Risk Factors In Male Patients Research Articles

Gender-Specific Risk Factors for Asymmetric Bone Density in Adult Degenerative Lumbar Scoliosis: A Retrospective Cohort Analysis.

BACKGROUND This study aimed to evaluate the performance of Hounsfield Unit (HU) value on the vertebral bone mineral density associated with adult degenerative lumbar scoliosis (ADLS) and to compare the HU and coronal height changes of the lumbar spine on the concave and convex sides. The secondary aim was to investigate the risk factors for increased asymmetric ratio of HU (ARH) by concave-to-convex. MATERIAL AND METHODS A total of 74 patients aged ≥50 years were retrospectively reviewed. The height and the HU values of the region of interest were measured and compared. Multiple linear regression and gender-stratified analyses were performed to explore risk factors. Restricted cubic spline (RCS) was used to visually assess the dose-effect relationship between the Cobb angle and ARH. RESULTS The heights on the concave sides were significantly lower while HU values were significantly higher than that of the convex side. Cobb angle (95% CI: 0.001 to 0.009, P=0.034) was positively correlated with the increased ARH, while apex orientation to the right (95% CI: -0.152 to -0.013, P=0.022) was negatively associated. Gender-stratified analyses showed age and apex vertebrae location are 2 additional risk factors in male patients but not in female patients. Cobb angle was identified by RCS as a risk factor both in males and females and the inflection points were 15 and 17.5, respectively. CONCLUSIONS HU values on the concave side are significantly higher than on the convex side, showing the asymmetrical bone mass distribution of ADLS patients. Several gender-related risk factors for increased ARH have been identified.

Aneurysmal Subarachnoid Hemorrhage and Sex Differences: Analysis of Epidemiology, Outcomes, and Risk Factors.

The differences in outcomes after aneurysmal subarachnoid hemorrhage (aSAH) between the sexes have not been concretely determined. This study aimed to evaluate the differences in epidemiology, outcomes, and risk factors between male and female patients with aSAH. We performed a multicenter, retrospective study of patients with aSAH from 2017 to 2020. We investigated the epidemiological differences between the two sexes. Propensity score matching (PSM) was used to compare short-term outcomes between the sexes. Binary logarithmic regression was performed to investigate the odds ratio (OR) for dependent survival in patients of different sexes. A total of 5,407 consecutive patients with aSAH were included in this study, and the female-to-male ratio was 1.8:1. The peak incidence of aSAH occurred in the 6th and 7th decades in males and females, respectively. There were more female patients with internal carotid artery or posterior communicating artery aneurysms (53.2%), and there were more male patients with anterior cerebral artery or anterior communicating artery aneurysms (43.2%). The incidence of multiple aneurysms was greater in female patients (21.5% vs. 14.2%, P < 0.001). There was no significant difference in outcomes before and after PSM at discharge. The dependent survival risk was related only to the clinical condition on admission in women. In addition, age > 50years (OR 1.88, 95% confidence interval 1.17-3.02; P = 0.01) and hypertension (OR 1.81, 95% confidence interval 1.25-2.61; P = 0.002) were also risk factors for male patients. There were more female patients with aneurysms than male patients in this study. Most aneurysm locations were different between the two groups. There was no significant difference in discharge outcomes before and after PSM. The risk factors for dependent survival were different between female and male patients.

Sarcopenia defined with L3-SMI is an independent predictor of survival in male patients with ARLD in mainland China.

The burden of alcohol-related liver disease (ARLD) is increasing in China. Patients with ARLD are more likely to have comorbid sarcopenia, which may impair their survival. This study aimed to evaluate the relationship between the prognoses of patients with ARLD and sarcopenia, identified using the skeletal muscle index at the third lumbar vertebra level (L3-SMI). Hospitalized patients with ARLD were retrospectively enrolled between 2015 and 2018 and followed up for 24 months to evaluate their survival profiles. Cox proportional hazards regression models were used to estimate patient survival factors. A receiver operating characteristic curve was created to identify the cut-off point of the L3-SMI for predicting the prognoses of Chinese patients with ARLD. The study enrolled 168 male patients with ARLD who were followed-up for 24 months or until a study endpoint was met. The overall L3-SMI in patients with ARLD was 42.61 ± 9.15 cm2/m2, and 42.86% (72/168) of patients with ARLD were comorbid with sarcopenia. The overall survival in patients with ARLD was 77.38% at 24 months. The survival rate of patients with sarcopenia was lower than that of patients without sarcopenia (66.67% vs. 85.42%, p = 0.004). Multiple Cox regression analysis showed that sarcopenia, abstinence, and baseline creatinine level were independent prognostic factors of 24-month survival with hazard ratios (95% confidence intervals) of 2.022 (1.025-3.991), 0.275 (0.122-0.617), and 1.018 (1.008-1.027), respectively. The cut-off value of the L3-SMI for predicting 24-month survival was 40.0 cm2/m2 for male patients with ARLD. Sarcopenia is an independent mortality risk factor in male patients with ARLD in mainland China. Early diagnosis and intervention of sarcopenia are important for optimizing the management of patients with ARLD.

