Significant Higher Occurrence Research Articles

Peripheral location of lung cancer is associated with higher local disease recurrence.

Our goal was to evaluate the association between the distance of the tumour to the visceral pleura and the rate of local recurrence in patients surgically treated for stage pI lung cancer. We conducted a single-centre retrospective review of 578 consecutive patients with clinical stage IA lung cancer who underwent a lobectomy or segmentectomy from January 2010 to December 2019. We excluded 107 patients with positive margins, previous lung cancer, neoadjuvant treatment and pathological stage II or higher status or for whom preoperative computed tomography (CT) scans were not available at the time of the study. The distance between the tumour and the closest visceral pleura area (fissure/mediastinum/lateral) was assessed by 2 independent investigators who used preoperative CT scans and multiplanar 3-dimensional reconstructions. An area under the receiver operating characteristic curve analysis was performed to determine the best threshold for the tumour/pleura distance. Then multivariable survival analyses were used to assess the relationship between local recurrence and this threshold in relation to other variables. Local recurrence occurred in 27/471 patients (5.8%). A cut-off value of 5 mm between the tumour and the pleura was determined statistically. In the multivariable analysis, the local recurrence rate was significantly higher in patients with a tumour-to-pleura distance ≤5 mm compared to patients with a tumour-to-pleura distance >5 mm (8.5% vs 2.7%, hazard ratio 3.36, 95% confidence interval: 1.31-8.59, P = 0.012). Subgroup analyses of patients with pIA and tumour size ≤2 cm identified local recurrences in 4/78 patients treated with segmentectomy (5.1%), with a significantly higher occurrence with tumour-to-pleura distances ≤5 mm (11.4% vs 0%, P = 0.037), and in 16/292 patients treated with lobectomy (5.5%) without significant higher occurrence in tumour-to-pleura distances of ≤5 mm (7.7% vs 3.4%, P = 0.13). The peripheral location of a lung tumour is associated with a higher rate of local recurrence and should be taken into account during preoperative planning when considering segmental versus lobar resection.

O-078 Predictive factors of autologous Oocyte Post-warming Survival rate

Abstract Study question Are there any clinical or paraclinical predictive factors of Oocyte Post-warming Survival (OPS) rate? Summary answer Woman age, Body mass Index, estradiol level on triggering day and estradiol/oocyte ratio are critical predicting factors that should be considered before performing oocyte vitrification. What is known already Since the development and the validation of oocyte vitrification, we vitrify oocytes in different medical situations for patients who benefit ICSI. Although the OPS rate in our centre is satisfying, occasionally, it happens to be lower. OPS is dependent on quality of oocyte as demonstrated by the difference of OPS in oocyte donation/autologous cycles. The present study questions the existence of clinical and paraclinical factors predicting in OPS. In order to tackle this issue, we have assessed several parameters related to the woman and to her response to hormonal treatment known to influence oocyte quality in relation to OPS Study design, size, duration A retrospective observational study of 786 autologous oocyte vitrification cycles was performed from October 2011 to July 2018 in 5 situations: cycles where only a part of mature collected oocytes were vitrified [1] Partial oocyte vitrification program(n = 605), [2] Patients opposed to embryo cryopreservation(n = 2) and oocyte freeze-all cycles for the following reasons [3] Uncontrolled Ovarian hyperstimulation( = 89), [4] Unfavorable uterine environment/receptivity(n = 71) and [5] Absence of spermatozoa(n = 20). 1175 warming cycles were analyzed to identify predictive factors for OPS. Participants/materials, setting, methods Oocytes were vitrified/warmed using Kitazato media and system. The ratio of OPS survival was measured between the number of intact oocytes and the number of warmed oocytes. The factors assessed as potential predictors of OPS were: woman age, body mass Index (BMI), Estradiol level on triggering day (E2), E2/ number of recovered oocytes (EOR), number of recovered oocytes and maturity ratio (number of mature oocytes/number of recovered oocytes). Statistics were performed using SPSS software. Main results and the role of chance A total of 1175 studied warming cycles were performed and 5421 oocytes were warmed with a mean OPS rate of 84,6% (±22,6). OPS rates were comparable in all situations: [1] 3084/3688 (83,6%), [2] 6/6 (100%), [3] 931/1121 (83,1%), [4] 393/458 (85,8%), [5] 125/148 (84,5%). The mean woman age (33,2 years±4,9 vs 33,1 years ±4,3), mean woman BMI (23,1 kg/m2±3,9 vs 22,9 kg/m2±4,2), mean E2 (2587,7pg/ml±1140,5 vs 2513,2pg/ml±1098,7), mean EOR (207,5pg/ml±119,4 vs 196,0pg/ml ±119,4), mean number of total recovered oocytes (15,0±6,8 vs 14,7±6,8), mean maturity ratio (85,4%±13,7 vs 86,0%±14,2) showed no statistical difference in women with reduced OPS (≤85%) as compared to women with standard OPS (>85%). Subgroups analyses revealed significant higher occurrence of reduced OPS in advanced age women (>40years) (OR = 2,4; [95%CI:1,3-4,4] p < 0,05) as compared to women of other age categories: < 30years (OR = 0,5; [95%CI:0,2-0,9]), 30-35years (OR = 0,4; [95%CI:0,2-0,7]), 36-40years (OR = 0,2; [95%CI: 0,3-0,5]). The combination of advanced age with abnormal BMI ( < 18,5 or > 24,9kg/m2: OR = 7,3[95%CI:1,6-34,0] p < 0,01), or elevated E2 (>3000pg/ml: OR = 3,3[95%CI:1,0-11,0] p < 0,05) or atypical EOR ( < 140 or > 250pg/ml: OR = 3,7[1,1-12,2] p < 0,05) amplified the risk of reduced OPS. Women with abnormal BMI combined with elevated E2 (OR = 2,1[95%CI:1,1-3,9] p < 0,05) or atypical EOR (OR = 1,6[95%CI:1,0-2.6] p < 0,05) were also at higher risk of reduced OPS. Limitations, reasons for caution Oocyte vitrification is a manual technique that depends on the skill of the operator. Inter-operator variability was not taken into account in our statistical analyses neither were data regarding ovarian stimulation protocols nor were infertility etiologies. Wider implications of the findings This work enabled to identify patient or treatment related factors that highly influence the outcome of oocyte vitrification/warming cycles. Our findings will likely help refining criteria for the selection of candidate patients for oocyte vitrification or to cancel bad prognosis cycles. Trial registration number NA

