cases and controls (10.17 ± 7.21 vs. 11.02 ± 8.03, p = 0.168). However, after γ-radiation treatment, γ-radiation-induced telomerase activity was significantly higher in the cases than in the controls (1.51 ± 0.93 vs. 1.22 ± 0.66, p < 0.001). Using the median value of γ-radiation-induced telomerase activity in the controls as a cutoff point, we observed that high γ-radiation-induced telomerase activity was associated with a significantly increased GC risk (adjusted odds ratio, 2.45; 95% confidence interval, 1.83-3.18). Moreover, a dose response association was noted between γ-radiation-induced telomerase activity and GC risk. Age, but not sex, smoking and drinking status seem to have a modulating effect on the γ-radiation-induced telomerase activities in both cases and controls. Overall, our findings for the first time suggest that the increased γ-radiation-induced telomerase activity in PBLs might be associated with elevated GC risk. Further confirmation of this association using a prospective study design is warranted

  19. Combining evidence from multiple electronic health care databases: performances of one-stage and two-stage meta-analysis in matched case-control studies.

    Science.gov (United States)

    La Gamba, Fabiola; Corrao, Giovanni; Romio, Silvana; Sturkenboom, Miriam; Trifirò, Gianluca; Schink, Tania; de Ridder, Maria

    2017-10-01

    Clustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. First, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates. Second, we made the same comparison using empirical data from the ARITMO project, a multiple database study investigating the risk of ventricular arrhythmia following the use of medications with arrhythmogenic potential. In our study, we specifically investigated the effect of current use of promethazine. Bias increased for one-stage meta-analysis with increasing (1) between-database variance of exposure effect and (2) heterogeneous confounding generated by two covariates. The efficiency of one-stage meta-analysis was slightly lower than that of two-stage meta-analysis for the majority of investigated scenarios. Based on ARITMO data, there were no evident differences between one-stage (OR = 1.50, CI = [1.08; 2.08]) and two-stage (OR = 1.55, CI = [1.12; 2.16]) approaches. When the effect of interest is heterogeneous, a one-stage meta-analysis ignoring clustering gives biased estimates. Two-stage meta-analysis generates estimates at least as accurate and precise as one-stage meta-analysis. However, in a study using small databases and rare exposures and/or outcomes, a correct one-stage meta-analysis becomes essential. Copyright © 2017 John Wiley & Sons, Ltd.

  20. The SLC4A7 variant rs4973768 is associated with breast cancer risk: evidence from a case-control study and a meta-analysis.

    Science.gov (United States)

    Chen, Wei; Zhong, Rong; Ming, Jie; Zou, Li; Zhu, Beibei; Lu, Xuzai; Ke, Juntao; Zhang, Yu; Liu, Li; Miao, Xiaoping; Huang, Tao

    2012-12-01

    Recent genome-wide association study has identified a genetic variant rs4973768, located in 3'-UTR of solute carrier family 4, sodium bicarbonate cotransporter, member 7 (SLC4A7), was associated with increased risk of breast cancer (BC). However, several following replication studies cannot yield consistent results. We thus conducted a hospital-based case-control study including 485 patients and 514 controls, combined a meta-analysis including 108,632 cases and 135,818 controls to explore the relationship between this variant and BC risk. Our case-control study showed that rs4973768 was significantly associated with increased BC risk with the odds ratio (OR) of 1.29 (95 % confidence interval [CI]: 1.04-1.60) under the allelic model. In addition, the meta-analysis also indicated that the variant slightly increased the risk of BC with the pooled OR of the per-allele effect being 1.08 (95 % CI: 1.04-1.11) although with significant heterogeneity between studies. Stratified analyses showed that ethnicity, sample size, and study design may explain part of the heterogeneity. Moreover, the bioinformatics analysis suggested that this variant may influence the transcriptional capacity of SLC4A7. In summary, our results showed that the SLC4A7 variant, rs4973768, is associated with risk of BC although the underlying biologic mechanism warrants further studies.

  1. A fully-automated software pipeline for integrating breast density and parenchymal texture analysis for digital mammograms: parameter optimization in a case-control breast cancer risk assessment study

    Science.gov (United States)

    Zheng, Yuanjie; Wang, Yan; Keller, Brad M.; Conant, Emily; Gee, James C.; Kontos, Despina

    2013-02-01

    Estimating a woman's risk of breast cancer is becoming increasingly important in clinical practice. Mammographic density, estimated as the percent of dense (PD) tissue area within the breast, has been shown to be a strong risk factor. Studies also support a relationship between mammographic texture and breast cancer risk. We have developed a fullyautomated software pipeline for computerized analysis of digital mammography parenchymal patterns by quantitatively measuring both breast density and texture properties. Our pipeline combines advanced computer algorithms of pattern recognition, computer vision, and machine learning and offers a standardized tool for breast cancer risk assessment studies. Different from many existing methods performing parenchymal texture analysis within specific breast subregions, our pipeline extracts texture descriptors for points on a spatial regular lattice and from a surrounding window of each lattice point, to characterize the local mammographic appearance throughout the whole breast. To demonstrate the utility of our pipeline, and optimize its parameters, we perform a case-control study by retrospectively analyzing a total of 472 digital mammography studies. Specifically, we investigate the window size, which is a lattice related parameter, and compare the performance of texture features to that of breast PD in classifying case-control status. Our results suggest that different window sizes may be optimal for raw (12.7mm2) versus vendor post-processed images (6.3mm2). We also show that the combination of PD and texture features outperforms PD alone. The improvement is significant (p=0.03) when raw images and window size of 12.7mm2 are used, having an ROC AUC of 0.66. The combination of PD and our texture features computed from post-processed images with a window size of 6.3 mm2 achieves an ROC AUC of 0.75.

  2. Is intravesical instillation of hyaluronic acid and chondroitin sulfate useful in preventing recurrent bacterial cystitis? A multicenter case control analysis.

    Science.gov (United States)

    Gugliotta, Giorgio; Calagna, Gloria; Adile, Giorgio; Polito, Salvatore; Saitta, Salvatore; Speciale, Patrizia; Palomba, Stefano; Perino, Antonino; Granese, Roberta; Adile, Biagio

    2015-10-01

    Urinary tract infections (UTIs) are common in the female population and, over a lifetime, about half of women have at least one episode of UTI requiring antibiotic therapy. The aim of the current study was to compare two different strategies for preventing recurrent bacterial cystitis: intravesical instillation of hyaluronic acid (HA) plus chondroitin sulfate (CS), and antibiotic prophylaxis with sulfamethoxazole plus trimethoprim. This was a retrospective review of two different cohorts of women affected by recurrent bacterial cystitis. Cases (experimental group) were women who received intravesical instillations of a sterile solution of high concentration of HA + CS in 50 mL water with calcium chloride every week during the 1(st) month and then once monthly for 4 months. The control group included women who received traditional therapy for recurrent cystitis based on daily antibiotic prophylaxis using sulfamethoxazole 200 mg plus trimethoprim 40 mg for 6 weeks. Ninety-eight and 76 patients were treated with experimental and control treatments, respectively. At 12 months after treatment, 69 and 109 UTIs were detected in the experimental and control groups, respectively. The proportion of patients free from UTIs was significantly higher in the experimental than in the control group (36.7% vs. 21.0%; p = 0.03). Experimental treatment was well tolerated and none of the patients stopped it. The intravesical instillation of HA + CS is more effective than long-term antibiotic prophylaxis for preventing recurrent bacterial cystitis. Copyright © 2015. Published by Elsevier B.V.

  3. Risk factors for human salmonellosis originating from pigs, cattle, broiler chickens and egg laying hens: a combined case-control and source attribution analysis.

    Directory of Open Access Journals (Sweden)

    Lapo Mughini-Gras

    Full Text Available Several case-control studies have investigated risk factors for human salmonellosis while others have used Salmonella subtyping to attribute human infections to different food and animal reservoirs. This study combined case-control and source attribution data into a single analysis to explore risk factors at the point of exposure for human salmonellosis originating from four putative food-producing animal reservoirs (pigs, cattle, broilers and layers/eggs in the Netherlands. We confirmed that most human cases (∼ 90% were attributable to layers/eggs and pigs. Layers/eggs and broilers were the most likely reservoirs of salmonellosis in adults, in urban areas, and in spring/summer, whereas pigs and cattle were the most likely reservoirs of salmonellosis in children, in rural areas, and in autumn/winter. Several reservoir-specific risk factors were identified. Not using a chopping board for raw meat only and consuming raw/undercooked meat were risk factors for infection with salmonellas originating from pigs, cattle and broilers. Consuming raw/undercooked eggs and by-products were risk factors for layer/egg-associated salmonellosis. Using antibiotics was a risk factor for pig- and cattle-associated salmonellosis and using proton-pump inhibitors for salmonellosis attributable to any reservoir. Pig- and cattle-associated infections were also linked to direct contact with animals and environmental exposure (e.g. playing in sandboxes. Eating fish, meat in pastry, and several non-meat foods (fruit, vegetables and pasteurized dairy products were protective factors. Consuming pork and occupational exposure to animals and/or raw meats were protective against layer/egg-associated salmonellosis. We concluded that individuals acquiring salmonellosis from different reservoirs have different associated risk factors, suggesting that salmonellas may infect humans through various transmission pathways depending on their original reservoirs. The outcome of

  4. Risk Factors for Human Salmonellosis Originating from Pigs, Cattle, Broiler Chickens and Egg Laying Hens: A Combined Case-Control and Source Attribution Analysis

    Science.gov (United States)

    Mughini-Gras, Lapo; Enserink, Remko; Friesema, Ingrid; Heck, Max; van Duynhoven, Yvonne; van Pelt, Wilfrid

    2014-01-01

    Several case-control studies have investigated risk factors for human salmonellosis while others have used Salmonella subtyping to attribute human infections to different food and animal reservoirs. This study combined case-control and source attribution data into a single analysis to explore risk factors at the point of exposure for human salmonellosis originating from four putative food-producing animal reservoirs (pigs, cattle, broilers and layers/eggs) in the Netherlands. We confirmed that most human cases (∼90%) were attributable to layers/eggs and pigs. Layers/eggs and broilers were the most likely reservoirs of salmonellosis in adults, in urban areas, and in spring/summer, whereas pigs and cattle were the most likely reservoirs of salmonellosis in children, in rural areas, and in autumn/winter. Several reservoir-specific risk factors were identified. Not using a chopping board for raw meat only and consuming raw/undercooked meat were risk factors for infection with salmonellas originating from pigs, cattle and broilers. Consuming raw/undercooked eggs and by-products were risk factors for layer/egg-associated salmonellosis. Using antibiotics was a risk factor for pig- and cattle-associated salmonellosis and using proton-pump inhibitors for salmonellosis attributable to any reservoir. Pig- and cattle-associated infections were also linked to direct contact with animals and environmental exposure (e.g. playing in sandboxes). Eating fish, meat in pastry, and several non-meat foods (fruit, vegetables and pasteurized dairy products) were protective factors. Consuming pork and occupational exposure to animals and/or raw meats were protective against layer/egg-associated salmonellosis. We concluded that individuals acquiring salmonellosis from different reservoirs have different associated risk factors, suggesting that salmonellas may infect humans through various transmission pathways depending on their original reservoirs. The outcome of classical case-control

  5. Spatial analysis of lung, colorectal, and breast cancer on Cape Cod: An application of generalized additive models to case-control data

    Directory of Open Access Journals (Sweden)

    Aschengrau Ann

    2005-06-01

    Full Text Available Abstract Background The availability of geographic information from cancer and birth defect registries has increased public demands for investigation of perceived disease clusters. Many neighborhood-level cluster investigations are methodologically problematic, while maps made from registry data often ignore latency and many known risk factors. Population-based case-control and cohort studies provide a stronger foundation for spatial epidemiology because potential confounders and disease latency can be addressed. Methods We investigated the association between residence and colorectal, lung, and breast cancer on upper Cape Cod, Massachusetts (USA using extensive data on covariates and residential history from two case-control studies for 1983–1993. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. The resulting continuous surface estimates disease rates relative to the whole study area. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. Results Maps of colorectal cancer were relatively flat. Assuming 15 years of latency, lung cancer was significantly elevated just northeast of the Massachusetts Military Reservation, although the result did not hold when we restricted to residences of longest duration. Earlier non-spatial epidemiology had found a weak association between lung cancer and proximity to gun and mortar positions on the reservation. Breast cancer hot spots tended to increase in magnitude as we increased latency and adjusted for covariates, indicating that confounders were partly hiding these areas. Significant breast cancer hot spots were located near known groundwater plumes and the Massachusetts Military Reservation. Discussion Spatial epidemiology of population-based case-control studies addresses many methodological criticisms of cluster studies and generates new exposure

  6. Human Campylobacteriosis in Luxembourg, 2010-2013: A Case-Control Study Combined with Multilocus Sequence Typing for Source Attribution and Risk Factor Analysis.

    Science.gov (United States)

    Mossong, Joël; Mughini-Gras, Lapo; Penny, Christian; Devaux, Anthony; Olinger, Christophe; Losch, Serge; Cauchie, Henry-Michel; van Pelt, Wilfrid; Ragimbeau, Catherine

    2016-02-10

    Campylobacteriosis has increased markedly in Luxembourg during recent years. We sought to determine which Campylobacter genotypes infect humans, where they may originate from, and how they may infect humans. Multilocus sequence typing was performed on 1153 Campylobacter jejuni and 136 C. coli human strains to be attributed to three putative animal reservoirs (poultry, ruminants, pigs) and to environmental water using the asymmetric island model. A nationwide case-control study (2010-2013) for domestic campylobacteriosis was also conducted, including 367 C. jejuni and 48 C. coli cases, and 624 controls. Risk factors were investigated by Campylobacter species, and for strains attributed to different sources using a combined case-control and source attribution analysis. 282 sequence types (STs) were identified: ST-21, ST-48, ST-572, ST-50 and ST-257 were prevailing. Most cases were attributed to poultry (61.2%) and ruminants (33.3%). Consuming chicken outside the home was the dominant risk factor for both Campylobacter species. Newly identified risk factors included contact with garden soil for either species, and consuming beef specifically for C. coli. Poultry-associated campylobacteriosis was linked to poultry consumption in wintertime, and ruminant-associated campylobacteriosis to tap-water provider type. Besides confirming chicken as campylobacteriosis primary source, additional evidence was found for other reservoirs and transmission routes.

  7. A Retrospective Analysis of Neonatal Encephalocele Predisposing Factors and Outcomes.

    Science.gov (United States)

    Yucetas, Seyho Cem; Uçler, Necati

    2017-01-01

    This study evaluates the predisposing factors and outcomes of surgical management of encephaloceles at our institution. A retrospective analysis of 32 occipital encephaloceles managed operatively at the Neurosurgery Department Clinics of the Faculty of Medicine, Adıyaman University, was performed between 2011 and 2015. Among the study population, 19 mothers had been exposed to TORCH infections (toxoplasma, rubella, cytomegalovirus, herpes simplex virus), 18 were in consanguineous marriages, and 3 had regular prenatal screening. Associated congenital anomalies were common. Eight infants required reoperation, and 9 died during follow-up. The study identified key areas for prevention. Knowledge of the intracranial and associated anomalies can guide management. © 2016 S. Karger AG, Basel.

  8. Retrospective panoramic radiographic analysis for idiopathic osteosclerosis in Indians

    Directory of Open Access Journals (Sweden)

    Srikanth H Srivathsa

    2016-01-01

    Full Text Available Introduction: Idiopathic osteosclerosis is an area of increased radiodensity observed on panoramic radiographs. The prevalence of this entity is not known, especially in Indians. Aims and Objectives: To determine the prevalence and epidemiological characteristics of idiopathic osteosclerosis. Materials and Methods: Six hundred and forty panoramic radiographs were retrospectively analyzed for the presence of idiopathic osteosclerosis by a single trained oral radiologist. Statistical Analysis: The data obtained were analyzed using Microsoft Excel (Version 2007 for Windows. Results: Idiopathic osteosclerosis was identified in 32 individuals with a prevalence of 5%. There were 21 female (65.7% and 11 male (34.3% participants. There were 31 single, unilateral (96.85% osteosclerotic lesions and 1 (3.15% bilateral lesion. Right side localization was noted in 19 participants (57.57% and left side localization in 14 participants (42.42%. Conclusion: This study illustrates the prevalence of idiopathic osteosclerosis in Indians. Further, it depicts the characteristics of idiopathic osteosclerotic lesions.

  9. [A retrospective analysis of 97 drunk driving cases].

    Science.gov (United States)

    Cheng, Xiang-Wei; Chu, Yun; Zong, Xiong-Xin; Wang, Zi-Wei; Chu, Jian-Xin

    2013-04-01

    Based on a retrospective analysis of the drunk driving cases, to explore the drunk drivers' personnel composition, occurrence time and psychology. As a result of punishment of the drunk driving by criminal law for one year from May 1st, 2011 to April 30th, 2012, 91 drunk driving cases were statistically analyzed the easy-happening time of drunk driving, the drunk drivers' age, gender, occupational characteristics, domicile and psychological factors. In 97 drunk driving cases, 26-40 years old, non-local domiciled and non-professional male drivers were prone to drunk driving at night from 22:00 to 5:00. The behavior of drunk driving is relevant to time, age, genders and occupation. The psychological characteristics of most drivers are fluky, making-life-easy, competitive and peacockish.

  10. Retrospective analysis of 'gamma distribution' based IMRT QA criteria

    International Nuclear Information System (INIS)

    Wen, C.; Chappell, R.A.

    2010-01-01

    Full text: IMRT has been implemented into clinical practice at Royal Hobart Hospital (RHH) since mid 2006 for treating patients with Head and Neck (H and N) or prostate tumours. A local quality assurance (QA) acceptance criteria based on 'gamma distribution' for approving IMRT plan was developed and implemented in early 2007. A retrospective analysis of such criteria over 194 clinical cases will be presented. The RHH IMRT criteria was established with assumption that gamma distribution obtained through inter-comparison of 2 D dose maps between planned and delivered was governed by a positive-hail' normal distribution. A commercial system-MapCheck was used for 2 D dose map comparison with a built-in gamma analysis tool. Gamma distribution histogram was generated and recorded for all cases. By retrospectively analysing those distributions using curve fitting technique, a statistical gamma distribution can be obtained and evaluated. This analytical result can be used for future IMRT planing and treatment delivery. The analyses indicate that gamma distribution obtained through MapCheckTM is well under the normal distribution, particularly for prostate cases. The applied pass/fail criteria is not overly sensitive to identify 'false fails' but can be further tighten-up for smaller field while for larger field found in both H and N and prostate cases, the criteria was correctly applied. Non-uniform distribution of detectors in MapCheck and experience level of planners are two major factors to variation in gamma distribution among clinical cases. This criteria derived from clinical statistics is superior and more accurate than single-valued criteria for lMRT QA acceptance procedure. (author)

  11. Retrospective Analysis of Mosh-Pit-Related Injuries.

    Science.gov (United States)

    Milsten, Andrew M; Tennyson, Joseph; Weisberg, Stacy

    2017-12-01

    . Milsten AM , Tennyson J , Weisberg S , Retrospective analysis of mosh-pit-related injuries. Prehosp Disaster Med. 2017;32(6):636-641.

  12. FTO Genotype and Type 2 Diabetes Mellitus: Spatial Analysis and Meta-Analysis of 62 Case-Control Studies from Different Regions

    Directory of Open Access Journals (Sweden)

    Ying Yang

    2017-02-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a global health problem that results from the interaction of environmental factors with genetic variants. Although a number of studies have suggested that genetic polymorphisms in the fat mass and obesity-associated (FTO gene are associated with T2DM risk, the results have been inconsistent. To investigate whether FTO polymorphisms associate with T2DM risk and whether this association is region-related, we performed this spatial analysis and meta-analysis. More than 60,000 T2DM patients and 90,000 controls from 62 case-control studies were included in this study. Odds ratios (ORs, 95% confidence intervals (CIs and Moran’s I statistic were used to estimate the association between FTO rs9939609, rs8050136, rs1421085, and rs17817499, and T2DM risk in different regions. rs9939609 (OR = 1.15, 95% CI 1.11–1.19 and rs8050136 (OR = 1.14, 95% CI 1.10–1.18 conferred a predisposition to T2DM. After adjustment for body mass index (BMI, the association remained statistically significant for rs9939609 (OR = 1.11, 95% CI 1.05–1.17 and rs8050136 (OR = 1.08, 95% CI 1.03–1.12. In the subgroup analysis of rs9939609 and rs8050136, similar results were observed in East Asia, while no association was found in North America. In South Asia, an association for rs9939609 was revealed but not for rs8050136. In addition, no relationship was found with rs1421085 or rs17817499 regardless of adjustment for BMI. Moran’s I statistic showed that significant positive spatial autocorrelations existed in rs9939609 and rs8050136. Studies on rs9939609 and rs8050136 focused on East Asia and South Asia, whereas studies on rs1421085 and rs17817499 were distributed in North America and North Africa. Our data suggest that the associations between FTO rs9939609, rs8050136 and T2DM are region-related, and the two single-nucleotide polymorphisms contribute to an increased risk of T2DM. Future studies should investigate this issue in more regions.

  13. Use of the Ishikawa diagram in a case-control analysis to assess the causes of a diffuse lamellar keratitis outbreak

    Directory of Open Access Journals (Sweden)

    Luis Henrique Lira

    Full Text Available ABSTRACT Purpose: To identify the causes of a diffuse lamellar keratitis (DLK outbreak using a systematic search tool in a case-control analysis. Methods: An Ishikawa diagram was used to guide physicians to determine the potential risk factors involved in this outbreak. Coherence between the occurrences and each possible cause listed in the diagram was verified, and the total number of eyes at risk was used to calculate the proportion of affected eyes. Multivariate analysis was performed using logistic regression to determine the independent effect of the risk factors, after controlling for confounders and test interactions. Results: All DLK cases were reported in 2007 between June 13 and December 21; during this period, 3,698 procedures were performed. Of the 1,682 flap-related procedures, 204 eyes of 141 individuals presented with DLK. No direct relationship was observed between the occurrence of DLK and the presence of any specific factors; however, flap-lifting enhancements, procedures performed during the morning shift, and non-use of therapeutic contact lenses after the surgery were significantly related to higher occurrence percentages of this condition. Conclusions: The Ishikawa diagram, like most quality tools, is a visualization and knowledge organization tool. This systematization allowed the investigators to thoroughly assess all the possible causes of DLK outbreak. A clear view of the entire surgical logistics permitted even more rigid management of the main factors involved in the process and, as a result, highlighted factors that deserved attention. The case-control analysis on every factor raised by the Ishikawa diagram indicated that the commonly suspected factors such as biofilm contamination of the water reservoir in autoclaves, the air-conditioning filter system, glove powder, microkeratome motor oil, and gentian violet markers were not related to the outbreak.

  14. Use of the Ishikawa diagram in a case-control analysis to assess the causes of a diffuse lamellar keratitis outbreak.

    Science.gov (United States)

    Lira, Luis Henrique; Hirai, Flávio E; Oliveira, Marivaldo; Portellinha, Waldir; Nakano, Eliane Mayumi

    2017-01-01

    To identify the causes of a diffuse lamellar keratitis (DLK) outbreak using a systematic search tool in a case-control analysis. An Ishikawa diagram was used to guide physicians to determine the potential risk factors involved in this outbreak. Coherence between the occurrences and each possible cause listed in the diagram was verified, and the total number of eyes at risk was used to calculate the proportion of affected eyes. Multivariate analysis was performed using logistic regression to determine the independent effect of the risk factors, after controlling for confounders and test interactions. All DLK cases were reported in 2007 between June 13 and December 21; during this period, 3,698 procedures were performed. Of the 1,682 flap-related procedures, 204 eyes of 141 individuals presented with DLK. No direct relationship was observed between the occurrence of DLK and the presence of any specific factors; however, flap-lifting enhancements, procedures performed during the morning shift, and non-use of therapeutic contact lenses after the surgery were significantly related to higher occurrence percentages of this condition. The Ishikawa diagram, like most quality tools, is a visualization and knowledge organization tool. This systematization allowed the investigators to thoroughly assess all the possible causes of DLK outbreak. A clear view of the entire surgical logistics permitted even more rigid management of the main factors involved in the process and, as a result, highlighted factors that deserved attention. The case-control analysis on every factor raised by the Ishikawa diagram indicated that the commonly suspected factors such as biofilm contamination of the water reservoir in autoclaves, the air-conditioning filter system, glove powder, microkeratome motor oil, and gentian violet markers were not related to the outbreak.

  15. Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis.

    Directory of Open Access Journals (Sweden)

    Chen-Ge Song

    Full Text Available Epstein-Barr virus (EBV-positive diffuse large B-cell lymphoma (DLBCL in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity.In situ hybridization (ISH analysis of Epstein-Barr virus (EBV and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3 was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly.A total of 16 patients (7.0% were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB subtypes (87.5% and high Ki67 (75% and CD30 expression (93.8%. For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8% had complete remission, 2 (12.5% had partial remission, 2 (12.5% had stable disease, and 5 (31.3% had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001.EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.

  16. Meta-analysis for genome-wide association studies using case-control design: application and practice.

    Science.gov (United States)

    Shim, Sungryul; Kim, Jiyoung; Jung, Wonguen; Shin, In-Soo; Bae, Jong-Myon

    2016-01-01

    This review aimed to arrange the process of a systematic review of genome-wide association studies in order to practice and apply a genome-wide meta-analysis (GWMA). The process has a series of five steps: searching and selection, extraction of related information, evaluation of validity, meta-analysis by type of genetic model, and evaluation of heterogeneity. In contrast to intervention meta-analyses, GWMA has to evaluate the Hardy-Weinberg equilibrium (HWE) in the third step and conduct meta-analyses by five potential genetic models, including dominant, recessive, homozygote contrast, heterozygote contrast, and allelic contrast in the fourth step. The 'genhwcci' and 'metan' commands of STATA software evaluate the HWE and calculate a summary effect size, respectively. A meta-regression using the 'metareg' command of STATA should be conducted to evaluate related factors of heterogeneities.

  17. Meta-analysis for genome-wide association studies using case-control design: application and practice

    Directory of Open Access Journals (Sweden)

    Sungryul Shim

    2016-12-01

    Full Text Available This review aimed to arrange the process of a systematic review of genome-wide association studies in order to practice and apply a genome-wide meta-analysis (GWMA. The process has a series of five steps: searching and selection, extraction of related information, evaluation of validity, meta-analysis by type of genetic model, and evaluation of heterogeneity. In contrast to intervention meta-analyses, GWMA has to evaluate the Hardy–Weinberg equilibrium (HWE in the third step and conduct meta-analyses by five potential genetic models, including dominant, recessive, homozygote contrast, heterozygote contrast, and allelic contrast in the fourth step. The ‘genhwcci’ and ‘metan’ commands of STATA software evaluate the HWE and calculate a summary effect size, respectively. A meta-regression using the ‘metareg’ command of STATA should be conducted to evaluate related factors of heterogeneities.

  18. The Associations between VEGF Gene Polymorphisms and Diabetic Retinopathy Susceptibility: A Meta-Analysis of 11 Case-Control Studies

    Directory of Open Access Journals (Sweden)

    Liyuan Han

    2014-01-01

    Full Text Available Aims. Published data on the associations of VEGF polymorphisms with diabetic retinopathy (DR susceptibility are inconclusive. A systematic meta-analysis was undertaken to clarify this topic. Methods. Data were collected from the following electronic databases: PubMed, Embase, OVID, Web of Science, Elsevier Science Direct, Excerpta Medica Database (EMBASE, and Cochrane Library with the last report up to January 10, 2014. ORs and 95% CIs were calculated for VEGF–2578C/A (rs699947, –1154G/A (rs1570360, –460T/C (rs833061, −634G>C (rs2010963, and +936C/T (rs3025039 in at least two published studies. Meta-analysis was performed in a fixed/random effect model by using the software STATA 12.0. Results. A total of 11 studies fulfilling the inclusion criteria were included in this meta-analysis. A significant relationship between VEGF+936C/T (rs3025039 polymorphism and DR was found in a recessive model (OR = 3.19, 95% CI = 1.20–8.41, and P(z=0.01 in Asian and overall populations, while a significant association was also found between –460T/C (rs833061 polymorphism and DR risk under a recessive model (OR = 2.12, 95% CI = 1.12–4.01, and P(z=0.02. Conclusions. Our meta-analysis demonstrates that +936C/T (rs3025039 is likely to be associated with susceptibility to DR in Asian populations, and the recessive model of –460T/C (rs833061 is associated with elevated DR susceptibility.

  19. Natural history definition and a suggested clinical approach to Buerger's disease: a case-control study with survival analysis.

    Science.gov (United States)

    Fazeli, Bahare; Ravari, Hassan; Assadi, Reza

    2012-08-01

    The aim of this study was first to describe the natural history of Buerger's disease (BD) and then to discuss a clinical approach to this disease based on multivariate analysis. One hundred eight patients who corresponded with Shionoya's criteria were selected from 2000 to 2007 for this study. Major amputation was considered the ultimate adverse event. Survival analyses were performed by Kaplan-Meier curves. Independent variables including gender, duration of smoking, number of cigarettes smoked per day, minor amputation events and type of treatments, were determined by multivariate Cox regression analysis. The recorded data demonstrated that BD may present in four forms, including relapsing-remitting (75%), secondary progressive (4.6%), primary progressive (14.2%) and benign BD (6.2%). Most of the amputations occurred due to relapses within the six years after diagnosis of BD. In multivariate analysis, duration of smoking of more than 20 years had a significant relationship with further major amputation among patients with BD. Smoking cessation programs with experienced psychotherapists are strongly recommended for those areas in which Buerger's disease is common. Patients who have smoked for more than 20 years should be encouraged to quit smoking, but should also be recommended for more advanced treatment for limb salvage.

  20. Retrospective Analysis of Lophodermium seditiosum Epidemics in Estonia

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    HANSO, MÄRT

    2007-01-01

    Full Text Available The needle trace method (NTM, created and developed by the Finnish forest pathologists prof. T. Kurkela, dr. R. Jalkanen and T. Aalto during the last decade of the XX century, has been already used by several researchers of different countries for retrospective analysis of needle diseases (Hypodermella sulcigena, by R. Jalkanen et al. in Finland or herbivorous insect pests of Scots pine (Diprion pini, by T. Kurkela et al. in Finland; Bupalus piniaria, by H. Armour et al. in Scotland, but as well of pests of Sitka spruce (Gilpinia hercyniae, by D.T. Williams et al. in England. Scots pine in forest nurseries and young plantations of Estonia is often but irregularly suffering from the epidemics of the needle cast fungus Lophodermium seditiosum. Current environmental regulations exclude from the regulatory (control measures all the others except of well-argued prophylactic systems, built up on reliable prognoses. The last is inconceivable without the availability of a reliable, as well, and long-lasting retrospective time-series of L. seditiosum epidemics, which, as it is known from the last half of the XX century, are occupying large forest areas, usually not least than a half of (the small Estonia. An appropriate time-series would be useful, as well, for the more basic understanding of the accelerated mortality processes during the stand formation in early pole-age Scots pine plantations. Methodological principles of the use of NTM in an appropriate investigation together with the preliminary results of our research work, looking back for more than a century, are introduced and discussed in this investigation.

  1. Association analysis of PALB2 and BRCA2 in bipolar disorder and schizophrenia in a scandinavian case-control sample

    DEFF Research Database (Denmark)

    Tesli, Martin; Athanasiu, Lavinia; Mattingsdal, Morten

    2010-01-01

    ,868/2,938) and the STEP-UCL/ED-DUB-STEP2 study (n¿=¿2,558/3,274) in a meta-analysis which revealed a P-value of 1.2¿×¿10(-5) for association between PALB2 SNP rs420259 and BD (n¿=¿5,547/20,241). Neither the PALB2 SNP rs420259 nor the BRCA2 SNP rs9567552 were nominally significantly associated with the SCZ phenotype...

  2. A retrospective case-control study of hepatitis C virus infection and oral lichen planus in Japan: association study with mutations in the core and NS5A region of hepatitis C virus

    Science.gov (United States)

    2012-01-01

    Background The aims of this study were to assess the prevalence of hepatitis C virus (HCV) infection in Japanese patients with oral lichen planus and identify the impact of amino acid (aa) substitutions in the HCV core region and IFN-sensitivity-determining region (ISDR) of nonstructural protein 5A (NS5A) associated with lichen planus. Methods In this retrospective study, 59 patients (group 1-A) with oral lichen planus among 226 consecutive patients who visited our hospital and 85 individuals (group 1-B, controls) with normal oral mucosa were investigated for the presence of liver disease and HCV infection. Risk factors for the presence of oral lichen planus were assessed by logistic regression analysis. We compared aa substitutions in the HCV core region (70 and/or 91) and ISDR of NS5A of 12 patients with oral lichen planus (group 2-A) and 7 patients who did not have oral lichen planus (group 2-B) among patients (high viral loads, genotype 1b) who received interferon (IFN) therapy in group1-A. Results The prevalence of anti-HCV and HCV RNA was 67.80% (40/59) and 59.32% (35/59), respectively, in group 1-A and 31.76% (27/85) and 16.47% (14/85), respectively, in group 1-B. The prevalence of anti-HCV (P oral lichen planus. The adjusted odds ratios for these three factors were 6.58, 3.53 and 2.58, respectively, and each was statistically significant. No significant differences in viral factors, such as aa substitutions in the core region and ISDR of NS5A, were detected between the two groups (groups 2-A and -B). Conclusion We observed a high prevalence of HCV infection in patients with oral lichen planus. Longstanding HCV infection, hypoalbuminemia, and smoking were significant risk factors for the presence of oral lichen planus in patients. It is advisable for Japanese patients with lichen planus to be tested for HCV infection during medical examination. PMID:22490000

  3. Evaluation of logistic regression models and effect of covariates for case-control study in RNA-Seq analysis.

    Science.gov (United States)

    Choi, Seung Hoan; Labadorf, Adam T; Myers, Richard H; Lunetta, Kathryn L; Dupuis, Josée; DeStefano, Anita L

    2017-02-06

    Next generation sequencing provides a count of RNA molecules in the form of short reads, yielding discrete, often highly non-normally distributed gene expression measurements. Although Negative Binomial (NB) regression has been generally accepted in the analysis of RNA sequencing (RNA-Seq) data, its appropriateness has not been exhaustively evaluated. We explore logistic regression as an alternative method for RNA-Seq studies designed to compare cases and controls, where disease status is modeled as a function of RNA-Seq reads using simulated and Huntington disease data. We evaluate the effect of adjusting for covariates that have an unknown relationship with gene expression. Finally, we incorporate the data adaptive method in order to compare false positive rates. When the sample size is small or the expression levels of a gene are highly dispersed, the NB regression shows inflated Type-I error rates but the Classical logistic and Bayes logistic (BL) regressions are conservative. Firth's logistic (FL) regression performs well or is slightly conservative. Large sample size and low dispersion generally make Type-I error rates of all methods close to nominal alpha levels of 0.05 and 0.01. However, Type-I error rates are controlled after applying the data adaptive method. The NB, BL, and FL regressions gain increased power with large sample size, large log2 fold-change, and low dispersion. The FL regression has comparable power to NB regression. We conclude that implementing the data adaptive method appropriately controls Type-I error rates in RNA-Seq analysis. Firth's logistic regression provides a concise statistical inference process and reduces spurious associations from inaccurately estimated dispersion parameters in the negative binomial framework.

  4. Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis.

    Science.gov (United States)

    Woliński, Kosma; Stangierski, Adam; Gurgul, Edyta; Bromińska, Barbara; Czarnywojtek, Agata; Lodyga, Martha; Ruchała, Marek

    2017-01-01

    Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors. We searched medical documentation of patients with acromegaly treated in our department between 2003 and 2013. The prevalence of thyroid abnormalities was compared with the group of patients with hormonally inactive adrenal incidentalomas. To perform the meta-analytic part of the paper we also searched ten databases to find relevant papers. Two hundred and five patients with acromegaly and 184 patients with incidentalomas were included. Any thyroid lesions were present in 77.6% of patients with acromegaly vs. 63.0% with incidentalomas (p = 0.002), multinodular goitre - 66.8% vs. 47.8% (p = 0.0002), and TC- 5.4% vs. 2.7% (p = 0.21) respectively. For thyroid lesions the pooled odds ratio (OR) was 3.1 (95% confidence interval [CI] 1.8-5.5), and for TCs the OR was 4.5 (95% CI 1.9-10.3). According to our results thyroid lesions were significantly more common in patients with acromegaly; in case of TC the difference was not significant. The updated meta-analysis showed significantly increased prevalence of both disorders. In conclusion, systematic thyroid examination should be an important part of follow-up in case of acromegalic patients. (Endokrynol Pol 2017; 68 (1): 2-6).

  5. Genetic analysis of the vitamin D receptor gene in two epithelial cancers: melanoma and breast cancer case-control studies

    International Nuclear Information System (INIS)

    Barroso, Eva; Arias, Jose I; Zamora, Pilar; Blanco, Monserrat; Lazaro, Pablo; Benitez, Javier; Ribas, Gloria; Fernandez, Lara P; Milne, Roger L; Pita, Guillermo; Sendagorta, Elena; Floristan, Uxua; Feito, Marta; Aviles, Jose A; Martin-Gonzalez, Manuel

    2008-01-01

    Vitamin D serum levels have been found to be related to sun exposure and diet, together with cell differentiation, growth control and consequently, cancer risk. Vitamin D receptor (VDR) genotypes may influence cancer risk; however, no epidemiological studies in sporadic breast cancer (BC) or malignant melanoma (MM) have been performed in a southern European population. In this study, the VDR gene has been evaluated in two epithelial cancers BC and MM. We have conducted an analysis in 549 consecutive and non-related sporadic BC cases and 556 controls, all from the Spanish population, and 283 MM cases and 245 controls. Genotyping analyses were carried out on four putatively functional SNPs within the VDR gene. An association with the minor allele A of the non-synonymous SNP rs2228570 (rs10735810, FokI, Met1Thr) was observed for BC, with an estimated odds ratio (OR) of 1.26 (95% CI = 1.02–1.57; p = 0.036). The synonymous variant rs731236 (TaqI) appeared to be associated with protection from BC (OR = 0.80, 95%CI = 0.64–0.99; p = 0.047). No statistically significant associations with MM were observed for any SNP. Nevertheless, sub-group analyses revealed an association between rs2228570 (FokI) and absence of childhood sunburns (OR = 0.65, p = 0.003), between the 3'utr SNP rs739837 (BglI) and fair skin (OR = 1.31, p = 0.048), and between the promoter SNP rs4516035 and the more aggressive tumour location in head-neck and trunk (OR = 1.54, p = 0.020). In summary, we observed associations between SNPs in the VDR gene and BC risk, and a comprehensive analysis using clinical and tumour characteristics as outcome variables has revealed potential associations with MM. These associations required confirmation in independent studies

  6. Management of pancreatic pseudocysts-A retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Sebastian Rasch

    Full Text Available Pancreatic pseudocysts arise mostly in patients with alcohol induced chronic pancreatitis causing various symptoms and complications. However, data on the optimal management are rare. To address this problem, we analysed patients with pancreatic pseudocysts treated at our clinic retrospectively.We searched our clinical database for the diagnosis pancreatitis from 2004 till 2014, selected patients with pseudocysts larger than 10 mm and entered all relevant information in a database for statistical analysis.In total, 129 patients with pancreatic pseudocysts were treated at our institution during the study period. Most patients suffered from alcohol induced chronic pancreatitis (43.4%; 56/129. Pseudocysts were more frequent in female than in male (2:1 and were mainly located in the pancreatic head (47.3%; 61/129. Local complications like obstructive jaundice were associated with the diameter of the cysts (AUC 0.697 in ROC-curve analysis. However, even cysts up to a diameter of 160 mm can regress spontaneously. Besides a lower re-intervention rate in surgically treated patients, endoscopic, percutaneous and surgical drainage are equally effective. Most treatment related complications occur in large pseudocysts located in the pancreatic head.Conservative management of large pseudocysts is successful in many patients. Therefore, indication for treatment should be made carefully considering the presence and risk of local complications. Endoscopic and surgical drainage are equally effective.

