Kehlet, Henrik; Jensen, Troels Staehelin; Woolf, Clifford J.
therapy for postoperative pain should be investigated, since the intensity of acute postoperative pain correlates with the risk of developing a persistent pain state. Finally, the role of genetic factors should be studied, since only a proportion of patients with intraoperative nerve damage develop...... chronic pain. Based on information about the molecular mechanisms that affect changes to the peripheral and central nervous system in neuropathic pain, several opportunities exist for multimodal pharmacological intervention. Here, we outline strategies for identification of patients at risk...
Aasvang, Eske K; Gmaehle, Eliza; Hansen, Jeanette B
BACKGROUND: Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP. METHODS: A prospective study was conducted in 464...... patients undergoing open or laparoscopic transabdominal preperitoneal elective groin hernia repair. Primary outcome was identification of risk factors for substantial pain-related functional impairment at 6 months postoperatively assessed by the validated Activity Assessment Scale (AAS). Data on potential...... risk factors for PPP were collected preoperatively (pain from the groin hernia, preoperative AAS score, pain from other body regions, and psychometric assessment). Pain scores were collected on days 7 and 30 postoperatively. Sensory functions including pain response to tonic heat stimulation were...
Nakai, K; Fujii, H; Ishimura, T; Fujisawa, M; Nishi, S
Persistent hyperparathyroidism after kidney transplantation is related to graft function, but pre-transplantation risk factors of persistent hyperparathyroidism have not been evaluated in detail. We enrolled 86 patients who had undergone kidney transplantation between 2008 and 2014. Nine patients showed persistent hyperparathyroidism characterized by the following: 1) serum parathyroid hormone levels >65 pg/mL and serum calcium levels >10.5 mg/dL at 1 year after kidney transplantation; 2) parathyroidectomy after kidney transplantation; and 3) reintroduction of cinacalcet after kidney transplantation. Compared with other patients, these 9 patients had significantly longer duration of dialysis therapy (186 ± 74 mo vs 57 ± 78 mo) and more frequent treatment with cinacalcet during dialysis (89% vs 12%). Multivariate analysis showed that dialysis vintage, calcium phosphate products, and cinacalcet use before kidney transplantation were independent risk factors of persistent hyperparathyroidism after kidney transplantation. A receiver operating characteristic curve showed 72 months as the cutoff value of dialysis vintage and 55 as the cutoff value of calcium phosphate products. In conclusion, dialysis vintage >6 years, calcium phosphate products >55 (mg/dL) 2 , and cinacalcet use before kidney transplantation are strong predictors of persistent hyperparathyroidism. High-risk patients should be evaluated for parathyroid enlargement, and parathyroidectomy must be considered before kidney transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.
Yang, Chunxue; Kong, Alice Pik Shan; Cai, Zongwei; Chung, Arthur C K
The rising prevalence of obesity and diabetes cannot be fully explained by known risk factors, such as unhealthy diet, a sedentary lifestyle, and family history. This review summarizes the available studies linking persistent organic pollutants (POPs) to obesity and diabetes and discusses plausible underlying mechanisms. Increasing evidence suggest that POPs may act as obesogens and diabetogens to promote the development of obesity and diabetes and induce metabolic dysfunction. POPs are synthesized chemicals and are used widely in our daily life. These chemicals are resistant to degradation in chemical or biological processes, which enable them to exist in the environment persistently and to be bio-accumulated in animal and human tissue through the food chain. Increasingly, epidemiologic studies suggest a positive association between POPs and risk of developing diabetes. Understanding the relationship of POPs with obesity and diabetes may shed light on preventive strategies for obesity and diabetes.
This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)
Marklund, Susanna; Häggman-Henrikson, Birgitta; Wänman, Anders
Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.
Wang, Lingcheng; Gao, Shuncui; Zhu, Wei; Su, Jun
Objectives : To determine the risk factors associated with persistent airflow limitation in patients with asthma. Method s: This study was designed and carried out in the department of respiratory medicine, fourth People?s Hospital of Jinan City, Shandong province, China between Jan 2012 and Dec 2012. Three hundred and six asthma patients participating in the study were divided into persistent airflow limitation group (PAFL) and no persistent airflow limitation group (NPAFL). The patients par...
Hulme, Katrin; Hudson, Joanna L; Rojczyk, Philine; Little, Paul; Moss-Morris, Rona
Fatigue is a prevalent and debilitating symptom, preceded by an acute infectious episode in some patients. This systematic review aimed to identify risk factors for the development of persistent fatigue after an acute infection, to develop an evidence-based working model of post-infectious fatigue. Electronic databases (Medline, PsycINFO and EMBASE) were searched, from inception to March 2016, for studies which investigated biopsychosocial risk factors of on-going fatigue after an acute infection. Inclusion criteria were: prospective design; biological, psychological or social risk factors; standardised measure of post-infectious fatigue (self-report scales or clinical diagnosis). Studies were excluded if the sample had a pre-existing medical condition, infection was conceptualised as 'vaccination' or they were intervention trials. A narrative synthesis was performed. Eighty-one full texts were screened, of which seventeen were included in the review. Over half included glandular fever populations. Other infections included dengue fever, 'general'/'viral' and Q-fever. Risk factors were summarised under biological, social, behavioural, cognitive and emotional subthemes. Patients' cognitive and behavioural responses to the acute illness, and pre-infection or baseline distress and fatigue were the most consistent risk factors for post-infectious fatigue. An empirical summary model is provided, highlighting the risk factors most consistently associated with persistent fatigue. The components of the model, the possible interaction of risk factors and implications for understanding the fatigue trajectory and informing preventative treatments are discussed. Copyright © 2017. Published by Elsevier Inc.
Rupp, Christian; Bode, Konrad Alexander; Chahoud, Fadi; Wannhoff, Andreas; Friedrich, Kilian; Weiss, Karl-Heinz; Sauer, Peter; Stremmel, Wolfgang; Gotthardt, Daniel Nils
Candidiasis is commonly observed in patients with primary sclerosing cholangitis (PSC), but the clinical risk factors associated with its presence have not been fully investigated. In this study, we aimed to analyse the incidence, risk factors, and transplantation-free survival in primary sclerosing cholangitis (PSC) patients with persistent biliary candidiasis. We retrospectively analysed patients diagnosed with PSC who were admitted to our department during 2002 to 2012. One-hundred fifty patients whose bile cultures were tested for fungal species were selected, and their clinical and laboratory parameters were investigated. The results of endoscopic retrograde cholangiography (ERC) and bile cultures were analysed using chart reviews. The cases of biliary candidiasis were sub-classified as transient or persistent. Thirty out of 150 (20.0%) patients had biliary candidiasis. Although all patients demonstrated comparable baseline characteristics, those with biliary candidiasis showed significantly reduced transplantation-free survival (p candidiasis. A subgroup analysis showed reduced survival with a greater necessity for orthotopic liver transplantation (OLT) only in patients with persistence of Candida (p = 0.007). The survival in the patients with transient biliary candidiasis was comparable to that in candidiasis-free patients. In a multivariate regression analysis that included Mayo risk score (MRS), sex, age, dominant stenosis, inflammatory bowel disease, autoimmune hepatitis overlap syndrome, and number of times ERC was performed, biliary candidiasis was an independent risk factor for reduced survival (p = 0.008). Risk factors associated with acquisition of biliary candidiasis were age at PSC diagnosis and number of ERCs. The persistence of biliary candidiasis is associated with markedly reduced transplantation-free survival in PSC patients. By contrast, actuarial survival in patients with transient biliary candidiasis approaches that for patients without any
Zhou, Zhen-Hu; Ma, Long-Le; Wang, Le-Xin
To investigate the predicting factors for persistent atrial fibrillation (AF) following radioiodine therapy for hyperthyroidism. Standard 12-lead ECG and 24-h Holter monitoring were performed in 94 patients (38 males, mean age 46.1±8.2 years) with persistent AF following radioiodine therapy for hyperthyroidism. Left ventricular (LV) function was assessed with two-dimensional echocardiography. Euthyroidism or hypothyroidism was achieved in 81% and 19% of the patients, respectively, after radioiodine therapy. At the end of follow-up (1.6±1.3 years), LV ejection fraction in the 52 patients with LV dysfunction was increased from 39.3±3.3% to 59.0±5.5% (ptreatment paroxysmal AF, no AF was documented during the follow-up. In the 45 patients with pre-treatment persistent AF, AF was found in 27 (60%) during the follow-up. Multivariate logistic regression analysis showed that more than 55 years old in age (RR 2.76, 95% CI: 1.16-8.79, phyperthyroidism (RR 3.08, 95% CI: 1.22-11.41, ptreatment atrial fibrillation (RR 2.96, 95% CI: 1.31-7.68, phyperthyroidism and pre-treatment duration of AF are risk factors for persistent AF following radioiodine therapy.
Andersen, Kenneth Geving; Kehlet, Henrik
for prevention and treatment. However, nerve damage and radiotherapy appear to be significant risk factors for chronic pain. A proposal for the design of future prospective studies is presented. PERSPECTIVE: A comprehensive and systematic approach to research in chronic pain after breast cancer treatment......Chronic pain after breast cancer treatment is a major clinical problem, affecting 25 to 60% of patients. Development of chronic pain after breast cancer treatment, as well as other surgical procedures, involves a complex pathophysiology that involves pre-, intra- and post-operative factors....... This review is a systematic analysis on methodology and evidence in research into persistent pain after breast cancer treatment during the period 1995 to 2010, in order to clarify the significance and relative role of potential risk factors. Literature was identified by a search in PubMed and OVID, as well...
Full Text Available Background. Atrial fibrillation (AF is one of the commonest cardiovascular manifestations of thyrotoxicosis. A significant proportion of patients have persistent AF which may have long term consequences, for example, ischemic stroke. Methods. We performed a retrospective cohort study in a regional hospital from January 2004 to June 2016 to examine the clinical characteristics and outcomes of thyrotoxic patients who presented with atrial fibrillation and to investigate possible factors associated with persistent atrial fibrillation and ischemic stoke. Results. Among 1918 patients who had a diagnosis of thyrotoxicosis, 133 (6.9% patients presented with AF. Spontaneous sinus conversion occurred in 89 (66.9% patients in which 85 (94% patients developed sinus conversion before or within 6 months after having achieved euthyroidism. The remaining 44 (33.1% had persistent AF. The rate of ischemic stroke was numerically higher among patients who had persistent AF than those with spontaneous sinus conversion (15.9% versus 10.1%; log-rank 0.442, p=0.506. Patients who sustained an ischemic stroke were older (71 ± 11 years versus 62 ± 16 years, p=0.023 and had a trend towards higher CHA2DS2-VASc score (2.9 ± 1.7 versus 2.3 ± 1.7, p=0.153. History of smoking (adjusted odds ratio 4.9, 95% CI [1.8,14.0], p=0.002, a larger left atrial diameter (adjusted odd ratio 2.6, 95% CI [1.2,5.5], p=0.014, and a relatively lower free thyroxine level at diagnosis (adjusted odd ratio 2.1, 95% CI [1.2,3.5], p=0.008 were associated with persistence of AF on multivariate analysis. Conclusion. Persistence of thyrotoxic AF occurred in one-third of patients and spontaneous sinus conversion was unlikely after six months of euthyroidism. High rate of ischemic stroke was observed among patients with persistent thyrotoxic AF and older age. Patients with factors associated with persistent AF, especially older people, should be closely monitored beyond 6 months so that
Durval Campos Kraychete
Full Text Available Abstract Background and objectives: Postoperative persistent chronic pain (POCP is a serious health problem, disabling, undermining the quality of life of affected patients. Although more studies and research have addressed the possible mechanisms of the evolution from acute pain to chronic postoperatively, there are still no consistent data about the risk factors and prevention. This article aims to bring what is in the panorama of the current literature available. Content: This review describes the definition, risk factors, and mechanisms of POCD, its prevention and treatment. The main drugs and techniques are exposed comprehensively. Conclusion: Postoperative persistent chronic pain is a complex and still unclear etiology entity, which interferes heavily in the life of the subject. Neuropathic pain resulting from surgical trauma is still the most common expression of this entity. Techniques to prevent nerve injury are recommended and should be used whenever possible. Despite efforts to understand and select risk patients, the management and prevention of this syndrome remain challenging and inappropriate.
Perrin, P; Caillard, S; Javier, R M; Braun, L; Heibel, F; Borni-Duval, C; Muller, C; Olagne, J; Moulin, B
The risk of fractures after kidney transplantation is high. Hyperparathyroidism frequently persists after successful kidney transplantation and contributes to bone loss, but its impact on fracture has not been demonstrated. This longitudinal study was designed to evaluate hyperparathyroidism and its associations with mineral disorders and fractures in the 5 posttransplant years. We retrospectively analyzed 143 consecutive patients who underwent kidney transplantation between August 2004 and April 2006. The biochemical parameters were determined at transplantation and at 3, 12 and 60 months posttransplantation, and fractures were recorded. The median intact parathyroid hormone (PTH) level was 334 ng/L (interquartile 151-642) at the time of transplantation and 123 ng/L (interquartile 75-224) at 3 months. Thirty fractures occurred in 22 patients. The receiver operating characteristic (ROC) curve analysis for PTH at 3 months (area under the ROC curve = 0.711, p = 0.002) showed that a good threshold for predicting fractures was 130 ng/L (sensitivity = 81%, specificity = 57%). In a multivariable analysis, independent risk factors for fracture were PTH >130 ng/L at 3 months (adjusted hazard ratio [AHR] = 7.5, 95% CI 2.18-25.50), and pretransplant osteopenia (AHR = 2.7, 95% CI 1.07-7.26). In summary, this study demonstrates for the first time that persistent hyperparathyroidism is an independent risk factor for fractures after kidney transplantation. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.
Shi, Nianmin; Lu, Qiang; Zhang, Jiao; Li, Li; Zhang, Junnan; Zhang, Fanglei; Dong, Yanhong; Zhang, Xinyue; Zhang, Zheng; Gao, Wenhui
This study aims to prevent persistentinfection, reduce the incidence of cervical cancer, and improve women's health by understanding the theoretical basis of the risk factors for continuous infection of asymptomatic women with high-risk human papilloma virus (HPV) strains via information collected, which includes the persistent infection rate and the most prevalent HPV strain types of high risk to asymptomatic women in the high-risk area of cervical cancer in Linfen, Shanxi Province. Based on the method of cluster sampling, locations were chosen from the industrial county and agricultural county of Linfen, Shanxi Province, namely the Xiangfen and Quwo counties. Use of the convenience sampling (CS) method enables the identification of women who have sex but without symptoms of abnormal cervix for analyzing risk factors of HPV-DNA detection and performing a retrospective questionnaire survey in these 2 counties. Firstly, cervical exfoliated cell samples were collected for thin-layer liquid-based cytology test (TCT), and simultaneously testing high-risk type HPV DNA, then samples with positive testing results were retested to identify the infected HPV types. The 6-month period of testing was done to derive the 6-month persistent infection rate. The retrospective survey included concepts addressed in the questionnaire: basic situation of the research objects, menstrual history, marital status, pregnancy history, sexual habits and other aspects. The questionnaire was divided into a case group and a comparison group, which are based on the high-risk HPV-DNA testing result to ascertain whether or not there is persistent infection. Statistical analysis employed Epidate3.1 software for date entry, SPSS17.0 for date statistical analysis. Select statistic charts, Chi-Square Analysis, single-factor analysis and multivariate Logistic regression analysis to analyze the protective factors and risk factors of high-risk HPV infection. Risk factors are predicted by using the
Stensen, Signe; Kjær, Susanne K; Jensen, Signe Marie
of pregnancies or births or use of a hormonal intrauterine device, hormonal therapy or nonsteroidal anti-inflammatory drugs was not associated with risk for HR HPV persistence. A history of genital warts and current use of oral contraceptives or systemic glucocorticoids increased the risk, potentially indicating...
Vilalta-Franch, Joan; López-Pousa, Secundino; Calvó-Perxas, Laia; Garre-Olmo, Josep
To establish the prevalence, incidence, persistence, risk factors, and mortality risk increase of psychosis of Alzheimer disease (PoAD) in a clinical sample. Cross-sectional, observational study of 491 patients with probable AD who, at baseline visit, were evaluated with the Cambridge Examination for Mental Disorders of the Elderly, the Neuropsychiatric Inventory-10, the Rapid Disability Rating Scale-2, and the Zarit Burden Interview. All participants were reevaluated at 6, 12, 18, and 24 months. PoAD diagnoses were made using specific criteria. PoAD prevalence was 7.3%, and the cumulative incidence at 6, 12, 18, and 24 months was 5.8%, 10.6%, 13.5%, and 15.1%, respectively. After 1 year, psychotic symptoms persisted in 68.7% of the patients with initial PoAD. At baseline, patients with PoAD scored lower in the Cambridge Cognitive Examination and Mini-Mental State Examination and higher in the Rapid Disability Rating Scale-2 and Zarit Burden Interview tests. Both low scores in the Cambridge Cognitive Examination subscale of learning memory (hazard ratio [HR] = 0.874; 95% CI: 0.788-0.969; Wald χ2 = 6.515; df = 1) and perception (HR = 0.743; 95% CI: 0.610-0.904; Wald χ2 = 8.778; df = 1), and high scores in expressive language (HR = 1.179; 95% CI: 1.024-1.358; Wald χ2 = 5.261; df = 1) and calculation skills (HR = 1.763; 95% CI: 1.067-2.913; Wald χ2 = 4.905; df = 1) were found to be associated with PoAD. PoAD leads to a faster functional impairment, and it increases mortality risk (HR = 2.191; 95% CI: 1.136-4.228; Wald χ2 = 5.471; df = 1) after controlling for age, gender, cognitive and functional disability, general health status, and antipsychotic treatment. PoAD seems to define a phenotype of AD of greater severity, with worsened functional progression and increased mortality risk. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Tijssen, M J A; Van Os, J; Wittchen, H U; Lieb, R; Beesdo, K; Wichers, Marieke
To examine factors increasing the risk for onset and persistence of subthreshold mania and depression. In a prospective cohort community study, the association between risk factors [a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD) and temperamental/personality traits] and onset of manic/depressive symptoms was determined in 705 adolescents. The interaction between baseline risk factors and baseline symptoms in predicting 8-year follow-up symptoms was used to model the impact of risk factors on persistence. Onset of manic symptoms was associated with cannabis use and novelty seeking (NS), but NS predicted a transitory course. Onset of depressive symptoms was associated with a family history of depression. ADHD and harm avoidance (HA) were associated with persistence of depressive symptoms, while trauma and a family history of depression predicted a transitory course. Different risk factors may operate during onset and persistence of subthreshold mania and depression. The differential associations found for mania and depression dimensions suggest partly different underlying mechanisms.
Yudi M Hidayat
Full Text Available Introduction: Changes in complete hydatidiform mole (CHM that become persistent are difficult to handle because the malignant pathogenesis of CHM is still unclear. The growth of abnormal cells in CHM is thought to be caused by cell cycle abnormalities. Some components that play a role in this phase include cyclin D and retinoblastoma (Rb. The aim of our study was to determine the role of clinical risk factors, as well as cyclin D1, cyclin D3 and Rb-protein, in the occurrence of persistent moles. Materials and Method: This study involves 68 CHM cases at Dr. Hasan Sadikin Hospital from 2007–2011. The protein expression of cyclin D1, cyclin D3, and Rb were determined by immunohistochemistry. The results were analyzed by comparing the two groups of CHM that became persistent to those that returned to normal, as determined by a Mochizuki regression curve assessment. Results: 20 cases (29% of CHM became persistent and that 48 cases (71% returned to normal. Significant clinical variables were age (p 0.05. Conclusion: There is a strong relationship between clinical risk factors of age, excessive proliferation histopathology, serum βhCG levels ≥100,000 mU/mL, cyclin D1 and Rb mutations with the incidence of persistent moles after the evacuation of the CHM. We proposed a model to predict the risks of persistent moles with a cut-off point of 2.384, which can be used as a reference for patients with CHM.
Background Although neck pain is common in young adulthood, studies on predictive factors for its onset and persistence are scarce. It is therefore important to identify possible risk factors among young adults so as to prevent the development of neck pain later in life. Methods A prospective study was carried out in healthy undergraduate students. At baseline, a self-administered questionnaire and standardized physical examination were used to collect data on biopsychosocial factors. At 3, 6, 9, and 12 months thereafter, follow-up data were collected on the incidence of neck pain. Those who reported neck pain on ≥ 2 consecutive follow-ups were categorized as having persistent neck pain. Two regression models were built to analyze risk factors for the onset and persistence of neck pain. Results Among the recruited sample of 684 students, 46% reported the onset of neck pain between baseline and 1-year follow-up, of whom 33% reported persistent neck pain. The onset of neck pain was associated with computer screen position not being level with the eyes and mouse position being self-rated as suitable. Factors that predicted persistence of neck pain were position of the keyboard being too high, use of computer for entertainment Neck pain is quite common among undergraduate students. This study found very few proposed risk factors that predicted onset and persistence of neck pain. The future health of undergraduate students deserves consideration. However, there is still much uncertainty about factors leading to neck pain and more research is needed on this topic. PMID:21756362
Marklund, Susanna; Wänman, Anders
To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.
Full Text Available Background: Gastrostomy for feeding disorders or swallowing dysfunctions can be complicated by persistent gastrostomy site infection (PGSI. PGSI causes nutrient leakage, with dilated PGSI requiring gastrostomy reconstruction. The purpose of this study was to evaluate the causes, patient characteristics, and perioperative management of PGSI after Nissen fundoplication and gastrostomy for patients with gastro-oesophageal reflux. Patients and Methods: The records of all patients who underwent Nissen fundoplication and gastrostomy for gastro-oesophageal reflux over the past 12 years were retrieved. Risk factors were analysed, including age at surgery, gender, operative procedure, use of postoperative ventilator management, gastrostomy tube migration towards the pylorus, bacterial culture results, and length of hospital stay. PGSI as a cause of inflammation was analysed statistically. Results: Forty patients were identified, ranging in age from 1 to 49 years (median, 11 years surgically. Twenty each underwent laparoscopic and open surgery, with all undergoing gastrostomy using the Stamm technique. Four patients developed PGSI. Gastrostomy tubes had migrated postoperatively to the pyloric side in three of these four patients (P < 0.005, increasing intragastric pressure. Three of these four patients also required positive pressure ventilation during the perioperative period (P < 0.001. Conclusion: PGSI correlates with the perioperative management of positive pressure and with increased intragastric pressure resulting from pyloric obstruction, which is caused by aberrant distribution of the gastrostomy tube to the pyloric side. Statistical Analysis Used: Factors in the two groups were compared statistically by Mann–Whitney U-test to determine whether PGSI caused inflammation. Statistical significance was defined as P < 0.05.
López-Gatius, F; Santolaria, P; Yániz, J; Fenech, M; López-Béjar, M
Cystic ovarian disease is a major cause of reproductive failure and economic loss for the dairy industry. Many cysts that develop during the early postpartum period regress spontaneously. However, it is difficult to decide at what point it would be more cost effective to treat ovarian cysts than to wait for spontaneous recovery. The objective of this study was to analyze risk factors for the development of the ovarian cystic condition during early and late postpartum, and for its persistence or recovery during the pre-service period in lactating dairy cows. Using multiple logistic regression, we analyzed data derived from 873 lactating dairy cows from a single herd. An ovarian cyst was diagnosed if it was possible to observe a single follicular structure with an antrum diameter > or = 25 mm in the absence of a corpus luteum in three sonograms performed at 7-day intervals. The cystic condition was denoted as early if the cyst was diagnosed 43-49 days postpartum, and late if detected 57-63-day postpartum. Spontaneous cyst regression before 60-day postpartum was regarded as early cystic recovery. For the early cystic group, there were no significant effects of lactation number, body condition score on prepartum Day 60, at parturition or on postpartum Day 30, or of body condition loss from parturition to 30-day postpartum. Cows calving in summer were 2.6 times more likely to develop ovarian cysts than those giving birth in winter. The risk of having a cyst was 1.9 times higher in cows with an abnormal puerperium. A 1-kg increase in milk yield raised the risk of cysts by a factor of 1.05. A 1-unit increase in body condition score (scale from 1 to 5) from prepartum Day 60 to parturition increased the risk of cyst development 8.4 times. Milk production and lactation number were negatively correlated with spontaneous early cyst recovery. A 1-kg decrease in milk production increased the probability of cyst recovery by a factor of 1.06, and a 1-unit drop in lactation number
Frega, Antonio; Stentella, Patrizia; De Ioris, Andrea; Piazze, Juan Josè; Fambrini, Massimiliano; Marchionni, Mauro; Cosmi, Ermelando Vinicio
Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections (STIs) in young women. They can occur in one or multiple areas of the female genitalia. Usually, the vulva is the initial site of implantation for HPV. The purpose of our study is to evaluate the epidemiological aspects, incidence of single or multiple lesions in the lower genital tract, correlation between sexual behaviour and their localization and behaviour risk factors for persistence and recurrence of HPV lesions and cervical intraepithelial lesion (CIN) in a long-term follow-up among young women. We recruited 268 patients aged 11-21 years who previously had cytology and/or physical examination suspicious for HPV infection. The women were interviewed and asked information about lifestyle, sexual behaviour, work, personal or family history of genital warts and school attendance. We considered individuals to be 'smokers' if they smoked more than five cigarettes/day. No specific data were recorded about oral contraception, nevertheless, no woman had used oral contraceptives (OCs) for more than 2 years. Young women included in the study were between the age of 12 and 21 years who had HVP lesions after entry examinations and had undergone no treatment for HPV lesions prior to entry. Other exclusion criteria relevant to this study included cervical excisional treatment prior to entry or later. Two hundred and thirty-four young women were included in our study group. Our diagnostic schedule for a complete evaluation included exo- and endocervical cytology, colposcopy, directed biopsy and microcolpohysteroscopy. The treatment was performed with a LASER CO2 Coherent 400, model 451, with Zeiss photocolposcopy attachment. The finding that, among 126/234 (53.8%) adolescents using contraceptives, only 85 (36.3%) have used condom, the only barrier form of contraceptive effectively protecting against virus, shows a low awareness of the high risk for contracting HPV infection among
Lassen, C. F.; Mikkelsen, S.; Kryger, Ann Isabel
to elbow, forearm, or wrist-hand pain during the 12 months preceding the baseline questionnaire. Pain status (recovery versus persistence) at follow-up was examined in relation to computer work aspects and ergonomic, psychosocial, and personal factors by questionnaire. In addition, data on objectively......, and type-A behavior, the prognosis seemed independent of psychosocial workplace factors and personal factors. A few cases with severe pain were affected at a level which could be compared to clinical pain conditions. CONCLUSIONS: Our results do not support the hypothesis that computer work activity......OBJECTIVES: This study examined the influence of work-related and personal factors on the prognosis of "severe" elbow, forearm, and wrist-hand pain among computer users. METHODS: In a 1-year follow-up study of 6943 computer users, 673 (10%) participants reported "quite a lot" or more trouble due...
Betts, Kelly J.; Shirley, Janet A.; Kennedy, Robert
Background: Student success in a baccalaureate nursing program is of utmost importance at a southern College of Nursing (CON).CON faculty wanted to understand better what academic/ social risk factors attributed to attrition in the first year of the nursing program. The purpose of this study was to determine academic and social risk factors…
Schmelzer, Amy C; Salt, Elizabeth; Wiggins, Amanda; Crofford, Leslie J; Bush, Heather; Mannino, David M
The purpose of this study was to examine the association between smoking and stress with nonpersistent and persistent back pain. Participants included 3703 women who took part in the Kentucky Women's Health Registry in 2008 and 2011. Multivariate logistic regression modeling was used to examine whether smoking status and stress levels were predictive of nonpersistent and persistent back pain, controlling for sociodemographic characteristics. Stress level was associated with both nonpersistent and persistent back pain, whereas smoking was associated with only persistent back pain. Current smokers were 1.5 times more likely to report persistent back pain compared with never smokers, controlling for age, race, body mass index, educational attainment, and employment status. Women experiencing large or overwhelming amounts of stress were 1.8 times more likely to have nonpersistent back pain and 1.6 times more likely to report persistent back pain, compared with women experiencing small amounts of stress. This study further substantiates the findings of prior research that describes a significant relationship between back pain, stress, and smoking. Understanding the role of modifiable risk factors (ie, smoking and stress) and their impact on back pain provides an opportunity to offer a comprehensive and tailored treatment plan.
