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Risk Class (risk + class)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Review of the Liposuction, Abdominoplasty, and Face-Lift Mortality and Morbidity Risk Literature

DERMATOLOGIC SURGERY, Issue 7 2005
Robert A. Yoho MD
Background The statistical discrepancies that exist in the mortality and morbidity risk literature are such that surgeons and patients cannot accurately assess the true risk rates associated with plastic surgery procedures. Objectives and Methods To review any relevant literature published to date in which the risk rates from liposuction, abdominoplasty, and rhytidectomy are cited and to reassess these figures alongside those published for both elective and emergency general surgeries. Results and Conclusion Despite the lack of reliable, comprehensive reporting of deaths and complications resulting from cosmetic surgeries, published data demonstrate that the risks associated with liposuction and rhytidectomy compare favorably with those from most general surgical procedures. In contrast, the morbidity and mortality rates from abdominoplasty remain unacceptably high. A significant lack of literature documenting cosmetic breast implant surgery and blepharoplasty risks is observed, which should be of concern to both patients and physicians. Liposuction and face-lift surgery data generally show that surgical centers are statistically safer than hospital operating rooms, although the data have not been standardized for the patients' American Society of Anesthesiologists (ASA) risk class, the health of the patient prior to surgery. General anesthesia may carry a risk roughly equivalent to or perhaps greater than cosmetic surgery, although, again, ASA class variables confound clear comparison between studies. Recent anesthesia literature refutes the many claims that general anesthesia risks are now remote: a landmark study that surveyed the entire scholarly literature showed a mortality rate of 1 in 13,000, roughly similar to overall cosmetic surgery mortality risks. Moreover, a prolonged operating time has been repeatedly implicated in other surgical literature to be related to morbidity and mortality. The latter certainly has relevance to cosmetic surgery. [source]

Factor VIII gene (F8) mutations as predictors of outcome in immune tolerance induction of hemophilia A patients with high-responding inhibitors

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 11 2009
A. COPPOLA
Summary.,Background:, Immune tolerance induction (ITI) is the only therapeutic approach that can eradicate factor VIII (FVIII) inhibitors in patients with hemophilia A. Predictors of ITI outcome are still debated, and the role of F8 gene mutations in this is not well established. Objectives: To investigate the relationship between F8 genotype and ITI outcome in patients with severe hemophilia A and high-responding inhibitors. Patients and Methods:F8 mutations were identified in 86 patients recruited as part of the Italian ITI registry (the PROFIT study). ITI outcome was centrally reviewed according to the following definitions: success (undetectable inhibitor and normal FVIII pharmacokinetics), partial success (inhibitor titer < 5 BU mL,1 and/or abnormal FVIII pharmacokinetics), and failure. Results:F8 mutations known to be associated with a high risk of inhibitor development (large deletions, inversions, nonsense mutations and splice site mutations) were found in 70 patients (81%); among these, the intron 22 inversion was present in 49 patients (57%). In 16 patients (19%) lower-risk F8 defects (small insertions/deletions and missense mutations) were identified. The latter group of patients showed a significantly higher ITI success rate than those carrying high-risk mutations [13/16 (81%) vs. 33/70 (47%); risk ratio 1.7, 95% confidence interval (CI) 1.1,2.1, P = 0.01]. On multivariate analysis, the mutation risk class remained a significant predictor of success [adjusted odds ratio (OR) 6.2, 95% CI 1.1,36.0, P = 0.04], as were inhibitor titer at ITI start (< 5 BU mL,1, OR 11.8, 95% CI 3.5,40.2, P < 0.001), and peak titer during ITI (< 100 BU mL,1, OR 11.4, 95% CI 3.2,40.8, P < 0.001). Conclusions: ITI success is influenced by F8 genotype. This knowledge should contribute to the stratification of prognosis, and to the clinical choices made for ITI in patients with high-responding inhibitors. [source]

A Risk Scale for Predicting Extensive Subclinical Spread of Nonmelanoma Skin Cancer

DERMATOLOGIC SURGERY, Issue 2 2002
R. Sonia Batra MD
background. The clinical appearance of nonmelanoma skin cancer may represent only a portion of microscopic tumor invasion. objective. To develop a scale based on high-risk characteristics for predicting the probability of extensive subclinical spread of nonmelanoma skin cancer. methods. Retrospective analysis of 1095 Mohs micrographic surgical cases (MMS) yielded high-risk factors for extensive tumor spread, defined as requirement of ,3 MMS layers. Predictive characteristics included: any BCC on the nose, morpheaform BCC on the cheek, neck tumors and recurrent BCC in men, location on the eyelid, temple, or ear helix, and size>10 mm. Multivariate logistic regression was applied to develop a risk index. results. Tumor characteristics were assigned point values calculated from the respective odds of extension and categorized into six risk classes with probabilities of extensive subclinical spread ranging from 10% to 56%. conclusion. A risk scale simplifies and enhances prediction of extensive tumors. The associated probabilities can help to guide patient preparation and appropriate therapy. [source]

The Stability of the Relation Between the Stock Market and Macroeconomic Forces

ECONOMIC NOTES, Issue 3 2002
Fabio Panetta
This paper identifies the macroeconomic factors that influence Italian equity returns and tests the stability of their relation with securities returns. The relation between stock returns and the macroeconomic factors is found to be unstable: not only are the factor loadings of individual securities virtually uncorrelated over time, but a high percentage of the shares experience a reversal of the sign of the estimated loadings. This result is not confined to single periods or to a small group of shares, but holds in different sub,periods and for securities in all risk classes. These findings suggest that research should carefully investigate the specification of the return generating process and the stability of the risk measures. (J.E.L.: G12, E44). [source]