Higher Odds Ratio Values Research Articles

CORONET online risk assessment tool and Charlson comorbidity index in predicting fatalities in cancer patients with COVID-19

Purpose of the study. Сomparing and evaluating the prognostic potential of the CORONET online risk assessment tool and the Charlson Comorbidity Index in predicting mortality in cancer patients with COVID-19.Materials and methods. The results are drawn from the data of 168 case histories of cancer patients who were undergoing inpatient treatment for COVID-19 at the University Clinical Hospitals of Sechenov University between March 2020 and February 2022. The study was conducted as part of the program of the world-class research center “Digital Biodesign and Personalized Healthcare” of Sechenov University, with participation in the ESMO-CoCARE Registry project. Patients with a history of solid or hematologic malignancies were included in the study; their treatment period before the study was 5 years or less. The age ranged from 37 to 100 years, the median age was 69 years. The CORONET online risk assessment tool and the Charlson comorbidity index were used to objectify the severity of multimorbidity status and prognosis of fatal outcomes in cancer patients with COVID-19.Results. It was demonstrated that statistically significant effects on the prognosis of mortality in patients with cancer were: age, percentage of saturation on admission, treatment in intensive care units (ICU), National Early Warning Score 2 (NEWS2) distress syndrome severity scale score, computed tomography (CT) assessment of disease course severity, decreased blood albumin and platelet counts, and increased blood neutrophil counts in both categorical and immediate indicator value formats. In addition, it was determined that as the number of comorbidities increased, the probability of mortality increased significantly, odds ratio (OR) = 2.162 (CI 95 % 1.016–4.600; p = 0.045). The CORONET calculator score yields one of the highest OR values among all established statistically significant predictors,20.410 (CI 95 % 4.894–85.113; p < 0.001). For oncopathology in COVID-19 patients, the Charlson index score shows statistical significance as a predictor of mortality, OR =1.396 (CI 9 5 % 1.105–1.765; p = 0.005).Conclusion. The obtained advantages in using the CORONET online decision support tool over the Charlson comorbidity index in predicting mortality in cancer patients with COVID-19 are recognized as convincing.

Фактори ризику акушерських і перинатальних ускладнень після перенесеного захворювання COVID-19

Purpose - to identify risk factors for obstetric and perinatal complications after COVID-19. Materials and methods. 21 patients with severe course of COVID-19 (the Group 1) and 126 pregnant women with moderate severity of the disease - the Group 2 were comprehensively examined. The odds ratio (OR) was calculated with a 95% confidence interval (CI), significance level - p<0.05. Results. A high level of inflammation markers demonstrated the highest OR values: the 1st, the 3rd, the 5th place - increased procalcitonin (OR=48.4; 95% CI: 13.5-173.0), interleukin-6 (OR=39.1; 95% CI: 4.3-355.8), C-reactive protein (OR=8.5; 95% CI: 2.6-27.8), which in SARS-CoV-2 indicate a severe course of the disease. The indicator “difficulty of breathing” (OR=8.5; 95% CI: 2.6-27.8), which clearly reflects the severity of the disease in coronavirus disease, was in the 2nd place. The 4th in the indicator “increase in D-dimer to 10,000 ng/ml and above” (OR=13.2; 95% CI: 1.1-152.3), which indicates a high risk of thrombosis. The level of OR is also significantly high in the indicators “III-IV degree obesity” (OR=8.0; 95% CI: 2.3-28.0), “increased aspartate aminotransferase” (OR=6.9; 95% CI 2.4-20.1), “vitamin D deficiency” (OR=5.0; 95% CI: 1.4-17.7). Conclusions. The pathogenetic mechanisms of the development of perinatal complications in SARS-CoV-2 include: a high level of inflammatory processes mediated by the severity of the course of the disease, a violation of the immune system (hyperreaction - “cytokine storm”), prothrombotic changes in the hemostasis system, vitamin D deficiency, obesity and an increase in transaminases. The study was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was adopted by the Local Ethics Committee of the institution specified in the work. Informed consent from women was obtained for the study. No conflict of interests was declared by the authors.

