Case-control Study Of Risk Factors Research Articles

Association of Vascular Risk With Severe vs Non-Severe Stroke: An Analysis of the INTERSTROKE Study.

Acute stroke is associated with a spectrum of functional deficits. The objective of this analysis was to explore whether the importance of individual risk factors differ by stroke severity, which may be of relevance to public health strategies to reduce disability. INTERSTROKE is an international case-control study of risk factors of first acute stroke (recruitment 2007-August 2015) in 32 countries. Stroke severity was measured using the modified Rankin Scale (mRS) score within 72 hours of admission to hospital. Severe stroke is defined as mRS scores of 4-6 (and non-severe stroke, score of 0-3). We used multinomial logistic regression to estimate comparative odds ratios (ORs; 95% CIs) for severe and non-severe stroke and tested for heterogeneity (pheterogeneity). We also conducted a matched case-case analysis (matched for age, sex, country, and primary stroke subtype) to determine whether the prevalence of risk factors differed significantly between severe and non-severe stroke. A significant difference in the association of a risk factor of severe stroke compared with non-severe stroke was defined as p < 0.05 for both pheterogeneity and pcase-case. Of patients with acute stroke (n = 13,460), 64.0% (n = 8,612) were reported to have mRS scores of 0-3 and 36.0% (n = 4,848) scores of 4-6. The mean age was 61.7 years for patients with non-severe stroke and 62.9 years for patients with severe stroke (p = 0.72). 38.1% (n = 3,278) of patients with non-severe stroke and 44.6% (n = 2,162) of patients with severe stroke were female. Hypertension (OR 3.21; 95% CI 2.97-3.47 for severe stroke, OR 2.87; 95% CI 2.69-3.05 for non-severe stroke; pheterogeneity = 0.03; pcase-case < 0.001), atrial fibrillation (OR 4.70; 95% CI 4.05-5.45 for severe stroke, OR 3.61; 95% CI 3.16-4.13 for non-severe stroke; pheterogeneity = 0.009; pcase-case < 0.001), and smoking (OR 1.87; 95% CI 1.72-2.03 for severe stroke, OR 1.65; 95% CI 1.54-1.77 for non-severe stroke; pheterogeneity = 0.02; pcase-case < 0.001) had a stronger association with severe stroke, compared with non-severe stroke. The waist-to-hip ratio had a stronger association with non-severe stroke compared with severe stroke (pheterogeneity < 0.001; pcase-case < 0.001). Hypertension, atrial fibrillation, and smoking had a stronger magnitude of association with severe stroke (compared with non-severe stroke) while the increased waist-to-hip ratio had a stronger magnitude of association with non-severe stroke.

Markers of periodontal disease and risk of stroke: INTERSTROKE case-control study

BackgroundPeriodontal disease may be an important modifiable risk factor for stroke. AimsTo determine the contribution of markers of periodontal disease to stroke risk globally, within subpopulations, and by stroke subtypes. MethodsINTERSTROKE is the largest international case-control study of risk factors for first acute stroke. All participants were asked a standardised set of questions about the presence or absence of painful teeth, painful gums or lost teeth, as markers of periodontal disease, within the previous year. The total number of reported variables was calculated per participant. Multivariable conditional logistic regression examined the association of these variables with acute stroke. ResultsIn 26901 participants, across 32 countries, there was a significant multivariable association between lost teeth and stroke (OR 1.11, 95 % CI 1.01 – 1.22), but not painful teeth (OR 1.00, 95 % CI 0.91-1.10) or painful gums (OR 1.01, 95 % CI 0.89 – 1.14). When these symptoms were considered together there was a graded increased odds of stroke, with the largest magnitude of association seen if a patient reported all three of painful teeth, painful gums and lost teeth (OR 1.34, 95 % CI 1.00 – 1.79). ConclusionsOur findings suggest that features of severe periodontal disease are a risk factor for acute stroke. Periodontal disease should be considered as a potentially modifiable risk factor for stroke.

Blood pressure variability in acute stroke: Risk factors and association with functional outcomes at 1 month.