  7. Spinal cord gliomas: A multi-institutional retrospective analysis

    International Nuclear Information System (INIS)

    Abdel-Wahab, May; Etuk, Blessing; Palermo, James; Shirato, Hiroki; Kresl, John; Yapicier, Ozlem; Walker, Gail; Scheithauer, Bernd W.; Shaw, Edward; Lee, Charles; Curran, Walter; Thomas, Terry; Markoe, Arnold

    2006-01-01

    Purpose: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. Patients and Methods: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. Results: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). Conclusion: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS

  8. Case-control studies in neurosurgery.

    Science.gov (United States)

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  9. A case-control study of maternal periconceptual and pregnancy recreational drug use and fetal malformation using hair analysis.

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    Anna L David

    Full Text Available OBJECTIVE: Maternal recreational drug use may be associated with the development of fetal malformations such as gastroschisis, brain and limb defects, the aetiology due to vascular disruption during organogenesis. Using forensic hair analysis we reported evidence of recreational drug use in 18% of women with a fetal gastroschisis. Here we investigate this association in a variety of fetal malformations using the same method. METHODS: In a multi-centre study, women with normal pregnancies (controls and those with fetal abnormalities (cases gave informed consent for hair analysis for recreational drug metabolites using mass spectrometry. Hair samples cut at the root were tested in sections corresponding to 3 month time periods (pre and periconceptual period. RESULTS: Women whose fetus had gastroschisis, compared to women with a normal control fetus, were younger (mean age 23.78 ± SD4.79 years, 18-37 vs 29.79 ± SD6 years, 18-42, p = 0.00001, were more likely to have evidence of recreational drug use (15, 25.4% vs 21, 13%, OR2.27, 95thCI 1.08-4.78, p = 0.028, and were less likely to report periconceptual folic acid use (31, 53.4% vs 124, 77.5%, OR0.33, 95thCI 0.18-0.63, p = 0.001. Age-matched normal control women were no less likely to test positive for recreational drugs than women whose fetus had gastroschisis. After accounting for all significant factors, only young maternal age remained significantly associated with gastroschisis. Women with a fetus affected by a non-neural tube central nervous system (CNS anomaly were more likely to test positive for recreational drugs when compared to women whose fetus was normal (7, 35% vs 21, 13%, OR3.59, 95th CI1.20-10.02, p = 0.01. CONCLUSIONS: We demonstrate a significant association between non neural tube CNS anomalies and recreational drug use in the periconceptual period, first or second trimesters, but we cannot confirm this association with gastroschisis. We confirm the association of

  10. An ecological analysis of secondary school students' drug use in Hong Kong: A case-control study.

    Science.gov (United States)

    Tse, Samson; Zhu, Shimin; Yu, Chong Ho; Wong, Paul; Tsang, Sandra

    2016-02-01

    Youth drug use is a significant at-risk youth behaviour and remains as one of the top priorities for mental health services, researchers and policy planners. The ecological characteristics of secondary school students' behaviour in Hong Kong are understudied. To examine individual, familial, social and environmental correlates of drug use among secondary students in Hong Kong. Data were extracted from a school survey with 3078 students. Among the 3078 students, 86 students reported to have used drugs in the past 6 months. A total of 86 age- and gender-matched controls with no drug-use behaviour in the past 6 months were randomly selected from the remaining students. Multiple logistic analysis was used to examine differential correlates between those who used and did not use substance in the past 6 months. Positive school experience and perspective to school and parental support are protective factors of drug use. Lower self-esteem, lower self-efficacy against using drugs and higher level of permissive attitude towards drugs were associated with drug use. Students who were low in self-esteem and rather impulsive tend to use drugs. To prevent students from drug use, efforts in individual, family, school and community-levels should be addressed. © The Author(s) 2015.

  11. A case-control analysis of common variants in GIP with type 2 diabetes and related biochemical parameters in a South Indian population

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    Kumar Harish

    2010-07-01

    Full Text Available Abstract Background Glucose-dependent insulinotropic polypeptide (GIP is one of the incretins, which plays a crucial role in the secretion of insulin upon food stimulus and in the regulation of postprandial glucose level. It also exerts an effect on the synthesis and secretion of lipoprotein lipase, from adipocytes, important for lipid metabolism. The aim of our study was to do a case-control association analysis of common variants in GIP in association with type 2 diabetes and related biochemical parameters. Method A total of 2000 subjects which includes 1000 (584M/416F cases with type 2 diabetes and 1000 (470M/530F normoglycemic control subjects belonging to Dravidian ethnicity from South India were recruited to assess the effect of single nucleotide polymorphisms (SNPs in GIP (rs2291725, rs2291726, rs937301 on type 2 diabetes in a case-control manner. The SNPs were genotyped by using tetra primer amplification refractory mutation system-PCR (ARMS PCR. For statistical analysis, our study population was divided into sub-groups based on gender (male and female. Association analysis was carried out using chi-squared test and the comparison of biochemical parameters among the three genotypes were performed using analysis of covariance (ANCOVA. Result Initial analysis revealed that, out of the total three SNPs selected for the present study, two SNPs namely rs2291726 and rs937301 were in complete linkage disequilibrium (LD with each other. Therefore, only two SNPs, rs2291725 and rs2291726, were genotyped for the association studies. No significant difference in the allele frequency and genotype distribution of any of the SNPs in GIP were observed between cases and controls (P > 0.05. Analysis of biochemical parameters among the three genotypes showed a significant association of total cholesterol (P = 0.042 and low density lipoprotein (LDL with the G allele of the SNP rs2291726 in GIP (P = 0.004, but this was observed only in the case of female

  12. A retrospective dosimetry method and its uncertainty analysis

    International Nuclear Information System (INIS)

    Zhang, L.; Jia, D.; Dai, G.

    2000-01-01

    The main aim of a radiation epidemiological study is to assess the risk of the population exposed to ionizing radiation. The actual work of the assessment may be very difficult because dose information about the population is often indirect and incomplete. It is very important, therefore, to find a way of estimating reasonable and reliable doses of the population by a retrospective method from limited information. In order to provide reasonable dose information for the cohort study of Chinese medical diagnostic X-ray workers, a retrospective dosimetry method was established. In China, a cohort study of more than 27,000 medical diagnostic X-ray workers, with 25,000 controls, has been carried out for about fifteen years in order to assess the risk to an occupationally exposed population. Obviously, a key to the success of the study is to obtain reliable and reasonable results of dose estimation by the dose reconstruction method. Before 1985, there was a lack of information regarding personal dose measured directly; however, we can obtain other indirect information. Examples are information about working loads from the documents of the hospitals, information about operational conditions of the workers of different statuses by a survey of occupational history, and the exposure levels of various working conditions by some simulation methods. The information for estimating organ dose can also be obtained by simulating experiments with a phantom. Based on the information mentioned above, a mathematical model and computerizing system for dose reconstruction of this occupational population was design and developed. Uncertainty analysis very important for dose reconstruction. The sources of uncertainty of our study are coming from two fields. One is coming from the mode of dose reconstruction. Another is coming from the survey of the occupational history. In the result reported, main results of the uncertainty will be presented. In order to control the uncertainty of the

  13. Association between the rs1143634 polymorphism in interleukin-1B and chronic periodontitis: Results from a meta-analysis composed by 54 case/control studies.

    Science.gov (United States)

    da Silva, Felipe Rodolfo Pereira; Vasconcelos, Any Carolina Cardoso Guimarães; de Carvalho França, Luiz Felipe; Di Lenardo, David; Nascimento, Hélio Mateus Silva; Vasconcelos, Daniel Fernando Pereira

    2018-08-20

    Several factors are involved in the periodontitis with host response through cytokines and as well as with influence of polymorphisms in cytokine genes, however the results remained contradictory. This study aimed at evaluating the rs1143634 polymorphism in interleukin-1B gene, a cytokine gene, and the risk of chronic periodontitis with conducting a meta-analysis focusing in ethnicity. A review in literature was performed in several databases to studies published before June 2017. Data extraction was performed by two calibrated investigators and the calculations of the meta-analysis were obtained through Review Manager version 5.2 statistical software with Odds Ratio (OR) calculation and Funnel plot (P  0.05). No publication bias was found in allelic evaluation. This meta-analysis in 9376 participants with 54 case/control studies revealed the rs1143634 polymorphism was associated with elevated risk of chronic periodontitis in overall analysis as well as Caucasian and Asian ethnicities and Mixed population. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Esophageal achalasia: retrospective analysis of treatment during 2000–2010

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    Tomaž Štupnik

    2011-10-01

    Full Text Available BACKGROUND Esophageal achalasia (EA is a primary esophageal motility disorder of unclear aetiology. Standard treatments of EA are: pneumatic balloon dilation (PBD of the lower esophageal sphyncter (LES and surgical cleaving of the muscle by Heller myotomy. Although the treatment effectively cures dysphagia, the symptoms recur in about a half of the patients. Our point of interest was long-term effectiveness of EA treatment at our department. METHODSWe made a retrospective analysis of EA patients treated at our department of thoracic surgery during the 2000–2010 period.RESULTSIn 11 years we performed 187 PBD and 22 laparoscopic myotomies (LM in 148 patients. Three years after the procedure 65 % of patients after PBD and 90 % of patients after LM showed no signs of disease. The risk of recurrence was 3.56-times greater (p = 0.03 after PBD (in comparison to LM, whereas patients older than 50 years bear 0.51-times lower risk (p = 0.02. The most significant complicatios were esophageal perforation in 3 patients (1.6 % after PBD and gastroesophageal reflux in 3 patients (15 % after LM.CONCLUSIONSPBD is a fast, simple, inexpensive and very efficient method of EA treatment, which can be safely performed in almost every patient. LM is far more expensive and a more complicated method that is more suitable for younger patients, in whom PBD is less effective.

  15. Retrospective analysis of paediatric achalasia in India: Single centre experience

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    Sunita Singh

    2012-01-01

    Full Text Available Background: Developing countries at tertiary referral centre. The aim of this study was to share our experience of paediatric achalasia in Indian scenario. Materials and Methods: This was a retrospective analysis of children <16 years, operated for achalasia at our centre, from December 1998 to December 2011. Results: Total 40 patients (mean age 39 ± 4.29 months, including 1 patient of megaesophagus were operated over 13 years of period; 17 patients (associated congenital H-type tracheoesophageal fistula in one patient, non- responders/ lost follow-up for minimum of 3 years in 16 patients were excluded from the study. The response rate of parents in follow-up was 60.0%. Mean symptoms duration was 27.88 ± 2 months. Most common symptoms were regurgitation and failure to thrive (78.2%. Mean symptom scoring in follow-up after 3 year was 1 ± 0.7 compared to 5 ± 0.51 at the time of admission (P < 0.012. One infant expired (mediastenitis, one developed adhesive intestinal obstruction and one needed posterior re-myotomy (for megaesophagus. There were no treatment failures in mean follow-up of 40.2 ± 5.07 months. Conclusions: Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents′ perspective.

  16. Occipitocervical fusions in children. Retrospective analysis and technical considerations.

    Science.gov (United States)

    Rodgers, W B; Coran, D L; Emans, J B; Hresko, M T; Hall, J E

    1999-07-01

    This report presents a retrospective analysis of the authors' experience with occipitocervical fusions in children and adolescents during the last 2 decades. A description of an operative technique devised by the senior author (JEH), and a comparison of the results using this and other methods of fusion are given. Twenty-three patients underwent occipitocervical fusion. Fifteen of the patients were operated on using the authors' technique. To achieve stable fixation of the distal cervical vertebra a threaded Kirschner wire was passed transversely through the spinous process; occipital fixation was achieved by the traditional method of wiring corticocancellous bone graft to the skull through burr holes. The occipital wires then were wrapped around the Kirschner wire and the graft was cradled in the resulting nest. Halo immobilization was used in 10 patients for an average of 12.5 weeks (range, 6-24 weeks). Twenty-two patients achieved successful fusion at an average followup of 5.8 years (range, 1-14.33 years). Several complications, including transient quadriplegia in one patient, pseudarthrosis in two (one of which persists), hardware fixation failure in one, unintended distal extension of the fusion, pneumonia, wound infection, halo pin infection, skin breakdown under the halo vest, hydrocephalus, cerebrospinal fluid leak, and traumatic fusion fracture were encountered. Results using the technique described herein are comparable with or better than the results reported in the previous literature, and the results of the patients in this series in whom the technique was not used.

  17. Retrospective evaluation of tritium fallout by tree-ring analysis

    International Nuclear Information System (INIS)

    Kozak, K.; Biro, T.; Golder, F.; Rank, D.; Rajner, V.; Staudner, F.

    1993-01-01

    Tritium analyses of tree-ring cellulose were made to test its suitability for retrospective evaluation of a local tritium fallout. Several spruce trees were taken from an Austrian alpine area where tritium contamination of May 1974 precipitation had been detected. Wood from the annual growth rings of 1973, 1974 and 1975 was separated and the cellulose extracted. After isotopic equilibration with dead water, cellulose was combusted to yield water, whose tritium concentration was measured by liquid scintillation counting. Rigorous statistical treatment proved the significance of the increased tritium concentration caused by the tritium anomaly, which occurred during the growing season. The long-term trends of local atmospheric tritium, including the 1974 peak, were also well reflected by analysis of a 24-year ring sequence from a single tree in the contaminated area. The tritium data gained by the given method can be used at present qualitatively and a better understanding of the possible sources of contamination is required in order that the quantitative criteria be satisfied. (Author)

  18. Odontoid fractures: A retrospective analysis of 53 cases

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    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  19. Analysis of Virechana karma with Danti avaleha: A retrospective study

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    Sreelakshmi Chaganti

    2015-01-01

    Full Text Available Virechana (therapeutic purgation is a common procedure that is widely practiced among the panchakarma treatments (pentad treatments. Various Virechaka dravyas (purgative drugs have been described for Virechana. Even after critical analysis of Virechaka dravyas in the literature, still there is difficulty in the fixation of dose. Hence, the retrospective analysis of varied outcomes of Virechana with Danti (Baliospermum montanum avaleha (linctus is discussed in this paper. The study included twenty-seven case reports of patients who were administered Virechana with Danti avaleha. These case reports are of patients suffering from various ailments such as irregular menstrual cycles, polycystic ovarian syndrome, primary and secondary infertility, and psoriasis. Danti avaleha was administered at dose of 10 g and 5 g in the Krura (~strong and Madhyama (~moderate/normal Koshta (~GI tract patients, respectively. Among seven Krura koshta patients, three of them resulted with Pravara (excellent Shuddhi and other four resulted with Madhyama (medium Shuddhi. In twenty Madhyama koshta patients, sixteen of them resulted with avara (minimum Shuddhi and remaining four patients resulted with Madhyama shuddhi. Complications like Udara shoola (spasmodic pain of abdomen and Vamana (emesis were observed during Virechana. Majority of the patients suffered with Udara shoola were of Madhyama koshta. Vamana was seen in both Krura and Madhyama koshta patients. Irrespective of the type of Shuddhi and complications, all the patients resulted with Samyak Kaphaantiki Virikta lakshana (signs of perfect purgation with end expulsion of Kapha. The study concluded that the Krura koshta patients were tolerable for dose of 10 g and are expected to attain Pravara Shuddhi. Whereas Madhyama koshta patients were intolerable even to mild dose of 5 g, producing Avara shuddhi.

  20. Exposure to pesticides as risk factor for non-Hodgkin's lymphoma and hairy cell leukemia: pooled analysis of two Swedish case-control studies.

    Science.gov (United States)

    Hardell, Lennart; Eriksson, Mikael; Nordstrom, Marie

    2002-05-01

    Increased risk for non-Hodgkin's lymphoma (NHL) following exposure to certain pesticides has previously been reported. To further elucidate the importance of phenoxyacetic acids and other pesticides in the etiology of NHL a pooled analysis was performed on two case-control studies, one on NHL and another on hairy cell leukemia (HCL), a rare subtype of NHL. The studies were population based with cases identified from cancer registry and controls from population registry. Data assessment was ascertained by questionnaires supplemented over the telephone by specially trained interviewers. The pooled analysis of NHL and HCL was based on 515 cases and 1141 controls. Increased risks in univariate analysis were found for subjects exposed to herbicides (OR 1.75, CI 95% 1.26-2.42), insecticides (OR 1.43, CI 95% 1.08-1.87), fungicides (OR 3.11, CI 95% 1.56-6.27) and impregnating agents (OR 1.48, CI 95% 1.11-1.96). Among herbicides, significant associations were found for glyphosate (OR 3.04, CI 95% 1.08-8.52) and 4-chloro-2-methyl phenoxyacetic acid (MCPA) (OR 2.62, CI 95% 1.40-4.88). For several categories of pesticides the highest risk was found for exposure during the latest decades before diagnosis. However, in multivariate analyses the only significantly increased risk was for a heterogeneous category of other herbicides than above.

  1. Relationship between Long Chain n-3 Polyunsaturated Fatty Acids and Autism Spectrum Disorder: Systematic Review and Meta-Analysis of Case-Control and Randomised Controlled Trials

    Directory of Open Access Journals (Sweden)

    Hajar Mazahery

    2017-02-01

    Full Text Available Omega-3 long chain polyunsaturated fatty acid supplementation (n-3 LCPUFA for treatment of Autism Spectrum Disorder (ASD is popular. The results of previous systematic reviews and meta-analyses of n-3 LCPUFA supplementation on ASD outcomes were inconclusive. Two meta-analyses were conducted; meta-analysis 1 compared blood levels of LCPUFA and their ratios arachidonic acid (ARA to docosahexaenoic acid (DHA, ARA to eicosapentaenoic acid (EPA, or total n-6 to total n-3 LCPUFA in ASD to those of typically developing individuals (with no neurodevelopmental disorders, and meta-analysis 2 compared the effects of n-3 LCPUFA supplementation to placebo on symptoms of ASD. Case-control studies and randomised controlled trials (RCTs were identified searching electronic databases up to May, 2016. Mean differences were pooled and analysed using inverse variance models. Heterogeneity was assessed using I2 statistic. Fifteen case-control studies (n = 1193 were reviewed. Compared with typically developed, ASD populations had lower DHA (−2.14 [95% CI −3.22 to −1.07]; p < 0.0001; I2 = 97%, EPA (−0.72 [95% CI −1.25 to −0.18]; p = 0.008; I2 = 88%, and ARA (−0.83 [95% CI, −1.48 to −0.17]; p = 0.01; I2 = 96% and higher total n-6 LCPUFA to n-3 LCPUFA ratio (0.42 [95% CI 0.06 to 0.78]; p = 0.02; I2 = 74%. Four RCTs were included in meta-analysis 2 (n = 107. Compared with placebo, n-3 LCPUFA improved social interaction (−1.96 [95% CI −3.5 to −0.34]; p = 0.02; I2 = 0 and repetitive and restricted interests and behaviours (−1.08 [95% CI −2.17 to −0.01]; p = 0.05; I2 = 0. Populations with ASD have lower n-3 LCPUFA status and n-3 LCPUFA supplementation can potentially improve some ASD symptoms. Further research with large sample size and adequate study duration is warranted to confirm the efficacy of n-3 LCPUFA.

  2. Medulloblastoma in adults. A retrospective single institution analysis

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    Hadi, Indrawati; Roengvoraphoj, Olarn; Niyazi, Maximilian; Nachbichler, Silke Birgit [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); Roeder, Falk [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Research Center (DKFZ), Molecular Radiation Oncology, Heidelberg (Germany); Schueller, Ulrich [University Medical Center, Institute of Neuropathology, Hamburg-Eppendorf (Germany); Research Institute Children' s Cancer Center, Hamburg (Germany); University Medical Center, Department of Pediatric Hematology and Oncology, Hamburg-Eppendorf (Germany); Belka, Claus [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Consortium (DKTK), Munich (Germany)

    2018-03-15

    Adult medulloblastoma is a rare disease treated according to the current pediatric treatment guidelines. This retrospective analysis investigated the clinical outcomes and prognostic factors of adult medulloblastoma patients, who received multimodal therapy at our institution. Treatment charts of all patients over the age of 15 years of age with de novo medulloblastoma, who had been treated at our institution between 2001 and 2014, were retrospectively analyzed. Patients' demographic parameters, initial symptoms, treatment modalities, toxicities, and survival outcomes were investigated. In all, 21 patients with a median age of 30.2 years were identified. The most frequent histologies were desmoplastic and classic, and the most common molecular subtype was sonic hedgehog (SHH). After tumor resection, all patients received craniospinal irradiation (median dose 35.2 Gy) and a boost to the posterior fossa (median dose 19.8 Gy). Simultaneous chemotherapy with vincristine was given to 20 patients and sequential chemotherapy to 15 patients. The most common side effects were hematological toxicities. Median overall survival (OS) has not been reached after a median follow-up of 92 months. Estimated 5- and 10-year OS was 89 and 80%, respectively. Estimated 5- and 10-year progression-free survival (PFS) was 89 and 81%, respectively. In univariate analysis, a shorter interval between tumor resection and end of irradiation was significantly associated with improved OS and PFS, anaplastic histology with worse OS and PFS. The combined modality treatment showed a good outcome in adults with medulloblastoma. Treatment time was revealed to be prognostic and should be kept as short as possible. (orig.) [German] Das Medulloblastom des Erwachsenen ist eine seltene Erkrankung, die analog paediatrischer Behandlungsprotokolle therapiert wird. Diese retrospektive Analyse untersuchte die klinischen Ergebnisse und prognostischen Faktoren von erwachsenen Medulloblastompatienten, die eine

  3. Traditional Dietary Pattern Increases Risk of Prostate Cancer in Argentina: Results of a Multilevel Modeling and Bias Analysis from a Case-Control Study

    International Nuclear Information System (INIS)

    Niclis, C.; Roman, M. D.; Eynard, A. R.; Diaz, M. D. P.

    2015-01-01

    There is increasing evidence that dietary habits play a role in prostate cancer (PC) occurrence. Argentinean cancer risk studies require additional attention because of the singular dietary pattern of this population. A case-control study (147 PC cases, 300 controls) was conducted in Cordoba (Argentina) throughout 2008-2013. A principal component factor analysis was performed to identify dietary patterns. A mixed logistic regression model was applied, taking into account family history of cancer. Possible bias was evaluated by probabilistic bias analysis. Four dietary patterns were identified: Traditional (fatty red meats, offal, processed meat, starchy vegetables, added sugars and sweets, candies, fats, and vegetable oils), Prudent (non starchy vegetables, whole grains), Carbohydrate (sodas/juices and bakery products), and Cheese (cheeses). High adherence to the Traditional (OR 2.82, 95 % CI: 1.569-5.099) and Carbohydrate Patterns (OR 2.14, 95 % CI: 1.470-3.128) showed a promoting effect for PC, whereas the Prudent and Cheese Patterns were independent factors. PC occurrence was also associated with family history of PC. Bias adjusted ORs indicate that the validity of the present study is acceptable. High adherence to characteristic Argentinean dietary patterns was associated with increased PC risk. Our results incorporate original contributions to knowledge about scenarios in South American dietary patterns and PC occurrence.

  4. Traditional Dietary Pattern Increases Risk of Prostate Cancer in Argentina: Results of a Multilevel Modeling and Bias Analysis from a Case-Control Study

    Directory of Open Access Journals (Sweden)

    Camila Niclis

    2015-01-01

    Full Text Available There is increasing evidence that dietary habits play a role in prostate cancer (PC occurrence. Argentinean cancer risk studies require additional attention because of the singular dietary pattern of this population. A case-control study (147 PC cases, 300 controls was conducted in Córdoba (Argentina throughout 2008–2013. A principal component factor analysis was performed to identify dietary patterns. A mixed logistic regression model was applied, taking into account family history of cancer. Possible bias was evaluated by probabilistic bias analysis. Four dietary patterns were identified: Traditional (fatty red meats, offal, processed meat, starchy vegetables, added sugars and sweets, candies, fats, and vegetable oils, Prudent (nonstarchy vegetables, whole grains, Carbohydrate (sodas/juices and bakery products, and Cheese (cheeses. High adherence to the Traditional (OR 2.82, 95%CI: 1.569–5.099 and Carbohydrate Patterns (OR 2.14, 95%CI: 1.470–3.128 showed a promoting effect for PC, whereas the Prudent and Cheese Patterns were independent factors. PC occurrence was also associated with family history of PC. Bias adjusted ORs indicate that the validity of the present study is acceptable. High adherence to characteristic Argentinean dietary patterns was associated with increased PC risk. Our results incorporate original contributions to knowledge about scenarios in South American dietary patterns and PC occurrence.

  5. Mortality in former Olympic athletes: retrospective cohort analysis

    Science.gov (United States)

    Zwiers, R; Zantvoord, F W A; van Bodegom, D; van der Ouderaa, F J G; Westendorp, R G J

    2012-01-01

    Objective To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity. Design Retrospective cohort study. Setting Former Olympic athletes. Participants 9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact. Main outcome measure All cause mortality. Results Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact. Conclusions Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life. PMID:23241269

  6. Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

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    James C. Anderson

    2017-07-01

    Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

  7. Retrospective analysis of RF heating measurements of passive medical implants.

    Science.gov (United States)

    Song, Ting; Xu, Zhiheng; Iacono, Maria Ida; Angelone, Leonardo M; Rajan, Sunder

    2018-05-09

    The test reports for the RF-induced heating of metallic devices of hundreds of medical implants have been provided to the U.S. Food and Drug Administration as a part of premarket submissions. The main purpose of this study is to perform a retrospective analysis of the RF-induced heating data provided in the reports to analyze the trends and correlate them with implant geometric characteristics. The ASTM-based RF heating test reports from 86 premarket U.S. Food and Drug Administration submissions were reviewed by three U.S. Food and Drug Administration reviewers. From each test report, the dimensions and RF-induced heating values for a given whole-body (WB) specific absorption rate (SAR) and local background (LB) SAR were extracted and analyzed. The data from 56 stents were analyzed as a subset to further understand heating trends and length dependence. For a given WB SAR, the LB/WB SAR ratio varied significantly across the test labs, from 2.3 to 11.3. There was an increasing trend on the temperature change per LB SAR with device length. The maximum heating for stents occurred at lengths of approximately 100 mm at 3 T, and beyond 150 mm at 1.5 T. Differences in the LB/WB SAR ratios across testing labs and various MRI scanners could lead to inconsistent WB SAR labeling. Magnetic resonance (MR) conditional labeling based on WB SAR should be derived from a conservative estimate of global LB/WB ratios. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  8. Fournier's gangrene: A retrospective analysis of 25 patients.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Başak, Fatih; Kılıç, Ali; Ünal, Ethem; Yüksekdağ, Sema; Acar, Aylin; Baş, Gürhan

    2017-09-01

    Fournier's gangrene is a surgical emergency that progresses rapidly and insidiously and results in high morbidity and mortality rates unless it is immediately diagnosed and managed. Here we analyze the outcomes of patients who were followed up and treated for Fournier's gangrene. We conducted a retrospective analysis of the medical data of 25 patients operated on for Fournier's gangrene between January 2010 and June 2015. The diagnosis of Fournier's gangrene was made by performing a physical examination. Patients who had genital, perineal, and perianal tenderness; induration; cyanosis; gangrene; and subcutaneous crepitation were considered as having Fournier's gangrene. Following resuscitation, aggressive surgical debridement was performed and vacuum-assisted closure (VAC) was conducted in addition to debridement in select patient. Repeat debridements were performed as requirement. This study included 25 patients. Fourteen patients (56%) were females and 11 (44%) were males. The mean age of the patients was 54.3 years (range: 27-82 years). The mean duration of hospital stay was 21.4 days; the mean number of debridements performed was 2.4. Thirteen patients (52%) had perianal abscesses, and 20 (80%) had diabetes mellitus. All patients underwent extensive debridement; 16 patients (64%) underwent VAC in addition to debridement. Patients undergoing VAC had significantly longer durations of hospital stay and a higher mean number of debridements performed (p=0.004 and p=0.048, respectively). An ostomy was made in one patient, and one patient died. In Fournier's gangrene, early diagnosis, effective resuscitation, aggressive debridement, and VAC application in suitable cases may reduce the morbidity and mortality rates and the need for an ostomy.

  9. Retrospective Analysis of Low Flows at Headwater Watersheds in Wyoming

    Science.gov (United States)

    Voutchkova, D. D.; Miller, S. N.

    2016-12-01

    Understanding summer low-flow variability and change in the mountainous West has important implications for water allocations downstream and for maintaining water availability for drinking water supply, reservoir storage, industrial, agricultural, and ecological needs. Wildfires and insect infestations are classical disturbance hydrology topics. It is unclear, however, what are their effects on streamflow and in particular low-flows, when vegetation disturbances are overlapping in time and combined with highly variable and potentially changing local climate. The purpose of this study, therefore, is to quantify changes in low-flows resulting from disturbance in headwater streams. Here we present a retrospective analysis based on: (1) 49-75 complete water years (wy) of daily streamflow data (USGS) for 14 high-elevation headwater watersheds with varying areas (60-1730 km2, 86-100% of watershed area >2000masl) and evergreen forest cover (15-82%), (2) 25-36 complete wy of daily snow-water equivalent accumulation (SWE) and precipitation data from Wyoming SNOTEL stations, (3) burned area boundaries for 20wy (MTBS project), (4) aerial surveys by R1, R2, R4 Forest Service Regions for 18wy (data on tree mortality). We quantify the change in various low-flow characteristics (e.g. post-snowmelt baseflow, Q90 and Q95, 3-,7-, 30- and 90-day annual minima etc.) while accounting for local inter- and multi-annual climate variability by using SWE accumulation data, as it integrates both temperature and precipitation changes. Our approach differs from typical before-after field-based investigation for paired watersheds, as it provides a synthesis over large temporal and spatial scales, resulting in spectrum of possible hydrologic responses due to varying disturbance severity. Quantifying the changes in low-flows and low-flow variability will improve our understanding and will facilitate water management and planning at local state-wide level.

  10. A Retrospective Analysis of Factors Affecting Early Stoma Complications.

    Science.gov (United States)

    Koc, Umit; Karaman, Kerem; Gomceli, Ismail; Dalgic, Tahsin; Ozer, Ilter; Ulas, Murat; Ercan, Metin; Bostanci, Erdal; Akoglu, Musa

    2017-01-01

    Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors. Variables abstracted included gender, age, and BMI; existence of malignant disease; comorbidities (diabetes mellitus, hypertension, coronary artery disease, chronic respiratory disease); use of neoadjuvant chemoradiotherapy; permanent or temporary stoma; type of stoma (loop/end stoma); stoma localization; and the use of preoperative marking of the stoma site. Data were entered and analyzed using statistical software. Descriptive statistics, chi-squared, and Mann-Whitney U tests were used to describe and analyze all variables, and logistic regression analysis was used to determine independent risk factors for stoma complications. Ostomy-related complications developed in 131 patients (28.4%) Of these, superficial mucocutaneous separation was the most frequent complication (90 patients, 19.5%), followed by stoma retraction (15 patients, 3.2%). In univariate analysis, malignant disease (P = .025), creation of a colostomy (P = .002), and left lower quadrant stoma location (P toma complication. Only stoma location was an independent risk factor for the development of a stoma complication (P = .044). The rate of stoma complications was not significantly different between patients who underwent nonemergent surgery (30% in patients preoperatively sited versus 28.4% not sited) and patients who underwent emergency surgery (27.1%). Early stoma complication rates were higher

  11. Rs7574865 polymorphism in signal transducers and activators of transcription 4 gene and rheumatoid arthritis: an updated meta-analysis of 28 case-control comparisons.

    Science.gov (United States)

    Gu, EnPeng; Lu, Jun; Xing, Dan; Chen, XingRan; Xie, HaiBo; Liang, JinQian; Li, Lin

    2015-01-01

    The objective of the present meta-analysis was to investigate whether the combined evidence shows an association between the STAT4 rs7574865 polymorphism and RA. A systematic search of all relevant studies published through April 2013 was conducted using MEDLINE, EMBASE, OVID, and ScienceDirect. The observational studies that were related to an association between the STAT4 rs7574865 polymorphism and RA were identified. The association between the STAT4 rs7574865 polymorphism and RA susceptibility was assessed using genetic models. Seventeen case-control studies with a total of 28 comparisons (25 300 RA patients and 26 326 controls) met the inclusion criteria. A meta-analysis was conducted for genotype TT versus GT+GG, GT+TT versus GG, TT versus GG and T-allele. The meta-analysis showed an association between RA and the STAT4 rs7574865 TT genotype, GT+TT genotype and T-allele in all subjects. Stratification of RA patients according to ethnic group showed that the TT genotype, GT+TT genotype and T-allele were significantly associated with RA in Europeans, Asians, Africans and Latin Americans. A subgroup analysis according to the absence or presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies revealed that the association between the STAT4 rs7574865 polymorphism and RA may be independent of the presence of RF and anti-CCP antibodies. This meta-analysis demonstrated that the STAT4 rs7574865 polymorphism confers susceptibility to RA in major ethnic groups. The association may not be dependent on the presence of RF and anti-CCP antibodies. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  12. Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery: A multicenter case-control study with propensity score matching analysis.

    Science.gov (United States)

    Soutome, Sakiko; Yanamoto, Souichi; Funahara, Madoka; Hasegawa, Takumi; Komori, Takahide; Yamada, Shin-Ichi; Kurita, Hiroshi; Yamauchi, Chika; Shibuya, Yasuyuki; Kojima, Yuka; Nakahara, Hirokazu; Oho, Takahiko; Umeda, Masahiro

    2017-08-01

    The aim of this study was to investigate the effectiveness of oral care in prevention of postoperative pneumonia associated with esophageal cancer surgery.Postoperative pneumonia is a severe adverse event associated with esophageal cancer surgery. It is thought to be caused by aspiration of oropharyngeal fluid containing pathogens. However, the relationship between oral health status and postoperative pneumonia has not been well investigated.This study included 539 patients with esophageal cancer undergoing surgery at 1 of 7 university hospitals. While 306 patients received perioperative oral care, 233 did not. Various clinical factors as well as occurrence of postoperative pneumonia were retrospectively evaluated. Propensity-score matching was performed to minimize selection biases associated with comparison of retrospective data between the oral care and control groups. Factors related to postoperative pneumonia were analyzed by logistic regression analysis.Of the original 539 patients, 103 (19.1%) experienced postoperative pneumonia. The results of multivariate analysis of the 420 propensity score-matched patients revealed longer operation time, postoperative dysphagia, and lack of oral care intervention to be significantly correlated with postoperative pneumonia.The present findings demonstrate that perioperative oral care can reduce the risk of postoperative pneumonia in patients undergoing esophageal cancer surgery.

  13. Retrospective Analysis of Inflight Exercise Loading and Physiological Outcomes

    Science.gov (United States)

    Ploutz-Snyder, L. L.; Buxton, R. E.; De Witt, J. K.; Guilliams, M. E.; Hanson, A. M.; Peters, B. T.; Pandorf, M. M. Scott; Sibonga, J. D.

    2014-01-01

    Astronauts perform exercise throughout their missions to counter the health declines that occur as a result of long-term exposure to weightlessness. Although all astronauts perform exercise during their missions, the specific prescriptions, and thus the mechanical loading, differs among individuals. For example, inflight ground reaction force data indicate that subject-specific differences exist in foot forces created when exercising on the second-generation treadmill (T2) [1]. The current exercise devices allow astronauts to complete prescriptions at higher intensities, resulting in greater benefits with increased efficiency. Although physiological outcomes have improved, the specific factors related to the increased benefits are unknown. In-flight exercise hardware collect data that allows for exploratory analyses to determine if specific performance factors relate to physiological outcomes. These analyses are vital for understanding which components of exercise are most critical for optimal human health and performance. The relationship between exercise performance variables and physiological changes during flight has yet to be fully investigated. Identifying the critical performance variables that relate to improved physiological outcomes is vital for creating current and future exercise prescriptions to optimize astronaut health. The specific aims of this project are: 1) To quantify the exercise-related mechanical loading experienced by crewmembers on T2 and ARED during their mission on ISS; 2) To explore relationships between exercise loading variables, bone, and muscle health changes during the mission; 3) To determine if specific mechanical loading variables are more critical than others in protecting physiology; 4) To develop methodology for operational use in monitoring accumulated training loads during crew exercise programs. This retrospective analysis, which is currently in progress, is being conducted using data from astronauts that have flown long

  14. The Glioma International Case-Control Study

    DEFF Research Database (Denmark)

    Amirian, E. Susan; Armstrong, Georgina N; Zhou, Renke

    2016-01-01

    Decades of research have established only a few etiological factors for glioma, which is a rare and highly fatal brain cancer. Common methodological challenges among glioma studies include small sample sizes, heterogeneity of tumor subtypes, and retrospective exposure assessment. Here, we briefly...... describe the Glioma International Case-Control (GICC) Study (recruitment, 2010-2013), a study being conducted by the Genetic Epidemiology of Glioma International Consortium that integrates data from multiple data collection sites, uses a common protocol and questionnaire, and includes biospecimen...

  15. A multicenter matched case-control analysis on seven polymorphisms from HMGB1 and RAGE genes in predicting hepatocellular carcinoma risk.

    Science.gov (United States)

    Wang, Dan; Qi, Xiaoying; Liu, Fang; Yang, Chuanhua; Jiang, Wenguo; Wei, Xiaodan; Li, Xuri; Mi, Jia; Tian, Geng

    2017-07-25

    Based on 540 hepatocellular carcinoma patients and 540 age- and gender-matched controls, we tested the hypothesis that high mobility group protein box1 (HMGB1) and the receptor for advanced glycation end products (RAGE) genes are two potential candidate susceptibility genes for hepatocellular carcinoma in a multicenter hospital-based case-control analysis. The genotypes of seven widely-studied polymorphisms were determined, and their distributions respected the Hardy-Weinberg equilibrium. The mutant alleles of two polymorphisms, rs1045411 in HMGB1 gene and rs2070600 in RAGE gene, had significantly higher frequencies in patients than in controls (P hepatocellular carcinoma significantly, particularly for rs2070600 under the additive (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.34-2.32; P hepatocellular carcinoma compared with the commonest C-C-T haplotype after adjustment. In RAGE gene, the T-T-A-G (rs1800625-rs1800624-rs2070600-rs184003) (adjusted OR; 95% CI; P: 1.75; 1.02-3.03; 0.045) and T-T-A-T (adjusted OR; 95% CI; P: 1.95; 1.01-3.76; 0.048) haplotypes were associated with a marginally increased risk of hepatocellular carcinoma compared with the commonest T-T-G-G haplotype. In summary, we identified two risk-associated polymorphisms (rs1045411 and rs2070600), and more importantly a joint impact of seven polymorphisms from the HMGB1/RAGE axis in susceptibility to hepatocellular carcinoma.

  16. Human Lung Cancer Risks from Radon – Part III - Evidence of Influence of Combined Bystander and Adaptive Response Effects on Radon Case-Control Studies - A Microdose Analysis

    Science.gov (United States)

    Leonard, Bobby E.; Thompson, Richard E.; Beecher, Georgia C.