PERINATAL ASPECTS OF IMMUNOLOGICAL DISTURBANCES IN PREGNANT WOMEN AFTER INFLUENZA TRANSFERRED IN THE EARLY TIME

The aim of the study was to study the characteristics of the immunity of pregnant women after suffering from influenza in the early stages of gestation and to assess the perinatal aspects of the revealed changes.Materials and research methods. We examined 120 women who had had flu in the first trimester of pregnancy. Two groups were identified: the main group - 68 patients with placental dysfunction, the comparison group - 52 pregnant women without signs of placental insufficiency. Natural killer cell cytotoxicity was assessed using flow cytometry. The level of cytokines in the peripheral blood has been studied by enzyme immunoassay. Statistical processing was carried out using the odds ratio (OR).Research results. For women with placental insufficiency after influenza transferred in early pregnancy, both an increase and a decrease in NK cytotoxicity are characteristic, which increases the risk of placental insufficiency several times (from 2.87 to 5.03 by OR for each indicator or their combination). The increase in indicators, which indicates a high pro-inflammatory potential and the damaging effect of NK cells, has a higher predictive value than a decrease. There is an imbalance in the cytokine profile, mainly in the pro-inflammatory direction. The highest OR values show an increase in TNF levels over 8 pg / ml (OR = 4.17) and an increase in the ratio of pro- and anti-inflammatory cytokines IL-1 / IL-10> 1.3 (OR = 3.44). Most often, placental dysfunction was associated with fetal distress (76.5%) and delayed growth (54.4%); there was a high incidence of asphyxia at birth (46.5%). In half (51.5%) of the children, various syndromes of dysadaptation were observed, most often neurological disorders (32.4%) and respiratory disorders (27.9%) were observed.Conclusions. Excessive inflammatory reaction, combined with an increase in NK-cytotoxicity, has a damaging effect on the endothelium, and a decrease in immune responses, causes a prolonged course of influenza and insufficient immune control of the trophoblast invasion processes. Immune regulation disorders were noted in pregnant women after the early influenza infection, which, when combined with possible hormonal dysfunctions, lead to the formation of placental dysfunction and a high frequency of perinatal complications.

Cesarean section in the perinatal center of iii level - indications and risk factors

In the structure of labour, the frequency of caesarean section should not exceed 15%. Therefore, it is extremely important to clearly define clinical situations in which caesarean section can be abandoned and, conversely, identify pregnant women in whom it is advisable to plan a caesarean section to prevent urgent situations.The aim of the study was to study the structure of indications for emergency abdominal delivery in a level III medical department - the urban perinatal center of Kharkov to optimize childbirth tactics.Material and methods. Clinical and statistical analysis of pregnancy and childbirth histories of 550 women in labour who gave birth in the Kharkov city perinatal center during 2018-2019 was performed. The structure of the indications and the caesarean section frequency was analysed depending on clinical and anamnestic data using descriptive statistics methods, χ2 criterion and calculation of the odds ratio (OR) using the PSSР statistical software package.Results. The highest OR values were in diabetes mellitus, burdened gynecological history and cardiovascular diseases (OR more than 5.0). Gestational hypertension, first labour, genital tract infections, nervous system diseases, preeclampsia, obesity of the digestive system diseases, large fetus and vegetative-vascular dystonia (OR from 2.108 to 4.113) had a lesser effect, myopia, first pregnancy, and late reproductive age (OR from 1.619 to 1.958).Conclusion. The most common causes of emergency caesarean section were weak labour (29.5%) and fetal distress (13.2%). In 20.9% of women - concomitant diseases of the mother and large fetus. Indications for emergency caesarean section most often occurred in women in labour with diabetes mellitus, weighed down by a gynecological history and with cardiovascular diseases

A novel urinary biomarker protein panel to identify children with ureteropelvic junction obstruction – A pilot study