Refracture after plate removal of midshaft clavicle fractures after bone union—incidence, risk factors, management and outcomes

IntroductionThere is a great debate on the routine use of open reduction and internal fixation (ORIF) for midshaft clavicle fractures, and one concern is the adverse events after ORIF, such as implant removal after bone union. In this retrospective study, we assessed the incidence, risk factors, management and outcomes of refracture after plate removal of midshaft clavicle fractures after bone union.Materials and methodsThree hundred fifty-two patients diagnosed with acute midshaft clavicle fractures who had complete medical records from primary fractures to refracture were recruited. Details of imaging materials and clinical characteristics were carefully reviewed and analysed.ResultsThe incidence rate of refracture was 6.5% (23/352), and the average interval from implant removal to refracture was 25.6 days. Multivariate analysis showed that the risk factors were Robinson type-2B2 and fair/poor reduction. Females were 2.4 times more likely to have refracture, although it was not significant in multivariate analysis (p = 0.134). Postmenopausal females with a short interval (≤ 12 months) from primary surgery to implant removal had a significant risk for refracture. Tobacco use and alcohol use during bone healing were potential risk factors for male patients, although they were not significant in multivariate analysis. Ten patients received reoperation with or without bone graft, and they had a higher rate of bone union than 13 patients who refused reoperation.ConclusionThe incidence of refracture following implant removal after bone union is underestimated, and severe comminute fractures and unsatisfactory reduction during primary surgery are risk factors. Implant removal for postmenopausal female patients is not recommended due to a high rate of refracture.

THE HOUSEHOLD ECONOMIC BURDEN OF HEAD AND NECK CANCER PATIENTS IN PESHAWAR, PAKISTAN

The most prevalent cancer in the world is head and neck cancer. The age of the patients positively associates with the disease's incidence. About 85% of the male patients diagnosed with this condition are older than 45 years of age. The main risk factors for head and neck cancer include tobacco use, smoking, and alcohol consumption. These are especially significant risk factors for male patients with head and neck cancer. The objective of this study is to measure the economic burden of head and neck cancer disease in the male population. Households have a heavy financial burden because of head and neck cancer. To examine the impact of head and neck cancer on patients, we got the list of the patients from the territory care hospitals in Peshawar and interviewed 235 patients to estimate the health cost. The study's methodology is divided into two parts: empirical estimations and descriptive statistics. The Ordinary Least Square (OLS) estimate technique was employed in the study to identify the variables affecting the expense of head and neck cancer. According to the analysis, the stage of cancer and the length of the treatment is increasing the cost of head and neck cancer and the number of cancer patients visiting these hospitals from the KPK, Islamabad, etc. The majority of respondents reported significant intangible burdens, such as fear, pain, mental distress, and family management. Patients with head and neck cancer were more likely to face several psychological issues because of their health condition.

Ethnicity and risk factors among Indian coronary artery disease patients.

In this study, an attempt was made to investigate the distribution of coronary risk factors in male patients with coronary artery disease (CAD)(n=50 each) belonging to Jaat and Vaishya castes. A Significantly higher average height, waist and hip circumferences, glucose, and waist-height ratio were observed in Jaats compared to the Vaishyas (p=0.000). Mean BMI, total cholesterol (total-C) and non-high density lipoprotein cholesterol (HDL-C), and lean body mass index (LBMI) were significantly higher in Vaishyas against Jaats (p=0.00). A significantly higher percentage of type 2 diabetes(T2DM) (p=0.03) and isolated hypertriglyceridemia(p=0.01) was observed in Jaats against Vaishya men. Percentage of general obesity(p=0.01), high total-C, high low density lipoprotein cholesterol (LDL-C) (p=0.00), high total-C/HDL-C(p=0.04), combined positive family history of hypertension and type 2 diabetes, and general obesity, was significantly higher in Vaishya when compared to Jaat men. In univariate logistic regression analyses, a significant association of T2DM (p=0.039) and isolated hypertriglyceridemia (p=0.020) with Jaat ethnic group and general obesity, high totalC, high LDL-C, and high total-C/HDL-C with Vaishya ethnic group was observed. Results of the present study suggest that a population-specific than a global approach should be used in identifying high-risk groups and designing of interventions to reduce the complications and management of CAD.

Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study.

ObjectiveIn individuals with epiglottitis, chronic obstructive pulmonary disease (COPD) is a common comorbidity; however, the impact of COPD under such circumstances is not well documented. Therefore, we performed this population-based study to determine whether, in adults, COPD is a risk factor for epiglottitis.MethodsIn this retrospective matched-cohort study, data obtained from the Taiwan National Health Insurance Research Database were analyzed. We identified all patients newly diagnosed as having COPD in 2000–2011 and performed frequency matching and propensity-score matching for every patient with COPD individually to another patient without a COPD diagnosis. We used epiglottitis occurrence as the study endpoint, and we investigated the hazard ratio of epiglottitis by using the Cox proportional hazards model after adjustment for potential confounders.ResultsIn the frequency matching, the cumulative epiglottitis incidence was significantly higher (p = 0.005) in the COPD cohort. According to the adjusted Cox proportional hazard model, COPD exhibited a significant association with elevated epiglottitis incidence (adjusted hazard ratio: 1.76; 95% confidence interval: 1.15–2.70, p = 0.009). Similar trend was observed in the propensity-score matching analysis (adjusted hazard ratio: 1.50; 95% confidence interval: 0.99–2.29, p = 0.057). Our subgroup analysis revealed COPD to be an epiglottitis risk factor in male patients and those aged 40–64 years.ConclusionsThis is the first nationwide matched-cohort research to examine the association of COPD with epiglottitis. Our results revealed that COPD may be a potential risk factor for epiglottitis; thus, clinicians should be mindful of the potential increased risk of epiglottitis following COPD.

Ultrasonic Characteristics Improve Prediction of Central Lymph Node Metastasis in cN0 Unifocal Papillary Thyroid Cancer.

BackgroundPrediction of central lymph node metastasis (CLNM) is vital for clinical decision-making processes in clinically N0 (cN0) unifocal papillary thyroid carcinoma (PTC), but the sensitivity of preoperative detection of CLNM is limited. The aim of the present study was to determine whether there are ultrasonic (US) characteristics associated with CLNM.MethodsIn total, 1657 PTC patients (514 men and 1143 women) were enrolled in the present study between January 2018 and May 2021. The patients met the following inclusion criteria based on preoperative detection: suspected nodule confirmed as PTC by biopsy; the nodule was unifocal and less than 4 cm in diameter; no prior neck radiation exposure; no extrathyroidal extension; and no CLNM or distant metastases on imaging. All the enrolled patients underwent total thyroidectomy with prophylactic central lymph node dissection (CLND). A postoperative pathological diagnosis was made.ResultsCLNM was found in 58.4% of male patients and 36.9% of female patients. In univariate analysis, size, adjacent anterior capsule, distance to the lower pole and color Doppler flow imaging (CDFI) were considered risk factors for the male and female groups (p < 0.05). In multivariate analyses, size, adjacent anterior capsule, distance to the lower pole and CDFI were independent risk factors for male patients. For females, the independent risk factors included size, adjacent anterior capsule, distance to the lower pole and CDFI.ConclusionIn the present cohort, US imaging characteristics, including size, adjacent anterior capsule, distance to the lower pole and CDFI, were identified to be potentially beneficial in preoperative clinical decision-making processes for cN0 unifocal PTC patients.