Prevalence and risk factors for bone loss in Southern Chinese with rheumatic diseases

BackgroudThis study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients.MethodA cross-sectional study recruits 1398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression.Results(1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of ‘score below the expected range for age’, osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors.ConclusionYoung patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.

ISAC multiplex testing – results of examination in 100 patients suffering from atopic dermatitis

ABSTRACT To find the molecular components with the highest underlying probability of sensitization in patients suffering from atopic dermatitis and in subgroup of patients with allergic rhinitis, asthma bronchiale and to determine whether there is some difference of sensitization in mild, moderate and severe form of AD, in patients suffering from asthma bronchiale and allergic rhinitis. The complete dermatological and allergological examination including the examination of the sensitization to molecular allergens with Multiplex ISAC testing was performed. Altogether 100 atopic dermatitis patients were examined – 48 men, 52 women, the average age 40.9 years; the sensitization to molecular components was confirmed in 93% of patients. The highest observed sensitization rate was 61.0% to grass specific molecule Phl p 1, the second most frequent sensitization was 57.0% to Betulaceae-specific molecule Bet v 1. Frequently observed sensitizations were those to PR-10 proteins, NPC2 proteins family, Uteroglobin and Lipocalin. In severe form of atopic dermatitis sensitization to molecular components of NPC2 proteins family, Uteroglobin, Lipocalin and Aspergillus were recorded with a significant higher occurrence.

Folate System Gene Variant rs1801394 66A>G may have a Causal Role in Down Syndrome in the Eastern Indian Population.

Down syndrome (DS) is associated with trisomy of the 21st chromosome in more than 95% cases. The extra chromosome mostly derives due to abnormal chromosomal segregation, i.e. non-disjunction, during meiosis. Earlier reports showed that abnormal folate metabolism can lead to DNA hypomethylation and abnormal chromosomal segregation. We analyzed three functional folate gene variants, namely 5-methyltetrahydrofolate-homocysteine methyltransferase rs1805087, 5-methyltetrahydrofolate-homocysteine methyltransferase reductase rs1801394, and reduced folate carrier 1 rs1051266, for contribution in the etiology of DS. Ethnically matched subjects including DS probands (N=183), their parents (N=273), and controls (N=286) were recruited after obtaining informed written consent for participation. Karyotype analysis confirmed trisomy 21 in DS patients recruited. Genomic DNA, purified from peripheral blood leukocytes was used for genotyping of the target sites by PCR based methods, and data obtained was subjected to population- as well as family-based association analysis. Frequency of rs1801394 ‘G’ allele and ‘GG’ genotype was higher in DS probands (P < 0.0001). Statistically significant higher occurrence of the ‘G’ allele in parents of DS probands (P < 0.0001) and maternal bias in transmission of the “G” allele was also noticed (P < 0.0001). Genetic model analysis demonstrated rs1801394 “G” as a risk allele under both dominant and recessive models. DS probands also showed higher occurrence of rs1051266 “G” (P = 0.05). Quantitative trait analysis revealed significant negative influence of rs1805087 “A” on birth weight. Screening for rs1801394 “G” could be useful in monitoring the risk of DS, at least in the studied population.

