Non-modifiable Risk Factors Research Articles

Dementia prevention: Raising awareness about dementia and risk reduction

Dementia prevention: Raising awareness about dementia and risk reduction We hear from Dr Anthony J. Levinson, who is part of an academic group developing evidence-based online resources to complement dementia prevention strategies and support care partners. The prevalence of dementia is increasing as our population ages. From a public health standpoint, we need to continue to try to prevent or delay conditions that lead to dementia while also striving to better support people living with dementia and their family/friend care partners. While age and other factors like genetics are important non-modifiable risk factors, there is increasing evidence that several modifiable risk factors account for up to 40% of dementias. While some factors – such as physical activity – may be familiar to some, other factors, such as hearing loss, blood pressure, or social activity, may be much less well-known to the public as risk factors for dementia. For individuals newly diagnosed with dementia or family/friends trying to support and care for their loved ones, they may have very little knowledge about the condition and what to expect. This is where access to easy-to-understand educational content about dementia can be beneficial.

Risk Factors that Impact Treatment with Oral Janus Kinase Inhibitors Among Adult Patients with Atopic Dermatitis: A Nationwide Registry Study.

The European Medicines Agency recently limited the use of oral Janus kinase inhibitors in certain patient populations, including those with atopic dermatitis. This cross-sectional study used the Danish national registers and Danish Skin Cohort to assess the prevalence of risk factors that potentially impact choice of treatment with oral Janus kinase inhibitors in adult patients with atopic dermatitis. From the Danish national registers and Danish Skin Cohort, 18,618 and 3,573 adults with atopic dermatitis, respectively, were identified. Half of the patients (49.5%) had, at some point, been registered to have at least 1 risk factor that could impact treatment with oral Janus kinase inhibitors. Non-modifiable risk factors recorded were cancer (5.6%), major adverse cardiovascular events (2.6%), venous thromboembolism (2.0%), smoking history (15.6%), and age ≥ 65 years (12.4%). Among patients ≥ 65 years of age, the mean (standard deviation) number of risk factors were 3 (1.4), and almost half of these patients had, at some point, been registered to have 1 or more non-modifiable risk factors in addition to their age. In conclusion, risk factors that may impact treatment with oral Janus kinase inhibitors were frequent in Danish adults with atopic dermatitis, especially among older individuals. Dermatologists need support and continuously updated long-term safety data when risk-evaluating patients with atopic dermatitis prior to initiation of advanced.

Aromatherapy: an alternative treatment for migraine headaches

Neurological disorders are recognized as one of the leading causes of death and disability worldwide. Migraines are a neurological disorder that is often accompanied by symptoms such as pain, light and sound sensitivity, nausea, vomiting, and changes in vision. There are many challenges to managing episodic and chronic migraines. There are several non-modifiable and modifiable risk factors associated with migraine onset. Pharmacological management has been shown to be effective. Research has also shown that aromatherapy can have a positive impact on preventing and managing migraine headaches. The purpose of this mini review is to provide current data on migraines and to offer options beyond prescribed pharmaceutical medication to alleviate symptoms of this disorder. It is important to offer alternative preventative solutions to manage migraine disorders.

Modifiability of surgical timing in postinjury multiple organ failure patients.

Postinjury multiple organ failure (MOF) is the leading cause of late trauma deaths, with primarily non-modifiable risk factors. Timing of surgery as a potentially modifiable risk factor is frequently proposed, but has not been quantified. We aimed to compare mortality, hospital length of stay (LOS), and ICU LOS between MOF patients who had surgery that preceded MOF with modifiable timings versus those with non-modifiable timings. Retrospective analysis of an ongoing 17-year prospective cohort study of ICU polytrauma patients at-risk of MOF. Among MOF patients (Denver score>3), we identified patients who had surgery that preceded MOF, determined whether the timing of these operation(s) were modifiable(M) or non-modifiable (non-M), and evaluated the change in physiological parameters as a result of surgery. Of 716 polytrauma patients at-risk of MOF, 205/716 (29%) developed MOF, and 161/205 (79%) had surgery during their ICU admission. Of the surgical MOF patients, 147/161 (91%) had one or more operation(s) that preceded MOF, and 65/161 (40%) of them had operation(s) with modifiable timings. There were no differences in age (mean (SD) 52 (19) vs 53 (21)years), injury severity score (median (IQR) 34 (26-41)vs34 (25-44)), admission physiological and resuscitation parameters, between M and non-M-patients. M patients had longer ICU LOS (median (IQR) 18 (12-28)versus 11 (8-16)days, p<0.0001) than non-M-patients, without difference in mortality (14%vs16%, p=0.7347), or hospital LOS (median (IQR) 32 (18-52)vs27 (17-47)days, p=0.3418). M-patients had less fluids and transfusions intraoperatively. Surgery did not compromise patient physiology. Operations preceding MOF are common in polytrauma and seem to be safe in maintaining physiology. The margin for improvementfrom optimizing surgical timing is modest, contrary to historical assumptions.