Reliable urinary biomarker proteins would be invaluable in identifying children with ureteropelvic junction obstruction (UPJO) as the existing biomarker proteins are inconsistent in their predictive ability. Therefore, the aim of this study was to identify consistent and reliable urinary biomarker proteins in children with UPJO. To identify candidate biomarker proteins, total protein from age-restricted (<2 years) and sex-matched (males) control (n=22) and UPJO (n=21) urine samples was analyzed by mass spectrometry. Proteins that were preferentially identified in UPJO samples were selected (2-step process) and ranked according to their diagnostic odds ratio value. The top ten proteins with highest odds ratio values were selected and tested individually by ELISA. The total amount of each protein was normalized to urine creatinine and the median with interquartile ranges for control and UPJO samples was determined. Additionally, fold change (UPJO/Control) of medians of the final panel of 5 proteins was also determined. Finally, we calculated the average+3(SD) and average+4(SD) values of each of the 5 proteins in the control samples and used it as an arbitrary cutoff to classify individual control and UPJO samples. In the first step of our selection process, we identified 171 proteins in UPJO samples that were not detected in the majority of the control samples (16/22 samples, or 72.7%). Of the 171 proteins, only 50 proteins were detected in at least 11/21 (52.4%) of the UPJO samples and hence were selected in the second step. Subsequently, these 50 proteins were ranked according to the odds ratio value and the top 10 ranked proteins were validated by ELISA. Five of the 10 proteins - prostaglandin-reductase-1, ficolin-2, nicotinate-nucleotide pyrophosphorylase [carboxylating], immunoglobulin superfamily-containing leucine-rich-repeat-protein and vascular cell adhesion molecule-1 were present at higher levels in the UPJO samples (fold-change of the median protein concentrations ranging from 2.9 to 9.4) and emerged as a panel of biomarkers to identify obstructive uropathy. Finally, the order of prevalence of the 5 proteins in UPJO samples is PTGR1>FCN2>QPRT>ISLR>VCAM1. In summary, this unique screening strategy led to the identification of previously unknown biomarker proteins that when screened collectively, may reliably distinguish between obstructed vs. non-obstructed infants and may prove useful in identifying informative biomarker panels for biological samples from many diseases.

Influence of the Mediterranean Diet on 25-Hydroxyvitamin D Levels in Adults

The Mediterranean diet (MD) is a dietary pattern effective in terms of prevention of obesity-related diseases, and represents the gold standard in preventive medicine, due to the synergistic action of many nutrients with antioxidant and anti-inflammatory properties. In addition, excess body weight significantly increases the risk of hypovitaminosis D, a well-recognized common feature of individuals with obesity. It is well-known that there is a clear gender difference in the adherence to the MD. The aim of this study was to investigate the association between adherence to the MD and 25-hydroxyvitamin D (25OHD) levels in adults, according to gender. Study population consisted of 617 participants; 296 were males and 321 were females, matched by age and body mass index (BMI). A validated 14-item questionnaire PREDIMED (Prevención con dieta Mediterránea) was used for the assessment of adherence to the MD. The 25OHD levels were determined by a direct competitive chemiluminescence immunoassay. Females have a higher PREDIMED score than males (7.4 ± 2.8 vs. 6.7 ± 3.1 score, p = 0.001), and according to PREDIMED categories, a greater percentage of males had low adherence to the MD compared to their female counterparts (40.2% vs. 37.1%; χ2 = 8.94, p = 0.003). The 25OHD levels were higher in males than in females (18.3 ± 7.3 vs. 16.8 ± 7.8 ng/mL, p = 0.01), and a higher percentage of males had sufficient 25OHD levels (>30 ng/mL) than their female counterparts (10.5% vs. 3.4%, χ2 = 10.96, p < 0.001). Stratifying the sample population according to 25OHD categories, BMI decreased and PREDIMED score increased significantly along with the increased 25OHD levels, in both males and females, respectively (p < 0.001). Looking at the bivariate correlations, PREDIMED score was positively correlated with 25OHD levels after adjusting for age and BMI, in both males (r = 0.21, p < 0.001) and females (r = 0.30, p < 0.001). At the bivariate proportional odds ratio (OR) model, 25OHD levels presented the highest OR values in the category low adherence vs. high adherence to the MD, in both genders (OR 1.21 and OR 1.31, in males and females, respectively). Receiver operator characteristic (ROC) analysis was performed to determine the cut-off values of PREDIMED scores predictive of 25OHD levels: PREDIMED score >5 in males (p < 0.001) and >7 in females (p < 0.001) could serve as thresholds for 25OHD levels above the median. The results of our study highlighted a novel positive association between adherence to the MD and 25OHD levels in both genders. Although 25OHD levels were higher in males than females, 69.7% were deficient. To the best of our knowledge, this is the first study to show that high adherence to the MD is associated with low BMI and high 25OHD levels in both genders, probably through the anti-inflammatory and anti-oxidant effects that are synergistically exerted by either MD or vitamin D on body weight.