Blood pressure variability, in acute stroke, may be an important modifiable determinant of functional outcome after stroke. In a large international cohort of participants with acute stroke, it was sought to determine the association of blood pressure variability (in the early period of admission) and functional outcomes, and to explore risk factors for increased blood pressure variability. INTERSTROKE is an international case-control study of risk factors for first acute stroke. Blood pressure was recorded at the time of admission, the morning after admission and the time of interview in cases (median time from admission 36.7 h). Multivariable ordinal regression analysis was employed to determine the association of blood pressure variability (standard deviation [SD] and coefficient of variance) with modified Rankin score at 1-month follow-up, and logistic regression was used to identify risk factors for blood pressure variability. Amongst 13,206 participants, the mean age was 62.19 ± 13.58 years. When measured by SD, both systolic blood pressure variability (odds ratio 1.13; 95% confidence interval 1.03-1.24 for SD ≥20 mmHg) and diastolic blood pressure variability (odds ratio 1.15; 95% confidence interval 1.04-1.26 for SD ≥10 mmHg) were associated with a significant increase in the odds of poor functional outcome. The highest coefficient of variance category was not associated with a significant increase in risk of higher modified Rankin score at 1 month. Increasing age, female sex, high body mass index, history of hypertension, alcohol use, and high urinary potassium and low urinary sodium excretion were associated with increased blood pressure variability. Increased blood pressure variability in acute stroke, measured by SD, is associated with an increased risk of poor functional outcome at 1 month. Potentially modifiable risk factors for increased blood pressure variability include low urinary sodium excretion.

Case-Control Study Of Risk Factors Associated With Acute Unintentional Poisoning In Children Aged 1-12 Years In A District Hospital, Puducherry, India

Unintentional poisoning, particularly among children under five, is a global concern. A case-control study conducted in a South Indian tertiary care institute aimed to identify socio-epidemiological risk factors for acute unintentional poisoning in children aged 1-12 years. Through caregiver interviews, 480 children were categorized as cases (with acute unintentional poisoning) or controls (with acute medical illnesses). Household poisons ingestion was prevalent, with inadequate storage and accessibility as significant contributors. Prompt hospital presentation correlated with better outcomes. Higher birth order, low maternal education, paternal substance abuse, and inadequate storage emerged as risk factors. Though developmental delays weren't prevalent, maternal education, paternal income, and substance abuse were linked to childhood poisoning. Targeted interventions promoting household safety, parental education, and supervision are crucial for prevention, along with health education campaigns on safe storage practices, labeling, and substance disposal. Timely medical intervention and improved healthcare access are essential to reduce childhood poisoning-related morbidity and mortality, especially in resource-limited settings like India.

A case-control study of risk factors for incident hepatitis B virus infection in South African blood donors

ObjectivesHepatitis B virus (HBV) infection remains a global health problem. Risk factors for HBV infection are usually assessed in prevalent rather than incident infections. To identify demographic and behavioral risks associated with incident HBV among South African blood donors. MethodsA case-control study was performed between November 2014 and January 2018. Cases were blood donors testing positive for HBV DNA with or without hepatitis B surface antigen but negative for antibody to hepatitis B core antigen. Participants completed an audio computer-assisted structured interview on exposures during the previous 6 months. Sex-specific multivariable logistic regression yielded independent associations between risks and HBV infection. Results56 females and 37 males with incident HBV were compared to 438 female and 439 male controls, respectively. For females, risk factors were accepting money or goods for sex, using agents to prepare one's anus prior to anal sex, penetrating injury, non-Black race, and lower educational status. Men reporting homosexual or bisexual orientation or sex with other men, previous injury, referral for HBV testing, or lack of medical insurance were at increased risk. For both sexes, having more than two male sexual partners increased risk. ConclusionsSexual behaviors predominated over parenteral exposures as risks for incident HBV in both female and male blood donors.

A pharmacoepidemiological nested case-control study of risk factors for venous thromboembolism with the focus on diabetes, cancer, socioeconomic group, medications, and comorbidities.

