1.Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
Sima VAZQEZ ; Ankita DAS ; Eris SPIROLLARI ; Paige BRABANT ; Bridget NOLAN ; Kevin CLARE ; Jose F. DOMINGUEZ ; Neha DANGAYACH ; Krishna AMULURU ; Shadi YAGHI ; Ji CHONG ; Chaitanya MEDICHERLA ; Halla NUOAMAN ; Neisha PATEL ; Stephan A. MAYER ; Chirag D. GANDHI ; Fawaz AL-MUFTI
Journal of Stroke 2024;26(3):425-433
Background:
and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).
Methods:
The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality.
Results:
Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes.
Conclusion
Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
2.Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
Sima VAZQEZ ; Ankita DAS ; Eris SPIROLLARI ; Paige BRABANT ; Bridget NOLAN ; Kevin CLARE ; Jose F. DOMINGUEZ ; Neha DANGAYACH ; Krishna AMULURU ; Shadi YAGHI ; Ji CHONG ; Chaitanya MEDICHERLA ; Halla NUOAMAN ; Neisha PATEL ; Stephan A. MAYER ; Chirag D. GANDHI ; Fawaz AL-MUFTI
Journal of Stroke 2024;26(3):425-433
Background:
and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).
Methods:
The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality.
Results:
Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes.
Conclusion
Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
3.Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
Sima VAZQEZ ; Ankita DAS ; Eris SPIROLLARI ; Paige BRABANT ; Bridget NOLAN ; Kevin CLARE ; Jose F. DOMINGUEZ ; Neha DANGAYACH ; Krishna AMULURU ; Shadi YAGHI ; Ji CHONG ; Chaitanya MEDICHERLA ; Halla NUOAMAN ; Neisha PATEL ; Stephan A. MAYER ; Chirag D. GANDHI ; Fawaz AL-MUFTI
Journal of Stroke 2024;26(3):425-433
Background:
and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).
Methods:
The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality.
Results:
Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes.
Conclusion
Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
4.Inpatient Outcomes of Cerebral Venous Thrombosis in Patients With Malignancy Throughout the United States
Sima VAZQEZ ; Ankita DAS ; Eris SPIROLLARI ; Paige BRABANT ; Bridget NOLAN ; Kevin CLARE ; Jose F. DOMINGUEZ ; Neha DANGAYACH ; Krishna AMULURU ; Shadi YAGHI ; Ji CHONG ; Chaitanya MEDICHERLA ; Halla NUOAMAN ; Neisha PATEL ; Stephan A. MAYER ; Chirag D. GANDHI ; Fawaz AL-MUFTI
Journal of Stroke 2024;26(3):425-433
Background:
and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).
Methods:
The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality.
Results:
Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes.
Conclusion
Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.
5.The prevalence of CYP2D6 Gene Polymorphisms among Filipinos and their use as biomarkers for lung cancer risk
Eva Maria Cutiongco-de la Paz ; Corazon A. Ngelangel ; Aileen David-Wang ; Jose B. Nevado Jr. ; Catherine Lynn T. Silao ; Rosalyn Hernandez-Sebastian ; Richmond B. Ceniza ; Leander Linus Philip P. Simpao ; Lakan U. Beratio ; Eleanor A. Dominguez ; Albert B. Albay Jr ; Rey A. Desales ; Nelia Tan-Liu ; Sullian Sy-Naval ; Roberto M. Montevirgen ; Catalina de Siena Gonda-Dimayacyac ; Pedrito Y. Tagayuna ; Elizabeth A. Nuqui ; Arnold Joseph M. Fernandez ; Andrew D. Dimacali ; Maria Constancia Obrerro-Carrillo ; Virgilio P. Banez ; Oliver G. Florendo G. Florendo ; Ma. Cecilia M. Sison ; Francisco T. Roxas ; Alberto B. Roxas ; Orlino C. Bisquera Jr. ; Luminardo M. Ramos ; John A. Coloma ; Higinio T. Mappala ; Alex C. Tapia ; Emmanuel F. Montana Jr. ; Jonathan M. Asprer ; Reynaldo O. Joson ; Sergio P. Paguio ; Conrado C. Cajucom ; Richard C. Tia ; Tristan Chipongian ; Joselito F. David ; Florentino C. Doble ; Maria Noemi G. Pato ; Hans Francis D. Ferraris ; Benito B. Bionat Jr. ; Adonis A. Guancia ; Eriberto R. Layda ; Frances Maureen C. Rocamora ; Roemel Jeusep Bueno ; Carmencita D. Padilla
Acta Medica Philippina 2017;51(3):207-215
Objectives:
The highly polymorphic nature of the CYP2D6 gene and its central role in the metabolism of commonly used drugs make it an ideal candidate for pharmacogenetic screening. This study aims to determine the prevalence of CYP2D6 polymorphisms among Filipinos and their association to lung cancer.