Full Text Available STUDY DESIGN: Two-year, prospective cohort data from the Japan epidemiological research of occupation-related back pain study in urban settings were used for this analysis. OBJECTIVE: To examine the association between aggravated low back pain and psychosocial factors among Japanese workers with mild low back pain. SUMMARY OF BACKGROUND DATA: Although psychosocial factors are strongly indicated as yellow flags of low back pain (LBP leading to disability, the association between aggravated LBP and psychosocial factors has not been well assessed in Japanese workers. METHODS: At baseline, 5,310 participants responded to a self-administered questionnaire including questions about individual characteristics, ergonomic work demands, and work-related psychosocial factors (response rate: 86.5%, with 3,811 respondents completing the 1-year follow-up questionnaire. The target outcome was aggravation of mild LBP into persistent LBP during the follow-up period. Incidence was calculated for the participants with mild LBP during the past year at baseline. Logistic regression was used to explore risk factors associated with persistent LBP. RESULTS: Of 1,675 participants who had mild LBP during the preceding year, 43 (2.6% developed persistent LBP during the follow-up year. Multivariate analyses adjusted for individual factors and an ergonomic factor found statistically significant or almost significant associations of the following psychosocial factors with persistent LBP: interpersonal stress at work [adjusted odds ratio (OR: 1.96 and 95% confidence interval (95%CI: 1.00-3.82], job satisfaction (OR: 2.34, 95%CI: 1.21-4.54, depression (OR: 1.92, 95%CI: 1.00-3.69, somatic symptoms (OR: 2.78, 95%CI: 1.44-5.40, support from supervisors (OR: 2.01, 95%CI: 1.05-3.85, previous sick-leave due to LBP (OR: 1.94, 95%CI: 0.98-3.86 and family history of LBP with disability (OR: 1.98, 95%CI: 1.04-3.78. CONCLUSIONS: Psychosocial factors are important risk factors for
Jordan, Hannah T; Friedman, Stephen M; Reibman, Joan; Goldring, Roberta M; Miller Archie, Sara A; Ortega, Felix; Alper, Howard; Shao, Yongzhao; Maslow, Carey B; Cone, James E; Farfel, Mark R; Berger, Kenneth I
Objectives We studied the course of lower respiratory symptoms (LRS; cough, wheeze or dyspnoea) among community members exposed to the 9/11/2001 World Trade Center (WTC) attacks during a period of 12–13 years following the attacks, and evaluated risk factors for LRS persistence, including peripheral airway dysfunction and post-traumatic stress disorder (PTSD). Methods Non-smoking adult participants in a case-control study of post-9/11-onset LRS (exam 1, 2008–2010) were recruited for follow-up (exam 2, 2013–2014). Peripheral airway function was assessed with impulse oscillometry measures of R5 and R5-20. Probable PTSD was a PTSD checklist score ≥44 on a 2006–2007 questionnaire. Results Of 785 exam 1 participants, 545 (69%) completed exam 2. Most (321, 59%) were asymptomatic at all assessments. Among 192 participants with initial LRS, symptoms resolved for 110 (57%) by exam 2, 55 (29%) had persistent LRS and 27 (14%) had other patterns. The proportion with normal spirometry increased from 65% at exam 1 to 85% at exam 2 in the persistent LRS group (p<0.01) and was stable among asymptomatic participants and those with resolved LRS. By exam 2, spirometry results did not differ across symptom groups; however, R5 and R5-20 abnormalities were more common among participants with persistent LRS (56% and 46%, respectively) than among participants with resolved LRS (30%, p<0.01; 27%, p=0.03) or asymptomatic participants (20%, p<0.001; 8.2%, p<0.001). PTSD, R5 at exam 1, and R5-20 at exam 1 were each independently associated with persistent LRS. Conclusions Peripheral airway dysfunction and PTSD may contribute to LRS persistence. Assessment of peripheral airway function detected pulmonary damage not evident on spirometry. Mental and physical healthcare for survivors of complex environmental disasters should be coordinated carefully. PMID:28341697
Maria das Graças Moura Lins
Full Text Available RACIONAL: A diarréia persistente é uma doença multicausal. A análise do risco para o prolongamento do quadro diarréico envolve variáveis ambientais, biológicas e do manejo clínico. OBJETIVO: Identificar fatores de risco para a diarréia persistente em crianças hospitalizadas na fase aguda do quadro diarréico. PACIENTES E MÉTODOS: O estudo foi do tipo caso-controle. A amostra consistiu de 216 crianças menores de 24 meses hospitalizadas por diarréia de início abrupto, no Instituto Materno-Infantil de Pernambuco, Recife, PE. O grupo de casos incluiu as crianças com diarréia persistente e o de controles aquelas com diarréia aguda. Foram analisadas variáveis socioeconômicas, biológicas, de morbidade anterior, clínicas e do manejo terapêutico prévio à admissão. Utilizou-se o odds ratio não ajustado e ajustado, com seus respectivos intervalos de confiança de 95%, observando-se o nível de significância de 5%. A análise multivariada foi feita através de regressão logística. RESULTADOS: O risco de persistência da diarréia foi maior nas crianças com: disenteria, febre no início do quadro, dieta suspensa e uso de antibiótico à admissão hospitalar. O risco de diarréia persistente foi cerca de três vezes maior para crianças sem geladeira no domicílio e que apresentavam hiperemia perianal ao exame físico na admissão hospitalar, sendo estas as variáveis que apresentaram significância estatística após o ajuste para fatores de confusão. CONCLUSÕES: A melhoria das condições ambientais e o manejo adequado e individualizado da criança hospitalizada por diarréia pode contribuir para a redução da morbidade da doença.BACKGROUND: Persistent diarrhea is a multicausal disease. The analysis of risk factors for persistent diarrhea includes environmental and biological variables as well as therapeutical management. AIM: To identify risk factors for persistent diarrhea among children hospitalized with acute diarrhea
Emerson, Eric; Blacher, Jan; Einfeld, Stewart; Hatton, Chris; Robertson, Janet; Stancliffe, Roger J
We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kristy Van Dervoort
Full Text Available Background Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG are presumed to have ureteropelvic junction obstruction (UPJO. There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality. Objective To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality. Methods This retrospective single center review examined infants and children <5 years of age with hydronephrosis who were followed for at least 12 months. Results 136 children were identified (96 male:40 female. The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72% of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67% available patients, 30 (26% had been referred to urology, and 12 (10% had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001. There was an association between detection at birth and lack of resolution of hydronephrosis. Conclusions Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.
ten Brinke, A.; Zwinderman, A. H.; Sterk, P. J.; Rabe, K. F.; Bel, E. H.
Persistent airflow limitation can develop in nonsmoking patients with asthma. However, the prevalence and risk factors for airways obstruction with incomplete reversibility in asthma are unknown. We assessed the prevalence of persistent airflow limitation (defined as postbronchodilator FEV(1) or
Walton, David M; Macdermid, Joy C; Giorgianni, Anthony A; Mascarenhas, Joanna C; West, Stephen C; Zammit, Caroline A
Systematic review and meta-analysis. To update a previous review and meta-analysis on risk factors for persistent problems following whiplash secondary to a motor vehicle accident. Prognosis in whiplash-associated disorder (WAD) has become an active area of research, perhaps owing to the difficulty of treating chronic problems. A previously published review and meta-analysis of prognostic factors included primary sources up to May 2007. Since that time, more research has become available, and an update to that original review is warranted. A systematic search of international databases was conducted, with rigorous inclusion criteria focusing on studies published between May 2007 and May 2012. Articles were scored, and data were extracted and pooled to estimate the odds ratio for any factor that had at least 3 independent data points in the literature. Four new cohorts (n = 1121) were identified. In combination with findings of a previous review, 12 variables were found to be significant predictors of poor outcome following whiplash, 9 of which were new (n = 2) or revised (n = 7) as a result of additional data. The significant variables included high baseline pain intensity (greater than 5.5/10), report of headache at inception, less than postsecondary education, no seatbelt in use during the accident, report of low back pain at inception, high Neck Disability Index score (greater than 14.5/50), preinjury neck pain, report of neck pain at inception (regardless of intensity), high catastrophizing, female sex, WAD grade 2 or 3, and WAD grade 3 alone. Those variables robust to publication bias included high pain intensity, female sex, report of headache at inception, less than postsecondary education, high Neck Disability Index score, and WAD grade 2 or 3. Three existing variables (preaccident history of headache, rear-end collision, older age) and 1 additional novel variable (collision severity) were refined or added in this updated review but showed no significant
... cells do not invade nearby tissues or spread. Risk Factors Key Points Factors That are Known to ... chemicals . Factors That are Known to Increase the Risk of Cancer Cigarette Smoking and Tobacco Use Tobacco ...
van Vugt, E.; Loeber, R.; Pardini, D.
Background Children born to mothers who were younger than average at their first childbirth are at increased risk for future persistent delinquent behaviour, but explanations for this remain unclear. Aims Our aim was to identify possible family and parenting variables that may help explain this
Araujo, Maria Júlia Correia Lima Nepomuceno; Ramalho, Janaina Almeida Mota; Elias, Rosilene Motta; Jorgetti, Vanda; Nahas, William; Custodio, Melani; Moysés, Rosa M A; David-Neto, Elias
Although a successful kidney transplant (KTx) improves most of the mineral and bone disorders (MBD) produced by chronic kidney disease (CKD), hyperparathyroidism may persist (pHPT). Current guidelines recommend parathyroidectomy if serum parathormone is persistently elevated 1 year after KTx, because pHPT has been recently associated with poor graft outcomes. However, whether patients with pHPT and adequate renal function are at risk for long-term graft failure is unknown. Longitudinal follow-up of 911 adults submitted to KTx between January 2005 and December 2014, with estimated glomerular filtration rate (eGFR) ≥ 30 mL/min 1 year after surgery. Clinical and laboratory data were collected from electronic database. Graft failure was defined as return to dialysis. Overall, 62% of the patients were classified as having pHPT 1 year after KTx. After a mean follow-up time of 47 months, there were 59 graft failures (49 in pHPT and 10 in non-pHPT group, P = .003). At last follow-up, death-censored graft survival was lower in the pHPT group (P = .009), even after adjustment for age at KTx, donor age, donor type, acute rejection, parathyroidectomy, and eGFR at 1 year after transplantation (odds ratio [OR] 1.99; 1.004-3.971; P = .049). A PTH of 150 pg/mL at 6 months was the best cutoff to predict pHPT at 1 year (specificity = 92.1%). Having pHPT after a successful KTx increases the long-term risk of death-censored graft failure. This result highlights the need for better recognition and management of CKD-MBD before and during the first year after KTx, and opens a discussion on the more appropriate timing to perform parathyroidectomy. Copyright © 2017 Elsevier Inc. All rights reserved.
Early discontinuation of antibiotic prophylaxis in patients with persistent primary vesicoureteral reflux initially detected during infancy: outcome analysis and risk factors for febrile urinary tract infection.
Moriya, Kimihiko; Mitsui, Takahiko; Kitta, Takeya; Nakamura, Michiko; Kanno, Yukiko; Kon, Masafumi; Nishimura, Yoko; Shinohara, Nobuo; Nonomura, Katsuya
We retrospectively assessed the incidence of and risk factors for febrile urinary tract infection in children during active surveillance after early discontinuation of antibiotic prophylaxis. We retrospectively evaluated 9 females and 61 uncircumcised males diagnosed with primary vesicoureteral reflux before age 1 year who had persistent reflux on followup voiding cystourethrogram and were subsequently followed under active surveillance without continuous antibiotic prophylaxis. Patients with secondary vesicoureteral reflux or associated urological abnormality were excluded. Clinical outcomes, including incidence of febrile urinary tract infection and new scar formation, were evaluated. Risk factors for febrile urinary tract infection were also analyzed. Mean age at stopping continuous antibiotic prophylaxis was 21 months, and mean followup was 61 months. During active surveillance 21 patients had febrile urinary tract infection, and the 5-year infection-free rate under active surveillance was 67.5%. One or 2 foci of minimal new scarring developed in 4 of 16 patients who underwent followup dimercapto-succinic acid scan after febrile urinary tract infection. On multivariate analysis dilated vesicoureteral reflux on followup voiding cystourethrogram was the only significant risk factor for febrile urinary tract infection. This study revealed that about two-thirds of patients with persistent vesicoureteral reflux were free of febrile urinary tract infection during 5 years of active surveillance. Those with dilated vesicoureteral reflux on followup voiding cystourethrogram are at significantly greater risk for febrile urinary tract infection. Accordingly active surveillance, especially in patients with nondilated vesicoureteral reflux on followup voiding cystourethrogram, seems to be a safe option even in children who have not yet been toilet trained. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights
van Vugt, Eveline; Loeber, Rolf; Pardini, Dustin
Children born to mothers who were younger than average at their first childbirth are at increased risk for future persistent delinquent behaviour, but explanations for this remain unclear. Our aim was to identify possible family and parenting variables that may help explain this relationship. We hypothesised that parental stress, large number of children in the home, low socioeconomic status (including neighbourhood problems) and poor parenting would account for the link between early first motherhood and their offspring's delinquency. Four hundred and sixty-two boys were selected from the Pittsburgh Youth Study, a longitudinal study of a random sample of school boys in Pittsburgh, initially assessed half-yearly and then annually from 7 to 19 years of age, using self-reporting and other reporting methods. Indirect effect models were used to test relationships between variables. Higher levels of parental stress, poorer parent-child communication and caring for a larger number of children all mediated the relationship between maternal youth and persistent delinquency by their boys, but only explained about 20% of it. At least partial explanations of the relationship between a mother's age at first childbirth and persistent delinquency in her male offspring suggest that future research should test whether early interventions with younger mothers to decrease their sense of stress in parenting and improve their capacity for communication with their child(ren) may help to prevent persistent delinquency in their boys. Programmes designed to help young women make more informed and planned decisions about their pregnancies should also be evaluated. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Sodemann, Morten; Jakobsen, M S; Mølbak, Kare
that these episodes initially were less acute. Use of oral rehydration salts did not have an impact on development of PD, whereas home medication tended to increase the risk of PD. Our study confirms the close association between systemic illness and PD as well as the importance of cryptosporidiosis as a cause of PD...... the episode stopped or after 14 days with diarrhoea. Children who still had diarrhoea after 14 days (n = 40, 12.5% of episodes) were regarded as suffering from PD. Clinical signs, perceived by the mother, were recorded together with care-seeking behaviour and management actions. Tired and rapid breathing...... prior (OR = 6.52 (95% CI 1.69-25.1)), mother had to force breast feeding (OR = 8.01 (2.99-21.5)) and current infection with Cryptosporidium (OR = 5.53 (2.10-14.6)) were the most important independent risk factors for the development of PD. Late consultation (> 48 h) was associated with PD, reflecting...
Dennery, M.; Dupont, M.A.
This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)
Parthasarathy, Sairam; Vasquez, Monica M; Halonen, Marilyn; Bootzin, Richard; Quan, Stuart F; Martinez, Fernando D; Guerra, Stefano
Insomnia has been associated with mortality risk, but whether this association is different in subjects with persistent vs intermittent insomnia is unclear. Additionally, the role of systemic inflammation in such an association is unknown. We used data from a community-based cohort to determine whether persistent or intermittent insomnia, defined based on persistence of symptoms over a 6-year period, was associated with death during the following 20 years of follow-up. We also determined whether changes in serum C-reactive protein (CRP) levels measured over 2 decades between study initiation and insomnia determination were different for the persistent, intermittent, and never insomnia groups. The results were adjusted for confounders such as age, sex, body mass index, smoking, physical activity, alcohol, and sedatives. Of the 1409 adult participants, 249 (18%) had intermittent and 128 (9%) had persistent insomnia. During a 20-year follow-up period, 318 participants died (118 due to cardiopulmonary disease). In adjusted Cox proportional-hazards models, participants with persistent insomnia (adjusted hazards ratio [HR] 1.58; 95% confidence interval [CI], 1.02-2.45) but not intermittent insomnia (HR 1.22; 95% CI, 0.86-1.74) were more likely to die than participants without insomnia. Serum CRP levels were higher and increased at a steeper rate in subjects with persistent insomnia as compared with intermittent (P = .04) or never (P = .004) insomnia. Although CRP levels were themselves associated with increased mortality (adjusted HR 1.36; 95% CI, 1.01-1.82; P = .04), adjustment for CRP levels did not notably change the association between persistent insomnia and mortality. In a population-based cohort, persistent, and not intermittent, insomnia was associated with increased risk for all-cause and cardiopulmonary mortality and was associated with a steeper increase in inflammation. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available 10% of all individuals in Germany develop persistent symptoms due to nonspecific back pain (NSBP causing up to 90% of direct and indirect expenses for health care systems. Evidence indicates a strong relationship between chronic nonspecific back pain and psychosocial risk factors. The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ and the German Heidelberger Kurzfragebogen Rückenschmerz (HKF-R 10 are deemed valid in prediction of persistent pain, functional loss or amount of sick leave. This study provides and discusses validity criteria for these questionnaires using ROC-curve analyses. Quality measurements included sensitivity and specificity, likelihood-ratio related test-efficiencies and clinical utility in regard to predictive values.265 patients recruited from primary and secondary care units completed both questionnaires during the same timeframe. From the total, 133 patients returned a 6-month follow-up questionnaire to assess the validity criteria for outcomes of pain, function and sick leave.Based on heterogeneous cut-offs for the ÖMPSQ, sensitivity and specificity were moderate for outcome of pain (72%/75%. Very high sensitivity was observed for function (97%/57% and high specificity for sick leave (63%/85%. The latter also applied to the HKF-R 10 (pain 50%/84%. Proportions between sensitivity and specificity were unbalanced except for the ÖMPSQ outcome of pain. Likelihood-ratios and positive predictive values ranged from low to moderate.Although the ÖMPSQ may be considered useful in identification of long-term functional loss or pain, over- and underestimation of patients at risk of chronic noncspecific back pain led to limited test-efficiencies and clinical utility for both questionnaires. Further studies are required to quantify the predictive validity of both questionnaires in Germany.
Walton, David M; Pretty, Jason; MacDermid, Joy C; Teasell, Robert W
Systematic review and meta-analysis. Whiplash-associated disorder (WAD) is the most common reported injury following motor vehicle accident. Evidence for prognosis and intervention are difficult to interpret due to differences in inception times, outcomes used, and sample heterogeneity. An extensive literature search was conducted to identify published studies of prognosis following whiplash. Rigorous inclusion criteria were applied to allow for meaningful results to be drawn. Data were extracted, transformed where necessary, and pooled to allow estimation of the odds ratio for any factor with at least 3 data points in the literature. From 11 cohorts (n = 3193), 25 factors were identified with at least 3 data points in the existing literature. Of these, 9 were found to be significant predictors based on the odds ratio and confidence limits: no postsecondary education, female gender, history of previous neck pain,baseline neck pain intensity greater than 55/100, presence of neck pain at baseline, presence of headache at baseline, catastrophizing, WAD grade 2 or 3, and no seat belt in use at time of collision. Neck pain intensity, WAD grade, headache, and no postsecondary education were robust to publication bias. Using a rigorous process for the identification and extraction of data from a homogenous subset of the prognostic WAD literature, we were able to identify several factors for which information is easy to collect clinically and could provide clinicians with a good sense of prognosis following whiplash injury.
Kent, Peter; Kjær, Per
Background: There is considerable interest in whether best practice management of nonspecific low back pain (NSLBP) should include the targeting of treatment to subgroups of people with identifiable clinical characteristics. However, there are no published systematic reviews of the efficacy...... were randomised controlled trials of targeted psychosocial interventions that used trial designs capable of providing robust information on the efficacy of targeted treatment (treatment effect modification) for the outcomes of pain, activity limitation and psychosocial factors (fear avoidance...... limitation at 12 months, when targeted to people with higher movement-related pain. Few studies have investigated targeted psychosocial interventions in NSLBP, using trial designs suitable for measuring treatment effect modification, and they do not provide consistent evidence supporting such targeting...
Daniel Guimarães Tiezzi
selecionar pacientes que não necessitariam de seguimento na forma realizada atualmente e impede também a seleção com precisão de casos com indicação de quimioterapia profilática.PURPOSE: to evaluate the epidemiologic data and signs of trophoblastic hyperplasia in patients with complete hydatidiform mole (CHM and to estimate the risk associated with the persistence of the disease. METHODS:: we evaluated 214 patients with CHM submitted to uterine evacuation between 1980 and 2001. The patients were included prospectively. All patients were followed until negative bHCG with weekly clinical evaluation and bHCG quantification. We considered persistence when the patient needed another treatment after uterine evacuation. The risk factors for persistence were evaluated through univariate and multivariate analysis, and the odds ratio (OR was calculated for each one. RESULTS: among the epidemiologic factors, only negative Rh was significant (OR=2.28. All signs of trophoblastic hyperplasia, represented by uterine size larger than expected, sonographic uterine volume, tecaluteinic cysts, and betaHCG higher than 10(5 were associated with risk for the presistence of the disease. The presence of at least one sign of trophoblastic hyperplasia showed sensitivity of 82% and predictive positive value of 35.1% (OR=4.8. The logistic regression identified larger uterine size than expected and bHCG higher than 10(5 as risk factors for persistence of the gestational trophoblastic disease (OR=4.1 and 5.5, respectively. CONCLUSIONS: the signs of trophoblastic hyperplasia showed good sensitivity to predict persistence of the disease; however, the low predictive positive value does not allow using these criteria to change treatment. It is very important to reinforce the importance of serial betaHCG quantification in these high-risk patients.
Sverre, Elise; Otterstad, Jan Erik; Gjertsen, Erik; Gullestad, Lars; Husebye, Einar; Dammen, Toril; Moum, Torbjørn; Munkhaugen, John
Understanding the determinants of persistent smoking after a coronary event constitutes the basis of modelling interventions of smoking cessation in secondary prevention programs. We aim to identify the potentially modifiable medical, sociodemographic and psychosocial factors, comprising the study factors, associated with unfavourable risk factor control after CHD events. A cross-sectional explorative study used logistic regression analysis to investigate the association between study factors and smoking status in 1083 patients hospitalized with myocardial infarction and/or coronary revascularization. Hospital record data, a self-report questionnaire, clinical examination and blood samples were applied. At the index hospitalization, 390 patients were smoking and at follow-up after 2-36 months 167 (43%) of these had quit, while 230 reported persistent smoking. In adjusted analyses, unemployed or disability benefits (Odds ratio (OR) 4.1), low education (OR 3.5), longer smoking duration (OR 2.3) and not having ST-elevation myocardial infarction (STEMI) as index event (OR 2.3) were significantly associated with persistent smoking. Psychosocial factors at follow-up were not associated with persistent smoking. Smokers reported high motivation for cessation, with 68% wanting help to quit. Only 42% had been offered nicotine replacement therapy or other cessation aids. Smokers rated use of tobacco as the most important cause of their coronary disease (6.8 on a 1-10 Likert scale). Low socioeconomic status, prior duration of smoking, and not having STEMI as index event were associated with persisting smoking. Persistent smokers in this study seem to have an acceptable risk perception and were motivated to cease smoking, but needed assistance through cessation programs including prescription of pharmacological aids. Registered at ClinicalTrials.gov: NCT02309255 , registered retrospectively.
Papadopoulou, Athina; Menegola, Milena; Kuhle, Jens; Ramagopalan, Sreeram V; D'Souza, Marcus; Sprenger, Till; Radue, Ernst-Wilhelm; Kappos, Ludwig; Yaldizli, Özgür
Progenitor cells from the subventricular zone (SVZ) of the lateral ventricles are assumed to contribute to remyelination and resolution of black holes (BHs) in multiple sclerosis (MS). This process may depend on the distance between the lesion and the SVZ. The objective of this paper is to investigate the relationship between lesion-to-ventricle (LV) distance and persistence of new BHs. We analysed the magnetic resonance images (MRIs) of 289 relapsing-remitting (RR) MS patients, obtained during a multi-centre, placebo-controlled phase II trial over one year. Overall, 112/289 patients showed 367 new BHs at the beginning of the trial. Of these, 225 were located in 94/112 patients at the level of the lateral ventricles on axial MRIs and included in this analysis. In total, 86/225 (38%) BHs persisted at month 12. LV distance in persistent BHs (PBHs) was not longer than in transient BHs. In fact PBHs tended to be closer to the SVZ than transient BHs. A generalised linear mixed multivariate model adjusted for BHs clustered within a patient and including patient- as well as lesion-specific factors revealed size, ring contrast enhancement, and shorter LV distance as independent predictors for BH persistence. Location of BHs close to the lateral ventricles does not appear to favourably influence the resolution of new BHs in RRMS.
Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...
Robbins, Catherine J; Connors, K C; Sheehan, Timothy J; Vaughan, James S
Minimize surprises on your financial statement by adopting a model for integrated risk management that: Examines interrelationships among operations, investments, and financing. Incorporates concepts of the capital asset pricing model to manage unexpected volatility
Williamson, Esther; Williams, Mark A; Gates, Simon; Lamb, Sarah E
(1) To identify risk factors for chronic disability in people with acute whiplash associated disorders (WAD). (2) To estimate the impact of the numbers of risk factors present. Prospective cohort study. Data were collected, on average, 32 days after injury (SD=10.9) and 12 months later. Baseline measures of pain, disability, neck movement, psychological and behavioural factors were independent variables and chronic disability at 12 months was the dependent variable in a multivariable logistic regression analysis. National Health Service physiotherapy departments. Participants (n=599) with symptoms 3 weeks after injury, self-referred to physiotherapy as part of a randomised controlled trial. 430 (72%) participants provided complete data for this analysis. Chronic disability based on Neck Disability Index scores. 136 (30%) participants developed chronic disability. High baseline disability (OR 3.3, 95% CI 1.97 to 5.55), longer predicted recovery time (OR 2.4, 95% CI 1.45 to 3.87), psychological distress (OR 1.9, 95%CI 1.05 to 3.51), passive coping (OR 1.8, 95% CI 1.07 to 2.97) and greater number of symptoms (OR 1.7, 95% CI 1.07 to 2.78) were associated with chronic disability. One risk factor resulted in 3.5 times the risk (95% CI 1.04 to 11.45) of chronic disability but this risk increased to 16 times (95%CI 5.36 to 49.27) in those with four or five risk factors. Baseline disability had the strongest association with chronic disability but psychological and behavioural factors were also important. Treatment strategies should reflect this which may require a change to current physiotherapy approaches for acute WAD. The number of risk factors present should be considered when evaluating potential for poor outcome. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
O'Connell Ferster, Ashley P; Tanner, April Michelle; Karikari, Kodjo; Roberts, Christopher; Wiltz, Derek; Carr, Michele M
Over a million ventilation tubes are placed annually in the United States, making this one of the most commonly performed procedures in the field of medicine. Certain factors increase the risk of persistent tympanic membrane perforation following the extrusion of short term ventilation tubes. Persistent perforations may fail to heal on their own, necessitating surgical closure to avoid conductive hearing loss. It is important to detect factors that may predict children who are at increased risk for persistent perforations. This study was a retrospective chart review that involved 757 patients between 2003 and 2008. The patients studied were within the age of 2 months-17 years, and all had short term tubes placed. The chart data also included demographic information, comorbidities, and information related to tube insertion and follow-up care. Chi-square, t-test, and multivariate logistic regression were conducted to compare variables between patients with perforations and those without. Data from 757 patients was analyzed, showing that perforation rate is associated with rhinorrhea, operative tube removal, aural polyps, and otorrhea (OR 1.72, 8.16, 4.69, and 1.72 respectively). The absence of otorrhea decreased the likelihood of TM perforations and no significant differences were found in gender, total number of sets of tubes, type of tube, use of nasal steroids, adenoidectomy, or nasal congestion. Our findings suggest that children with rhinorrhea, otorrhea, aural polyps, or prolonged intubation requiring operative tube removal should be identified clinically as children at risk of persisting perforation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
... You are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is ... what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does not tend to run in families ...
... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...
Pizzoferrato, Anne-Cécile; Fauconnier, Arnaud; Quiboeuf, Emeline; Morel, Karine; Schaal, Jean-Patrick; Fritel, Xavier
Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery. Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) women continent 4 and 12 years after first delivery; (B) women continent at 4 and incontinent at 12 years; (C) women incontinent at 4 and continent at 12 years; and (D) women incontinent at 4 and 12 years. Multivariate logistic regressions were used to determine risk factors of UI prevalence (groups B + D vs. A + C), incidence (B vs. A), remission (C vs. D), and onset of UI (D vs. Factors associated with UI 12 years after first pregnancy were: BMI (OR = 1.17 [95%CI: 1.04-1.32], by 1 kg/m(2) ) and increasing BMI (1.43 [1.19-1.73]), first child's weight (1.08 [1.001-1.16], by 100 g) and UI during first pregnancy (3.77 [1.83-7.76]). Factors associated with UI incidence were age at first delivery (0.86 [0.75-0.98]) and high BMI (1.24 [1.05-1.45]). Increasing BMI, UI during first pregnancy, and heavy first child reduce the likelihood of UI remission (0.37 [0.20-0.68], 0.11 [0.02-0.63], and 0.73[0.59-0.91], respectively). UI during first pregnancy could be indicative of individual susceptibility to UI. Obesity appears to be a modifiable factor for remission of UI in women. © 2013 Wiley Periodicals, Inc.
Pizzoferrato, Anne-Cécile; Fauconnier, Arnaud; Quiboeuf, Emeline; Morel, Karine; Schaal, Jean-Patrick; Fritel, Xavier
International audience; AIMS: Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery. METHODS: Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) wome...
The persistence of gender inequality in Zimbabwe: factors that impede the ... Specifically, we sought to identify the factors perceived by women school heads to be causes ... all other roles; and lack of support from the home and the workplace.
Just, Jocelyne; Belfar, Samira; Wanin, Stéphanie; Pribil, Céline; Grimfeld, Alain; Duru, Gérard
Persistent asthma in adults starts often early in childhood and is associated with alterations in respiratory function that occur early in life. The aim of this study was to evaluate the importance of innate and environmental factors associated with occurrence of asthma during childhood in a population of recurrent wheezing infants followed prospectively. A cohort of infants less than 30 months old with recurrent wheezing was established in order to assess severity of respiratory symptoms and to look for the presence of atopy and environmental risk factors. At the age of 6 years, they were reevaluated with respect to remission or persistence of wheezing over the previous 12-month period. Data were available for 219 subjects aged 15 +/- 5 months. In 27% of the infants with recurrent wheeze, wheezing persisted until the age of 6 years. In multivariate analysis, stepwise logit analysis showed that the risk factors for persistent wheezing are eosinophilia >or=470/mm(3), allergenic sensitization, and a father with asthma. Environmental factors present during the first year of life that protect from persistence of wheezing are ( 1 ) breastfeeding for longer than 3 months, ( 2 ) pets at home, and ( 3 ) >or=3 siblings. The detection rate for persistent wheezing in this model is 72%. The persistence score showed good specificity 91% but low sensitivity 35%. This study confirms the role of atopic host factors on wheezing persistence during childhood and detected protective environmental factors.
Full Text Available Background and Objectives: Renal stone disease is a common disorder of the urinary tract and also a significant problem because of incidence, recurrence, and severe consequences. The complex pathogenetic mechanisms of renal stone formation involve both biologic and environmental risk factors. The present study was performed to identify the role of these parameters among renal stone patients and normal individuals from a coastal union territory region in South India. Methods: The authors conducted a case–control study of renal stone disease among outpatient department patients more than 30 years of age using systematic random sampling procedure with 100 study participants (50 subjects for each group. A questionnaire to explore some relevant history as well as to note general examination findings was used along with a house visit to collect a sample of water. Analysis was undertaken using appropriate statistical techniques. Results: The study showed statistically significant association for renal stones with female sex, illiteracy, body mass index (BMI (>25 kg/m2, sodium (>50 mg/L, water consumption (<1.5 L/day, water source being borewell, consuming soft drink, sedentary work, and family history of renal stones. The adjusted odds ratios (ORs were significantly higher for consuming soft drink (OR: 8.19; 95% confidence interval: 1.99–33.69, sedentary work (10.01; 1.27–78.91, and water consumption < 1.5 L/day (7.73; 2.24–26.69. Interpretation and Conclusions: We conclude that in this part of India, female gender, illiteracy, high BMI, high sodium in drinking water, inadequate water consumption, borewell drinking water, soft-drink consumption, sedentary work, and family history of renal stones can lead to a significant increase in the risk of renal stone disease.
Hancock, Kirsten J.; Mitrou, Francis; Taylor, Catherine L.; Zubrick, Stephen R.
The risk factors associated with absenteeism are well known. However, children's exposure to combinations of risks and how these relate to absence patterns remains unclear. Understanding variations in risk profiles among persistently non-attending children will inform the development of absence interventions. Using a longitudinal sample of…
... oxygen. Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of ... a disease or condition. This article discusses the risk factors for stroke and things you can do ...
Gosvig, Camilla Flarup; Huusom, Lene Drasbek; Andersen, Klaus Kaae
Women with early cervical cancer or intraepithelial neoplasia grades 2 and 3 (CIN2+) are treated by conization; however, they still have a higher risk for subsequent CIN2+ than the general female population. Persistence of high-risk (HR) human papillomavirus (HPV) is a key factor in the development...
Shah, Aalap; Horowitz, Michael
Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up. A risk assessment model was constructed with the inclusion of six clinically or statistically significant variables from the univariate analyses. A receiving operator characteristic curve was generated, and area under the curve was calculated to determine the strength of the predictive model. A risk assessment model was first created consisting of significant pre-operative variables (Model 1) (age >50, female gender, history of botulinum toxin use, platysma muscle involvement). This model demonstrated borderline predictive value for persistent spasm at discharge (AUC .60; p=.045) and fair predictive value at follow-up (AUC .75; p=.001). Intraoperative variables (e.g. LSR persistence) demonstrated little additive value (Model 2) (AUC .67). Patients with a higher risk score (three or greater) demonstrated greater odds of persistent HFS at the time of discharge (OR 1.5 [95%CI 1.16-1.97]; p=.035), as well as greater odds of persistent or recurrent spasm at the time of follow-up (OR 3.0 [95%CI 1.52-5.95]; p=.002) Conclusions: A risk assessment model consisting of pre-operative clinical characteristics is useful in prognosticating HFS persistence at follow-up.