A pharmacoepidemiological study to assess VTE risk factors in a diabetes-rich population. The study comprised 299,590 individuals. We observed 3450 VTEs and matched them with 15,875 controls using a nested case-control approach and collected data on comorbidities and prescriptions. By multivariable conditional logistic regression, we calculated ORs with 95%CIs for comorbidities and medications to evaluate their associations with VTE. Diabetes (aOR 2.16; 95%CI 1.99-2.34), inflammatory bowel disease (1.84; 1.27-2.66), and severe psychiatric disorders (1.72; 1.43-2.05) had the strongest associations among the non-cancer comorbidities. Pancreatic (12.32; 7.11-21.36), stomach (8.57; 4.07-18.03), lung and bronchus (6.26; 4.16-9.43), and ovarian (6.72; 2.95-15.10) cancers were ranked as high-risk for VTE. Corticosteroids, gabapentinoids, psychotropic drugs, risedronic acid, and pramipexole were most strongly associated (aOR exceeding 1.5) with VTE. Insulin (3.86; 3.33-4.47) and sulphonylureas (2.62; 2.18-3.16) had stronger associations than metformin (1.65; 1.49-1.83). Statins and lercanidipine (0.78; 0.62-0.98) were associated with a lowered risk of VTE. In this cohort, with 50% diabetes prevalence, pancreatic, stomach, lung and bronchus, and ovarian cancers were strongly associated with VTE. Corticosteroids, gabapentinoids, and psychotropic medications had the strongest associations with VTE among medications. This may be valuable for generating hypotheses for the further research. Lercanidipine may be a novel protective medication against VTE.

Outpatient administration of high-dose methotrexate in adults without drug monitoring – a case-control study of risk factors for acute kidney injury

IntroductionHigh-dose methotrexate (HDMTX) is an essential part of chemotherapy regimens for hematologic neoplasms. The incidence of acute kidney injury (AKI) after HDMTX in unmonitored outpatient infusion had not been reported in adults yet. In this study, we evaluated toxicity data after outpatient administration of HDMTX without drug monitoring. MethodsPatients 16 years old or over with acute lymphoblastic leukemia and non-Hodgkin lymphoma who received at least one outpatient infusion of HDMTX without drug level monitoring were included. This is a retrospective, nested case-control study, in which the cases comprised patients who developed AKI after HDMTX. ResultsOverall, 302 patients were included, encompassing 840 infusions. Hospitalization occurred in 8.6 %. A total of 25 patients presented AKI after HDMTX administration, corresponding to 3 % of the methotrexate (MTX) infusions and 8.3 % of the patients. HIV-associated Burkitt lymphoma was more common in patients who presented AKI (18 vs. 6.8 %, p = 0.03). Baseline factors related to AKI after HDMTX were age > 44 y, body surface area ≥ 1.76 m2, body mass index (BMI) ≥ 23.8 kg/m2, glomerular filtration rate, and thrombocytopenia (< 150×109/L). Multivariable analysis for adjusting such factors found that BMI was independently related to AKI after HDMTX (OR 3.8). Death after AKI occurred in 56 %. ConclusionOur data showed a similar rate of AKI after HDMTX to that reported in the literature, even without drug monitoring. However, patients who developed AKI in our cohort fared worse than expected, with more hospitalizations and death. A higher BMI was associated with the MTX-induced AKI in our cohort, suggesting a differential drug clearance and the need for specific guidelines for obese patients.

Abstract 11801: Timing of Critical Congenital Heart Defect (CCHD) Detection at 7 U.S. Sites, the Birth Defects Study to Evaluate Pregnancy Exposures (BD-STEPS), 2014-2018

Background: CCHD detection prenatally or at birth hospitalization may reduce infant mortality and morbidity, yet little is known about prevalence and characteristics associated with timing of detection. Objective: To examine prevalence and characteristics associated with prenatal and late (&gt;3 days after birth) detection of CCHD among infants in BD-STEPS, a multi-site population-based case-control study of risk factors for birth defects. Methods: Liveborn infants with non-syndromic CCHD without genetic causes born 2014-2018 with interviewed mothers were included. Timing of detection was based on date of earliest fetal or postnatal echocardiogram. Multivariable log-binomial models calculated adjusted prevalence ratios (aPR) for prenatal (vs postnatal) and late (vs not late) CCHD detection, by clinical and demographic characteristics. Log-linear models evaluated trends over time. Results: Among the 588/672 infants with CCHD and complete data, most infants’ mothers were Non-Hispanic White (53.4%), had some prenatal insurance (94.4%), and were multiparous (74.5%). Prenatal detection increased from 2014 to 2018 (24.7% to 40.1%) while late detection decreased (22.4% to 8.7%, Fig 1). Hypoplastic left heart syndrome had the highest prenatal detection (58.6%); late detection was highest for coarctation of the aorta (41.7%). Prenatal detection was more likely in infants of mothers 30-34 vs. 25-29 years at delivery (aPR=1.4, 95% confidence interval 1.0-1.9), and with additional non-cardiac defects (1.2, 1.1-1.4), and less likely among infants of mothers with &lt;11 years of education vs. &gt; bachelor’s degree (0.6, 0.3-1.0). Late detection was more likely among infants of mothers without prenatal insurance (1.8, 1.1-3.1), and less likely among those with non-cardiac defects (0.4, 0.2-0.8). Conclusion: From 2014 to 2018, prenatal detection increased and late detection decreased. Yet, disparities in detection by maternal insurance and education were observed.