PS01.131: POSTOPERATIVE ANASTOMOTIC LEAKAGE AND PNEUMONIA FOLLOWING ESOPHAGECTOMY: A RETROSPECTIVE SINGLE-CENTER ANALYSIS

Abstract Background Anastomotic leakage and pneumonia following esophagectomy remain a significant clinical challenge and contribute to the postoperative outcome. Aim of this study was to investigate the relation between risk factors for the occurrence of leakage or pneumonia and the postoperative outcome and to identify further risk factors. Methods We analyzed 53 consecutive patients who underwent a surgical resection of the esophagus (distal esophagectomy and abdominothoracical esophagectomy) from January 2015 until August 2017. Patients demographics, perioperative parameters, and postoperative events were analyzed. Patient data were expressed as mean ± SD (range). P &lt; 0.05 was considered statistically significant. Results Postoperative pneumonia and anastomotic leakage occurred in 15 (28%) and 8 (15%) patients, respectively. Median operative time was 330.7 (± 69.6) minutes, and median length of stay was 24.8 (± 10.6) days. 2 (3.8%) of the patients required blood transfusion due to intraoperative bleeding. BMI, ASA-score, and an intraoperative performed lymphadenectomy did not affect the occurrence of pneumonia or anastomotic leakage. Patients with anastomotic leakage stayed longer at the ICU. However, the overall hospitalization rate did not differ significantly. As an independent risk factor, we identified that hypoproteinaemia with a protein level ≤ 5 g/dl (p-value 0.036) leads to a significant higher occurrence of anastomotic leakage. We could not identify any risk factors with regards to postoperative pneumonia. Conclusion The prevalence of hypoproteinaemia in patients after esophagectomy was associated with a higher occurrence of postoperative anastomotic leakage. These results indicate the importance of the perioperative nutrition aiming for a balanced protein level irrespective of comorbidity and surgical procedure. Disclosure All authors have declared no conflicts of interest.

The Dopamine Receptor D5 May Influence Age of Onset: An Exploratory Study on Indo-Caucasoid ADHD Subjects.

The objective was to investigate contribution of the dopamine receptor 5 (DRD5) gene variants in the symptoms of attention-deficit/hyperactivity disorder (ADHD) probands since brain regions identified to be affected in these group of patients have higher expression of the DRD5 receptor. Out of 22 exonic variants, 19 were monomorphic in the Indo-Caucasoid individuals. rs6283 "C" and rs113828117 "A" exhibited significant higher occurrence in families with ADHD probands. Several haplotypes showed biased occurrence in the probands. Early and late onset groups exhibited significantly different genotypic frequencies. A new G>A substitution was observed in the control samples only. The late onset group exhibited higher scores for hyperactivity as compared to the early onset group. The authors infer that the age of onset of ADHD may at least partially be affected by DRD5 variants warranting further investigation on the role of DRD5 in the disease etiology.

Effect of gender on circadian variations and outcome in ST-segment elevated anterior wall myocardial infarction patients

Background and Aim: The circadian rhythm is known to influence a number of physiological and pathological cardiovascular processes including the incidence of acute myocardial infarction. Therefore, in the present work the role of gender in anterior wall ST-Segment Elevated Myocardial Infarction (STEMI) patients have been studied. Methods: In this hospital-based, cross-sectional study, 200 patients were chosen as per the selection criteria from among the acute myocardial infraction (MI) patients admitted in the Department of Cardiology, Medical College Hospital, Kottayam. Results: Of the 200 subjects, 166 (83%) survived MI while 34 (17%) developed complications; statistical analytic tests applied between the time of onset of symptoms and the clinical outcome of the subjects were nonsignificant. A progressive increase was seen in the incidence of anterior wall myocardial infarction as age advances. There is a statistically significant higher occurrence of systemic hypertension in female subjects compared to the incidence of other comorbid illnesses among males and females. Conclusion: Occurrence of STEMI shows the first peak between 6 AM and 12 Noon and the second peak was from 12 Noon to 6 PM. There is a statistically significant higher occurrence of systemic hypertension in female subjects compared to the incidence of other comorbid illnesses among males and females. There is no significant correlation between the time of onset of symptoms and complications in any particular gender. Mortality was higher in males and the deaths in each period were proportionate irrespective of the circadian pattern.