    2012-01-01

    Since the publication of the BEIR VI (1999) report on health risks from radon, a significant amount of new data has been published showing various mechanisms that may affect the ultimate assessment of radon as a carcinogen, in particular the potentially deleterious Bystander Effect (BE) and the potentially beneficial Adaptive Response radio-protection (AR). The case-control radon lung cancer risk data of the pooled 13 European countries radon study (Darby et al 2005, 2006) and the 8 North American pooled study (Krewski et al 2005, 2006) have been evaluated. The large variation in the odds ratios of lung cancer from radon risk is reconciled, based on the large variation in geological and ecological conditions and variation in the degree of adaptive response radio-protection against the bystander effect induced lung damage. The analysis clearly shows Bystander Effect radon lung cancer induction and Adaptive Response reduction in lung cancer in some geographical regions. It is estimated that for radon levels up to about 400 Bq m−3 there is about a 30% probability that no human lung cancer risk from radon will be experienced and a 20% probability that the risk is below the zero-radon, endogenic spontaneous or perhaps even genetically inheritable lung cancer risk rate. The BEIR VI (1999) and EPA (2003) estimates of human lung cancer deaths from radon are most likely significantly excessive. The assumption of linearity of risk, by the Linear No-Threshold Model, with increasing radon exposure is invalid. PMID:22942874

  17. Retrospective analysis of oral and maxillofacial surgery cases in a ...

    African Journals Online (AJOL)

    Method: This was a retrospective study conducted at the Oral Dental Health Centre, Akure, Ondo state, Nigeria covering the period September, 2000 and April, 2004. ... Conclusion: A wide variety of cases were seen but socioeconomic, human resource and infrastructural problems limited the scope of practice. Keywords: ...

  18. Transfusion transmitted infections – A retrospective analysis from the ...

    African Journals Online (AJOL)

    Background: The emergence of transfusion transmitted infection (TTI) especially HIV/AIDS has created a huge obstacle in ensuring blood safety. To assess the situation in Eritrea, we carried out a retrospective study of 29,501 blood donors for the prevalence of TTI's i.e. HIV, HBV, HCV and Syphilis. Methods: The study ...

  19. Retrospective analysis of Newcastle disease diagnosed at the ...

    African Journals Online (AJOL)

    Newcastle disease (ND) is a highly contagious viral disease of domestic and wild birds with devastating impact on poultry health and production. Many vaccines and vaccination schedules are in use in controlling the disease but prevention and control are still a problem. A ten-year retrospective study (2002-2011) of ...

  20. Uterine rupture: a retrospective analysis of causes, complications ...

    African Journals Online (AJOL)

    We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ... Out of 72,570 deliveries 163 cases of ruptured uterus were recorded in seven years, making an incidence of 2.25 per 1000 births.

  1. Role of TNF-α -308G/A gene polymorphism in gastric cancer risk: A case control study and meta-analysis.

    Science.gov (United States)

    Du, Li Chuan; Gao, Ru

    2017-07-01

    In the Chinese population, gastric cancer (GC) is ranked as the third most common type of cancer. Although the exact etiology of GC development is unclear, several factors, including genetic and environmental, have been identified as risk factors. Variations in cytokine genes and their receptors have been related to a higher risk of GC. A single nucleotide polymorphism in the promoter region of tumor necrosis factor-α (TNF-α) (-308G>A) has been associated with a higher risk of GC and in the present study we evaluated its possible association with GC in a Chinese cohort. In addition, we performed a meta-analysis to draw a firm conclusion about the association between TNF-α gene polymorphisms and GC. We enrolled 400 Chinese GC patients and matched healthy controls hailing from similar geographical areas. The TNF-α -308G/A polymorphism was genotyped by allele-specific polymerase chain reaction (AS-PCR). For the meta-analysis, earlier published articles were searched and eligible studies were included. Prevalence of the heterozygous mutant (GA) and minor allele (A) were significantly higher in GC cases compared to healthy controls (GA: pA) with susceptibility to GC was only found in the Caucasian population (A vs G: p=0.001; AA vs GG: p=0.01; AG vs GG: p<0.0001; AA vs AG+GG: p=0.01; AA+AG vs p=0.003). The results of the present case control study and meta-analysis showed that associations between TNF-a variants with susceptibility to GC development is population and ethnic specific.

  2. Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies

    Directory of Open Access Journals (Sweden)

    Mikito Inokuchi

    2016-01-01

    Full Text Available Background. Some meta-analyses of case-controlled studies (CCSs have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG had some short-term advantages over open total gastrectomy (OTG. However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG. Methods. CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients’ status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software. Result. This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG (n = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85, P=0.01, I2 = 0%, and OR 0.46, 95% CI 0.17–0.52, P<0.0001, I2 = 0%. However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG (n = 2,560; OR 1.44, 95% CI 0.96–2.16, P=0.08, I2 = 0%. Conclusion. LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

  3. Complications in lumbar spine surgery: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Luca Proietti

    2013-01-01

    Full Text Available Background: Surgical treatment of adult lumbar spinal disorders is associated with a substantial risk of intraoperative and perioperative complications. There is no clearly defined medical literature on complication in lumbar spine surgery. Purpose of the study is to retrospectively evaluate intraoperative and perioperative complications who underwent various lumbar surgical procedures and to study the possible predisposing role of advanced age in increasing this rate. Materials and Methods: From 2007 to 2011 the number and type of complications were recorded and both univariate, (considering the patients′ age and a multivariate statistical analysis was conducted in order to establish a possible predisposing role. 133 were lumbar disc hernia treated with microdiscetomy, 88 were lumbar stenosis, treated in 36 cases with only decompression, 52 with decompression and instrumentation with a maximum of 2 levels. 26 patients showed a lumbar fracture treated with percutaneous or open screw fixation. 12 showed a scoliotic or kyphotic deformity treated with decompression, fusion and osteotomies with a maximum of 7.3 levels of fusion (range 5-14. 70 were spondylolisthesis treated with 1 or more level of fusion. In 34 cases a fusion till S1 was performed. Results: Of the 338 patients who underwent surgery, 55 showed one or more complications. Type of surgical treatment ( P = 0.004, open surgical approach (open P = 0.001 and operative time ( P = 0.001 increased the relative risk (RR of complication occurrence of 2.3, 3.8 and 5.1 respectively. Major complications are more often seen in complex surgical treatment for severe deformities, in revision surgery and in anterior approaches with an occurrence of 58.3%. Age greater than 65 years, despite an increased RR of perioperative complications (1.5, does not represent a predisposing risk factor to complications ( P = 0.006. Conclusion: Surgical decision-making and exclusion of patients is not justified only

  4. Shoulder injuries in professional rugby: a retrospective analysis.

    Science.gov (United States)

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-04-26

    In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome. The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort. Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in

  5. Candidate gene analysis of spontaneous preterm delivery: New insights from re-analysis of a case-control study using case-parent triads and control-mother dyads

    Directory of Open Access Journals (Sweden)

    Myking Solveig

    2011-12-01

    Full Text Available Abstract Background Spontaneous preterm delivery (PTD has a multifactorial etiology with evidence of a genetic contribution to its pathogenesis. A number of candidate gene case-control studies have been performed on spontaneous PTD, but the results have been inconsistent, and do not fully assess the role of how two genotypes can impact outcome. To elucidate this latter point we re-analyzed data from a previously published case-control candidate gene study, using a case-parent triad design and a hybrid design combining case-parent triads and control-mother dyads. These methods offer a robust approach to genetic association studies for PTD compared to traditional case-control designs. Methods The study participants were obtained from the Norwegian Mother and Child Cohort Study (MoBa. A total of 196 case triads and 211 control dyads were selected for the analysis. A case-parent triad design as well as a hybrid design was used to analyze 1,326 SNPs from 159 candidate genes. We compared our results to those from a previous case-control study on the same samples. Haplotypes were analyzed using a sliding window of three SNPs and a pathway analysis was performed to gain biological insight into the pathophysiology of preterm delivery. Results The most consistent significant fetal gene across all analyses was COL5A2. The functionally similar COL5A1 was significant when combining fetal and maternal genotypes. PON1 was significant with analytical approaches for single locus association of fetal genes alone, but was possibly confounded by maternal effects. Focal adhesion (hsa04510, Cell Communication (hsa01430 and ECM receptor interaction (hsa04512 were the most constant significant pathways. Conclusion This study suggests a fetal association of COL5A2 and a combined fetal-maternal association of COL5A1 with spontaneous PTD. In addition, the pathway analysis implied interactions of genes affecting cell communication and extracellular matrix.

  6. Association of Human Methionine Synthase-A2756G Transition With Prostate Cancer: A Case-Control Study and in Silico Analysis

    Directory of Open Access Journals (Sweden)

    Arezou Ebrahimi

    2017-07-01

    Full Text Available Methionine synthase (MTR is one of the key enzymes of folate pathway, which play a key role in the construction, repair, and methylation of DNA. In this study, an association of MTR A2756G gene transition with prostate cancer in men populations of Kashan-Iran was investigated by a case-control study and an in silico analysis. The 200 samples including 100 patients with prostate cancer, as case group and 100 healthy men, as control group included in this study. MTR-A2756G genotyping was performed by PCR-RFLP technique. Some in silico tools used to evaluate the effects of A2756G transition on the structure and function of MTR. Results showed that the AG genotype (OR: 2.4014, 95% CI: 1.3216-4.3636, P=0.0040, and GG genotype (OR: 3.6324, 95% CI: 1.2629-10.4475, P=0.0167 and G allele (OR: 2.0120, 95% CI: 1.3098-3.0905, P=0.0014 were associated with prostate cancer. In silico analysis showed that polymorphisms of the enzyme protein might change properties of MTR such as relative mutability and flexibility, which leads to alteration of stability and function of the enzyme. Based on the results, an MTR-A2756G polymorphism which changes activity and stability of the methionine synthase associated with prostate cancer in men. It is a preliminary study and is presenting data for future comprehensive study for making a clinical conclusion that this gene transition is a biomarker for susceptibility to prostate cancer.

  7. Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies.

    Science.gov (United States)

    Xu, Ping; Luo, Hong; Huang, Guang-Lei; Yin, Xin-Hai; Luo, Si-Yang; Song, Ju-Kun

    2015-01-01

    Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma. The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and 95% confidence intervals (95% CIs) were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed. Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70-1.32; dental X-rays: OR, 1.05; 95% CI, 0.89-1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76-1.34). However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28-2.34). Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed. Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.

  8. The association of interleukin-1alpha and interleukin-1beta polymorphisms with the risk of Graves' disease in a case-control study and meta-analysis.

    Science.gov (United States)

    Liu, Nan; Li, Xuejun; Liu, Changqin; Zhao, Yongju; Cui, Bin; Ning, Guang

    2010-04-01

    The proinflammatory cytokine interleukin (IL)-1 family has a central role in mediating inflammation and joint destruction in Graves' disease (GD). A number of studies, investigating rs1800587 (IL-1alpha, T-889 C) and rs16944 (IL-1beta, A-511 G) polymorphisms to test their possible association with GD and Graves' ophthalmopathy (GO), had inconsistent results. Our study aims to further evaluate the possible association of these two polymorphisms with GD and GO within the Han Chinese population using a case-control association study as well as a meta-analysis covering three previous studies from Taiwan, Iran, and Poland. Based on 760 Chinese GD patients, including 190 of GO cases among them, and 735 healthy control subjects, our data showed that the genotype or allele distributions of rs1800587 and rs16944 polymorphisms were significantly associated with GD (p = 0.003-0.049) and more so with GO (p = 0.001-0.021). The meta-analysis showed the risk-increasing effects for the TC and TT genotypes of rs1800587 in GD (odds ratio [OR] = 2.07, p = 0.03) and GO (OR = 3.22, p = 0.04), and a protective effect for the AA genotype of rs16944 in GD (OR = 0.70, p = 0.002) and GO (OR = 0.65, p = 0.02). The results confirmed that the rs1800587 (IL-alpha, T-889 C) and rs16944 (IL-1beta, A-511 G) polymorphisms may confer susceptibility to GD and GO in Asian population.

  9. Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies.

    Directory of Open Access Journals (Sweden)

    Ping Xu

    Full Text Available Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma.The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR estimates and 95% confidence intervals (95% CIs were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed.Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70-1.32; dental X-rays: OR, 1.05; 95% CI, 0.89-1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76-1.34. However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28-2.34. Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed.Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.

  10. Genetic variants on chromosome 8q24 and colorectal neoplasia risk: a case-control study in China and a meta-analysis of the published literature.

    Directory of Open Access Journals (Sweden)

    Mian Li

    Full Text Available Previous studies have found that common genetic variants on chromosome 8q24 are associated with the risk of developing colorectal neoplasia. We conducted a hospital-based case-control study, including 435 cases and 788 unrelated controls to investigate the associations between common variants on 8q24 and the risk of colorectal cancer in a Chinese population. We also evaluated the association of rs6983267 with colorectal neoplasia in the published literature via a meta-analysis study. We found that rs6983267 was significantly associated with the risk of colorectal cancer in the Chinese population, with an adjusted odds-ratio (OR for the GT heterozygotes and GG homozygotes of 1.30 (95% CI= 0.98-1.71, P = 0.069 and 1.66 (95% CI = 1.18-2.34, P = 0.004, respectively, compared to the TT homozygotes, with a P-trend value of 0.003. No association was found for the other three loci (rs16901979, rs1447295 and rs7837688. In the meta-analysis of the published genetic association studies, the rs6983267 variant was found to be associated with an increased risk of colorectal neoplasia. The heterozygous GT carriers showed a 20% increased risk of colorectal neoplasia (OR= 1.20, 95% CI= 1.16-1.25; random effects model with a summary OR for homozygous GG carriers of 1.39 (95% CI= 1.32-1.48; random effects model compared to the TT genotype carriers. We found no significant differences between the association of rs6983267 and colorectal cancer and colorectal adenomas. In summary, our study confirms that the variant rs6983267 is a risk factor for colorectal neoplasia in various populations, including the Chinese population.

  11. Mobile phone and cordless phone use and the risk for glioma - Analysis of pooled case-control studies in Sweden, 1997-2003 and 2007-2009.

    Science.gov (United States)

    Hardell, Lennart; Carlberg, Michael

    2015-03-01

    We made a pooled analysis of two case-control studies on malignant brain tumours with patients diagnosed during 1997-2003 and 2007-2009. They were aged 20-80 years and 18-75 years, respectively, at the time of diagnosis. Only cases with histopathological verification of the tumour were included. Population-based controls, matched on age and gender, were used. Exposures were assessed by questionnaire. The whole reference group was used in the unconditional regression analysis adjusted for gender, age, year of diagnosis, and socio-economic index. In total, 1498 (89%) cases and 3530 (87%) controls participated. Mobile phone use increased the risk of glioma, OR=1.3, 95% CI=1.1-1.6 overall, increasing to OR=3.0, 95% CI=1.7-5.2 in the >25 year latency group. Use of cordless phones increased the risk to OR=1.4, 95% CI=1.1-1.7, with highest risk in the >15-20 years latency group yielding OR=1.7, 95% CI=1.1-2.5. The OR increased statistically significant both per 100h of cumulative use, and per year of latency for mobile and cordless phone use. Highest ORs overall were found for ipsilateral mobile or cordless phone use, OR=1.8, 95% CI=1.4-2.2 and OR=1.7, 95% CI=1.3-2.1, respectively. The highest risk was found for glioma in the temporal lobe. First use of mobile or cordless phone before the age of 20 gave higher OR for glioma than in later age groups. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Artifact in Pediatric Oculomotor Findings during Videonystagmography: A Retrospective Analysis.

    Science.gov (United States)

    Doettl, Steven M; Plyler, Patrick N; McCaslin, Devin L

    2017-04-01

    Accurate measurement of oculomotor function using videonystagmography (VNG) is imperative for diagnosis and management of patients with reported dizziness. The oculomotor evaluation during VNG utilizes video-oculography providing valuable information regarding the central structures and pathways that control eye movements. Artifact may have an effect on the overall validity and reliability of VNG oculomotor tracings and can result from patient and/or recording errors. It is postulated that artifact could occur more frequently in the pediatric population due to both patient and equipment factors. The purpose of this study was to systematically evaluate the occurrence and impact of artifact on saccades, smooth pursuit, and optokinetic (OPK) testing in normal pediatric and adult subjects using commercially available clinical VNG equipment and standard clinical protocols for oculomotor testing. The present study utilized a retrospective analysis of a repeated measures design. Oculomotor results from a total of 62 participants were analyzed. Portions of these data have been presented in a previous research study. Group 1 consisted of twenty-nine 4- to 6-yr-olds with an average age of 4.86 (SD = 0.88) yr. Group 2 consisted of thirty-three 22- to 44-yr-olds with an average age of 25.2 (SD = 5.34) yr. Raw oculomotor recordings were analyzed "offline" by a single masked, trained investigator. Each tracing was evaluated for instances of artifact including eye blinks, eye closure, eyes moving in opposite direction of the target, eye tracking software problems, and overall poor morphology. The number of instances of artifact were noted and recorded for each participant in both groups. Individual eye movements not affected by artifact were included for final analysis. Artifact rejection techniques were also compared. The results indicated increased artifact for the pediatric group for saccade and smooth pursuit testing. Additionally, a significant decrease in instances of

  13. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

    OpenAIRE

    Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

    2017-01-01

    Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD’s symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two group...

  14. Lack of association between cytotoxic T-lymphocyte antigen 4 (CTLA-4 -1722T/C (rs733618 polymorphism and cancer risk: from a case-control study to a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Weifeng Tang

    Full Text Available BACKGROUND: The association between cytotoxic T-lymphocyte antigen 4 (CTLA-4 gene -1722T/C polymorphism (rs733618 and cancer has been widely assessed, and a definitive conclusion remains elusive. We first performed a hospital based case-control study to measure this association of esophageal cancer with CTLA-4 -1722T/C polymorphism in Han Chinese population, and then carried out a meta-analysis to obtain a comprehensive evaluation for this issue. METHODOLOGY/PRINCIPAL FINDINGS: This case-control study involved 629 esophageal squamous cell carcinoma (ESCC cases and 686 age and gender well matched cancer-free controls. PCR-LDR (polymerase chain reaction-ligase detection reactions method was used to identify genotypes. Meta-analysis was conducted by STATA (v12.0 software. This case-control study showed no significant difference in the genotype and allele distributions of CTLA-4 -1722T/C polymorphism between esophageal cancer cases and control subjects, in accord with the findings of the further meta-analysis in all genetic models. Evidence of large heterogeneity was observed among all eligible studies in the recessive model. Further subgroup analyses by ethnicity, cancer type and system, detected null associations in this meta-analysis. CONCLUSION: This case-control study and the further meta-analysis, failed to identify the association between CTLA-4 -1722T/C polymorphism and cancer risk.

  15. Significant association between asthma risk and the GSTM1 and GSTT1 deletion polymorphisms: an updated meta-analysis of case-control studies.

    Science.gov (United States)

    Liang, Siqiao; Wei, Xuan; Gong, Chen; Wei, Jinmei; Chen, Zhangrong; Chen, Xiaoli; Wang, Zhibo; Deng, Jingmin

    2013-07-01

    Polymorphisms in GSTM1 and GSTT1 may be associated with asthma risk, yet several studies and meta-analyses have reported inconclusive results. Therefore, an updated meta-analysis was conducted. Literature searches were performed using the Pubmed, Embase and Web of Science databases until October 2012. Variant 'null' genotype was compared with wild-type 'present' in the pooled data. All statistical analyses were performed using STATA 11.0. A total of 26 case-control studies were suitable for inclusion in the meta-analysis. In the overall population, a significant association was found for both the GSTM1 (odds ratio (OR) = 1.452; 95% confidence interval (CI): 1.192-1.770) and GSTT1 polymorphism (OR = 1.792; 95% CI:1.293-2.483). For subgroup analysis by age, GSTM1 significantly increased risk for both children (OR = 1.368; 95% CI: 1.051-1.781) and adults (OR = 1.859; 95% CI: 1.183-2.921). For GSTT1, a significant association was only found in the adult population (OR = 2.312; 95%CI: 1.204-4.439). Based on subgroup analysis by ethnicity, a significant association for GSTM1 was found in Europe (OR = 1.303; 95% CI: 1.018-1.667), Africa (OR = 2.175; 95%CI: 1.560-3.031) and Latin America (OR = 2.265; 95%CI: 1.375-3.729). For GSTT1, significantly increased risk was found only for Asian (OR = 2.105; 95% CI: 1.101-4.025) and Russian (OR = 2.747; 95% CI: 1.071-7.046) populations. This meta-analysis provides evidence that GSTM1 and GSTT1 polymorphisms may be risk factors for asthma. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  16. Obsessive-Compulsive Disorder and quality of life outcomes: protocol for a systematic review and meta-analysis of cross-sectional case-control studies

    Directory of Open Access Journals (Sweden)

    Anna Coluccia

    2015-06-01

    Full Text Available Background. Obsessive-compulsive Disorder (OCD is a chronic disabling psychological condition, which can severely affect quality of life (QOL. Growing interest has been dedicated to assessing which domains of QOL are more severely affected in patients with OCD. However, research yielded conflicting findings. Investigating QOL in OCD could suggest the need for integration of interventions aimed at improving those specific domains more severely impaired by obsessions and compulsions.Methods. We will conduct a systematic review of cross-sectional case-control studies according to PRISMA guidelines, where patients with a primary OCD diagnosis were compared on QOL outcomes with healthy controls. Primary objectives will be to examine differences in QOL outcomes between patients with OCD and healthy controls, and to assess which QOL domains are more severely impaired in patients compared with controls, particularly subjective well-being, social and interpersonal functioning, work functioning, and family functioning. Subsequently, the study will investigate potential moderators of QOL in OCD, including participants characteristics (age, sex, presence of comorbid personality disorders, OCD symptom severity, severity of concurrent depressive symptoms, duration of OCD symptoms, and generational cohort, and study characteristics (date of publication and methodological quality of the studies. Online databases will be searched (PsycINFO, PubMED, Science Direct, Cinahl, Biological Abstracts, Psyclit, Embase, The Cochrane Central Register of Controlled Trials, and Google Scholar. To locate unpublished records, conference abstracts, doctoral dissertations and theses will be handsearched, and experts will be contacted. Statistical analyses will be performed though random effect model meta-analysis. Risk of bias assessments will be conducted using the instrument Methodological Index for Non-Randomized Studies.

  17. Pooled analysis of two case-control studies in New Caledonia and French Polynesia of body mass index and differentiated thyroid cancer: the importance of body surface area.

    Science.gov (United States)

    Cléro, Enora; Leux, Christophe; Brindel, Pauline; Truong, Thérèse; Anger, Antoinette; Teinturier, Cécile; Diallo, Ibrahima; Doyon, Françoise; Guénel, Pascal; de Vathaire, Florent

    2010-11-01

    New Caledonia and French Polynesia have among of the world highest thyroid cancer incidence rates. Studies have demonstrated a relationship between anthropometric parameters and the prevalence of cancer. In this study we evaluated further the relationship between body mass index (BMI) and other anthropometric parameters on the incidence of thyroid cancer in the New Caledonia and French Polynesia populations. We performed a pooled analysis of two case-control studies in New Caledonia and French Polynesia. We included a total of 554 cases (65 men and 489 women) of differentiated thyroid cancers and 776 population control subjects matched on sex, age, and study. Anthropometric factors (height, weight, BMI, body fat percentage [BF%], and body surface area [BSA]), at age 18 and before diagnosis, were analyzed by conditional logistic regression, adjusting for other independent risk factors. A high proportion of cases (73%) were overweight (25-29.9 kg/m(2)) or obese (≥30 kg/m(2)) before diagnosis of thyroid cancer (against 57% of control subjects). An increased risk of thyroid cancer was observed with greater height, weight, BMI, BF%, and BSA. The association of thyroid cancer risk with height, weight, BMI, and BF% did not remain when adjustment was made for BSA. By comparison, the odds ratios for the highest versus the lowest quartile of BSA at age 18 were 3.97 (95% confidence interval, 2.57-6.15; p < 0.001) for women and 4.06 (95% confidence interval, 1.03-16.06; p = 0.04) for men. The association between thyroid cancer risk and each of anthropometric factors did not depend on tumor size or menopausal status before diagnosis. Among anthropometric factors, BSA plays a dominant role in thyroid cancer risk and explains the apparent role of BMI.

  18. Meta-analysis of association between the TP53 Arg72Pro polymorphism and risk of endometriosis based on case-control studies.

    Science.gov (United States)

    Yan, Yulan; Wu, Renzheng; Li, Shaojing; He, Jinlong

    2015-06-01

    In the light of the relationship between the TP53 Arg72Pro (rs1042522) polymorphism and the risk of endometriosis remains inclusive or controversial. For better understanding of the effect of TP53 Arg72Pro polymorphism on endometriosis risk, we performed a meta-analysis. The relevant studies were identified through a search of PubMed, Web of Science, EMBASE, Ovid, Springer, China National Knowledge Infrastructure (CNKI), cqvip, Wanfang database, and Chinese Biomedical Literature (CBM) databases up to December, 2014. The association between the TP53 Arg72Pro polymorphism and endometriosis risk was pooled by conducted by odds ratios and 95% confidence intervals. A total of fifteen case-control studies with 2683 cases and 3335 controls were eventually identified. There was significant association between Arg72Pro polymorphism and endometriosis risk in all of the five models in overall populations (C vs. G: OR=1.32, 95%CI=1.14-1.53, p=0.00; CC vs. GG: OR=1.80, 95%CI=1.28-2.53, p=0.001; GC vs. GG: OR=1.52, 95%CI=1.22-1.88, p=0.00; CC vs. OR=1.32, 95%CI=1.05-1.66, p=0.016; CC/GC vs. GG: OR=1.59, 95%CI=1.26-2.00, p=0.00). In the sub-group analysis according to ethnicity, the results suggested that TP53 Arg72Pro polymorphism was not associated with endometriosis risk in Caucasians. However, the significant association was found in Asians and Mixed race (MIX) under the five models. The results of this meta-analysis suggest that the TP53 Arg72Pro polymorphism can increase the risk of endometriosis, especially among Asians and MIX populations. Considering the limited sample size and ethnicities included in the meta-analysis, further larger scaled and well-designed studies are needed to confirm our results. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Metabolomic analysis of 92 pulmonary embolism patients from a nested case-control study identifies metabolites associated with adverse clinical outcomes.

    Science.gov (United States)

    Zeleznik, O A; Poole, E M; Lindstrom, S; Kraft, P; Van Hylckama Vlieg, A; Lasky-Su, J A; Harrington, L B; Hagan, K; Kim, J; Parry, B A; Giordano, N; Kabrhel, C

    2018-03-01

    Essentials Risk-stratification often fails to predict clinical deterioration in pulmonary embolism (PE). First-ever high-throughput metabolomics analysis of risk-stratified PE patients. Changes in circulating metabolites reflect a compromised energy metabolism in PE. Metabolites play a key role in the pathophysiology and risk stratification of PE. Background Patients with acute pulmonary embolism (PE) exhibit wide variation in clinical presentation and outcomes. Our understanding of the pathophysiologic mechanisms differentiating low-risk and high-risk PE is limited, so current risk-stratification efforts often fail to predict clinical deterioration and are insufficient to guide management. Objectives To improve our understanding of the physiology differentiating low-risk from high-risk PE, we conducted the first-ever high-throughput metabolomics analysis (843 named metabolites) comparing PE patients across risk strata within a nested case-control study. Patients/methods We enrolled 92 patients diagnosed with acute PE and collected plasma within 24 h of PE diagnosis. We used linear regression and pathway analysis to identify metabolites and pathways associated with PE risk-strata. Results When we compared 46 low-risk with 46 intermediate/high-risk PEs, 50 metabolites were significantly different after multiple testing correction. These metabolites were enriched in the following pathways: tricarboxylic acid (TCA) cycle, fatty acid metabolism (acyl carnitine) and purine metabolism, (hypo)xanthine/inosine containing. Additionally, energy, nucleotide and amino acid pathways were downregulated in intermediate/high-risk PE patients. When we compared 28 intermediate-risk with 18 high-risk PE patients, 41 metabolites differed at a nominal P-value level. These metabolites were enriched in fatty acid metabolism (acyl cholines), and hemoglobin and porphyrin metabolism. Conclusion Our results suggest that high-throughput metabolomics can provide insight into the

  20. Incremental cost-effectiveness of proton pump inhibitors for the prevention of NSAID ulcers: a pharmacoeconomic analysis linked to a case-control study.

    NARCIS (Netherlands)

    Vonkeman, Harald Erwin; Braakman-Jansen, Louise Marie Antoinette; Klok, Rogier M.; Postma, Maarten J.; Brouwers, Jacobus R.B.J.; van de Laar, Mart A F J

    2008-01-01

    Introduction We estimated the cost effectiveness of concomitant proton pump inhibitors (PPIs) in relation to the occurrence of non-steroidal anti-inflammatory drug (NSAID) ulcer complications. Methods This study was linked to a nested case-control study. Patients with NSAID ulcer complications were

  1. Ethnic differences in metabolite signatures and type 2 diabetes: a nested case-control analysis among people of South Asian, African and European origin

    NARCIS (Netherlands)

    van Valkengoed, Irene G. M.; Argmann, Carmen; Ghauharali-van der Vlugt, Karen; Aerts, Johannes M. F. G.; Brewster, Lizzy M.; Peters, R. J. G.; Vaz, Frédéric M.; Houtkooper, Riekelt H.

    2017-01-01

    Accumulation of metabolites may mark or contribute to the development of type 2 diabetes mellitus (T2D), but there is a lack of data from ethnic groups at high risk. We examined sphingolipids, acylcarnitines and amino acids, and their association with T2D in a nested case-control study among 54

  2. Ethnic differences in metabolite signatures and type 2 diabetes : a nested case-control analysis among people of South Asian, African and European origin

    NARCIS (Netherlands)

    Valkengoed, van I.G.M.; Argmann, C.; Ghauharali-van, der Vlugt K.; Aerts, J.M.F.G.; Brewster, L.M.; Peters, R.J.G.; Vaz, F.M.; Houtkooper, R.H.

    2017-01-01

    Accumulation of metabolites may mark or contribute to the development of type 2 diabetes mellitus (T2D), but there is a lack of data from ethnic groups at high risk. We examined sphingolipids, acylcarnitines and amino acids, and their association with T2D in a nested case-control study among 54

  3. [Medical negligence in surgery: 112 cases retrospective analysis].

    Science.gov (United States)

    Xiang, Jian; Chang, Lin; Wang, Xu; Zhang, Feng-Qin

    2013-06-01

    To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.

  4. A genetic variant in miR-196a2 increased digestive system cancer risks: a meta-analysis of 15 case-control studies.

    Directory of Open Access Journals (Sweden)

    Jing Guo

    Full Text Available BACKGROUND: MicroRNAs (miRNAs negatively regulate the gene expression and act as tumor suppressors or oncogenes in oncogenesis. The association between single nucleotide polymorphism (SNP in miR-196a2 rs11614913 and the susceptibility of digestive system cancers was inconsistent in previous studies. METHODOLOGY/PRINCIPAL FINDINGS: An updated meta-analysis based on 15 independent case-control studies consisting of 4999 cancer patients and 7606 controls was performed to address this association. It was found that miR-196a2 polymorphism significantly elevated the risks of digestive system cancers (CT vs. TT, OR = 1.25, 95% CI = 1.07-1.45; CC vs. TT, OR = 1.38, 95% CI = 1.13-1.67; CC/CT vs. TT, OR = 1.29, 95% CI = 1.10-1.50; CC vs. CT/TT, OR = 1.14, 95% CI = 1.01-1.30; C vs. T, OR = 1.15, 95% CI = 1.05-1.26. We also found that variant in miR-196a2 increased the susceptibility of colorectal cancer (CRC (CT vs. TT, OR = 1.23, 95% CI = 1.04-1.44; CC vs. TT, OR = 1.32, 95% CI = 1.08-1.61; CC/CT vs. TT, OR = 1.25, 95% CI = 1.07-1.46; C vs. T, OR = 1.15, 95% CI = 1.05-1.28, while the association in recessive model (CC vs. CT/TT, OR = 1.16, 95% CI = 0.98-1.38 showed a marginal significance. Additionally, significant association between miR-196a2 polymorphism and increased risk of hepatocellular cancer (HCC was detected. By stratifying tumors on the basis of site of origin, source of controls, ethnicity and allele frequency in controls, elevated cancer risks were observed. CONCLUSION/SIGNIFICANCE: Our findings suggest the significant association between miR-196a2 polymorphism and increased susceptibility of digestive system cancers, especially of CRC, HCC and Asians. Besides, C allele may contribute to increased digestive cancer risks.

  5. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Ludwig, Lea; Pasman, Joëlle A; Nicholson, Timothy; Aybek, Selma; David, Anthony S; Tuck, Sharon; Kanaan, Richard A; Roelofs, Karin; Carson, Alan; Stone, Jon

    2018-04-01

    Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder. We did a meta-analysis, with assessments of methodology, sources of bias, and sensitivity analyses. 34 case-control studies, with 1405 patients, were eligible. Studies were of moderate-to-low quality. The frequency of childhood and adulthood stressors was increased in cases compared with controls. Odds ratios (OR) were higher for emotional neglect in childhood (49% for cases vs 20% for controls; OR 5·6, 95% CI 2·4-13·1) compared with sexual abuse (24% vs 10%; 3·3, 2·2-4·8) or physical abuse (30% vs 12%; 3·9, 2·2-7·2). An association with stressful life events preceding onset (OR 2·8, 95% CI 1·4-6·0) was stronger in studies with better methods (interviews; 4·3, 1·4-13·2). Heterogeneity was significant between studies (I 2 21·1-90·7%). 13 studies that specifically ascertained that the participants had not had either severe life events or any subtype of maltreatment all found a proportion of patients with functional neurological disorder reporting no stressor. Stressful life events and maltreatment are substantially more common in people with functional neurological disorder than in healthy controls and patient controls. Emotional neglect had a higher risk than traditionally emphasised sexual and physical abuse, but many cases report no stressors. This outcome supports changes to diagnostic criteria in DSM-5; stressors, although relevant to the cause in many patients, are not a core diagnostic feature. This

  6. Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997-2003 and 2007-2009 and use of mobile and cordless phones.

    Science.gov (United States)

    Hardell, Lennart; Carlberg, Michael; Söderqvist, Fredrik; Mild, Kjell Hansson

    2013-10-01

    We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20-80 years, diagnosed during 1997-2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007-2009 including both men and women aged 18-75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0-4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8-21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1-2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8-4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1-2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7-26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1-2.0 increasing to OR = 8.1, 95% CI = 2.0-32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2-9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless phones. OR increased per 100 h

  7. Human Campylobacteriosis in Luxembourg, 2010?2013: A Case-Control Study Combined with Multilocus Sequence Typing for Source Attribution and Risk Factor Analysis

    OpenAIRE

    Mossong, Jo?l; Mughini-Gras, Lapo; Penny, Christian; Devaux, Anthony; Olinger, Christophe; Losch, Serge; Cauchie, Henry-Michel; van Pelt, Wilfrid; Ragimbeau, Catherine

    2016-01-01

    Campylobacteriosis has increased markedly in Luxembourg during recent years. We sought to determine which Campylobacter genotypes infect humans, where they may originate from, and how they may infect humans. Multilocus sequence typing was performed on 1153 Campylobacter jejuni and 136 C. coli human strains to be attributed to three putative animal reservoirs (poultry, ruminants, pigs) and to environmental water using the asymmetric island model. A nationwide case-control study (2010?2013) for...

  8. Shrinkage Estimators for Robust and Efficient Inference in Haplotype-Based Case-Control Studies

    KAUST Repository

    Chen, Yi-Hau

    2009-03-01

    Case-control association studies often aim to investigate the role of genes and gene-environment interactions in terms of the underlying haplotypes (i.e., the combinations of alleles at multiple genetic loci along chromosomal regions). The goal of this article is to develop robust but efficient approaches to the estimation of disease odds-ratio parameters associated with haplotypes and haplotype-environment interactions. We consider "shrinkage" estimation techniques that can adaptively relax the model assumptions of Hardy-Weinberg-Equilibrium and gene-environment independence required by recently proposed efficient "retrospective" methods. Our proposal involves first development of a novel retrospective approach to the analysis of case-control data, one that is robust to the nature of the gene-environment distribution in the underlying population. Next, it involves shrinkage of the robust retrospective estimator toward a more precise, but model-dependent, retrospective estimator using novel empirical Bayes and penalized regression techniques. Methods for variance estimation are proposed based on asymptotic theories. Simulations and two data examples illustrate both the robustness and efficiency of the proposed methods.

  9. Shrinkage Estimators for Robust and Efficient Inference in Haplotype-Based Case-Control Studies

    KAUST Repository

    Chen, Yi-Hau; Chatterjee, Nilanjan; Carroll, Raymond J.

    2009-01-01

    Case-control association studies often aim to investigate the role of genes and gene-environment interactions in terms of the underlying haplotypes (i.e., the combinations of alleles at multiple genetic loci along chromosomal regions). The goal of this article is to develop robust but efficient approaches to the estimation of disease odds-ratio parameters associated with haplotypes and haplotype-environment interactions. We consider "shrinkage" estimation techniques that can adaptively relax the model assumptions of Hardy-Weinberg-Equilibrium and gene-environment independence required by recently proposed efficient "retrospective" methods. Our proposal involves first development of a novel retrospective approach to the analysis of case-control data, one that is robust to the nature of the gene-environment distribution in the underlying population. Next, it involves shrinkage of the robust retrospective estimator toward a more precise, but model-dependent, retrospective estimator using novel empirical Bayes and penalized regression techniques. Methods for variance estimation are proposed based on asymptotic theories. Simulations and two data examples illustrate both the robustness and efficiency of the proposed methods.

  10. osDesign: An R Package for the Analysis, Evaluation, and Design of Two-Phase and Case-Control Studies

    Directory of Open Access Journals (Sweden)

    Sebastien Haneuse

    2011-08-01

    Full Text Available The two-phase design has recently received attention in the statistical literature as an extension to the traditional case-control study for settings where a predictor of interest is rare or subject to missclassification. Despite a thorough methodological treatment and the potential for substantial efficiency gains, the two-phase design has not been widely adopted. This may be due, in part, to a lack of general-purpose, readily-available software. The osDesign package for R provides a suite of functions for analyzing data from a two-phase and/or case-control design, as well as evaluating operating characteristics, including bias, efficiency and power. The evaluation is simulation-based, permitting flexible application of the package to a broad range of scientific settings. Using lung cancer mortality data from Ohio, the package is illustrated with a detailed case-study in which two statistical goals are considered: (i the evaluation of small-sample operating characteristics for two-phase and case-control designs and (ii the planning and design of a future two-phase study.

  11. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients.