Schizophrenia is a multifactorial, neurodevelopmental disorder caused by a combination of genetic and environmental risk factors. Disturbances of brain development begin prenatally, while different environmental insults further affect postnatal brain maturation during childhood and adolescence. Genome-wide association studies (GWAS) have succeeded in identifying hundreds of new risk variants for common, multifactorial diseases. In schizophrenia research, GWAS have found several rare copy number variants that considerably increase the risk of schizophrenia, and have shown an association between schizophrenia and the major histocompatibility complex. Research on environmental risk factors in recent years has provided new information particularly on risk factors related to pregnancy and childhood rearing environment. Gene-environment interactions have become a central research topic. There is evidence that genetically susceptible children are more vulnerable to the effects of unstable childhood rearing environment and other environmental risk factors.
Brachner, A.; Grosche, B.
A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG) [de
To identify work factors that predict persistent fatigue in nurses' aides. The sample comprised 5547 Norwegian nurses' aides, not on leave when they completed a mailed questionnaire in 1999. Of these, 4645 (83.7%) completed a second questionnaire 15 months later. The outcome measure was the occurrence of persistent fatigue, defined as having felt "usually fatigued" or "always fatigued" in daytime during the previous 14 days. In respondents without persistent fatigue at baseline, medium and high work demands, heavy smoking, being single, and having long term health problems were associated with increased risk of persistent fatigue at follow up. Medium and high rewards for well done work, medium levels of leadership fairness, and regular physical exercise were associated with reduced risk of persistent fatigue at follow up. In respondents with persistent fatigue at baseline, medium and high levels of positive challenges at work, high support from immediate superior, medium feedback about quality of one's work, and changes of work or work tasks that resulted in less heavy work or lower work pace were associated with increased odds of recovery (no persistent fatigue at follow up). Working in a nursing home and being intensely bothered by long term health problems were associated with reduced odds of recovery. High demands and lack of rewards at work may cause persistent fatigue in nurses' aides. Reduction of demands, adequate feedback, and mental stimulation in the form of support and positive challenges may facilitate recovery in those who have persistent fatigue. Leaders in the health services may be in a position to regulate factors that influence the level of fatigue in nurses' aides.
van Rossem, Lenie; Wijga, Alet H.; Brunekreef, Bert; de Jongste, Johan C.; Kerkhof, Marjan; Postma, Dirkje S.; Gehring, Ulrike; Smit, Henriette A.
Background: A considerable proportion of children with early-life overweight attain a normal weight. To recognize infants at risk of persistent overweight, we compared early-life factors of children with a longitudinal pattern of persistent overweight to children with a pattern of overweight in
van Rossem, Lenie; Wijga, Alet H; Brunekreef, Bert; de Jongste, Johan C; Kerkhof, Marjan; Postma, Dirkje S; Gehring, Ulrike; Smit, Henriëtte A
BACKGROUND: A considerable proportion of children with early-life overweight attain a normal weight. To recognize infants at risk of persistent overweight, we compared early-life factors of children with a longitudinal pattern of persistent overweight to children with a pattern of overweight in
Potaturkina-Nesterova, N I; Il'ina, N A; Bugero, N V; Nesterov, A S
Persistence activity manifested in the expression of anti-lysozyme, anti-lactoferrin, and antihistone factors promoting inactivation of natural anti-infection resistance factors in the body was revealed in Blastocystis hominis protozoa. Activities of these factors were ranged. The frequency of these factors in clinical isolates of blastocyst decreased in the following order: anti-lactoferrin activity (84.5±3.7%)→anti-lysozyme activity (64.8±5.7%)→anti-histone activity (48.1±2.3%). In healthy humans, the corresponding parameters were 7.3±1.3, 5.3±0.9, and 3.3±0.4%, respectively (pprotozoa.
Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L
In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be
Cowan-Ellsberry, Christina E; McLachlan, Michael S; Arnot, Jon A; Macleod, Matthew; McKone, Thomas E; Wania, Frank
Fate and exposure modeling has not, thus far, been explicitly used in the risk profile documents prepared for evaluating the significant adverse effect of candidate chemicals for either the Stockholm Convention or the Convention on Long-Range Transboundary Air Pollution. However, we believe models have considerable potential to improve the risk profiles. Fate and exposure models are already used routinely in other similar regulatory applications to inform decisions, and they have been instrumental in building our current understanding of the fate of persistent organic pollutants (POP) and persistent, bioaccumulative, and toxic (PBT) chemicals in the environment. The goal of this publication is to motivate the use of fate and exposure models in preparing risk profiles in the POP assessment procedure by providing strategies for incorporating and using models. The ways that fate and exposure models can be used to improve and inform the development of risk profiles include 1) benchmarking the ratio of exposure and emissions of candidate chemicals to the same ratio for known POPs, thereby opening the possibility of combining this ratio with the relative emissions and relative toxicity to arrive at a measure of relative risk; 2) directly estimating the exposure of the environment, biota, and humans to provide information to complement measurements or where measurements are not available or are limited; 3) to identify the key processes and chemical or environmental parameters that determine the exposure, thereby allowing the effective prioritization of research or measurements to improve the risk profile; and 4) forecasting future time trends, including how quickly exposure levels in remote areas would respond to reductions in emissions. Currently there is no standardized consensus model for use in the risk profile context. Therefore, to choose the appropriate model the risk profile developer must evaluate how appropriate an existing model is for a specific setting and
Persistent organic pollutants in breast milk of primiparae and multiparae Mothers sampled from three health facilities in the Greater Accra and Central Regions of Ghana: Levels of Contamination, Influencing factors and infant risk assessment
Human Breast milk is the optimal source of nutrition for babies and infants during the first six (6) months following birth. Breast milk protects the infants against diseases and infections. Interestingly, because breast milk is a lipid-rich tissue, it attracts, retains and accumulates lipophilic contaminants like persistent organic pollutants (POPs) from the ambient environment. The lipophilic contaminant load of the mother’s breast milk is subsequently, transferred to the breast-fed child. This makes breast milk an important biological matrix for the monitoring of the lactating mother’s body burden of persistent organic pollutants (POPs). The study, assessed the levels of persistent organic pollutants (POPs) [polychlorinated biphenyls (PCBs) and organochlorine pesticide (OCPs)] in the breast milk of lactating mothers (primiparae and multiparae) who reside within the catchment areas and attend child welfare clinic at one of three health facilities in Southern Ghana [Princess Marie Louis (PML) Children Hospital (Korle Wokon, Accra Central); GAEC Hospital (Kwabenya, Accra); and Gomoa Brofo Community based Health and Planning Services, (Gomoa Brofo, Gomoa West district, Central region)]. The study also evaluated the factors (age of lactating mothers, parity and area of residence) influencing the accumulation of the POPs; and, in addition, assessed the potential health risk associated with the ingestion of breast milk by the infants through estimation of the infant’s daily intakes and hazard quotient. A total of two hundred and eighty-eight (288) healthy lactating mothers between the ages of 17-38 years from the three sampling locations [PML (135), GAEC (112), CHPS (41)] were selected for the study based on questionnaires administered to obtain information on the mothers [personal characteristics, number of births (parity), age, weight, height and body mass index (BMI)]. The non-invasive sampling technique was used for the collection of breast milk samples. Gas
Voltas, Núria; Hernández-Martínez, Carmen; Arija, Victoria; Canals, Josefa
Anxiety disorders are the most common mental health problems during childhood and adolescence. This study examined the course of anxiety symptoms in early adolescents from the general population over three phases. Prospective cohort study. Two hundred and forty-two participants (mean-age of 13.52) from a baseline sample of 1514 (mean-age of 10.23) were followed up three times. Of the 1514 children, those with emotional risk and controls without risk constituted the second-phase sample (n = 562; mean-age of 11.25). The Screen for Child Anxiety Related Emotional Disorders-SCARED was administered in all three phases. Fifty-six percent and 32% of respondents showed total scores above the SCARED cutoff point at one and three years follow-up, respectively. Eight percent showed fluctuating symptoms. Fifty-five percent of respondents showed high scores for any subtype of anxiety over three years. Social phobia and generalized anxiety symptoms were the most prevalent and persistent. Participants with persistent separation anxiety showed the highest co-occurrence with symptoms of other psychopathological disorders. Participants with persistent anxiety showed lower academic performance. Being male was a protective factor against persistence. The data support anxiety maintenance during early adolescence. Early adolescence is a critical period which may involve other serious academic, social, and family problems.
It is no longer reasonable to divide cancers into those that are genetic in origin and those that are environmental in origin. With rare exception, carcinogenesis involves environmental factors that directly or indirectly exert a change in the cell's genome. Virtually all causes of cancer are multifactorial, sometimes involving an inherited predisposition to the carcinogenic effects of environmental factors, which include chemicals, ionizing radiation, and oncogenic virus. Carcinogenesis is a multistep process including induction, promotion, and progression. Initiation requires an irreversible change in the cellular genome, whereas promotion is commonly associated with prolonged and reversible exposure. Tumor progression results in genotypic and phenotypic changes associated with tumor growth, invasion, and metastasis. Most information on human cancer risk is based on epidemiologic studies involving both exposed and unexposed individuals. The quality of such studies depends on their ability to assess the strength of any association of exposure and disease and careful attention to any potential bias. Few cancers are inherited in a Mendelian fashion. Several preneoplastic conditions, however, are clearly inherited and several malignancies demonstrate weak familial patterns. Environmental factors may exert their effect on DNA in a random fashion, but certain consistent changes, including specific translocations of genetic information, are often found. Currently, there is great interest in the close proximity of certain oncogenes governing growth control to the consistent chromosomal changes observed. Such changes may represent a final common pathway of action for environmental carcinogens. Sufficient laboratory and epidemiologic evidence exists to establish a causal association of several chemical agents with cancer
Roč. 37, č. 9 (2013), s. 1911-1928 ISSN 0165-1889 R&D Projects: GA ČR(CZ) GAP403/11/2288 Institutional support: RVO:67985998 Keywords : long-run risk * endogenous economic uncertainty * forecast error variance Subject RIV: AH - Economics Impact factor: 1.057, year: 2013
Roč. 37, č. 9 (2013), s. 1911-1928 ISSN 0165-1889 R&D Projects: GA ČR(CZ) GAP403/11/2288 Institutional support: RVO:67985998 Keywords : long-run risk * endogenous economic uncertainty * forecast error variance Subject RIV: AH - Economic s Impact factor: 1.057, year: 2013
Roč. 37, č. 9 (2013), s. 1911-1928 ISSN 0165-1889 Institutional support: PRVOUK-P23 Keywords : long-run risk * endogenous economic uncertainty * forecast error variance Subject RIV: AH - Economic s Impact factor: 1.057, year: 2013
The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.
Gülşen Tükenmez Demirc
Full Text Available Background and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients.Material and method: A total of 42 patients (15 male and 27 female who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus.
Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry
Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....
van Rooij, S J H; Kennis, M; Sjouwerman, R; van den Heuvel, M P; Kahn, R S; Geuze, E
Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether hippocampal volume normalizes with successful treatment of PTSD, or whether a smaller hippocampus is a risk factor for the persistence of PTSD. Magnetic resonance imaging (MRI) scans and clinical interviews were collected from 47 war veterans with PTSD, 25 healthy war veterans (combat controls) and 25 healthy non-military controls. All veterans were scanned a second time with a 6- to 8-month interval, during which PTSD patients received trauma-focused therapy. Based on post-treatment PTSD symptoms, patients were divided into a PTSD group who was in remission (n = 22) and a group in whom PTSD symptoms persisted (n = 22). MRI data were analysed with Freesurfer. Smaller left hippocampal volume was observed in PTSD patients compared with both control groups. Hippocampal volume of the combat controls did not differ from healthy controls. Second, pre- and post-treatment analyses of the PTSD patients and combat controls revealed reduced (left) hippocampal volume only in the persistent patients at both time points. Importantly, hippocampal volume did not change with treatment. Our findings suggest that a smaller (left) hippocampus is not the result of stress/trauma exposure. Furthermore, hippocampal volume does not increase with successful treatment. Instead, we demonstrate for the first time that a smaller (left) hippocampus constitutes a risk factor for the persistence of PTSD.
Verlinden, S; Hersen, M; Thomas, J
Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.
Arrue, Miren; Diez-Itza, Irene; Ibañez, Larraitz; Paredes, Jone; Murgiondo, Arantzazu; Sarasqueta, Cristina
To identify factors involved in the persistence of stress urinary incontinence (SUI) from pregnancy to 2 years post partum. In a longitudinal study at Donostia Hospital, San Sebastián, Spain, 458 primigravid women were recruited from April to October 2007. SUI was diagnosed via the 2002 International Continence Society definition. Severity was assessed via the Incontinence Severity Index, and impact on quality of life via the International Consultation on Incontinence Questionnaire. Means (Student t test and analysis of variance) and percentages (χ(2) and Fisher exact tests) were compared, and multiple logistic regression analysis was performed with variables that were significant or close to significant in a univariate analysis (Ppregnancy. Incontinence severity was slight or moderate in most cases and the impact on quality of life was low. A higher body mass index (BMI) in pregnant women at term was the only factor found to be associated with persistent SUI (odds ratio 1.19; 95% confidence interval 1.08-1.32). Higher BMI in pregnant women at term was an independent risk factor for the persistence of SUI from pregnancy to 2 years post partum. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.
... Â» [ pdf, 433 kb ] Order Materials Â» Stroke Risk Factors and Symptoms Risk Factors for a Stroke Stroke prevention is still ... it. Treatment can delay complications that increase the risk of stroke. Transient ischemic attacks (TIAs). Seek help. ...
Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke
As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.
Fjeld, Olaf; Grotle, Margreth; Siewers, Vibeke; Pedersen, Linda M; Nilsen, Kristian Bernhard; Zwart, John-Anker
Prospective cohort study. To identify potential prognostic factors for persistent leg-pain at 12 months among patients hospitalized with acute severe sciatica. The long-term outcome for patients admitted to hospital with sciatica is generally unfavorable. Results concerning prognostic factors for persistent sciatica are limited and conflicting. A total of 210 patients acutely admitted to hospital for either surgical or nonsurgical treatment of sciatica were consecutively recruited and received a thorough clinical and radiographic examination in addition to responding to a comprehensive questionnaire. Follow-up assessments were done at 6 weeks, 6 months, and 12 months. Potential prognostic factors were measured at baseline and at 6 weeks. The impact of these factors on leg-pain was analyzed by multiple linear regression modeling. A total of 151 patients completed the entire study, 93 receiving nonrandomized surgical treatment. The final multivariate models showed that the following factors were significantly associated with leg-pain at 12 months: high psychosocial risk according to the Örebro Musculosceletal Pain Questionnaire (unstandardized beta coefficient 1.55, 95% confidence interval [CI] 0.72-2.38, P sciatica. 2.
Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P
Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.
...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...
Andersen, Kenneth Geving; Duriaud, Helle Molter; Jensen, Helle Elisabeth
Previous studies have reported that 15% to 25% of patients treated for breast cancer experience long-term moderate-to-severe pain in the area of surgery, potentially lasting for several years. Few prospective studies have included all potential risk factors for the development of persistent pain...... after breast cancer surgery (PPBCS). The aim of this prospective cohort study was to comprehensively identify factors predicting PPBCS. Patients scheduled for primary breast cancer surgery were recruited. Assessments were conducted preoperatively, the first 3 days postoperatively, and 1 week, 6 months...... were included, and 475 (88%) were available for analysis at 1 year. At 1-year follow-up, the prevalence of moderate-to-severe pain at rest was 14% and during movement was 7%. Factors associated with pain at rest were age breast conserving surgery (OR: 2.0, P...
... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women Need To Know About The Hidden Risk Factors ... 2012) This year, more than 100,000 U.S. women under 65 will have a stroke. Stroke is ...
Abshire, Demetrius Alexander
The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…
Osterrieder, Daniela; Schotman, Peter C.
We develop a model that can match two stylized facts of the term-structure. The first stylized fact is the predictability of excess returns on long-term bonds. Modeling this requires sufficient volatility and persistence in the price of risk. The second stylized fact is that long-term yields...... are dominated by a level factor, which requires persistence in the spot interest rate. We find that a fractionally integrated process for the short rate plus a fractionally integrated specification for the price of risk leads to an analytically tractable almost affine term structure model that can explain...... the stylized facts. In a decomposition of long-term bond returns we find that the expectations component from the level factor is more volatile than the returns themselves. It therefore takes a volatile risk premium that is negatively correlated with innovations in the level factor to explain the volatility...
Klinda, J.; Lieskovska, Z.
In this chapter the physical risk factors (as radiation [air contamination, contamination of the environment components and food contamination], radon and its radioactive decay products, radioactive wastes, noise), chemical risk factors [chemical substances, xenobiotics in the food chain the ozone depletion], wastes (waste generation, waste management, municipal waste management, import, export and transit of waste) and natural an technological hazards (water quality deterioration as a result of various accidents and fire risk) in the Slovak Republic in 1997 are reviewed
Fillit, Howard; Nash, David T; Rundek, Tatjana; Zuckerman, Andrea
Dementias, such as Alzheimer's disease (AD) and vascular dementia, are disorders of aging populations and represent a significant economic burden. Evidence is accumulating to suggest that cardiovascular disease (CVD) risk factors may be instrumental in the development of dementia. The goal of this review was to discuss the relationship between specific CVD risk factors and dementia and how current treatment strategies for dementia should focus on reducing CVD risks. We conducted a review of the literature for the simultaneous presence of 2 major topics, cardiovascular risk factors and dementia (eg, AD). Special emphasis was placed on clinical outcome studies examining the effects of treatments of pharmacologically modifiable CVD risk factors on dementia and cognitive impairment. Lifestyle risk factors for CVD, such as obesity, lack of exercise, smoking, and certain psychosocial factors, have been associated with an increased risk of cognitive decline and dementia. Some evidence suggests that effectively managing these factors may prevent cognitive decline/dementia. Randomized, placebo-controlled trials of antihypertensive medications have found that such therapy may reduce the risk of cognitive decline, and limited data suggest a benefit for patients with AD. Some small open-label and randomized clinical trials of statins have observed positive effects on cognitive function; larger studies of statins in patients with AD are ongoing. Although more research is needed, current evidence indicates an association between CVD risk factors--such as hypertension, dyslipidemia, and diabetes mellitus--and cognitive decline/dementia. From a clinical perspective, these data further support the rationale for physicians to provide effective management of CVD risk factors and for patients to be compliant with such recommendations to possibly prevent cognitive decline/dementia.
Full Text Available Bercin Tarlan,1 Hayyam Kiratli21Department of Ophthalmology, Kozluk State Hospital, Batman, Turkey; 2Ocular Oncology Service, Hacettepe University Schoolof Medicine, Ankara, TurkeyAbstract: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.Keywords: subconjunctival hemorrhage, contact lens, hypertension, red eye
Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut
Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional de......Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...
Full Text Available Host genetic factors might affect the risk of progression from infection with carcinogenic human papillomavirus (HPV, the etiologic agent for cervical cancer, to persistent HPV infection, and hence to cervical precancer and cancer.We assessed 18,310 tag single nucleotide polymorphisms (SNPs from 1113 genes in 416 cervical intraepithelial neoplasia 3 (CIN3/cancer cases, 356 women with persistent carcinogenic HPV infection (median persistence of 25 months and 425 randomly selected women (non-cases and non-HPV persistent from the 10,049 women from the Guanacaste, Costa Rica HPV natural history cohort. For gene and SNP associations, we computed age-adjusted odds ratio and p-trend. Three comparisons were made: 1 association with CIN3/cancer (compared CIN3/cancer cases to random controls, 2 association with persistence (compared HPV persistence to random controls, and 3 progression (compared CIN3/cancers with HPV-persistent group. Regions statistically significantly associated with CIN3/cancer included genes for peroxiredoxin 3 PRDX3, and ribosomal protein S19 RPS19. The single most significant SNPs from each gene associated with CIN3/cancer were PRDX3 rs7082598 (P(trend<0.0001, and RPS19 rs2305809 (P(trend=0.0007, respectively. Both SNPs were also associated with progression.These data suggest involvement of two genes, RSP19 and PRDX3, or other SNPs in linkage disequilibrium, with cervical cancer risk. Further investigation showed that they may be involved in both the persistence and progression transition stages. Our results require replication but, if true, suggest a role for ribosomal dysfunction, mitochondrial processes, and/or oxidative stress, or other unknown function of these genes in cervical carcinogenesis.
Bukharin, O V; Boĭko, A V; Zhuravleva, L A
Factors of persistence and/or pathogenicity in Vibrio parahaemolyticus and Aeromonas hydrophila (hemolytic, lipase, lecithin, DNAase, RNAase, antilysozyme, "anti-interferon", anticomplementary activities and capacity for absorbing Congo red) were studied. The study revealed the interspecific and subpopulation (hospital and extraorganismal parts of the population) differences in the activity of the manifestation of these factors. Strong dependence of the whole complex of persistence and pathogenicity factors of their belonging to the hostal part of Vibrio and Aeromonas populations was shown.
Full Text Available Post-transplant erythrocytosis (PTE is characterized by persistently ele-vated hematocrit level 0 51%. This complication is reported to develop in 10-20% of renal allografts recipients, mostly 2 years after kidney transplantation. PTE is self-limited in 25% of the patients; however it may persist in patients with an increased susceptibility for thrombosis and potential fatal outcome. To evaluate the prevalence and risk factors of PTE in our center, we reviewed the records of 235 patients who received renal allografts from 1999 to 2004. Polycythemia was found in 45 (19% patients. There was no significant correlation of polycythemia and age, history of hypertension, diabetes, pre-transplant hematocrit level, pre-transplant history of transfusion, graft′s function, and source of kidney. A significantly higher proportion of PTE patients were males, patients with history of polycystic kidney disease, and patients with glomerulonephritis. We conclude that PTE is an important complication of kidney transplantation. There are several risk factors that should be addressed to prevent this complication.
Steensma, Thomas D; McGuire, Jenifer K; Kreukels, Baudewijntje P C; Beekman, Anneke J; Cohen-Kettenis, Peggy T
To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence. The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls. Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Elton, Edwin J; Gruber, Martin J; Blake, Christopher R
The authors examine predictability for stock mutual funds using risk-adjusted returns. They find that past performance is predictive of future risk-adjusted performance. Applying modern portfolio theory techniques to past data improves selection and allows the authors to construct a portfolio of funds that significantly outperforms a rule based on past rank alone. In addition, they can form a combination of actively managed portfolios with the same risk as a portfolio of index funds but with ...
Feb 2, 2010 ... Several factors have been suggested as independent risk factors for their development. Identification of these ... with age, gender or haematological test. ... A meta-analysis of prospective studies on ..... The marked difference may be because monthly .... and dyslipidemia among patients taking first-line,.
Tapia-Rombo, C A; Velasco-Lavín, M R; Nieto-Caldelas, A
The purpose of the present study is to compare risk factors of necrotizing enterocolitis (NEC) between two group: group A, newborns with the disease and group B, newborns with other diseases different from NEC, in order to know if these risk factors are more frequent or not in the first group. We assessed the clinical records of all the patients hospitalized in the Neonatal Intensive Care Unit and Neonatology Service of the La Raza General Hospital between 1987 and 1991 with the diagnosis of NEC. They were compared with 65 clinical records chosen at random of patients hospitalized in the same Unit with other diagnosis at the same time, and who were discharged by improvement or deceased. In all of them were look for known risk factors for NEC generally accepted such as: prematurity, neonatal asphyxia, poliglobulia, cyanotic congenital heart disease, patent ductus arteriosus, respiratory distress syndrome, catheterization of umbilical vessels, early feeding of elevated formula increases, exchange exchange transfusion, hypoxic ischemic encephalopathy, infection, etc. Just 25 records of the possible 50 with the diagnosis of NEC full filled inclusion criteria. There were no statistically significant difference in weight, sex, mortality and known risk factors of NEC between both groups. Were concluded that NEC is a disease of unknown etiology that should be studied more thoroughly. The known risk factors must be avoided because the patient susceptibility probably play an important role.
Härdle, Wolfgang Karl; Mungo, Julius
The volatility implied by observed market prices as a function of the strike and time to maturity form an Implied Volatility Surface (IV S). Practical applications require reducing the dimension and characterize its dynamics through a small number of factors. Such dimension reduction is summarized by a Dynamic Semiparametric Factor Model (DSFM) that characterizes the IV S itself and their movements across time by a multivariate time series of factor loadings. This paper focuses on investigati...
... of factors related to prior schooling on student persistence in higher education. ... Once reliable profiles of these students have been established and related to ... school counsellors, teachers in both schooling and higher education, and for ...
Full Text Available Febrile seizures are the most frequent neurological disorder in the childhood. According to American Academy of Pediatrics (AAP, they have been defined as seizures provoked by high temperature in children aged between 6 months and 5 years, without previous history of afebrile seizures, intracranial infections and other possible causes of seizures. Seizures can be typical and atypical, according to the characteristics. Pathogenesis of this disorder has not been clarified yet, and it is believed to be a combination of genetic factors, high body temperature and brain maturation. The risk factors for recurrence of febrile seizures are: age in which seizures appeared for the first time, epilepsy in the first degree relative, febrile seizures in the first degree relative, frequent diseases with fever and low body temperature on the beginning of seizures. The frequency of recurrent seizures The risk for occurrence of epilepsy in children with simple seizures is about 1-1.5%, which is slightly higher compared to general population, while it increases to 4-15% in patients with complex seizures. However, there is no evidence that therapy prevents occurrence of epilepsy. When the prevention of recurrent seizures is considered, it is necessary to separate simple from complex seizures. The aim of this paper was to analyze the most important risk factors for febrile seizures, and to evaluate their impact on occurrence of recurrent seizures. Our study included 125 children with febrile seizures, aged from 6 months to 5 years. The presence of febrile seizures and epilepsy in the first degree relative has been noted in 22% of children. Typical febrile seizures were observed in 76% of cases, and atypical in 24%. Most patients had only one seizure (73.6%. Children, who had seizure earlier in life, had more frequent recurrences. Both risk factors were present in 25% of patients, while 68% of patients had only one risk factor. For the children with febrile disease
For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10 - 6 rem - 1 . This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10 - 6 yr - 1 . This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)
Cowan-Ellsberry, Christina E.; McLachlan, Michael S.; Arnot, Jon A.; MacLeod, Matthew; McKone, Thomas E.; Wania, Frank
Fate and exposure modeling has not thus far been explicitly used in the risk profile documents prepared to evaluate significant adverse effect of candidate chemicals for either the Stockholm Convention or the Convention on Long-Range Transboundary Air Pollution. However, we believe models have considerable potential to improve the risk profiles. Fate and exposure models are already used routinely in other similar regulatory applications to inform decisions, and they have been instrumental in building our current understanding of the fate of POP and PBT chemicals in the environment. The goal of this paper is to motivate the use of fate and exposure models in preparing risk profiles in the POP assessment procedure by providing strategies for incorporating and using models. The ways that fate and exposure models can be used to improve and inform the development of risk profiles include: (1) Benchmarking the ratio of exposure and emissions of candidate chemicals to the same ratio for known POPs, thereby opening the possibility of combining this ratio with the relative emissions and relative toxicity to arrive at a measure of relative risk. (2) Directly estimating the exposure of the environment, biota and humans to provide information to complement measurements, or where measurements are not available or are limited. (3) To identify the key processes and chemical and/or environmental parameters that determine the exposure; thereby allowing the effective prioritization of research or measurements to improve the risk profile. (4) Predicting future time trends including how quickly exposure levels in remote areas would respond to reductions in emissions. Currently there is no standardized consensus model for use in the risk profile context. Therefore, to choose the appropriate model the risk profile developer must evaluate how appropriate an existing model is for a specific setting and whether the assumptions and input data are relevant in the context of the application
Yanelis Emilia Tabío Henry
Full Text Available The human leptospirosis is a zoonosis of world distribution, were risk factors exist that have favored the wild and domestic animal propagation and so man. A descpitive investigation was made with the objective of determining the behavior of risk factors in outpatients by human leptospirosis in “Camilo Cienfuegos“ University General Hospital from Sncti Spíritus In the comprised time period betwen december 1 st and 3 st , 2008.The sample of this study was conformed by 54 risk persons that keep inclusion criteria. Some variables were used:age, sex, risk factors and number of ill persons, according to the month. Some patients of masculine sex prevailed (61,9%, group of ages between 15-29 and 45-59 years (27,7%, patients treated since october to december (53,7%, the direct and indirect contact with animals (46,2 %. The risk factors cassually associated to human leptospirosis turned to be: the masculine sex, the contac with animals, the occupational exposition and the inmersion on sources of sweet water.
Zong, Geng; Valvi, Damaskini; Coull, Brent
BACKGROUND: Exposure to persistent organic pollutants (POPs) may predispose to the development of type 2 diabetes (T2D), but prospective human evidence is scarce. OBJECTIVES: We investigated the association between plasma-POP concentrations in the late 1990s and incident T2D over 11 years of follow......-ortho congeners, PCB-105, 118, 156, 157, and 167. Adjustment for previous weight change and body mass index (BMI) at blood draw attenuated these associations, but that for DL-PCBs remained (OR[95% CI] = 1.78[1.14, 2.76]; Ptrend = 0.006). Age, breastfeeding history, previous weight change and BMI at blood draw......-up in the Nurses' Health Study II. DISCUSSION: Three organochlorine pesticides and 20 polychlorinated biphenyls (PCBs) were measured in banked plasma from 793 case-control pairs of T2D. In a multiviarate-adjusted model, T2D ORs (95%CIs) comparing extreme POP tertiles (high vs. low) were 1.67 (1.24, 2.23; Ptrend...
O'Hare, E A; O'Donohue, W
A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.
Brouwers, M.M.; Bruijne, L.M. de; Gier, R.P.E. de; Zielhuis, G.A.; Feitz, W.F.J.; Roeleveld, N.
OBJECTIVE: To contribute to the understanding of the etiology of undescended testis (UDT), by exploring a wide range of potential risk factors in a case-referent study. PATIENTS AND METHODS: Cases and referents were recruited at five hospitals and included 200 boys with surgically corrected UDT and
Marti-Soler, Helena; Gubelmann, Cédric; Aeschbacher, Stefanie
OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist...
Wang, Sophia S; Bratti, M Concepcion; Rodríguez, Ana Cecilia; Herrero, Rolando; Burk, Robert D; Porras, Carolina; González, Paula; Sherman, Mark E; Wacholder, Sholom; Lan, Z Elizabeth; Schiffman, Mark; Chanock, Stephen J; Hildesheim, Allan
We examined host genetic factors to identify those more common in individuals whose human papillomavirus (HPV) infections were most likely to persist and progress to cervical intraepithelial neoplasia grade 3 (CIN3) and cancer. We genotyped 92 single-nucleotide polymorphisms (SNPs) from 49 candidate immune response and DNA repair genes obtained from 469 women with CIN3 or cancer, 390 women with persistent HPV infections (median duration, 25 months), and 452 random control subjects from the 10,049-woman Guanacaste Costa Rica Natural History Study. We calculated odds ratios and 95% confidence intervals (CIs) for the association of SNP and haplotypes in women with CIN3 or cancer and HPV persistence, compared with random control subjects. A SNP in the Fanconi anemia complementation group A gene (FANCA) (G501S) was associated with increased risk of CIN3 or cancer. The AG and GG genotypes had a 1.3-fold (95% CI, 0.95-1.8-fold) and 1.7-fold (95% CI, 1.1-2.6-fold) increased risk for CIN3 or cancer, respectively (P(trend) = .008; referent, AA). The FANCA haplotype that included G501S also conferred increased risk of CIN3 or cancer, as did a different haplotype that included 2 other FANCA SNPs (G809A and T266A). A SNP in the innate immune gene IRF3 (S427T) was associated with increased risk for HPV persistence (P(trend) = .009). Our results require replication but support the role of FANCA variants in cervical cancer susceptibility and of IRF3 in HPV persistence.
