scholarly journals P09.06 Risk factors associated with Meningioma in a Cohort of 2 Million Israeli Adolescents

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii39-iii40
Author(s):  
S Yust-Katz ◽  
E Derzane ◽  
L Keinan ◽  
A Amiel ◽  
A Honig ◽  
...  

Abstract Background: Meningiomas are the most common primary central nervous system tumors. Risk factors including- obesity, height, history of allergy/atopy or autoimmune diseases, have been assessed with conflicting results. In this study, we reviewed the database of a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas. Methods: This study analyzed a cohort of 2,035,915 Jewish men and women who underwent compulsory physical examination as part of screening for army drafting between the age of 16 to 19 from 1948 to 1991. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according the several risk factors including sex, BMI, height, history of allergic and autoimmune disease. Results: Linkage of the adolescent military database with the Israeli cancer registry revealed 480 cases of meningioma. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only gender (female) and height were significantly associated with the risk of meningioma for the whole study population (p<0.01 for both variables). When analyzed separately for gender- height was significant only for men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI was not associated with an elevated risk of meningioma even when analyzed separately for gender. Past medical history including asthma, diabetes, and other atopic and autoimmune diseases were not found to be associated with the risk of meningioma. Conclusion: In this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of meningioma.

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi74-vi74
Author(s):  
Shlomit Yust-Katz ◽  
Alexandra Amiel ◽  
Ramiz Abu Shkara ◽  
Tali Siegal ◽  
Gilad Twig

Abstract BACKGROUND Meningiomas are the most common primary central nervous system tumors. Risk factors for meningiomas including obesity, height, history of allergy/atopy or autoimmune diseases, have been previously assessed with conflicting results. We reviewed a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas. METHODS This study analyzed a cohort of 2,035,915 Jewish men and women who underwent obligatory physical examination when aged 16 to 19 years, from 1967 to 2011. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according to sex, body mass index (BMI), height, history of allergic and autoimmune disease. RESULTS Linkage of the adolescent military database with the Israeli cancer registry identified 480 cases (152 males and 328 females) of meningioma during a follow up of 40,304,078-person years. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only female gender (p< 0.01) and height (p< 0.01) were associated with risk for meningioma in the total study population. When stratified by gender, height remained a significant risk factor only in men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI, past medical history including asthma, diabetes, and atopic and autoimmune diseases, were not associated with meningioma risk. CONCLUSION in this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of adult meningioma.


Author(s):  
David C. Lauzier ◽  
Joshua W. Osbun ◽  
Arindam R. Chatterjee ◽  
Christopher J. Moran ◽  
Akash P. Kansagra

OBJECTIVE Catheter-based cerebral angiography is commonly used for neurovascular diagnosis in children. In this work, the authors aimed to quantify the complication rate of cerebral angiography in children, characterize these complications, and identify risk factors for complications. METHODS Relevant clinical data were retrospectively obtained for 587 consecutive cerebral angiography procedures performed in 390 children from March 2002 to March 2020. Complications were categorized as neurological or nonneurological, and severity was graded using a standard schema. Incidences of complications were reported as point estimates. Associations between risk factors and complications were characterized in univariate analysis using the two-tailed Fisher exact test and in multivariate analysis using multiple logistic regression with bidirectional elimination based on the Akaike information criterion. In both univariate and multivariate analyses, statistical significance was corrected for multiple comparisons using the Benjamini-Hochberg method. RESULTS Complications occurred in 6.5% of procedures, including neurological complications in 1.9% and nonneurological complications in 4.8%. Permanent deficits occurred in only 0.2% of cases. Overall, 0.5% of procedures resulted in major complications, while 6.0% resulted in minor complications. Female sex and a history of hypertension or ischemic stroke were associated with an increased risk of complications, while femoral artery access was associated with a decreased risk of complications. CONCLUSIONS Pediatric cerebral angiography was shown to have a low rate of major or permanent complications. Children who were female and those with a history of hypertension or ischemic stroke were shown to be at higher risk of complications, while the use of femoral access carried a lower risk of complications.


2020 ◽  
Vol 35 (12) ◽  
pp. 2095-2102
Author(s):  
Suyuan Peng ◽  
Huai-Yu Wang ◽  
Xiaoyu Sun ◽  
Pengfei Li ◽  
Zhanghui Ye ◽  
...  