Sex differences in antipsychotic-related triglyceride levels are associated with metabolic hormone differences in patients with severe mental disorders

BackgroundAdverse effects of antipsychotics (AP) contribute to cardiovascular disease (CVD) risk in patients with severe mental disorders (SMD). We investigated sex differences in AP-related CVD risk factors and the role of metabolic hormones. MethodsPatients with SMD (N = 1791) receiving AP with different CVD risk were recruited and grouped into olanzapine and/or clozapine (N = 532), other APs (N = 744) or no use of APs (N = 515). Associations between CVD risk factor (total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), body mass index (BMI), glucose, blood pressure), sex and AP groups were tested in multiple linear regression with interactions, controlling for diagnostic group, lifestyle factors, polypharmacy, age and ethnicity. Next, we tested associations between sex differences in AP-related CVD risk factors and metabolic regulatory hormones. ResultsAP groups and male sex were significantly associated with higher levels of LDL-C, TG and BMI, and lower levels of HDL-C. Significant interaction between AP groups and sex were found for TG (p = 0.017), with larger increase in males. Serum adiponectin, insulin, cortisol, leptin, testosterone, free thyroxine and thyroid-stimulating hormone (TSH) were associated with TG levels (all p ≤ 0.001), and a significant interaction with sex for insulin (p = 0.005), cortisol (p = 0.016), leptin (p < 0.001) and TSH (p = 0.001). ConclusionsWe found more severe AP-related CVD risk factors in male patients with SMD. The male-dependent increase in TG levels was associated with leptin, insulin, cortisol and TSH levels. Clinicians treating patients with SMD should be aware of increased vulnerability for AP-related lipid abnormalities in males.

Prevalence and risk factors of erectile dysfunction in patients with liver cirrhosis: a systematic review and meta-analysis.

Liver cirrhosis is associated with an increased risk of developing erectile dysfunction (ED). The aim of this systematic review and meta-analysis was to evaluate the prevalence of ED and its risk factors in male patients with liver cirrhosis. A systematic search of PubMed (Medline), EMBASE, OVID Medline, the Cochrane Library, and other databases was performed for this review. Two investigators reviewed the abstracts obtained from the search and selected manuscripts for full-text review. The event rates were calculated with random-effects model and quality effects model. Fourteen studies evaluating ED with the International Index of Erectile Function (IIEF) scores were selected. A total of 770 patients with liver cirrhosis were analyzed. The prevalence of ED in cirrhotic patients was 79% [decompensated: 88.4%, CI 35.95-70.84%, I2 heterogeneity 85%; compensated: 53.6%, CI 77.64-32%, I2 heterogeneity 80%]. Through a meta-regression analysis, we discovered that the presence of decompensation, use of beta-blocker and diuretics were related with ED. In addition, risk factors for ED included high body mass index [odds ratio (OR) 1.13, 95% CI 1.01-1.26], advanced Child-Pugh class (OR 2.29, 95% CI 1.12-4.72), MELD score (OR 1.19, 95% CI 1.05-1.35), diabetes (OR 3.44, 95% CI 1.38-8.57), and hypertension (OR 8.24, 95% CI 1.62-41.99). ED is relatively common in male patients with cirrhosis, and presence of risk factors increases the prevalence of ED. PROSPERO (International Prospective Register of Systematic Reviews), CRD42020220411.

Study on the relationship between non-alcoholic fatty liver disease and sarcopenia in type 2 diabetes mellitus

Objective: To explore the relationship between non-alcoholic fatty liver disease and sarcopenia in patients with type 2 diabetes mellitus. Methods: 792 cases with type 2 diabetes mellitus who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University from June 2013 to December 2015 were enrolled in this cross-sectional study. Liver ultrasound examination and dual-energy X-ray absorptiometry (DXA) were used to examine the body composition. Patients were grouped according to gender and whether or not they had combined NAFLD, and indicators such as age, duration of diabetes, body mass index (BMI), waist circumference, biochemical indicators, skeletal muscle mass index (SMI), prevalence of sarcopenia, and medication status were collected. An independent-sample t-test, two-sample Kolmogorov-Smirnov test or χ (2) test were performed on the data. Logistic regression model was used to analyze the correlation between NAFLD, sarcopenia and SMI in diabetic patients of different genders. Results: The average age of 792 cases were (64.54 ± 9.61) years, and there were 301 (38%) patients with NAFLD. The prevalence of sarcopenia in male and female NAFLD patients was significantly higher than non-NAFLD patients (male 20.2% and 9.9%, χ(2) = 9.67, P = 0.002; female 12.2% and 5.1%, χ(2) = 5.64, P = 0.018). Male SMI (30.92 ± 2.31 and 31.81 ± 2.17, P < 0.001) and female SMI (25.48 ± 2.14 and 26.34 ± 2.28, P < 0.001) in NAFLD patients were significantly lower than non-NAFLD patients. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for NAFLD in male patients with type 2 diabetes mellitus (OR = 2.006, 95% CI: 1.012 ~ 3.976, P = 0.046). There was no correlation between sarcopenia and NAFLD in female patients after adjusting for clinical risk factors. Conclusion: There is an independent correlation between sarcopenia and NAFLD in male patients with type 2 diabetes, and sarcopenia may be an independent risk factor for male patients with NAFLD.