Genetic variations of the GP6 regulatory region in patients with sticky platelet syndrome and miscarriage

Introduction: Thrombophilia increases the risk of venous thrombosis during pregnancy and may predispose to gestational vascular complications. Objective: The aim of this study is to evaluate the variability of GP6 regulatory regions in a group of patients with platelet hyperaggregability manifested as miscarriage compared with control subjects. Methods: We examined 27 female patients with platelet hyperaggregability and history of spontaneous abortion and 42 healthy women. Platelet hyperaggregability was established by light transmission aggregometry. We also assessed eight SNPs within the GP6 gene. Results: We found a higher occurrence of three SNPs in patients with platelet hyperaggregability and history of miscarriage (rs1671152, rs1654433, rs1671215). The haplotype analysis showed a significant higher occurrence of two haplotypes (ACGG, CCGT). Conclusions: Our results support the idea that genetic variability of GP6 regulatory regions can be associated with platelet hyperaggregability – a possible cause of miscarriage.

Antiphospholipid Antibodies in Patients with Lupus Nephritis

The aim of this study was to compare the prevalence of anticardiolipin antibodies with other types of antiphospholipid antibodies (aPL) (antiphosphatidylserine—aPS, antiphosphatidylinositol—aPI, antiphosphatidylethanolamine—aPE) in patients with lupus nephritis and to find if the examination of a panel of various aPL is valuable for further diagnosis of patients. Additionally we determined the levels of autoantibodies against β2-glycoprotein I (β2GPI) and oxidized low-density lipoprotein (anti-oxLDL) and also investigated the relationship between antibodies against β2GPI and oxLDL, which were assessed by ELISA methods. Twenty-two patients with lupus nephritis were studied. The control group consisted of 62 healthy blood donors. A statistically significant higher occurrence of all aPLs in the patients with lupus nephritis in comparison to the control group was found. The prevalence of polyspecific antibodies, which reacted with at least two various phospholipids, was 82% in the group of SLE patients. Significantly higher levels of IgG anti-β2GPI in the sera of SLE patients (p = 0.0003) was detected. The levels of anti-oxLDL in the sera of the patients group did not differ significantly from the control one. Some positive samples for anti-β2GPI and negative for aCL or anti-oxLDL and vice versa were found. It can be concluded that the production of aPL including anti-β2GPI and anti-oxLDL in the lupus nephritis patients is higher in comparison with healthy blood donors. We assume that the estimation of various types of aPL may be important in the selection of the group patients with renal diseases. The synthesis of aPL can reflect the spreading of the autoimmune response for several antigens modified on the vessel wall.

The effect of isolation and history on colonization patterns of plant species in secondary woodland

Colonization success of woodland originating after 1850 was determined for seventeen forest plant species having different dispersal strategies. Colonization rate of the studied endo‐and exozoochorous species apparently was considerable higher than that of species having short distance dispersal like myrmecochores and species lacking dispersal mechanisms. The occurrence of eight species in this young forest habitat was related to the distance to the nearest source patch (DNS), as well as to the age of the young patches and to their former land use. DNS calculated to old, existent and occupied source patches affected most analysed species. Only Ilex aquifolium L. had a significant higher occurrence in woodland originating before 1916 than in those originating after 1916. Former land use showed significant effects for three species. Although colonization rate and effects of studied parameters on occurrence were different for the studied species, no clear differences were found between different dispersal groups. The consequences of these results for the understanding of colonization processes of the species studied is discussed.

Effect of fork-lift truck driving on low-back trouble.

In a population of 240 male fork-lift truck drivers who drove at least 4 h daily, the occurrence of low-back trouble was studied in relation to that of two reference groups. The participation rate of the fork-lift truck drivers was 88%. The responses to a questionnaire concerning low-back trouble were reviewed. Among the fork-lift truck drivers, a statistically significant higher occurrence of low-back trouble was reported for the year preceding the study, in comparison, according to age, to that of a reference group of 399 working men (65 against 47%); however, there was no significantly increased frequency when compared to that of a reference group of 66 unskilled male workers (65 against 51%). The fork-lift truck drivers had a significantly higher rate of absence from work within the previous year due to low-back trouble than the two reference groups (22% compared to 7 and 9%). These findings were confirmed during the follow-up year. A correlation was found between length of employment as a fork-lift truck driver and the occurrence of low-back trouble within the preceding year. It was concluded that fork-lift truck driving may be a contributory cause for low-back trouble.