    Science.gov (United States)

    Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

    2017-01-01

    Aim . Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods . A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results . Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion . This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

  12. Oral paracoccidioidomycosis: Retrospective analysis of 55 Brazilian patients.

    Science.gov (United States)

    Trindade, Aline Heloísa; Meira, Henrique Côrtes; Pereira, Igor Figueiredo; de Lacerda, Julio César Tanos; de Mesquita, Ricardo Alves; Santos, Vagner Rodrigues

    2017-08-01

    Paracoccidioidomycosis (PCM) is a rare fungal infection in the world, but endemic and acquired exclusively in Latin America, with the highest prevalence in South America and Brazil, particularly. Changes in oral cavity are common and constitute the first clinical manifestation in many patients. The aim of this study was to describe the prevalence of oral PCM and analyse the profile of the disease and patients. Retrospective research, consisting of information present in the medical records in the period 1998-2015, whose histopathological diagnosis was oral PCM. Fifty-five oral PCM cases were confirmed. Of these patients, 90.9% were males and 9.1% were females. The average age was 49.66 years and the most reported occupation was rural workers. The painful symptomatology was present in 61.82% of patients. Erythematous lesions were predominant in 73% of them. In single lesions (22 cases), the most common locations were jugal mucosa and tongue. In multiple involvement (30 cases), the most affected regions were lips, jugal mucosa and alveolar ridge. Epidemiology of PCM, was similar to several other studies, especially in Brazil. This is the most important fungal infection in Latin America and the recognition of oral lesions is extremely important, as is often the first and in many cases the only manifestation of the disease. © 2017 Blackwell Verlag GmbH.

  13. Hepatocellular carcinoma: a retrospective analysis of 118 cases

    International Nuclear Information System (INIS)

    Aman-ur-Rehman; Murad, S.

    2002-01-01

    Objective: This study aimed at documenting the spectrum of clinico pathological variations in hepatocellular carcinoma (HCC). Design: It was a retrospective study. Place and duration of Study: This study was conducted at the Institute of Nuclear Medicine and Oncology (INMOL) Hospital, Lahore from March 1997 to December 2000. Patients and Methods: The profiles of 118 patients with a biopsy proven hepatocellular carcinoma were analyzed in this period. The data collected was age, sex, clinical presentation and laboratory investigations including liver function tests, alpha fetoprotein and hepatitis profile. Results: Weight loss, jaundice and right upper quadrant abdominal pain were the main presenting symptoms. Out of 118 patients, alpha fetoprotein values were raised in 63(53.38%) patients 106 (89.83%) patients were found to have or have had HBV infections, and 92 (77.96%) patients were anti-HCV positive. Eighty-three (70.33%) patients were cirrhotic. History of alcohol abuse was bound in three patients. Conclusion: The common association of HCC with cirrhosis and hepatitis B and C suggests that vaccination against HBV on nationwide basis can decrease prevalence of this malignancy. There is a need to generate public awareness regarding the transmission of these viruses. Early diagnosis and intervention is also important to the successful management of HCC. (author)

  14. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

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    Carlo Di Paolo

    2017-01-01

    Full Text Available Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs. The aim of this study was to evaluate, retrospectively, if headache influences TMD’s symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH and Group without Headache (GwoH. Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities, and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

  15. The relationship of temporomandibular disorders with headaches: a retrospective analysis.

    Science.gov (United States)

    Özkan, Nilüfer Cakir; Ozkan, Fatih

    2011-01-01

    The objective of this study was to retrospectively analyze the incidence of the concurrent existence of temporomandibular disorders (TMD) and headaches. Forty patients (36 female, 4 male, mean age: 29.9±9.6 years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: range of mouth opening, temporomandibular joint (TMJ) noises, pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles, and magnetic resonance imaging of the TMJ. According to patient records, a total of 40 (66.6%) patients were diagnosed with TMD among 60 patients with headache. Thirty-two (53%) patients had TMJ internal derangement (ID), 8 (13%) patients had only myofascial pain dysfunction (MPD) and 25 (41.6%) patients had concurrent TMJ ID/MPD. There were statistically significant relationships between the number of tender masseter muscles and MPD patients (p=0.04) and between the number of tender medial pterygoid muscles and patients with reducing disc displacement (RDD) (p=0.03). The TMJ and associated orofacial structures should be considered as possible triggering or perpetuating factors for headaches, especially tension-type. There might be a significant connection between TMD and headache. However, most medical and dental practitioners are unaware of this relationship. Therefore, a careful evaluation of the TMJ and associated orofacial structures is required for a correct interpretation of the craniofacial pain in headache patients, and these patients should be managed with a multidisciplinary approach.

  16. Childhood intussusception in Uzbekistan: Analysis of retrospective surveillance data

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    Flem Elmira

    2011-03-01

    Full Text Available Abstract Background Estimates of baseline incidence of childhood intussusception could help safety monitoring after the introduction of rotavirus vaccines. We studied the incidence of intussusception in Uzbekistan, a GAVI-fund eligible state in Central Asia. Methods We retrospectively reviewed intussusception cases in children Results Over a 5-year study period, 67 confirmed cases were identified, of which 67% were boys. The median age was 12 months, and no seasonal trend in the distribution of cases was observed. The diagnostic methods used included abdominal radiography (87% and ultrasonography (57%. Intussusception reduction by air enema was successful in 33 (49% patients and 34 (50% cases underwent surgery. A total of 4 deaths occurred, including 3 deaths in infants aged 0-6 months. The median length of hospital stay was 7.3 (range 0-37 days. The incidence of intussusception is estimated at 23 (95% CI 13.6-32.4 cases per 100,000 child-years, corresponding to approximately 237 cases annually. Conclusions This is the first study to estimate the incidence of childhood intussusception prior to the introduction of the rotavirus vaccination in Uzbekistan. A prospective surveillance system using a standardized case definition is needed in order to better examine the occurrence of intussusception in developing countries.

  17. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

    Science.gov (United States)

    Di Paolo, Carlo; D'Urso, Anna; Di Sabato, Francesco; Pompa, Giorgio

    2017-01-01

    Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity. PMID:28420942

  18. Histopathological features of post-mortem pituitaries: A retrospective analysis

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    Francisco José Tortosa Vallecillos

    Full Text Available SUMMARY Objective: As a result of the use of neuroimaging techniques, silent pituitary lesions are diagnosed more and more frequently; however, there are few published post-mortem studies about this gland. Incidence data of pituitary lesions are rare and in Portugal they are outdated or even non-existent. The aim of this study is to determine the prevalence of normal patterns and incidental post-mortem pituitary pathology at Centro Hospitalar Lisboa Norte, analyzing the associations with clinical data and assessing the clinical relevance of the findings. Method: We reviewed retrospectively and histologically 167 pituitaries of a consecutive series of autopsies from the Department of Pathology of this centre. They were done between 2012 and 2014, and in all cases medical records were reviewed. The morphological patterns observed, were classified into three major groups: 1 Normal histological patterns and variants; 2 Infectious-inflammatory pathology, metabolic and vascular disorders; 3 Incidental primary proliferation and secondary to systemic diseases. Results: The subjects included in this study were of all age groups (from 1 day to 91 years old, 71 were female and 96 male. Fifty-seven of these glands didn’t show any alteration; 51 showed colloid cysts arising from Rathke cleft; 44 presented hyperplasia in adenohypophysis and we identified 20 adenomas in 19 glands (immunohistochemically, eight PRL-producing and five ACTH-producing tumors, ten of which associated with obesity, 11 to hypertension and six to diabetes mellitus. There were two cases with metastasis. Conclusion: Subclinical pathology in our country is similar to that seen in other parts of the world, but at older ages.

  19. Semantic Verbal Fluency test in dementia: Preliminary retrospective analysis

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    Marcos Lopes

    Full Text Available Abstract The Semantic Verbal Fluency (SVF test entails the generation of words from a given category within a pre-set time of 60 seconds. Objectives: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. Methods: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. Results: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p<0.001 but correlation between the number of clusters and responses was strong (r=0.883, p<0.001. The number of items on the SVF was statistically significant with MMSE score (p=0.01 and there was a tendency for significance on the CDR (p=0.06. The results indicated little activity regarding what we propose to call cluster recalling in the two groups. Discussion: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

  20. False traumatic aneurysms and arteriovenous fistulas: retrospective analysis.

    Science.gov (United States)

    Davidovic, Lazar B; Banzić, Igor; Rich, Norman; Dragaš, Marko; Cvetkovic, Slobodan D; Dimic, Andrija

    2011-06-01

    The purpose of this study was to analyze the incidence, clinical presentation, diagnosis, and treatment of false traumatic aneurysms and arteriovenous fistulas as well as the outcomes of the patients. A retrospective, 16-year survey has been conducted regarding the cases of patients who underwent surgery for false traumatic aneurysms (FTA) of arteries and traumatic arteriovenous fistulas (TAVF). Patients with iatrogenic AV fistulas and iatrogenic false aneurysms were excluded from the study. There were 36 patients with TAVF and 47 with FTA. In all, 73 (87.95%) were male, and 10 (12.05%) were female, with an average age of 36.93 years (13-82 years). In 25 (29.76%) cases TAVF and FTA appeared combat-related, and 59 (70.24%) were in noncombatants. The average of all intervals between the injury and surgery was 919. 8 days (1 day to 41 years) for FTA and 396.6 days (1 day to 9 years) for TAVF. Most of the patients in both groups were surgically treated during the first 30 days after injury. One patient died on the fourth postoperative day. There were two early complications. The early patency rate was 83.34%, and limb salvage was 100%. There were no recurrent AV fistulas that required additional operations. Because of their history of severe complications, FTA and TAV fistulas require prompt treatment. The treatment is simpler if there is only a short interval between the injury and the operation. Surgical endovascular repair is mostly indicated.

  1. Imported malaria in pregnant women: a retrospective pooled analysis

    Science.gov (United States)

    Käser, Annina K.; Arguin, Paul M.; Chiodini, Peter L.; Smith, Valerie; Delmont, Jean; Jiménez, Beatriz C.; Färnert, Anna; Kimura, Mikio; Ramharter, Michael; Grobusch, Martin P.; Schlagenhauf, Patricia

    2015-01-01

    Summary Background Data on imported malaria in pregnant women are scarce. Method A retrospective, descriptive study of pooled data on imported malaria in pregnancy was done, using data from 1977 to 2014 from 8 different collaborators in Europe, the United States and Japan. Most cases were from the period 1991–2014. National malaria reference centresas well as specialists on this topic were asked to search their archives for cases of imported malaria in pregnancy. A total of 632 cases were collated, providing information on Plasmodium species, region of acquisition, nationality, country of residence, reason for travel, age, gestational age, prophylactic measures and treatment used, as well as on complications and outcomes in mother and child. Results Datasets from some sources were incomplete. The predominant Plasmodium species was P. falciparum in 72% of cases. Among the 543 cases where information on the use of chemoprophylaxis was known, 471 (74.5%) did not use chemoprophylaxis or used incorrect or incomplete chemoprophylaxis. The main reason for travelling was “visiting friends and relatives” VFR (48.6%) and overall, most cases of malaria were imported from West Africa (85.9%). Severe anaemia was the most frequent complication in the mother. Data on offspring outcome was limited, but spontaneous abortion was a frequently reported foetal outcome (n = 14). A total of 50 different variants of malaria treatment regimens were reported. Conclusion Imported cases of malaria in pregnancy are mainly P. falciparum acquired in sub-Saharan Africa. Malaria prevention and treatment in pregnant travellers is a challenge for travel medicine due to few data on medication safety and maternal and foetal outcomes. International, collaborative efforts are needed to capture standardized data on imported malaria cases in pregnant women. PMID:26227740

  2. Retrospective Analysis of 119 Osteosarcomas in a Single Centre Experience

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    Meral Gunaldi

    2016-01-01

    Full Text Available Aim: Osteosarcomas must be managed by a team which includes pathologists, radiologists, surgeons, radiation therapists, and medical oncologists. Treatment modalities and demographic charasteristics of osteosarcomas were analysed in this study. Material and Method: Primary osteosarcomas treated between 1999-2010 in Cukurova University Medical Faculty Department of Medical Oncology were analysed retrospectively. Results: Of the total 119 patients, 74% were male and 26% female. The median age was 19. The median follow up time was 37 months. The most frequently seen sarcomas were osteoblastic at 82.4%. Localization of the disease was found to be 55% in the lower extremity, 14.1% in the upper extremity, 13% in the head-neck, 6.6% in the thoracic area, and 4.1 % in the pelvic region. Some 6.41% were local stage, 25.64% locally advanced, 15.8% metastatic, and 14.10% were diagnosed with nuks disease. Chemotherapy was administered in 77 of 119 patients. Patients received different treatments: 23.1% were treated with preoperative chemotherapy, 16.67% postoperative, 9.52% palliative, 33.33% preoperative postoperative, 2.38% postoperative palliative, 9.52% preoperative postoperative palliative chemotherapy, and 4.76% of the patients did not receive chemotherapy. Both radical and conservative surgery was performed. The most common metastatic site was the lungs. The overall length of survival was 65 months (95%CI 30-59. The survival rates did not vary between the groups of preoperative, postoperative, preoperative postoperative chemotherapy and other groups (respectively 23 versus 36 versus 28 versus 44 months (p=0.8. No differences were evident for radiotherapy (p=0.06. Discussion: Osteosarcomas can be treated successfully with surgery, chemotherapy, and radiotherapy. There was no cumulative survival difference in results based on the types of chemotherapy used in this study. These results show the importance of a multimodality treatment approach including

  3. Primary Intracranial Germinomas: Retrospective Analysis of Five Cases.

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    Abdallah, Anas; Asilturk, Murad; Uysal, Mustafa Levent; Emel, Erhan; Abdallah, Betul Guler; Bilgic, Bilge; Gundogdu, Gokcen

    2018-01-01

    Primary intracranial germinomas (PIGs) are rare malignant brain tumors that represent approximately 0.2% to 1.7% of all primary intracranial tumors. PIGs have infrequent, but there is a possibility of spinal cord metastases. In this study, clinical outcomes of five consecutive PIGs have been presented. Medical records were retrospectively reviewed in 1,849 cases of intracranial tumors who underwent surgery between the years 2005 and 2015 and cases confirmed as germinoma histopathologically were included in this study. Five cases of PIGs were detected in two female (40%) and 3 male (60%) patients. The mean age was 15.2±5.6 (8-23) years. The mean follow-up period was 52.3±56.4 (9-135) months. The most common complaint was headache (60%), followed by nausea±vomiting (40%). Four cases (80%) affected the suprasellar region while the fifth patient"s tumor was localized in the pineal region. The duration between the initial symptom and time of surgical intervention ranged between 15 days and 2 months. Twelve months after the first operation, one patient presented with drop seeding metastasis. Four-year survival (with exception of the case that died as a early surgical complication) was 100%. Gross total resection (GTR) was achieved in one patient. Surgical mortality rate was 20%. PIGs" morbidity rate was 60%. PIG is a mostly malignant tumor that generally affects the pediatric age group. They are radiosensitive tumors. Subtotal or near-total resection using stereotactic guide or direct surgery to confirm the histopathological diagnosis followed by chemotherapy and whole brain or in some cases craniospinal radiotherapy rather than GTR is therefore the treatment of choice.

  4. ANALYSIS OF MINERAL COMPOSITION OF CANINE UROLITHS - A RETROSPECTIVE STUDY

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    P. Siva Parvathamma

    2017-06-01

    Full Text Available Twenty six cases were studied for analysis of uroliths surgically retrieved from canine of different age, sex, body weight, geographical location and nutritional status. The uroliths were quantitatively analyzed by atomic absorption spectrophotometric analysis (AAS, Flame photometry and calcium and phosphorus estimation. The struvite stones were found to be more predominant in number, than other type of uroliths.

  5. Radioiodine therapy in Graves' disease - A retrospective analysis

    International Nuclear Information System (INIS)

    Mittal, B.R.; Bhattacharya, A.; Dutta, P.; Bhansali, A.

    2007-01-01

    Full text: Radioiodine is a safe form of treatment for all patients with primary hyperthyroidism. The thyroid's unique capacity to store iodine (thus also radioiodine) makes it a natural target for radioiodine therapy. We retrospectively analyzed the outcome of radioiodine therapy in a cohort of 151 patients of primary hyperthyroidism treated on an outpatient basis in our institute from January 2001 to November 2006. Of these 151 patients, 113 (38 male, 75 female; age range: 17- 65 years) were of Graves' disease. The median duration of symptoms in these patients was 4 years. (Range: 3 months to 20 years). Diagnosis was established on basis of clinical, biochemical and scintigraphic features. All the patients were treated medically with Neomercazole (Carbimazole) for varying durations (median 3.5 years). The dose range varied from 5 to 80 mg per day (median 20 mg per day). Clinical assessment of thyroid size revealed 39 patients with grade 0, 14 with grade 1, 30 with grade 2, and 30 with grade 3 goiters. Pre-therapy radioactive iodine uptake was done in 28 patients, which showed median values of 50 % at 4 hrs, 57.45 % at 24 hrs, and 56.2 % at 48 hrs respectively. These patients were treated empirically with I-131 in a dose range of 5 to 15 mCi, depending upon the clinical presentation and the RAIU values. Remission of symptoms with a single dose therapy was noticed in 68 patients. Of the 83 patients, 15 became hypothyroid within 3 months. These patients were on Neomercazole for a varying period of 2 to 20 years, at a dose range of 10 to 80 mg per day. 14 patients achieved remission after 2 doses with a cumulative RAI dose in the range of 10 to 19 mCi, at a median period of 7 to 24 months. Eight patients still showed hyperthyroid activity even after a second dose and are on follow-up. Seven patients achieved remission with a cumulative dose range of 17 to 35 mCi at a median duration of 10 months. One patient of Graves' disease who took Neomercazole for 10 years, at

  6. Simultaneus bilateral spontaneus pneumothoraces: A Retrospective Analysis of 11 Cases

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    Ufuk Cobanoglu

    2011-09-01

    Full Text Available Spontaneous pneumothorax (SP is relatively common in clinical practice and occurs more frequently in young, tall thin men, and in smokers. However, simultaneous bilateral spontaneous pneumothorax (SBSP is a rare clinical condition that often presents with significant respiratory distress. It is often dangerous; therefore, the chest drain should be inserted immediately. In this study, simultaneus bilateral spontaneus pneumothoraces cases were divided into two groups and retrospectively evaluated according to age, sex, diagnostic methods, treatments, and results. Material and Methods :Between January 2006 and May 2009, 11 patients with SBSP were enrolled into our study. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, duration of chest tube and postoperative hospital stay of the patients were reviewed. Arterial blood gas values (before and after intervention in patiens with primary and secondary spontaneous pneumothorax were evaluated. Results; 7 patients (63.63 % were male and 4 patients (36.37 % were female and their mean age was 34,5±6.81 years. There were 4 (36.37% primary SP and 4 (36.37% secondary SP patients. Chronic obstructive pulmonary disease (COPD was the most common cause in secondary SP patients. In two (18.18% patients recurrency were observed. Eight (72.72% patients had smoking history. The most common symptom in both groups was dyspnea. All patients had immediate bilateral chest tubes on admission. We treated these patients with chest drain insertion, VATS (Video-Assisted Thoracoscopic Surgery, axillary thoracotomy, and chemical pleurodesis. Postoperative morbidity was detected in 3 (27.27% patients (prolonged air leak in 1 case, empyema in 1 case and pneumonia in 1 case. No mortality was observed in alll cases. Recurrence developed in 3 (27.27% patients in this series. Conclusions: An urgent and effective treatment requires in the

  7. Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997–2003 and 2007–2009 and use of mobile and cordless phones

    Science.gov (United States)

    HARDELL, LENNART; CARLBERG, MICHAEL; SÖDERQVIST, FREDRIK; MILD, KJELL HANSSON

    We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20–80 years, diagnosed during 1997–2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007–2009 including both men and women aged 18–75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0–4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8–21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1–2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8–4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1–2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7–26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1–2.0 increasing to OR = 8.1, 95% CI = 2.0–32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2–9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless

  8. Prelinguistic communication development in children with childhood apraxia of speech: a retrospective analysis.

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    Highman, Chantelle; Leitão, Suze; Hennessey, Neville; Piek, Jan

    2012-02-01

    In a retrospective study of prelinguistic communication development, clinically referred preschool children (n = 9) aged 3-4 years, who as infants had failed a community-based screening program, were evaluated for features of childhood apraxia of speech (CAS). Four children showed no features and either delayed or normal language, five had from three-to-seven CAS features and all exhibited delayed language. These children were matched by age with 21 children with typically-developing (TD) speech and language skills. Case-control comparisons of retrospective data from 9 months of age for two participants with more severe features of CAS at preschool age showed a dissociated pattern with low expressive quotients on the Receptive-Expressive Emergent Language Assessment-Second Edition (REEL-2) and records of infrequent babbling, but normal receptive quotients. However, other profiles were observed. Two children with milder CAS features showed poor receptive and expressive development similar to other clinically referred children with no CAS features, and one child with severe CAS features showed poor receptive but normal expressive developmental milestones at 9 months and records of frequent babbling. Results suggest some but not all children with features of suspected CAS have a selective deficit originating within speech motor development.

  9. [Acupuncture for aphasia: a retrospective analysis of clinical literature].

    Science.gov (United States)

    Tan, Jie; Zhang, Hong; Han, Guodong; Ai, Kun; Deng, Shifeng

    2016-04-01

    With the Meta-analysis method, the clinical efficacy of acupuncture and other regular methods for aphasia was evaluated, and the acupoints selection for aphasia was explored. The acupuncture literature of clinical randomized control trials for aphasia published in CNKI, WANFANG, VIP and CBM database was searched; the statistical analysis of clinical efficacy of acupuncture and other regular methods for aphasia was performed by using software Revman 5. 2 provided by Cochrane library. A file of Microsoft Excel was established to perform the analysis of acupoints selection based on frequency analysis method, so as to summarize the characteristics and rules. Totally 385 articles were searched, and 37 articles those met the inclusive criteria was included, involving 1,260 patients in the acupuncture group and 1 238 patients in the control group. The Meta-analysis results showed OR = 3.82, 95% Cl [3.01, 4.85]; rhombus was located on the right side and the funnel plot was nearly symmetry, indicating the treatment effect of the acupuncture group for aphasia was superior to the control group (Z = 11.04, P aphasia is superior to that of speech rehabilitation training and medication treatment alone. The clinical treatment for aphasia focuses on its local effect; the main acupoints are in the head and face, and the meridians are governor vessel, extra channels and conception vessel.

  10. Adaptation of Chain Event Graphs for use with Case-Control Studies in Epidemiology.

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    Keeble, Claire; Thwaites, Peter Adam; Barber, Stuart; Law, Graham Richard; Baxter, Paul David

    2017-09-26

    Case-control studies are used in epidemiology to try to uncover the causes of diseases, but are a retrospective study design known to suffer from non-participation and recall bias, which may explain their decreased popularity in recent years. Traditional analyses report usually only the odds ratio for given exposures and the binary disease status. Chain event graphs are a graphical representation of a statistical model derived from event trees which have been developed in artificial intelligence and statistics, and only recently introduced to the epidemiology literature. They are a modern Bayesian technique which enable prior knowledge to be incorporated into the data analysis using the agglomerative hierarchical clustering algorithm, used to form a suitable chain event graph. Additionally, they can account for missing data and be used to explore missingness mechanisms. Here we adapt the chain event graph framework to suit scenarios often encountered in case-control studies, to strengthen this study design which is time and financially efficient. We demonstrate eight adaptations to the graphs, which consist of two suitable for full case-control study analysis, four which can be used in interim analyses to explore biases, and two which aim to improve the ease and accuracy of analyses. The adaptations are illustrated with complete, reproducible, fully-interpreted examples, including the event tree and chain event graph. Chain event graphs are used here for the first time to summarise non-participation, data collection techniques, data reliability, and disease severity in case-control studies. We demonstrate how these features of a case-control study can be incorporated into the analysis to provide further insight, which can help to identify potential biases and lead to more accurate study results.

  11. Case-control studies in diabetes. Do they really use a case-control design?

    Science.gov (United States)

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  12. Retrospective analysis of outcomes from two intensive comprehensive aphasia programs.

    Science.gov (United States)

    Persad, Carol; Wozniak, Linda; Kostopoulos, Ellina

    2013-01-01

    Positive outcomes from intensive therapy for individuals with aphasia have been reported in the literature. Little is known about the characteristics of individuals who attend intensive comprehensive aphasia programs (ICAPs) and what factors may predict who makes clinically significant changes when attending such programs. Demographic data on participants from 6 ICAPs showed that individuals who attend these programs spanned the entire age range (from adolescence to late adulthood), but they generally tended to be middle-aged and predominantly male. Analysis of outcome data from 2 of these ICAPs found that age and gender were not significant predictors of improved outcome on measures of language ability or functional communication. However, time post onset was related to clinical improvement in functional communication as measured by the Communication Activities of Daily Living, second edition (CADL-2). In addition, for one sample, initial severity of aphasia was related to outcome on the Western Aphasia Battery-Revised, such that individuals with more severe aphasia tended to show greater recovery compared to those with mild aphasia. Initial severity of aphasia also was highly correlated with changes in CADL-2 scores. These results suggest that adults of all ages with aphasia in either the acute or chronic phase of recovery can continue to show positive improvements in language ability and functional communication with intensive treatment.

  13. The association between the FABP2 Ala54Thr variant and the risk of type 2 diabetes mellitus: a meta-analysis based on 11 case-control studies

    OpenAIRE

    Liu, Peng; Yu, Dan; Jin, Xiaoping; Li, Cai; Zhu, Feng; Zheng, Zhou; Lv, Chenlin; He, Xinwei

    2015-01-01

    Fatty acid binding protein 2 (FABP2) Ala54Thr gene polymorphism has been suggested to be associated with the increased risk of developing type 2 diabetes mellitus (T2DM), but some studies show the inconsistent result. The purpose of this meta-analysis is to assess the association between FABP2 Ala54Thr gene polymorphism variants and the T2DM. A total of 7095 subjects in 11 case-control studies were included in this meta-analysis. Under the allele model (T versus A), the pooled OR of Asian sub...

  14. Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases

    NARCIS (Netherlands)

    Raber-Durlacher, J. E.; Weijl, N. I.; Abu Saris, M.; de Koning, B.; Zwinderman, A. H.; Osanto, S.

    2000-01-01

    The incidence and the severity of chemotherapy-associated oral mucositis were determined in a retrospective analysis of 150 patients with various solid tumors. In addition, possible risk factors for the development of mucositis were identified. Patients were treated with chemotherapeutic regimens

  15. Financial analysis of potential retrospective premium assessments under the Price-Anderson system

    International Nuclear Information System (INIS)

    Wood, R.S.

    1985-04-01

    Ten representative nuclear utilities have been analyzed over the period 1981 to 1983 to evaluate the effects of three levels of retrospective premiums on various financial indicators. This analysis continues and expands on earlier analyses prepared as background for deliberations by the US Congress for possible extension or modification of the Price-Anderson Act

  16. Retrospective analysis of the treatment of psoriasis of the palms and soles

    NARCIS (Netherlands)

    Spuls, P. I.; Hadi, S.; Rivera, L.; Lebwohl, M.

    2003-01-01

    In this retrospective analysis, the effect of currently used treatments in 26 patients with psoriasis of the palms and soles were analyzed. In general, patients are treated initially with topical medications including superpotent topical corticosteroids in combination with calcipotriene ointment or

  17. Differential effects of saturated fatty acids on the risk of metabolic syndrome: a matched case-control and meta-analysis study.

    Science.gov (United States)

    Yang, Wei-Sin; Chen, Pei-Chun; Hsu, Hsiu-Ching; Su, Ta-Chen; Lin, Hung-Ju; Chen, Ming-Fong; Lee, Yuan-Teh; Chien, Kuo-Liong

    2018-06-01

    We investigated the association between plasma saturated fatty acids (SFAs) and the risk of metabolic syndrome among ethnic Chinese adults in Taiwan who attended a health check-up center. A case-control study based on 1000 cases of metabolic syndrome and 1:1 matched control participants (mean age, 54.9 ± 10.7 y; 36% females) were recruited. Metabolic syndrome was defined according to the criteria of the International Diabetes Federation. Gas chromatography was used to measure the distribution of fatty acids in plasma (% of total fatty acids). Even-chain SFAs, including 14:0, 16:0, and 18:0, were associated with metabolic syndrome; the adjusted odds ratio [OR] and 95% confidence interval [CI] per standard deviation [SD] difference was 3.32, [1.98-5.59]; however, very-long-chain SFAs, including 20:0, 21:0, 22:0, 23:0, and 24:0, were inversely associated with metabolic syndrome. The adjusted OR [95% CI] per SD difference was 0.67 [0.58-0.78]. The area under the receiver operative characteristic curve increased from 0.814 in the basic model to 0.815 (p = 0.54, compared with the basic model), 0.818 (p metabolic syndrome, implying that SFAs are not homogenous for the effects. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis.

    Science.gov (United States)

    Endara, P; Vaca, M; Platts-Mills, T A E; Workman, L; Chico, M E; Barreto, M L; Rodrigues, L C; Cooper, P J

    2015-02-01

    The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. We performed nested case-control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE) and skin prick test (SPT) reactivity to aeroallergens. Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37-8.00, P children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections. © 2014 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.

  19. Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis.

    Science.gov (United States)

    MacCabe, J H; Sariaslan, A; Almqvist, C; Lichtenstein, P; Larsson, H; Kyaga, S

    2018-06-01

    Many studies have addressed the question of whether mental disorder is associated with creativity, but high-quality epidemiological evidence has been lacking.AimsTo test for an association between studying a creative subject at high school or university and later mental disorder. In a case-control study using linked population-based registries in Sweden (N = 4 454 763), we tested for associations between tertiary education in an artistic field and hospital admission with schizophrenia (N = 20 333), bipolar disorder (N = 28 293) or unipolar depression (N = 148 365). Compared with the general population, individuals with an artistic education had increased odds of developing schizophrenia (odds ratio = 1.90, 95% CI = [1.69; 2.12]) bipolar disorder (odds ratio = 1.62 [1.50; 1.75]) and unipolar depression (odds ratio = 1.39 [1.34; 1.44]. The results remained after adjustment for IQ and other potential confounders. Students of artistic subjects at university are at increased risk of developing schizophrenia, bipolar disorder and unipolar depression in adulthood.Declaration of interestNone.

  20. Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-control study.

    Science.gov (United States)

    Williams, Andrew M; Huang, Wei; Muir, Kelly W; Stinnett, Sandra S; Stone, Jordan S; Rosdahl, Jullia A

    2018-01-01

    To examine the factors associated with blindness from primary open-angle glaucoma (POAG) among black and white patients at our institution. For this retrospective, case-control study, patients legally blind from POAG ("cases") were matched on age, race, and gender with non-blind POAG patients ("controls"). Thirty-seven black case-control pairs and 19 white case-control pairs were included in this study. Clinical variables were compared at initial presentation and over the course of follow-up. Black case-control pairs and white case-control pairs had similar characteristics at presentation, including cup-to-disc ratio and number of glaucoma medications. However, over the course of follow-up, black cases underwent significantly more glaucoma surgeries than matched controls (2.4 versus 1.2, p =0.001), whereas white cases and controls had no significant difference in glaucoma operations (0.9 versus 0.6, p =0.139). Our analysis found that glaucoma surgery is associated with blindness in black patients (odds ratio [OR] 1.6, 95% CI 1.1-2.2) but not in white patients (OR 1.5, 95% CI 0.7-3.2). Black and white case-control pairs with POAG shared similar risk factors for blindness at presentation. However, over the follow-up period, black cases required significantly more glaucoma surgeries compared to black controls, whereas there was no significant difference in surgery between white cases and controls. There was no difference in medication changes in either case-control set.

  1. The role of brain-derived neurotrophic factor (BDNF) Val66Met genetic polymorphism in bipolar disorder: a case-control study, comorbidities, and meta-analysis of 16,786 subjects.

    Science.gov (United States)

    González-Castro, Thelma Beatriz; Nicolini, Humberto; Lanzagorta, Nuria; López-Narváez, Lilia; Genis, Alma; Pool García, Sherezada; Tovilla-Zárate, Carlos Alfonso

    2015-02-01

    The aim of this study was to evaluate the association of Val66Met brain-derived neurotrophic factor (BDNF) polymorphism with bipolar disorder in (i) a meta-analysis and (ii) a case-control study in a Mexican population. We also investigated the possible association of this polymorphism with clinical features. We performed a keyword search of the PubMed and Web of Science databases. A total of 22 studies that have investigated the association of Val66Met (rs6265) with bipolar disorder were selected for inclusion and combined with random effects meta-analysis, using allelic, additive, dominant, and recessive models. Finally, the single nucleotide polymorphism (rs6265) Val66Met in the BDNF gene was genotyped and compared between 139 patients with bipolar disorder and 141 healthy volunteers in a Mexican population. The pooled results from the meta-analysis (9,349 cases and 7,437 controls) did not show a significant association in any of the models. The same results were obtained in our case-control study when analyzing the distribution of the genotypic frequencies of the Val66Met polymorphism in patients with bipolar disorder. However, when we analyzed the association between rs6265 and lifetime history of suicidal behavior, we found an association between genotype Val-Val and suicide attempt (p = 0.02). Although the present study has some limitations, the results indicate a lack of association between the Val66Met polymorphism and bipolar disorder. However, in our case-control study in a Mexican population, the Val66Met polymorphism was associated with suicidal behavior in patients with bipolar disorder. Nevertheless, it is important to consider potential interactions of the BDNF gene, the environment, and different inheritance patterns, when carrying out future genetic studies with larger samples. © 2014 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

  2. Night shift work and breast cancer: a pooled analysis of population-based case-control studies with complete work history.

    Science.gov (United States)

    Cordina-Duverger, Emilie; Menegaux, Florence; Popa, Alexandru; Rabstein, Sylvia; Harth, Volker; Pesch, Beate; Brüning, Thomas; Fritschi, Lin; Glass, Deborah C; Heyworth, Jane S; Erren, Thomas C; Castaño-Vinyals, Gemma; Papantoniou, Kyriaki; Espinosa, Ana; Kogevinas, Manolis; Grundy, Anne; Spinelli, John J; Aronson, Kristan J; Guénel, Pascal

    2018-04-01

    Night shift work has been suspected to increase breast cancer risk but epidemiological studies have been inconsistent due to heterogeneous assessment of exposure to night work. To overcome this limitation, we pooled data of five population-based case-control studies from Australia, Canada, France, Germany, and Spain into a single harmonized dataset using a common definition of night work including 6093 breast cancer cases and 6933 population controls. The odds ratio for breast cancer in women who ever worked at night for at least 3 h between midnight and 5 a.m. as compared to never night workers was 1.12 (95% CI 1.00-1.25). Among pre-menopausal women, this odds ratio was 1.26 [1.06-1.51], increasing to 1.36 [1.07-1.74] for night shifts ≥ 10 h, 1.80 [1.20-2.71] for work ≥ 3 nights/week, and 2.55 [1.03-6.30] for both duration of night work ≥ 10 years and exposure intensity ≥ 3 nights/week. Breast cancer risk in pre-menopausal women was higher in current or recent night workers (OR = 1.41 [1.06-1.88]) than in those who had stopped night work more than 2 years ago. Breast cancer in post-menopausal women was not associated with night work whatever the exposure metric. The increase in risk was restricted to ER+ tumors, particularly those who were both ER+ and HER2+ . These results support the hypothesis that night shift work increases the risk of breast cancer in pre-menopausal women, particularly those with high intensity and long duration of exposure. Risk difference between pre- and post-menopausal women deserves further scrutiny.

  3. Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies

    Science.gov (United States)

    Rasmussen, Christina B.; Kjaer, Susanne K.; Albieri, Vanna; Bandera, Elisa V.; Doherty, Jennifer A.; Høgdall, Estrid; Webb, Penelope M.; Jordan, Susan J.; Rossing, Mary Anne; Wicklund, Kristine G.; Goodman, Marc T.; Modugno, Francesmary; Moysich, Kirsten B.; Ness, Roberta B.; Edwards, Robert P.; Schildkraut, Joellen M.; Berchuck, Andrew; Olson, Sara H.; Kiemeney, Lambertus A.; Massuger, Leon F. A. G.; Narod, Steven A.; Phelan, Catherine M.; Anton-Culver, Hoda; Ziogas, Argyrios; Wu, Anna H.; Pearce, Celeste L.; Risch, Harvey A.; Jensen, Allan

    2017-01-01

    Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to tumor behavior and histotype. We pooled data from 13 case-control studies, conducted between 1989 and 2009, from the Ovarian Cancer Association Consortium (OCAC), including 9,162 women with ovarian cancers, 2,354 women with borderline tumors, and 14,736 control participants. Study-specific odds ratios were estimated and subsequently combined into a pooled odds ratio using a random-effects model. A history of PID was associated with an increased risk of borderline tumors (pooled odds ratio (pOR) = 1.32, 95% confidence interval (CI): 1.10, 1.58). Women with at least 2 episodes of PID had a 2-fold increased risk of borderline tumors (pOR = 2.14, 95% CI: 1.08, 4.24). No association was observed between PID and ovarian cancer risk overall (pOR = 0.99, 95% CI: 0.83, 1.19); however, a statistically nonsignificantly increased risk of low-grade serous tumors (pOR = 1.48, 95% CI: 0.92, 2.38) was noted. In conclusion, PID was associated with an increased risk of borderline ovarian tumors, particularly among women who had had multiple episodes of PID. Although our results indicated a histotype-specific association with PID, the association of PID with ovarian cancer risk is still somewhat uncertain and requires further investigation. PMID:27941069

  4. Hypophosphatemia. From retrospective analysis to the analysis of the potential role of phosphatemia in panic disorders

    Directory of Open Access Journals (Sweden)

    Alessandro Riccardi

    2010-09-01

    Full Text Available The detection of a low serum phosphate level is not unusual in an Emergency Department, especially in clinical conditions linked to hyperventilation and subsequent respiratory alkalosis, asthma, sepsis, severe pain, anxiety. Symptoms of hypophosphatemia are typically not specific when the imbalance is not particularly severe, but if hyphophosphatemia does not resolve rhabdomyolisis, hemolysis, decreased tissue oxygenation and respiratory failure can be observed. Only recently some authors have pointed out that the level of serum phosphate in patient with anxiety and panic disorders can give information on the severity of the attacks as well on the clinical course of the disease. In a retrospective analysis on 599 case of hypophosphatemia observed in our ED, the percentage of case of panic disorders was particularly high among patients with lower phosphatemia. Therefore, we decided to examine this aspect closely, assessing if the determination of serum phosphate could be useful in the management of panic attacks at first approach in emergency room. Our observation are consistent with the statement that hypophosphatemia is one of the main clinical aspect of panic attack, and strongly support the hypothesis that hypophosphatemia correlates with the most severe symptoms of panic attack and should be itself considered as one of the most important aspect of this syndrome. Serum phosphate levels appear to mirror its clinical course, and can be used in the clinical setting of an Emergency Department, for the confirmation of a diagnosis of anxiety-panic disorder and as marker of the response to therapy

  5. Analysis of luminescence from common salt (NaCl) for application to retrospective dosimetry

    International Nuclear Information System (INIS)

    Spooner, N.A.; Smith, B.W.; Williams, O.M.; Creighton, D.F.; McCulloch, I.; Hunter, P.G.; Questiaux, D.G.; Prescott, J.R.

    2011-01-01

    Thermoluminescence (TL), Optically-Stimulated Luminescence (OSL) and Infrared-Stimulated Luminescence (IRSL) emitted from a set of 19 salt (NaCl) samples were studied for potential application to retrospective dosimetry. TL emission spectra revealed intense TL emissions from most samples, centred on 590 nm; UV and blue emissions were also found. Significant thermally-induced sensitivity changes were observed and TL, OSL and IRSL growth curves were measured. Pulse anneal analysis was performed, as was quantitative imaging of the TL, OSL and IRSL to assess sample heterogeneity. Kinetic analysis found lifetimes at 20 °C of the 200 °C and 240 °C TL peaks to be 0.6 ka and 4 ka respectively; sufficient for application to retrospective dosimetry.

  6. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    OpenAIRE

    Metin Uysalol; Ezgi Paslı Uysalol; Gamze Varol Saraçoğlu; Semra Kayaoğlu

    2011-01-01

    Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female) who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide into...