Bogani, Giorgio; Martinelli, Fabio; Ditto, Antonino; Taverna, Francesca; Lombardo, Claudia; Signorelli, Mauro; Chiappa, Valentina; Leone Roberti Maggiore, Umberto; Fontanella, Caterina; Sabatucci, Ilaria; Borghi, Chiara; Recalcati, Dario; Indini, Alice; Lorusso, Domenica; Raspagliesi, Francesco
High-grade vaginal intraepithelial neoplasia (vaginal HSIL) represents an uncommon entity. Here, we sought to identify predictors for recurrence and risk factor for developing genital cancers after primary treatment for vaginal HSIL. Data of consecutive 5104 women who had human papillomavirus (HPV) DNA test were searched for identify women with histological confirmed vaginal HSIL. Disease-free interval and the risk of developing HPV-related gynecological cancers were assessed using Kaplan-Meier and Cox proportional hazard models. Overall, 77 patients were included. After a mean (SD) follow-up of 69.3 (33.0) months, 11 (14%) and 4 (5%) patients experienced vaginal HSIL recurrence and the occurrence of HPV-related gynecological cancers, respectively. Via multivariate analysis factors predicting for vaginal HSIL recurrence were infection from HPV31 at diagnosis (HR: 5.0 (95%CI:1.17, 21.3); p=0.03) and persistence of HPV infection after treatment (HR: 7.0 (95%CI:1.54, 31.6); p=0.01). Additionally, patients who had LASER ablation experienced a trend toward a lower risk of recurrence in comparison to medical treatment (HR: 0.20 (95%CI:0.03, 1.09); p=0.06). Considering the occurrence of HPV-related gynecological cancers, we observed that no factors independently correlated with this risk; while, a trend towards higher risk was observed for women with HIV infection (HR:16.4 (95%CI:0.90, 300.1); p=0.06) and persistence of HPV infection (HR: 13.3 (95%CI:0.76, 230.2); p=0.07). Patients affected by vaginal HSIL experienced a relatively high risk of recurrence. Persistence of HPV after treatment and pretreatment HPV-31 infection predicts for high-grade vaginal intraepithelial neoplasia recurrence. Further investigations are warranted in order to corroborate our data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Milk production is largely related to the shape of the lactation curve. Key elements of the lactation pattern are peak yield, which is the maximum daily yield reached during lactation, and lactation persistency, which is the medium rate of milk yield decrease after the lactation peak. The ideal lactation curve should have a reasonably high peak and a flat trend afterwards. A more persistent lactation is desirable because it is related to better animal health and reduction of feeding costs. Effective strategies to improve lactation persistency require a deep understanding of the main factors that affect this trait, including genetics, hormonal status and administration, udder morphology, seasonal changes, management, animal health (e.g. mastitis, stress and nutrition. This review covers the effects of non-nutritional factors on lactation persistency in dairy sheep.
Chen, Danhong; Thomsen, Michael R; Nayga, Rodolfo M; Bennett, Judy L
Arkansas is among the poorest states and has high rates of childhood obesity. In 2003, it became the first state to systematically screen public schoolchildren for unhealthy weight status. This study aims to examine the socioeconomic disparities in Body Mass Index (BMI) growth and the risk of the onset of obesity from childhood through adolescence. This study analyzed (in 2015) the data for a large cohort of Arkansas public schoolchildren for whom BMIs were measured from school years 2003/2004 through 2009/2010. A linear growth curve model was used to assess how child-level sociodemographics and neighborhood characteristics were associated with growth in BMI z-scores. Cox regression was subsequently used to investigate how these factors were associated with the onset of obesity. Because children might be classified as obese in multiple years, sensitivity analysis was conducted using recurrent event Cox regression. Survival analysis indicated that the risk of onset of obesity rose sharply between ages of 5 and 10 and then again after age 15. The socioeconomic disparities in obesity risk persisted from kindergarten through adolescence. While better access to full service restaurants was associated with lower risk of the onset of obesity (Hazard Ratio (HR)=0.98, 95% CI=0.97-0.99), proximity to fast food restaurants was related to increased risk of the onset of obesity (HR=1.01, 95% CI=1.00-1.01). This analysis stresses the need for policies to narrow the socioeconomic gradient and identifies important time periods for preventative interventions in childhood obesity. Copyright © 2016 Elsevier Inc. All rights reserved.
Munch, Tina Noergaard; Rasmussen, Marie-Louise Hee; Wohlfahrt, Jan
. Furthermore, to identify the risk factors unique for isolated CHC as compared to syndromic CHC. METHODS: We established a cohort of all children born in Denmark between 1978 and 2008. Information on CHC and maternal medical diseases were obtained from the National Patient Discharge Register, maternal intake...... increased risk of isolated CHC compared to unexposed children (RR 2.52, 95% CI 1.47 to 4.29) (1.5/1000 born children). Risk factors also found for syndromic CHC were: Male gender, multiples and maternal diabetes. CONCLUSIONS: The higher risk for isolated CHC in first-born children as well as behavioural......-born children, we observed 1193 cases of isolated CHC (0.062/1000) born children. First-borns had an increased risk of isolated CHC compared to later-borns (1.32 95% CI 1.17 to 1.49) (0.72/1000 born children). First trimester exposure to maternal use of antidepressants was associated with a significantly...
Painter, John; Parker, Matthew; Lowenthal, Phillip; Flood, Jennifer; Fu, Yunxin; Asis, Redentor; Reves, Randall
Rationale: Current guidelines limit latent tuberculosis infection (LTBI) evaluation to persons in the United States less than or equal to 5 years based on the assumption that high TB rates among recent entrants are attributable to high LTBI reactivation risk, which declines over time. We hypothesized that high postarrival TB rates may instead be caused by imported active TB. Objectives: Estimate reactivation and imported TB in an immigrant cohort. Methods: We linked preimmigration records from a cohort of California-bound Filipino immigrants during 2001–2010 with subsequent TB reports. TB was likely LTBI reactivation if the immigrant had no evidence of active TB at preimmigration examination, likely imported if preimmigration radiograph was abnormal and TB was reported less than or equal to 6 months after arrival, and likely reactivation of inactive TB if radiograph was abnormal but TB was reported more than 6 months after arrival. Measurements and Main Results: Among 123,114 immigrants, 793 TB cases were reported. Within 1 year of preimmigration examination, 85% of TB was imported; 6 and 9% were reactivation of LTBI and inactive TB, respectively. Conversely, during Years 2–9 after U.S. entry, 76 and 24% were reactivation of LTBI and inactive TB, respectively. The rate of LTBI reactivation (32 per 100,000) did not decline during Years 1–9. Conclusions: High postarrival TB rates were caused by detection of imported TB through active postarrival surveillance. Among immigrants without active TB at baseline, reported TB did not decline over 9 years, indicating sustained high risk of LTBI reactivation. Revised guidelines should support LTBI screening and treatment more than 5 years after U.S. arrival. PMID:24308495
López-Carbajal, Mario Joaquín; Manríquez-Moreno, María Esther; Gálvez-Camargo, Daniela; Ramírez-Jiménez, Evelia
preeclampsia constitutes one of the main causes of maternal and perinatal morbidity and mortality. The aim was to identify the risk factors associated to the developmental of preeclampsia mild-moderate and severe, as well as the force of association of these factors in a hospital of second-level medical care. study of cases and controls, a relation 1:1, in women withdrawn of the Service of Gynecology and Obstetrics during 2004 to 2007. Pregnant women with more than 20 weeks gestation were included. In the cases group we included patients with diagnosis of preeclampsia mild-moderate or severe (corroborated clinical and laboratory). In the controls group that had a normal childbirth without pathology during the pregnancy. 42 cases and 42 controls. The average age was of 27 years. The associated risk factors were overweight, obesity, irregular prenatal control, short or long intergenesic period, history of caesarean or preeclampsia in previous pregnancies. the knowledge of the risk factors will allow the accomplishment of preventive measures and decrease the fetal and maternal morbidity and mortality due to preeclampsia.
Ballegaard, Søren; Petersen, Pernille B.; Harboe, Gitte S.
Abstract Objectives. To evaluate the possible association between pressure pain sensitivity of the chest bone (PPS) and cardiovascular physiological factors related to persistent stress in connection with a three-month PPS-guided stress-reducing experimental intervention programme. Methods. Forty......-two office workers with an elevated PPS (≥ 60 arbitrary units) as a sign of increased level of persistent stress, completed a single-blinded cluster randomized controlled trial. The active treatment was a PPS (self-measurement)-guided stress management programme. Primary endpoints: Blood pressure (BP), heart...... between-group reductions were observed in respect to BP, HR, PRP, total and LDL cholesterol, and total number of elevated risk factors (p stress intervention method applied in this study induced a decrease in PPS which was associated with a clinically relevant decrease in resting...
Bøttcher, Louise; Dammeyer, Jesper
Empirical research has established that children with disabilities are more likely to develop psychopathology than children without disabilities. But too little is known about the association between disability and psychopathology. The aim of this article is to discuss developmental...... psychopathological models that conceptualize the connection between childhood disability and psychopathology. Empirical studies of psychopathology among children with a congenital hearing impairment and children with cerebral palsy will be reviewed, representing in-depth examples of association between disability...... and psychopathology. Both a congenital hearing impairment and cerebral palsy were found to be dominating risk factors for all types of psychopathology, but no relationship was identified between degree of disability and risk of psychopathology. The higher risk cannot be explained by biological impairments alone...
Full Text Available The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
Sanchez, J.A.; Retamar, J.A.; Blazquez, J.; Castano, J.C.
The was to study the natural course of pneumothorax produced after aspiration biopsy in the attempt to differentiate those cases that will resolve spontaneously from those that will require drainage, and to assess the possible risk factors associated with the development of this entity. Eighty-nine CT-guided aspiration biopsies were performed in 80 patients. Control CT was done immediately after the procedure and 24 hours later. When pneumothorax persisted, CT was repeated at 48 h, 72 h, day 5 and day 7 or until a drainage tube was introduced. The cases of pneumothorax were classified as minimal, anterior or anterolateral. Seven variables were assessed as possible risk factors for its occurrence. Pneumothorax developed on 29 occasions (32.5%), requiring drainage in 12 cases (13.5%). In 20 patients (22%), pneumothorax occurred immediately, while in the remaining 9 (10%) it was detected in the 24 h CT scan. When studied according to type, drainage was required in 3 of the 19 cases of minimal or anterior pneumothorax (15%) and in 9 or the 10 cases of anterolateral location (90%) (p<0.0005). The mean thickness of the parenchyma punctured was 3.4 cm +- 2.2. cm when pneumothorax developed and 1.3 cm+- 2 cm when it did not (p<0.0001). There is a statistically significant association between the development of anterolateral pneumothorax and the need for chest drainage. The thickness of the punctured parenchyma is associated with the production of pneumothorax. 16 refs
Brachner, A.; Grosche, B.
The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG) [de
Barber-Meyer, Shannon M.; Mech, L. David; Newton, Wesley E.; Borg, Bridget
Risk to predators hunting dangerous prey is an emerging area of research and could account for possible persistent differences in gray wolf (Canis lupus) pack sizes. We documented significant differences in long-term wolf-pack-size averages and variation in the Superior National Forest (SNF), Denali National Park and Preserve, Yellowstone National Park, and Yukon, Canada (pwolves’ risk when hunting primary prey, for those packs (N=3) hunting moose (Alces americanus) were significantly larger than those (N=10) hunting white-tailed deer (Odocoileus virginianus) (F1,8=16.50, p=0.004). Our data support the hypothesis that differential pack-size persistence may be perpetuated by differences in primary prey riskiness to wolves, and we highlight two important extensions of this idea: (1) the potential for wolves to provision and defend injured packmates from other wolves and (2) the importance of less-risky, buffer prey to pack-size persistence and year-to-year variation. Risk to predators hunting dangerous prey is an emerging area of research and could account for possible persistent differences in gray wolf (Canis lupus) pack sizes. We documented significant differences in long-term wolf-pack-size averages and variation in the Superior National Forest (SNF), Denali National Park and Preserve, Yellowstone National Park, and Yukon, Canada (pwolves’ risk when hunting primary prey, for those packs (N=3) hunting moose (Alces americanus) were significantly larger than those (N=10) hunting white-tailed deer (Odocoileus virginianus) (F1,8=16.50, p=0.004). Our data support the hypothesis that differential pack-size persistence may be perpetuated by differences in primary prey riskiness to wolves, and we highlight two important extensions of this idea: (1) the potential for wolves to provision and defend injured packmates from other wolves and (2) the importance of less-risky, buffer prey to pack-size persistence and year-to-year variation.
BACKGROUND: A breastfeeding infant’s intake of persistent organic pollutants (POPs) may be much greater than his/her mother’s average daily POP exposure. In many cases, current human health risk assessment methods do not account for differences between maternal and infant POP exp...
Arrebola, Juan P; Fernández, Mariana F; Martin-Olmedo, Piedad
The aim of this study was to assess the influence of adipose tissue concentrations of a group of persistent organic pollutants (POPs) on the risk of hypertension in an adult cohort of residents of Granada (Southern Spain) over a 10-year follow-up. No chemical was significantly associated with the...
Zong, Geng; Grandjean, Philippe; Wang, Xiaobin
OBJECTIVE: Lactation may help curb diabetes risk and is also known as an excretion route for some environmental pollutants. We evaluated associations of lifetime lactation history with serum concentrations of persistent organic pollutants (POPs) in the National Health and Nutrition Examination....... Prospective studies are needed to clarify how lactation could complement diabetes prevention through decreasing the POP body burdens....
Eidson, M; Lybarger, J A; Parsons, J E; MacCormack, J N; Freeman, J I
Tornadoes in North and South Carolina on 28 March 1984 caused 252 people to be injured seriously enough to require hospitalization and 59 to be killed. To evaluate risk factors, we gathered information on 238 (94%) of those hospitalized and 46 (78%) of those killed. Those hospitalized or deceased had statistically significantly more deep cuts, concussions, unconsciousness and broken bones than those with them at the time of the tornado who were not hospitalized or killed. People living in mobile homes were more likely to be hospitalized or die than people occupying conventional houses. Other risk factors for hospitalization or death included advanced age (60+ years), no physical protection (not having been covered with a blanket or other object), having been struck by broken window glass or other falling objects, home lifted off its foundation, collapsed ceiling or floor, or walls blown away. More awareness of the tornado risk before it strikes and better adherence to tornado protection guidelines could reduce injuries and deaths in the future.
Full Text Available The persistence of risk levels of local General Equity unit trusts is evaluated. Variations in absolute and market-adjusted returns are measured to determine whether investors can use historical risk as a proxy for future risk levels. The General Equity funds are fairly homogenous, and different funds should exhibit stable risk levels if the fund managers’ investment mandates and investment styles remain stable over time. The results indicate a degree of absolute and market-adjusted risk stability over time. The market-adjusted risk and return relationship remained stable through the 2008 global crises, indicating that, on average, the fund managers maintained their benchmark-related risk exposures. Both the absolute and market-adjusted results indicate no statistically significant relationship between risk and return for the 2000 to 2012 period.
Full Text Available The persistence of risk levels of local General Equity unit trusts is evaluated. Variations in absolute and market-adjusted returns are measured to determine whether investors can use historical risk as a proxy for future risk levels. The General Equity funds are fairly homogenous, and different funds should exhibit stable risk levels if the fund managers’ investment mandates and investment styles remain stable over time. The results indicate a degree of absolute and market-adjusted risk stability over time. The market-adjusted risk and return relationship remained stable through the 2008 global crises, indicating that, on average, the fund managers maintained their benchmark-related risk exposures. Both the absolute and market-adjusted results indicate no statistically significant relationship between risk and return for the 2000 to 2012 period.
Elliott, Jennifer C; Stohl, Malka; Wall, Melanie M; Keyes, Katherine M; Goodwin, Renee D; Skodol, Andrew E; Krueger, Robert F; Grant, Bridget F; Hasin, Deborah S
Alcohol and nicotine dependence are associated with considerable morbidity and mortality, especially when cases are persistent. The risk for alcohol and nicotine dependence is increased by childhood maltreatment. However, the influence of childhood maltreatment on dependence course is unknown, and is evaluated in the current study. Physical, sexual and emotional abuse, and physical and emotional neglect, were evaluated as predictors of persistent alcohol and nicotine dependence over 3 years of follow-up, with and without control for other childhood adversities. National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). NESARC participants completing baseline and follow-up who met criteria at baseline for past-year alcohol dependence (n = 1172) and nicotine dependence (n = 4017). Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) measures of alcohol/nicotine dependence, childhood maltreatment and other adverse childhood experiences (e.g. parental divorce). Controlling for demographics only, physical, sexual and emotional abuse and physical neglect predicted 3-year persistence of alcohol dependence [adjusted odds ratio (AOR) = 1.50-2.99; 95% CI = 1.04-4.68] and nicotine dependence (AOR = 1.37-1.74; 95% CI = 1.13-2.11). With other childhood adversities also controlled, maltreatment types remained predictive for alcohol persistence (AOR = 1.53-3.02; 95% CI = 1.07-4.71) and nicotine persistence (AOR = 1.35-1.72; 95% CI = 1.11-2.09). Further, a greater number of maltreatment types incrementally influenced persistence risk (AOR = 1.19-1.36; 95% CI = 1.11-1.56). A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence. © 2014 Society for the Study of Addiction.
Gielen, Stephan; Sandri, Marcus; Schuler, Gerhard; Teupser, Daniel
Despite the advances in interventional techniques, the management of stable atherosclerosis remains the domain of optimal guideline-oriented therapy. Recent studies on the effects of aggressive lipid lowering on atheroma volume changes using intravascular ultrasound indicate that it is possible to achieve atherosclerosis regression by reaching low-density lipoprotein (LDL) levels less than 75 mg/dl. The pleiotropic anti-inflammatory effects of statins contribute to the reduction of cardiovascular (CV) event observed with aggressive lipid lowering. As a second important strategy to prevent disease progression, lifestyle changes with regular physical exercise are capable of halting the atherosclerotic process and reducing angina symptoms and CV events. Optimal medical therapy, a healthy lifestyle with regular physical exercise, and coronary interventions are not mutually exclusive treatment strategies. Over the last few decades, both have proved to be effective in significantly reducing the CV mortality in the Western world. However, risk factor modification contributed to at least half the effect in the reduction of CV mortality. This figure provides an estimate of what could be achieved if we were to take risk factor modification more seriously - especially in the acute care setting. The knowledge is there: today we have a better understanding on how to stop progression and even induce regression of atherosclerosis. Much research still needs to be done and will be done. In the meantime, however, our primary focus should lie in implementing what is already known. In addition, it is essential not just to treat CV risk factors, but also to treat them to achieve the target values as set by the guidelines of European Society of Cardiology.
Maria Siettou; Maria Saridi
Teenage pregnancy is a worldwide medical and social issue, associated with many physical, psychological and social consequences and can result in birth, miscarriage or abortion. Aim: The aim of the present study is to find those risk factors that contribute to teenage pregnancy. Results: In U.S.A., according to data from Unicef, the birth rate among teenagers touches the 52.1% and it is four times higher, than the corresponding rate recorded in the countries of Western Europe. The United King...
Full Text Available The objective of the article is to analyse and present the classification of risks actual to derivative securities. The analysis is based on classical and modern literature findings and analysis of newest statistical data. The analysis led to the conclusion, that the main risks typical for derivatives contracts and their traders are market risk, liquidity risk, credit and counterparty risk, legal risk and transactions risk. Pricing risk and systemic risk is also quite important. The analysis showed that market risk is the most important kind of risk that in many situations influences the level of remaining risks.
Full Text Available Staphylococcus aureus is an important pathogen in cystic fibrosis (CF. However, it is not clear which factors are associated with worse lung function in patients with persistent S. aureus airway cultures. Our main hypothesis was that patients with high S. aureus density in their respiratory specimens would more likely experience worsening of their lung disease than patients with low bacterial loads.Therefore, we conducted an observational prospective longitudinal multi-center study and assessed the association between lung function and S. aureus bacterial density in respiratory samples, co-infection with other CF-pathogens, nasal S. aureus carriage, clinical status, antibiotic therapy, IL-6- and IgG-levels against S. aureus virulence factors.195 patients from 17 centers were followed; each patient had an average of 7 visits. Data were analyzed using descriptive statistics and generalized linear mixed models. Our main hypothesis was only supported for patients providing throat specimens indicating that patients with higher density experienced a steeper lung function decline (p<0.001. Patients with exacerbations (n = 60, S. aureus small-colony variants (SCVs, n = 84 and co-infection with Stenotrophomonas maltophilia (n = 44 had worse lung function (p = 0.0068; p = 0.0011; p = 0.0103. Patients with SCVs were older (p = 0.0066 and more often treated with trimethoprim/sulfamethoxazole (p = 0.0078. IL-6 levels positively correlated with decreased lung function (p<0.001, S. aureus density in sputa (p = 0.0016, SCVs (p = 0.0209, exacerbations (p = 0.0041 and co-infections with S. maltophilia (p = 0.0195 or A. fumigatus (p = 0.0496.In CF-patients with chronic S. aureus cultures, independent risk factors for worse lung function are high bacterial density in throat cultures, exacerbations, elevated IL-6 levels, presence of S. aureus SCVs and co-infection with S. maltophilia.ClinicalTrials.gov NCT00669760.
Meretoja, Tuomo J; Andersen, Kenneth Geving; Bruce, Julie
are missing. The aim was to develop a clinically applicable risk prediction tool. Methods The prediction models were developed and tested using three prospective data sets from Finland (n = 860), Denmark (n = 453), and Scotland (n = 231). Prediction models for persistent pain of moderate to severe intensity......), high body mass index ( P = .039), axillary lymph node dissection ( P = .008), and more severe acute postoperative pain intensity at the seventh postoperative day ( P = .003) predicted persistent pain in the final prediction model, which performed well in the Danish (ROC-AUC, 0.739) and Scottish (ROC......-AUC, 0.740) cohorts. At the 20% risk level, the model had 32.8% and 47.4% sensitivity and 94.4% and 82.4% specificity in the Danish and Scottish cohorts, respectively. Conclusion Our validated prediction models and an online risk calculator provide clinicians and researchers with a simple tool to screen...
Junge, S. (Sibylle); Görlich, D. (Dennis); Reijer, M.D. (Martijn Den); B. Wiedemann (Baerbel); B. Tümmler (Burkhard); H. Ellemunter; Dübbers, A. (Angelika); Küster, P. (Peter); M. Ballmann; Koerner-Rettberg, C. (Cordula); Große-Onnebrink, J. (Jörg); Heuer, E. (Eberhardt); Sextro, W. (Wolfgang); Mainz, J.G. (Jochen G.); Hammermann, J. (Jutta); Riethmüller, J. (Joachim); Graepler-Mainka, U.M. (Ute M.); Staab, D. (Doris); Wollschläger, B. (Bettina); Szczepanski, R. (Rüdiger); A. Schuster (Antje); Tegtmeyer, F.-K. (Friedrich-Karl); Sutharsan, S. (Sivagurunathan); Wald, A. (Alexandra); Nofer, J.-R. (Jerzy-Roch); W.J.B. van Wamel (Willem); Becker, K. (Karsten); Peters, G. (Georg); Kahl, B.C. (Barbara C.)
textabstractBackground Staphylococcus aureus is an important pathogen in cystic fibrosis (CF). However, it is not clear which factors are associated with worse lung function in patients with persistent S. aureus airway cultures. Our main hypothesis was that patients with high S. aureus density in
Fruchart, Jean-Charles; Nierman, Melchior C.; Stroes, Erik S. G.; Kastelein, John J. P.; Duriez, Patrick
Advances in our understanding of the ways in which the traditional cardiovascular risk factors, including standard lipid (eg, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and nonlipid (eg, hypertension) risk factors, interact to initiate
Hardell, Lennart; Bavel, Bert; Lindström, Gunilla; Eriksson, Mikael; Carlberg, Michael
Testicular cancer is the most common tumour type in young men. In Sweden the annual age-adjusted incidence increased significantly by 2.4% during the time period 1984-1993 and during 1994-2003 by 1.4%. Exposure to endocrine disrupting chemicals during the foetal period has been postulated to be a risk factor. In this investigation we studied the concentrations of chlorinated biphenyls (PCBs), p,p'-dichlorodiphenyl-dichloroethylene (pp'-DDE), hexachlorobenzene (HCB), chlordanes and polybrominated diphenylethers (PBDEs) in 58 cases with testicular cancer and 61 age-matched controls. Furthermore, case and control mothers were also asked to participate and 44 case mothers and 45 control mothers agreed. No significant differences were found between cases and controls. Case mothers had in general higher concentrations of these chemicals. For the sum of PCBs an odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.4-10 was calculated using the median concentration for the controls as cut-off value. For HCB OR = 4.4, CI = 1.7-12 and for PBDE OR = 2.5, 95% CI = 1.02-6.0 were obtained, whereas OR was not significantly increased for pp'-DDE and sum of chlordanes. The cases were born during a period with high concentrations of persistent organic pollutants (POPs) in humans. The decline of the increasing incidence of testicular cancer during recent years may reflect decreasing body burden of certain POPs since the 1980s.
Jan 18, 2011 ... injury. Risk factors may be considered as characteristic indicators ... by examining the cardiovascular risk factors that are related to various forms .... Cross country race, Handball, Jogging, Rope jumping, Running Soccer,.
In a large international collaborative analysis of risk factors for non-Hodgkin lymphoma (NHL), scientists were able to quantify risk associated with medical history, lifestyle factors, family history of blood or lymph-borne cancers, and occupation for 11
Cleopas Martin Rumende
Diabetes mellitus has been a well-known risk factor for TB in the past. The global convergence of the accelerating type 2 DM pandemic, high TB prevalence and drug-resistant TB during the past couple of decades has become a serious challenge to clinicians worldwide. Over the past few years, some studies have shown that the treatment failure rate is higher in TB patients with DM as comorbidity. Moreover, there is significant association between DM an MDR-TB. There is higher chance of TB bacilli persistence to be present in sputum of pulmonary TB patient with DM than TB-only patient after 5 months treatment, and this persistence made it necessary for more longer treatment. Presence of DM in TB patients cause a longer period for sputum conversion, therefore it may become a major cause of poor treatment outcome in TB patients. Previous studies showed that a major mechanism for the emergence of drugs resistance in TB bacilli is random mutation in the bacterial genome and the pressure of selection by anti-TB drugs. Pulmonary TB in diabetic patients usually show higher mycobacterial loads at the initiation of treatment, hence they may have higher chance of bacillary mutation and the emergence of MDR-TB with the presenting of higher bacterial loads, longer treatment is needed to clear the bacteria. Therefore, it is not suprising that a higher chance of MDR-TB patients could be find in those patients. A pharmacokinetic study noted that plasma levels of rifampicin were 53% lower in TB patients with diabetes, which might affect treatment outcomes. Inadequate immune respons of the host may also be important in this negative effect of diabetes. Depressed production of IFN-γ in diabetic patients is related to decreasing immune response to TB infection. Reduction of IL-12 response to mycobacterial stimulation in leukocytes from TB with diabetic patients suggest a compromise of innate immune response.
Ghisari, Mandana; Eiberg, Hans; Long, Manhai
BACKGROUND: We have previously reported that chemicals belonging to the persistent organic pollutants (POPs) such as perfluorinated compounds (PFAS) and polychlorinated biphenyls (PCBs) are risk factors in Breast Cancer (BC) development in Greenlandic Inuit women. The present case-control study...... on BC risk in Greenlandic Inuit women. METHODS: The study population consisted of 31 BC cases and 115 matched controls, with information on serum levels of POPs. Genotyping was conducted for CYP1A1 (Ile462Val; rs1048943), CYP1B1 (Leu432Val; rs1056836), COMT (Val158Met; rs4680), CYP17A1 (A1> A2; rs743572...... aimed to investigate the main effect of polymorphisms in genes involved in xenobiotic metabolism and estrogen biosynthesis, CYP1A1, CYP1B1, COMT and CYP17, CYP19 and the BRCA1 founder mutation in relation to BC risk and to explore possible interactions between the gene polymorphisms and serum POP levels...
Full Text Available Difficult temperament in infancy is a risk factor for forms of later internalizing and externalizing psychopathology, including depression and anxiety. A better understanding of the roots of difficult temperament requires assessment of its early development with a genetically informative design. The goal of this study was to estimate genetic and environmental contributions to individual differences in infant negative emotionality, their persistence over time and their influences on stability between 5 and 18 months of age.Participants were 244 monozygotic and 394 dizygotic twin pairs (49.7% male recruited from birth. Mothers rated their twins for negative emotionality at 5 and 18 months. Longitudinal analysis of stability and innovation between the two time points was performed in Mplus.There were substantial and similar heritability (approximately 31% and shared environmental (57.3% contributions to negative emotionality at both 5 and 18 months. The trait's interindividual stability across time was both genetically- and environmentally- mediated. Evidence of innovative effects (i.e., variance at 18 months independent from variance at 5 months indicated that negative emotionality is developmentally dynamic and affected by persistent and new genetic and environmental factors at 18 months.In the first two years of life, ongoing genetic and environmental influences support temperamental negative emotionality but new genetic and environmental factors also indicate dynamic change of those factors across time. A better understanding of the source and timing of factors on temperament in early development, and role of sex, could improve efforts to prevent related psychopathology.
Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi
Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....
Modai, Shira; Shomron, Noam
Schizophrenia (SZ) is a complex and strongly heritable mental disorder, which is also associated with developmental-environmental triggers. As opposed to most diagnosable diseases (yet similar to other mental disorders), SZ diagnosis is commonly based on psychiatric evaluations. Recently, large-scale genetic and epigenetic approaches have been applied to SZ research with the goal of potentially improving diagnosis. Increased computational analyses and applied statistical algorithms may shed some light on the complex genetic and epigenetic pathways contributing to SZ pathogenesis. This review discusses the latest advances in molecular risk factors and diagnostics for SZ. Approaches such as these may lead to a more accurate definition of SZ and assist in creating extended and reliable clinical diagnoses with the potential for personalized treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sri Agustina Basuki
Full Text Available The purpose of this research is to understand the influence of investor reaction towards profit that measured by the earning response coefficient with the variable of conservatism accountancy, persistence of profit and the systematic risk at the company, which have high market capitalization and listed in the LQ 45 index. Population in the research are companies, which are listed in the LQ 45 index from the period of 2011 to 2015 that have complete financial information, and have financial notation in the form of Rupiah and excluded from the banking sector. The analysis method that being used is multiple linier regressions analysis and the result shows that conservatism accountancy partially significant affecting the Earning Response Coefficient. It shows that there is an investor reaction towards companies in the Index LQ 45, which applies conservatism accountancy in gaining profit. Profit persistence and the systematic risk is not significantly affecting earnings response coefficient.
Christina A Brook
Full Text Available Christina A Brook, Louis A SchmidtDepartment of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, CanadaAbstract: Social anxiety disorder (SAD is a debilitating and chronic illness characterized by persistent fear of one or more social or performance situations, with a relatively high lifetime prevalence of 7% to 13% in the general population. Although the last two decades have witnessed enormous growth in the study of biological and dispositional factors underlying SAD, comparatively little attention has been directed towards environmental factors in SAD, even though there has been much ongoing work in the area. In this paper, we provide a recent review and critique of proposed environmental risk factors for SAD, focusing on traditional as well as some understudied and overlooked environmental risk factors: parenting and family environment, adverse life events, cultural and societal factors, and gender roles. We also discuss the need for research design improvements and considerations for future directions.