Pulmonary Function Trajectories Over 6 Years and Their Determinants in Type 2 Diabetes: The Fremantle Diabetes Study Phase II.

To assess whether there are clusters of people with type 2 diabetes with distinct temporal profiles of lung function changes and characteristics. Group-based trajectory modeling (GBTM) identified groups of participants with type 2 diabetes from the community-based observational Fremantle Diabetes Study Phase II (FDS2) who had at least two biennial measurements of forced expiratory volume in 1 s as a percentage of predicted (FEV1%pred) over 6 years. Independent associates of group membership were assessed using multinomial regression. Of 1,482 potential FDS2 participants, 1,074 (72.5%; mean age, 65.2 years; 45.5% female; median diabetes duration, 8.0 years) were included in the modeling. The best fitting GBTM model identified four groups categorized by FEV1%pred trajectory: high (19.5%; baseline FEV1%pred, 106.5 ± 9.5%; slope 0%/year), medium (47.7%; FEV1%pred, 87.3 ± 8.7%; slope, -0.32%/year), low (25.0%; baseline FEV1%pred, 68.9 ± 9.8%; slope, -0.72%/year), and very low (7.9%; baseline FEV1%pred, 48.8 ± 9.6%; slope, -0.68%/year). Compared with the high group, the other groups were characterized by nonmodifiable and modifiable risk factors associated with lung function decline in the general population (including ethnicity, marital status, smoking, obesity, coronary heart disease, and chronic respiratory disease). The main, diabetes-specific, significant predictor of group membership was a higher HbA1c in the very low group. There was a graded increase in mortality from 6.7% in the high group to 22.4% in the very low group. Measurement of lung function in type 2 diabetes could help optimize clinical management and improve prognosis, including addressing glycemic control in those with a very low FEV1%pred.

Establishing associated risk factors, including fungal and parasitic infections among Malaysians living with schizophrenia

The aetiology of schizophrenia is multifactorial, and the identification of its risk factors are scarce and highly variable. A cross-sectional study was conducted to investigate the risk factors associated with schizophrenia among Malaysian sub-population. A total of 120 individuals diagnosed with schizophrenia (SZ) and 180 non-schizophrenic (NS) individuals participated in a questionnaire-based survey. Data of complete questionnaire responses obtained from 91 SZ and 120 NS participants were used in statistical analyses. Stool samples were obtained from the participants and screened for gut parasites and fungi using conventional polymerase chain reaction (PCR). The median age were 46 years (interquartile range (IQR) 37 to 60 years) and 35 years (IQR 24 to 47.75 years) for SZ and NS respectively. Multivariable binary logistic regression showed that the factors associated with increased risk of SZ were age, sex, unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week. These factors, except sex, were positively associated with the severity of SZ. Breastfed at infancy as well as vitamin and supplement consumption showed a protective effect against SZ. After data clean-up, fungal or parasitic infections were found in 98% (39/42). of SZ participants and 6.1% (3/49) of NS participants. Our findings identified non-modifiable risk factors (age and sex) and modifiable lifestyle-related risk factors (unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week) associated with SZ and implicate the need for medical attention in preventing fungal and parasitic infections in SZ.

Economic evaluation of lifestyle interventions in infertility management: A systematic review.