  7. Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sarah J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wei, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-01

    Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes in the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.

  8. Hospital stay as a proxy indicator for severe injury in earthquakes: a retrospective analysis.

    Science.gov (United States)

    Zhao, Lu-Ping; Gerdin, Martin; Westman, Lina; Rodriguez-Llanes, Jose Manuel; Wu, Qi; van den Oever, Barbara; Pan, Liang; Albela, Manuel; Chen, Gao; Zhang, De-Sheng; Guha-Sapir, Debarati; von Schreeb, Johan

    2013-01-01

    Earthquakes are the most violent type of natural disasters and injuries are the dominant medical problem in the early phases after earthquakes. However, likely because of poor data availability, high-quality research on injuries after earthquakes is lacking. Length of hospital stay (LOS) has been validated as a proxy indicator for injury severity in high-income settings and could potentially be used in retrospective research of injuries after earthquakes. In this study, we assessed LOS as an adequate proxy indicator for severe injury in trauma survivors of an earthquake. A retrospective analysis was conducted using a database of 1,878 injured patients from the 2008 Wenchuan earthquake. Our primary outcome was severe injury, defined as a composite measure of serious injury or resource use. Secondary outcomes were serious injury and resource use, analysed separately. Non-parametric receiver operating characteristics (ROC) and area under the curve (AUC) analysis was used to test the discriminatory accuracy of LOS when used to identify severe injury. An 0.7earthquake survivors. However, LOS was found to be a proxy for major nonorthopaedic surgery and blood transfusion. These findings can be useful for retrospective research on earthquake-injured patients when detailed hospital records are not available.

  9. Traditional cardiovascular risk factors and coronary collateral circulation: Protocol for a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Xing, Zhenhua; Pei, Junyu; Tang, Liang; Hu, Xinqun

    2018-04-01

    Well-developed coronary collateral circulation usually results in fewer infarct size, improved cardiac function, and fewer mortality. Traditional coronary risk factors (diabetes, hypertension, and smoking) have some effects on coronary collateral circulation. However, the association between these risk factors and coronary collateral circulation are controversial. Given the confusing evidences regarding traditional cardiovascular risk factors on coronary collateral circulation, we performed this meta-analysis protocol to investigate the relationship between traditional risk factors of coronary artery disease and coronary collateral circulation. MEDINE, EMBASE, and Science Citation Index will be searched to identify relevant studies. The primary outcomes of this meta-analysis are well-developed coronary collateral circulation. Meta-analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) of traditional coronary risk factors (diabetes, smoking, hypertriton). Pooled ORs were computed as the Mantel-Haenszel-weighted average of the ORs for all included studies. Sensitivity analysis, quality assessment, publication bias analysis, and the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE) will be performed to ensure the reliability of our results. This study will provide a high-quality synthesis of current evidence of traditional risk factors on collateral circulation. This conclusion of our systematic review and meta-analysis will provide evidence to judge whether traditional risk factors affects coronary collateral circulation.Ethics and dissemination: Ethical approval is not required because our systematic review and meta-analysis will be based on published data without interventions on patients. The findings of this study will be published in a peer-reviewed journal.

  10. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

    Science.gov (United States)

    Friedman, M H; Weisberg, J

    2000-07-01

    Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

  11. A Case-Control Study and Meta-Analysis Reveal BDNF Val66Met Is a Possible Risk Factor for PTSD

    Directory of Open Access Journals (Sweden)

    Dagmar Bruenig

    2016-01-01

    Full Text Available Posttraumatic stress disorder (PTSD is a debilitating condition that develops in some people after exposure to a traumatic event. Brain-derived neurotrophic factor (BDNF is highly expressed in the mammalian brain and is thought to be involved in learning and memory processes. A nonsynonymous polymorphism in the BDNF gene, rs6265 (Val66Met, has been hypothesised to be associated with PTSD. Association studies examining the Val66Met polymorphism and PTSD have been inconclusive, likely due to the variability in type of trauma exposure analysed. Vietnam veterans (n=257 screened for PTSD and controlled for trauma exposure were genotyped for BDNF Val66Met. The association was not significant so we incorporated our data into a meta-analysis to obtain greater statistical power. A comprehensive search of more than 1237 articles revealed eight additional studies suitable for meta-analysis (n=3625. A random-effects meta-analysis observed a potential protective factor of the Val/Val genotype. After removing two studies with violation of Hardy-Weinberg equilibrium, findings for the Val/Val genotype reached significance. Subgroup analyses confirmed a trend for this finding. Limitations of some studies that inform this meta-analysis include poorly screened controls and a lack of examination of population stratification. Effectively designed studies should inform this line of research in the future.

  12. Laryngeal sarcoidosis: a case-control study.

    Science.gov (United States)

    Duchemann, Boris; Lavolé, Armelle; Naccache, Jean-Marc; Nunes, Hilario; Benzakin, Sylvain; Lefevre, Marine; Kambouchner, Marianne; Périé, Sophie; Valeyre, Dominique; Cadranel, Jacques

    2014-10-20

    We undertook a study on a series of laryngeal sarcoidosis (LS), a very rare and often threatening localization to better specify laryngeal manifestations, sarcoidosis clinical expression and long-term follow-up. This was a retrospective case-control study. All LS patients from two French centers were included and compared to sarcoidosis patients without laryngeal localization with two controls for one patient. Twelve consecutive LS patients were recruited between 1993 and 2011. LS revealed sarcoidosis in eight cases (67%). The most common symptoms were hoarseness (77%), inspiratory dyspnea (38%) and dysphagia (38%). Epidemiological characterisics were not different. Extrapulmonary localizations were significantly more common in LS patients than in controls (92% vs. 54%, p=0.02), particularly lupus pernio (25% vs. 0%, p=0.03) and nasosinusal involvement (83% vs. 4%, p<0.01) while thoracic involvement was less frequent (58% vs 100%, p < 0.01). Treatment rates were higher in the LS group (92% vs. 58%, p=0.04), and treatment duration was longer (median: 81 vs. 13 months, p=0.04), with frequent long-term treatment (67%, N=8/12). Two patients underwent surgery. One patient needed temporary tracheostomy during the course of the disease; Remission rates were lower in LS patients (9% vs. 58% at 2 years p<0.01). Eventually, there was no death nor definitive tracheotomy. LS is a rare condition that is often associated to other loco-regional localizations. LS are often difficult to manage. Survival is good but may require a medico-surgical approach.

  13. The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

    Science.gov (United States)

    Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

    2017-06-01

    Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

  14. CYP1A2 rs762551 polymorphism contributes to cancer susceptibility: a meta-analysis from 19 case-control studies

    Directory of Open Access Journals (Sweden)

    Wang Hongge

    2012-11-01

    Full Text Available Abstract Background Genetic polymorphism (rs762551A>C in gene encoding cytochrome P450 1A2 (CYP1A2 has been shown to influence the inducibility of CYP1A2 expression and thus might be associated with risk of several types of human cancer. However, the results of previous studies on the associations of this polymorphism with risk of cancer are not all consistent. To clarify the potential contribution of CYP1A2 rs762551 to cancer risk, we performed a meta-analysis of the published case–control studies. Methods We used PubMed, Embase, OVID, ScienceDirect, and Chinese National Knowledge Infrastructure databases to identify the related publications for this meta-analysis. The pooled odds ratio (OR and 95% confidence interval (CI were calculated using random effect model to evaluate the association of rs762551 with cancer risk. A χ2-based Q-test was used to examine the heterogeneity assumption and the funnel plot and Egger’s test were used to examine the potential publication bias. The leave-one-out sensitivity analysis was conducted to determine whether our assumptions or decisions have a major effect on the results of the review. Results Our analysis of 19 eligible case–control studies showed a significant association between rs762551C variant with risk of cancer in the genetic model of CC versus AA (OR = 1.30, 95% CI = 1.02-1.64 and the dominant model (OR = 1.19, 95% CI = 1.04-1.36. In subgroup analysis based on ethnicity, the rs762551CC genotype was associated with increased cancer risk (OR = 1.29, 95% CI = 1.27-1.63 in co-dominate model and OR = 1.17, 95% CI = 1.02-1.34 in dominant model in Caucasians, but not in Asians and the mixed population. Conclusion These results suggested that CYP1A2 rs762551 polymorphism is likely to be associated with susceptibility to cancer in Caucasians.

  15. Impact of TNF -308 G>A (rs1800629) gene polymorphism in modulation of leprosy risk: a reappraise meta-analysis of 14 case-control studies.

    Science.gov (United States)

    Areeshi, Mohammed Y; Mandal, Raju K; Dar, Sajad A; Jawed, Arshad; Wahid, Mohd; Lohani, Mohtashim; Panda, Aditya K; Mishra, Bhartendu N; Akhter, Naseem; Haque, Shafiul

    2017-10-31

    Earlier studies have shown that tumor necrosis factor ( TNF ) -308 G>A (rs1800629) gene polymorphism is implicated in the susceptibility to leprosy, but results were inconsistent. A meta-analysis of 14 studies involving 3327 leprosy cases and 3203 controls was performed to appraise the association of TNF -308 G>A polymorphism with leprosy using MEDLINE (PUBMED), EMBASE, and Google Scholar web databases. Overall, no significant association was observed in allelic (A vs. G: P =0.068; OR = 0.836, 95% CI = 0.689-1.013), homozygous (AA vs. GG: P =0.394; OR = 0.810, 95% CI = 0.499-1.315), heterozygous (GA vs. GG: P =0.059; OR = 0.780, 95% CI = 0.603-1.010), dominant (AA + GA vs. GG: P =0.067; OR = 0.797, 95% CI = 0.625-1.016), and recessive (AA vs. GG + GA: P =0.594; OR = 0.877, 95% CI = 0.542- 1.420) genetic models. Subgroup analysis showed no association in Asians. Whereas, reduced risk was found in allelic contrast (A vs. G: P =0.014; OR = 0.832, 95% CI = 0.718-0.963) and dominant models (AA + GA vs. GG: P =0.004; OR = 0.790, 95% CI = 0.673-0.928) of the mixed population. TNF -308 G>A polymorphism is not associated with leprosy risk in the overall population. However, subgroup analysis demonstrated protective effect of the said polymorphism in leprosy risk in the Latin American population, but showed no association in the Asians. © 2017 The Author(s).

  16. Meta-analysis of the association between COX-2 polymorphisms and risk of colorectal cancer based on case-control studies.

    Directory of Open Access Journals (Sweden)

    Qiliu Peng

    Full Text Available OBJECTIVE: Cyclooxygenase-2 (COX-2 is an inducible enzyme converting arachidonic acid to prostaglandins and playing important roles in inflammatory diseases as well as tumor development. Previous studies investigating the association between COX-2 polymorphisms and colorectal cancer (CRC risk reported conflicting results. We performed a meta-analysis of all available studies to explore this association. METHODS: All studies published up to October 2013 on the association between COX-2 polymorphisms and CRC risk were identified by searching electronic databases PubMed, EMBASE, and Cochrane library. The association between COX-2 polymorphisms and CRC risk was assessed by odds ratios (ORs together with their 95% confidence intervals (CIs. RESULTS: Ten studies with 6,774 cases and 9,772 controls were included for -1195A>G polymorphism, 13 studies including 6,807 cases and 10,052 controls were available for -765G>C polymorphism, and 8 studies containing 5,121 cases and 7,487 controls were included for 8473T>C polymorphism. With respect to -765G>C polymorphism, we did not find a significant association with CRC risk when all eligible studies were pooled into the meta-analysis. However, in subgroup analyses by ethnicity and cancer location, with a Bonferroni corrected alpha of 0.05/2, statistical significant increased CRC risk was found in the Asian populations (dominant model CC+CG vs. GG: OR = 1.399, 95%CI: 1.113-1.760, P = 0.004 and rectum cancer patients (CC vs. GG: OR = 2.270, 95%CI: 1.295-3.980, P = 0.004; Recessive model CC vs. CG+GG: OR = 2.269, 95%CI: 1.297-3.970, P = 0.004. In subgroup analysis according to source of control, no significant association was detected. With respect to -1195A>G and 8473T>C polymorphisms, no significant association with CRC risk was demonstrated in the overall and subgroup analyses. CONCLUSIONS: The present meta-analysis suggests that the COX-2 -765G>C polymorphism may be a risk factor for

  17. Association of interleukin-1 family cytokines single nucleotide polymorphisms with susceptibility to systemic sclerosis: an independent case-control study and a meta-analysis.

    Science.gov (United States)

    Huang, Xiao-Lei; Wu, Guo-Cui; Wang, Yu-Jie; Yang, Xiao-Ke; Yang, Guo-Jun; Tao, Jin-Hui; Duan, Yu; Yan, Jun-Wei; Li, Xiang-Pei; Ye, Dong-Qing; Wang, Jing

    2016-08-01

    The aim of our study was to investigate the association of five single nucleotide polymorphisms in interleukin-1 (IL-1) gene with susceptibility to systemic sclerosis (SSc) in a Chinese population. A total of 58 SSc patients and 113 healthy controls were enrolled. TaqMan allele discrimination assay was performed to detect the genotyping of IL-1A -889C/T (rs1800587), IL-1B -511C/T (rs16944), IL-18 -607C/A (rs1946518), IL-18 -137G/C (rs187238) and IL-33 rs7044343. The association between these SNPs and SSc risk was analyzed. Furthermore, a meta-analysis of relevant studies on the association of IL-1A -889C/T (rs1800587) and IL-1B -511C/T (rs16944) with the susceptibility to SSc was performed. Through the genotyping, significant associations for SSc were found for: IL-1A -889C/T genotype frequencies (P = 0.000), dominant model (P = 0.000), recessive model (P = 0.001) and allele T frequency (P = 0.000). Among SSc patients, dyspnea was significantly associated with IL-18 -607C/A genotype frequency and IL-33 rs7044343 allele frequency (P = 0.037, P = 0.042, respectively). In addition, elevated erythrocyte sedimentation rate was significantly associated with IL-18 -137G/C (rs187238) genotype and allele frequency (P = 0.019, P = 0.006, respectively). While meta-analysis showed there was no significant association between IL-1A -889C/T polymorphism and SSc, for IL-1B -511C/T (rs16944), significant associations were found in the comparison of allele C versus T (OR 1.267, 95 % CI 1.016-1.580) by combined different outcomes. Results showed that IL-1A -889C/T (rs1800587) was associated with SSc susceptibility in the Chinese population. However, this association was not supported by a meta-analysis of all relevant studies. Further investigations are required to verify our findings.

  18. The tryptophan hydroxylase 1 (TPH1) gene, schizophrenia susceptibility, and suicidal behavior: a multi-centre case-control study and meta-analysis

    DEFF Research Database (Denmark)

    Saetre, Peter; Lundmark, Per; Wang, August

    2010-01-01

    Serotonin (5-hydroxytryptamin; 5-HT) alternations has since long been suspected in the pathophysiology of schizophrenia. Tryptophan hydroxylase (tryptophan 5-monooxygenase; TPH) is the rate-limiting enzyme in the biosynthesis of 5-HT, and sequence variation in intron 6 of the TPH1 gene has been...... affected individuals having attempted suicide at least once and patients with no history of suicide attempts (P = 0.84). A systematic literature review and meta-analysis support the A218C polymorphism as a susceptibility locus for schizophrenia (odds ratio 1.17, 95% confidence interval 1.......07-1.29). Association studies on suicide attempts are however conflicting (heterogeneity index I(2) = 0.54) and do not support the A218C/A779C polymorphisms being a susceptibility locus for suicidal behavior among individuals diagnosed with a psychiatric disorder (OR = 0.96 [0.80-1.16]). We conclude that the TPH1 A218...

  19. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis.

    Science.gov (United States)

    Azmi, NA; Razak, HRA; Vinjamuri, S.

    2017-05-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population.

  20. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis

    International Nuclear Information System (INIS)

    Azmi, NA; Razak, HRA; Vinjamuri, S

    2017-01-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population. (paper)

  1. Genetic predisposition to fracture non-union: a case control study of a preliminary single nucleotide polymorphisms analysis of the BMP pathway

    Directory of Open Access Journals (Sweden)

    Giannoudis Peter V

    2011-02-01

    Full Text Available Abstract Background Despite the known multi-factorial nature of atrophic fracture non-unions, a possible genetic predisposition for the development of this complication after long bone fractures remains unknown. This pilot study aimed to address this issue by performing a preliminary SNP analysis of specific genes known to regulate fracture healing. Methods A total of fifteen SNPs within four genes of the Bone Morphogenetic Protein (BMP pathway (BMP-2, BMP-7, NOGGIN and SMAD6 were examined, in 109 randomly selected patients with long bone fractures as a result of motor vehicle accident, fall or direct blow. There were sixty-two patients with atrophic non-union and forty-seven patients (54 fractures with uneventful fracture union. Overall SNPs frequencies were computed with respect to patient's age, gender, smoking habits, fracture-associated parameters and the use of nonsteroidal anti-inflammatory drugs (NSAIDs, and tested for their association to the impaired bone healing process, using binary logistic regression (STATA 11.1; StataCorp, Texas USA. Results Statistical analysis revealed age to be an important covariate in the development of atrophic non-union (p = 0.01, OR 1.05 [per year], and two specific genotypes (G/G genotype of the rs1372857 SNP, located on NOGGIN and T/T genotype of the rs2053423 SNP, located on SMAD6 to be associated with a greater risk of fracture non-union (p = 0.02, OR 4.56 and p = 0.04, OR 10.27, respectively, after adjustment for age. Conclusions This is the first clinical study to investigate the potential existence of genetic susceptibility to fracture non-union. Even though no concrete conclusions can be obtained from this pilot study, our results indicate the existence of a potential genetically predetermined impairment within the BMP signalling cascade, initiated after a fracture and when combined with other risk factors could synergistically increase the susceptibility of a patient to develop non-union. Further

  2. Association of XPC Gene Polymorphisms with Colorectal Cancer Risk in a Southern Chinese Population: A Case-Control Study and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Rui-Xi Hua

    2016-09-01

    Full Text Available Xeroderma pigmentosum group C (XPC is a key component of the nucleotide excision repair (NER pathway. Dysfunctional XPC protein may impair NER-mediated DNA repair capacity and further lead to genomic instability and carcinogenesis. Two common nonsynonymous polymorphisms in the XPC gene, Lys939Gln (rs2228001 A > C and Ala499Val (rs2228000 C > T, have been investigated in various types of cancer. We genotyped these two polymorphisms in 1141 cases with histologically confirmed colorectal cancer (CRC and 1173 healthy controls to explore their causative association with CRC susceptibility. Overall, no association was observed between these two variants and the risk of CRC. Our meta-analysis also confirmed a lack of overall association. Stratified analyses were performed by age, gender, smoking status, pack-year, drinking status, tumor sites, and Duke’s stages. We found that XPC Lys939Gln polymorphism was significantly associated with an increased CRC risk in subjects at 57 years of age or younger (adjusted odds ratio (OR = 1.37, 95% confidence interval (CI = 1.004–1.86, p = 0.047 and non-drinkers (adjusted OR = 1.53, 95% CI = 1.10–2.12, p = 0.011. Our results indicated that XPC Lys939Gln may be a low-penetrance CRC susceptibility polymorphism. Our findings warrant further validation.

  3. Retrospective analysis of dengue specific IgM reactive serum samples

    OpenAIRE

    Nemai Bhattacharya; Bhaswati Bandyopadhyay; Indranil Bhattacharjee; Hiranmoy Mukherjee; Srabani Talukdar; Ruby Mondal; Netai Pramanick; Goutam Chandra; Amiya K. Hati

    2013-01-01

    Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1) antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: Th...

  4. Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

    Directory of Open Access Journals (Sweden)

    Paola Nicolini

    Full Text Available Mild cognitive impairment (MCI is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA of heart rate variability (HRV at rest and during provocative manoeuvres.This cross-sectional study involved 80 older outpatients (aged ≥ 65 consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline, supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation, and active standing (orthosympathetic stimulation--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn and high frequency (HFn powers and the LF/HF ratio. Blood pressure (BP was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will

  5. Significant association between ERCC2 and MTHR polymorphisms and breast cancer susceptibility in Moroccan population: genotype and haplotype analysis in a case-control study.

    Science.gov (United States)

    Hardi, Hanaa; Melki, Rahma; Boughaleb, Zouhour; El Harroudi, Tijani; Aissaoui, Souria; Boukhatem, Noureddine

    2018-03-15

    Genetic determinants of breast cancer (BC) remained largely unknown in the majority of Moroccan patients. The purpose of this study was to explore the association of ERCC2 and MTHFR polymorphisms with genetic susceptibility to breast cancer in Moroccan population. We genotyped ERCC2 polymorphisms (rs1799793 (G934A) and rs13181 (A2251C)) and MTHFR polymorphisms (rs1801133 (C677T) and rs1801131 (A1298C)) using TaqMan SNP Genotyping Assays. Genotypes were compared in 151 BC cases and 156 population-matched controls. Allelic, genotypic and haplotype associations with the risk and clinicopathological features of BC were assessed using logistic regression analyses. ERCC2-rs1799793-AA genotype was associated with high risk of BC compared to wild type genotype (recessive model: OR: 2.90, 95% CI: 1.34-6.26, p = 0.0069) even after Bonferroni correction (p < 0,0125). MTHFR rs1801133-TT genotype was associated with increased risk of BC (recessive model, OR: 2.49, 95% CI: 1.17-5.29, p = 0.017) but the association turned insignificant after Bonferroni correction. For the rest of SNPs, no statistical associations to BC risk were detected. Significant association with clinical features was detected for MTHFR-rs1801133-TC genotype with early age at diagnosis and familial BC. Following Bonferroni correction, only association with familial BC remained significant. MTHFR-rs1801131-CC genotype was associated with sporadic BC. ERCC2-rs1799793-AA genotype correlated with ER+ and PR+ breast cancer. ERCC2-rs13181-CA genotype was significantly associated large tumors (T ≥ 3) in BC patients. None of these associations passed Bonferroni correction. Haplotype analysis showed that ERCC2 A-C haplotype was significantly associated with increased BC risk (OR: 3.71, 95% CI: 1.7-8.12, p = 0.0002 and p = 0.0008 before and after Bonferroni correction, respectively) and positive expression of ER and PR in BC patients. ERCC2 G-C haplotype was correlated with PR negative and

  6. Dynamic contrast-enhanced case-control analysis in 3T MRI of prostate cancer can help to characterize tumor aggressiveness

    Energy Technology Data Exchange (ETDEWEB)

    Sanz-Requena, Roberto, E-mail: roberto.sanz@quironsalud.es [Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia (Spain); Radiology Department, Hospital Quirónsalud Valencia, Valencia (Spain); GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia (Spain); Martí-Bonmatí, Luis [Radiology Department, Hospital Quirónsalud Valencia, Valencia (Spain); GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia (Spain); Pérez-Martínez, Rosario [Radiology Department, Hospital Quirónsalud Valencia, Valencia (Spain); García-Martí, Gracián [Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia (Spain); Radiology Department, Hospital Quirónsalud Valencia, Valencia (Spain); GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia (Spain); CIBER-SAM, Instituto de Salud Carlos III, Madrid (Spain)

    2016-11-15

    Highlights: • Curve types showed no statistical association with healthy/tumor peripheral areas. • K{sup trans}, v{sub e}, upslope and AUC showed significant differences in controls vs. tumors. • The global diagnostic performance of standard MRI perfusion parameters is poor. • Normalized K{sup trans}, upslope and AUC had good diagnostic accuracy for tumor grading. - Abstract: Purpose: The aim of this work is to establish normality and tumor tissue ranges for perfusion parameters from dynamic contrast-enhanced (DCE) MR of the peripheral prostate at 3T and to compare the diagnostic performance of quantitative and semi-quantitative parameters. Materials and methods: Thirty-six patients with prostate carcinomas (18 Gleason-6, 15 Gleason-7, and 3 Gleason-8) and 33 healthy subjects were included. Image analysis workflow comprised four steps: manual segmentation of whole prostate and lesions, series registration, voxelwise T1 mapping and calculation of pharmacokinetic and semi-quantitative parameters. Results: K{sup trans}, v{sub e}, upslope and AUC60 showed statistically significant differences between healthy peripheral areas and tumors. Curve type showed no association with healthy/tumor peripheral areas (chi-square = 0.702). Areas under the ROC curves were 0.64 (95% CI: 0.54–0.75), 0.70 (0.60–0.80), 0.62 (0.51–0.72) and 0.63 (0.52–0.74) for K{sup trans}, v{sub e}, upslope and AUC60, respectively. The optimal cutoff values were: K{sup trans} = 0.21 min{sup −1} (sensitivity = 0.61, specificity = 0.64), v{sub e} = 0.36 (0.63, 0.71), upslope = 0.59 (0.59, 0.59) and AUC60 = 2.4 (0.63, 0.64). Significant differences were found between Gleason scores 6 and 7 for normalized K{sup trans}, upslope and AUC60, with good diagnostic accuracy (area under ROC curve 0.80, 95% CI: 0.60–1.00). Conclusion: Quantitative (K{sup trans} and v{sub e}) and semi-quantitative (upslope and AUC60) perfusion parameters showed significant differences between tumors and control

  7. Radiographic evaluation of INBONE total ankle arthroplasty: a retrospective analysis of 30 cases

    International Nuclear Information System (INIS)

    Datir, Abhijit; Xing, Minzhi; Kakarala, Aparna; Terk, Michael R.; Labib, Sameh A.

    2013-01-01

    The objectives of this work were to retrospectively describe the radiographic assessment of INBONE total ankle arthroplasty in 30 patients using validated linear and angular measurements and to correlate these findings with the final surgical outcome over a 2-year follow-up period. Thirty consecutive patients (21 females, nine males; mean age, 64.8 years) underwent INBONE total ankle arthroplasty during 2007-2011. After IRB approval, a retrospective pre- and post-operative radiographic analysis was performed using validated linear and angular measurements. The pre- and post-operative assessment included the tibial angle, talar angle, tibial slope, and coronal deformity. Post-operative measurements also included the talocalcaneal angle, joint space height, talar height, lateral tibial component angle, lateral talar component angle, and anteroposterior tibial component angle. The post-operative bone loss, subluxation, positioning, and subsidence were also assessed. Statistical analysis was performed using two-sample t test and Fisher's exact test. Out of 30 patients, 23 had a successful clinical outcome with intact prosthesis at a 2-year follow-up. The only variables with significant correlation (p < 0.05) to the post-surgical outcome were the lateral talar component angle (p = 0.002) and the mean difference between pre- and post-operative tibial slope (p = 0.001). The coronal deformity had significant mean difference between pre- and post-operative values (p < 0.001); however, it lacked a significant correlation to the final surgical outcome. None of the categorical variables had a significant correlation with post-surgical outcome. In our retrospective study, only the lateral talar component angle and the mean difference between the pre- and post-operative tibial slope had significant correlation with post-surgical outcome in INBONE ankle arthroplasty. These measurements may be helpful in radiographic assessment of the INBONE ankle arthroplasty. (orig.)

  8. Myeloperoxidase mRNA detection for lineage determination of leukemic blasts: retrospective analysis.

    Science.gov (United States)

    Crisan, D; Anstett, M J

    1995-07-01

    Myeloperoxidase (MPO) mRNA is an early myeloid marker; its detection in the morphologically and immunophenotypically primitive blasts of acute undifferentiated leukemia (AUL) establishes myeloid lineage and allows reclassification as acute myelogenous leukemia with minimal differentiation (AML-MO). We have previously reported a procedure for MPO mRNA detection by RT-PCR (reverse transcription-polymerase chain reaction) and an adaptation for use of routine hematology smears. This variant procedure allows retrospective analysis of mRNA and is used in the present study to evaluate the lineage of leukemic blasts in seven cases with morphology and cytochemistry consistent with AUL. All hematology smears used in this study were air-dried, unstained or Wright-stained and stored at room temperature for periods varying between 3 days and 2 years. MPO mRNA was detected in six cases, establishing the myeloid lineage of the blasts and the diagnosis of AML-MO. In the remaining case, the blasts were MPO mRNA negative, confirming the diagnosis of AUL. The RT-PCR procedure for retrospective mRNA analysis is useful in the clinical setting, due to its high specificity and sensitivity, speed (less than 24 h), safety (no radioactivity) and convenient use of routine hematology smears; it is particularly attractive in clinical situations when fresh or frozen specimens are no longer available at the time when the need for molecular diagnostics becomes apparent.

  9. Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.

    Science.gov (United States)

    Banaszkiewicz, Zbigniew; Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates.

  10. Identification of Design Work Patterns by Retrospective Analysis of Work Sheets

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1999-01-01

    project is carried out where we seek to identify design work patterns by retrospective analysis of documentation created during design projects.An elements to satisfy the wish for an efficient design process could be to identify work patterns applied by engineering designers, evaluate these patterns...... with respect to their efficiency, and reuse the most efficient in future projects. Thus, the objective of this research is to analyse design projects in order to identify the work patterns applied. Based on an evaluation of identified work patterns we expect a recommendation of work patterns supporting...... an efficient design process can be established.In this paper we describe the analysis method, and present observations from analyses of three projects....

  11. Kinetic therapy reduces complications and shortens hospital stay in patients with cardiogenic shock - a retrospective analysis.

    Science.gov (United States)

    Simonis, Gregor; Flemming, Kerstin; Ziegs, Enrico; Haacke, Katrin; Rauwolf, Thomas; Strasser, Ruth H

    2007-03-01

    Kinetic therapy (KT) has been shown to reduce complications and to shorten hospital stay in trauma patients. Data in non-surgical patients are inconclusive, and kinetic therapy has not been tested in patients with cardiogenic shock. The present analysis compares KT with standard care in patients with cardiogenic shock. A retrospective analysis of 133 patients with cardiogenic shock admitted to 1 academic heart center was performed. Patients with standard care (SC, turning every 2 h by the staff) were compared with kinetic therapy (KT, using oscillating air-flotation beds). 68 patients with KT were compared with 65 patients with SC. Length of ventilator therapy was 11 days in KT and 18 days in SC (p=0.048). The mortality was comparable in both groups. Pneumonia occurred in 14 patients in KT and 39 patients in SC (ppatients treated with kinetic therapy. The use of KT shortens hospital stay and reduces rates of pneumonia and pressure ulcers as compared to SC.

  12. Efficacy of Alteplase in a Mouse Model of Acute Ischemic Stroke: A Retrospective Pooled Analysis.

    Science.gov (United States)

    Orset, Cyrille; Haelewyn, Benoit; Allan, Stuart M; Ansar, Saema; Campos, Francesco; Cho, Tae Hee; Durand, Anne; El Amki, Mohamad; Fatar, Marc; Garcia-Yébenes, Isaac; Gauberti, Maxime; Grudzenski, Saskia; Lizasoain, Ignacio; Lo, Eng; Macrez, Richard; Margaill, Isabelle; Maysami, Samaneh; Meairs, Stephen; Nighoghossian, Norbert; Orbe, Josune; Paramo, Jose Antonio; Parienti, Jean-Jacques; Rothwell, Nancy J; Rubio, Marina; Waeber, Christian; Young, Alan R; Touzé, Emmanuel; Vivien, Denis

    2016-05-01

    The debate over the fact that experimental drugs proposed for the treatment of stroke fail in the translation to the clinical situation has attracted considerable attention in the literature. In this context, we present a retrospective pooled analysis of a large data set from preclinical studies, to examine the effects of early versus late administration of intravenous recombinant tissue-type plasminogen activator. We collected data from 26 individual studies from 9 international centers (13 researchers; 716 animals) that compared recombinant tissue-type plasminogen activator with controls, in a unique mouse model of thromboembolic stroke induced by an in situ injection of thrombin into the middle cerebral artery. Studies were classified into early (stroke in mice. The power analysis reveals that a multicenter trial would require 123 animals per group instead of 40 for a single-center trial. © 2016 American Heart Association, Inc.

  13. Evolution of Canadian nursing curricula: a critical retrospective analysis of power and caring.

    Science.gov (United States)

    Anthony, Susan E; Landeen, Janet

    2009-01-01

    The evolution of Canadian nursing curricula has mutually influenced and reflected nursing's historical course: nursing practice and education are inextricably linked. This paper is a critical retrospective analysis of the evolution of nursing curricula in Canada from the 20th century to the present. Falk Rafael's (1996) dialectic exploration of power and caring in nursing guides the analysis. An ordered, assimilated, and empowered curriculum development framework results. Foucault's (1980) work in the sociology of knowledge and Belenky, Clinchy, Goldberger, and Tarule's (1986) epistemological conceptualization of women's knowledge development are incorporated. The intricacies of the relationship between nursing curriculum development and Canadian history, the navigation of societal paradoxes that mutually drive and inform education and practice, and the instrumental need for nursing education research are considered. A fourth and new dialectic layer is suggested that places nursing on the inter-professional team of architects of a co-constructed emancipatory curriculum.

  14. Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Carpenter, Alberta [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-01-06

    This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular, the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.

  15. Effects of Radiotherapy in the treatment of multiple myeloma: a retrospective analysis of a Single Institution

    International Nuclear Information System (INIS)

    Matuschek, Christiane; Ochtrop, Thomas A; Bölke, Edwin; Ganswindt, Ute; Fenk, Roland; Gripp, Stephan; Kröpil, Patric; Gerber, Peter Arne; Kammers, Kai; Hamilton, Jackson; Orth, Klaus; Budach, Wilfried

    2015-01-01

    Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie & Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of at least one and up to 6 bony lesions at different times. In order to evaluate the effect of local radiotherapy on pain relief and bone recalcification a uni- and multivariate analysis was performed using a binary logistic regression model to correct for multiple measurements. Complete information on dose, fractionation and volume of radiotherapy was available from 81 patients treated in 136 target volumes for pain relief, and from 69 patients treated in 108 target volumes for recalcification. Total radiation doses varied between 8 Gy to 50 Gy (median dose 25 Gy in 2.5 Gy fractions, 5 times a week). Radiotherapy resulted in complete local pain relief in 31% and partial local pain relief in 54% of the patients. In the univariate analysis, higher total radiation doses (p = 0.023) and higher age (p = 0.014) at the time of radiotherapy were significantly associated with a higher likelihood of pain relief, whereas no significant association was detected for concurrent systemic treatment, type and stage of myeloma and location of bone lesions. The same variables were independent predictors for pain relief in the multivariate analysis. Recalcification was observed in 48% of irradiated bone lesions. In the uni- and multivariate analysis higher radiation doses were significantly associated (p = 0.048) with an increased likelihood of recalcification. Side effects of radiotherapy were generally mild. Higher total biological radiation doses were associated with better pain relief and recalcification in this

  16. Prolonged outbreak of Serratia marcescens in Tartu University Hospital: a case-control study.

    Science.gov (United States)

    Adamson, Vivika; Mitt, Piret; Pisarev, Heti; Metsvaht, Tuuli; Telling, Kaidi; Naaber, Paul; Maimets, Matti

    2012-10-31

    The aim of our study was to investigate and control an outbreak and identify risk factors for colonization and infection with Serratia marcescens in two departments in Tartu University Hospital. The retrospective case-control study was conducted from July 2005 to December 2006. Molecular typing by pulsed field gel electrophoresis was used to confirm the relatedness of Serratia marcescens strains. Samples from the environment and from the hands of personnel were cultured. The outbreak involved 210 patients, 61 (29%) developed an infection, among them 16 were invasive infections. Multivariate analysis identified gestational age, arterial catheter use and antibiotic treatment as independent risk factors for colonization and infection with Serratia marcescens. Molecular typing was performed on 83 Serratia marcescens strains, 81 of them were identical and 2 strains were different. Given the occasionally severe consequences of Serratia marcescens in infants, early implementation of aggressive infection control measures involving patients and mothers as well as the personnel is of utmost importance.

  17. Use of yoked prisms in patients with acquired brain injury: a retrospective analysis.

    Science.gov (United States)

    Bansal, Surbhi; Han, Esther; Ciuffreda, Kenneth J

    2014-01-01

    The purpose of this retrospective study was to determine the clinical practices for prescribing yoked prisms, as well as to assess related patient responses, in a sample of visually-symptomatic patients having acquired brain injury (ABI). The clinical records of individuals with acquired brain injury (ABI) that were assessed for yoked prisms were reviewed retrospectively. This query resulted in 60 patient records for analysis between January 2011 and December 2012. The following diagnostic groups were analysed: homonymous hemianopsia (HH)/homonymous quadranopsia, abnormal egocentric localization (AEL) and visual neglect. HH/homonymous quadranopsia (58.3%) was the primary indication to prescribe yoked prisms, followed by visual neglect/unilateral spatial inattention (USI) (40.0%) and AEL (11.7%). The most common favourable patient responses were increased awareness of their blind visual field and improved gait, mobility and balance. The magnitude and direction of prisms prescribed were dependent upon the subjective responses in patients manifesting AEL. In contrast, base direction was dependent upon the direction of visual field loss in patients with HH/homonymous quadranopsia and visual neglect. Two-thirds of the present sample population responded favourably to the yoked prisms. The results of the present study should prove useful to clinicians for the successful prescription of yoked prisms as a treatment modality in patients presenting with the above three diagnoses.

  18. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  19. Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

    International Nuclear Information System (INIS)

    Vignali, Claudio; Bargellini, Irene; Lazzereschi, Michele; Cioni, Roberto; Petruzzi, Pasquale; Caramella, Davide; Pinto, Stefania; Napoli, Vinicio; Zampa, Virna; Bartolozzi, Carlo

    2005-01-01

    Purpose. To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting. Methods. From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22±12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter. Results. Comparing group A and B patients (χ 2 test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was ≥6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents). Conclusion. Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm

  20. Retrospective analysis of patients clinical manifestations before and after pheochromocytoma surgery.

    Science.gov (United States)

    Balazovjech, I; Davidova, H; Breza, J

    2004-01-01

    A retrospective analysis of presurgical clinical picture and blood pressures of 34 patients with histologically verified pheochromocytoma. Assessment of clinical state, blood pressure and prognosis in the course of patients control hospitalizations from 2001 to 2002. The study was designed as a synoptic one, based on a retrospective analysis of 34 patients records with histologically verified pheochromocytoma (26 women and 8 men). Our assessments of clinical symptomatology, maximum paroxysmal hypertension values, average blood pressure values in patients with persistent arterial hypertension, arterial hypertension grade and circadian index were based on patients records. Patients epinephrectomies were followed during their control hospitalizations to assess their clinical state. Their blood pressures were evaluated by means of their circadian monitoring. From the 34 patients, 21 were diagnosed with solitary pheochromocytomas. The circadian index persistence analysis prior to the surgery was associated with circadian blood pressure monitoring in 21 patients. It was lost in 57% of patients. During their control hospitalization as many as 82% of patients preserved their circadian blood pressure variability with a more than 10% decrease in the night time, 5 patients did not preserve their circadian blood pressure variability. Seven from the original 34 patients died: Three of them died from their primary disease, one 63-year old man died from shock following tumour extirpation. The death of other 3 patients was not associated with their primary disease. Long-lasting survival of patients with pheochromocytoma after surgical treatment--except for those with malignant disease--was demonstrated. Although our assessment of the resulting treatment effects was positive, a long-term follow-up is inevitable because of a difficult pathologic-anatomical verification of the malignant nature of the disease as well as of the risk of tumour relapse assessment. (Tab. 1, Fig. 5, Ref 36.)

  1. Relationship Between the Risk of Suffering a First-Time Noncontact ACL Injury and Geometry of the Femoral Notch and ACL: A Prospective Cohort Study With a Nested Case-Control Analysis.