Performance of tumor testing for Lynch syndrome identification in patients with colorectal cancer: A retrospective single-center study.

To investigate the performance of tumor testing approaches in the identification of Lynch syndrome (LS) in a single-center cohort of people with colorectal cancer (CRC). A retrospective analysis of data stored in a dedicated database was carried out to identify patients with CRC suspected for LS who were referred to Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, between 1999 and 2014. The sensitivity and specificity of immunohistochemistry (IHC) for mismatch repair (MMR) proteins and microsatellite instability (MSI) analysis (alone or combined) were calculated with respect to the presence of causative MMR germline variants. A total of 683 patients with CRC suspected for LS were identified. IHC results of MMR protein analysis and MSI were assessed in 593 and 525 CRCs, respectively, while germline analysis was performed in 418 patients based on the IHC or MSI test result and/or clinical features. Univariate and multivariate analysis revealed a significant correlation of pathogenic MMR germline variants with all clinicopathologic features including Amsterdam criteria, presence of endometrial cancer, CRC site, age at onset, stage, and grade. The highest odds ratio values were observed for IHC and MSI (17.1 and 8.8, respectively). The receiver operating characteristic curve and area under the curve values demonstrated that IHC alone or combined with other clinicopathologic parameters was an excellent test for LS identification. This study confirms the effectiveness of tumor testing to identify LS among patients with CRC. Although IHC and MSI analysis were similarly effective, IHC could be a better strategy for LS identification as it is less expensive and more feasible.

Human leucocyte antigens class II allele and haplotype association with Type 1 Diabetes in Madeira Island (Portugal).

This study confirms for Madeira Island (Portugal) population the Type 1 Diabetes (T1D) susceptible and protective Human leucocyte antigens (HLA) markers previously reported in other populations and adds some local specificities. Among the strongest T1D HLA associations, stands out, as susceptible, the alleles DRB1*04:05 (OR=7.3), DQB1*03:02 (OR=6.1) and DQA1*03:03 (OR=4.5), as well as the haplotypes DRB1*04:05-DQA1*03:03-DQB1*03:02 (OR=100.9) and DRB1*04:04-DQA1*03:01-DQB1*03:02 (OR=22.1), and DQB1*06:02 (OR=0.07) and DRB1*15:01-DQA1*01:02-DQB1*06:02 (OR=0.04) as protective. HLA-DQA1 positive for Arginine at position 52 (Arg52) (OR=15.2) and HLA-DQB1 negative for Aspartic acid at the position 57 (Asp57) (OR=9.0) alleles appear to be important genetic markers for T1D susceptibility, with higher odds ratio values than any single allele and than most of the haplotypes. Genotypes generated by the association of markers Arg52 DQA1 positive and Asp57 DQB1 negative increase T1D susceptibility much more than one would expected by a simple additive effect of those markers separately (OR=26.9). This study also confirms an increased risk for DRB1*04/DRB1*03 heterozygote genotypes (OR=16.8) and also a DRB1*04-DQA1*03:01-DQB1*03:02 haplotype susceptibility dependent on the DRB1*04 allele (DRB1*04:01, OR=7.9; DRB1*04:02, OR=3.2; DRB1*04:04, OR=22.1).

Relationship between blood glucose levels and cardiovascular risk in the Spanish Mediterranean population.

Diabetes is associated with an increased prevalence of cardiovascular disease. Impaired fasting glucose (IFG) is an intermediate clinical situation between normal glucose levels and type 2 diabetes. The aim of this study is to determine how fasting glucose concentrations affect different cardiovascular risk scales. A descriptive study was conducted with 59,041 Mediterranean Spanish workers. IFG was determined using the American Diabetes Association (ADA) and the World Health Organization (WHO) criteria. Different indicators of cardiovascular risk were analyzed: body mass index, waist circumference, waist-to-height ratio, blood pressure, lipid parameters, atherogenic indices, metabolic syndrome, and various scales of cardiovascular risk such as REGICOR, DORICA, SCORE, Heart Age, and Vascular Age. All cardiovascular scales showed statistically significant differences between the IFG group and the normal glucose group. In all cases, values were worse in the IFG group; furthermore, men exhibited more unfavorable levels of cardiovascular risk factors than women. Higher odds ratio values were present in employees with metabolic syndrome according to ATP III criteria (9.42, 95% CI: 8.56-10.37 using WHO criteria and 9.25, 95% CI: 8.67-9.87 using ADA criteria).Conclusions: IFG increases cardiovascular risk whether using classical scales (REGICOR, SCORE, and metabolic syndrome) or other less studied scales (atherogenic indices, Heart Age, and Vascular Age).