Infertility, a global concern affecting both sexes, is influenced by modifiable and non-modifiable risk factors. While the literature predominantly underscores the clinical- and cost-effectiveness of lifestyle interventions in the realm of infertility treatment, a holistic compilation analysing the economic dimensions of such interventions is lacking. This systematic review aimed to fill this gap by evaluating the economic facets of lifestyle interventions in the management of infertility. An exhaustive search was conducted within the PubMed, Embase, and Scopus databases from their inception to February 2024. The aim was to find articles related to the economic aspects of lifestyle interventions in infertility management. These included clinical studies covering economic outcomes and economic evaluations. The Drummond Checklist was used to assess the quality of the included studies. From an initial yield of 7555 articles, five studies were deemed eligible for inclusion, comprising three cost-effectiveness analyses, one prospective cohort study and a randomized controlled trial, all of which were undertaken in high-income countries (the Netherlands, Australia and Japan). These studies included patients receiving infertility treatments for conditions such as unexplained infertility, polycystic ovary syndrome, ovulation disorders, or mild male infertility, inclusive of individuals with and without obesity. The women who participated in these studies were up to 45 years of age. The findings suggested that integrating lifestyle intervention programmes tends to enhance pregnancy and live birth outcomes. These programmes encompass coaching, psychological or behavioural guidance, nutritional adjustments, exercise regimes, weight management, smoking cessation and mindfulness techniques. Moreover, these interventions are likely to be more cost-effective than standard infertility care. For couples embarking on infertility treatments, the integration of lifestyle interventions into their management strategy not only fosters clinical benefits but also represents a cost-effective alternative to conventional care, particularly within high-income settings.

Risk Factors for Death among Hospitalized and Nonhospitalized Patients due to COVID-19 in a Triple International Border Municipality.

The severity of COVID-19 in the general population ranges from minimally symptomatic disease to critical illness, which may require hospitalization and progress to death. A retrospective cohort study carried out with all positive cases of COVID-19 reported in the municipality of Foz do Iguaçu (PR) between the period from March 2020 to December 2021. Data were collected from Bank Notifies COVID-19 is the name of the information system that provides notifications by professionals of suspected and confirmed cases of the disease. Data were analyzed using descriptive statistical techniques and calculation of relative risk. 24,647 confirmed cases were identified in the study; among these, 22,211 (90.1%) were not hospitalized and 2436 (9.9%) were hospitalized. Among the 2436 patients hospitalized for COVID-19, 947 (38.9%) died and 1489 (61.1%) recovered. Among the 22,211 outpatients, 93 (0.4%) died and 22,118 (99.6%) recovered. An association between death and the following characteristics was identified among the cases that were hospitalized: male gender, all age groups over 40 years, indigenous race/color, hospital staylength of more than 10 days,hospitalization in a Unified Health System (SUS) bed and in an Intensive Care Unit (ICU). According to the clinical characteristics of symptoms and comorbidities, the following prevailed:ities dyspnea, intercostal retraction, cyanosis, hypertension, diabetes, obesity, cardiovascular disease, smoking, lung disease, kidneydisease, neurological disease, neoplasia, and immunodeficiency. Among the cases that were not hospitalized, death was associated with: malegender, all age groups over 50 years, dyspnea, cyanosis, hypertension, diabetes, obesity, cardiovascular disease, kidney disease, neurological disease, neoplasia, and liver disease. Older adults, male, and Caucasian people are commonly affected by COVID-19 and can evolve with aggravation when they have modifiable risk factors such as obesity and smoking, as well as nonmodifiable risk factors such as: cardiovascular disease, neurological disease, renal, hypertension, diabetes, and immunosuppression.

Pattern and trend of cancer in Saurashtra region in Gujarat state of India, a hospital-based study.