A Dehghani; M zahedi; M moezzi; M dafei; H Falahzadeh
Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective ...
Weinstein, A G
Crying behavior of the asthmatic child may induce wheezing symptoms. This may be a clinical problem for families with asthmatic children who exhibit frequent and persistent crying behavior. This case report identifies behaviors by the child and parents that may be responsible for continual crying. Child factors include (1) "spoiled" personality, (2) poor self-image, (3) biologic sensitivity to foods, medication, and environmental allergens producing irritability. Parental factors include poor disciplinary practices secondary to (1) disrupted home life, (2) guilt, and (3) overprotective behavior. Identification of these factors may be helpful in establishing clinical management strategies to reduce crying-induced asthma.
Kawwass, Jennifer F.; Crawford, Sara; Kissin, Dmitry M.; Session, Donna R.; Boulet, Sheree; Jamieson, Denise J.
OBJECTIVE To assess trends of tubal factor infertility and to evaluate risk of miscarriage and delivery of preterm or low birth weight (LBW) neonates among women with tubal factor infertility using assisted reproductive technology (ART). METHODS We assessed trends of tubal factor infertility among all fresh and frozen, donor, and nondonor ART cycles performed annually in the United States between 2000 and 2010 (N=1,418,774) using the National ART Surveillance System. The data set was then limited to fresh, nondonor in vitro fertilization cycles resulting in pregnancy to compare perinatal outcomes for cycles associated with tubal compared with male factor infertility. We performed bivariate and multivariable analyses controlling for maternal characteristics and calculated adjusted risk ratios (RRs) and 95% confidence intervals (CI). RESULTS The percentage of ART cycles associated with tubal factor infertility diagnoses decreased from 2000 to 2010 (26.02–14.81%). Compared with male factor infertility, tubal factor portended an increased risk of miscarriage (14.0% compared with 12.7%, adjusted RR 1.08, 95% CI 1.04–1.12); risk was increased for both early and late miscarriage. Singleton neonates born to women with tubal factor infertility had an increased risk of pre-term birth (15.8% compared with 11.6%, adjusted RR 1.27, 95% CI 1.20–1.34) and LBW (10.9% compared with 8.5%, adjusted RR 1.28, 95% CI 1.20–1.36). Significant increases in risk persisted for early and late preterm delivery and very low and moderately LBW delivery. A significantly elevated risk was also detected for twin, but not triplet, pregnancies. CONCLUSION Tubal factor infertility, which is decreasing in prevalence in the United States, is associated with an increased risk of miscarriage, preterm birth, and LBW delivery as compared with couples with male factor infertility using ART. PMID:23812461
Fiona J Clay
Full Text Available Persistent or chronic pain is prevalent in many developed countries, with estimates ranging from 10% to higher than 50%, and is a major economic burden to individuals and societies. However, the variation in pain outcomes after acute orthopedic trauma and treatment confronts treating physicians with uncertainty in providing prognostic advice regarding long-term recovery. Although several previous reviews have addressed the determinants of chronic pain outcomes secondary to acute trauma, they have primarily focused on specific injury samples and, furthermore, lack consistency with respect to the important prognostic factors, which limits the generalizability of findings. This review, however, aimed specifically to identify the early prognostic factors associated with variation in persistent pain outcomes following acute orthopedic trauma presenting with a spectrum of pathologies.
Junge, S. (Sibylle); Görlich, D. (Dennis); Reijer, M.D. (Martijn Den); Wiedemann, Baerbel; Tümmler, Burkhard; Ellemunter, H.; Dübbers, A. (Angelika); Küster, P. (Peter); Ballmann, M.; Koerner-Rettberg, C. (Cordula); Große-Onnebrink, J. (Jörg); Heuer, E. (Eberhardt); Sextro, W. (Wolfgang); Mainz, J.G. (Jochen G.); Hammermann, J. (Jutta)
textabstractBackground Staphylococcus aureus is an important pathogen in cystic fibrosis (CF). However, it is not clear which factors are associated with worse lung function in patients with persistent S. aureus airway cultures. Our main hypothesis was that patients with high S. aureus density in their respiratory specimens would more likely experience worsening of their lung disease than patients with low bacterial loads. Methods Therefore, we conducted an observational prospective longitudi...
Junge, Sibylle; G?rlich, Dennis; den Reijer, Martijn; Wiedemann, B?rbel; T?mmler, Burkhard; Ellemunter, Helmut; D?bbers, Angelika; K?ster, Peter; Ballmann, Manfred; Koerner-Rettberg, Cordula; Gro?e-Onnebrink, J?rg; Heuer, Eberhardt; Sextro, Wolfgang; Mainz, Jochen G.; Hammermann, Jutta
Background Staphylococcus aureus is an important pathogen in cystic fibrosis (CF). However, it is not clear which factors are associated with worse lung function in patients with persistent S. aureus airway cultures. Our main hypothesis was that patients with high S. aureus density in their respiratory specimens would more likely experience worsening of their lung disease than patients with low bacterial loads. Methods Therefore, we conducted an observational prospective longitudinal multi-ce...
Prevalence, risk factors and risk perception of tuberculosis infection among medical students and healthcare workers in Johannesburg, South Africa. A van Rie, K McCarthy, L Scott, A Dow, WDF Venter, WS Stevens ...
Niemann, Isa; Hansen, Estrid S; Sunde, Lone
classifications, and compared the ability of the two classifications to discriminate between patients with and without a substantial risk of persistent trophoblastic disease. METHODS: 294 cases of consecutively collected hydropic placentas clinically suspected of hydatidiform mole made the basis......OBJECTIVE: Hydatidiform mole can be classified by histopathologic characteristics and by genetic constitutions and most complete moles are diploid, whereas most partial moles are triploid. We investigated the concordance between these two classifications, characterized moles with conflicting......-molar miscarriage, 20 were triploids, 2 were diploid androgenetic and 2 were diploid biparental. In 23% of the conceptuses, the histopathologic and genetic classifications were conflicting. 5% of the patients with hydropic placentas classified as partial mole encountered persistent trophoblastic disease; however...
Dean, Lorraine T; Gehlert, Sarah; Neuhouser, Marian L; Oh, April; Zanetti, Krista; Goodman, Melody; Thompson, Beti; Visvanathan, Kala; Schmitz, Kathryn H
Greater attention to social factors, such as race/ethnicity, socioeconomic position, and others, are needed across the cancer continuum, including breast cancer, given differences in tumor biology and genetic variants have not completely explained the persistent Black/White breast cancer mortality disparity. In this commentary, we use examples in breast cancer risk assessment and survivorship to demonstrate how the failure to appropriately incorporate social factors into the design, recruitment, and analysis of research studies has resulted in missed opportunities to reduce persistent cancer disparities. The conclusion offers recommendations for how to better document and use information on social factors in cancer research and care by (1) increasing education and awareness about the importance of inclusion of social factors in clinical research; (2) improving testing and documentation of social factors by incorporating them into journal guidelines and reporting stratified results; and (3) including social factors to refine extant tools that assess cancer risk and assign cancer care. Implementing the recommended changes would enable more effective design and implementation of interventions and work toward eliminating cancer disparities by accounting for the social and environmental contexts in which cancer patients live and are treated.
Shrier, Ian; Colditz, Graham A; Steele, Russell J
Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided. The objective of this brief report was to provide the derivation of a more general form of the equation that allows the incorporation of risk factors with three or more levels.
Fraporti, Marisete Inês; Scherer Adami, Fernanda; Dutra Rosolen, Michele
Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes. To investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil. This is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0. Obesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01). Children living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.
U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...
Mitchell, James E; Crosby, Ross; de Zwaan, Martina; Engel, Scott; Roerig, James; Steffen, Kristine; Gordon, Kathryn H; Karr, Trisha; Lavender, Jason; Wonderlich, Steve
There is a growing research literature suggesting that there may be elevated risk of suicide following bariatric surgery. Most of the data reported thus far has been cross-sectional and observational, and very little is known about the possible specific causal variables involved. The purpose of this report is to review this literature and to review possible risk factors for increased suicidal risk following bariatric surgery, to delineate future research directions. First a variety of medical, biological, and genetic factors, including the persistence or recurrence of medical comorbidities after bariatric surgery, the disinhibition and impulsivity secondary to changes in the absorption of alcohol, hypoglycemia, as well as pharmacokinetic changes that may affect the absorption of various medications including antidepressant medications are reviewed. Also reviewed are possible mediating factors involving changes in various peptidergic systems such as GLP-1 and Ghrelin. A number of psychosocial issues that might be involved are discussed, including lack of improvement in quality of life after surgery, continued or recurrent physical mobility restrictions, persistence or recurrence of sexual dysfunction and relationship problems, low self-esteem, and a history of child maltreatment. Inadequate weight loss or weight regain are also discussed. A number of possible contributing factors have been identified. Possible theoretical models involved and directions for research are suggested. Copyright © 2012 The Obesity Society.
Bower, Julienne E.
Fatigue is one of the most common and distressing side effects of cancer and its treatment, and may persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and may be a risk factor for reduced survival. The prevalence and course of fatigue in cancer patients has been well characterized, and there is growing understanding of underlying biological mechanisms. Inflammation has emerged as a key biological pathway for cancer-related fatigue, with studies documenting links between markers of inflammation and fatigue before, during, and particularly after treatment. There is considerable variability in the experience of cancer-related fatigue that is not explained by disease- or treatment-related characteristics, suggesting that host factors may play an important role in the development and persistence of this symptom. Indeed, longitudinal studies have begun to identify genetic, biological, psychosocial, and behavioral risk factors for cancer-related fatigue. Given the multi-factorial nature of cancer-related fatigue, a variety of intervention approaches have been examined in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. Although there is currently no gold standard for treating fatigue, several of these approaches have shown beneficial effects and can be recommended to patients. This report provides a state of the science review of mechanisms, risk factors, and interventions for cancer-related fatigue, with a focus on recent longitudinal studies and randomized trials that have targeted fatigued patients. PMID:25113839
Bower, Julienne E
Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and might be a risk factor of reduced survival. The prevalence and course of fatigue in patients with cancer have been well characterized and there is growing understanding of the underlying biological mechanisms. Inflammation seems to have a key role in fatigue before, during, and after cancer-treatment. However, there is a considerable variability in the presentation of cancer-related fatigue, much of which is not explained by disease-related or treatment-related characteristics, suggesting that host factors might be important in the development and persistence of this symptom. Indeed, longitudinal studies have identified genetic, biological, psychosocial, and behavioural risk factors associated with cancer-related fatigue. Although no current gold-standard treatment for fatigue is available, a variety of intervention approaches have shown beneficial effects in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue, focusing on recent longitudinal studies and randomized trials that have targeted fatigued patients.
Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive
Introduction: Osteoradionecrosis (ORN) of the jaws is defined as exposed irradiated bone that fails to heal over a period of 3 months without the evidence of a persisting or recurrent tumor. In the previous decades, numerous factors were associated with the risk of ORN development and severity. Aims: The purposes of this study were to present the data of the patients that were treated for ORN in the Department of Oral and Maxillofacial Surgery in Munich (LMU), to detect factors that contributed to the onset of ORN, to identify risk factors associated with the severity of ORN and finally, to delineate and correlate these factors with the personal, health and treatment characteristics of the patients. Material and Methods: A retrospective study was conducted during the period from January 2003 until December 2012 that included all ORN cases having been treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU). The total sample was categorized in three groups according to stage and several variables were evaluated in an attempt to identify possible correlations between them and the necrosis severity. Results: One hundred and fifty three cases of ORN were documented. Among them, 23 (15.1%) cases were stage I, 31 (20.2%) were stage II and 99 (64.7%) were stage III and all localised in the mandible. There was a predominance of the disease in the posterior region when compared to the anterior region. The majority of cases was addicted to alcohol and tobacco abuse and was suffering from Diabetes Mellitus (DM). All cases were treated with RT and 80.4% of them with concomitant chemotherapy. The initial tumor was predominantly located in the floor of the mouth, the tongue and the pharynx. Approximately two thirds of the cases occured either after dental treatment or due to a local pathological condition. Logistic regression analysis identified Diabetes Mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive
Simon, Tiffany Monique
The purpose of this qualitative study was to identify factors that influence African Americans to pursue and complete doctoral degrees in engineering and applied science disciplines. Critical race theory (CRT), two models of doctoral student persistence, and graduate student persistence literature guided the conceptual framework of this study. In-depth and focus group interviews were conducted to learn the key factors that positively impacted the persistence of 19 African Americans who earned doctoral degrees in engineering and applied science. The following two factors were found to significantly contribute to the decision to pursue the doctorate: encouragement from others and participation in a research or internship program. Key factors impacting doctoral degree completion included: peer support, faculty adviser support, support from university administrators, and family support. In addition to identifying factors that influenced 19 African Americans to pursue and complete doctoral degrees in engineering and applied science, this study was about the importance of diversity and inclusion of multiple perspectives in education research and scholarship. To this end, the study served to promote and include the expert knowledge of African American doctoral degree recipients in engineering and applied science in the scholarly discourse on the issue of low participation rates of African Americans in engineering and applied science disciplines. Such knowledge will challenge traditional views on this issue and hopefully inspire new ways of addressing and remedying this issue. With African Americans and other minority populations growing at an exponential rate, people of color are quickly becoming the majority in key states across the nation. Therefore, it is imperative that all Americans have an opportunity to develop skills necessary to compete for professional positions in the science and engineering workforce. This mandate is required for the United States to maintain
Kjaer, Thora Wesenberg; Faurholt-Jepsen, Daniel; Medrano, Rosalinda; Elwan, Deena; Mehta, Kala; Christensen, Vibeke Brix; Wojcicki, Janet M
Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.
Lehmann, Geniece M; Verner, Marc-André; Luukinen, Bryan; Henning, Cara; Assimon, Sue Anne; LaKind, Judy S; McLanahan, Eva D; Phillips, Linda J; Davis, Matthew H; Powers, Christina M; Hines, Erin P; Haddad, Sami; Longnecker, Matthew P; Poulsen, Michael T; Farrer, David G; Marchitti, Satori A; Tan, Yu-Mei; Swartout, Jeffrey C; Sagiv, Sharon K; Welsh, Clement; Campbell, Jerry L; Foster, Warren G; Yang, Raymond S H; Fenton, Suzanne E; Tornero-Velez, Rogelio; Francis, Bettina M; Barnett, John B; El-Masri, Hisham A; Simmons, Jane Ellen
Lipophilic persistent environmental chemicals (LPECs) have the potential to accumulate within a woman's body lipids over the course of many years prior to pregnancy, to partition into human milk, and to transfer to infants upon breastfeeding. As a result of this accumulation and partitioning, a breastfeeding infant's intake of these LPECs may be much greater than his/her mother's average daily exposure. Because the developmental period sets the stage for lifelong health, it is important to be able to accurately assess chemical exposures in early life. In many cases, current human health risk assessment methods do not account for differences between maternal and infant exposures to LPECs or for lifestage-specific effects of exposure to these chemicals. Because of their persistence and accumulation in body lipids and partitioning into breast milk, LPECs present unique challenges for each component of the human health risk assessment process, including hazard identification, dose-response assessment, and exposure assessment. Specific biological modeling approaches are available to support both dose-response and exposure assessment for lactational exposures to LPECs. Yet, lack of data limits the application of these approaches. The goal of this review is to outline the available approaches and to identify key issues that, if addressed, could improve efforts to apply these approaches to risk assessment of lactational exposure to these chemicals.
Setodji, Claude M; Martino, Steven C; Scharf, Deborah M; Shadel, William G
To quantify the persistence of pro-smoking media exposure effects on college students' intentions to smoke and smoking refusal self-efficacy. A total of 134 college students (ages 18-24 years) were enrolled in an ecological momentary assessment study in which they carried handheld data collection devices for 3 weeks and reported their exposures to pro-smoking media as they occurred in the real world. Smoking intentions and smoking refusal self-efficacy were assessed after each exposure to pro-smoking media and at random prompts during each day of the 3-week assessment period. A generalized additive model was used to determine how long the effect of an exposure to pro-smoking media persisted. The effect of pro-smoking media exposures persisted for 7 days. After exposure, smoking intentions immediately increased (.56; 95% confidence interval [CI]: [.26, .87]) and then steadily decreased (-.12; 95% CI: [-.19, -.05]) each day for 7 days, while smoking refusal self-efficacy immediately decreased (-.42; 95% CI: [-.75, -.10]) and then steadily increased (.09; 95% CI: [.02, .16]) each day for 7 days. Daily changes occurring after 7 days were not statistically significant, suggesting that smoking intentions and refusal self-efficacy had stabilized and were no longer affected by pro-smoking media exposure. Exposures to pro-smoking media may have strong implications for emerging young adults smoking risk as the impact of an individual exposure appears to persist for at least a week. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.
Wenzel, Sally E.; Barnes, Peter J.; Bleecker, Eugene R.; Bousquet, Jean; Busse, William; Dahlén, Sven-Erik; Holgate, Stephen T.; Meyers, Deborah A.; Rabe, Klaus F.; Antczak, Adam; Baker, James; Horvath, Ildiko; Mark, Zsuzsanna; Bernstein, David; Kerwin, Edward; Schlenker-Herceg, Rozsa; Lo, Kim Hung; Watt, Rosemary; Barnathan, Elliot S.; Chanez, Pascal; Chanez, P.; Tunon-de-Lara, M.; Antczak, A.; Pierzchala, W.; Bukowczan, Z.; Trawinska, E.; Baker, J.; Wenzel, S. E.; Katial, R.; Bernstein, D.; Kerwin, E.; Bensch, G.; Castro, M.; Noonan, M.; Nayak, A.; Chupp, G.; Kline, J.; Busse, W.; Kavuru, M. S.; Lang, D.; Wolfe, R.; Baughman, R.; Korenblat, P.; Mansfield, L.; Bleecker, E.; Lisberg, E.; Liu, M.; Panettieri, R.; Spangenthal, S.; Bel, E. H.
RATIONALE: The treatment effect of golimumab, a human monoclonal antibody against tumor necrosis factor (TNF)-alpha, in severe persistent asthma is unknown. OBJECTIVES: To assess the safety and efficacy of golimumab in a large population of patients with uncontrolled, severe persistent asthma.
Schaakxs, Roxanne; Comijs, Hannie C; van der Mast, Roos C; Schoevers, Robert A; Beekman, Aartjan T F; Penninx, Brenda W J H
INTRODUCTION: The occurrence of well-established risk factors for depression differs across the lifespan. Risk factors may be more strongly associated with depression at ages when occurrence, and therefore expectance, is relatively low ("on-time off-time" hypothesis). This large-scale study examined
Ariëns, Geertje A M; Van Mechelen, Willem; Bongers, Paulien M.; Bouter, Lex M.; Van Der Wal, Gerrit
To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22
Zetstra-van der Woude, Alethea Priscilla
This thesis aims to investigate the different methods of data collection of risk factors in pregnancy. Several observational epidemiologic study designs were used to assess associations between risk factors and negative birth outcomes. We especially looked at the use of folic acid around pregnancy
Østerlund, Anna H; Lander, Flemming; Nielsen, Kent
Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient...... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...... in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries...
Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen
Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...
Tammy R. Dugas
Full Text Available Airborne fine and ultrafine particulate matter (PM are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR. EPFR has been demonstrated in both ambient air PM2.5 (diameter < 2.5 µm and in PM from a variety of combustion sources. Thus, low-temperature, thermal treatment of soils can potentially increase the concentration of EPFR in areas in and around Superfund sites. In this review, we will outline the evidence to date supporting EPFR formation and its environmental significance. Furthermore, we will address the lack of methodologies for specifically addressing its risk assessment and challenges associated with regulating this new, emerging contaminant.
Bonner, C.; van Lelyveld, I.P.P.; Zymek, R.
We assess the determinants of banks’ liquidity holdings using data for nearly 7000 banks from 25 OECD countries. We highlight the role of several bank-specific, institutional and policy variables in shaping banks’ liquidity risk management. Our main question is whether liquidity regulation
Full Text Available Background: Falls are common geriatric problems. The risk factors of falls are the intrinsic and extrinsic risk factors. Studies on falls are scarcely conducted in Indonesia, especially in Bandung. Therefore, this study was conducted to identify the intrinsic risk factors of falls among elderly. Methods: A descriptive study was carried out from August to October 2013 at the Geriatric Clinic of Dr. Hasan Sadikin General Hospital Bandung. Fifty three participants were selected according to the inclusion and exclusion criteria using consecutive sampling. The determined variables in this study were classification of the risk of falls, demographic profile, history of falls, disease, and medications. After the selection, the participants were tested by Timed up-and-go test (TUGT. Moreover, an interview and analysis of medical records were carried out to discover the risk factors of falls. The collected data were analyzed and presented in the form of percentages shown in tables. Results: From 53 patients, women (35.66% were considered to have higher risk of fall than men (18.34%. The majority of patients (66% with the risk of fall were from the age group 60–74 years. The major diseases suffered by patients were hypertension, osteoarthritis and diabetes mellitus. Drugs that were widely used were antihypertensive drugs; analgesic and antipyretic drugs and antidiabetic drugs. Conclusions: There are various intrinsic risk factors of falls in elderly and each of the elderly has more than one intrinsic risk factor of falls.
Full Text Available Whiplash-associated disorders (WAD are the most common injuries that are associated with car collisions in Japan and many Western countries. However, there is no clear evidence regarding the potential risk factors for poor recovery from WAD. Therefore, we used an online survey of the Japanese population to examine the association between potential risk factors and the persistence of symptoms in individuals with WAD.An online survey was completed by 127,956 participants, including 4,164 participants who had been involved in a traffic collision. A random sample of the collision participants (n = 1,698 were provided with a secondary questionnaire. From among the 974 (57.4% respondents to the secondary questionnaire, we selected 183 cases (intractable neck pain that was treated over a period of 6 months and 333 controls (minor neck pain that was treated within 3 months. Multivariable logistic regression analysis was used to evaluate the potential risk factors for prolonged treatment of WAD.Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important. These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.
Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten
Several risk scores for disease progression in Smoldering Multiple Myeloma (SMM) patients have been proposed, however, all have been developed using single center registries. To examine risk factors for time to progression (TTP) to Multiple Myeloma (MM) for SMM we analyzed a nationwide population......-based cohort of 321 newly diagnosed SMM patients registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥ 30g/l and immunoparesis significantly influenced......-high risk of transformation to MM. Using only immunoparesis and M-protein ≥ 30g/l, we created a scoring system to identify low, intermediate and high risk SMM. This first population-based study of SMM patients confirms that an M-protein ≥ 30g/l and immunoparesis remain important risk factors for progression...
Visser, Chantal A. N.; Garcia-Marcos, Luis; Eggink, Jenny; Brand, Paul L. P.
Factors operating in the first year of life are critical in determining the onset and persistence of wheezing in preschool children. This study was designed to examine the prevalence and risk factors of wheeze in the first year of life in Dutch infants. This was a population-based survey of
Moskwa, C A; Nicholas, J A; Goldberg, B
In brief: Many children and adolescents participate in sports that put them at risk for musculoskeletal injuries. Underlying physical conditions, or risk factors, may predispose them to particular types of sports injuries. Research shows that these risk factors fall into five categories: body type, flexibility, muscle strength, inadequate rehabilitation of a previous injury, and skeletal malalignment and anomalies. Some findings show, for example, that youthful football players who are also heavy have an increased rate of injury, sprains and strains are less common in flexible athletes, and patellar pain or subluxation may be related to a variety of malalignment factors. The authors recommend using a systematic, integrated approach to risk assessment of the athlete, both for detecting risk factors and determining their potential for con tribu ting to a sports injury.
Prostate cancer has the highest prevalence of any non-skin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating an...
Nicholson, Robert A.; Houle, Timothy T.; Rhudy, Jamie L.; Norton, Peter J.
Headache is a chronic disease that occurs with varying frequency and results in varying levels of disability. To date, the majority of research and clinical focus has been on the role of biological factors in headache and headache-related disability. However, reliance on a purely biomedical model of headache does not account for all aspects of headache and associated disability. Using a biopsychosocial framework, the current manuscript expands the view of what factors influence headache by considering the role psychological (i.e., cognitive and affective) factors have in the development, course, and consequences of headache. The manuscript initially reviews evidence showing that neural circuits responsible for cognitive–affective phenomena are highly interconnected with the circuitry responsible for headache pain. The manuscript then reviews the influence cognitions (locus of control and self-efficacy) and negative affect (depression, anxiety, and anger) have on the development of headache attacks, perception of headache pain, adherence to prescribed treatment, headache treatment outcome, and headache-related disability. The manuscript concludes with a discussion of the clinical implications of considering psychological factors when treating headache. PMID:17371358
Crescimbene, Massimo; La Longa, Federica; Pessina, Vera; Pino, Nicola Alessandro; Peruzza, Laura
The communication of natural hazards and their consequences is one of the more relevant ethical issues faced by scientists. In the last years, social studies have provided evidence that risk communication is strongly influenced by the risk perception of people. In order to develop effective information and risk communication strategies, the perception of risks and the influencing factors should be known. A theory that offers an integrative approach to understanding and explaining risk perception is still missing. To explain risk perception, it is necessary to consider several perspectives: social, psychological and cultural perspectives and their interactions. This paper presents the results of the CATI survey on seismic risk perception in Italy, conducted by INGV researchers on funding by the DPC. We built a questionnaire to assess seismic risk perception, with a particular attention to compare hazard, vulnerability and exposure perception with the real data of the same factors. The Seismic Risk Perception Questionnaire (SRP-Q) is designed by semantic differential method, using opposite terms on a Likert scale to seven points. The questionnaire allows to obtain the scores of five risk indicators: Hazard, Exposure, Vulnerability, People and Community, Earthquake Phenomenon. The questionnaire was administered by telephone interview (C.A.T.I.) on a statistical sample at national level of over 4,000 people, in the period January -February 2015. Results show that risk perception seems be underestimated for all indicators considered. In particular scores of seismic Vulnerability factor are extremely low compared with house information data of the respondents. Other data collected by the questionnaire regard Earthquake information level, Sources of information, Earthquake occurrence with respect to other natural hazards, participation at risk reduction activities and level of involvement. Research on risk perception aims to aid risk analysis and policy-making by
Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling
PURPOSE: Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do...... and having children, reduced the risk of being subjected to coercive measure (all p risk factors associated with coercive measures. Our findings can assist researchers in identifying patients at risk of coercion and thereby help...... measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased...
Kwon, Yu Hyun; Kim, Seul Ki; Cho, Jung Hwan; Kwon, Hyemi; Park, Se Eun; Oh, Hyung Geun; Park, Cheol Young; Lee, Won Young; Oh, Ki Won; Park, Sung Woo; Rhee, Eun Jung
Hypertriglyceridemia is known to have an association with increased risks of insulin resistance and diabetes. The aim of this study was to investigate the risk of diabetes mellitus, according to changes in the concentrations of triglycerides, over time. A total of 15,932 non-diabetic participants (mean age 43.2 years, 68% men) who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital, between January 2010 and December 2014, were recruited. Participants were classified according to their triglyceride concentrations; normal (<150 mg/dL) and abnormal (≥150 mg/dL). According to the triglyceride levels in 2010 and 2012, subjects were divided into four groups: normal-normal, normal-abnormal, abnormal-normal, and abnormal-abnormal. The risk for incident diabetes was assessed in 2014. Among the total subjects, 67.5% belonged to the normal-normal group, 8.6% to the normal-abnormal group, 9.4% to the abnormal-normal group, and 14.5% to the abnormal-abnormal group. A total of 234 subjects (1.5%) were newly diagnosed with diabetes, between 2010 and 2014. Over 4 years, 1%, 1.5%, 2.1%, and 3.0% of the subjects developed diabetes in the normal-normal, normal-abnormal, abnormal-normal, and abnormal-abnormal groups, respectively. When the risk for incident diabetes was analyzed in the groups, after adjusting the confounding variables, a 1.58-fold increase in the risk of diabetes (95% confidence interval [CI], 1.10 to 2.26) was observed in the participants with persistent hypertriglyceridemia (abnormal-abnormal group). This was attenuated by further adjustments for body mass index (BMI) (hazard ratio, 1.25; 95% CI, 0.86 to 1.80). In this large study population, persistent hypertriglyceridemia, over a period of 2 years, was significantly associated with the risk of incident diabetes, which was attenuated after adjustment for BMI. Copyright © 2018 Korean Endocrine Society.
Nygaard, Ingrid; Brubaker, Linda; Chai, Toby C; Markland, Alayne D; Menefee, Shawn A; Sirls, Larry; Sutkin, Gary; Zimmern, Phillipe; Arisco, Amy; Huang, Liyuan; Tennstedt, Sharon; Stoddard, Anne
The purpose of this study is to describe risk factors for post-operative urinary tract infection (UTI) the first year after stress urinary incontinence surgery. Multivariable logistic regression analyses were performed on data from 1,252 women randomized in two surgical trials, Stress Incontinence Surgical Treatment Efficacy trial (SISTEr) and Trial Of Mid-Urethral Slings (TOMUS). Baseline recurrent UTI (rUTI; ≥3 in 12 months) increased the risk of UTI in the first 6 weeks in both study populations, as did sling procedure and self-catheterization in SISTEr, and bladder perforation in TOMUS. Baseline rUTI, UTI in the first 6 weeks, and PVR > 100 cc at 12 months were independent risk factors for UTI between 6 weeks and 12 months in the SISTEr population. Few (2.3-2.4%) had post-operative rUTI, precluding multivariable analysis. In women with pre-operative rUTI, successful surgery (negative cough stress test) at 1 year did not appear to decrease the risk of persistent rUTI. Pre-operative rUTI is the strongest risk factor for post-operative UTI.
Kjær, Susanne K; Frederiksen, Kirsten; Plum, Christian Edinger Munk
Infection with high-risk human papillomavirus (HPV) is the main cause of high-grade cervical intraepithelial neoplasia (CIN) and cancer. It has been suggested that information about high-risk HPV type-specific infection might make cervical cancer screening more effective. Persistent HPV infection...
Dugas, Tammy R; Lomnicki, Slawomir; Cormier, Stephania A; Dellinger, Barry; Reams, Margaret
Airborne fine and ultrafine particulate matter (PM) are often generated through widely-used thermal processes such as the combustion of fuels or the thermal decomposition of waste. Residents near Superfund sites are exposed to PM through the inhalation of windblown dust, ingestion of soil and sediments, and inhalation of emissions from the on-site thermal treatment of contaminated soils. Epidemiological evidence supports a link between exposure to airborne PM and an increased risk of cardiovascular and pulmonary diseases. It is well-known that during combustion processes, incomplete combustion can lead to the production of organic pollutants that can adsorb to the surface of PM. Recent studies have demonstrated that their interaction with metal centers can lead to the generation of a surface stabilized metal-radical complex capable of redox cycling to produce ROS. Moreover, these free radicals can persist in the environment, hence their designation as Environmentally Persistent Free Radicals (EPFR). EPFR has been demonstrated in both ambient air PM2.5 (diameter challenges associated with regulating this new, emerging contaminant.
Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír
Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.