Sex Differences in Coronary Arterial Calcification in Symptomatic Patients

Despite the increasing use of Coronary Artery Calcium (CAC) scoring for cardiovascular risk stratification in asymptomatic patients, the gender differences in CAC among symptomatic patients have not been well evaluated. We analyzed patients presenting to the emergency department (ED) with chest pain suggesting possible coronary artery disease (CAD) who received coronary computed tomography angiography (CCTA). Ordinal logistic regression was used to determine the odds ratio for the association of traditional cardiovascular risk factors and CAC. Patients with a CAC score ≥ 100 were followed for cardiovascular events or changes in medical management. Our cohort included 542 individuals (263 male, 279 female). Ordinal logistic regression model showed that among traditional cardiovascular risk factors, male sex had the highest odds ratio (OR) of 3.04 (p < 0.001, 95% CI [2.01, 4.59]) for the presence of CAC. Also, males had more diffuse distribution of coronary atherosclerosis (p=0.01). Subgroup analysis revealed that obesity was a bigger risk factor in male patients (OR 2.16), while smoking showed the greatest effect (OR 4.27) on CAC in women. Of patients who had CAC > 100 with an average follow-up of 346 days, there was an increase in both aspirin and statin use, yet significant sex differences were observed especially in patients with non-obstructive lesions on CCTA. Among male patients with non-obstructive lesions, 68.2% were on aspirin and 86.4% were on statin therapy after the CCTA compared to 27.3% and 45.5% respectively in their female counterparts. In conclusion, sex not only is the most powerful predictor for higher CAC among traditional cardiovascular risk factors in symptomatic patients but also influences the contribution of various traditional risk factors to elevated CAC. Furthermore, the discovery of CAD led to the initiation of medical therapy in male patients more frequently than in female patients, even after adjusting for the degree of luminal stenosis detected on coronary CT angiography.

Bone metabolic biomarkers and bone mineral density in male patients with early-stage Alzheimer's disease.

Alzheimer's disease (AD), osteoporosis, and osteopenia are the most common diseases in older individuals and share some similar pathophysiological processes of degeneration. The aim of this study is to investigate the association between bone metabolic biomarkers, bone mineral density (BMD), and early-stage AD in men. Forty-two male early-stage AD patients and 40 age-matched healthy older volunteers were enrolled. Serum calcium, osteocalcin, 1,25(OH)2D3, urine deoxypyridinoline/creatinine (DPD/Cr) ratio, urine calcium/creatinine (Ca/Cr) ratio, and BMD were measured. The correlation between early-stage AD and bone quality was evaluated. The urine DPD/Cr, urine Ca/Cr, and serum osteocalcin levels in the early-stage AD patients were significantly higher than those in the healthy control (HC) group (P < 0.05). The BMD data showed that the cortical and total BMD at 38% of the tibial length in the early-stage AD patients were lower than those in the HC group (P < 0.05). Furthermore, there was a negative correlation between the Montreal Cognitive Assessment score and serum osteocalcin or urine DPD/Cr levels. Abnormal urine DPD/Cr, urine Ca/Cr, and cortical BMD levels were independent risk factors in male patients with early-stage AD. Bone metabolic biomarkers and BMD are closely associated with early-stage AD in male patients. Our data indicated that the measurement of bone metabolic biomarkers and BMD may provide an alternative approach for screening AD patients at the early stage.

Erectile dysfunction and associated risk factors in male patients with ischemic stroke: A cross-sectional study.