Cancer is growing concern for every country. Reliable data is a source to define the magnitude of the problem, which then helps to plan for necessary action. This epidemiological study involves the collection and analysis of hospital registry data to assess the quantum of the problem of cancer over a five-year period from 2012-16 and to plan priority action. Hospital-based data for five years from 2012-2016 was retrieved from the department of radiotherapy at M. P. Shah Government Medical College, Jamnagar, Gujarat, India, and analysed to define the magnitude of the problem. All data was studied using Microsoft Excel 2016. A total of 7355 patients were registered between 2012 and 2016, out of which 62 percent were male. Cancers of the cervix and uterus were discernibly less common in the Saurashtra region and accounted for only 12.37% of all cancers in females. Lung cancer was the leading cancer as a single site in males (24.13% of all cancers in males) and breast cancer in females (37.36% of all cancers in females). Head and neck cancer, all sites clubbed, was most common in males (42%). Jamnagar taluka represented around 50% of all cases at the study center. Tobacco-related cancers were most common in the male population, and stringent implementation of a national tobacco control program is the most appropriate measure to curtail incidences and hence mortality in this male population. Non-modifiable risk factors like gender-related cancer were more common in the female population, and resource-appropriate screening is a suitable option for these diseases. A population-based cancer registry is required to further define the pattern pertinently, or an epidemiological study is required to find causes of the noticeably lower incidence of cancer of the cervix,.

Assessment of the Relationship between High Blood Pressure and the Risk of Prostate Cancer among Patients in South-West, Nigeria

Abstract Introduction: Prostate cancer is the sixth leading cause of death worldwide. Nonmodifiable and modifiable lifestyle risk factors have been implicated and associated to its development and progression. There is a need to assess and establish the relationship between blood pressure (BP) and the risk of prostate cancer. Materials and Methods: This was a multicenter, prospective cross-sectional study of 400 patients at four tertiary hospitals in South-West, Nigeria. Participants were recruited into four arms, namely freshly diagnosed prostate cancer, hypertensive, combined hypertensive with prostate cancer, and control. Anthropometric measurements, BP, and family history were extracted from the case files. Biochemical analyses of venous samples were performed. One-way analysis of variance followed by post hoc Duncan test was conducted to determine the difference in the mean BP levels among the four arms. Results: High-density lipoprotein cholesterol in hypertensive patients was significantly lower (P ≤ 0.035) when compared with the other arms. Plasma total cholesterol (P &lt; 0.074), low-density lipoprotein cholesterol (P &lt; 0.029), and the mean C-reactive protein (P &lt; 0.017) were significantly high in the hypertensive with prostate cancer group when compared with the other arms. The mean plasma testosterone concentration (P &lt; 0.041) and the plasma calcium levels (P &lt; 0.055) were significantly higher in the control group compared with other arms. Conclusion: Virtually, the same parameters were altered in hypertensive, prostate, and hypertensive prostate cancer patients, showing an association between hypertension and prostate cancer, which can be concluded that hypertension may be a predisposing factor to the development of prostate cancer.

КЛИНИЧЕСКИЕ ОСОБЕННОСТИ ОСТРОЙ ЦИТОМЕГАЛОВИРУСНОЙ ИНФЕКЦИИ, СОПРОВОЖДАЮЩЕЙСЯ ТРОМБОТИЧЕСКИМИ ОСЛОЖНЕНИЯМИ, У ИММУНОКОМПЕТЕНТНЫХ ПАЦИЕНТОВ

Objective of the study. To identify and analyse clinical and laboratory features in immunocompetent patients with thrombotic complications in acute cytomegalovirus infection. Development of the algorithm of prognosis and early diagnosis of thrombotic complications in order to reduce the risk of severe course of the disease and lethal outcome. Materials and Methods. The study included 100 immunocompetent adult patients undergoing inpatient observation and treatment with laboratory-proven acute cytomegalovirus infection. All patients had a detailed clinical and epidemiological history for the possible presence of modifiable and/or non-modifiable prothrombotic risk factors; a multifaceted laboratory and instrumental examination was performed. Results. Out of one hundred patients with acute cytomegalovirus infection selected in the study, thrombotic diseases were observed in 7% of cases (in 7 patients). The mean age of the patients was 41 (38; 42) years. Patients were hospitalised on average on 12 (10; 14) days from the onset of the disease. The main complaints on admission were: prolonged fever up to 38°C and marked general weakness. The patients had elevated ALT and AST in 88% and 80% of cases, respectively. The presence of reactive lymphocytes was registered in 57% of cases. Enlargement of liver and spleen was observed in 67% and 70% of cases, respectively. Compared to patients with uncomplicated course of acute cytomegalovirus infection, statistically significant laboratory differences were observed in SRB (p&lt;0.001) and D-dimers (p&lt;0.05) in patients who had thrombotic complications. All patients who had genetic material (DNA) to CMV in the blood had positive tests for rr65 antigenemia. The polymorphism of factor V gene G1691A (FVLeiden) was detected in only one patient, who was a carrier of heterozygous GA allele. Conclusion. Acute cytomegalovirus infection in immunocompetent patients includes a symptom complex consisting of a typical clinical picture (prolonged febrile intoxication, hepatosplenomegaly, elevated hepatic transaminases, CRP and D-dimer levels) and obligatory laboratory detection of the virus (positive PCR and/or Ag pp65 tests for CMV). Cytomegalovirus is an independent and reliable prothrombotic risk factor, with thrombotic complications occurring in 7% of cases. Patients with risk factors for thrombotic complications with verified acute cytomegalovirus infection are recommended to be prescribed anticoagulant therapy at prophylactic doses. Also, patients with a proven case of thrombotic process on the background of acute cytomegalovirus infection are recommended a course of etiotropic antiviral therapy.