Abstract Background Acute kidney injury (AKI) is an important complication of coronavirus disease 2019 (COVID-19), which could be caused by both systematic responses from multi-organ dysfunction and direct virus infection. While advanced evidence is needed regarding its clinical features and mechanisms. We aimed to describe two phenotypes of AKI as well as their risk factors and the association with mortality. Methods Consecutive hospitalized patients with COVID-19 in tertiary hospitals in Wuhan, China from 1 January 2020 to 23 March 2020 were included. Patients with AKI were classified as AKI-early and AKI-late according to the sequence of organ dysfunction (kidney as the first dysfunctional organ or not). Demographic and clinical features were compared between two AKI groups. Their risk factors and the associations with in-hospital mortality were analyzed. Results A total of 4020 cases with laboratory-confirmed COVID-19 were included and 285 (7.09%) of them were identified as AKI. Compared with patients with AKI-early, patients with AKI-late had significantly higher levels of systemic inflammatory markers. Both AKIs were associated with an increased risk of in-hospital mortality, with similar fully adjusted hazard ratios of 2.46 [95% confidence interval (CI) 1.35–4.49] for AKI-early and 3.09 (95% CI 2.17–4.40) for AKI-late. Only hypertension was independently associated with the risk of AKI-early. While age, history of chronic kidney disease and the levels of inflammatory biomarkers were associated with the risk of AKI-late. Conclusions AKI among patients with COVID-19 has two clinical phenotypes, which could be due to different mechanisms. Considering the increased risk for mortality for both phenotypes, monitoring for AKI should be emphasized during COVID-19.


2015 ◽  
Vol 81 (5) ◽  
pp. 492-497 ◽  
Author(s):  
Tara M. Connelly ◽  
Rafel Tappouni ◽  
Paul Mathew ◽  
Javier Salgado ◽  
Evangelos Messaris

Incisional hernia (IH) is a relatively common sequelae of sigmoidectomy for diverticulitis. The aim of this study was to investigate factors that may predict IH in diverticulitis patients. Two hundred and one diverticulitis patients undergoing sigmoidectomy between January 2002 and December 2012 were identified (mean follow-up 5.15 ± 2.33 years). Patients with wound infections were excluded. Thirteen patient-associated, three diverticular disease-related, and 17 operative variables were evaluated in patients with and without IH. Volumetric fat was measured on pre-operative CTs. Fischer's exact, χ2, and Mann–Whitney tests and multivariate regression analysis were used for statistics. Thirty-four (17%) patients had an IH. On multivariate analysis, wound packing (OR 3.4, P = 0.017), postoperative nonwound infection (OR 7.4, P = 0.014), and previous hernia (OR 3.6, P = 0.005) were as independent predictors of IH. Fifteen of 34 (44%) patients who developed a hernia had a history of prior hernia. Of 33 potential risk factors analyzed, including smoking, chronic obstructive pulmonary disease, and obesity, the only patient factor present preoperatively associated with increased risk of a postsigmoidectomy hernia after multivariate analysis was a history of a previous hernia. Preoperative identification of patients with a history of hernia offers the opportunity to employ measures to decrease the likelihood of IH.


2011 ◽  
Vol 29 (21) ◽  
pp. 2897-2903 ◽  
Author(s):  
Sigurdur Y. Kristinsson ◽  
Magnus Björkholm ◽  
Malin Hultcrantz ◽  
Åsa R. Derolf ◽  
Ola Landgren ◽  
...  

Purpose Patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) often present with infections, but there are little data to assess whether a personal history of selected infections may act as pathogenic triggers. To additionally expand our knowledge on the role of immune stimulation in the causation of AML and MDS, we have conducted a large, population-based study to evaluate the risk of AML and MDS associated with a prior history of a broad range of infections or autoimmune diseases. Patients and Methods By using population-based central registries in Sweden, we included 9,219 patients with AML, 1,662 patients with MDS, and 42,878 matched controls. We used logistic regression to calculate odds ratios (ORs) and 95% CIs for the association of AML or MDS with infectious and/or autoimmune diseases. Results Overall, a history of any infectious disease was associated with a significantly increased risk of both AML (OR, 1.3; 95% CI, 1.2 to 1.4) and MDS (OR, 1.3; 95% CI, 1.1 to 1.5). These associations were significant even when we limited infections to those occurring 3 or more years before AML/MDS. A previous history of any autoimmune disease was associated with a 1.7-fold (95% CI, 1.5 to 1.9) increased risk for AML and 2.1-fold (95% CI, 1.7 to 2.6) increased risk for MDS. A large range of conditions were each significantly associated with AML and MDS. Conclusion Our novel findings indicate that chronic immune stimulation acts as a trigger for AML/MDS development. The underlying mechanisms may also be due to a common genetic predisposition or an effect of treatment for infections/autoimmune conditions.


2014 ◽  
Vol 44 (12) ◽  
pp. 2557-2566 ◽  
Author(s):  
D. Kounali ◽  
S. Zammit ◽  
N. Wiles ◽  
S. Sullivan ◽  
M. Cannon ◽  
...  