Lee, Hyun-Kyung; Jeong, Yunsun; Lee, Sunggyu; Jeong, Woochang; Choy, Eun-Jung; Kang, Chang-Keun; Lee, Won-Chan; Kim, Sang-Jo; Moon, Hyo-Bang
Data on persistent organochlorines (OCs) in sharks are scarce. Concentrations of OCs such as polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were determined in the muscle tissue of 13 shark species (n=105) collected from offshore (Indian and Pacific Oceans) and coastal waters of Korea, to investigate species-specific accumulation of OCs and to assess the potential health risks associated with consumption of shark meat. Overall OC concentrations were highly variable not only among species but also within the same species of shark. The concentrations of PCBs, DDTs, chlordanes, hexachlorobenzene, and heptachlor in all shark species ranged from shark in our study were relatively lower than those reported in other studies. Aggressive shark species and species inhabiting the Indian Ocean had the highest levels of OCs. Inter-species differences in the concentrations and accumulation profiles of OCs among shark species could be explained by differences in feeding habit and sampling locations. Several confounding factors such as growth velocity, trophic position, and regional contamination status may affect the bioaccumulation of OCs in sharks. Hazard ratios of non-cancer risk for all the OCs were below one, whereas the hazard ratios of lifetime cancer risks of PCBs and DDTs exceeded one, implying potential carcinogenic effects in the general population in Korea. This is the first report to document the occurrence of OCs in sharks from Korea. Copyright © 2015 Elsevier Inc. All rights reserved.
Chen, Hui-Chi; Schiffman, Mark; Lin, Ching-Yu; Pan, Mei-Hung; You, San-Lin; Chuang, Li-Chung; Hsieh, Chang-Yao; Liaw, Kai-Li; Hsing, Ann W; Chen, Chien-Jen
Human papillomavirus (HPV) persistence is the pivotal event in cervical carcinogenesis. We followed a large-scale community-based cohort for 16 years to investigate the role of genotype-specific HPV persistence in predicting cervical cancer including invasive and in situ carcinoma. At the baseline examination in 1991-1992, 11,923 participants (aged 30-65 years) consented to HPV testing and cytology; 6923 participants were reexamined in 1993-1995. For HPV testing, we used a polymerase chain reaction-based assay that detected 39 HPV types. Women who developed cervical cancer were identified from cancer and death registries. Cumulative risks for developing cervical cancer among infected and persistently infected women were calculated by the Kaplan-Meier method. Of 10,123 women who were initially cytologically normal, 68 developed cervical cancer. The 16-year cumulative risks of subsequent cervical cancer for women with HPV16, HPV58 (without HPV16), or other carcinogenic HPV types (without HPV16 or HPV58) were 13.5%, 10.3%, and 4.0%, respectively, compared with 0.26% for HPV-negative women. Women with type-specific persistence of any carcinogenic HPV had greatly increased risk compared with women who were HPV-negative at both visits (hazard ratio = 75.4, 95% confidence interval = 31.8 to 178.9). The cumulative cervical cancer risks following persistent carcinogenic HPV infections increased with age: The risks were 5.5%, 14.4%, and 18.1% for women aged 30-44 years, 45-54 years, and 55 years and older, respectively. However, newly acquired infections were associated with a low risk of cervical cancer regardless of age. HPV negativity was associated with a very low long-term risk of cervical cancer. Persistent detection of HPV among cytologically normal women greatly increased risk. Thus, it is useful to perform repeated HPV testing following an initial positive test.
Akar, Banu; Jiang, Bin; Somo, Sami I; Appel, Alyssa A; Larson, Jeffery C; Tichauer, Kenneth M; Brey, Eric M
Gradients of soluble factors play an important role in many biological processes, including blood vessel assembly. Gradients can be studied in detail in vitro, but methods that enable the study of spatially distributed soluble factors and multi-cellular processes in vivo are limited. Here, we report on a method for the generation of persistent in vivo gradients of growth factors in a three-dimensional (3D) biomaterial system. Fibrin loaded porous poly (ethylene glycol) (PEG) scaffolds were generated using a particulate leaching method. Platelet derived growth factor BB (PDGF-BB) was encapsulated into poly (lactic-co-glycolic acid) (PLGA) microspheres which were placed distal to the tissue-material interface. PLGA provides sustained release of PDGF-BB and its diffusion through the porous structure results in gradient formation. Gradients within the scaffold were confirmed in vivo using near-infrared fluorescence imaging and gradients were present for more than 3 weeks. The diffusion of PDGF-BB was modeled and verified with in vivo imaging findings. The depth of tissue invasion and density of blood vessels formed in response to the biomaterial increased with magnitude of the gradient. This biomaterial system allows for generation of sustained growth factor gradients for the study of tissue response to gradients in vivo. Published by Elsevier Ltd.
Helen A. Weiss
Full Text Available The aim of this study was to describe the epidemiology of problem drinking in a cohort of women at high-risk of HIV in Kampala, Uganda. Overall, 1027 women at high risk of HIV infection were followed from 2008 to 2013. The CAGE and AUDIT questionnaires were used to identify problem drinkers in the cohort. Interviewer-administered questionnaires were used to ascertain socio-demographic and behavioural factors. Blood and genital samples were tested for HIV and other sexually transmitted infections. At enrollment, most women (71% reported using alcohol at least weekly and about a third reported having drunk alcohol daily for at least 2 weeks during the past 3 months. Over half (56% were problem drinkers by CAGE at enrollment, and this was independently associated with vulnerability (being divorced/separated/widowed, less education, recruiting clients at bars/clubs, and forced sex at first sexual experience. Factors associated with problem drinking during follow-up included younger age, meeting clients in bars/clubs, number of clients, using drugs and HSV-2 infection. HIV prevalence was associated with drinking at enrollment, but not during follow-up. This longitudinal study found high levels of persistent problem drinking. Further research is needed to adapt and implement alcohol-focused interventions in vulnerable key populations in sub-Saharan Africa.
Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review. ... ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes.
So many presumed risk factors for female tubal infertility are seen among. Nigerian women. ... strategies such as health awareness campaigns against unwanted pregnancy, promotion of responsible ..... of CT findings in acute pyogenic pelvic.
Ouzounian, Joseph G
Shoulder dystocia complicates ∼1% of vaginal births. Although fetal macrosomia and maternal diabetes are risk factors for shoulder dystocia, for the most part its occurrence remains largely unpredictable and unpreventable.
G. Carson, Charlotte
The aim of this thesis was to investigate possible risk factors affecting the development of AD. AD is a frequent disease among children and has a substantial impact on the lives of both the child and its family. A better understanding of the disease would enable better treatment, prevention...... and information to the families involved. Previous risk factor studies have been hampered by an unsuitable study design and/or difficulties in standardization when diagnosing AD, which limit their conclusions. In paper I, we conducted a traditional cross-sectional analysis testing 40 possible risk factors...... exposure to dog was the only environmental exposure that significantly reduced the disease manifestation, suggesting other, yet unknown environmental factors affecting the increasing prevalence of AD in children. Length at birth was shown to be inversely associated with the risk of later developing AD...
Lagerlund, Magdalena; Hvidberg, Line; Hajdarevic, Senada
Background: Sweden and Denmark are neighbouring countries with similarities in culture, healthcare, and economics, yet notable differences in cancer statistics. A crucial component of primary prevention is high awareness of risk factors in the general public. We aimed to determine and compare...... awareness of risk factors for cancer between a Danish and a Swedish population sample, and to examine whether there are differences in awareness across age groups. Methods: Data derive from Module 2 of the International Cancer Benchmarking Partnership. Telephone interviews were conducted with 3000 adults...... in Denmark and 3070 in Sweden using the Awareness and Beliefs about Cancer measure. Data reported here relate to awareness of 13 prompted risk factors for cancer. Prevalence ratios with 95 % confidence intervals were calculated to examine associations between country, age, and awareness of risk factors...
Екатерина Игоревна Лебедева
Conclusion. Mixed somatic and gynecological pathology, abnormalities in hemostasis, combination of inherited and acquired thrombogenic risk factors dominates in women with initial reproductive loss, though only 37,3 % such pregnancies have favorable outcome.
Deborah T. Gold
Full Text Available Purpose. Determine patient-reported reasons for discontinuation with teriparatide. Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months, and follow-up questionnaire 2 (QF2, 12 months. Discontinuation reported at QF1 and QF2 was defined as “early” and “late,” respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation. Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were “concerns about treatment outweighing the benefits” (n=53 and “difficulty paying” (n=47. Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.
Guimaraes-Pereira, Luis; Valdoleiros, Ines; Reis, Pedro; Abelha, Fernando
Persistent postoperative pain (PPP) is defined as persistent pain after surgery of greater than three months' duration. Identify the incidence of PPP in our hospital and its associated factors; evaluate quality of life (QoL) and treatment of patients. We conducted an observational prospective study in adults proposed to various types of surgery using the brief pain inventory short form preoperatively (T0), one day after surgery, and three months later (T3). If the patient had pain at T3 and other causes of pain were excluded, they were considered to have PPP, and the McGill Pain Questionnaire Short Form was applied. QoL was measured with the EuroQol 5-dimension questionnaire (EQ-5D). One hundred seventy-five patients completed the study. The incidence of PPP was 28%, and the affected patients presented lower QoL. The majority referred to a moderate to severe level of interference in their general activity. Cholecystectomies were less associated with PPP, and total knee/hip replacements were more associated with it. Preoperative pain, preoperative benzodiazepines or antidepressants, and more severe acute postoperative pain were associated with the development of PPP. Half of the patients with PPP were under treatment, and they refer a mean symptomatic relief of 69%. This study, apart from attempting to better characterize the problem of PPP, emphasizes the lack of its treatment.
Full Text Available The evaluation of landslide specific risk, defined as the expected degree of loss due to landslides, requires the parameterization and the combination of a number of socio-economic and geological factors, which often needs the interaction of different skills and expertise (geologists, engineers, planners, administrators, etc.. The specific risk sub-components, i.e., hazard and vulnerability of elements at risk, can be determined with different levels of detail depending on the available auxiliary data and knowledge of the territory. These risk factors are subject to short-term variations and nowadays turn out to be easily mappable and evaluable through remotely sensed data and GIS (Geographic Information System tools. In this work, we propose a qualitative approach at municipal scale for producing a “specific risk” map, supported by recent satellite PSI (Persistent Scatterer Interferometry data derived from SENTINEL-1 C-band images in the spanning time 2014–2017, implemented in a GIS environment. In particular, PSI measurements are useful for the updating of a landslide inventory map of the area of interest and are exploited for the zonation map of the intensity of ground movements, needed for evaluating the vulnerability over the study area. Our procedure is presented throughout the application to the Volterra basin and the output map could be useful to support the local authorities with updated basic information required for environmental knowledge and planning at municipal level. Moreover, the proposed procedure is easily managed and repeatable in other case studies, as well as exploiting different SAR sensors in L- or X-band.
This paper focused on the reduction of cardiovascular disease risk factors, through aerobic exercises. The central argument here is that through exercise there is the tendency for increased strength of the heart muscles. When this is the case, what follows is a reduction in body weight and ultimately less risk on the ...
Orosova, Ol'ga; Gajdosova, Beata; Madarasova-Geckova, Andrea; Van Dijk, Jitse P.
The study presents the state-of-art of knowledge of risk factors of drug use as a form of risk behaviour in adolescents in individual, interpersonal, and environmental domain (family, school, society). The attention is paid to general deviation syndrome and to the construct of general tendency to
Heemskerk, Charlotte P.M.; Pereboom, Marieke; van Stralen, Karlijn; Berger, Florine A.; van den Bemt, Patricia M.L.A.; Kuijper, Aaf F.M.; van der Hoeven, Ruud T M; Mantel-Teeuwisse, Aukje K.; Becker, Matthijs L
Purpose: Prolongation of the QTc interval may result in Torsade de Pointes, a ventricular arrhythmia. Numerous risk factors for QTc interval prolongation have been described, including the use of certain drugs. In clinical practice, there is much debate about the management of the risks involved. In
Lysen, Victoria C.; Walker, Robert
Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…
Tsai, Jack; Rosenheck, Robert A.
Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171
Ul Haq, Faheem; Jalil, Fatima; Hashmi, Saman; Jumani, Maliha Iqbal; Imdad, Aamer; Jabeen, Mehnaz; Hashmi, Javad Tauseef; Irfan, Furqan Bin; Imran, Muhammad; Atiq, Mehnaz
Congenital heart disease (CHD) is associated with multiple risk factors, consanguinity may be one such significant factor. The role of consanguinity in the etiology of CHD is supported by inbreeding studies, which demonstrate an autosomal recessive pattern of inheritance of some congenital heart defects. This study was done to find out the risk factors for CHD. A case-control study was done on pediatric patients at a tertiary care hospital, Aga Khan University Hospital, located in Karachi, Pakistan. A total of 500 patients, 250 cases and 250 controls were included in the study. Amongst the 250 cases (i.e. those diagnosed with CHD), 122 patients (48.8%) were born of consanguineous marriages while in the controls (i.e. non-CHD) only 72 patients (28.9%) showed a consanguinity amongst parents. On multivariate analysis, consanguinity emerged as an independent risk factor for CHD; adjusted odds ratio 2.59 (95% C. I. 1.73 - 3.87). Other risk factors included low birth weight, maternal co-morbidities, family history of CHD and first born child. On the other hand, medications used by the mother during the index pregnancy, maternal age and gender of the child did not significantly increase the risk of developing CHD. Analyses of our results show that parental consanguinity, family history of CHD, maternal co-morbidities, first born child and low birth weight are independent risk factors for CHD
Breithardt, G.; Ravens, U.; Kirchhof, P.; van Gelder, I. C.
The development of atrial fibrillation (AF) is closely linked to risk factors like hypertension and heart failure, diabetes mellitus, myocardial infarction and valvular heart disease. These factors partly overlap with those which determine the progression of atrial fibrillation and the incidence of
Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James
Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. Copyright © 2012 Elsevier Inc
Gupta, Vinay; Magon, Rakesh; Mishra, B P; Sidhu, G B S; Mahajan, Ranjiv
Neuroleptic malignant syndrome (NMS) is an uncommon but potentially serious idiosyncratic response to neuroleptic antipsychotics. It usually affects young males, but the risk has been seen to increase with certain factors including the administration practices of antipsychotic neuroleptics in these individuals. Even though no predictors for NMS are yet known, this article highlights the findings on certain risk factors as seen from a series of fifteen patients who developed NMS. Cautious use of neuroleptics in those at risk, early recognition and institution of immediate management is important.
Janoutová, J.; Janáčková, P.; Šerý, Omar; Zeman, T.; Ambrož, P.; Kovalová, M.; Vařechová, K.; Hosák, L.; Jiřík, V.; Janout, V.
Roč. 37, č. 1 (2016), s. 1-8 ISSN 0172-780X R&D Projects: GA MZd NT14504 Institutional support: RVO:67985904 Keywords : schizophrenia * risk factors * epidemiology Subject RIV: FQ - Public Health Care, Social Medicine Impact factor: 0.918, year: 2016
Ekaterina Valeriyevna Ilyinykh
Full Text Available The paper considers different risk factors for osteonecrosis (ON and some aspects of its pathogenesis: impairments in the differentiation of stromal cells, the vascular provision of intraand extravasal genesis, the quality of proper bone tissue due to generalized or local osteoporosis, intravascular coagulation factors contributing to microthrombogenesis. The basic types of ON are identified.
Bhutta, Zulfiqar Ahmed
Nutritional rehabilitation of persistent diarrhea in childhood: factors determining recovery and the relationship of systemic infections with intestinal function Zulfiqar A. Bhutta Nutritional rehabilitation of persistent diarrhea (PD), a major killer of children in the third world, poses an enormous challenge. We validated the efficacy of a traditional local weaning diet based on rice-lentils (Khitchri) and yogurt (K-Y diet) for nutritional rehabilitation of PD. ...
de Groot, D; Pasterkamp, G; Hoefer, I E
Arterial lumen narrowing and vascular occlusion is the actual cause of morbidity and mortality in atherosclerotic disease. Collateral artery formation (arteriogenesis) refers to an active remodelling of non-functional vascular anastomoses to functional collateral arteries, capable to bypass the site of obstruction and preserve the tissue that is jeopardized by ischaemia. Hemodynamic forces such as shear stress and wall stress play a pivotal role in collateral artery formation, accompanied by the expression of various cytokines and invasion of circulating leucocytes. Arteriogenesis hence represents an important compensatory mechanism for atherosclerotic vessel occlusion. As arteriogenesis mostly occurs when lumen narrowing by atherosclerotic plaques takes place, presence of cardiovascular risk factors (e.g. hypertension, hypercholesterolaemia and diabetes) is highly likely. Risk factors for atherosclerotic disease affect collateral artery growth directly and indirectly by altering hemodynamic forces or influencing cellular function and proliferation. Adequate collateralization varies significantly among atherosclerotic patients, some profit from the presence of extensive collateral networks, whereas others do not. Cardiovascular risk factors could increase the risk of adverse cardiovascular events in certain patients because of the reduced protection through an alternative vascular network. Likewise, drugs primarily thought to control cardiovascular risk factors might contribute or counteract collateral artery growth. This review summarizes current knowledge on the influence of cardiovascular risk factors and the effects of cardiovascular medication on the development of collateral vessels in experimental and clinical studies.
Frantzeskou, Elpida; Jensen, Olaf; Linos, Athena
Background Studies have shown that fishermen have a higher mortality from cardiovascular diseases, cancer and accidents. The majority of cardiovascular disease is caused by external risk factors such as the diet, tobacco, alcohol and lack of physical activity. The purpose of this paper...... was to review the available information on the prevalence of these preventable risk factors in order to strengthen the preventive strategies. Methods A search for the last decade was done via Medline, Google and Google Scholar with the keywords "diet, tobacco, alcohol, physical exercise, overweight....... Of the Danish fishermen 25%-, 34% and 37% were obese in the 18-24, 25-44 and 45-64 years age groups. Conclusion Health risk factors among fishermen need to be highlighted and further investigated as they represent occupational risks of major impact to chronic diseases prevalence with projections to quality...
Van der Velden, U.; Abbas, F.; Armand, S.; Loos, B. G.; Timmerman, M. F.; Van der Weijden, G. A.; Van Winkelhoff, A. J.; Winkel, E. G.
Objective: To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. Material and Methods: For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on
Nash, David T; Fillit, Howard
The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.
Vilain, J; Galliot, A-M; Durand-Roger, J; Leboyer, M; Llorca, P-M; Schürhoff, F; Szöke, A
Evidence of variations in schizophrenia incidence rates has been found in genetically homogenous populations, depending on changes within time or space of certain environmental characteristics. The consideration of the impact of environmental risk factors in etiopathogenic studies has put the environment in the forefront of research regarding psychotic illnesses. Various environmental factors such as urbanicity, migration, cannabis, childhood traumas, infectious agents, obstetrical complications and psychosocial factors have been associated with the risk of developing schizophrenia. These risk factors can be biological, physical, psychological as well as social and may operate at different times in an individual's life (fetal period, childhood, adolescence and early adulthood). Whilst some of these factors act on an individual level, others act on a populational level, modulating the individual risk. These factors can have a direct action on the development of schizophrenia, or on the other hand act as markers for directly implicated factors that have not yet been identified. This article summarizes the current knowledge on this subject. An extensive literature search was conducted via the search engine Pubmed. Eight risk factors were selected and developed in the following paper: urbanicity (or living in an urban area), cannabis, migration (and ethnic density), obstetrical complications, seasonality of birth, infectious agents (and inflammatory responses), socio-demographic factors and childhood traumas. For each of these factors, we provide information on the importance of the risk, the vulnerability period, hypotheses made on the possible mechanisms behind the factors and the level of proof the current research offers (good, medium, or insufficient) according to the amount, type, quality and concordance of the studies at hand. Some factors, such as cannabis, are "unique" in their influence on the development of schizophrenia since it labels only one risk factor
Gill, Sharon K
Coronary artery disease and stroke predominantly affect older women as opposed to younger women, but the risk factors that contribute to atherosclerotic cardiovascular disease risk often start in young women. Young women with polycystic ovary syndrome (PCOS), with migraine, and who use oral contraceptive pills (OCPs) have short-term increases in thrombotic complications that can result in coronary events or stroke. Attention should be focused on risk reduction in women of all ages. Screening for and discussing diabetes, hypertension, obesity, smoking, migraine, PCOS, and pregnancy complication history and discussing the pros and cons of hormone and statin medications are part of reducing cardiovascular risk for women. Published by Elsevier Inc.
Evans, Suzanne B.; Kaufman, Seth A.; Price, Lori Lyn; Cardarelli, Gene; Dipetrillo, Thomas A.; Wazer, David E.
Purpose: To investigate the incidence of, and possible factors associated with, seroma formation after intraoperative placement of the MammoSite catheter for accelerated partial breast irradiation. Methods and Materials: This study evaluated 38 patients who had undergone intraoperative MammoSite catheter placement at lumpectomy or reexcision followed by accelerated partial breast irradiation with 34 Gy in 10 fractions. Data were collected regarding dosimetric parameters, including the volume of tissue enclosed by the 100%, 150%, and 200% isodose shells, dose homogeneity index, and maximal dose at the surface of the applicator. Clinical and treatment-related factors were analyzed, including patient age, patient weight, history of diabetes and smoking, use of reexcision, interval between surgery and radiotherapy, total duration of catheter placement, total excised specimen volume, and presence or absence of postprocedural infection. Seroma was verified by clinical examination, mammography, and/or ultrasonography. Persistent seroma was defined as seroma that was clinically detectable >6 months after radiotherapy completion. Results: After a median follow-up of 17 months, the overall rate of any detectable seroma was 76.3%. Persistent seroma (>6 months) occurred in 26 (68.4%) of 38 patients, of whom 46% experienced at least modest discomfort at some point during follow-up. Of these symptomatic patients, 3 required biopsy or complete cavity excision, revealing squamous metaplasia, foreign body giant cell reaction, fibroblasts, and active collagen deposition. Of the analyzed dosimetric, clinical, and treatment-related variables, only body weight correlated positively with the risk of seroma formation (p = 0.04). Postprocedural infection correlated significantly (p = 0.05) with a reduced risk of seroma formation. Seroma was associated with a suboptimal cosmetic outcome, because excellent scores were achieved in 61.5% of women with seroma compared with 83% without seroma
Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete
trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during......People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time...... admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors...
Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete
People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time...... trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during...... is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment...
Abrich, Victor; Brozek, Annabelle; Boyle, Timothy R; Chyou, Po-Huang; Yale, Steven H
To identify risk factors associated with spontaneous recurrent epistaxis. This was a retrospective cohort study assessing patients in the Marshfield Clinic system diagnosed as having epistaxis between January 1, 1991, and January 1, 2011. There were 461 cases with at least 2 episodes of spontaneous epistaxis within 3 years and 912 controls with only 1 episode in the same time frame. More than 50 potential risk factors were investigated, including demographic features, substance use, nasal anatomical abnormalities, nasal infectious and inflammatory processes, medical comorbidities, medications, and laboratory values. A Cox proportional hazards regression modeling approach was used to calculate hazard ratios of epistaxis recurrence. Traditional risk factors for epistaxis, including nasal perforation, nasal septum deviation, rhinitis, sinusitis, and upper respiratory tract infection, did not increase the risk of recurrence. Significant risk factors for recurrent epistaxis included congestive heart failure, diabetes mellitus, hypertension, and a history of anemia. Warfarin use increased the risk of recurrence, independent of international normalized ratio. Aspirin and clopidogrel were not found to increase the risk of recurrence. Few major adverse cardiovascular events were observed within 30 days of the first epistaxis event. Congestive heart failure is an underappreciated risk factor for recurrent epistaxis. Hypertension and diabetes mellitus may induce atherosclerotic changes in the nasal vessels, making them friable and more at risk for bleeding. Patients with recurrent epistaxis may also be more susceptible to developing anemia. Physicians should promote antiplatelet and antithrombotic medication adherence despite an increased propensity for recurrent epistaxis to prevent major adverse cardiovascular events. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Mubarak, Husin, Saiful; Oktaviati, Mutia
Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.
Canals C, Andrea; Cavada C, Gabriel; Nazer H, Julio
The relative importance of congenital malformations as a cause of death in the first year of life is increasing along with the control of preventable causes of perinatal mortality. To identify risk factors for congenital malformations. Retrospective case-control study of births registered in the database of The Latin American Collaborative Study of Congenital Malformations (ECLAMC), in the period 2001-2010. Birth weight and gestational age were significantly lower in cases than controls, behaving as risk factors and associated with a greater severity of congenital malformations. The risk and severity of congenital malformations increased along with mother's age. Fetal growth retardation, a history of congenital malformations in the family, physical factors and acute illnesses of the mother in the first trimester of pregnancy were also significant risk factors for congenital malformations and their severity. The educational level of the mother was a protective factor for congenital malformations and their severity. Variables previously identified as risk factors for congenital malformations, were significantly related with the occurrence of congenital malformations and their severity.
Vayá, Amparo; Mira, Yolanda; Martínez, Marcial; Villa, Piedad; Ferrando, Fernando; Estellés, Amparo; Corella, Dolores; Aznar, Justo
Hypercoagulable states due either to inherited or acquired thrombotic risk factors are only present in approximately half of cases of DVT, but the causes in the other half, remain unknown. The importance of biological risk factors such as hyperlipidemia, hypofibrinolysis and hemorheological alterations in the pathogenesis of DVT has not been well established. In order to ascertain whether the above mentioned biological factors are associated with DVT and could constitute independent risk factors, we carried out a case-control study in 109 first DVT patients in whom inherited or acquired thrombophilic risk factors had been ruled out and 121 healthy controls age (42+/-15 years) and sex matched. From all the biological variables analyzed (cholesterol, triglycerides, glucose, fibrinogen, erythrocyte aggregation, hematocrit, plasma viscosity and PAI-1) only fibrinogen concentration reached a statistically significant difference on the comparison of means (290+/-73 mg/dl in cases vs 268+/-58 mg/dl in controls, p220 mg/dl, hematocrit >45% and fibrinogen >300 mg/dl was higher in cases than in controls: 38% vs 22%; p30 ng/ml, 37% vs 25% was borderline significant; p=0.055. Multivariate logistic regression analysis showed that cholesterolemia >220 mg/dl and fibrinogen >300 mg/dl constitute independent predictors of venous thrombotic risk. The adjusted OR's were 2.03 (95% CI; 1.12-3.70) for cholesterolemia and 1.94 (95% CI; 1.07-3.55) for fibrinogen. When these two variables combined DVT risk rose about fourfold (3.96; p<0.05). Our results suggest that hypercholesterolemia and hyperfibrinogenemia should be added to the list of known DVT risk factors and we recommend adopting measures to decrease these variables in the population with a high risk of DVT.
Seguí, X.; Pujolasus, E.; Betrò, S.; Àgueda, A.; Casal, J.; Ocampo-Duque, W.; Rudolph, I.; Barra, R.; Páez, M.; Barón, E.; Eljarrat, E.; Barceló, D.; Darbra, R.M.
We developed a model for evaluating the environmental risk of persistent organic pollutants (POPs) to aquatic organisms. The model is based on fuzzy theory and uses information provided by international experts through a questionnaire. It has been tested in two case studies for a particular type of POPs: brominated flame retardants (BFRs). The first case study is related to the EU-funded AQUATERRA project, with sampling campaigns carried out in two Ebro tributaries in Spain (the Cinca and Vero Rivers). The second one, named the BROMACUA project, assessed different aquatic ecosystems in Chile (San Vicente Bay) and Colombia (Santa Marta Marsh). In both projects, the BFRs under study were polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCD). However, the model can be extrapolated to other POPs and to different aquatic ecosystems to provide useful results for decision-makers. -- The risk of POPs for aquatic organisms was assessed at several sites around the world, using a fuzzy-based model to provide useful results for decision-makers
Hallisey Elaine J
Full Text Available Abstract Background Child maltreatment and its consequences are a persistent problem throughout the world. Public health workers, human services officials, and others are interested in new and efficient ways to determine which geographic areas to target for intervention programs and resources. To improve assessment efforts, selected perinatal factors were examined, both individually and in various combinations, to determine if they are associated with increased risk of infant maltreatment. State of Georgia birth records and abuse and neglect data were analyzed using an area-based, ecological approach with the census tract as a surrogate for the community. Cartographic visualization suggested some correlation exists between risk factors and child maltreatment, so bivariate and multivariate regression were performed. The presence of spatial autocorrelation precluded the use of traditional ordinary least squares regression, therefore a spatial regression model coupled with maximum likelihood estimation was employed. Results Results indicate that all individual factors or their combinations are significantly associated with increased risk of infant maltreatment. The set of perinatal risk factors that best predicts infant maltreatment rates are: mother smoked during pregnancy, families with three or more siblings, maternal age less than 20 years, births to unmarried mothers, Medicaid beneficiaries, and inadequate prenatal care. Conclusion This model enables public health to take a proactive stance, to reasonably predict areas where poor outcomes are likely to occur, and to therefore more efficiently allocate resources. U.S. states that routinely collect the variables the National Center for Health Statistics (NCHS defines for birth certificates can easily identify areas that are at high risk for infant maltreatment. The authors recommend that agencies charged with reducing child maltreatment target communities that demonstrate the perinatal risks
Hansen, Louise; Vestergaard, Peter; Petersen, Karin Dam
experience a 19% increased mortality within the first year following hip fractures. Furthermore, studies have shown that within 10 years after first hip fracture 40% will experience another hip fracture. The risk for second hip fracture is markedly increased, initiating at a relative risk of 11.8 within...... the first month after fracture and does not normalise until 15 years later. Fracture prevention programs have focused on identifying patients at risk of secondary low energy trauma fractures. The secondary prevention programs for fractures begin immediately after the first fracture, through identification...... of risk factors and initiate pharmaceutical treatment. The aim of this study was to estimate the potential benefits from alendronate treatment for secondary low energy trauma fracture patients in Denmark, compared to no pharmaceutical treatment for this group of patients. METHODS: A Markov model...
Lashner, B.A.; Epstein, S.S.
Colorectal cancer is the second most common malignancy in the United States, and its incidence rates have sharply increased recently, especially in males. Industrial exposures, both occupational and environmental, are important colorectal cancer risk factors that are generally unrecognized by clinicians. Migration studies have documented that colorectal cancer is strongly associated with environmental risk factors. The causal role of occupational exposures is evidenced by a substantial literature associating specific work practices with increased colorectal cancer risks. Industrially related environmental exposures, including polluted drinking water and ionizing radiation, have also been associated with excess risks. Currently, there is a tendency to attribute colorectal cancer, largely or exclusively, to dietary and other lifestyle factors, thus neglecting these industrially related effects. Concerted efforts are needed to recognize the causal role of industrial risk factors and to encourage government and industry to reduce carcinogenic exposures. Furthermore, cost-effective screening programs for high-risk population groups are critically needed to further reduce deaths from colorectal cancer. 143 references
Full Text Available Anorexia nervosa is a complex eating disorder characterized by the voluntary reduction, and subsequent maintenance, of body weight at a level below 85% of optimal body weight, a pathological fear of food and weight gain, and disturbance of experience of weight and body shape. Development, sustainability and complexity of symptoms depend upon different biological, psychological and social factors. The aim of the paper is to present risk factors that can significantly contribute to the development and severity of the symptoms of anorexia nervosa. This review paper presents the key factors in the development of the disorder. Attachment styles, perfectionism and concerns about body shape, as core psychological factors for development and severity of symptoms, are the principle areas discussed. Lack of self-esteem and self-confidence, unresolved emotional issues, high, unrealistic standards and ideals of physical appearance to which people rigidly hold and which they persistently and consistently attempt to reach, dissatisfaction with body shape, and significant discrepancy between perceived and ideal body image are all associated with maladaptive behavior and attitudes towards food, and often precede the diagnosis of the disorder. The review of research indicates that insecure emotional attachment styles, perfectionism and concern about body shape significantly correlate with symptoms of anorexia nervosa and represent risk and maintaining factors of the disorder. Focus on these problems can significantly contribute to more comprehensive prevention and treatment of the disorder.