Факторы риска ишемической болезни сердца и их профилактика

Abstract. This research presents the results of systematizing knowledge on risk factors for coronary heart disease, classifying them and analyzing possible ways of prevention. The research shows that risk factors are not only a medical, but also a social issue, since the society, social conditions, and government policy are an integral part of the life of every individual. The relevance of this research is justified by the high proportion of cardiovascular diseases, among which coronary heart disease predominates. The incidence of coronary heart disease is inextricably linked with lifestyle, so its modification is the first major issue that requires modern solutions. Systematization of the available scientific data on risk factors for coronary heart disease will help doctors, including primary care, to actively identify and systematically influence risk factors for coronary heart disease, using an individual approach to each patient. Classification into modifiable, non-modifiable and social risk factors creates a clear understanding of the existing risk factors. That gives an idea of those risk factors that can be influenced and should be taken into account when stratifying the risk of cardiovascular pathology and selecting relevant modern therapy for a particular patient.

Endovascular complications: Antiplatelet management for flow diversion

Up to 3−5% of the general population is affected by cerebral aneurysms that are associated with both modifiable as well as non-modifiable risk factors ranging from familial to acquired neurovascular conditions. The initial treatment option was aneurysm clipping and evolved to including primary or adjuvant endovascular treatment. Aneurysm re-rupture, although rare, can have devastating consequences such as intracranial bleeding and carotidcavernous fistula. Emergent surgery in view of delayed aneurysm rupture in patients maintained on dual antiplatelet therapy presents with the need to carefully assess the procedure-related risk factors and evaluate the patients’ platelet function. With the advent of novel technology, flow diverters came into play. These devices utilize the deployment of metallic stents into the parent artery that serves the diversion of blood flow away from the pouching aneurysm. Despite their efficacy, flow diverter insertion and catheter manipulation come with a risk of developing ischemia and stroke, hemorrhage and aneurysm re-rupture, in-stent thrombosis and stenosis, and aneurysmal occlusion amongst other complications. The prospect of thromboembolic events necessitates the use of aggressive antiplatelet regimen with the dual antiplatelet regimen utilizing clopidogrel and aspirin used most frequently. Prasugrel and Ticagrelor have been shown to be superior to Clopidogrel in terms of thromboembolic consequences in cardiovascular literature. Given their potential benefit over the current standard of treatment in this patient population, more extensive randomized-controlled studies are warranted for the evaluation of the efficacy and non-inferiority of Prasugrel and Aspirin or Ticagrelor and Aspirin to Clopidogrel and Aspirin.

Identification of Hub Genes and Pathways of Middle Cerebral Artery Occlusion in Aged Rats Using the Gene Expression Omnibus Database.