BackgroundAn argument often used to support the view that psychotic experiences (PEs) in general population samples are a valid phenotype for studying the aetiology of schizophrenia is that risk factors for schizophrenia show similar patterns of association with PEs. However, PEs often co-occur with depression, and no study has explicitly tested whether risk factors for schizophrenia are shared between PEs and depression, or are psychopathology specific, while jointly modelling both outcomes.MethodWe used data from 7030 subjects from a birth cohort study. Depression and PEs at age 18 years were assessed using self-report questionnaires and semi-structured interviews. We compared the extent to which risk factors for schizophrenia across sociodemographic, familial, neurodevelopmental, stress–adversity, emotional–behavioural and substance use domains showed different associations with PEs and depression within bivariate models that allowed for their correlation.ResultsMost of the exposures examined were associated, to a similar degree, with an increased risk of both outcomes. However, whereas female sex and family history of depression showed some discrimination as potential risk factors for depression and PEs, with stronger associations in the former, markers of abnormal neurodevelopment showed stronger associations with PEs.ConclusionsThe argument that PEs are valid markers for studying the aetiology of schizophrenia, made simply on the basis that they share risk factors in common, is not well supported. PEs seem to be a weak index of genetic and environmental risk for schizophrenia; however, studies disentangling aetiological pathways to PEs from those impacting upon co-morbid psychopathology might provide important insights into the aetiology of psychotic disorders.


2009 ◽  
Vol 4 (3) ◽  
pp. 285-288 ◽  
Author(s):  
Masoud Majed ◽  
Farideh Nejat ◽  
Mostafa El Khashab ◽  
Parvin Tajik ◽  
Mohammad Gharagozloo ◽  
...  

Object Patients with myelomeningoceles (MMCs) are at increased risk of latex allergy and sensitization. Number of surgeries and history of atopy are known risk factors. The object of this study was to evaluate the role of diagnostic procedures and nonsurgical treatments in latex sensitization in young patients with MMC. Methods Seventy-three children with MMC were included in the study. For each child a questionnaire was administered and serum determination of IgE was performed, and 62 children underwent skin prick tests (SPTs), 60 of which had reliable results. Multivariate logistic regression modeling was performed, using latex sensitization as the dependent variable. Results The mean age of the 73 patients was 3.8 years. The SPT results were positive in 30.6%, whereas results of testing for latex-specific IgE were positive in only 8.2%. In univariate analysis, history of untethering, barium enema, and number of clean intermittent catheterizations (CICs) per day were significantly associated with positive results on the SPT. Although the number of surgical procedures was significantly higher in patients who had shunts, no significant relationship between the presence of a shunt and latex sensitization was seen. Conclusions The young age of the patients in this study may account for the low prevalence of latex sensitization that was found. In young patients with MMC, the numbers of CICs per day, a history of untethering, circumcision, and a barium enema performed without latex-free equipment could be risk factors for latex sensitization. The use of latex-free gloves in all procedures performed in these cases, nonlatex polyvinyl chloride catheters in CIC, and ordinary nonballoon tips in barium enemas could decrease the risk of sensitization.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 139-139 ◽  
Author(s):  
Julie Jaffray ◽  
Sarah H. O'Brien ◽  
Char M Witmer ◽  
Rosa Diaz ◽  
Lingyun Ji ◽  
...  