Patients with ischemic stroke (IS) often suffered from the problem of erectile dysfunction (ED) and psychological disease. However, they are often ignored because these symptoms are more obvious in the convalescent stage of stroke, which affects the quality of sexual life of patients. This study aimed to investigate the incidence of ED, sexual quality of life, and mental state of patients after stroke, as well as analyze the relevant risk factors affecting their psychological status.A total of 361 IS patients were enrolled. The international erectile function index-5 scale was used to diagnose ED. Accordingly, the patients were divided into ED group and non-ED group. Magnetic resonance imaging was used to evaluate the brain lesions of patients. We assessed neurological deficits by the National Institutes of Health Stroke Scale score and patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) were used to evaluate the depression and anxiety. The differences between the ED group and the non-ED group clinical factors were compared.The response rate was 88.6% (n = 320), and more than two-thirds of patients reported ED (77.8%). Patients with ED had higher PHQ-9 (8.40 ± 4.18 vs 4.94 ± 3.73, P < .01) and GAD-7 (6.73 ± 3.56 vs 4.51 ± 3.35, P < .01) scores, were more likely to have the frontal lobe (75.1% vs 49.3%, P < .01) and lateral ventricle (69.8% vs 53.5%, P = .01) lesions, with hypertension (75.1% vs 46.5%, P < .01) and hyperlipidemia (48.2% vs 25.4%), and on antihypertensive (67.9% vs 35.25, P < .01) and hypolipidemic drug (43.4% vs 16.9%, P < .01). Multivariate logistic regression analysis showed that antihypertensive drug (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.02–6.10, P = .04), depression (OR: 1.18, 95% CI: 1.06–1.32, P < .01) and anxiety (OR: 1.13, 95% CI: 1.01–1.27, P = .04) might be the independent risk factors for ED group.ED is more common in male IS patients. Antihypertensive drug, depression and anxiety are the main factors affecting ED.

Sex-specific risk factors determine the survivorship of female and male patients after metal-on-metal hip resurfacing.

The need for revision surgery after hip resurfacing arthroplasty (HRA) is more prevalent for women than for men. However, there is a paucity of information to explain this observation. We aimed (1) to determine sex-specific risk factors leading to revision surgery; and (2) to correlate these risk factors to the dominant modes of failure of HRA. 1101 patients (1375 consecutive hips) including 292 women (355 hips) and 809 men (1020 hips) with a mean age of 51.3 years were included regardless of bone quality. The contact patch to rim distance was computed. A contact patch to rim (CPR) distance of ⩽7 mm, an aetiology of developmental dysplasia, a postoperative abduction-adduction arc of ⩾95°, and a metaphyseal stem left uncemented were risk factors associated with revision surgery for female patients, while a CPR distance of ⩽10 mm, a component size of ⩽46 mm, an age at surgery of ⩽55 years, and an early femoral preparation technique were risk factors for male patients. Hips with no risk factors from the female group had a survivorship of 98.7% at 15 years, matching or exceeding the results of all male subgroups. However the risk factors in the female group increased the risk of revision much more than in the male group. In the absence of risk factors, the survivorship of HRA in female patients is equal to that of males. Many female patients can safely benefit from HRA by excluding severe dysplasia and optimising surgical technique.

RISK FACTORS OF CARDIOVASCULAR DISEASE AMONG ST-ELEVATION MYOCARDIAL INFARCTION MALE PATIENTS IN MALAYSIA FROM 2006 TO 2013

Cardiovascular disease is the leading cause of death in Malaysia and globally. This study aimed to identify associated risk factors in cardiovascular disease among ST elevation myocardial infarction (STEMI) male patients and obtain a feasible model to describe the data. A total of 16,673 STEMI male patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate analysis was conducted. Significant variables from the univariate analysis were further analysed by a multivariate logistic analysis to identify the prognostic factors. The most prevalent risk factor for male patients was smoking (79.3%), followed by hypertension (54.9%) and diabetes mellitus (40.4%). At univariate level, this study is consistent with the findings from the Malaysian National Health and Morbidity Survey (NHMS) where smoking is a significant risk factor. After adjustment in multivariate logistic model, the risk factors for cardiovascular death among male patients are related to age, premorbid condition such as diabetes mellitus, hypertension, family history of CVD, Killip class, type of treatment such as percutaneous coronary intervention (PCI) and relevant comorbidity such as renal disease. Drastic efforts in the management of all risk factors in males is needed to improve adherence outcomes.