Modification of the association of bisphenol A with abnormal liver function by polymorphisms of oxidative stress-related genes

Some studies suggested oxidative stress as a possible mechanism for the relation between exposure to bisphenol A (BPA) and liver damage. Therefore, we evaluated modification of genetic polymorphisms of cyclooxygenase 2 (COX2 or PTGS2), epoxide hydrolase 1 (EPHX1), catalase (CAT), and superoxide dismutase 2 (SOD2 or MnSOD), which are oxidative stress-related genes, on the relation between exposure to BPA and liver function in the elderly. We assessed the association of visit-to-visit variations in BPA exposure with abnormal liver function by each genotype or haplotype after controlling for age, sex, BMI, alcohol consumption, exercise, urinary cotinine levels, and low density lipoprotein cholesterol using a GLIMMIX model. A significant association of BPA with abnormal liver function was observed only in participants with COX2 GG genotype at rs5277 (odds ratio (OR)=3.04 and p=0.0231), CAT genotype at rs769218 (OR=4.16 and p=0.0356), CAT CT genotype at rs769217 (OR=4.19 and p=0.0348), SOD2 TT genotype at rs4880 (OR=2.59 and p=0.0438), or SOD2 GG genotype at rs2758331 (OR=2.57 and p=0.0457). Moreover, we also found higher OR values in participants with a pair of G-G haplotypes for COX2 (OR=2.81 and p=0.0384), G-C-A haplotype for EPHX1 (OR=4.63 and p=0.0654), A-T haplotype for CAT (OR=4.48 and p=0.0245), or T-G-A haplotype for SOD2 (OR=2.91 and p=0.0491) compared with those with the other pair of haplotypes for each gene. Furthermore, the risk score composed of 4 risky pair of haplotypes showed interactive effect with BPA on abnormal liver function (p=0.0057). Our study results suggest that genetic polymorphisms of COX2, EPHX1, CAT, and SOD2 modify the association of BPA with liver function.

Associations of Physical Activity with Perception of Stress and Self-rated Health in Korean Female Students with Early Menarche

The purpose of this study was to investigate the association between regular Physical Activity (PA), perception of stress, and self-rated health in Korean female students with early menarche based on the 10th (2014) Korea Youth Risk Behavior Web-based Survey (KYRBS) data, targeting a total of 1,845 female students. In order to analyze the relationship between PA, perception of stress, and self-rated health, we performed complex sample design logistic regression to calculate Odds Ratio (OR) and Confidence Interval (CI) after adjusting for school grades, depression, academic achievement, suicidal ideation, current smoking, current alcohol consumption, and family socio-economic status. The results of this study were as follows. The female students who did not participate in regular physical activity showed higher OR values in the perception of stress and lower OR values in the self-rated health variable compared to participants in regular physical activity. These findings suggest that encouraging to participate in regular PA would be effective stress management and self-rated health improvement to female students with early menarche.

Methodological Approaches to Evaluate Teratogenic Risk Using Birth Defect Registries: Advantages and Disadvantages