Method:
Forty seven single nucleotide polymorphisms (SNPs) of the CYP2D6 gene were genotyped from DNA samples of 115 cases with lung cancer and age- and sex-matched 115 controls.
Results:
Results show that 18 out of 47 polymorphisms have significant genotypic variability (>1% for at least 2 genotypes). No variant is associated with lung cancer. However, rs1135840,
rs16947 and rs28360521, were found to be highly variable among Filipinos.
Conclusion
This study demonstrated that CYP2D6 polymorphisms are present among Filipinos, which, although not found to be associated with lung cancer, can be useful biomarkers for future pharmacogenetic studies. The SNP rs16947 is found to be associated with cancer and timolol-induced bradycardia; the SNP rs1135840, on the other hand, is only shown to be linked with cancer. The genetic variant rs28360521 is known to be associated with low-dose aspirin-induced lower gastrointestinal bleeding.
Pharmacogenetics
;
Cytochrome P-450 CYP2D6
;
Lung Neoplasms
;
Biomarkers
6.Genetic polymorphisms in NAT1, NAT2, GSTM1, GSTP1 and GSTT1 and susceptibility to colorectal cancer among Filipinos
Eva Maria C. Cutiongco-de la Paz ; Corazon A. Ngelangel ; Virgilio P. Bañ ; ez ; Francisco T. Roxas ; Catherine Lynn T. Silao ; Jose B. Nevado Jr. ; Alberto B. Roxas ; Oliver G. , Florendo ; Ma. Cecilia M. Sison ; Orlino Bisquera, Jr ; Luminardo M. Ramos ; Elizabeth A. Nuqui ; Arnold Joseph M. Fernandez ; Maria Constancia O. Carrillo ; Beatriz J. Tiangco ; Aileen D. Wang ; Rosalyn H. Sebastian ; Richmond B. Ceniza ; Leander Linus Philip P. Simpao ; Lakan U. Beratio ; Eleanor A. Dominguez ; Albert B. Albay Jr. ; Alfredo Y. Pontejos Jr. ; Nathaniel W. Yang ; Arsenio A. Cabungcal ; Rey A. Desales ; Nelia S. Tan-Liu ; Sullian S. Naval ; Roberto M. Montevirge ; Catalina de Siena E. Gonda-Dimayacyac ; Pedrito Y. Tagayuna ; John A. Coloma ; Gil M. Vicente ; Higinio T. Mappala ; Alex C. Tapia ; Emmanuel F. Montana Jr. ; Jonathan M. Asprer ; Reynaldo O. Joson ; Sergio P. Paguio ; Tristan T. Chipongian ; Joselito F. David ; Florentino C. Doble ; Maria Noemi G. Pato ; Benito B. Bionat Jr ; Hans Francis D. Ferraris ; Adonis A. Guancia ; Eriberto R. Layda ; Andrew D. Dimacali ; Conrado C. Cajucom ; Richard C. Tia ; Mark U. Javelosa ; Regie Lyn P. Santos-Cortez ; Frances Maureen C. Rocamora ; Roemel Jeusep Bueno ; Carmencita D. Padilla
Acta Medica Philippina 2017;51(3):216-222
Objectives. Polymorphisms in metabolic genes which alter rates of bioactivation and detoxification have been shown to modulate susceptibility to colorectal cancer. This study sought to evaluate the colorectal cancer risk from environmental factors and to do polymorphism studies on genes that code for Phase I and II xenobiotic metabolic enzymes among Filipino colorectal cancer patients and matched controls. Methods. A total of 224 colorectal cancer cases and 276 controls from the Filipino population were genotyped for selected polymorphisms in GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subject participants.Results. Univariate logistic regression of non-genetic factors identified exposure to UV (sunlight) (OR 1.99, 95% CI: 1.16-3.39) and wood dust (OR 2.66, 95% CI: 1.21-5.83) and moldy food exposure (OR 1.61, 95% CI:1.11-2.35) as risk factors; while the NAT2*6B allele (recessive model OR 1.51, 95% CI :1.06-2.16; dominant model OR 1.87, 95% CI: 1.05-3.33) and homozygous genotype (OR 2.19, 95% CI: 1.19-4.03) were found to be significant among the genetic factors. After multivariate logistic regression of both environmental and genetic factors, only UV radiation exposure (OR 2.08, 95% CI: 1.21-3.58) and wood dust exposure (OR 2.08, 95% CI: 0.95-5.30) remained to be significantly associated with increasing colorectal cancer risk in the study population.Conclusion. This study demonstrated that UV sunlight and wood dust exposure play a greater role in influencing colorectal cancer susceptibility than genotype status from genetic polymorphisms of the GST and the NAT` genes.
Colorectal Neoplasms
;
Polymorphism, Genetic