    Science.gov (United States)

    Whitney, Darryl C; Sturnick, Daniel R; Vacek, Pamela M; DeSarno, Mike J; Gardner-Morse, Mack; Tourville, Timothy W; Smith, Helen C; Slauterbeck, James R; Johnson, Robert J; Shultz, Sandra J; Hashemi, Javad; Beynnon, Bruce D

    2014-08-01

    The morphometric characteristics of the anterior cruciate ligament (ACL) and the femoral intercondylar notch within which it resides have been implicated as risk factors for injuries to this important stabilizer of the knee. Prior research has produced equivocal results with differing methodologies, and consequently, it is unclear how these characteristics affect the injury risk in male and female patients. The morphometric characteristics of the ACL and femoral intercondylar notch are individually and independently associated with the risk of suffering a noncontact ACL injury, and these relationships are different in male and female patients. Case-control study; Level of evidence, 3. Magnetic resonance imaging scans of the bilateral knees were obtained on 88 case-control pairs (27 male, 61 female) matched for age, sex, and participation on the same sports team. Patients had suffered a grade III, first-time, noncontact ACL tear. The femoral notch width at 4 locations, the thickness of the bony ridge at the anteromedial outlet of the femoral notch, the femoral notch volume, ACL volume, and ACL cross-sectional area were measured. Multivariate analysis of combined data from male and female patients revealed that decreased ACL volume (odds ratio [OR], 0.829), decreased femoral notch width (OR, 0.700), and increased bony ridge thickness at the anteromedial outlet of the femoral notch (OR, 1.614) were significant independent predictors of an ACL injury. Separate analyses of male and female patients indicated that the femoral notch ridge may be more strongly associated with a risk in female patients, while ACL volume is more strongly associated with a risk in male patients. However, statistical analysis performed with an adjustment for body weight strengthened the association between ACL volume and the risk of injuries in female patients. Morphometric features of both the ACL and femoral notch combine to influence the risk of suffering a noncontact ACL injury. When

  2. Association between the IL1B (-511), IL1B (+3954), IL1RN (VNTR) polymorphisms and Graves' disease risk: a meta-analysis of 11 case-control studies.

    Science.gov (United States)

    Chen, Min-Li; Liao, Ning; Zhao, Hua; Huang, Jian; Xie, Zheng-Fu

    2014-01-01

    Data on the association between the interleukin-1 (IL-1) gene polymorphisms and Graves' disease (GD) risk were conflicting. A meta-analysis was undertaken to assess this association. We searched for case-control studies investigating the association between the IL1B (-511), IL1B (+3954), IL1RN (VNTR) polymorphisms and GD risk. We extracted data using standardized forms and calculated odds ratios (OR) with 95% confidence intervals (CI). A total of 11 case-control studies were included in this meta-analysis. Available data indicated that the IL1B (-511) polymorphism was associated with GD risk in the overall populations (Caucasians and Asians) in homozygote model (TT vs. CC, OR = 0.86, 95% CI: 0.76-0.97, Pz  = 0.015), but not in dominant and recessive models (TT+TC vs. CC: OR = 0.95, 95% CI: 0.81-1.12, Pz  =  0.553 and TT vs. TC+CC: OR = 0.82, 95% CI: 0.60-1.12, Pz  =  0.205, respectively). No association between the IL1B (+3954), IL1RN (VNTR) polymorphisms and GD risk was found in the overall populations in any of the genetic models. In subgroup analyses according to ethnicity, the IL1B (-511) polymorphism was associated with GD risk in Asians in recessive and homozygote models (TT vs. TC+CC: OR =  0.68, 95% CI: 0.55-0.84, Pz VNTR) polymorphisms and GD risk was indicated in Asians, and we found no association between the IL1B (-511), IL1B (+3954), IL1RN (VNTR) polymorphisms and GD risk in Caucasians in any of the genetic models. The IL1B (-511) polymorphism, but not the IL1B (+3954) and IL1RN (VNTR) polymorphisms was associated with GD risk in Asians. There was no association between these polymorphisms and GD risk in Caucasians.

  3. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  4. Anemia and growth failure among HIV-infected children in India: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Shet Anita

    2009-06-01

    Full Text Available Abstract Background Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods We analyzed retrospective data from 248 HIV-infected children aged 1–12 years attending three outpatient clinics in South India (2004–2006. Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses. Results The overall prevalence of anemia (defined as hemoglobin Conclusion The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children.

  5. Retrospective Evaluations of Sequences: Testing the Predictions of a Memory-Based Analysis.

    Science.gov (United States)

    Aldrovandi, Silvio; Poirier, Marie; Kusev, Petko; Ayton, Peter

    2015-01-01

    Retrospective evaluation (RE) of event sequences is known to be biased in various ways. The present paper presents a series of studies that examined the suggestion that the moments that are the most accessible in memory at the point of RE contribute to these biases. As predicted by this memory-based analysis, Experiment 1 showed that pleasantness ratings of word lists were biased by the presentation position of a negative item and by how easy the negative information was to retrieve. Experiment 2 ruled out the hypothesis that these findings were due to the dual nature of the task called upon. Experiment 3 further manipulated the memorability of the negative items--and corresponding changes in RE were as predicted. Finally, Experiment 4 extended the findings to more complex stimuli involving event narratives. Overall, the results suggest that assessments were adjusted based on the retrieval of the most readily available information.

  6. Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

    Energy Technology Data Exchange (ETDEWEB)

    Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

    2006-06-08

    This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

  7. [Retrospective analysis of 24 recurrent glioblastoma after chemoradiation and treated with nitrosoureas or irinotecan and bevacizumab].

    Science.gov (United States)

    Vauleon, Elodie; Mesbah, Habiba; Gedouin, Daniel; Lecouillard, Isabelle; Louvel, Guillaume; Hamlat, Abderrahmane; Riffaud, Laurent; Carsin, Béatrice; Quillien, Véronique; Audrain, Odile; Lesimple, Thierry

    2012-02-01

    Despite progress in the initial management of glioblastoma (GB), the vast majority of patients will experience recurrence within 2-3 years. The medical treatment of these recurrences is being modified by the use of antiangiogenic therapies. Twenty-four patients, who relapsed from GB after chemoradiation followed by adjuvant temozolomide in Rennes, were treated by conventional chemotherapy (nitrosourea) or by the combination of irinotecan and bevacizumab. In this retrospective analysis, overall survival from diagnosis of recurrence was significantly longer in patients treated with the combination of bevacizumab and irinotecan than with nitrosourea (5 months versus 11.5 months). The combination of irinotecan and bevacizumab appeared to provide clinical benefit to patients with recurrent GB.

  8. Retrospective Analysis of T and B Cells Flow-Cross Matches in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Lakshmi Kiran C

    2008-01-01

    Full Text Available Complement-mediated cytotoxic antibodies in conventional cross match, often result in misappropriation of true positives and borderline positives which are detrimental to allograft survival. Flow cross matches (FCXM are sensitive to capture even non comple-ment fixing cytotoxic antibodies. This retrospective study evaluates the utility of FCXM in effectively predicting acute allograft rejection. A total of 17 cases were processed for FCXM (T and B cell of whom seven had no rejection episodes, while the remaining 11 had acute rejection despite negative cross match and panel reacting antibodies being ne-gative (less than 20%. The sensitivity and specificity of the FCXM outcome demons-trated that positive B-cell FCXM has potential to be a good tool in pre-transplant scree-ning. The current analysis proposes the possible utility of B-cell positive FCXM as a more sensitive parameter in predicting acute allograft rejection prior to transplantation.

  9. Retrospective analysis of factors affecting the efficacy of surgical treatment of the scar.

    Science.gov (United States)

    Yang, Z; Shi, X; Zhang, Y; Wang, S; Lei, Z; Liu, X; Fan, D

    2014-04-01

    The scar is a major problem in the medical profession. Its timely treatment is very important for the better outcome of the scar treatment and for the improvement of the life quality of the patients. The aim of this study was retrospectively analyzed the epidemiological characteristics affecting the efficacy of the scar surgical treatment of the people in the western part of China. Total 414 scar cases were retrospectively analyzed to clarify the epidemiological characteristics and the factors affecting the scar surgical treatment efficacy. The factors included were sex, age, area distribution, treatment seasons, injury sites, injury causes, and the time from scarring to the surgical treatment. All scar cases were surgically treated with the repairing technology including skin graft, flap and soft tissue dilation. There were 206 males and 208 females with the average age 20.53±12.9 years (age range 1-68 years). The patient proportions in the age groups of 0-20, 21-40 and >40 years were 61.4% (254 cases), 29.2% (121 cases), and 9.4% (39 cases) respectively. The patient's attendance rate reached the highest during the summer and winter. Most patients were from the rural areas with an increasing tendency each year. The burn scars were the most abundant and the injury sites were mostly the head and face. Univariate analysis showed that the time from scarring to the surgical treatment and the injury sites were significantly influenced the scar surgical treatment efficacy. Logistic regression analysis demonstrated that the injured sites of the head and face significantly influenced the scar surgical treatment efficacy. With the development of economy in China, more scar patients especially younger and children visit doctors predominantely from the rural areas. Usually, they get their scars in the exposed area of their bodies (head and face) which seriously affect the patient's appearance and function. Factors influencing the scar surgical treatment efficacy has

  10. Colorectal cancer with intestinal perforation – a retrospective analysis of treatment outcomes

    Science.gov (United States)

    Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Aim of the study Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. Material and methods A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Results Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). Conclusions In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates. PMID:25784840

  11. Association between bullous pemphigoid and neurologic diseases: a case-control study.

    Science.gov (United States)

    Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

    2014-11-01

    In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

  12. Analysis of sexual assault survivours in a tertiary care hospital in delhi: a retrospective analysis.

    Science.gov (United States)

    Lal, Sweta; Singh, Alpana; Vaid, Neelam Bala; Behera, Sanjeeta

    2014-09-01

    Rape and abuse of women are common occurrences, which, many a times go unspoken due to social stigma or fear of retribution. Rape is a crime not against a single human being but against the entire humanity. For granting justice to the rape survivor it becomes necessary that such matters are properly presented before the Courts of Law. Healthcare workers play an important role in this regard because they are the first person who examine the rape victims. They prepare a documented record of medical condition of rape victim and do relevant sample collection. The objective of this study is to analyse demographic and event characteristics of rape victims who presented to the Emergency Department in tertiary care, Delhi after sexual assault. Data was retrospectively collected from the medico legal register of the Department of Obstetrics and Gynecology between June 2010 to December 2013. We noted a marked increase in the number of cases. Mean age of victims was 17 and most belonged to the lower socio-economic strata of the society. Use of sedatives and physical trauma was not common. Victims often knew the perpetrator of the event. Most (58%) of them reported within one day of the incident. Major degrees of perineal tears were seen in young victims. By understanding the demography of the sexual assault victims, we need to train our doctors for proper evidence collection not just in a government set up but also in private clinics, to help rape victims get justice and proper medical treatment.

  13. Invasive micropapillary carcinoma of the breast has a better long-term survival than invasive ductal carcinoma of the breast in spite of its aggressive clinical presentations: a comparison based on large population database and case-control analysis.

    Science.gov (United States)

    Chen, Hongliang; Wu, Kejin; Wang, Maoli; Wang, Fuwen; Zhang, Mingdi; Zhang, Peng

    2017-12-01

    There are controversies in the comparison of overall survival between invasive micropapillary carcinoma of the breast (IMPC) and invasive ductal carcinoma (IDC). The objective of this study was to compare the long-term survival outcome between non-metastatic IMPC and IDC. The Surveillance, Epidemiology, and End Results database was searched to identify women with non-metastatic IMPC and IDC diagnosed between 2001 and 2013. Comparisons of patient and tumor characteristics were performed using Pearson's chi-square. The propensity score matching method was applied with each IMPC matched to one IDC. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Multivariate analysis was performed through Cox models. IMPC was presented with aggressive clinical presentations such as larger tumor, more positive lymph nodes, and more advanced stage compared with IDC. A higher rate of estrogen receptor (ER)/progesterone receptor (PR) positivity was also observed in IMPC. With a median follow-up of 64 months, IMPC had a better BCSS (P = 0.031) and OS (P = 0.012) compared with IDC. In a case-control analysis IMPC was still an independent favorable prognostic factor for BCSS (HR = 0.410, P analysis, IMPC always showed a better survival outcome compared with IDC except in AJCC stage I and histologic grade I disease. IMPC has a better long-term survival outcome compared with IDC in spite of its highly aggressive clinical presentation. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  14. Survival after Second and Subsequent Recurrences in Osteosarcoma: A Retrospective Multicenter Analysis.

    Science.gov (United States)

    Tirtei, Elisa; Asaftei, Sebastian D; Manicone, Rosaria; Cesari, Marilena; Paioli, Anna; Rocca, Michele; Ferrari, Stefano; Fagioli, Franca

    2017-05-01

    Purpose Osteosarcoma (OS) is the most common primary bone tumor. Despite complete surgical removal and intensive chemotherapeutic treatment, 30%-35% of patients with OS have local or systemic recurrence. Some patients survive multiple recurrences, but overall survival after OS recurrence is poor. This analysis aims to describe and identify factors influencing post-relapse survival (PRS) after a second OS relapse. Methods This is a retrospective analysis of 60 patients with a second relapse of OS of the extremities in 2 Italian centers between 2003 and 2013. Results Treatment for first and subsequent relapses was planned according to institutional guidelines. After complete surgical remission (CSR) following the first recurrence, patients experienced a second OS relapse with a median disease-free interval (DFI) of 6 months. Lung disease was prevalent: 44 patients (76%) had pulmonary metastases. Survival after the second relapse was 22% at 5 years. Lung disease only correlated with better survival at 5 years (33.6%) compared with other sites of recurrence (5%; p = 0.008). Patients with a single pulmonary lesion had a better 5-year second PRS (42%; p = 0.02). Patients who achieved a second CSR had a 5-year second PRS of 33.4%. Chemotherapy (p<0.001) benefited patients without a third CSR. Conclusions This analysis confirms the importance of an aggressive, repeated surgical approach. Lung metastases only, the number of lesions, DFI and CSR influenced survival. It also confirms the importance of chemotherapy in patients in whom surgical treatment is not feasible.

  15. Ultrasound and PET-CT Correlation in Shoulder Pathology: A 5-Year Retrospective Analysis.

    Science.gov (United States)

    Burke, Christopher J; Walter, William R; Adler, Ronald S; Babb, James S; Sanger, Joseph; Ponzo, Fabio

    2017-10-01

    To correlate shoulder ultrasound and radiography with F-FDG PET-CT to establish FDG uptake and therefore range of metabolic activity, as defined by SUV analysis, in various symptomatic shoulder pathologies. Retrospective database query was performed for shoulder ultrasound and PET-CT scans between January 2012 and January 2017. Patients who had both studies within 1 year were included. Age- and sex-matched control patients with PET-CT scans only were also included. Retrospective image review determined shoulder pathology, and F-FDG SUVmax was measured using regions of interest placed at the glenohumeral joint, rotator cuff/bursa, and bicipital groove. Glenohumeral and acromioclavicular osteoarthrosis was assessed by radiography using the Kellgren-Lawrence classification system. Thirty-three patients had both imaging studies within 1 year. Ten patients (11 cases) were included, ranging in age from 56 to 90 years (mean, 67.9 years). Control subjects were selected among patients receiving PET-CT within 1 week of symptomatic patients. Glenohumeral osteoarthrosis was mild in 3 (27%), moderate in 2 (18%), and severe in 2 (18%). Six full-thickness rotator cuff tears (55%) were identified. SUVmax means were compared between the pathologic and control groups and were significantly higher in the former: glenohumeral joint (1.96 vs 1.32; P = 0.016), rotator cuff/bursa (2.80 vs 2.0; P = 0.005), and bicipital groove (2.19 vs 1.48; P = 0.007). The highest values were seen in full-thickness rotator cuff tear and severe biceps tenosynovitis. Increased metabolic activity about the shoulder is associated with a spectrum of rotator cuff, glenohumeral joint, and other soft tissue pathology that can be correlated with diagnostic ultrasound findings.

  16. Retrospective analysis of necropsy reports suggestive of abuse in dogs and cats.

    Science.gov (United States)

    Almeida, Daniel C; Torres, Sheila M F; Wuenschmann, Arno

    2018-02-15

    OBJECTIVE To identify historical and necropsy findings suggestive of neglect or abuse of dogs and cats by retrospective analysis of necropsy reports from a veterinary diagnostic laboratory. DESIGN Retrospective cohort study. SAMPLE 119 necropsy reports of dogs and cats. PROCEDURES Necropsy reports from February 2001 to May 2012 were electronically searched to identify potential animal abuse or neglect cases. Cases were selected and categorized according to a previously proposed method for classification of animal abuse. Inclusion criteria included signs of neglect, nonaccidental injury (NAI; blunt-force or sharp-force trauma, gunshot, burns, drowning, asphyxiation, and suspicious intoxications), and sexual abuse. Poor preservation of cadavers, age abuse cases, determined on the basis of all necropsies performed in the study period, was 73 of 8,417 (0.87%) in dogs and 46 of 4,905 (0.94%) in cats. Neglect and NAI were commonly identified in cats; NAI was most commonly found in dogs. Gunshot and blunt-force trauma were the most common NAIs in dogs and cats, respectively. Pit bull-type dogs (29/73 [40%]) were overrepresented in several abuse categories. Most cats (29/46 [63%]) were domestic shorthair, but no breed association was found. Most (41/71 [58%]) affected animals with age data available were ≤ 2 years old. CONCLUSIONS AND CLINICAL RELEVANCE Approximately 1% of dogs and cats necropsied in the study period had signs suggestive of abuse. Medical findings alone are not necessarily indicative of abuse, but some findings can increase the index of suspicion.

  17. Sequencing chemotherapy and radiotherapy in locoregional advanced breast cancer patients after mastectomy – a retrospective analysis

    International Nuclear Information System (INIS)

    Piroth, Marc D; Pinkawa, Michael; Gagel, Bernd; Stanzel, Sven; Asadpour, Branka; Eble, Michael J

    2008-01-01

    Combined chemo- and radiotherapy are established in breast cancer treatment. Chemotherapy is recommended prior to radiotherapy but decisive data on the optimal sequence are rare. This retrospective analysis aimed to assess the role of sequencing in patients after mastectomy because of advanced locoregional disease. A total of 212 eligible patients had a stage III breast cancer and had adjuvant chemotherapy and radiotherapy after mastectomy and axillary dissection between 1996 and 2004. According to concerted multi-modality treatment strategies 86 patients were treated sequentially (chemotherapy followed by radiotherapy) (SEQgroup), 70 patients had a sandwich treatment (SW-group) and 56 patients had simultaneous chemoradiation (SIM-group) during that time period. Radiotherapy comprised the thoracic wall and/or regional lymph nodes. The total dose was 45–50.4 Gray. As simultaneous chemoradiation CMF was given in 95.4% of patients while in sequential or sandwich application in 86% and 87.1% of patients an anthracycline-based chemotherapy was given. Concerning the parameters nodal involvement, lymphovascular invasion, extracapsular spread and extension of the irradiated region the three treatment groups were significantly imbalanced. The other parameters, e.g. age, pathological tumor stage, grading and receptor status were homogeneously distributed. Looking on those two groups with an equally effective chemotherapy (EC, FEC), the SEQ- and SW-group, the sole imbalance was the extension of LVI (57.1 vs. 25.6%, p < 0.0001). 5-year overall- and disease free survival were 53.2%/56%, 38.1%/32% and 64.2%/50%, for the sequential, sandwich and simultaneous regime, respectively, which differed significantly in the univariate analysis (p = 0.04 and p = 0.03, log-rank test). Also the 5-year locoregional or distant recurrence free survival showed no significant differences according to the sequence of chemo- and radiotherapy. In the multivariate analyses the sequence had no

  18. Video content analysis on body-worn cameras for retrospective investigation

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; ter Haar, Frank B.; Eendebak, Pieter T.; den Hollander, Richard J. M.; Burghouts, Gertjan J.; Wijn, Remco; van den Broek, Sebastiaan P.; van Rest, Jeroen H. C.

    2015-10-01

    In the security domain, cameras are important to assess critical situations. Apart from fixed surveillance cameras we observe an increasing number of sensors on mobile platforms, such as drones, vehicles and persons. Mobile cameras allow rapid and local deployment, enabling many novel applications and effects, such as the reduction of violence between police and citizens. However, the increased use of bodycams also creates potential challenges. For example: how can end-users extract information from the abundance of video, how can the information be presented, and how can an officer retrieve information efficiently? Nevertheless, such video gives the opportunity to stimulate the professionals' memory, and support complete and accurate reporting. In this paper, we show how video content analysis (VCA) can address these challenges and seize these opportunities. To this end, we focus on methods for creating a complete summary of the video, which allows quick retrieval of relevant fragments. The content analysis for summarization consists of several components, such as stabilization, scene selection, motion estimation, localization, pedestrian tracking and action recognition in the video from a bodycam. The different components and visual representations of summaries are presented for retrospective investigation.

  19. Intentional and accidental paracetamol poisoning in childhood – a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Katarzyna Kominek

    2015-04-01

    Full Text Available Paracetamol is one of the most commonly used analgesics and antipyretics available without limits as preparations of the OTC group (over the counter drugs. Overdose and poisoning with this drug always brings about the risk of acute hepatic failure. The objective of the study was a retrospective evaluation of patients hospitalized in the Paediatric Clinic during the period 2004–2012 due to poisoning with paracetamol.The analysis covered 44 patients hospitalized in the Paediatric Clinic during 2004–2012 due to poisoning with paracetamol. Patients were divided into three groups: intentional poisonings, accidental poisonings, and drug overdose.During the period of the study, 44 patients aged 2.1–17.1, poisoned with paracetamol, were hospitalized. Among these patients there were 30 (68.2% cases of intentional poisonings, 10 (22.7% of accidental poisonings, and only 4 patients (9.1% were children hospitalized after a paracetamol overdose. The majority of patients in all groups were females (93.3%.Paracetamol intoxication may occur after exceeding a single allowable dose, in the case of intentional poisoning, more rarely after exceeding the daily dose, in the case of intense pain complaints, or in the treatment of persistent fever.Based on the analysis performed, an increase was observed in the frequency of poisoning with paracetamol, especially intentional poisoning. Unlimited access to paracetamol as an OTC drug should be reconsidered.

  20. Climate Data Guide - Modern Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2)

    Science.gov (United States)

    Cullather, Richard; Bosilovich, Michael

    2017-01-01

    The Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2) is a global atmospheric reanalysis produced by the NASA Global Modeling and Assimilation Office (GMAO). It spans the satellite observing era from 1980 to the present. The goals of MERRA-2 are to provide a regularly-gridded, homogeneous record of the global atmosphere, and to incorporate additional aspects of the climate system including trace gas constituents (stratospheric ozone), and improved land surface representation, and cryospheric processes. MERRA-2 is also the first satellite-era global reanalysis to assimilate space-based observations of aerosols and represent their interactions with other physical processes in the climate system. The inclusion of these additional components are consistent with the overall objectives of an Integrated Earth System Analysis (IESA). MERRA-2 is intended to replace the original MERRA product, and reflects recent advances in atmospheric modeling and data assimilation. Modern hyperspectral radiance and microwave observations, along with GPS-Radio Occultation and NASA ozone datasets are now assimilated in MERRA-2. Much of the structure of the data files remains the same in MERRA-2. While the original MERRA data format was HDF-EOS, the MERRA-2 supplied binary data format is now NetCDF4 (with lossy compression to save space).

  1. Real-world Outcomes of Multiple Myeloma: Retrospective Analysis of the Czech Registry of Monoclonal Gammopathies.

    Science.gov (United States)

    Hájek, Roman; Jarkovsky, Jiri; Maisnar, Vladimír; Pour, Ludek; Špička, Ivan; Minařík, Jiri; Gregora, Evžen; Kessler, Petr; Sýkora, Michal; Fraňková, Hana; Campioni, Marco; DeCosta, Lucy; Treur, Maarten; Gonzalez-McQuire, Sebastian; Bouwmeester, Walter

    2018-06-01

    Real-world data on patient outcomes and treatment patterns in multiple myeloma (MM) are limited. The present noninterventional, observational, retrospective analysis of prospectively collected Czech patient medical record data from the Registry of Monoclonal Gammopathies estimated real-world outcomes in adults with a diagnosis of symptomatic MM made between May 2007 and June 2014. In total, 2446 patients had initiated first-line treatment. The median overall survival since the diagnosis (primary endpoint) was 50.3 months (95% confidence interval, 46.1-54.5 months) and decreased with each successive treatment line. A similar trend was observed for progression-free survival and the depth of response. In line with European guidelines and clinical practice, bortezomib-, thalidomide-, and lenalidomide-based regimens were most commonly used across all treatment lines (42.3%, 28.9%, and 18.4%, respectively). In the first line, bortezomib and thalidomide were used most often, with lenalidomide the most commonly used agent in the relapse setting (second to fourth lines). Exploratory analyses revealed that younger age (≤ 65 years), lower international staging system stage, and previous stem cell transplantation were associated with significant improvements in overall and progression-free survival, especially in the early treatment lines. The present study is the first analysis of Czech data from the Registry of Monoclonal Gammopathies, and it provides important insights into the real-world management of MM for physicians and healthcare providers. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island (China)

    Science.gov (United States)

    Titlyanov, Eduard A.; Titlyanova, Tamara V.; Xia, Bangmei; Bartsch, Inka

    2016-09-01

    Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island in the period 1933-1992 is presented in this paper. There are two extensive sample collection periods of benthic macroalgae: the early collection (EC) covers a period between the early 1930s and the 1980s before considerable urbanization and reef degradation took place and a late collection (LC) was performed in 1990/1992 during a phase of rapid urbanization. Analysis of data also including an earlier published inventory of green algae covering the same collection sites (Titlyanov et al. 2011a) revealed that the marine flora of the island comprises 426 taxa in total, with 59% red algae, 18% brown algae and 23% green algae. In total 59 species of red algae, 11 species of brown algae and 37 species of green algae sampled during the LC are new records for Hainan Island. Considerable floristic changes between EC and LC became evident. In the LC there were significantly more filamentous, tubular or fine blade-like, and often epiphytic, green and red algae with a high surface-to-volume ratio. Additionally a reduction of green, brown and red algal species with larger fleshy or foliose thalli and a low surface-to-volume ratio was observed. It is assumed that the changes reflect the degradation of the coral reef ecosystem around Hainan, which was damaged by human activities especially in the 1950s-1970s.

  3. Hospitalization for partial nephrectomy was not associated with intrathecal opioid analgesia: Retrospective analysis.

    Science.gov (United States)

    Weingarten, Toby N; Del Mundo, Serena B; Yeoh, Tze Yeng; Scavonetto, Federica; Leibovich, Bradley C; Sprung, Juraj

    2014-10-01

    The aim of this retrospective study is to test the hypothesis that the use of spinal analgesia shortens the length of hospital stay after partial nephrectomy. We reviewed all patients undergoing partial nephrectomy for malignancy through flank incision between January 1, 2008, and June 30, 2011. We excluded patients who underwent tumor thrombectomy, used sustained-release opioids, or had general anesthesia supplemented by epidural analgesia. Patients were grouped into "spinal" (intrathecal opioid injection for postoperative analgesia) versus "general anesthetic" group, and "early" discharge group (within 3 postoperative days) versus "late" group. Association between demographics, patient physical status, anesthetic techniques, and surgical complexity and hospital stay were analyzed using multivariable logistic regression analysis. Of 380 patients, 158 (41.6%) were discharged "early" and 151 (39.7%) were "spinal" cases. Both spinal and early discharge groups had better postoperative pain control and used less postoperative systemic opioids. Spinal analgesia was associated with early hospital discharge, odds ratio 1.52, (95% confidence interval 1.00-2.30), P = 0.05, but in adjusted analysis was no longer associated with early discharge, 1.16 (0.73-1.86), P = 0.52. Early discharge was associated with calendar year, with more recent years being associated with early discharge. Spinal analgesia combined with general anesthesia was associated with improved postoperative pain control during the 1(st) postoperative day, but not with shorter hospital stay following partial nephrectomy. Therefore, unaccounted practice changes that occurred during more recent times affected hospital stay.

  4. Prevalence of multidrug resistant pathogens in children with urinary tract infection: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Srinivasan S, Madhusudhan NS

    2014-11-01

    Full Text Available Urinary tract infection (UTI is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria. Aims & Objectives: To know the bacteriological profile and susceptibility pattern of urinary tract infections in children and to know the prevalence of multidrug resistant uropathogens. Materials & Methods: A retrospective analysis was done on all paediatric urine samples for a period of one year. A total of 1581 samples were included in the study. Antimicrobial susceptibility testing was done on samples showing significant growth by Kirby-Bauer disc diffusion method. Statistical analysis: Prevalence and pattern were analyzed using proportions and percentages. Results: E.coli was the most predominant organism (56% causing UTI in children followed by Klebsiella sp (17%. Fifty three percent of gram negative organisms isolated from children were found to be multidrug resistant. Majority of E. coli isolates were found to be highly resistant to Ampicillin (91% and Cotrimoxazole (82% and highly sensitive to Imipenem (99% and Amikacin (93%. Conclusion: Paediatric UTI was common in children less than 5 years of age. Gram negative bacteria (E. coli and Klebsiella sp were more common than gram positive bacteria. Our study revealed that multidrug resistance was higher in E.coli.

  5. Sudden illness while driving a vehicle--a retrospective analysis of commercial drivers in Japan.

    Science.gov (United States)

    Hitosugi, Masahito; Gomei, Sayaka; Okubo, Takao; Tokudome, Shogo

    2012-01-01

    We performed a retrospective analysis of commercial drivers to clarify the background of incidents of sudden illness while driving. The analysis used reports submitted by employers to the Japan Ministry of Land, Infrastructure, Transport, and Tourism regarding commercial drivers who had been ordered to stop driving owing to health problems. Of 211 cases with an average work history of 15.2 years, there were 88 bus drivers, 70 taxi drivers, and 53 truck drivers, 36.0% of who had died as a result of their disease. Among taxi and truck drivers, more than 70% of incidents were due to cardiac, aortic, and cerebrovascular disease. More than 80% of these were unable to avoid traffic accidents caused by sudden illness. However, among bus drivers, cardiac, aortic, and cerebrovascular disease accounted for only 23.5% of incidents, and accidents were avoided in more than half of the cases. The duration between starting work and the incident time was significantly shorter among bus drivers [mean 3.3 hours, standard deviation (SD) 3.1] than taxi (7.7 hours, SD 5.8) and truck (7.2 hours, SD 6.3) drivers (Pprevent disabling events while driving. As a precaution, physicians should advise commercial drivers to stop driving as soon as they detect slight discomfort. To prevent accidents, more assertive health promotion aimed at professional drivers is needed.

  6. Retrospective questions or a diary method? A two-level multitrait-multimethod analysis

    NARCIS (Netherlands)

    Hox, J.J.; Kleiboer, A.M.

    2007-01-01

    This study describes a comparison between retrospective questions and daily diaries inquiring about positive and negative support in spousal interactions. The design was a multitrait-multimethod matrix with trait factors of positive and negative support, and method factors of retrospective questions

  7. Association between the European GWAS-identified susceptibility locus at chromosome 4p16 and the risk of atrial septal defect: a case-control study in Southwest China and a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Li Zhao

    Full Text Available Atrial septal defect (ASD is the third most frequent type of congenital heart anomaly, featuring shunting of blood between the two atria. Gene-environment interaction remains to be an acknowledged cause for ASD occurrence. A recent European genome-wide association study (GWAS of congenital heart disease (CHD identified 3 susceptibility SNPs at chromosome 4p16 associated with ASD: rs870142, rs16835979 and rs6824295. A Chinese-GWAS of CHD conducted in the corresponding period did not reveal the 3 susceptibility SNPs, but reported 2 different risk SNPs: rs2474937 and rs1531070. Therefore, we aimed to investigate the associations between the 3 European GWAS-identified susceptibility SNPs and ASD risk in the Han population in southwest China. Additionally, to increase the robustness of our current analysis, we conducted a meta-analysis combining published studies and our current case-control study. We performed association, linkage disequilibrium, and haplotype analysis among the 3 SNPs in 190 ASD cases and 225 age-, sex-, and ethnicity-matched healthy controls. Genotype and allele frequencies among the 3 SNPs showed statistically significant differences between the cases and controls. Our study found that individuals carrying the allele T of rs870142, the allele A of rs16835979, and the allele T of rs6824295 had a respective 50.1% (odds ratio (OR = 1.501, 95% confidence interval (CI = 1.122-2.009, PFDR-BH = 0.018, 48.5% (OR = 1.485, 95%CI = 1.109-1.987, PFDR-BH = 0.012, and 38.6% (OR = 1.386, 95%CI = 1.042-1.844, PFDR-BH = 0.025 increased risk to develop ASD than wild-type allele carriers in our study cohort. In the haplotype analysis, we identified a disease-risk haplotype (TAT (OR = 1.540, 95%CI = 1.030-2.380, PFDR-BH = 0.016. Our meta-analysis also showed that the investigated SNP was associated with ASD risk (combined OR (95%CI = 1.35 (1.24-1.46, P < 0.00001. Our study provides compelling evidence to motivate better understanding of the etiology

  8. A retrospective analysis of compact fluorescent lamp experience curves and their correlations to deployment programs

    International Nuclear Information System (INIS)

    Smith, Sarah Josephine; Wei, Max; Sohn, Michael D.

    2016-01-01

    Experience curves are useful for understanding technology development and can aid in the design and analysis of market transformation programs. Here, we employ a novel approach to create experience curves, to examine both global and North American compact fluorescent lamp (CFL) data for the years 1990–2007. We move away from the prevailing method of fitting a single, constant, exponential curve to data and instead search for break points where changes in the learning rate may have occurred. Our analysis suggests a learning rate of approximately 21% for the period of 1990–1997, and 51% and 79% in global and North American datasets, respectively, after 1998. We use price data for this analysis; therefore our learning rates encompass developments beyond typical “learning by doing”, including supply chain impacts such as market competition. We examine correlations between North American learning rates and the initiation of new programs, abrupt technological advances, and economic and political events, and find an increased learning rate associated with design advancements and federal standards programs. Our findings support the use of segmented experience curves for retrospective and prospective technology analysis, and may imply that investments in technology programs have contributed to an increase of the CFL learning rate. - Highlights: • We develop a segmented regression technique to estimate historical CFL learning curves. • CFL experience curves do not have a constant learning rate. • CFLs exhibited a learning rate of approximately 21% from 1990 to 1997. • The CFL learning rate significantly increased after 1998. • Increased CFL learning rate is correlated to technology deployment programs.

  9. Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014.

    Science.gov (United States)

    Crabtree, Nathan; Mo, Shirley; Ong, Leon; Jegathees, Thuvarahan; Wei, Daniel; Fahey, David; Liu, Jia Jenny

    2017-04-01

    Introduction Comprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events. Hypothesis Patient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements. A retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA). Between 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were

  10. Association of estrogen receptor α PvuII and XbaI polymorphisms with prostate cancer susceptibility and risk stratification: a meta-analysis from case-control studies

    Directory of Open Access Journals (Sweden)

    Zhao YN

    2017-06-01

    Full Text Available Yining Zhao,1,* Xi Zheng,2,* Lijie Zhang,3 Qiang Hu,3 Yitian Guo,3 Hua Jiang,3 Shennan Shi,4 Xiang Zhang1 1Department of Urology, Qilu Hospital of Shandong University, Jinan, 2Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 3Department of Urology, Affiliated Zhongda Hospital, Medical School, Southeast University, Nanjing, 4Department of General Surgery, Qilu Hospital of Shandong University, Jinan, People’s Republic of China *These authors contributed equally to this work Background: Studies on the association between two single nucleotide polymorphisms (SNPs in estrogen receptor α (ERα, PvuII (rs2234693 T>C and XbaI (rs9340799 A>G, and the prostate cancer risk are inconsistent. Therefore, we performed a meta-analysis to derive a more accurate estimation of this relationship. Methods: A literature search of PubMed, Embase, Web of Science databases until October 1, 2016, was conducted. Crude odds ratios (ORs with 95% confidence intervals (CIs were calculated to assess the strength of this association. Results: Eighteen case-control studies, with a total of 3,317 prostate cancer patients and 8,324 controls, were included. Results showed that both PvuII and XbaI polymorphisms were significantly associated with a higher prostate cancer risk in overall populations. To derive a more accurate estimation, subgroup analysis stratified by ethnicity revealed that this relationship existed only in Caucasians, but not in Asians. Furthermore, PvuII polymorphism was significantly associated with high Gleason grade (Gleason score ≥7 cancers. Conclusion: The current meta-analysis demonstrates that ERα PvuII and XbaI polymorphisms are associated with a higher prostate cancer risk in Caucasians, but not in Asians, and PvuII polymorphism is significantly associated with high Gleason grade tumors, indicating the probability of inherited susceptibility to prostate cancer arising from different genomic ERα SNPs

  11. Retrospective dosimetry of Chernobyl liquidators

    International Nuclear Information System (INIS)

    Chumak, V.V.; Bakhanova, E.V.; Sholom, S.V.; Pasalskaya, L.F.; Bouville, A.; Krjuchkov, V.P.