Stroke remained the leading cause of disability in the world, and the most important non-modifiable risk factor was age. The treatment of stroke for elder patients faced multiple difficulties due to its complicated pathogenesis and mechanism. Therefore, we aimed to identify the potential differentially expressed genes (DEGs) and singnalling pathways for aged people of stroke. To compare the DEGs in the aged rats with or without middle cerebral artery occlusion (MCAO) and to analyse the important genes and the key signaling pathways involved in the development of cerebral ischaemia in aged rats. The Gene Expression Omnibus (GEO) analysis tool was used to analyse the DEGs in the GSE166162 dataset of aged MCAO rats compared with aged sham rats. Differential expression analysis was performed in aged MCAO rats and sham rats using limma. In addition, the 74 DEGs (such as Fam111a, Lcn2, Spp1, Lgals3 and Gpnmb were up-regulated; Egr2, Nr4a3, Arc, Klf4 and Nr4a1 were down-regulated) and potential compounds corresponding to the top 20 core genes in the Protein-Protein Interaction (PPI) network was constructed using the STRING database (version 12.0). Among these 30 compounds, resveratrol, cannabidiol, honokiol, fucoxanthin, oleandrin and tyrosol were significantly enriched. These DEGs were subjected to Gene Ontology (GO) function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis to determine the most significantly enriched pathway in aged MCAO rats. Moreover, innate immune response, the complement and coagulation cascades signaling pathway, the IL-17 and other signaling pathways were significantly correlated with the aged MCAO rats. Our study indicates that multiple genes and pathological processes involved in the aged people of stroke. The immune response might be the key pathway in the intervention of cerebral infarction in aged people.

Cardiovascular risk screening: a 10-year prediction cross-sectional study in a Nigerian agrarian community.

cardiovascular disease (CVD) is a major public health issue with a high global death rate and a significant death contribution from low-and middle-income countries. Modifiable and non-modifiable risk factors assessment and screening are important in their effective prevention and control. This study was designed to screen and assess cardiovascular risk factors in an agrarian community in Nigeria and to predict their 10-year CVD risk. this was a cross-sectional study carried out in the Umueri community in Anambra State, Nigeria. Each participant responded to an epidemiologic survey using the World Health Organization (WHO) cardiovascular risk factors assessment tool with point-of-care screening procedures. The risk assessment for 10-year CV risk was conducted using region-specific WHO/ISH charts. Patients´ characteristics were analyzed and presented in frequencies and percentages. the mean age, systolic blood pressure, fasting plasma glucose, and total cholesterol of the study population were 54 years ± 1.27, 132 mmHg ± 2.088, 130 mg/dl ± 4.608, and 215 mg/dl ± 10.355 respectively. However, 98 (48.8%) have never had their blood pressure checked. About a quarter of the population had a high predicted risk of developing CVD within 10 years. most of the assessed cardiovascular risk factors in the community are on average above the normal ranges and their probability risk of developing CVD within the next 10 years is high.

1048 Population attributable risk proportion of modifiable and non-modifiable risk factors for stillbirth

1048 Population attributable risk proportion of modifiable and non-modifiable risk factors for stillbirth

An Interesting Case of a Patient with Prothrombin Gene (G20210) Mutation Developing a Thromboembolic Stroke

Introduction: Stroke is frequently diagnosed in the Emergency Department in older adults. Signs and symptoms are wellknown within the patient population, leading to established stroke workups in the hospital setting. When a younger adult presents with a stroke, an extensive workup is warranted for non-modifiable risk factors including hypercoagulability states, malignancy, and medication. Case Report: We present a case of a 51-year-old male with an extensive past medical history including ischemic strokes, left ventricular thrombus, and myocardial infarction, who presented with a stroke. After an extensive workup, he was diagnosed with Prothrombin gene (G20210A) mutation. Discussion: Prothrombin gene (G20210A) mutation is the second most common inherited thrombocytopenia and is highly associated with venous clots. However, extremely rare cases have occurred involving arterial clots, specifically in the brain. Conclusion: This case highlights the wide range of etiology for stroke and that extensive workup, particularly in patients under the age of 65, is critical to preventing future events.