Smoking As a Risk Factor for Postcraniotomy 30-Day Mortality

There is limited information on the impact of smoking on postcraniotomy mortality. In this study we used the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to examine this issue. We identified 16,280 postcraniotomy patients in the ACS-NSQIP database. Indications for surgery were categorized by vascular, trauma, epilepsy, malignant tumor, and benign tumor. Univariate and multivariable logistic regression analyses were used to identify risk factors associated with mortality. In the ACS-NSQIP dataset, postcraniotomy mortality within 30 days of surgery was 5.03%. An area under the curve analysis indicated 30 pack-years as the optimal discriminating threshold for risk stratification in terms of 30-day postcraniotomy mortality. Using this threshold, multivariate analyses revealed 3 variables that were closely associated with 30-day post-craniotomy mortality: male gender (P= 0.002), indication for operation (P < 0.001), and a smoking history of ≥30 pack-years (P < 0.001). In subsequent stratified analyses, smoking-associated mortality risk was observed only in males (odds ratio of 2.33 comparing males with ≥30 and <30 pack-years of smoking history; 97.5% confidence interval 1.36-4.03). When the analysis was further stratified by surgical indications, the mortality association with smoking was found only in male patients who underwent craniotomy as treatment for neurovascular diseases (odds ratio 3.88, 97.5% confidence interval 1.39-11.65). Such an association was not seen in patients who underwent craniotomy for traumatic brain injury, malignant tumors, benign tumors, or epilepsy. This study identified ≥30 pack-years as a risk factor for male patients undergoing craniotomy as treatment for neurovascular diseases.

Impact of gender as a prognostic factor in HBV-related Hepatocellular Carcinoma: the survival strength of female patients in BCLC stage 0-B.

Background and Aims: Although previous studies suggested that female patients who underwent curative resection in early-stage hepatocellular carcinoma (HCC) had better survival rates than male patients, it is unclear whether females in different HCC stages actually have survival advantage. This study aimed to investigate whether gender differences in the Barcelona Clinic Liver Cancer (BCLC) classification system contributed to different survival outcomes in hepatitis B virus (HBV)-related HCC.Methods: A retrospective analysis was performed of 1,753 patients diagnosed with HBV-related HCC between January 2008 and June 2017 at the Beijing Ditan hospital. The BCLC stages were classified into BCLC stage 0-B and BCLC stage C-D groups. Factors determining overall survival (OS) and progression-free survival (PFS) were analyzed via univariate and multivariate analysis using the Kaplan-Meier method and Cox proportional-hazards regression models.Results: The cohort consisted of 1,202 BCLC stage 0-B and 551 BCLC stage C-D HBV-related HCC patients. Gender was identified to be an independent risk factor for OS (HR = 0.617; 95% CI, 0.426-0.895; p = 0.011) and PFS (HR = 0.728; 95% CI, 0.558-0.950; p = 0.019) in BCLC stage 0-B HBV-related HCC patients. With respect to OS and PFS, there were significant differences between female and male patients only in BCLC stage 0-B, but not in BCLC stage C-D. The OS and PFS in BCLC stage 0-B for female patients was significantly greater than that for male patients (p = 0.0103, p = 0.0112). Tumor multiplicity and size were independent risk factors for female patients in BCLC stage 0-B, whereas tumor multiplicity, tumor size, HBV-DNA, hemoglobin, total bilirubin, and alpha-fetoprotein levels were independent risk factors for male patients in BCLC stage 0-B.Conclusions: Different outcomes in OS or PFS with respect to gender only exist in BCLC stage 0-B HBV-related HCC patients. Female patients have a better outcome than male patients in BCLC stage 0-B.

Hypogonadism and associated risk factors in male patients with type 2 diabetes mellitus attending the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

Background: A high prevalence of hypogonadism among men with type 2 diabetes mellitus (T2DM) has been reported worldwide. This in turn creates a substantial public health burden in terms of inadequ...

Interleukin-6 and Tumor Growth Factor-β are Risk Factors for Idiopathic Epistaxis.

To evaluate the serum levels of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, tumor growth factor (TGF)-β, endothelin, and immunoglobulin (Ig)E in patients with idiopathic epistaxis, compared with healthy control individuals. Serum levels of IL-6, IL-8, TNF-α, TGF-β, endothelin, and IgE were evaluated in 110 patients with idiopathic epistaxis and 100 healthy controls using the enzyme-linked immunosorbent assay (ELISA) technique. Serum levels of IL-6 (P <.001) and TGF-β (P = .001) were significantly increased in patients with idiopathic epistaxis, compared with controls. TNF-α serum levels were significantly increased in male patients, compared with female patients (P = .053). We observed decreased antihistamine levels and increased expression of TGF-β (P = .02) and TNF-α (P = .02), respectively. IL-6 and TGF-β appear to participate in the pathogenesis of idiopathic epistaxis. TNF-α may be considered a risk factor for male patients in developing epistaxis. Antihistamines may inhibit angiogenesis by decreasing expression of TGF-β and increasing expression of TNF-α.