    2000-01-01

    The numerous cohort of Chernobyl liquidators is a very attractive subject for epidemiological follow up due to high levels of exposure, age-gender distribution and availability of patients for medical examination. However, dosimetric information related to this population is incomplete, in many cases the quality of available dose records is doubtful and uncertainties of all dose values are not determined. Naive attempts to evaluate average doses on the basis of such factors as 'distance from the reactor' obviously fail due to large variation of tasks and workplace contamination. Therefore, prior to any sensible consideration of liquidators as a subject of epidemiological study, their doses should be evaluated (reevaluated) using the methods of retrospective dosimetry. Retrospective dosimetry in general got significant development over the last decade. However, most of the retrospective dosimetry techniques are time consuming, expensive and possess sensitivity threshold. Therefore, application of retrospective dosimetry for the needs of epidemiological follow up studies requires development of certain strategy. This strategy depends, of coarse, on the epidemiological design of the study, availability of resources and dosimetric information related to the time of clean up. One of the strategies of application of retrospective dosimetry may be demonstrated on the example of a cohort study with occasional nested case control consideration. In this case, the tools are needed for validation of existing dose records (of not always known quality), screening of the study cohort with express dosimetric method called to determine possible dose ranges, and 'state-of-the-art' assessment of individual doses for selected subjects (cases and controls). Verification of dose records involves analysis of the statistical regularities of dose distributions and detection of possible extraneous admixtures (presumably falsified dose records). This work is performed on impersonified data

  12. A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans

    International Nuclear Information System (INIS)

    Li, Guangjun; Wu, Kui; Peng, Guang; Zhang, Yingjie; Bai, Sen

    2014-01-01

    Volumetric-modulated arc therapy (VMAT) is now widely used clinically, as it is capable of delivering a highly conformal dose distribution in a short time interval. We retrospectively analyzed patient-specific quality assurance (QA) of VMAT and examined the relationships between the planning parameters and the QA results. A total of 118 clinical VMAT cases underwent pretreatment QA. All plans had 3-dimensional diode array measurements, and 69 also had ion chamber measurements. Dose distribution and isocenter point dose were evaluated by comparing the measurements and the treatment planning system (TPS) calculations. In addition, the relationship between QA results and several planning parameters, such as dose level, control points (CPs), monitor units (MUs), average field width, and average leaf travel, were also analyzed. For delivered dose distribution, a gamma analysis passing rate greater than 90% was obtained for all plans and greater than 95% for 100 of 118 plans with the 3%/3-mm criteria. The difference (mean ± standard deviation) between the point doses measured by the ion chamber and those calculated by TPS was 0.9% ± 2.0% for all plans. For all cancer sites, nasopharyngeal carcinoma and gastric cancer have the lowest and highest average passing rates, respectively. From multivariate linear regression analysis, the dose level (p = 0.001) and the average leaf travel (p < 0.001) showed negative correlations with the passing rate, and the average field width (p = 0.003) showed a positive correlation with the passing rate, all indicating a correlation between the passing rate and the plan complexity. No statistically significant correlation was found between MU or CP and the passing rate. Analysis of the results of dosimetric pretreatment measurements as a function of VMAT plan parameters can provide important information to guide the plan parameter setting and optimization in TPS

  13. A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans

    Energy Technology Data Exchange (ETDEWEB)

    Li, Guangjun [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China); Wu, Kui [Department of Radiotherapy, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province (China); Peng, Guang; Zhang, Yingjie [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China); Bai, Sen, E-mail: baisen@scu.edu.cn [Radiation Physics Center, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan (China)

    2014-01-01

    Volumetric-modulated arc therapy (VMAT) is now widely used clinically, as it is capable of delivering a highly conformal dose distribution in a short time interval. We retrospectively analyzed patient-specific quality assurance (QA) of VMAT and examined the relationships between the planning parameters and the QA results. A total of 118 clinical VMAT cases underwent pretreatment QA. All plans had 3-dimensional diode array measurements, and 69 also had ion chamber measurements. Dose distribution and isocenter point dose were evaluated by comparing the measurements and the treatment planning system (TPS) calculations. In addition, the relationship between QA results and several planning parameters, such as dose level, control points (CPs), monitor units (MUs), average field width, and average leaf travel, were also analyzed. For delivered dose distribution, a gamma analysis passing rate greater than 90% was obtained for all plans and greater than 95% for 100 of 118 plans with the 3%/3-mm criteria. The difference (mean ± standard deviation) between the point doses measured by the ion chamber and those calculated by TPS was 0.9% ± 2.0% for all plans. For all cancer sites, nasopharyngeal carcinoma and gastric cancer have the lowest and highest average passing rates, respectively. From multivariate linear regression analysis, the dose level (p = 0.001) and the average leaf travel (p < 0.001) showed negative correlations with the passing rate, and the average field width (p = 0.003) showed a positive correlation with the passing rate, all indicating a correlation between the passing rate and the plan complexity. No statistically significant correlation was found between MU or CP and the passing rate. Analysis of the results of dosimetric pretreatment measurements as a function of VMAT plan parameters can provide important information to guide the plan parameter setting and optimization in TPS.

  14. A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans.

    Science.gov (United States)

    Li, Guangjun; Wu, Kui; Peng, Guang; Zhang, Yingjie; Bai, Sen

    2014-01-01

    Volumetric-modulated arc therapy (VMAT) is now widely used clinically, as it is capable of delivering a highly conformal dose distribution in a short time interval. We retrospectively analyzed patient-specific quality assurance (QA) of VMAT and examined the relationships between the planning parameters and the QA results. A total of 118 clinical VMAT cases underwent pretreatment QA. All plans had 3-dimensional diode array measurements, and 69 also had ion chamber measurements. Dose distribution and isocenter point dose were evaluated by comparing the measurements and the treatment planning system (TPS) calculations. In addition, the relationship between QA results and several planning parameters, such as dose level, control points (CPs), monitor units (MUs), average field width, and average leaf travel, were also analyzed. For delivered dose distribution, a gamma analysis passing rate greater than 90% was obtained for all plans and greater than 95% for 100 of 118 plans with the 3%/3-mm criteria. The difference (mean ± standard deviation) between the point doses measured by the ion chamber and those calculated by TPS was 0.9% ± 2.0% for all plans. For all cancer sites, nasopharyngeal carcinoma and gastric cancer have the lowest and highest average passing rates, respectively. From multivariate linear regression analysis, the dose level (p = 0.001) and the average leaf travel (p < 0.001) showed negative correlations with the passing rate, and the average field width (p = 0.003) showed a positive correlation with the passing rate, all indicating a correlation between the passing rate and the plan complexity. No statistically significant correlation was found between MU or CP and the passing rate. Analysis of the results of dosimetric pretreatment measurements as a function of VMAT plan parameters can provide important information to guide the plan parameter setting and optimization in TPS. Copyright © 2014 American Association of Medical Dosimetrists. Published by

  15. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan

    NARCIS (Netherlands)

    Bekolo, C.E.; Loenhout, J.A. van; Rodriguez-Llanes, J.M.; Rumunu, J.; Ramadan, O.P.; Guha-Sapir, D.

    2016-01-01

    OBJECTIVE: To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. METHODS: The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South

  16. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H|info:eu-repo/dai/nl/304824755; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and

  17. Injection therapy for chronic prostatitis: A retrospective analysis of 77 cases

    Directory of Open Access Journals (Sweden)

    Attila Toth

    2018-03-01

    Full Text Available Objective: To compare pre- and post-therapy symptom scores reported on the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI after trans-rectal antibiotic injections therapy for men suffering from chronic prostatitis. Materials and methods: Retrospective analysis of NIHCPSI symptom scores obtained from chart reviews of 77 treated males suffering from chronic prostatitis before and after trans rectal injections for the treatment of chronic prostatitis. Results: Most patients reported a 40% to 60% improvement in symptom scores. In subgroups comparing scores in patients with less than 5 injections, the improvement was less than in patients who received 10 or more injections. Patients’ responses after a shorter (3 months follow up showed better pain scores than patient’s scores after longer, over one-year or more, follow- up periods. Conclusion: Our findings show that direct antibiotic injection for chronic prostatitis is a viable addition to standard therapies. Improvements in symptom scores are long lasting. Discomfort is minimal and side effects are rare and avoidable

  18. Retrospective Analysis of Outcome of Patients with Metastatic Leiomyosarcoma in a Tertiary Referral Center.

    Science.gov (United States)

    van Cann, Tom; Cornillie, Jasmien; Wozniak, Agnieszka; Debiec-Rychter, Maria; Sciot, Raf; Hompes, Daphne; Vergote, Ignace; Schöffski, Patrick

    2018-01-01

    Leiomyosarcoma is a common subtype of soft tissue sarcoma originating from smooth muscle. We evaluated the clinical course and treatment outcome of patients with metastatic leiomyosarcoma. We retrospectively reviewed the records of patients at the University Hospitals Leuven. We identified 122 patients with metastatic leiomyosarcoma, 77 female, median age 59.5 years. Most patients developed leiomyosarcoma in the extremities (35%), the uterus (20%) or the abdomen (19%); 69% developed metachronous metastasis, 31% had synchronous metastatic disease. Most patients (74%) received palliative systemic therapy. The most common first-line treatments were doxorubicin (n = 47) and an anthracycline combined with an alkylator (n = 28). The objective response rate to first-line palliative systemic therapy was 20% and the median progression-free survival was 4.9 months (range 0.1-17.1). The median survival from diagnosis of metastasis was 20.5 months (range 0.4-126.9). On multivariate analysis, metachronous disease, no progressive disease as best response to first-line treatment, the possibility of metastasectomy with curative intent and use of palliative radiotherapy were indicators for better survival. The prognosis of patients with metastatic leiomyosarcoma is limited and objective responses to first-line systemic therapy are rare. The treatment of metastatic leiomyosarcoma remains an unmet medical need. © 2018 S. Karger GmbH, Freiburg.

  19. A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery.

    Science.gov (United States)

    Choi, Ji-Won; Kim, Duk-Kyung; Kim, Jin-Kyoung; Lee, Eun-Jee; Kim, Jea-Youn

    2018-01-01

    Postoperative ileus (POI) is an important factor prolonging the length of hospital stay following colorectal surgery. We retrospectively explored whether there is a clinically relevant association between intraoperative hypothermia and POI in patients who underwent laparoscopic colorectal surgery for malignancy within the setting of an enhanced recovery after surgery (ERAS) program between April 2016 and January 2017 at our institution. In total, 637 patients were analyzed, of whom 122 (19.2%) developed clinically and radiologically diagnosed POI. Overall, 530 (83.2%) patients experienced intraoperative hypothermia. Although the mean lowest core temperature was lower in patients with POI than those without POI (35.3 ± 0.5°C vs. 35.5 ± 0.5°C, P = 0.004), the independence of intraoperative hypothermia was not confirmed based on multivariate logistic regression analysis. In addition to three variables (high age-adjusted Charlson comorbidity index score, long duration of surgery, high maximum pain score during the first 3 days postoperatively), cumulative dose of rescue opioids used during the first 3 days postoperatively was identified as an independent risk factor of POI (odds ratio = 1.027 for each 1-morphine equivalent [mg] increase, 95% confidence interval = 1.014-1.040, P POI within an ERAS pathway, in which items other than thermal measures might offset its negative impact on POI. However, as it was associated with delayed discharge from the hospital, intraoperative maintenance of normothermia is still needed.

  20. A retrospective analysis of antimicrobial resistance in bacterial pathogens in an equine hospital (2012-2015).

    Science.gov (United States)

    van Spijk, J N; Schmitt, S; Fürst, A E; Schoster, A

    2016-06-01

    Antimicrobial resistance has become an important concern in veterinary medicine. The aim of this study was to describe the rate of antimicrobial resistance in common equine pathogens and to determine the occurrence of multidrug-resistant isolates. A retrospective analysis of all susceptibility testing results from bacterial pathogens cultured from horses at the University of Zurich Equine Hospital (2012-2015) was performed. Strains exhibiting resistance to 3 or more antimicrobial categories were defined as multidrug-resistant. Susceptibility results from 303 bacterial pathogens were analyzed, most commonly Escherichia coli (60/303, 20%) and Staphylococcus aureus (40/303, 13%). High rates of acquired resistance against commonly used antimicrobials were found in most of the frequently isolated equine pathogens. The highest rate of multidrug resistance was found in isolates of Acinetobacter baumannii (23/24, 96%), followed by Enterobacter cloacae complex (24/28, 86%) and Escherichia coli (48/60, 80%). Overall, 60% of Escherichia coli isolates were phenotypically ESBL-producing and 68% of Staphylococcus spp. were phenotypically methicillin-resistant. High rates of acquired antimicrobial resistance towards commonly used antibiotics are concerning and underline the importance of individual bacteriological and antimicrobial susceptibility testing to guide antimicrobial therapy. Minimizing and optimizing antimicrobial therapy in horses is needed.

  1. Retrospective analysis of bottlenose dolphin foraging: a legacy of anthropogenic ecosystem disturbance

    Science.gov (United States)

    Rossman, Sam; Barros, Nélio B.; Ostrom, Peggy H.; Stricker, Craig A.; Hohn, Aleta A.; Gandhi, Hasand; Wells, Randall S.

    2013-01-01

    We used stable isotope analysis to investigate the foraging ecology of coastal bottlenose dolphins (Tursiops truncatus) in relation to a series of anthropogenic disturbances. We first demonstrated that stable isotopes are a faithful indicator of habitat use by comparing muscle isotope values to behavioral foraging data from the same individuals. δ13C values increased, while δ34S and δ15N values decreased with the percentage of feeding observations in seagrass habitat. We then utilized stable isotope values of muscle to assess temporal variation in foraging habitat from 1991 to 2010 and collagen from tooth crown tips to assess the time period 1944 to 2007. From 1991 to 2010, δ13C values of muscle decreased while δ34S values increased indicating reduced utilization of seagrass habitat. From 1944 to 1989 δ13C values of the crown tip declined significantly, likely due to a reduction in the coverage of seagrass habitat and δ15N values significantly increased, a trend we attribute to nutrient loading from a rapidly increasing human population. Our results demonstrate the utility of using marine mammal foraging habits to retrospectively assess the extent to which anthropogenic disturbance impacts coastal food webs.

  2. Results of radiotherapy in recurrent endometrial carcinoma: A retrospective analysis of 51 patients

    International Nuclear Information System (INIS)

    Kuten, A.; Grigsby, P.W.; Perez, C.A.; Fineberg, B.; Garcia, D.M.; Simpson, J.R.

    1989-01-01

    A retrospective analysis was performed of 51 patients with locoregional recurrence of endometrial carcinoma, treated by radiotherapy between 1959 and 1986. There were 17 patients (33%) with isolated vaginal recurrence, 12 patients (24%) with vaginal recurrence with pelvic extension, 7 patients (14%) with pelvic recurrence only, and 15 patients (29%) with simultaneous locoregional and distant failure. Eighty percent of the recurrences occurred within 3.5 years from primary treatment; time to relapse was shorter in patients with advanced-stage, high-grade malignancy at original diagnosis. Locoregional control was achieved in 18 patients (35%). Complete tumor regression in the vagina, irrespective of extravaginal pelvic disease status or distant metastasis, occurred in 28 of 34 patients with vaginal involvement (82%). The 5- and 10-year overall actuarial survivals for all patients were 18 and 12.5%, respectively. The 5- and 10-year progression-free survivals of patients with isolated vaginal recurrences were 40% and 29%, respectively; the 5-year progression-free survival of patients with vaginal recurrence with pelvic extension was 20%. There were no survivors beyond 1.5 years among patients with pelvic recurrence (p = 0.02). All patients with simultaneous locoregional and distant failure were dead by 3.5 years. Stage at original diagnosis, time to relapse from primary treatment, histologic pattern, and grade of malignancy were prognosticators of survival. Five patients (10%) developed a total of ten radiation-related sequelae

  3. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals.

    Science.gov (United States)

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-02-01

    Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Retrospective database analysis in a teaching hospital open access echocardiography service. Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology.

  4. Consumer concerns about paracetamol: a retrospective analysis of a medicines call centre.

    Science.gov (United States)

    Lau, Stephanie M; McGuire, Treasure M; van Driel, Mieke L

    2016-06-08

    To identify consumer information needs about paracetamol, the most commonly used analgesic and antipyretic worldwide. Retrospective analysis of medicines questions from the public. Australian consumer medicines call centre. Callers to National Prescribing Service Medicines Line between September 2002 and June 2010 (n=123 217). Enquiry profile: demographics, enquiry type and concurrent medicines included in paracetamol calls; question themes derived from subset of call narratives. Paracetamol comprised part of the enquiry in 5.2% of calls (n=6367). The caller age distribution for paracetamol calls was skewed towards a younger cohort, with 45.2% made by those aged 25-44 vs 37.5% in 'rest of calls'. Significantly more paracetamol-related calls were made for a child (23.7%) compared with 'rest of calls' (12.7%, pConsumers have many concerns about the use of paracetamol that may be under-recognised by healthcare providers, with the nature of enquiries differing across life stages. These concerns are not adequately addressed by available consumer information. Improving access to targeted information about paracetamol would promote the safe and effective use of this common medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Direct visual internal urethrotomy for isolated, post-urethroplasty strictures: a retrospective analysis.

    Science.gov (United States)

    Brown, Elizabeth Timbrook; Mock, Stephen; Dmochowski, Roger; Reynolds, W Stuart; Milam, Douglas; Kaufman, Melissa R

    2017-02-01

    Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty. We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU. Success was defined as lack of symptomatology and no subsequent intervention. Comparative analysis identified characteristics and stricture properties associated with success. A total of 436 urethroplasties were performed in 401 patients at our institution between 1999 and 2013. Stricture recurrence was noted in 64 (16%) patients. Of these, 47 (73%) underwent a DVIU. A total of 37 patients met inclusion criteria and underwent 50 DVIU procedures at the urethroplasty site. A single DVIU was successful in 13 of 37 patients (35%). A total of 4 of 6 patients required a second DVIU (67%). Overall, 17 of 43 (40%) of the total DVIUs were successful after urethroplasty. Success did not differ by age, stricture length or location, surgical technique, radiation history, prior urethroplasty or DVIU, time to failure, or etiology. Post-urethroplasty DVIU for isolated, recurrent strictures may be offered as a minimally invasive treatment option. Approximately 40% of patients were spared further intervention.

  6. Age-Related Changes in Pharyngeal Lumen Size: A Retrospective MRI Analysis.

    Science.gov (United States)

    Molfenter, Sonja M; Amin, M R; Branski, R C; Brumm, J D; Hagiwara, M; Roof, S A; Lazarus, C L

    2015-06-01

    Age-related loss of muscle bulk and strength (sarcopenia) is often cited as a potential mechanism underlying age-related changes in swallowing. Our goal was to explore this phenomenon in the pharynx, specifically, by measuring pharyngeal wall thickness and pharyngeal lumen area in a sample of young versus older women. MRI scans of the neck were retrospectively reviewed from 60 women equally stratified into three age groups (20s, 60s, 70+). Four de-identified slices were extracted per scan for randomized, blinded analysis: one mid-sagittal and three axial slices were selected at the anterior inferior border of C2 and C3, and at the pit of the vallecula. Pixel-based measures of pharyngeal wall thickness and pharyngeal lumen area were completed using ImageJ and then converted to metric units. Measures of pharyngeal wall thickness and pharyngeal lumen area were compared between age groups with one-way ANOVAs using Sidak adjustments for post-hoc pairwise comparisons. A significant main effect for age was observed across all variables whereby pharyngeal wall thickness decreased and pharyngeal lumen area increased with advancing age. Pairwise comparisons revealed significant differences between 20s versus 70+ for all variables and 20s versus 60s for all variables except those measured at C2. Effect sizes ranged from 0.54 to 1.34. Consistent with existing sacropenia literature, the pharyngeal muscles appear to atrophy with age and consequently, the size of the pharyngeal lumen increases.

  7. A retrospective analysis of boarding times for adolescents in psychiatric crisis.

    Science.gov (United States)

    Campbell, Michael; Pierce, Jessica

    2018-02-05

    The boarding of children and adolescents with identified psychiatric conditions at medical facilities has numerous negative effects on the patients and the systems that treat them. Efforts to minimize boarding times serves to increase patients' access to appropriate levels of care, redirect medical resources to patients who need them most, and reduce safety risks to people and property. This study explores the role Clinical Social Workers can play in facilitation of care and highlights the advantages of a coordinated data collection process facilitated by the effective use of the Electronic Medical Record. A retrospective chart analysis of 100 patients admitted to the Emergency department at a pediatric hospital in Central Florida was conducted for patients seen between 1 January 2015 and 30 June 2016. The data suggest key correlates that may impact the boarding times of pediatric patients presenting in a psychiatric crisis and the average duration of boarding time in hours (M = 5.11, SD = 2.07) was found to be significantly lower than prior published studies in the adult and pediatric literature. Discussion of these data implications on behavioral health practice is discussed.

  8. Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis.

    Science.gov (United States)

    Ungar, Wendy J; Davidson-Grimwood, Sara R; Cousins, Martha

    2007-11-01

    To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (kappa=0.80 [0.74, 0.86]), moderate for ED visits in the past year (kappa=0.60 [0.53, 0.67]), and slight for physician visits (kappa=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (Pasthma attack in the past 6 months (kappa=0.61 [0.54, 0.68]) compared to children who did not (kappa=0.25 [0.00, 0.59]). Parents of asthmatic children are reliable reporters of their child's respiratory-related urgent health services utilization.

  9. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    International Nuclear Information System (INIS)

    Li, H.; TenNapel, M.J.; Bhatia, S.K.; Ahmed, A.; Lin, L.; Jacobson, G.

    2014-01-01

    Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT) alone or with high dose rate (HDR) brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS) compared to surgery alone (Ρ =0.044 and Ρ =0.028 resp.). Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  10. Clinical and ultrasonographic features of male breast tumors: A retrospective analysis.

    Science.gov (United States)

    Yuan, Wei-Hsin; Li, Anna Fen-Yau; Chou, Yi-Hong; Hsu, Hui-Chen; Chen, Ying-Yuan

    2018-01-01

    The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. The medical records of male patients with breast lesions were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. A total of 112 men (125 breast masses) with preoperative breast ultrasonography (US) were included (median age, 59.50 years; age range, 15-96 years). Data extracted included patient age, if the lesions were bilateral, palpable, and tender, and the presence of nipple discharge. Breast lesion features on static US images were reviewed by three experienced radiologists without knowledge of physical examination or pathology results, original breast US image interpretations, or surgical outcomes. The US features were documented according to the BI-RADS (Breast Imaging-Reporting and Data System) US lexicons. A forth radiologist compiled the data for analysis. Of the 125 breast masses, palpable tender lumps and bilateral synchronous masses were more likely to be benign than malignant (both, 100% vs 0%, P nipples were common in malignant lesions (P nipple, irregular shape, the presence of an echogenic halo, predominantly internal vascularity, and rich color flow signal on color Doppler ultrasound were significantly related to malignancy (all, P < 0.05). An echogenic halo and the presence of rich color flow signal were independent predictors of malignancy. Specific clinical and US characteristics of male breast tumors may help guide treatment, and determine if surgery or conservative treatment is preferable.

  11. Detection of heart disease by open access echocardiography: a retrospective analysis of general practice referrals

    Science.gov (United States)

    Chambers, John; Kabir, Saleha; Cajeat, Eric

    2014-01-01

    Background Heart disease is difficult to detect clinically and it has been suggested that echocardiography should be available to all patients with possible cardiac symptoms or signs. Aim To analyse the results of 2 years of open access echocardiography for the frequency of structural heart disease according to request. Design and setting Retrospective database analysis in a teaching hospital open access echocardiography service. Method Reports of all open access transthoracic echocardiograms between January 2011 and December 2012 were categorised as normal, having minor abnormalities, or significant abnormalities according to the indication. Results There were 2343 open access echocardiograms performed and there were significant abnormalities in 29%, predominantly valve disease (n = 304, 13%), LV systolic dysfunction (n = 179, 8%), aortic dilatation (n = 80, 3%), or pulmonary hypertension (n = 91, 4%). If echocardiography had been targeted at a high-risk group, 267 with valve disease would have been detected (compared to 127 with murmur alone) and 139 with LV systolic dysfunction (compared to 91 with suspected heart failure alone). Most GP practices requested fewer than 10 studies, but 6 practices requested over 70 studies. Conclusion Open access echocardiograms are often abnormal but structural disease may not be suspected from the clinical request. Uptake by individual practices is patchy. A targeted expansion of echocardiography in patients with a high likelihood of disease is therefore likely to increase the detection of clinically important pathology. PMID:24567615

  12. Vascular access in lipoprotein apheresis: a retrospective analysis from the UK's largest lipoprotein apheresis centre.

    Science.gov (United States)

    Doherty, Daniel J; Pottle, Alison; Malietzis, George; Hakim, Nadey; Barbir, Mahmoud; Crane, Jeremy S

    2018-01-01

    Lipoprotein apheresis (LA) has proven to be an effective, safe and life-saving therapy. Vascular access is needed to facilitate this treatment but has recognised complications. Despite consistency in treatment indication and duration there are no guidelines in place. The aim of this study is to characterise vascular access practice at the UK's largest LA centre and forward suggestions for future approaches. A retrospective analysis of vascular access strategies was undertaken in all patients who received LA treatment in the low-density lipoprotein (LDL) Apheresis Unit at Harefield Hospital (Middlesex, UK) from November 2000 to March 2016. Fifty-three former and current patients underwent 4260 LA treatments. Peripheral vein cannulation represented 79% of initial vascular access strategies with arteriovenous (AV) fistula use accounting for 15%. Last used method of vascular access was peripheral vein cannulation in 57% versus AV fistula in 32%. Total AV fistula failure rate was 37%. Peripheral vein cannulation remains the most common method to facilitate LA. Practice trends indicate a move towards AV fistula creation; the favoured approach receiving support from the expert body in this area. AV fistula failure rate is high and of great concern, therefore we suggest the implementation of upper limb ultrasound vascular mapping in all patients who meet treatment eligibility criteria. We encourage close ties between apheresis units and specialist surgical centres to facilitate patient counselling and monitoring. Further prospective data regarding fistula failure is needed in this expanding treatment field.

  13. Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

    Science.gov (United States)

    Sardo, Pedro Miguel Garcez; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; Simões, João Filipe Fernandes Lindo; Melo, Elsa Maria de Oliveira Pinheiro de

    2016-08-01

    The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. IMPACT OF PHYSICIAN COMMUNICATION ON DIABETIC EYE EXAMINATION ADHERENCE: Results From a Retrospective Cohort Analysis.

    Science.gov (United States)

    Storey, Philip P; Murchison, Ann P; Pizzi, Laura T; Hark, Lisa A; Dai, Yang; Leiby, Benjamin E; Haller, Julia A

    2016-01-01

    To evaluate the effect of written communication between an ophthalmologist and a primary care physician (PCP) on patient adherence to diabetic eye examination recommendations. In a retrospective cohort study of a multiethnic population at an urban ophthalmology center, records of all patients with diabetes and clinic visits between 2007 and 2010 were reviewed. Data collected included patient demographics, insurance status, hemoglobin A1C, severity of diabetic retinopathy, follow-up examinations, and written communication between a patient's ophthalmologist and PCP. Statistical analyses were performed to examine the relationship between physician communication and adherence to diabetic eye examination based on the American Academy of Ophthalmology-published recommendations. A total of 1,968 people with diabetes were included. Written communication from an ophthalmologist to a PCP was associated with increased adherence to follow-up eye examination recommendations (Odds Ratio: 1.49; 95% Confidence Interval: 1.16-1.92; P = 0.0018). Communication from a PCP to an ophthalmologist was also associated with increased adherence (Odds Ratio: 1.94; 95% Confidence Interval: 1.37-2.77; P = 0.0002). Multivariable analysis controlling for other factors associated with examination adherence confirmed that communication both to and from an ophthalmologist was independently and significantly associated with increased follow-up adherence. Patients with communication between ophthalmologists and PCPs are more likely to adhere to diabetic eye examinations.

  15. Segmentation-based retrospective shading correction in fluorescence microscopy E. coli images for quantitative analysis

    Science.gov (United States)

    Mai, Fei; Chang, Chunqi; Liu, Wenqing; Xu, Weichao; Hung, Yeung S.

    2009-10-01

    Due to the inherent imperfections in the imaging process, fluorescence microscopy images often suffer from spurious intensity variations, which is usually referred to as intensity inhomogeneity, intensity non uniformity, shading or bias field. In this paper, a retrospective shading correction method for fluorescence microscopy Escherichia coli (E. Coli) images is proposed based on segmentation result. Segmentation and shading correction are coupled together, so we iteratively correct the shading effects based on segmentation result and refine the segmentation by segmenting the image after shading correction. A fluorescence microscopy E. Coli image can be segmented (based on its intensity value) into two classes: the background and the cells, where the intensity variation within each class is close to zero if there is no shading. Therefore, we make use of this characteristics to correct the shading in each iteration. Shading is mathematically modeled as a multiplicative component and an additive noise component. The additive component is removed by a denoising process, and the multiplicative component is estimated using a fast algorithm to minimize the intra-class intensity variation. We tested our method on synthetic images and real fluorescence E.coli images. It works well not only for visual inspection, but also for numerical evaluation. Our proposed method should be useful for further quantitative analysis especially for protein expression value comparison.

  16. Clinical nutrition counselling service in the veterinary hospital: retrospective analysis of equine patients and nutritional considerations.

    Science.gov (United States)

    Vergnano, D; Bergero, D; Valle, E

    2017-06-01

    Nutrition plays a very important role in the healthy and in the ill horse. Although research in this field clearly shows that incorrect nutritional practices may lead to severe pathologies, inappropriate feeding plans often continue to be used. A clinical nutrition counselling (CNC) service could thus be of great use to both horse owners and veterinarians. The aim of this study was to provide information on equine patients referred to the CNC service of the University of Turin and to provide standard dietary protocols as used in our Veterinary Teaching Hospital for the most common nutrition-related pathologies. The data were obtained by retrospective analysis of the nutritional records of referred equine patients. The data collected included information about anamnesis, nutritional assessment, current diet, referring person and follow-up of each patient. Sixty-one horses were included in the study. The majority were adult males. The most common breeds were the Italian Saddle Horse and the Friesian Horse. Old horses (>19 years) had a statistically lower BCS than brood mares or other adult horses (p equine gastric ulcer syndrome. All horses received first-cut meadow hay; 85% also ate concentrates. Young horses (equine population. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  17. Gandhi and Mao on manual labour in the school: A retrospective analysis

    Science.gov (United States)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

    Mahatma Gandhi's views on relating the world of formal education to the world of work were developed first in his experimental `Tolstoy Farm' in South Africa. On his return to India, Gandhi insisted that a required manual labour component in the curriculum would help regenerate India's village economy, develop in India's children a deeper understanding of India's cultural roots, motivate children to relate `book learning' to life in society, and destroy invidious caste distinctions. The major proposals and suggestions in Gandhi's writing will be discussed in the context of his hopes for using schooling as an agent of progress in India. Mao Ze-Dong's views, on the other hand, were developed in the context of his Yenan experience in the 1930s, i.e. the decision to consolidate a power base in the interior of China before waging a class war against the landlords and capitalists of China. Mao's views were also, to some extent, rooted in the Chinese reality of stagnant, poverty-stricken rural areas. But, Mao's writings indicate that Marxist hopes to relate theory and practice (as understood in dialectical materialism) and to ensure that everyone participated in mental as well as manual labour in a socialist society had led him to formulate his proposals. Both Gandhi's and Mao's views and proposals have been more or less abandoned in India and China respectively. The similar and dissimilar reasons which led to such a fate are examined in this retrospective analysis.

  18. Success rates of a skeletal anchorage system in orthodontics: A retrospective analysis.

    Science.gov (United States)

    Lam, Raymond; Goonewardene, Mithran S; Allan, Brent P; Sugawara, Junji

    2018-01-01

    To evaluate the premise that skeletal anchorage with SAS miniplates are highly successful and predictable for a range of complex orthodontic movements. This retrospective cross-sectional analysis consisted of 421 bone plates placed by one clinician in 163 patients (95 female, 68 male, mean age 29.4 years ± 12.02). Simple descriptive statistics were performed for a wide range of malocclusions and desired movements to obtain success, complication, and failure rates. The success rate of skeletal anchorage system miniplates was 98.6%, where approximately 40% of cases experienced mild complications. The most common complication was soft tissue inflammation, which was amenable to focused oral hygiene and antiseptic rinses. Infection occurred in approximately 15% of patients where there was a statistically significant correlation with poor oral hygiene. The most common movements were distalization and intrusion of teeth. More than a third of the cases involved complex movements in more than one plane of space. The success rate of skeletal anchorage system miniplates is high and predictable for a wide range of complex orthodontic movements.

  19. Maxillary arch width and buccal corridor changes with Damon and conventional brackets: A retrospective analysis.

    Science.gov (United States)

    Shook, Corey; Kim, Sohyon Michelle; Burnheimer, John

    2016-07-01

    To evaluate the effect of Damon self-ligating and conventional bracket systems on buccal corridor widths and areas. A retrospective sample of consecutively treated patients using either conventional (CG, n  =  45) or Damon self-ligating (SL, n  =  39) brackets was analyzed to determine any differences in buccal corridor widths and areas both within and between groups. Pretreatment and posttreatment frontal photographs were transferred to Photoshop CC, standardized using intercanthal width, and linear and area measurements were performed with tools in Photoshop CC. Ratios were then calculated for statistical analysis. Relationships between arch widths and buccal corridors were also examined. There were no significant differences in the posttreatment intercanine or intermolar widths either within or between the CG and SL groups. There were no significant differences in any buccal corridor width or area measurement either within or between the CG and SL groups. There were strong correlations with the intercanine width and the corresponding buccal corridor smile width measurements. There was an inverse correlation with the buccal corridor area in relation to the canine and the total smile width. It is likely that posttreatment increases in arch width can be seen in patients treated with either a conventional bracket system or the Damon system. It is highly unlikely that there is any significant difference in buccal corridor width or area in patients treated with the Damon self-ligating system or a conventional bracket system.

  20. Retrospective analysis of the efficacy of omalizumab in chronic refractory urticaria

    Science.gov (United States)

    Viswanathan, Ravi K.; Moss, Mark H.

    2013-01-01

    Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports. However, it remains unknown whether there are specific phenotypes of CU that are more responsive to omalizumab therapy. We sought to identify CU phenotypes responsive to treatment with omalizumab by characterizing patients and their response patterns. A retrospective chart review analysis of refractory CU patients unresponsive to high-dose H1-blockers and immunomodulators and subsequently treated with omalizumab at the University of Wisconsin Allergy Clinic was performed with particular focus on their autoimmune characteristics, response to therapy, and dosing parameters. We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19). Of these 19 patients, 9 patients (47%) had a complete response, 8 patients (42%) had a partial response, and 2 patients (11%) had no response. In comparing the response patterns to omalizumab, we found no statistically significant differences among “autoimmune positive” versus “autoimmune negative” patients. No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen. Our study shows that omalizumab has robust efficacy in refractory CU patients regardless of their autoimmune status, age, gender, IgE levels, or dosing protocol. PMID:23998242

  1. Retrospective analysis of dengue specific IgM reactive serum samples

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    Nemai Bhattacharya

    2013-04-01

    Full Text Available Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1 antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: This reconstructed study revealed that of those 91 dengue cases, 70.3% (64 and 29.7% (27 were suffering from secondary and primary dengue respectively, showing that number of secondary dengue cases were much more than that of primary dengue cases with a possibility of emergence of DHF. A small proportion of cases 18.7% (17 were reactive for NS1. The duration of fever in NS1 antigen positive cases varied between 5 and 7 days. Of 17 NS1 reactive cases, 10 (10.9% and 7 (7.7% were suffering from secondary and primary dengue respectively. Conclusions: Early detection of primary and secondary dengue cases would be facilitated by utilizing all three parameters (NS1 antigen, anti-dengue IgM and IgG helping to evaluate, monitor and treat a dengue case effectively.

  2. Differentiation between benign and malignant palatal tumors using conventional MRI: a retrospective analysis of 130 cases.

    Science.gov (United States)

    Zheng, Yingyan; Xiao, Zebin; Zhang, Hua; She, Dejun; Lin, Xuehua; Lin, Yu; Cao, Dairong

    2018-04-01

    To evaluate the discriminative value of conventional magnetic resonance imaging between benign and malignant palatal tumors. Conventional magnetic resonance imaging features of 130 patients with palatal tumors confirmed by histopathologic examination were retrospectively reviewed. Clinical data and imaging findings were assessed between benign and malignant tumors and between benign and low-grade malignant salivary gland tumors. The variables that were significant in differentiating benign from malignant lesions were further identified using logistic regression analysis. Moreover, imaging features of each common palatal histologic entity were statistically analyzed with the rest of the tumors to define their typical imaging features. Older age, partially defined and ill-defined margins, and absence of a capsule were highly suggestive of malignant palatal tumors, especially ill-defined margins (β = 6.400). The precision in determining malignant palatal tumors achieved a sensitivity of 92.8% and a specificity of 85.6%. In addition, irregular shape, ill-defined margins, lack of a capsule, perineural spread, and invasion of surrounding structures were more often associated with low-grade malignant salivary gland tumors. Conventional magnetic resonance imaging is useful for differentiating benign from malignant palatal tumors as well as benign salivary gland tumors from low-grade salivary gland malignancies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Clinical factors affecting engraftment and transfusion needs in SCT: a single-center retrospective analysis.

    Science.gov (United States)

    Liesveld, J; Pawlowski, J; Chen, R; Hyrien, O; Debolt, J; Becker, M; Phillips, G; Chen, Y

    2013-05-01

    Successful utilization of SCT modalities often requires utilization of both red cell and platelet transfusions. In this retrospective evaluation of clinical factors affecting transplant engraftment and transfusion utilization at a single transplant center in 505 patients from 2005 through 2009, we found that graft type, donor type and the conditioning regimen intensity significantly affected both the neutrophil engraftment time (PSCT patients required an average of 6.2 red cell units, and 7.9 platelet transfusions in the first 100 days with a wide s.d. Among auto-SCT patients, 5% required neither RBC nor platelet transfusions. Some reduced-intensity transplants were also associated with no transfusion need, and in allogeneic transplants, conditioning regimen intensity was positively correlated with platelet transfusion events as assessed by multivariate analysis. Other patient characteristics such as gender, graft type, donor type, underlying disease and use of TBI were all independently associated with transfusion needs in SCT patients. Further studies are required to understand the means to minimize transfusions and potential related complications in SCT patients.

  4. Spatial Distribution and a Retrospective Analysis of the Herpetofauna in the City of Plovdiv, Bulgaria

    Directory of Open Access Journals (Sweden)

    Ivelin A. Mollov

    2010-12-01

    Full Text Available The current study presents the contemporary status and distribution of theamphibians and reptiles in the city of Plovdiv. To track changes in the status ofamphibians and reptiles in the research area through time, a retrospective analysis wasmade based on available literary data. During the past 100 years four species ofamphibians (Triturus karelinii, Lissotriton vulgaris, Bombina bombina, B. variegata and fourspecies of reptiles (Coronella austriaca, Zamenis longissimus, Elaphe sauromates, Viperaammodytes probably have disappeared from the study area; one amphibian species (Bufobufo and one reptile (Natrix natrix have not changed their status, one amphibian(Pelobates syriacus and two reptile species (Ablepharus kitaibelii, Podarcis muralis havereduced their localities and four amphibian species (Epidalea viridis, Rana dalmatina,Pelophylax ridibundus, Hyla arborea and seven species of reptiles (Mediodactylus kotschyi,Lacerta trilineata, Lacerta viridis, Podarcis tauricus, Emys orbicularis, Dolichophis caspius,Natrix tessellata have increased their localities and frequency of occurrence. The recordsof the two tortoise species (Testudo hermanni and T. graeca in the city, and the presence ofthe Red-eared slider (Trachemys scripta elegans should be considered as accidental.Important Herpetological Areas (IHA in the study region are also identified.

  5. Risk factors of extubation failure in extremely low birth weight infants: a five year retrospective analysis.

    Science.gov (United States)

    Lee, Chao-Yi; Su, Bai-Horng; Lin, Tsung-Wen; Lin, Hung-Chih; Li, Tsai-Chung; Wang, Nai-Phon

    2002-01-01

    Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.

  6. Wet Wipe Allergens: Retrospective Analysis From the North American Contact Dermatitis Group 2011-2014.

    Science.gov (United States)

    Warshaw, Erin M; Aschenbeck, Kelly A; Zug, Kathryn A; Belsito, Donald V; Zirwas, Matthew J; Fowler, Joseph F; Taylor, James S; Sasseville, Denis; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Maibach, Howard I; Mathias, C G Toby; DeKoven, Joel G

    Although there are several case reports of wet wipe-associated contact dermatitis, the prevalence of wipes as a source of allergic contact dermatitis in larger populations and the responsible allergens are largely unknown. The aim of the study was to determine the prevalence of wet wipes as a source of contact allergy and the most commonly associated allergens in a North American tertiary referral patch test population. Data collected from 2011 to 2014 by the North American Contact Dermatitis Group was used to conduct a retrospective cross-sectional analysis of patient demographics and patch test results associated with the triple-digit source code for "wet wipe." Of the 9037 patients patch tested during the study period, 79 (0.9%) had a positive patch test reaction to an allergen identified with a wet wipe source. The most commonly associated allergens were preservatives, including the following: methylisothiazolinone (MI) (59.0%), methylchloroisothiazolinone (MCI)/MI (35.6%), bronopol (2-bromo-2-nitropropane-1,3-diol) (27.4%), and iodopropynyl butylcarbamate (12.3%). Fragrance (combined) represented 12.3%. Anal/genital dermatitis was 15 times more likely (P contact allergy had their contact allergens detected by the North American Contact Dermatitis Group screening series. Wet wipes are an important source of contact allergy. Preservatives are the main allergens, especially isothiazolinones.