Hospital-based case-control study of risk factors for early neonatal mortality in the Gaza Strip.

Early neonatal death is an essential epidemiological indicator of maternal and child health. To identify risk factors for early neonatal deaths in the Gaza Strip. This hospital-based case-control study included 132 women who experienced neonatal deaths from January to September 2018. The control group comprised 264 women who were selected using systematic random sampling and gave birth to live newborns at the time of data collection. The controls who had no history of neonatal death or stillbirth were less likely to have an early neonatal death than women who had such history. The controls who did not have meconium aspiration syndrome or amniotic fluid complications were less likely to have an early neonatal death than women who experienced these complications during delivery. The controls who had a singleton birth outcome were less likely to have an early neonatal death than women who had multiple births. Interventions are needed to provide preconception care, improve the quality of intrapartum and postnatal care, provide high-quality health education, and improve the quality of care provided by neonatal intensive care units in the Gaza Strip.

Depressive Symptoms and Risk of Acute Stroke: INTERSTROKE Case-Control Study.

Depression has been reported to be a risk factor of acute stroke, based largely on studies in high-income countries. In the INTERSTROKE study, we explored the contribution of depressive symptoms to acute stroke risk and 1-month outcome across regions of the world, within subpopulations and by stroke type. The INTERSTROKE is an international case-control study of risk factors of first acute stroke, conducted in 32 countries. Cases were patients with CT- or MRI-confirmed incident acute hospitalized stroke, and controls were matched for age, sex, and within sites. Standardized questions asked about self-reported depressive symptoms during the previous 12 months and the use of prescribed antidepressant medications were recorded. Multivariable conditional logistic regression was used to determine the association of prestroke depressive symptoms with acute stroke risk. Adjusted ordinal logistic regression was used to explore the association of prestroke depressive symptoms with poststroke functional outcome, measured with the modified Rankin scale at 1 month after stroke. Of 26,877 participants, 40.4% were women, and the mean age was 61.7 ± 13.4 years. The prevalence of depressive symptoms within the last 12 months was higher in cases compared with that in controls (18.3% vs 14.1%, p < 0.001) and differed by region (p interaction <0.001), with lowest prevalence in China (6.9% in controls) and highest in South America (32.2% of controls). In multivariable analyses, prestroke depressive symptoms were associated with greater odds of acute stroke (odds ratio [OR] 1.46, 95% CI 1.34-1.58), which was significant for both intracerebral hemorrhage (OR 1.56, 95% CI 1.28-1.91) and ischemic stroke (OR 1.44, 95% CI 1.31-1.58). A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms. While preadmission depressive symptoms were not associated with a greater odds of worse baseline stroke severity (OR 1.02, 95% CI 0.94-1.10), they were associated with a greater odds of poor functional outcome at 1 month after acute stroke (OR 1.09, 95% CI 1.01-1.19). In this global study, we recorded that depressive symptoms are an important risk factor of acute stroke, including both ischemic and hemorrhagic stroke. Preadmission depressive symptoms were associated with poorer functional outcome, but not baseline stroke severity, suggesting an adverse role of depressive symptoms in poststroke recovery.

Induction failure in granulomatosis with polyangiitis: a nationwide case-control study of risk factors and outcomes.