BackgroundDifferent approaches have been used in case-control studies to estimate maternal exposure to medications and the risk of birth defects. However, the performance of these approaches and how they affect the odds ratio (OR) estimates have not been evaluated using birth-defect surveillance programmes. The aim of this study was to evaluate the scope and limitations of three case-control approaches to assess the teratogenic risk of birth defects in mothers exposed to antiepileptic medications, insulin, or acetaminophen.Methodology/Principal FindingsWe studied 110,814 non-malformed newborns and 58,514 live newborns with birth defects registered by the Latin American Collaborative Study of Congenital Anomalies (ECLAMC) between 1967 and 2008. Four controls were randomly selected for each case in the same hospital and period, and three different control groups were used: non-malformed newborns (HEALTHY), malformed newborns (SICK), and a subgroup of SICK, only-exposed cases (OECA). Associations were evaluated using OR and Pearson's chi-square (P<0.01). There were no concordance correlations between the HEALTHY and OECA designs, and the average OR differences ranged from 3.0 to 11.5 for the three evaluated medicines. The overestimations observed for HEALTHY design were increased as higher OR values were given, with a high and statistically significant correlation between the difference and the mean. On the contrary, the concordance correlations obtained between the SICK and OECA designs were quite good, with no significant differences in the average risks.ConclusionsThe HEALTHY design estimates the true population OR, but shows a high rate of false-positive results presumably caused by differential misclassification bias. This bias decreases with the increase of the proportion of exposed controls. SICK and OECA odds ratios cannot be considered a direct estimate of the true population OR except under certain conditions. However, the SICK and OECA designs could provide practical information to generate hypotheses about potential teratogens.

Preslaughter risk factors associated with mortality and bruising in rabbits

The aim of this study was to identify and quantify risk factors associated with the mortality and bruising rate prevalence in 975 commercial batches of growing rabbits delivered for slaughter. The effects of environmental temperature, batch size (number of rabbits delivered per batch), journey and lairage duration on dead on arrival (DOA) and bruising prevalence were investigated and expressed as an odds ratio (OR). This value is equivalent to the relative risk, assessing each specific factor relative to its reference category (OR=1). The overall mortality rate of 0.09% was affected by environmental temperature, batch size, journey and lairage duration. A significantly increased DOA risk was associated with very low (<7.3°C; OR=1.28) and very high (≥22.6°C; OR=1.85) environmental temperatures. In addition, a significantly higher odds ratio (OR=1.70) was observed in the largest batches (≥3681 rabbits). Both increasing journey and lairage duration dramatically increased the risk of death during the preslaughter period. Rabbits belonging to batches either transported or laired for a long time had a roughly threefold higher risk of death. The overall prevalence of bruise percentage was 2.13% and was affected by environmental temperature, batch size and journey duration. Environmental temperatures ranging from 7.3 to 12.4°C decreased the risk of bruising (OR=0.90), whereas temperatures from 17.5 to 22.6°C and higher than 22.6°C exhibited significantly higher OR values (1.22 and 1.34, respectively). Moreover OR values were higher for small (734 to 1716 rabbits; OR=1.21) and very small (<734 rabbits; OR=1.36) batches, but also for very large ones (≥3681; OR=1.10). As for journey time, transport duration from 308 to 411 min and longer than 411 min duration increased bruising risk (OR= 1.15 and 1.19, respectively), while this risk was slightly decreased (OR=0.96) for medium journey duration (205 to 308 min). In conclusion, even though average DOA and bruising rates were quite low compared with chickens and turkeys, further logistics and planning improvements should be made in batch harvesting to reduce transport and lairage duration as far as possible in conjunction with extremely low and high environmental temperatures.

Obstacle-negotiating gait and related physical measurement indicators for the community-dwelling elderly in Japan

The aim of this study is to assess obstacle-negotiating gait (ONG) and explore its related physical factors. Subjects comprised 571 community-dwelling persons (195 men and 376 women) age ≥65 years and without cognitive impairment. ONG, timed up and go (TUG), and stair-climbing were measured and their relations were assessed. Walking ability (usual walking speed = UWS and daily walking steps = DWS), balance deficiency, and musculoskeletal function (handgrip strength and bone health) were examined objectively to explore ONG related physical factors. Logistic regression and general linear model analysis were performed with adjustment for age and body mass index (BMI). Time of ONG was 7.72 s in men and 8.93 s in women. Logistic regression analysis showed that the fast tertiles of ONG corresponding to the fast levels of TUG and stair-climbing had the highest odds ratio values. General linear model analysis showed that ONG was significantly associated with UWS and balance deficiency (no) in men, and with UWS, handgrip strength, DWS and balance deficiency (no) in women. Overall, ONG was considerably associated with falls screening tools and its determinants were also the main causes of falls. Training in ONG could be an attractive strategy for the prevention of falls among the elderly.