  7. A RETROSPECTIVE ANALYSIS OF ARTHROSCOPIC ACL RECONSTRUCTION WITH HAMSTRING TENDON GRAFT

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    Ashish R. Agarwal

    2017-08-01

    Full Text Available BACKGROUND ACL reconstruction is one of the commonest knee surgeries done. Young adults are the commonest patients; thus, this injury has a large impact on socioeconomic status of the family. The aim of the study is to study the outcome of arthroscopic ACL reconstruction with hamstring tendon graft. MATERIALS AND METHODS 50 patients following up in the OPD who had undergone ACL reconstruction with hamstring tendon graft are evaluated. Patients who had other lesions, such meniscal injuries or collateral injuries were discarded. These patients were evaluated by using Tegner and Lysholm score of 6 months, 12 months and 24 months. Settings- It is a retrospective analysis of the data collected from the patients who were opiated at Nair Hospital. RESULTS 90% of patients in the study were males. Mean age of the study population is 30.7 years. All the patients in the study had instability as a symptom, while 80% of them also had pain. Six months after surgery, according to Tegner and Lysholm score, 52% patients had good outcome, while 48% had fair outcome. At 2 years, 98% of study population had excellent outcome. CONCLUSION Arthroscopic ACL reconstruction with hamstring graft is an effective way of treating ACL tear.

  8. Performance evaluation of phage-displayed synthetic human single-domain antibody libraries: A retrospective analysis.

    Science.gov (United States)

    Henry, Kevin A; Tanha, Jamshid

    2018-05-01

    Fully human synthetic single-domain antibodies (sdAbs) are desirable therapeutic molecules but their development is a considerable challenge. Here, using a retrospective analysis of in-house historical data, we examined the parameters that impact the outcome of screening phage-displayed synthetic human sdAb libraries to discover antigen-specific binders. We found no evidence for a differential effect of domain type (V H or V L ), library randomization strategy, incorporation of a stabilizing disulfide linkage or sdAb display format (monovalent vs. multivalent) on the probability of obtaining any antigen-binding human sdAbs, instead finding that the success of library screens was primarily related to properties of target antigens, especially molecular mass. The solubility and binding affinity of sdAbs isolated from successful screens depended both on properties of the sdAb libraries (primarily domain type) and the target antigens. Taking attrition of sdAbs with major manufacturability concerns (aggregation; low expression) and sdAbs that do not recognize native cell-surface antigens as independent probabilities, we calculate the overall likelihood of obtaining ≥1 antigen-binding human sdAb from a single library-target screen as ~24%. Successful library-target screens should be expected to yield ~1.3 human sdAbs on average, each with average binding affinity of ~2 μM. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Retrospective analysis of co-occurrence of congenital aortic stenosis and pulmonary artery stenosis in dogs.

    Science.gov (United States)

    Kander, M; Pasławska, U; Staszczyk, M; Cepiel, A; Pasławski, R; Mazur, G; Noszczyk-Nowak, A

    2015-01-01

    The study has focused on the retrospective analysis of cases of coexisting congenital aortic stenosis (AS) and pulmonary artery stenosis (PS) in dogs. The research included 5463 dogs which were referred for cardiological examination (including clinical examination, ECG and echocardiography) between 2004 and 2014. Aortic stenosis and PS stenosis were detected in 31 dogs. This complex defect was the most commonly diagnosed in Boxers - 7 dogs, other breeds were represented by: 4 cross-breed dogs, 2 Bichon Maltais, 3 Miniature Pinschers, 2 Bernese Mountain Dogs, 2 French Bulldogs, and individuals of following breeds: Bichon Frise, Bull Terrier, Czech Wolfdog, German Shepherd, Hairless Chinese Crested Dog, Miniature Schnauzer, Pug, Rottweiler, Samoyed, West Highland White Terrier and Yorkshire Terrier. In all the dogs, the murmurs could be heard, graded from 2 to 5 (on a scale of 1-6). Besides, in 9 cases other congenital defects were diagnosed: patent ductus arteriosus, mitral valve dysplasia, pulmonary or aortic valve regurgitation, tricuspid valve dysplasia, ventricular or atrial septal defect. The majority of the dogs suffered from pulmonary valvular stenosis (1 dog had supravalvular pulmonary artery stenosis) and subvalvular aortic stenosis (2 dogs had valvular aortic stenosis). Conclusions and clinical relevance - co-occurrence of AS and PS is the most common complex congenital heart defect. Boxer breed was predisposed to this complex defect. It was found that coexisting AS and PS is more common in male dogs and the degree of PS and AS was mostly similar.

  10. [Occupational Hearing Loss (BK-No. 2301) - A Retrospective Analysis of 100 Consecutive Cases].

    Science.gov (United States)

    Reiter, R; Brosch, S

    2016-10-01

    Introduction: In order for a diagnosis of Occupational Hearing Loss (BK-no. 2301) to be made certain criteria must be fulfilled to establish that the hearing loss is occupational in origin. This work compares 2 groups, those who fulfil the criteria (BKE) and those who do not (BKNE). Methods: A 100 consecutive reports ("Lärmgutachten BK-no. 2301") written by the authors were examined retrospectively. These recorded audiometric examination, an analysis of any tinnitus and noise exposure plus use of hearing protection. Pre- and post-noise exposure status together with an expert assessment of work limitations was made to produce a 7 point score. Results: 67% of the group fulfilled the conditions for occupational hearing loss (9% were entitled to compensation). In the BKE group 82% showed typical audiometric signs of noise damage with 75% of them fulfilling at least 6 criteria of occupational disease no. 2301. Tinnitus typical for noise exposure was found in 26%. Discussion: A 7 point score could be useful in the future as a method of helping distinguish hearing loss and tinnitus from occupational as opposed to other causes. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Analysis of injuries from the Army Ten Miler: A 6-year retrospective review.

    Science.gov (United States)

    Pasquina, Paul F; Griffin, Sarah C; Anderson-Barnes, Victoria C; Tsao, Jack W; O'Connor, Francis G

    2013-01-01

    A number of long-distance running events are held each year in the United States; the Army Ten Miler (ATM) is one such race held annually in Washington, DC. The purpose of the present study was to retrospectively analyze medical encounters for runners participating in the ATM from 1998 to 2004. Of the estimated 91,750 runners over the 6-year period, 73,100 participants finished the race and were included in the data analysis. Demographic and injury data were collected from medical records of participants who received medical care while participating in the ATM, and injury-related factors were assessed. The most common category of injury was musculoskeletal (44%), followed by medical-related problems (27%) and dermatological injuries (27%). Similar to marathon and ironman races, ATM injury rates correlate with race-day temperature and dew point. Overall, however, the injury rates observed at the ATM were relatively low compared to those reported for longer distance events. Finally, we detail the medical coverage provided at the ATM, as this coverage could be used as a guide for similarly distanced races.

  12. Upper gastrointestinal bleeding following transcatheter aortic valve replacement: A retrospective analysis.

    Science.gov (United States)

    Stanger, Dylan E; Abdulla, Alym H; Wong, Frank T; Alipour, Sina; Bressler, Brian L; Wood, David A; Webb, John G

    2017-08-01

    The aim of this study was to identify the incidence of upper gastrointestinal bleeding (UGIB) in the postprocedural period following transcatheter aortic valve replacement (TAVR). As TAVR moves into intermediate- and low-risk patients, it has become increasingly important to understand its extracardiac complications. The patient population undergoing TAVR have clinical and demographic characteristics that place them at significant risk of UGIB. Practical aspects of TAVR, including use of antithrombotic therapy, further increase risk of UGIB. A retrospective single-center evaluation of 841 patients who underwent TAVR between January 2005 and August 2014 was performed in conjunction with analysis of referral patterns to the gastroenterology service for UGIB at the same site. The overall risk of UGIB following TAVR was found to be 2.0% (n = 17/841). Additionally, the risk of UGIB in patients receiving triple antithrombotic therapy was found to be 10-fold greater than patients not receiving triple antithrombotic therapy (11.8% vs 1.0%). Endoscopy findings demonstrated five high-risk esophageal lesions including erosive esophageal ulcers, visible vessels at the GE junction, erosions at distal esophagus, and an actively bleeding esophageal ring that had been intubated through by the transesophageal echocardiography (TEE) probe. This large cohort study demonstrates that TAVR is associated with a moderate risk of severe UGIB. The results of this study suggest that patients on triple antithrombotic therapy are at highest risk for severe UGIB. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Laparoscopic versus open incisional hernia repair: a retrospective cohort study with costs analysis on 269 patients.

    Science.gov (United States)

    Soliani, G; De Troia, A; Portinari, M; Targa, S; Carcoforo, P; Vasquez, G; Fisichella, P M; Feo, C V

    2017-08-01

    To compare clinical outcomes and institutional costs of elective laparoscopic and open incisional hernia mesh repairs and to identify independent predictors of prolonged operative time and hospital length of stay (LOS). Retrospective observational cohort study on 269 consecutive patients who underwent elective incisional hernia mesh repair, laparoscopic group (N = 94) and open group (N = 175), between May 2004 and July 2014. Operative time was shorter in the laparoscopic versus open group (p costs were lower (p = 0.02). At Cox regression analysis adjusted for potential confounders, large wall defect (W3) and higher operative risk (ASA score 3-4) were associated with prolonged operative time, while midline hernia site was associated with increased hospital LOS. Open surgical approach was associated with prolongation of both operative time and LOS. Laparoscopic approach may be considered safely to all patients for incisional hernia repair, regardless of patients' characteristics (age, gender, BMI, ASA score, comorbidities) and size of the wall defect (W2-3), with the advantage of shorter operating time and hospital LOS that yields reduced total institutional costs. Patients with higher ASA score and large hernia defects are at risk of prolonged operative time, while an open approach is associated with longer duration of surgical operation and hospital LOS.

  14. Open access to MRI for general practitioners: 12 years' experience at one institution -- a retrospective analysis.

    Science.gov (United States)

    Gough-Palmer, A L; Burnett, C; Gedroyc, W M

    2009-08-01

    The aim of this study was to evaluate 12 years of general practitioner (GP) use of open access MRI services at a single London teaching hospital. A retrospective analysis of reports from all GP requests for MRI scans between 1994 and 2005 was performed. The date, scanned body part, and requester details from 1798 scans requested by 209 individual GPs over a continuous 12-year period were recorded. All scans were then graded into four categories based on the severity of reported findings from normal to gross abnormality. Over the study period, GP requests as a percentage of the total (MRI) department workload remained low at approximately 2.6%. Spine, knee and brain requests constituted 86% (n = 1546) of requested scans. 48% (n = 868) of scans were reported as normal or minor degenerative changes only. 26% (n = 466) of scans demonstrated serious pathology that was likely to warrant hospital consultant referral. There was a wide range of scans requested per requester, from 1 to 240 over the period, with an average of 8.5 scans per GP. In conclusion, any department wishing to set up open access to MRI services for GPs could cover the majority of requests by offering spine, knee and brain imaging. The percentage of normal report rates for GP requests is comparable with previous studies of outpatient referrals. A large variation in requesting patterns between GPs suggests the need for increased communication between GPs and imaging departments to optimise use of the service.

  15. A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department.

    Science.gov (United States)

    Fawcett, Richard John; Kernohan, George

    2017-09-12

    To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. Single-centre, large UK major trauma centre offering a tertiary FGM clinic. Any woman coded during the study period as having undergone FGM. Number of FGM cases identified by the ED. Mean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status. 34 patients were identified as having undergone FGM, 19 had previously attended ED and none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation. This study demonstrates that the identification of FGM victims by an ED is very poor, and more work needs to be done to increase awareness of the subject by front-line staff. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Long-Term Use of Aldosterone-Receptor Antagonists in Uncontrolled Hypertension: A Retrospective Analysis

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    Pieter M. Jansen

    2011-01-01

    Full Text Available Background. The long-term efficacy of aldosterone-receptor antagonists (ARAs as add-on treatment in uncontrolled hypertension has not yet been reported. Methods. Data from 123 patients (21 with primary aldosteronism, 102 with essential hypertension with difficult-to-treat hypertension who received an ARA between May 2005 and September 2009 were analyzed retrospectively for their blood pressure (BP and biochemical response at first followup after start with ARA and the last follow-up available. Results. Systolic BP decreased by 22±20 and diastolic BP by 9.4±12 mmHg after a median treatment duration of 25 months. In patients that received treatment >5 years, SBP was 33±20 and DBP was 16 ± 13 mmHg lower than at baseline. Multivariate analysis revealed that baseline BP and follow-up duration were positively correlated with BP response. Conclusion. Add-on ARA treatment in difficult-to-treat hypertension results in a profound and sustained BP reduction.

  17. An audit of the outcome of amblyopia treatment: a retrospective analysis of 322 children.

    Science.gov (United States)

    Awan, M; Proudlock, F A; Grosvenor, D; Choudhuri, I; Sarvanananthan, N; Gottlob, I

    2010-08-01

    Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic. Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated. Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365. Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (amblyopia treatment are needed, possibly by using educational/motivational intervention.

  18. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    Directory of Open Access Journals (Sweden)

    Metin Uysalol

    2011-09-01

    Full Text Available Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide intoxication was heaters, waterheaters and fi re in 82.1%, 7.1% and 6% of cases, respectively. There was a statistically signifi cant difference between the carboxyhemoglobin levels of the patients according to the clinical classifi cation (p<0.05. The intoxication caused by heaters was observed signifi cantly in November, December and January (p<0.001, between 16:00-24:00 hours (p<0.001 and among more than one member of a family (p<0.001. A medium level correlation was detected between the treatment approach and clinical classifi cation (r=0.50, p<0.001. Conclusion: Carbon monoxide intoxication, in the presented series, was found to develop accidentally; mostly in the Winter season; during night hours when the family members gathered together. The carboxyhemoglobin levels were appropriate with the developing clinical findings. Carboxyhemoglobin level solely was not enough for achieving the diagnosis and planning the treatment.

  19. Association of vitamin D receptor BsmI, TaqI, FokI, and ApaI polymorphisms with susceptibility of chronic periodontitis: A systematic review and meta-analysis based on 38 case -control studies.

    Science.gov (United States)

    Mashhadiabbas, Fatemeh; Neamatzadeh, Hossein; Nasiri, Rezvan; Foroughi, Elnaz; Farahnak, Soudabeh; Piroozmand, Parisa; Mazaheri, Mahta; Zare-Shehneh, Masoud

    2018-01-01

    There has been increasing interest in the study of the association between Vitamin D receptor (VDR) gene polymorphisms and risk of chronic periodontitis. However, the results remain inconclusive. To better understand the roles of VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) in chronic periodontitis susceptibility, we conducted this systematic review and meta-analysis. The PubMed, Google Scholar, and Web of Science database were systemically searched to determine all the eligible studies about VDR polymorphisms and risk of chronic periodontitis up to April 2017. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the associations between VDR polymorphisms and chronic periodontitis risk. All the statistical analyses were performed by Comprehensive Meta-Analysis. All P values were two-tailed with a significant level at 0.05. Finally, a total of 38 case-control studies in 19 publications were identified which met our inclusion criteria. There are ten studies with 866 chronic periodontitis cases and 786 controls for BsmI, 16 studies with 1570 chronic periodontitis cases and 1676 controls for TaqI, five studies with 374 chronic periodontitis cases and 382 controls for FokI, and seven studies with 632 chronic periodontitis cases and 604 controls for ApaI. Overall, no significant association was observed between VDR gene BsmI, TaqI, FokI, and ApaI polymorphisms and risk of chronic periodontitis in any genetic model. Subgroup analysis stratified by ethnicity suggested a significant association between BsmI polymorphism and chronic periodontitis risk in the Caucasian subgroup under allele model (A vs. G: OR = 1.747, 95% CI = 1.099-2.778, P = 0.018). Further, no significant associations were observed when stratified by Hardy-Weinberg equilibrium status for BsmI, TaqI, and ApaI. Our results suggest that BsmI, TaqI, FokI, and ApaI polymorphisms in the VDR gene might not be associated with risk of chronic periodontitis in overall population.

  20. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    Energy Technology Data Exchange (ETDEWEB)

    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  1. Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

    Institute of Scientific and Technical Information of China (English)

    Changchun Su; Qinbao Qin

    2006-01-01

    BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis.Nerve conductive velocity is helpful in the diagnosis of atypical cases.OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG),motor and sensory nerve conduction velocity of patients with PMA.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, Guangzhou First People's Hospital.PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old,admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited.Informed consents were obtained from all the patients.METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed.MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients.RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA.Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ② Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down,especially in 16 patients with type Ⅰ PMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m

  2. THE RISKS OF DEVIANT BEHAVIOR ADOLESCENCE: EXPERIENCE IN A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Aminat Danjalovna Vislova

    2015-10-01

    Full Text Available The problem of the risks of drug abuse as a form of deviant behavior in the context of adolescence. In this study deviant behavior appears as actions (or willingness to commit them, contrary to the generally accepted cultural and moral values, as well as socio-psychological and legal norms, including the abuse of alcohol, drugs and other psychoactive substances Study prerequisites for the formation of drug addiction in adolescence age allows us to trace the link between awareness about drugs and those at risk of developing dependence on them, which are due to the age and psychological characteristics described L.S. Vygotsky and other scientists working in the paradigm of cultural-historical psychology. The article hypothesized that narcogene information can act as a factor of risk of drug use. It is argued that the basis of the commission of a narcotic substance samples is narcogene information and control over the sources that may contribute to the prevention of mass anesthesia teenagers. This assertion is supported by the results of a retrospective study of social and psychological factors in the emergence of drug abuse conducted in the Kabardino-Balkaria republic dispensary, which was attended by 24 active addict aged 18-28 who are registered with the method of questioning.Purpose. To study the role of information on drugs and drug addiction in the range of solutions «for» or «against» in a situation narcogene risk.Methodology. Questioning of active drug abusers.Results. Based on a retrospective analysis of risk factors for drug abuse as a form of deviant behavior found that narcogene information may lead to introduction to drugs. Lack of knowledge about the effects of drugs on the human body, and the temptation to create a stable, creates a high risk on narcotics debut. Drug use leads to a decrease of expression of fear and inadequate assessment of the degree of its danger. It creates a false impression that the drug is easy to give

  3. Incremental cost effectiveness of proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug ulcers : a pharmacoeconomic analysis linked to a case-control study

    NARCIS (Netherlands)

    Vonkeman, H.E.; Braakman-Jansen, L.M.A.; Klok, R.M.; Postma, M.J.; Brouwers, J.R.B.J.; van de Laar, M.A.F.J.

    2008-01-01

    Introduction We estimated the cost effectiveness of concomitant proton pump inhibitors (PPIs) in relation to the occurrence of non-steroidal anti-inflammatory drug (NSAID) ulcer complications. Methods This study was linked to a nested case-control study. Patients with NSAID ulcer complications were

  4. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients

    NARCIS (Netherlands)

    van den Bergh, B.; Karagozoglu, K.H.; Heijmans, M.W.; Forouzanfar, T.

    2012-01-01

    Introduction: The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a

  5. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients

    NARCIS (Netherlands)

    van den Bergh, B.; Karagozoglu, K.H.; Heymans, M.W.; Forouzanfar, T.

    2012-01-01

    Introduction The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a

  6. Graduate Management Project (GMP) Retrospective Analysis of Promotional Mediums for Tricare Prime in Tricare Region 11

    National Research Council Canada - National Science Library

    Carpenter, Steven

    1997-01-01

    This study provides retrospective market research information about the population who enrolled in TRICARE Prime in TRICARE Region 11 and the advertising mediums used to promote enrollment in the TRICARE Prime program...

  7. A retrospective analysis of survival and prognostic factors after stereotactic radiosurgery for aggressive meningiomas

    International Nuclear Information System (INIS)

    Ferraro, Daniel J; Zoberi, Imran; Simpson, Joseph R; Jaboin, Jerry J; Funk, Ryan K; Blackett, John William; Ju, Michelle R; DeWees, Todd A; Chicoine, Michael R; Dowling, Joshua L; Rich, Keith M; Drzymala, Robert E

    2014-01-01

    While most meningiomas are benign, aggressive meningiomas are associated with high levels of recurrence and mortality. A single institution’s Gamma Knife radiosurgical experience with atypical and malignant meningiomas is presented, stratified by the most recent WHO classification. Thirty-one patients with atypical and 4 patients with malignant meningiomas treated with Gamma Knife radiosurgery between July 2000 and July 2011 were retrospectively reviewed. All patients underwent prior surgical resection. Overall survival was the primary endpoint and rate of disease recurrence in the brain was a secondary endpoint. Patients who had previous radiotherapy or prior surgical resection were included. Kaplan-Meier and Cox proportional hazards models were used to estimate survival and identify factors predictive of recurrence and survival. Post-Gamma Knife recurrence was identified in 11 patients (31.4%) with a median overall survival of 36 months and progression-free survival of 25.8 months. Nine patients (25.7%) had died. Three-year overall survival (OS) and progression-free survival (PFS) rates were 78.0% and 65.0%, respectively. WHO grade II 3-year OS and PFS were 83.4% and 70.1%, while WHO grade III 3-year OS and PFS were 33.3% and 0%. Recurrence rate was significantly higher in patients with a prior history of benign meningioma, nuclear atypia, high mitotic rate, spontaneous necrosis, and WHO grade III diagnosis on univariate analysis; only WHO grade III diagnosis was significant on multivariate analysis. Overall survival was adversely affected in patients with WHO grade III diagnosis, prior history of benign meningioma, prior fractionated radiotherapy, larger tumor volume, and higher isocenter number on univariate analysis; WHO grade III diagnosis and larger treated tumor volume were significant on multivariate analysis. Atypical and anaplastic meningiomas remain difficult tumors to treat. WHO grade III diagnosis and treated tumor volume were significantly

  8. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

    Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

  9. Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients.

    Science.gov (United States)

    Fanelli, Guido; De Carolis, Giuliano; Leonardi, Claudio; Longobardi, Adele; Sarli, Ennio; Allegri, Massimo; Schatman, Michael E

    2017-01-01

    Despite growing interest in the therapeutic use of cannabis to manage chronic pain, only limited data that address these issues are available. In recent years, a number of nations have introduced specific laws to allow patients to use cannabis preparations to treat a variety of medical conditions. In 2015, the Italian government authorized the use of cannabis to treat several diseases, including chronic pain generally, spasticity in multiple sclerosis, cachexia and anorexia among AIDS and cancer patients, glaucoma, Tourette syndrome, and certain types of epilepsy. We present the first snapshot of the Italian experience with cannabis use for chronic pain over the initial year of its use. This is a retrospective case series analysis of all chronic pain patients treated with oral or vaporized cannabis in six hubs during the initial year following the approval of the new Italian law (December 2015 to November 2016). We evaluated routes of administration, types of cannabis products utilized, dosing, and effectiveness and safety of the treatment. As only one of the six centers has extensively used cannabinoids for intractable chronic pain (614 patients of 659), only the population from Azienda Ospedaliero Universitaria Pisana (Pisa) was considered. Cannabis tea was the primary mode of delivery, and in almost all cases, it was used in association with all the other pain treatments. Initial and follow-up cannabinoid concentrations were found to vary considerably. At initial follow-up, 76.2% of patients continued the treatment, and <15% stopped the treatment due to side effects (none of which were severe). We present the first analysis of Italian clinical practice of the use of cannabinoids for a large variety of chronic pain syndromes. From this initial snapshot, we determined that the treatment seems to be effective and safe, although more data and subsequent trials are needed to better investigate its ideal clinical indication.

  10. Pediatric reduction mammaplasty: A retrospective analysis of the Kids' Inpatient Database (KID).

    Science.gov (United States)

    Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hadad, Ivan; Socas, Juan; Flores, Roberto L; Tholpady, Sunil S

    2015-09-01

    Pediatric breast reduction mammaplasty is a procedure commonly performed in children suffering from excess breast tissue, back pain, and social anxiety. Minimal information exists regarding demographics, epidemiology, and complications in adolescents. As health care reform progresses, investigating the socioeconomic and patient-related factors affecting cost and operative outcomes is essential. The Kids' Inpatient Database (KID) was used from 2000 to 2009. Patients with an International Classification of Diseases, 9th Revision code of macromastia and procedure code of reduction mammaplasty 20 and less were included. Demographic data, including age, sex, payer mix, and location, were collected. Significant independent variables associated with complications and duration of stay were identified with bivariate and multiple regression analysis. A total of 1,345 patients between the ages 12 and 20 were evaluated. The majority of patients were white (64%), from a zip code with greatest income (36%), and had private insurance (75%). Overall comorbidity and complication rates were 30% and 3.2%, respectively. Duration of stay was associated with race, income quartile, insurance type, having complications, and hospital type. African-American race, Medicaid, lower income, and private-investor owned hospitals were predictive of greater hospital charges. In this large retrospective database analysis, pediatric reduction mammaplasty had a relatively low early complication rate and short duration of stay. Complications, total charges, and duration of stay discrepancies were associated with race, location, and socioeconomic status. Although demonstrably safe, this is the first study demonstrating the negative effect of race and socioeconomic status on a completely elective procedure involving children. These results demonstrate the intricate association between socioeconomic and patient-related factors influencing overall outcomes in the pediatric population. Copyright © 2015

  11. Poster - 22: Retrospective analysis of portal dosimetry based QA of Prostate VMAT Plans

    Energy Technology Data Exchange (ETDEWEB)

    Badu, Shyam; Darko, Johnson; Fleck, Andre; Osei, Ernest [Grand River Regional Cancer Centre , Kitchener , ON Canada (Canada)

    2016-08-15

    Purpose: The purpose of this study is to retrospectively analyze the portal dosimetry based quality assurance of prostate VMAT plans. Methods: Our standard quality assurance of VMAT treatment plans are performed using EPID installed on Varian TrueBeam Linac. In our current study we analyzed 84 prostate pretreatment VMAT plans. All plans consisted of two arcs, 7800cGy in 39 fractions with a 6MV beam. For each of these VMAT plans, the measured fluence for each arc is compared with the reference fluence using gamma index analysis. Results: We have compared the gamma passing rates for three criteria; 3%/3mm, 2%/2mm and 1%/1mm. Out of 168 arcs measured, the number below the gamma passing rate 95% using the area, Field+1cm, are 0, 2, and 124 for 3%/3mm, 2%/2mm and 1%/1mm criteria respectively. Corresponding numbers for MLC CIAO are 0, 2, and 139 respectively. The average gamma passing rate for all arcs measured using Field+1cm are 99.9±0.4, 99.6±1.2, and 90.9±6.5 for 3%/3mm, 2%/2mm and 1%/1mm respectively. Similarly if the MLC CIAO area is analyzed, a passing rate of 99.9±0.2, 99.2±1.2 and 87.2±8.5 respectively was observed. The average of the maximum gamma was also found to increase with tighter criteria. Conclusion: Analysis of prostate VMAT quality assurance plans indicate that the gamma passing rate is sensitive to the criteria and the area analyzed.

  12. Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients

    Science.gov (United States)

    Fanelli, Guido; De Carolis, Giuliano; Leonardi, Claudio; Longobardi, Adele; Sarli, Ennio; Allegri, Massimo; Schatman, Michael E

    2017-01-01

    Background Despite growing interest in the therapeutic use of cannabis to manage chronic pain, only limited data that address these issues are available. In recent years, a number of nations have introduced specific laws to allow patients to use cannabis preparations to treat a variety of medical conditions. In 2015, the Italian government authorized the use of cannabis to treat several diseases, including chronic pain generally, spasticity in multiple sclerosis, cachexia and anorexia among AIDS and cancer patients, glaucoma, Tourette syndrome, and certain types of epilepsy. We present the first snapshot of the Italian experience with cannabis use for chronic pain over the initial year of its use. Methods This is a retrospective case series analysis of all chronic pain patients treated with oral or vaporized cannabis in six hubs during the initial year following the approval of the new Italian law (December 2015 to November 2016). We evaluated routes of administration, types of cannabis products utilized, dosing, and effectiveness and safety of the treatment. Results As only one of the six centers has extensively used cannabinoids for intractable chronic pain (614 patients of 659), only the population from Azienda Ospedaliero Universitaria Pisana (Pisa) was considered. Cannabis tea was the primary mode of delivery, and in almost all cases, it was used in association with all the other pain treatments. Initial and follow-up cannabinoid concentrations were found to vary considerably. At initial follow-up, 76.2% of patients continued the treatment, and <15% stopped the treatment due to side effects (none of which were severe). Conclusion We present the first analysis of Italian clinical practice of the use of cannabinoids for a large variety of chronic pain syndromes. From this initial snapshot, we determined that the treatment seems to be effective and safe, although more data and subsequent trials are needed to better investigate its ideal clinical indication. PMID

  13. [Tracheobronchial stents: a retrospective analysis of indications, results and in particular complications].

    Science.gov (United States)

    Tonn, H; Mall, W; Schneider, K-D; Schönhofer, B

    2008-10-01

    Tracheobronchial stents are inserted mainly in cases of malignant and benign airway stenosis. Further indications are esophago-tracheal fistulas, mediastinal fistulas and tracheomalacia. A retrospective analysis was conducted on patients' records, information provided by the general practitioners and relatives of the patients from July 1993 to December 2006 in the Department of Pneumology of the Heidehaus Hospital Hannover (since 6/05 Department of Pneumology and Internal Intensive Care Medicine, Oststadt-Heidehaus Hospital). During the observation period of 13 years a total of 269 stents (177 permanent, 92 temporary) were implanted in 207 patients (1.3 stents per patient). The vast majority of patients (173/207) suffered from an underlying malignancy. About half of the stents were deployed in the trachea. The median length of placement was 116 days in patients with malignancies and 313 days in patients with benign diseases. In about 40 % of the patients notable complications were observed which were directly or indirectly associated with the stents. These findings show the importance of a critical indication for stent implantation. In benign diseases a stent can remain for years inside the tracheobronchial system, if it is well tolerated in the beginning. In malignant diseases the result depends decisively on the stage of the tumour: has the stent been implanted before any other tumour therapy is started or is it an end-stage tumor with no other therapeutic option? In general, complications of stents occur quite frequently. The analysis of stent data leads to some aspects for the prevention of stent-related complications. There should be a strict indication and appropriate choice of stent material. Nevertheless, there remains an ethical dilemma in patients with end-stage disease as to whether to implant a stent or to do nothing against the tumor, because the benefit immediately after stent insertion vanishes with progression of the tumour, so causing extra

  14. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    Science.gov (United States)

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; phomeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  15. NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

    Science.gov (United States)

    Thomas, D.; Wear, M.; VanBaalen, M.; Lee, L.; Fitts, M.

    2011-01-01

    As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future

  16. Metodologia caso-controle em epidemiologia de doenças cardiovasculares: II - Análise de dados Case-control design in cardiovascular disease epidemiology: II - Analysis of data

    Directory of Open Access Journals (Sweden)

    Suzana Alves de Moraes

    1998-02-01

    Full Text Available A larga difusão, nos últimos anos, de softwares estatísticos indicados para análises multivariadas, aliada à facilidade de seu manuseio, poderá conduzir os usuários à obtenção de estimativas enganosas caso não se conheçam os pressupostos teóricos necessários para o emprego destas técnicas. Com o propósito de se destacar alguns desses pressupostos, apresentam-se as etapas executadas para a análise dos dados de um estudo caso-controle, conduzido no Município de São Paulo, entre março de 1993 e fevereiro de 1994, cujo objetivo foi testar a associação do diabetes mellitus com a doença isquêmica do coração após o ajustamento para possíveis variáveis de confusão e/ou modificadoras de efeito. Para uma melhor visualização didática desses pressupostos metodológicos são destacadas quatro etapas fundamentais durante a fase de análise dos dados: a construção do banco de dados; b cálculo do poder estatístico; c categorização e codificação das variáveis e d a escolha do modelo de regressão logística multivariada.The widespread distribution of statistical software recommended for multivariate analysis as well as the ease in handling it can lead the users into adopting wrong measures if they do not pay attention to the theoretical principles behind those methods. With a view to bringing out some of these principles some steps for the data analysis of a case-control study undertaken in the city of S. Paulo-Brazil from March, 1993 to February, 1994 in order to test the association between diabetes mellitus and ischaemic heart disease after adjusting for potential confounders and/or modifiers of effect are presented. Methodologic issues are emphasized in the development of four steps: a the data bank structure; b the calculation of statistical power; c the definition of variables strata and codification and d the choice of the logistic regression method.

  17. Clinical Characteristics and Predictors of Outcome for Onconeural Antibody-Associated Disorders: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Shaohua Liao

    2017-11-01

    Full Text Available ObjectiveTo describe and analyze the clinical characteristics, laboratory data, management, and outcome of patients with onconeural antibody-associated disorders (OAAD and identify predictors for poor outcome.MethodsThis was a retrospective review of all patients with potential OAAD, who were hospitalized in Jinan General Hospital between September 2009 and July 2017. We clarified the diagnosis, collected comprehensive information and categorized patients into three groups: paraneoplastic neurological disorders (PNDs, autoimmune encephalitis (AE, and possible OAAD. Within the three groups, we analyzed a range of clinical and laboratory parameters and used univariate and multivariate regression analysis to identify predictors for poor outcome [modified Rankin Scale (mRS = 3–6].ResultsFrom 158 patients, we identified 70 who fulfilled the criteria for OAAD, including 44 men (62.9% and 26 women (37.1%. There were 38 patients (54.3% in the PNDs group, 14 patients (20% in the AE group, and 18 patients (25.7% in the possible OAAD group. After the last follow-up, 14 (36.8%, 9 (64.2%, and 12 (66.7% had a good outcome (mRS = 0–2. However, 6 (15.8%, 2 (14.3%, and 3 (16.7% died, respectively. Univariate analysis showed that duration prior to the hospital (p = 0.0224 and urinary incontinence/retention (p = 0.0043 were associated with poor outcome (mRS = 3–6. After multivariate regression analysis, urinary incontinence/retention (p = 0.0388 and an immunocompromised state (p = 0.0247 remained as significant factors for poor outcome.ConclusionUrinary incontinence/retention and an immunocompromised state represent significant predictors of a worse prognosis for patients with OAAD. By contrast, cerebrospinal fluid analysis showed that serum autoantibodies and tumor markers, the function of crucial organs, electrophysiology, and radiological findings were not associated with a poor outcome.

  18. Retrospective Analysis of the Survival Benefit of Induction Chemotherapy in Stage IVa-b Nasopharyngeal Carcinoma.

    Science.gov (United States)

    Lan, Xiao-Wen; Zou, Xue-Bin; Xiao, Yao; Tang, Jie; OuYang, Pu-Yun; Su, Zhen; Xie, Fang-Yun

    2016-01-01

    The value of adding induction chemotherapy to chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) remains controversial, yet high-risk patients with LA-NPC have poor outcomes after chemoradiotherapy. We aimed to assess the survival benefits of induction chemotherapy in stage IVa-b NPC. A total of 602 patients with stage IVa-b NPC treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy with or without induction chemotherapy were retrospectively analyzed. Overall survival (OS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method, log-rank test and Cox regression analysis. In univariate analysis, 5-year OS was 83.2% for induction chemotherapy plus concurrent chemotherapy and 74.8% for concurrent chemotherapy alone, corresponding to an absolute risk reduction of 8.4% (P = 0.022). Compared to concurrent chemotherapy alone, addition of induction chemotherapy improved 5-year DMFS (83.2% vs. 74.4%, P = 0.018) but not 5-year LRFS (83.7% vs. 83.0%, P = 0.848) or PFS (71.9% vs. 66.0%, P = 0.12). Age, T category, N category, chemotherapy strategy and clinical stage were associated with 5-year OS (P = 0.017, P = 0.031, P = 0.007, P = 0.022, P = 0.001, respectively). In multivariate analysis, induction chemotherapy plus concurrent chemotherapy was an independent favorable prognostic factor for OS (HR, 0.62; 95% CI, 0.43-0.90, P = 0.012) and DMFS (HR, 0.57; 95% CI, 0.38-0.83, P = 0.004). In subgroup analysis, induction chemotherapy significantly improved 5-year DMFS in stage IVa (86.8% vs. 77.3%, P = 0.008), but provided no significant benefit in stage IVb. In patients with stage IVa-b NPC treated with IMRT, addition of induction chemotherapy to concurrent chemotherapy significantly improved 5-year OS and 5-year DMFS. This study provides a basis for selection of high risk patients in future clinical therapeutic

  19. Retrospective and Prospective Decomposition Analysis of Chinese Manufacturing Energy Use, 1995-2020

    Energy Technology Data Exchange (ETDEWEB)

    Hasanbeigi, Ali [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Price, Lynn [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Fino-Chen, Cecilia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Lu, Hongyou [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group; Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division, Environmental Impacts Dept., China Energy Group

    2013-01-15

    In 2010, China was responsible for nearly 20 percent of global energy use and 25 percent of energy-related carbon dioxide (CO2) emissions. Unlike most countries, China’s energy consumption pattern is unique because the industrial sector dominates the country’s total energy consumption, accounting for about 70 percent of energy use and 72 percent of CO2 emissions in 2010. For this reason, the development path of China’s industrial sector will greatly affect future energy demand and dynamics of not only China, but the entire world. A number of analyses of historical trends have been conducted, but careful projections of the key factors affecting China’s industry sector energy use over the next decade are scarce. This study analyzes industrial energy use and the economic structure of the Chinese manufacturing sector in detail. First, the study analyzes the energy use of and output from 18 industry sub-sectors. Then, retrospective (1995-2010) and prospective (2010-2020) decomposition analyses are conducted for these industrial sectors in order to show how different factors (production growth, structural change, and energy intensity change) influenced industrial energy use trends in China over the last 15 years and how they will do so over the next 10 years. The results of this study will allow policy makers to quantitatively compare the level of structural change in the past and in the years to come and adjust their policies if needed to move towards the target of less energy-intensive industries. The scenario analysis shows the structural change achieved through different paths and helps to understand the consequences of supporting or limiting the growth of certain manufacturing subsectors from the point of view of energy use and structural change. The results point out the industries that have the largest influence in such structural change

  20. Lessons to be learned: a retrospective analysis of physiotherapy injury claims.

    Science.gov (United States)

    Johnson, Gillian M; Skinner, Margot A; Stephen, Rachel E

    2012-08-01

    Retrospective, descriptive analysis. To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care. In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described. De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal. There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains. Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription. Harm, level 4.

  1. An analysis of moderate sedation protocols used in dental specialty programs: a retrospective observational study.

    Science.gov (United States)

    Setty, Madhavi; Montagnese, Thomas A; Baur, Dale; Aminoshariae, Anita; Mickel, Andre

    2014-09-01

    Pain and anxiety control is critical in dental practice. Moderate sedation is a useful adjunct in managing a variety of conditions that make it difficult or impossible for some people to undergo certain dental procedures. The purpose of this study was to analyze the sedation protocols used in 3 dental specialty programs at the Case Western Reserve University School of Dental Medicine, Cleveland, OH. A retrospective analysis was performed using dental school records of patients receiving moderate sedation in the graduate endodontic, periodontic, and oral surgery programs from January 1, 2010, to December 31, 2012. Information was gathered and the data compiled regarding the reasons for sedation, age, sex, pertinent medical conditions, American Society of Anesthesiologists physical status classifications, routes of administration, drugs, dosages, failures, complications, and other information that was recorded. The reasons for the use of moderate sedation were anxiety (54%), local anesthesia failures (15%), fear of needles (15%), severe gag reflex (8%), and claustrophobia with the rubber dam (8%). The most common medical conditions were hypertension (17%), asthma (15%), and bipolar disorder (8%). Most patients were classified as American Society of Anesthesiologists c