To identify characteristics of granulomatosis with polyangiitis (GPA) associated with induction failure, describe salvage therapies and their efficacy. We conducted a nationwide retrospective case-control study of GPA with induction failure between 2006 and 2021. Each patient with induction failure was randomly paired to 3 controls matched for age, sex and induction treatment. We included 51 patients with GPA and induction failure (29 men and 22 women). At induction therapy, median age was 49 years. Twenty-seven patients received intravenous cyclophosphamide (ivCYC) and 24 rituximab (RTX) as induction therapy. Patients with ivCYC induction failure had more frequently PR3-ANCA (93% versus 70%, p= 0.02), relapsing disease (41% versus 7%, p< 0.001) and orbital mass (15% versus 0%, p< 0.01) compared with controls. Patients with disease progression despite RTX induction therapy had more frequently renal involvement (67% versus 25%, p= 0.02) with renal failure (serum creatinine >100 µmol/l in 42% versus 8%, p= 0.02) compared with controls. After salvage therapy, remission was achieved at 6 months in 35 (69%) patients. The most frequent salvage therapy was switching from ivCYC to RTX (or vice versa), showing an efficacy in 21/29 (72%). Remission was achieved in 9 (50%) patients with inappropriate response to ivCYC, while in patients with progression after RTX induction, remission was achieved in 4 (100%) who received ivCYC (with or without immunomodulatory therapy), but only in 3 (50%) after adding immunomodulatory therapy alone. In patients with induction failure, characteristics of GPA, salvage therapies and their efficacy vary according to induction therapy and failure modality.

The Frontline War: A Case-control study of risk factors for COVID-19 among health care workers

Purpose: The global pandemic of COVID-19 has infected several people worldwide. World Health Organization(WHO) has reported that an alarming number of health care workers (HCWs) have been affected and have also succumbed to this disease. Though health infrastructure can be boosted in a short period, the number of HCWs cannot. Hence understanding the risk factors that the HCWs are exposed to and strategically protecting them is of paramount importance. Methods: A case-control retrospective study was carried out on 116 HCWs at a tertiary care hospital treating COVID-19 patients in South India. We attempted to investigate and stratify the specific risk factors for COVID-19 transmission among HCWs. Data was collected regarding their exposure to COVID-19 patients, infection control precautions used, possible breaches in the protocol, and details of Hydroxychloroquine (HCQ) prophylaxis. Results: The demographics were equally distributed among the cases and controls. Exposure to surgical procedures on suspected/positive COVID patients was also found to affect contracting the COVID-19 illness. HCWs who wore face shields instead of eye goggles along with the use of scrubs and hospital gowns were found to have a lesser incidence of COVID-19 illness. Conclusion: This study helped us understand the varied risk factors that health care workers are exposed to while treating COVID-19 patients. It helped us contextualize and strategize our infection control practices to prevent further morbidity and mortality due to COVID-19.

Association of Psychosocial Stress With Risk of Acute Stroke

Psychosocial stress is considered a modifiable risk factor for stroke. Given the prevalence of chronic and acute exposure to stress, it represents a potentially attractive target for population-health interventions. To determine the association of psychosocial stress with the risk of acute stroke and explore factors that might modify the association of stress with risk of acute stroke in a large international population. INTERSTROKE is an international retrospective case-control study of risk factors for first acute stroke in 32 countries in Asia, North and South America, Europe, Australia, the Middle East, and Africa. A total of 13 462 patients with stroke and 13 488 matched controls were recruited between January 11, 2007, and August 8, 2015. The present analyses were performed from June 1 to 30, 2021, and included 13 350 cases and 13 462 controls with available data on psychosocial stress. Psychosocial stress and occurrence of stressful life events within the preceding year were measured using a standardized questionnaire of self-reported stress at home and work. The association of stress with acute stroke and its subtypes was examined using multivariable conditional logistic regression and factors that might modify the association, particularly self-reported locus of control. Among 26 812 participants included in the analysis, the mean (SD) age of cases was 62.2 (13.6) years; that of controls, 61.3 (13.3) years; 7960 cases (59.6%) and 8017 controls (59.6%) were men. Several periods of stress and permanent stress were reported for 2745 cases (20.5%) and 1933 controls (14.4%), with marked regional variation in prevalence, with the lowest in China (201 of 3981 [5.0%] among controls and 364 of 3980 [9.1%] among cases) and highest in South East Asia (233 of 855 [26.1%] among controls and 241 of 782 [30.8%] among cases). Increased stress at home (odds ratio [OR], 1.95 [95% CI, 1.77-2.15]) and at work (OR, 2.70 [95% CI, 2.25-3.23]) and recent stressful life events (OR, 1.31 [95% CI, 1.19-1.43]) were associated with an increased risk of acute stroke on multivariable analyses (vs no self-reported stress). Higher locus of control at home was associated with a reduced odds of all stroke (OR, 0.73 [95% CI, 0.68-0.79]), and higher locus of control both at work and at home were associated with a lower odds of acute stroke and significantly diminished the association with stress at work (OR, 2.20 [95% CI, 1.88-2.58]; P = .008 for interaction) and home (OR, 1.69 [95% CI, 1.44-1.98]; P < .001 for interaction) for acute stroke. Psychosocial stress is a common risk factor for acute stroke. The findings of this case-control study suggest that higher locus of control is associated with lower risk of stroke and may be an important effect modifier of the risk associated with psychosocial stress.