Abstract Introduction Central venous catheters (CVC) are necessary for medically complex and acutely ill children, but come with the risk of venous thromboembolism (VTE) or central line associated blood stream infection (CLABSI). The rate of VTE in pediatrics has increased, most likely due to the increased use and placement of CVCs, and questions remain regarding VTE risk factors for CVC associated thrombosis. Methods This prospective, multi-center study compared the incidence and risk factors for VTE between peripherally inserted central catheters (PICCs) and centrally inserted tunneled lines (TLs) in patients 6 months to <18 years from 4 pediatric hospitals from September 2013 to April 2018. Data were collected through medical record review regarding demographics, medical history and specific CVC data including insertion technique and catheter specifications. Subjects were prospectively monitored via medical record review for CVC complications including VTE, CLABSI or malfunction (use of tissue plasminogen activator, malposition, blockage, etc). Cumulative incidence rates of VTE, CLABSI, CVC malfunction and removal were estimated and compared between PICCs and TLs. These analyses focused on the first 6 months from CVC insertion using parametric survival models assuming a Weibull survival distribution. The association between occurrence of VTE and subject/CVC characteristics was first assessed in univariate analyses, and then assessed by a minimal multivariable model. Results A total of 1,969 CVCs from 1,744 unique patients were included. Median age at CVC insertion was 6.4 years (range: 0.6-17.9) with the majority, 1048 (53%) placed in males. PICCs made up 1,259 (64%) of the CVCs and 710 (36%) were TLs. Among 1,969 CVCs, 100 had a VTE with a cumulative incidence rate of 5.4±0.5%, and median time to VTE from CVC insertion was 0.6 months (range 0-5.8 months). Eighty percent of the VTEs were in PICCs and median time to VTE was 0.5 months (range 0-5.3 months) in PICCs compared to TLs with a median time to VTE of 1.4 months (range 0-5.8 months). The incidence rate of VTE was 2.9±0.6% for TLs, and 6.8±0.7% for PICCs (Figure 1). In univariate analysis, subjects with TLs had a significantly lower risk of developing a VTE than patients with PICCs (HR=0.14, 95%CI: 0.05-0.4, p<0.001). The incidence of CLABSI was 14±1.3% for TLs compared to 7.9±0.9% for PICCs and in univariate analysis CVCs with a CLABSI were 4 times (95%CI: 1.3-13) as likely to develop a VTE. The cumulative incidence of malfunction in all CVCs was 25±1.0%, and univariate analysis revealed CVCs with a malfunction were 10 times (95%CI: 3.6, 28) as likely to develop a VTE. In the multivariable analyses (Table 1), subjects with TLs were significantly less likely to develop a VTE compared to PICCs (HR=0.16, 95%CI: 0.06-0.4, p<0.001); subjects with leukemia were more likely to have a VTE than subjects without cancer or other cancer diagnosis (HR=3.6, 95%CI: 1.3-9.9, p=0.050); subjects with a previous history of VTE were significantly more likely to develop a new VTE (HR=36, 95%CI: 6.3-210, p<0.001); and compared to CVCs with 1 lumen, CVCs with 2-3 lumens resulted in a higher risk of developing a VTE (HR=4.4, 95%CI: 1.9-10, p=0.002). Diagnosis of a CLABSI (HR=6.3, 95%CI: 2.1-18, p<0.001) as well as CVC malfunction (HR=5.7, 95%CI: 2.3-14, p<0.001) were also associated with higher risk of developing a VTE. Conclusion This study represents the first prospective evaluation of the incidence and risk factors of VTE for TLs and PICCs placed in children. Almost 2,000 CVCs are included in this final analysis, which revealed a significant increase in VTE risk for children who have a PICC placed compared to a TL. The greatest risk factor for CVC associated VTE was a prior history of VTE. Additional risk factors included CLABSI, CVC malfunction, leukemia and having a multi-lumen CVC. Even though the ease of placing a PICC is enticing to avoid repeat peripheral intravenous (PIV) insertions or surgical intervention with TL placement, the increased risk of VTE in PICCs should give practitioners pause. When CVC placement is unavoidable, limiting the number of lumens is a modifiable VTE risk factor and efforts to prevent CLABSI may reduce VTE incidence. Interestingly, no insertion characteristics (e.g. placement vein, access side, catheter brand or material, tip location, insertion attempts) were associated with an increased risk of VTE. Disclosures Jaffray: Octapharma: Consultancy; CSL Behring: Consultancy, Research Funding; Bayer: Consultancy. Young:Kedrion: Consultancy; Genentech/Roche: Consultancy, Honoraria; CSL Behring: Consultancy, Honoraria; Bioverativ: Consultancy, Honoraria; Bayer: Consultancy; Novo Nordisk: Consultancy, Honoraria; Shire: Consultancy, Honoraria.


2016 ◽  
Vol 11 (1) ◽  
pp. 47-50
Author(s):  
Pooja Paudyal ◽  
Neelam Pradhan ◽  
Neebha Ojha

Aims: The aim of this study was to analyze the non-reproductive risk factors associated with uterovaginal prolapse (UVP) which is a major health concern of women.Methods: This was a hospital-based case control study, carried out in the Gynaecology Department of Tribhuvan University Teaching Hospital (TUTH) over one year from 13th April 2011 to 12th April 2012). Cases comprised of 116 women with UVP, second degree or more and controls were women without prolapse of the same age group within five years admitted subsequently after the cases. The variables studied were medical disorders like chronic obstructive  pulmonary disease (COPD)/chronic cough, constipation; smoking, family history of prolapse and body mass index (BMI). The p-value and odds ratio (OR) for each risk factor were calculated. Multivariate analysis was done for those risk factors found to be significant from the univariate analysis. Results: Smoking, family history of prolapse and low BMI were found to be significant risk factors from univariate analysis. Only two risk factors- family history of prolapse with OR 5.52 (2.11-14.49) and being underweight with OR 15.38 (1.88-125), were found to be significant by multivariate analysis.Conclusion: Providing good nutrition and preventing malnourishment in postmenopausal women, imparting awareness about increased risk in women with history of prolapse in first degree relatives and educating about the perils of smoking could contribute in  reducing morbidity due to prolapse.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Laura Conti ◽  
Edith Lahner ◽  
Gloria Galli ◽  
Gianluca Esposito ◽  
Marilia Carabotti ◽  
...  

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


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