Weber, Thomas J.; Shankaran, Harish; Wiley, H. S.; Opresko, Lee K.; Chrisler, William B.; Quesenberry, Ryan D.
basic fibroblast growth factor (bFGF or FGF2) plays an important role in epidermal wound healing in vivo and is associated with a persistent increased in the extracellular signal-regulated kinase (ERK) pathway in vitro. Here we have examined whether bFGF induces the closure of an experimental scratch wound in JB6 mouse epidermal cells and have explored the regulation of the ERK pathway by bFGF in the context of kinase oscillations. bFGF stimulation is associated with increases in cellular phospho-ERK and phospho-c-Jun levels. In addition, bFGF increases cell proliferation and a change in cell morphology (stellate appearance) in a dose-dependent fashion (0.1 – 100 ng/ml). bFGF treatment also promoted the closure of an experimental scratch wound in vitro. JB6 cells were stably transfected with an ERK1-GFP chimera to follow temporal ERK subcellular distribution patterns. We observe a persistent upregulation of the ERK pathway, as evidenced by a significant increase in nuclear ERK1-GFP levels at time points up to 24 hr after bFGF treatment. Interestingly, at the single cell level, ERK is observed to oscillate between nuclear and cytosolic compartments in response to bFGF treatment. Because this oscillatory behavior is asynchronous in the cell population, it is only clearly resolved at the single cell level. Collectively, data presented here are consistent with an important role for bFGF in wound healing and suggest a more complex regulation of the ERK pathway by bFGF than has previously been appreciated.
Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva
Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... in the population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....
Full Text Available BACKGROUND: Mitochondrial reactive oxygen species levels and nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB activity are increased in a lamb model of persistent pulmonary hypertension of the newborn (PPHN. These events can trigger hypoxia inducible factor (HIF signaling in response to hypoxia, which has been shown to contribute to pulmonary vascular remodeling in rodent models of pulmonary hypertension. However the role of HIF signaling in chronic intrauterine pulmonary hypertension is not well understood.AIM: To determine if HIF signaling is increased in the lamb model of PPHN, and to identify the underlying mechanisms. RESULTS: PPHN was induced in lambs by antenatal ligation of the ductus arteriosus at 128 days gestation. After 9 days, lungs and pulmonary artery smooth muscle cells (PASMC were isolated from control and PPHN lambs. HIF-1α expression was increased in PPHN lungs and HIF activity was increased in PPHN PASMC relative to controls. Hypoxia increased HIF activity to a greater degree in PPHN vs. control PASMC. Control PASMC were exposed to cyclic stretch at 1Hz and 15% elongation for 24h, as an in vitro model of vascular stress. Stretch increased HIF activity, which was attenuated by inhibition of mitochondrial complex III and NFκB.CONCLUSION: Increased HIF signaling in PPHN is triggered by stretch, via mechanisms involving mitochondrial ROS and NFκB. Hypoxia substantially amplifies HIF activity in PPHN vascular cells. Targeting these signaling molecules may attenuate and reverse pulmonary vascular remodeling associated with PPHN.
Full Text Available Introduction: Cerebrovascular disease is the third most common cause of death in the developed world after cancer and ischemic heart disease. In India, community surveys have shown a crude prevalence rate of 200 per 100000 population for hemiplegia. Aims and objectives: Identification of risk factors for c erebrovascular disease. Materials and Methods: Inclusion Criteria: Cases of acute stroke admitted in S.V.R.R.G.G.H, Tirupati were taken for the study. Exclusion Criteria: Head injury cases, neoplasm cases producing cerebrovascular disease were excluded. Re sults: Stroke was more common in male, 54% patients were male 46% were female. It was more common in 6 th and 7 th decade. More common risk factors were hypertension followed by smoking, diabetes mellitus. More common pathology was infarction. Conclusion: Com mon risk factors for acute stroke are hypertension, smoking, diabetes mellitus, alcoholism, obesity, cardiac disease. Stroke was confirmed by CT scan of brain.
Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan
of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....
van Rooijen, Stefanus; Carli, Francesco; Dalton, Susanne O
in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation...... program. METHODS: Prospectively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed. Modifiable risk factors were correlated to the Comprehensive Complication Index (CCI) and compared within two groups: none or mild complications (CCI ... complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS: In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe...
Pedersen, Jolene Masters; Lund, Rikke; Andersen, Ingelise
Background/Objectives: Metabolic deregulations and development of metabolic syndrome may be an important pathway underlying the relationship between stress and cardiovascular disease. We aim to estimate the effect of a comprehensive range of psychosocial factors on the risk of developing metabolic.......11) to be risk factors for developing the metabolic syndrome in women, while vital exhaustion (OR 2.09, 95% CI 0.95 to 4.59) and intake of sleep medications (OR 2.54, 95% CI 0.92 to 5.96) may play a more important role in men. Conclusions: Experiencing major life events in work and adult life and....../or dysfunctional social networks is a risk factor for metabolic syndrome in women, and stress reactions such as vital exhaustion and intake of sleep medications may play a more important role in the development of metabolic syndrome men....
Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus
Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence...... of cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... between subjects with and without psoriasis with regard to traditional cardiovascular risk factors. Conclusions Our results contrast with the hitherto-reported increased prevalence of metabolic syndrome in subjects with psoriasis in the general US population. However, our results agree with those of other...
Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg
of this study is to utilize data from the Copenhagen School Health Records Register (CSHRR) to evaluate cryptorchidism, birth weight and birth order as risk factors for testicular cancer. METHODS: The study population consisted of 408 cases of testicular cancer identified by a government issued identification...... in crude analyses [hazard ratio (HR) = 3.60, 95% CI 2.79-4.65]. Birth weight was inversely associated with testicular cancer and no clear association with birth order was observed. The positive association between cryptorchidism and testicular cancer was only slightly attenuated controlling for birth......PURPOSE: One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective...
Praveen, Pradeep A; Roy, Ambuj; Prabhakaran, Dorairaj
Atherosclerotic cardiovascular disease (CVD) is one of the leading causes of death and disability worldwide including in developing countries like India. Indians are known to be predisposed to CVD, which occur almost a decade earlier in them. Though these diseases manifest in the middle age and beyond, it is now clear that the roots of CVD lie in childhood and adolescence. Many of the conventional risk factors of CVD such as high blood pressure, dyslipidemia, tobacco use, unhealthy diet and obesity have their beginnings in childhood and then track overtime. It is thus important to screen and identify these risk factors early and treat them to prevent onset of CVD. Similarly community based strategies to prevent onset of these risk factors is imperative to tackle this burgeoning public health crisis especially in countries like ours with limited resources.
Agakidis, Charalampos; Agakidou, Eleni; Philip Thomas, Sumesh; Murthy, Prashanth; John Lloyd, David
To explore whether epidural analgesia (EA) in labor is independent risk factor for neonatal pyrexia after controlling for intrapartum pyrexia. Retrospective observational study of 480 consecutive term singleton infants born to mothers who received EA in labor (EA group) and 480 term infants delivered to mothers who did not receive EA (NEA group). Mothers in the EA group had significantly higher incidence of intrapartum pyrexia [54/480 (11%) vs. 4/480 (0.8%), OR = 15.1, p neonatal pyrexia [68/480 (14.2%) vs. 15/480 (3.1%), OR = 5.1, p Neonates in the EA group had a median duration of pyrexia of 1 h (maximum 5 h) with a peak temperature within 1 h. Stepwise logistic regression analysis showed that maternal EA was independent risk factor for neonatal pyrexia (>37.5°C) after controlling for intrapartum pyrexia (>37.9°C) and other confounders (OR = 3.44, CI = 1.9-6.3, p neonates. It is unnecessary to investigate febrile offspring of mothers who have had epidurals unless pyrexia persists for longer than 5 h or other signs or risk factors for neonatal sepsis are present.
Armaş, I.; Creãu, R. Z.; Stǎnciugelu, I.
Risks are mental models, which allow people to cope with dangerous phenomena (Renn, 2008; Jasanoff, 1998). The term "risk" refers to the likelihood of an adverse effect resulting from an event. The aim of the present study is to identify the psychological factors that are most predictive of risk perception in relation with age, gender, educational level and socio-economical status. Earthquake hazard was considered, because it is an emerging danger for Bucharest. 80% of the laypeople sample are waiting for this event to happen in the next three years. By integrating all the research data, it was attempted to build a risk profile of the investigated population, which could be used by institutions responsible for earthquake risk mitigation situations in Bucharest. This research appealed to the social learning Rotter (1966), auto-effectiveness Bandura (1977; 1983), and anxiety and stress theories. We used psychological variables that measured stress, personal effectiveness and the belief in personal control. The multi-modal risk perception questionnaire was structured on a 49 items sequence. The sample was composed of 1.376 participants recruited on a voluntary basis. The characteristics of risk (like probability and magnitude, time scales) are perceived differently according to psychological factors that play a role also in biases in people's ability to draw inferences from probabilistic information (like cognitive dissonance). Since the 1970's, it has been argued that those who perceive life's events as being beyond their locus of control (external locus of control) are significantly more anxious and less adapted. In this research, strongest associations and significant differences were obtained between sex, age and income categories with Stress vulnerability factor and the External Locus of Control factor. The profile of the low risk perceiver is that of a young, more educated, male individual with a higher self- efficacy level and an internal locus of control.
Full Text Available Cigarette smoking, high alcohol intake, and low dietary folate levels are risk factors for colorectal adenomas. Oxidative damage caused by these three factors can be repaired through the base excision repair pathway (BER. We hypothesized that genetic variation in BER might modify colorectal adenoma risk. In a sigmoidoscopy-based study, we examined associations between 182 haplotype tagging SNPs in 14 BER genes, and colorectal adenoma risk, and examined their potential role as modifiers of the effect cigarette smoking, alcohol intake, and dietary folate levels. Among all individuals, no statistically significant associations between BER SNPs and adenoma risk persisted after correction for multiple comparisons. However, among Asian-Pacific Islanders we observed two SNPs in FEN1 and one in NTHL1, and among African-Americans one SNP in APEX1 that were associated with colorectal adenoma risk. Significant associations were also observed between SNPs in the NEIL2 gene and rectal adenoma risk. Three SNPS modified the effect of smoking (MUTYH interaction p = 0.002; OGG1 interaction p = 0.013; FEN1 interaction p = 0.013, one SNP in LIG3 modified the effect of alcohol consumption (interaction p = 0.024 and two SNPs in LIG3 modified the effect of dietary folate (interaction p = 0.001 and p = 0.08 on colorectal adenoma risk. These findings support a role for genetic variants in the BER pathway as potential modifiers of colorectal adenoma risk. Our findings strengthen the role of oxidative damage induced by key lifestyle and dietary risk factors in colorectal adenoma formation.
Full Text Available Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective analysis was carried on in the winter of which 310 pregnant women participated in 11 health centers in Shahrekord. Of these 155 cases (patients and 155 controls (healthy that were matched for age Information required from the health records of pregnant women and complete Czech list of researcher whose validity was confirmed by experts were gathered. Information needed by pregnant women health records and complete list researcher was collected. Czech list contains a number of possible risk factors for illness and demographic characteristics of the study participants was Statistical analysis software spss version 16 by using chi square tests and logistic regression and t analysis was performed. Results: Among the variables vomiting (p = 0/00 a history of urinary tract infection in a previous pregnancy (P =.001, CI = 1.508-4.408, OR = 2.578 abortion own history (P =.014, CI = 1.165 -3.847, OR = 2.117, respectively, the most important risk factors for urinary tract infection in pregnant women were determined. Conclusion: Prevention and treatment of vomiting in pregnancy prevention of urinary tract infections during pregnancy. Prevention of abortion can play an important role in the prevention of urinary tract infection and its complications in pregnancy. The study also revealed a number of factors can have an impact on urinary tract infection in pregnancy that has not been enough attention and it is necessary that more attention be placed on health programs and
Laboratory evidence linking exercise with improved sleep quality raises the possibility that the lower levels of physical activity characteristic of older age groups may contribute to late-life insomnia. While support for this hypothesis appears to come from epidemiological surveys, few such studies have distinguished satisfactorily between social and physical activities which differ widely in terms of energy cost and theoretical significance. The present analyses were, therefore, designed to assess the independent influence of physical and social activity levels on the prevalence and natural history of late-life insomnia. Survivors from a nationally representative UK sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). Detailed assessments of physical and social activities, mental and physical health status, and sleep quality were made at each survey wave. Logistic regression models, adjusted for age, sex and health status, were used to assess relationships between activity levels and the prevalence, remission/persistence, and incidence of late-life insomnia. Lower physical health, depressed mood and lower physical (but not social) activity levels consistently emerged as significant risk factors for prevalent, persistent and incident insomnia. Age was unrelated to insomnia variables in all the cross-sectional models, but did emerge as a significant risk for cumulative 4-8-year insomnia incidence. These findings suggest that, independent of those activities more closely associated with social engagement, higher levels of customary physical activity per se appear to be protective against incident and chronic late-life insomnia.
Yin, X.; Subramanian, S.; Willinger, C.M.; Chen, G.; Juhasz, P.; Courchesne, P.; Chen, B.H.; Li, X.; Hwang, S.J.; Fox, C.S.; O'Donnell, C.J.; Muntendam, P.; Fuster, V.; Bobeldijk-Pastorova, I.; Sookoian, S.C.; Pirola, C.J.; Gordon, N.; Adourian, A.; Larson, M.G.; Levy, D.
Context: Metabolic dysregulation underlies key metabolic risk factors—obesity, dyslipidemia, and dysglycemia. Objective: To uncover mechanistic links between metabolomic dysregulation and metabolic risk by testing metabolite associations with risk factors cross-sectionally and with risk factor
Felipe Freire da Silva
Full Text Available A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL, other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events.
Ikoma, Ryo; Sakane, Sayaka; Niwa, Kazutomo; Kanetaka, Sayaka; Kawano, Toshiro; Oridate, Nobuhiko
The aim of the present study was to investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. We reviewed the records of 692 patients who underwent tonsillectomy (TE) at Yokohama Minami Kyosai Hospital in Japan. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode: (I) minimal hemorrhage that stopped after noninvasive treatment, (II) hemorrhage requiring treatment with local anesthesia, and (III) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, surgeon's skill level, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A category III PTH was observed in 18 patients; thus, the overall risk of reoperation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adults (Pdefinition of PTH. Clinical risk factors for PTH were adult age and male gender. The surgeon's skill level was an additional risk factor for category III PTH. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
The possibility of developing lung cancer (lc) as a consequence of inhaling hot particles from the Chernobyl accident is discussed. The risk from various factors is reviewed in order to assess the rate of contribution for any of them to carcinogenic process. The conclusions are based on data reported by National Centre of Oncology, Sofia (BG). A total of 2873 new cases have been recorded in 1990. The data for the period 1970-1990 show a crude increase for males and tend to stabilization for females. The similar pattern is obtained in other countries and geographic areas with steady rise of lc cases with about 0.5% per year. The contribution of particular risk factor and its interaction with other factors is assessed on the basis of large number of epidemiologic and experimental studies. The risk of cigarette smoking, as the principal cause for lc, is discussed in various aspects - age, duration, possible dropping the habit. The assessment of another risk factor - exposure to relatively high doses of natural radon daughter products - is more complicated. As an occupational hazard in uranium mines radon and its progeny reveals an increase in excess lc incidence. Regarding radon and its daughters as an environmental risk factor in dwellings, no clear positive relationship between exposure and lc incidence has been observed. In this case the assessment for population living in areas with higher concentration of radon products have to rely on data from uranium mines. Non radiation factors as asbestos, ethers, chromates, metallic iron, nickel, beryllium and arsenic, are also considered. The combined effect of all these factors, as well as of pathological cell processes, viruses, malfunctions of immune system, is mentioned as well. The possibility of interpreting the findings from epidemiological studies within the framework of theoretical multistage models of carcinogenic process is pointed out. (author)
Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra
Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.
E. A. Epanchintseva
Full Text Available Subjects and methods. A total of 917 men from infertile couples with abnormal ejaculate indicators were examined. Their age was 34.1 ± 6.3 years; the infertility period was 4.6 ± 3.9 years. A retrospective analysis of their case histories, clinical examination, questioning to identify risk factors for infertility, and anthropometric measurements of weight and height were made. Weight was rated normal at a body mass index (BMI of ≤ 24.9 kg/m2 ; overweight at 25.0–29.9 kg/m2 , and obesity at ≥ 30 kg/m2 . When identifying infertility risk factors, the investigators kept in mind 24 risk factors at the moment of examination or in the patient histories, which were grouped into 3 clusters: 1 – environmental factors and occupational hazards; 2 – evidence of congenital and acquired abnormalities; 3 – social and quality-of-life factors; this cluster also includes history and examination evidence of tuberculosis, sexually transmitted diseases, and other social diseases, such as hepatitis B and C, or human immunodeficiency infection. Then the men who did not show an exacerbation of somatic diseases, genetic anomalies associated with reproductive disorders, or an exacerbation of social diseases at the moment of examination were selected from the total sample. These were divided into 2 groups: normal weight and obese patients. The frequency of the above mentioned infertility risk factors and additionally the proportion of persons engaged in intellectual or manual labor were calculated in each group.Results and discussion. In the total sample, the frequency of infertility risk factors including occupational hazards and environmental factors was < 20 %; the incidence of congenital and acquired abnormalities was 1–39 %. The highest frequency of risk factors was noted in cluster 3. Among them, alcohol consumption (75 % occupied the first place; next were the rate of sexually transmitted infections (59 %, emotional stress (44 %, and smoking (42
Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in ...
van der Put, C.E.; Deković, M.; Stams, G.J.J.M.; van der Laan, P.H.; Hoeve, M.; van Amelsfort, L.
This study examined to what extent the significance of both static and dynamic risk factors for recidivism changes in the course of adolescence. For this purpose, file and interview data of 1,396 juveniles charged with a criminal offense were analyzed. This study showed that the impact of almost all
Knudsen, N.; Laurberg, P.; Perrild, H.
is probably dependent on iodine status, because it seems that the zenith of goiter prevalence appears earlier in life the more severe iodine deficiency the population is exposed to. The association with individual risk factors has been investigated in some studies, especially the association with tobacco......The occurrence of thyroid diseases is determined by interplay between genetic and environmental factors. The major environmental factor that determines goiter prevalence is iodine status, but other environmental factors influencing entire populations have been identified such as goitrogens in food...... and drinking water. Less focus has been on individual environmental factors and the interplay between factors. The goiter prevalence is higher in certain groups in the population. The variation in goiter prevalence between the genders is well known with a higher occurrence among women. The association with age...
Cobo, Eulogio Pleguezuelos; Mesquida, M Engracia Pérez; Fanegas, Elisabet Palomera; Atanasio, Eva Moreno; Pastor, M Beatriz Samitier; Pont, Cristina Perucho; Prieto, Carlos Matarrubia; Gómez, Genoveva Reverón; Cano, Lluis Guirao
Prospective longitudinal study. To identify prognosis factors that allow us to identify patients with risk of developing chronic symptoms and disabilities after a whiplash injury. The prognosis factors for poor recovery in acute whiplash are not conclusive. We included 557 patients who suffered whiplash injury after road traffic accident and visited the Department of Physical Medicine and Rehabilitation of Mataró Hospital (Spain) for medical evaluation and rehabilitation treatment. The variables were collected following a protocol designed for the study, and all patients were assessed through the Visual Analogue Scale (VAS) for the intensity of neck pain, the Goldberg Depression and Anxiety Scale and the Northwick Park Neck Pain Questionnaire (NPH) for cervical column functionality at initial evaluation and 6 months later. Factors related with VAS 6 months after the whiplash injury were women, age, number of days of cervical column immobilization, previous neck pain, self-employed workers, housewives, pensioners, students, presence of headache or dizziness, and VAS, Goldberg Depression and Anxiety scale, and NPH scores at initial evaluation. In multivaried analysis, it had been found that the variables that had influence on VAS 6 months after the whiplash injury were statistically significant for age, presence of dizziness, self-employed workers, and VAS and NPH scores at initial evaluation. Our findings indicate that factors that allow us to identify patients at risk for poor recovery are age, dizziness, and initial evaluation of neck pain with VAS and cervical column functionality with NPH.
Psychological risk factors and personality disorders comorbidities are more frequent than psychological risk factors only or personality disorders only in outpatient cardiology setting without cardiovascular diseases.
Full Text Available Fred A English,1 Louise C Kenny,1 Fergus P McCarthy1,2 1Irish Centre for Fetal and Neonatal Translational Research (INFANT, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; 2Women’s Health Academic Centre, King's Health Partners, St Thomas' Hospital, London, UK Abstract: Preeclampsia, a hypertensive disorder of pregnancy is estimated to complicate 2%–8% of pregnancies and remains a principal cause of maternal and fetal morbidity and mortality. Preeclampsia may present at any gestation but is more commonly encountered in the third trimester. Multiple risk factors have been documented, including: family history, nulliparity, egg donation, diabetes, and obesity. Significant progress has been made in developing tests to predict risk of preeclampsia in pregnancy, but these remain confined to clinical trial settings and center around measuring angiogenic profiles, including placental growth factor or newer tests involving metabolomics. Less progress has been made in developing new treatments and therapeutic targets, and aspirin remains one of the few agents shown to consistently reduce the risk of developing preeclampsia. This review serves to discuss recent advances in risk factor identification, prediction techniques, and management of preeclampsia in antenatal, intrapartum, and postnatal patients. Keywords: pregnancy, treatment, risk reduction, prediction
Alexander J. Ambinder
Full Text Available Follicular lymphoma (FL is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment.
Chung, Sung Suk; Joung, Kyoung Hwa
Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…
van Aken, M. O.; de Marie, S.; van der Lely, A. J.; Singh, R.; van den Berge, J. H.; Poublon, R. M.; Fokkens, W. J.; Lamberts, S. W.; de Herder, W. W.
To evaluate possible risk factors for meningitis, we retrospectively reviewed 228 transsphenoidal operations (in which a standard regimen of amoxicillin prophylaxis was used) for sellar pathology. The incidence of meningitis was 3.1% (seven of 228 cases). Cultures of preoperative specimens from the
David, A.; Kipp, J.M.
This paper reports that with the increasing internationalization of the petroleum industry, lenders to the industry must understand and overcome several new credit risk factors. As a result, new financial products are now available to reserve-based borrowers. Traditional project financing now also may include futures hedging, swaps, and collar elements
Risk factors associated with oesophageal malignancy among Ethiopian patients: a case control study. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, ...
The chapters of Part I of the thesis describe the development of techniques that can be used in the assessment of risk factors for the development of diabetes mellitus (DM) in cats. The hyperglycemic glucose clamp (HGC) was developed for use in conscious cats, equipped with arterial catheters for
MacPhee, Angela R.; Andrews, Jac J. W.
The purpose of this study was to identify salient risk factors for depression in early adolescence from a group of common predictors. The following nine predictors were examined: (1) perceived quality of peer relationships, (2) perceived parental nurturance, (3) perceived parental rejection, (4) self-esteem, (5) body image, (6) pubertal status,…
Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E
A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.
Ni Luh Putu Maharani
Full Text Available Background An estimated 6 of 1,000 children with live births suffer from permanent hearing loss at birth or the neonatal period. At least 90% of cases occur in developing countries. Hearing loss should be diagnosed as early as possible so that intervention can be done before the age of 6 months. Objective To determine risk factors for hearing loss in neonates. Methods We performed a case-control study involving 100 neonates with and without hearing loss who were born at Sanglah Hospital, Denpasar from November 2012 to February 2013. Subjects were consisted of 2 groups, those with hearing loss (case group of 50 subjects and without hearing loss (control group of 50 subjects. The groups were matched for gender and birth weight. We assessed the following risk factors for hearing loss: severe neonatal asphyxia, hyperbilirubinemia, meningitis, history of aminoglycoside therapy, and mechanical ventilation by Chi-square analysis. The results were presented as odds ratio and its corresponding 95% confidence intervals. Results Seventy percent of neonates with hearing loss had history of aminoglycoside therapy. Multivariable analysis revealed that aminoglycoside therapy of 14 days or more was a significant risk factor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040. There were no statistically significant associations between hearing loss and severe asphyxia, hyperbilirubinemia, meningitis, or mechanical ventilation. Conclusion Aminoglycoside therapy for >=14 days was identified as a risk factor for hearing loss in neonates.
Garassini, M E; Pulgar, Y; Alvarado, M; Garassini, M A
To establish the risk factors to hepatitis C virus (HCV) infection, we studied 120 patients divided in 2 groups: A first group of 40 patients with HCV infection, 24 (60%) with past medical history of blood transfusion, 14 (35%) of them also had hemodialysis and 3 Kidney transplant. 10 patients (25%) had mayor surgery without transfusion, 3 had frequent visits to the dentist and 3 month baby whose mother was HCV positive. In 4 patients we found no risk factors. A second group of 80 patients who visit our clinic for the first time, 2 were found positive for HCV (1.6%). 13 of them had blood transfusion, one was HCV+ (OR: 5.5, P = 0.73). 41 had history of mayor surgery, one HCV+ (OR: 0.95, P = 1.000). The risk factors related to HCV infection in our population were blood transfusion, hemodialysis and mayor surgery. The use of EV drugs, tatoos, sexual behavior, interfamiliar or vertical transmission were not risk factor in our population.
van Wijk, N. Ph. L.; de Bruijn, J. G. M.
One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence victimization in childhood. Divorce, single…
Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and ...
Boelens, C.; Hekman, E. E. G.; Verkerke, G. J.
OBJECTIVE: Fall prevention is a major issue in the ageing society. This study provides an overview of all risk factors for falls of older citizens. METHOD: A literature search was conducted to retrieve studies of the past 25 years. All participants from the studies lived in the community or
Stice, Eric; Ng, Janet; Shaw, Heather
Prospective studies have identified factors that increase risk for eating pathology onset, including perceived pressure for thinness, thin-ideal internalization, body dissatisfaction, dietary restraint, and negative affect. Research also suggests that body dissatisfaction and dietary restraint may constitute prodromal stages of the development of…
van Wijk, N.Ph.L.; de Bruijn, J.G.M.
One out of three people (25% of men, 38% of women) in Curacao have experienced some form of domestic violence at some point in their adult lives. The most significant risk factors for domestic violence in Curacao are the female gender, a young age, low education, and experiencing domestic violence
Heuvel, S. van den
It has been known for some time that risk factors in the workplace can have a negative effect on health. Ramazzini was one of the first scientists to identify occupational health hazards. He wrote about diseases of the musculoskeletal system caused by sudden and irregular movements and the adoption
Sol-de Rijk, B.G.M.
Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing
Kuehl, L.K.; Penninx, B.W.J.H.; Otte, C.
Major depression is an independent risk factor for the development of cardiovascular disease. In patients with existing cardiovascular disease, major depression has a large impact on the quality of life and is associated with a poor course and prognosis. Potential mechanisms responsible for this
Evidence is accumulating that lifestyle factors influence the incidence of fatal and non-fatal cardiovascular diseases (CVD). A healthy diet, being physically active, moderate alcohol consumption and not smoking are associated with a lower CVD risk. In
Frederiksen, Thomas Winther; Ramlau-Hansen, Cecilia Høst; Stokholm, Zara Ann
The objective of this study was to evaluate the influence of atherogenic risk factors on hearing thresholds. In a cross-sectional study we analyzed data from a Danish survey in 2009-2010 on physical and psychological working conditions. The study included 576 white- and blue-collar workers from c...
Dois, Angelina; Uribe, Claudia; Villarroel, Luis; Contreras, Aixa
Postpartum depression (PPD) is a public health problem with high prevalence in Chile. Many factors are associated with PPD. To analyze the factors associated with the incidence of depressive symptoms (SD) in women with low obstetric risk. Cross-sectional analytical study on a sample of 105 postpartum women with low obstetric risk assessed by the Edinburgh Depression Scale at the eighth week postpartum. A 37% prevalence of depressive symptoms was found. Univariate analysis showed that the perception of family functioning, overcrowding and number of siblings, were significantly associated with postpartum depressive symptoms. A multiple regression model only accepted family functioning as a predictor of depression. Perception of family functioning was the only variable that explained in part the presence of depressive symptoms in women with low obstetric risk.
Gawde, Nilesh Chandrakant; Kurlikar, Prashika R.
Context: Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Aims: Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. Settings and Design: A cross-sectional study was conducted among non-managerial employees from classified hotels in India. Materials and Methods: The study participants self-administered pre-designed pilot-tested questionnaires. Statistical analysis used: The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as ‘outcome’ variable of interest and binary multi-logistic regression analysis was used to identify determinants. Results: The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 – 2.655) and 3.245 (CI: 1.296 – 8.129) respectively of being overweight. Conclusions: Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks PMID:27390474
Gawde, Nilesh Chandrakant; Kurlikar, Prashika R
Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. A cross-sectional study was conducted among non-managerial employees from classified hotels in India. The study participants self-administered pre-designed pilot-tested questionnaires. The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as 'outcome' variable of interest and binary multi-logistic regression analysis was used to identify determinants. The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 - 2.655) and 3.245 (CI: 1.296 - 8.129) respectively of being overweight. Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks.
Richard, J-B; Thélot, B; Beck, F
Whatever the type of injury considered, prevention requires an improvement in health services' awareness of risk factors. The Health Barometer is a general population survey conducted in France since 1992 to contribute to surveillance in this field. The survey's statistical power and the numerous health topics included in the questionnaire provide accurate information for healthcare professionals and decision-makers. The Health Barometer 2010 was a nationwide telephone survey of 9110 persons representative of the 15-85-year-old population. One part of the questionnaire detailed injuries which had occurred during the past year. The numerous variables recorded enabled application of logistic regression models to explore risk factors related to different types of injury by age group. The findings were compared with the Health Barometer 2005 data to search for temporal trends of injury prevalence. The data analysis showed that 10.3% of the 15-85-year-olds reported an injury during the past year. This rate was higher than recorded in 2005; the increase was mainly due to domestic accidents and injuries occurring during recreational activities. Both type of injury and risk factors exhibited age-related variability. Domestic accidents and injuries occurring during recreational activities predominated in the older population and were associated with physical or mental health problems (chronic disease, diability, sleep disorders). For younger people, injuries were related to cannabis use, drunkedness, and insufficient sleep. Risk factors were also depended on type of injury: occupational accident-related injuries were linked with social disadvantage (manual worker population) whereas sports injuries were more common in the socially advantaged population. This survey confirms established knowledge and highlights, at different stages of life, new risk factors that contribute to injuries in France. These findings should be helpful for the development of adapted injury
Vafeiadi, Marina; Roumeliotaki, Theano; Chalkiadaki, Georgia; Rantakokko, Panu; Kiviranta, Hannu; Fthenou, Eleni; Kyrtopoulos, Soterios A; Kogevinas, Manolis; Chatzi, Leda
Persistent organic pollutants (POPs) are a group of diverse substances, including polychlorinated biphenyls (PCBs) and organochlorine pesticides that are resistant to biodegradation and ubiquitously present in our environment. Exposure to endocrine disrupting chemicals such as POPs has been linked to type 2 diabetes and metabolic disturbances in epidemiological and animal studies, but little is known about POPs exposure during pregnancy and the development of gestational diabetes mellitus (GDM). The purpose of this study was to determine the extent to which exposure to current low levels of different POPs in the first trimester of pregnancy is associated with GDM risk in 939 women from the "Rhea" pregnancy cohort in Crete, Greece. Concentrations of several PCBs, dichlorodiphenyldichloroethene (DDE), and hexachlorobenzene (HCB) were determined in first trimester maternal serum by triple quadrupole mass spectrometry. We defined total PCBs as the sum of all congeners, nondioxin-like PCBs as the sum of PCB 153, 138, 170 and 180, and dioxin-like PCBs as the sum of PCB 118 and 156. Pregnant women were screened for gestational diabetes mellitus (GDM) between 24 and 28weeks of gestation, and GDM was defined by the criteria proposed by Carpenter and Coustan. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models. Of the 939 women, 68 (7%) developed GDM. Serum concentrations of POPs were higher in women with GDM. Women in the medium and high tertiles of PCBs had 3.90 (95% CI: 1.37, 11.06) and 3.60 (95% CI: 1.14, 11.39) fold respectively higher odds of developing GDM compared to women in the lowest tertile of PCB exposure after adjusting for pre-pregnancy BMI and several other confounders. Odds of GDM for women in the medium and high tertiles of dioxin-like PCBs was 5.63 (95% CI: 1.81, 17.51) and 4.71 (95% CI: 1.38, 16.01) and for nondioxin-like PCBs 2.36 (95% CI: 0.89, 6.23) and 2.26 (95% CI: 0.77, 6
Anischenko, Aleksander; Arhangelskaya, Anna; Klenov, Michael; Burdukova, Ekaterina; Ogarev, Valrii; Ignatov, Nikolay; Osadchenko, Irina; Gurevich, Konstantin
Purpose To analyze the prevalence of risk factors among Russian students. Methods In this study, 834 students were included from five Federal universities which were localized in four Federal regions of Russian Federation. Future doctors, school teachers, and wellness trainers were included in this study. Students were specifically asked about smoking, physical activity International Physical Activity Questionnaire (IPAQ), and food preference. Waist, hip, weight, and height were measured. Results The region of study and ethnic group were not influenced with respect to age and body mass index ( p > .1), while all other factors had a significant influence ( p students in comparison with those in future teachers and wellness instructors ( p obesity (due to levels of body mass index and waist-hip ratio) were found in medical students. Perspective Special programs to prevent the most common behavior risk factors in future medical doctors have to be designed.