History and physycal examination

The most effective method for diagnosing food allergy is the clinical history, which includes anamnesis and physical examination. The anamnesis must include a directed and detailed questioning, and together with the physical examination, it will provide the necessary data to guide the diagnosis and suggest whether the pathophysiology is mediated or not by IgE, which is relevant for the selection and interpretation of the tests. specific and establish the accurate diagnosis, in addition to evaluating the possibility of distinguishing between the different differential diagnoses. It is important to assess the clinical history, because no in vivo or in vitro test is relevant if it is not confirmed with it. Even if there is a strong history of food allergy detected in the history, positive tests can confirm the diagnosis without the need for oral challenge, thus avoiding the risk and cost of performing it. The expression of food allergy is influenced by non-modifiable risk factors that include sex, race and genetics (familial), and modifiable factors: atopic dermatitis, vitamin D deficiency, diet high in polyunsaturated fats and deficient in antioxidants, consumption of antacid drugs, obesity, increased hygiene, influence of the microbiota, time and route of food exposure (increased risk by delaying oral ingestion of allergens and concomitant environmental exposure of the same that leads to sensitization and allergy).

MODIFIABLE RISK FACTORS FOR COLORECTAL CANCER DEVELOPMENT:&#x0D; A LITERATURE REVIEW

Relevance: Colorectal cancer (CRC) is one of the most commonly diagnosed types of cancer worldwide. CRC incidence has increased in Kazakhstan, as in many other countries in the past decade. Therefore, it is important to identify risk factors contributing to this pathological process&#x0D; to develop primary prevention programs at regional and national levels.&#x0D; The study aimed to investigate modifiable risk factors for the development of colorectal cancer.&#x0D; Methods: A systematic search was conducted in electronic databases, including PubMed, Cochrane Library, eLibrary, CyberLeninka, and&#x0D; Google Scholar. The study included reports of randomized and cohort studies conducted on large populations, meta-analyses, systematic reviews,&#x0D; and original full-text articles in English and Russian, available in open access and containing statistically validated conclusions. Exclusion criteria&#x0D; encompassed brief reports, newspaper articles, and personal communications. The search depth covered ten years (2012-2022).&#x0D; Results: Published data reflect the significant influence on the development of colorectal cancer (CRC) of modifiable risk factors such as&#x0D; dietary habits, smoking, alcohol consumption, obesity, and physical inactivity.&#x0D; Conclusion: CRC is a polyetiological disease that arises under the influence of both internal and external factors. However, only 25-30% of&#x0D; CRC cases are associated with non-modifiable risk factors, such as genetic factors, personal history of polyps, and inflammatory bowel diseases.&#x0D; 70-75% of CRC cases occur sporadically and are linked to modifiable risk factors, including smoking, alcohol consumption, unhealthy diet, sedentary lifestyle, lack of physical activity, and obesity

Lowering Cranioplasty Infection Incidence with Novel Bone Flap Storage Protocol: A Retrospective Cohort Study

IntroductionAfter craniectomy, autologous bone flaps may be stored using wet or dry cryopreservation. After brain edema subsides, they are replaced during an operation termed “cranioplasty.” Cranioplasty is associated with 15% infection incidence. MethodsWe conducted a retrospective comparison of infection outcomes between “wet” and “dry” cryopreservation of cranioplasty bone flaps. Historically, bone flaps were stored utilizing “wet” cryopreservation – bone flap storage in 1 L of Lactated Ringer’s solution containing 80mg gentamicin and 2g nafcillin in a sterile plastic container secured in an unsterile plastic bag. Our newer dry cryopreservation protocol involved storage in gauze soaked in 80mg gentamicin and 2g nafcillin within a 3-layer sterile bag system. Results119 autologous bone flaps were included with median follow-up of 3.9 months from cranioplasty. Overall, 10.9% became infected requiring subsequent surgery. 18.4% of 49 bone flaps stored using wet cryopreservation became infected compared to only 5.7% of 70 dry cryopreservation bone flaps (p 0.038; Relative risk 0.311; Absolute risk reduction 12.7%). Tobacco use (p 0.076; RR 3.17) was not associated with increased infection risk. Infection incidence was similar for traumatic craniectomy indications compared to the other indications (12.0% trauma versus 10.1% other; p 0.750). On average, infected cranioplasty patients spent 8.5 more days hospitalized and faced increased risk of additional complications. ConclusionDry cryopreservation significantly decreases infection after cranioplasty when compared with wet cryopreservation, which mitigates additional morbidity, mortality, and costs attributable to cranioplasty infection. Other nonmodifiable risk factors for cranioplasty infection were identified.