The Frontline War: A Case-control study of risk factors for COVID-19 among health care workers

Purpose: The global pandemic of COVID-19 has infected several people worldwide. World Health Organization(WHO) has reported that an alarming number of health care workers (HCWs) have been affected and have also succumbed to this disease. Though health infrastructure can be boosted in a short period, the number of HCWs cannot. Hence understanding the risk factors that the HCWs are exposed to and strategically protecting them is of paramount importance. Methods: A case-control retrospective study was carried out on 116 HCWs at a tertiary care hospital treating COVID-19 patients in South India. We attempted to investigate and stratify the specific risk factors for COVID-19 transmission among HCWs. Data was collected regarding their exposure to COVID-19 patients, infection control precautions used, possible breaches in the protocol, and details of Hydroxychloroquine (HCQ) prophylaxis. Results: The demographics were equally distributed among the cases and controls. Exposure to surgical procedures on suspected/positive COVID patients was also found to affect contracting the COVID-19 illness. HCWs who wore face shields instead of eye goggles along with the use of scrubs and hospital gowns were found to have a lesser incidence of COVID-19 illness. Conclusion: This study helped us understand the varied risk factors that health care workers are exposed to while treating COVID-19 patients. It helped us contextualize and strategize our infection control practices to prevent further morbidity and mortality due to COVID-19.

Risk Factors for Esophageal Squamous Cell Carcinoma in Patients with Head and Neck Squamous Cell Carcinoma

Background Esophageal squamous cell carcinoma (ESCC) is a common second primary neoplasia in patients with a history of head and neck squamous cell carcinoma (HNSCC). The aim of this study was to provide further information and novel insights into the risk factors for ESCC in patients with HNSCC. Methods We retrospectively analyzed 98 HNSCC patients diagnosed from 2007 to 2017, 30 HNSCC patients suffering from ESCC, who had undergone endoscopic examination because of positive imaging examinations or symptoms, and 68 HNSCC patients who had no ESCC occurrence for at least six years post-HNSCC diagnosis. Associated clinicopathological data and lifestyle information of the ESCC group and the without ESCC group were collected, and a case-control study of risk factors was analyzed between the two groups. Results The majority (83.4%) of the cases with HNSCC esophageal cancers were male patients over 50 years. We established that 93.75% (30/32) of the ESCC occurred within six years after HNSCC diagnosis. HNSCC location, stage, and radiotherapy history had no significant association with the development of ESCC. High Ki67 labeling index (Ki67 LI) (>46) patients tended to be 3.1 times (95% CI = 1.3–7.6) more likely to develop ESCC compared to low Ki67 LI (≤45) patients (P < 0.05). Drinkers with alcohol flushing response were at a 3.3 times higher risk to have ESCC (95% CI = 1.0–10.4) than drinkers without flush response (P < 0.05). Conclusions HNSCC patients, especially drinkers with an alcohol flushing response, as well as those with high Ki67 LI of HNSCC tissue, were more likely to develop ESCC.

Validation of birth certificate and maternal recall of events in labor and delivery with medical records in the Iowa health in pregnancy study

BackgroundEpidemiological research of events related to labor and delivery frequently uses maternal interview or birth certificates as a primary method of data collection; however, the validity of these data are rarely confirmed. This study aimed to examine the validity of birth certificate data and maternal interview of maternal demographics and events related to labor and delivery with data abstracted from medical records in a US setting.MethodsBirth certificate and maternal recall data from the Iowa Health in Pregnancy Study (IHIPS), a population-based case-control study of risk factors for preterm and small-for-gestational age births, were linked to medical record data to assess the validity of events that occurred during labor and delivery along with reported maternal demographics. Sensitivity, specificity, positive and negative predictive values, and kappa scores were calculated.ResultsPostpartum maternal recall and birth certificate data were excellent for infant characteristics (birth weight, gestational age, infant sex) and variables related to labor and delivery (mode of delivery) when compared with medical records. Birth certificate data for labor induction had low sensitivity (46.3%) and positive predictive value (18.3%) compared to medical records. Compared to maternal interview, birth certificate data also had poor agreement for smoking and alcohol use during pregnancy. Agreement between all three methods of data collection was very low for pregnancy weight gain (kappa = 0.07-0.08).ConclusionsMaternal interview and birth certificate data can be a valid source for collecting data on infant characteristics and events that occurred during labor and delivery. However, caution should be used if solely using birth certificate data to gather data on maternal demographic and/or lifestyle factors.

Characterization of hepatocellular carcinoma in Mansoura university Hospitals: A case-control study of risk factors.

Characterization of hepatocellular carcinoma in Mansoura university Hospitals: A case-control study of risk factors.

Familial History of Autoimmune Disorders Among Patients With Pediatric Multiple Sclerosis.

Background and ObjectiveThe objective of this study was to determine whether family members of patients with pediatric multiple sclerosis (MS) have an increased prevalence of autoimmune conditions compared with controls.MethodsData collected during a pediatric MS case-control study of risk factors included information about various autoimmune diseases in family members. The frequency of these disorders was compared between cases and controls.ResultsThere was an increased rate of autoimmune diseases among family members of pediatric MS cases compared with controls with first-degree history of MS excluded (OR = 2.27, 95% CI 1.71–3.01, p < 0.001). There was an increased rate of MS among second-degree relatives of pediatric MS cases compared with controls (OR = 3.47, 95% CI 1.36–8.86, p = 0.009). The OR for MS was 2.64 when restricted to maternal relatives and 6.37 when restricted to paternal relatives.DiscussionThe increased rates of autoimmune disorders, including thyroid disorders and MS among families of patients with pediatric MS, suggest shared genetic factors among families with children diagnosed with pediatric MS.

Feline ureteral obstruction: a case-control study of risk factors (2016-2019).

Ureteral obstruction (UO) in cats causes acute kidney injury and typically requires surgical intervention. Information is required about potentially modifiable risk factors to inform prevention strategies. A case-control study was performed to assess risk factors associated with feline UO. Cases were defined as cats with either of the following: (1) ureteral obstruction (ureteroliths: 13/18; unknown: 5/18) confirmed with pyelography; or (2) a creatinine concentration >140 µmol/l with both UO (ureteroliths: 6/10; blood clots: 3/10; pyonephrosis: 1/10) and pyelectasia ⩾5 mm on abdominal ultra sonography. Controls were defined as cats without evidence of UO on history, physical examination and abdominal ultrasound. Age, sex, breed (domestic shorthair/longhair), diet (predominantly dry, mixed or predominantly moist food), housing (indoors or mixed) and plasma total calcium were evaluated for their association with UO using multivariable logistic regression. A receiver operator characteristic (ROC) curve was created to evaluate the predictive ability of the final model. In total, 168 cats (28 cases, 140 controls) were included. Age, sex, breed, housing and total calcium were not significantly associated with UO; however, diet was. Compared with cats eating a predominantly moist food diet, cats fed a predominantly dry food diet were 15.9 times more likely to develop a UO (95% confidence interval 2.9-295; P = 0.009). There was no difference in the association between diet and UO in cats fed a mixed diet vs cats fed a predominantly moist food diet (P = 0.25). The area under the ROC curve was 72%. Changes in diet formulation could provide a simple and economical method to reduce the risk of UO.

Thin endometrial lining during frozen embryo cycles: a case-control study of risk factors and natural history

Objective: To identify predictors of thin endometrial lining in the first frozen embryo transfer cycles and to characterize the natural history of this condition over subsequent cycles. Design: Retrospective case-control study Conclusions: This study shows that prognosis after a diagnosis of thin endometrial lining is favorable. Lower weight and thinner fresh cycle lining are predictors of thin endometrial lining in FET cycles. Most importantly, women with a diagnosis of thin endometrial lining have similar live birth rates as those with adequate endometrial lining, although their time to achieve live birth is slightly longer.