Crowley, Matthew J; Holleman, Rob; Klamerus, Mandi L; Bosworth, Hayden B; Edelman, David; Heisler, Michele
Patients with persistent poorly controlled diabetes mellitus (PPDM), defined as an uninterrupted hemoglobin A1c >8.0% for ≥1 year despite standard care, are at high risk for complications. Additional research to define patient factors associated with PPDM could suggest barriers to improvement in this group and inform the development of targeted strategies to address these patients' resistant diabetes. We analyzed patients with type 2 diabetes from a multi-site randomized trial. We characterized patients with PPDM relative to other patients using detailed survey data and multivariable modeling. Of 963 patients, 118 (12%) had PPDM, 265 (28%) were intermittently poorly controlled, and 580 (60%) were well-controlled. Patients with PPDM had younger age, earlier diabetes diagnosis, insulin use, higher antihypertensive burden, higher low-density lipoprotein cholesterol, and lower statin use relative to well-controlled patients. Among patients with objective adherence data (Veterans Affairs patients), a larger oral diabetes medication refill gap was associated with PPDM. Strategies are needed to target-specific barriers to improvement among patients whose diabetes is resistant to standard diabetes care. Our data suggest that strategies for targeting PPDM should accommodate younger patients' lifestyles, include medication management for insulin titration and comorbid disease conditions, and address barriers to self-management adherence. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Lakke, Sandra E.; Soer, Remko; Takken, Tim; Reneman, Michiel F.
A wide variety of risk factors for the occurrence and prognostic factors for persistence of non-specific musculoskeletal pain (MSP) are mentioned in the literature. A systematic review of all these factors is not available. Thus a systematic review was conducted to evaluate MSP risk factors and
Gaddam, Srinivas; Singh, Mandeep; Balasubramanian, Gokulakrishnan; Thota, Prashanthi; Gupta, Neil; Wani, Sachin; Higbee, April D; Mathur, Sharad C; Horwhat, John D; Rastogi, Amit; Young, Patrick E; Cash, Brooks D; Bansal, Ajay; Vargo, John J; Falk, Gary W; Lieberman, David A; Sampliner, Richard E; Sharma, Prateek
Recent population-based studies have shown a low risk of esophageal adenocarcinoma (EAC) in patients with nondysplastic Barrett's esophagus (NDBE). We evaluated whether persistence of NDBE over multiple consecutive surveillance endoscopic examinations could be used in risk stratification of patients with Barrett's esophagus (BE). We performed a multicenter outcomes study of a large cohort of patients with BE. Based on the number of consecutive surveillance endoscopies showing NDBE, we identified 5 groups of patients. Patients in group 1 were found to have NDBE at their first esophagogastroduodenoscopy (EGD). Patients in group 2 were found to have NDBE on their first 2 consecutive EGDs. Similarly, patients in groups 3, 4, and 5 were found to have NDBE on 3, 4, and 5 consecutive surveillance EGDs. A logistic regression model was built to determine whether persistence of NDBE independently protected against development of cancer. Of a total of 3515 patients with BE, 1401 patients met the inclusion criteria (93.3% white; 87.5% men; median age, 60 ±17 years). The median follow-up period was 5 ± 3.9 years (7846 patient-years). The annual risk of EAC in groups 1 to 5 was 0.32%, 0.27%, 0.16%, 0.2%, and 0.11%, respectively (P for trend = .03). After adjusting for age, sex, and length of BE, persistence of NDBE, based on multiple surveillance endoscopies, was associated with a gradually lower likelihood of progression to EAC. Persistence of NDBE over several endoscopic examinations identifies patients who are at low risk for development of EAC. These findings support lengthening surveillance intervals or discontinuing surveillance of patients with persistent NDBE. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
Rabia, Hazza Abu
This qualitative study explored the factors that enhance Arab international students' persistence and facilitate their academic and cultural adjustment at postsecondary institutions in the United States. The sample for this study consisted of Arab international students from Saudi Arabia, Kuwait, Oman, Syria, UAE, Iraq, and Jordan. In-depth…
Wood, J. Luke; Harris, Frank, III
The purpose of this study was to understand the relationship (if any) between college selection factors and persistence for Black and Latino males in the community college. Using data derived from the Educational Longitudinal Study, backwards stepwise logistic regression models were developed for both groups. Findings are contextualized in light…
Louden, Emily; Marcotte, Michael; Mehlman, Charles; Lippert, William; Huang, Bin; Paulson, Andrea
Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation) were present in any combination. PMID:29596309
Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen
Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
Paul P. Connell
Full Text Available Age-related maculopathy (ARM is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
Connell, Paul P
Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715\\/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
Full Text Available Over the course of decades, the incidence of brachial plexus birth injury (BPBI has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation were present in any combination.
Nassar, Antonio Paulo; da Silva, Fernanda Maria Queiroz; de Cleva, Roberto
Although gastrointestinal motility disorders are common in critically ill patients, constipation and its implications have received very little attention. We aimed to determine the incidence of constipation to find risk factors and its implications in critically ill patients During a 6-month period, we enrolled all patients admitted to an intensive care unit from an universitary hospital who stayed 3 or more days. Patients submitted to bowel surgery were excluded. Constipation occurred in 69.9% of the patients. There was no difference between constipated and not constipated in terms of sex, age, Acute Physiology and Chronic Health Evaluation II, type of admission (surgical, clinical, or trauma), opiate use, antibiotic therapy, and mechanical ventilation. Early (constipation, a finding that persisted at multivariable analysis (P Constipation was not associated with greater intensive care unit or mortality, length of stay, or days free from mechanical ventilation. Constipation is very common among critically ill patients. Early enteral nutrition is associated with earlier return of bowel function.
Patel, Chirag; Kim, Stephen Jae; Chomsky, Amy; Saboori, Mazeyar
To determine the incidence of and associated risk factors for uveitis after cataract surgery. A total of 17,757 eyes were identified and records of 42 eyes that developed uveitis and 2320 eyes that did not were reviewed. Postsurgical uveitis was defined as persistent inflammation for ≥ 6 months after surgery. Forty-two eyes of 35 patients developed uveitis (0.24%). Eleven patients underwent consecutive cataract surgery but developed unilateral uveitis, and intraoperative complications occurred in 55% of uveitic eyes compared to 0% in fellow eyes (p < 0.05). Median duration of inflammation was 8 and 11.5 months in eyes with and without vitrectomy (p < 0.05). Intraocular complications occurred in 44 and 8.3% of eyes that did and did not develop uveitis, respectively (p = 0.01). Postsurgical uveitis developed after approximately 1 in 400 cataract surgeries and occurred more frequently in eyes experiencing intraoperative complications.
Arrebola, Juan P; Fernández, Mariana F; Martín-Olmedo, Piedad
There is an increasing trend in the incidence of cancer worldwide, and it has been accepted that environmental factors account for an important proportion of the global burden. The present paper reports preliminary findings on the influence of the historical exposure to a group of persistent orga...
Sally N. Adebamowo
Full Text Available BackgroundRecent studies have suggested that the vaginal microenvironment plays a role in persistence of high-risk human papillomavirus (hrHPV infection and thus cervical carcinogenesis. Furthermore, it has been shown that some mycoplasmas are efficient methylators and may facilitate carcinogenesis through methylation of hrHPV and cervical somatic cells. We examined associations between prevalence and persistence of Mycoplasma spp. in the vaginal microbiota, and prevalent as well as persistent hrHPV infections.MethodsWe examined 194 Nigerian women who were tested for hrHPV infection using SPF25/LiPA10 and we identified Mycoplasma genitalium and Mycoplasma hominis in their vaginal microbiota established by sequencing the V3–V4 hypervariable regions of the 16S rRNA gene. We defined the prevalence of M. genitalium, M. hominis, and hrHPV based on positive result of baseline tests, while persistence was defined as positive results from two consecutive tests. We used exact logistic regression models to estimate associations between Mycoplasma spp. and hrHPV infections.ResultsThe mean (SD age of the study participants was 38 (8 years, 71% were HIV positive, 30% M. genitalium positive, 45% M. hominis positive, and 40% hrHPV positive at baseline. At follow-up, 16% of the women remained positive for M. genitalium, 30% for M. hominis, and 31% for hrHPV. There was a significant association between persistent M. hominis and persistent hrHPV (OR 8.78, 95% CI 1.49–51.6, p 0.01. Women who were positive for HIV and had persistent M. hominis had threefold increase in the odds of having persistent hrHPV infection (OR 3.28, 95% CI 1.31–8.74, p 0.008, compared to women who were negative for both.ConclusionWe found significant association between persistent M. hominis in the vaginal microbiota and persistent hrHPV in this study, but we could not rule out reverse causation. Our findings need to be replicated in larger, longitudinal studies and if confirmed
De Raeve, Lore; Jansen, Nicole Wh; van den Brandt, Piet A; Vasse, Rineke M; Kant, Ijmert
The main goal of this study was to identify work-related risk factors for the onset of interpersonal conflicts at work. Longitudinal data from the Maastricht Cohort Study on "fatigue at work" (N=9241) were used. After the respondents who reported an interpersonal conflict at baseline were excluded, logistic regression analyses were used to determine the role of several work-related risk factors at baseline in the onset of a conflict with coworkers or supervisors after 1 year of follow-up. Higher psychological job demands, higher levels of role ambiguity, the presence of physical demands, higher musculoskeletal demands, a poorer physical work environment, shift work, overtime, and higher levels of job insecurity significantly predicted the onset of both a coworker conflict and a supervisor conflict. Higher levels of coworker and supervisor social support, more autonomy concerning the terms of employment, good overall job satisfaction, monetary gratification, and esteem reward significantly protected against the onset of both a coworker conflict and a supervisor conflict. Higher levels of decision latitude and more career opportunities also significantly protected against the onset of a supervisor conflict. Several factors in the work environment were related to the onset of interpersonal conflicts at work. Given the rather serious consequences of interpersonal conflicts at work with respect to health and well-being, the observed risk factors can serve as a starting point for effective prevention and intervention strategies in the workplace.
Broeders, M. J. M.; Verbeek, A. L. M.
Breast cancer is the most common malignancy among women in the Western society. Over the past decades it has become apparent that breast cancer incidence rates are increasing steadily, whereas the mortality rates for breast cancer have remained relatively constant. Information through the media on this rising number of cases has increased breast health awareness but has also introduced anxiety in the female population. This combination of factors has made the need for prevention of breast cancer an urgent matter. Breast cancer does not seem to be a single disease entity. A specific etiologic factor may therefore have more influence on one form may therefore have more influence on one form of breast cancer than another. So far though, as shown in their summary of current knowledge on established and dubious risk factors, no risk factors have been identified that can explain a major part of the incidence. Efforts to identify other ways for primary prevention have also been discouraging, even though breast cancer is one of the most investigated tumours world-wide. Thus, at this point i time, the most important strategy to reduce breast cancer mortality is early detection through individual counselling and organised breast screening programs. The recent isolation of breast cancer susceptibility genes may introduce new ways to reduce the risk of breast cancer in a small subset of women
Gurewitsch Allen, Edith D
A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.
Christoffersen, Mogens; Poulsen, Henrik Day; Nielsen, Anne
was also found among adolescents who had psychiatric disorder or a physical handicap, those who had been sentenced, were addicted to drugs, or had unstable education and unemployment records. A common feature of these significant risk factors seemed to be stigmatisation or social exclusion......This paper has been submitted to a journal for consideration, so please do not quote without permission. Adolescents' first-time suicide attempt tends to be characterized by parental psychiatric disorder or suicidal behaviour, family violence, especially child abuse and neglect. An increased risk...
Chabaya, Owence; Rembe, Symphorosa; Wadesango, Newman
We investigated and analysed the factors that women teachers consider as barriers to their advancement to headship positions in Zimbabwean primary schools. Specifically, we sought to identify the factors perceived by women school heads to be causes of persistent under-representation of women in school headship positions. Data were collected through structured face-to-face interviews and focus group discussions with 13 experienced women school heads. The findings revealed that although the ma...
Valera, Beatriz; Jørgensen, Marit Eika; Jeppesen, Charlotte
Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these contaminants accumulate in fish and marine mammals, which is an important part of the traditional diet of these populations. Epidemiological and experimental studies have reported significant associat......Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these contaminants accumulate in fish and marine mammals, which is an important part of the traditional diet of these populations. Epidemiological and experimental studies have reported significant...
Keskin, Kudret; Sezai Yildiz, Süleyman; Çetinkal, Gökhan; Çetin, Sükrü; Sigirci, Serhat; Kilci, Hakan; Aksan, Gökhan; Helvaci, Füsun; Gürdal, Ahmet; Balaban Kocas, Betül; Arslan, Sükrü; Orta Kiliçkesmez, Kadriye
Although smoking is an established risk factor for coronary artery disease, smoking cessation efforts, as part of a lifestyle change, have been disappointing so far. Therefore, assessing current smoking trends and identifying patients who are at risk of smoking continuation is of paramount importance. In this study, our aim was to assess current smoking rates after coronary revascularization as of 2017, and to define factors that potentially affect smoking cessation. Overall, 350 patients who had undergone coronary revascularization, either by percutaneous coronary intervention or bypass surgery were included in this cross-sectional, observational study. Patients were queried for various sociodemographic characteristics and smoking habits. Disease related data were obtained from the hospital archives. The overall smoking rate was 57% after coronary revascularization. Age, bypass surgery and the occurrence of in-hospital adverse events were found to be independent predictors of smoking cessation in multivariate analysis. Despite efforts, smoking rates after coronary intervention remain substantially high. Therefore, a multidisciplinary approach to smoking cessation that incorporates cardiac rehabilitation programs and medications should be implemented in clinical practice. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com
Malla, Ashok K; Norman, Ross M G; Takhar, Jatinder; Manchanda, Rahul; Townsend, Laurel; Scholten, Derek; Haricharan, Raj
Patients with schizophrenia who show persistent negative symptoms are an important subgroup, but they are difficult to identify early in the course of illness. The objective of this study was to examine characteristics that discriminate between first-episode psychosis (FEP) patients in whom primary negative symptoms did or did not persist after 1 year of treatment. Patients with a DSM-IV diagnosis of FEP whose primary negative symptoms did (N = 36) or did not (N = 35) persist at 1 year were contrasted on their baseline and 1-year characteristics. Results showed that patients with persistent primary negative symptoms (N = 36) had a significantly longer duration of untreated psychosis (p < .005), worse premorbid adjustment during early (p < .001) and late adolescence (p < .01), and a higher level of affective flattening (p < .01) at initial presentation compared with patients with transitory primary negative symptoms. The former group also showed significantly lower remission rates at 1 year (p < .001). Multiple regression analysis confirmed the independent contribution of duration of untreated psychosis, premorbid adjustment, and affective flattening at baseline to the patients' likelihood of developing persistent negative symptoms. It may therefore be possible to distinguish a subgroup of FEP patients whose primary negative symptoms are likely to persist on the basis of characteristics shown at initial presentation for treatment.
Ingre, Caroline; Roos, Per M; Piehl, Fredrik; Kamel, Freya; Fang, Fang
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. PMID:25709501
Holm, Jakob Præst; Hyldstrup, Lars; Jensen, Jens-Erik Beck
The aim of this article was to identify prevalent osteoporosis risk factors, medications and comorbidities associated with bone mineral density (BMD). Furthermore to evaluate changes in risk factor profiles over 12 years. 6285 women consecutively referred to an osteoporosis specialist clinic were...... was established in a real-life setting. The prevalence of osteoporosis and proportion of patient's having comorbidity's associated with osteoporosis were increasing during the inclusion period (start 23.8 %, end 29.7 %). Increasing age (OR = 1.05), current smoking (OR = 1.18), estrogen deficiency (OR = 1.......7), hyperthyroidism (OR = 1.5), previous major osteoporotic fracture (OR = 1.7), former osteoporosis treatment (OR = 3.5), higher BMI (OR = 0.87), use of calcium supplementation (OR = 1.2), high exercise level (OR = 0.7), and use of thiazide diuretics (OR = 0.7) were identified as predictors of osteoporosis by DXA...
Linares Fernandez, Tomasa Maria; Correa Lozano, Zoila; Ibarra Fernandez de la Vega, Enrique Jose; Bonet Gorbea Mariano
To identify the relative contribution of different occupational risk factors associated with the occurrence of skin cancer in the provinces of Havana City and Havana, Cuba , in 2006-2007. It was designed a case-control study of hospital base that included 112 cases of non-melanoma skin cancer and 448 witnesses, following the inclusion-exclusion criteria preset. We considered the totality of patients diagnosed with basal cell carcinoma and squamous cell histological study of skin biopsy or surgical excision. Risk factors with possible association with the disease were studied, such as sun exposure, ionizing and non-ionizing radiations and a wide range of chemical and biological substances potentially carcinogenic
Olfa Berriche; Amrouche Chiraz; Rym Ben Othman; Hamdi Souheila; Ines Lahmer; Chaabani Wafa; Imen Sebai; Haifa Sfar; Feten Mahjoub; Henda Jamoussi
Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and witnesses. Methods: We conducted a comparative cross-sectional study including 60 postmenopausal women and screening for osteoporosis by a bone densitometry, recruited the outp...
Lígia da Silva Leroy; Adélia Lúcio; Maria Helena Baena de Moraes Lopes
Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine...
Sticca, Fabio; Ruggieri, Sabrina; Alsaker, Françoise; Perren, Sonja
Cyberbullying has emerged as a new form of antisocial behaviour in the context of online communication over the last decade. The present study investigates potential longitudinal risk factors for cyberbullying. A total of 835 Swiss seventh graders participated in a short-term longitudinal study (two assessments 6 months apart). Students reported on the frequency of cyberbullying, traditional bullying, rule-breaking behaviour, cybervictimisation, traditional victimisation, and frequency of onl...
Thong, Bernard Y-H; Tan, Teck-Choon
The aim of this review was to describe the current evidence-based knowledge of the epidemiology, prevalence, incidence, risk factors and genetic associations of drug allergy. Articles published between 1966 and 2010 were identified in MEDLINE using the key words adult, adverse drug reaction reporting systems, age factors, anaphylactoid, anaphylaxis, anaesthetics, antibiotics, child, drug allergy, drug eruptions, ethnic groups, hypersensitivity, neuromuscular depolarizing agents, neuromuscular nondepolarizing agents, sex factors, Stevens Johnson syndrome and toxic epidermal necrolysis. Additional studies were identified from article reference lists. Relevant, peer-reviewed original research articles, case series and reviews were considered for review. Current epidemiological studies on adverse drug reactions (ADRs) have used different definitions for ADR-related terminology, often do not differentiate immunologically and non-immunologically mediated drug hypersensitivity, study different study populations (different ethnicities, inpatients or outpatients, adults or children), utilize different methodologies (spontaneous vs. non-spontaneous reporting, cohort vs. case-control studies), different methods of assessing drug imputability and different methods of data analyses. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. HLA associations for SCAR associated with allopurinol, carbamazepine and abacavir have been reported with the potential for clinical use in screening prior to prescription. Identification of risk factors for drug allergy and appropriate genetic screening of at-risk ethnic groups may improve the outcomes of drug-specific SCAR. Research and collaboration are necessary for the generation of clinically-relevant, translational pharmacoepidemiological and pharmacogenomic knowledge, and success of health outcomes research and policies on drug allergies. © 2011 The Authors
Full Text Available Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0, presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02 and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73 and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67 were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still
Anne F Peery
Full Text Available Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids.We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects' colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex.The study included 2,813 participants. Of these, 1,074 had hemorrhoids recorded. Constipation was associated with an increased prevalence of hemorrhoids (OR 1.43, 95% CI 1.11, 1.86. Of the fiber subtypes, high grain fiber intake was associated with a reduced risk (OR for quartile 4 versus quartile 1 = 0.78, 95% CI 0.62, 0.98. We found no association when comparing gravid and nulligravida women (OR 0.93, 95% CI 0.62-1.40. Sedentary behavior was associated with a reduced risk (OR 0.80, 95% CI 0.65-0.98, but not physical activity (OR 0.83, 95% CI 0.66-1.03. Neither being overweight nor obese was associated with the presence of hemorrhoids (OR 0.89, 95% CI 0.72-1.09 and OR 0.86, 95% CI 0.70-1.06.Constipation is associated with an increased risk of hemorrhoids. Gravidity and physical activity do not appear to be associated. High grain fiber intake and sedentary behavior are associated with a decreased risk of hemorrhoids.
Peery, Anne F; Sandler, Robert S; Galanko, Joseph A; Bresalier, Robert S; Figueiredo, Jane C; Ahnen, Dennis J; Barry, Elizabeth L; Baron, John A
Constipation, a low fiber diet, sedentary lifestyle and gravidity are commonly assumed to increase the risk of hemorrhoids. However, evidence regarding these factors is limited. We examined the association between commonly cited risk factors and the prevalence of hemorrhoids. We performed a cross sectional study of participants who underwent a colonoscopy in a colorectal adenoma prevention trial and who had a detailed assessment of bowel habits, diet and activity. The presence of hemorrhoids was extracted from the subjects' colonoscopy reports. We used logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for age and sex. The study included 2,813 participants. Of these, 1,074 had hemorrhoids recorded. Constipation was associated with an increased prevalence of hemorrhoids (OR 1.43, 95% CI 1.11, 1.86). Of the fiber subtypes, high grain fiber intake was associated with a reduced risk (OR for quartile 4 versus quartile 1 = 0.78, 95% CI 0.62, 0.98). We found no association when comparing gravid and nulligravida women (OR 0.93, 95% CI 0.62-1.40). Sedentary behavior was associated with a reduced risk (OR 0.80, 95% CI 0.65-0.98), but not physical activity (OR 0.83, 95% CI 0.66-1.03). Neither being overweight nor obese was associated with the presence of hemorrhoids (OR 0.89, 95% CI 0.72-1.09 and OR 0.86, 95% CI 0.70-1.06). Constipation is associated with an increased risk of hemorrhoids. Gravidity and physical activity do not appear to be associated. High grain fiber intake and sedentary behavior are associated with a decreased risk of hemorrhoids.
Jacqmin-Gadda, H; Fourrier, A; Commenges, D; Dartigues, J F
We report the results of a 5-year prospective cohort study of risk factors for fractures, including drinking fluoridated water, in a cohort of 3,216 men and women aged 65 years and older. We studied risk factors for hip fracture and fractures at other locations separately. We found a higher risk of hip fractures for subjects exposed to fluorine concentrations over 0.11 mg per liter but without a dose-effect relation (odds ratio (OR) = 3.25 for a concentration of 0.11-0.25 mg per liter; OR = 2.43 for > or = 0.25 mg per liter]. For higher thresholds (0.7 and 1 mg per liter), however, the OR was less than 1. We found no association between fluorine and non-hip fractures. Non-hip fractures were associated with polymedication rather than with specific drug use, whereas fracture was associated with polymedication and use of anxiolytic and antidepressive drugs. Subjects drinking spirits every day were more likely to have hip fractures. Tobacco consumption increased the risk for non-hip fractures.
March, Melissa I.; Gupta, Munish; Modest, Anna M.; Wu, Lily; Hacker, Michele R.; Martin, Camilia R.; Rana, Sarosh
Objective This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC). Methods This was a retrospective case control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications, and neonatal hospital course. Data was abstracted from medical records. Results 28 cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p=0.008). Infants with NEC had lower median birth weight than infants without NEC (p=0.009). Infants with NEC had more late-onset sepsis (p=0.01) and mortality before discharge (p=0.001). Conclusions The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC, however there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference. PMID:25162307
Gray, P; Hildebrand, K
Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremor, rigidity, bradykinesia, gait disturbance, and postural instability. Patients with PD suffer frequent falls, yet little research has been done to identify risks specific to PD patients. The objective of this study was to identify the risk factors associated with falls for PD patients through the collection of demographic, environmental, and medical information as well as fall diaries completed during a 3-month period. Patients with a diagnosis of idiopathic PD, with and without falls, were included in the study provided they could stand and walk and had no other condition that could predispose them to falls. Of the 118 participants, 59% reported one or more falls. A total of 237 falls were reported. Duration and severity of PD symptoms, particularly freezing, involuntary movements, and walking and postural difficulties, were significantly associated with an increased risk of falls. Other factors associated with falls were postural hypotension and daily intake of alcohol. Forty percent of falls resulted in injury, but serious injury was rare. The findings have implications for reducing the risk of falls through patient education.
Husain, Sohail Z; Morinville, Veronique; Pohl, John; Abu-El-Haija, Maisam; Bellin, Melena D; Freedman, Steve; Hegyi, Peter; Heyman, Melvin B; Himes, Ryan; Ooi, Chee Y; Schwarzenberg, Sarah J; Usatin, Danielle; Uc, Aliye
Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: hyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.
Husain, Sohail Z.; Morinville, Veronique; Pohl, John; Abu-El-Haija, Maisam; Bellin, Melena D.; Freedman, Steve; Hegyi, Peter; Heyman, Melvin B; Himes, Ryan; Ooi, Chee Y.; Schwarzenberg, Sarah Jane; Usatin, Danielle; Uc, Aliye
Objectives Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies and their rationale. Methods We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: (a) hyperlipidemia, (b) hypercalcemia, (c) chronic renal failure, (d) smoking exposure, (e) alcohol, and (f) medications. Areas of additional research were identified. Results Hypertriglyceridemia of 1000 mg/dl or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and by-stander status may be implicated. Other pancreatitis risk factors must be sought in all cases. Conclusions The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/ removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children. PMID:26594832
Julia Estela Willrich Boell
Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.
Full Text Available Background: Migraine is a chronic daily headache which interfere a quality of life. The purpose of this research is to obtain the prevalence, risk factors, and comorbidity of migraine. Methods: A cross sectional study involving 4771 subjects in 5 villages in the district of Central Bogor, Bogor City 2011–2012. Data collection was performed using WHO STEPS (interview, measurement, physical examination, and laboratory test. Results: In this study, the migraine prevalence was 22.43%, with significant risk factors were sex, age, and stress (p < 0.05. Comorbidity of migraine was coronary heart diseases (p < 0.05. There was no significant correlation between migraine with marital status, level of education, smoking, hypertension, obesity, total cholesterol, LDL, HDL, trigliseride level, and diabetes mellitus (p > 0.05. Conclusions: Risk factors which have significant association with migraine are sex, age, and stress, whereas coronary heart disease existed as a comorbidity with migraine.
Mejdahl, Mathias Kvist; Andersen, Kenneth Geving; Gärtner, Rune
To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain.......To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain....
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PURPOSE: To determine the incidence and risk factors of late corneal graft rejection after penetrating keratoplasty (PKP. METHODS: Records of all patients who had undergone PKP from 2002 to 2004 without immunosuppressive therapy other than systemic steroids and with at least one year of follow up were reviewed. The role of possible risk factors such as demographic factors, other host factors, donor factors, indications for PKP as well as type of rejection were evaluated. RESULTS: During the study period, 295 PKPs were performed on 286 patients (176 male, 110 female. Mean age at the time of keratoplasty was 38±20 (range, 40 days to 90 years and mean follow up period was 20±10 (range 12-43 months. Graft rejection occurred in 94 eyes (31.8% at an average of 7.3±6 months (range, 20 days to 39 months after PKP. The most common type of rejection was endothelial (20.7%. Corneal vascularization, regrafting, anterior synechiae, irritating sutures, active inflammation, additional anterior segment procedures, history of trauma, uncontrolled glaucoma, prior graft rejection, recurrence of herpetic infection and eccentric grafting increased the rate of rejection. Patient age, donor size and bilateral transplantation had no significant influence on graft rejection. CONCLUSION: Significant risk factors for corneal graft rejection include
Reed, Phil; Wu, Yaqionq
To outline the uses of logistic regression and other statistical methods for risk factor analysis in the context of research on stuttering. The principles underlying the application of a logistic regression are illustrated, and the types of questions to which such a technique has been applied in the stuttering field are outlined. The assumptions and limitations of the technique are discussed with respect to existing stuttering research, and with respect to formulating appropriate research strategies to accommodate these considerations. Finally, some alternatives to the approach are briefly discussed. The way the statistical procedures are employed are demonstrated with some hypothetical data. Research into several practical issues concerning stuttering could benefit if risk factor modelling were used. Important examples are early diagnosis, prognosis (whether a child will recover or persist) and assessment of treatment outcome. After reading this article you will: (a) Summarize the situations in which logistic regression can be applied to a range of issues about stuttering; (b) Follow the steps in performing a logistic regression analysis; (c) Describe the assumptions of the logistic regression technique and the precautions that need to be checked when it is employed; (d) Be able to summarize its advantages over other techniques like estimation of group differences and simple regression. Copyright © 2012 Elsevier Inc. All rights reserved.
Andréia Guedes Oliva Fernandes
Full Text Available OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4. Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.
Caroline Alves de Oliveira
Full Text Available CONTEXT AND OBJECTIVE: Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. DESIGN AND SETTING: Systematic review of the literature and meta-analysis at Instituto Fernandes Figueira. METHODS: This meta-analysis was on studies published between January 1989 and July 2009 that were identified in Medline, Scopus, Embase, Cochrane, SciELO, Lilacs, Adolec, Medcarib, Paho, Wholis, Popline, ISI Web of Science and Sigle. Articles were selected if they were cohort studies on electrosurgical excisional treatment of high-grade squamous intraepithelial lesions with a minimum follow-up of one year, a histopathological outcome of persistence of these lesions and a small risk of bias. RESULTS: The search identified 7,066 articles and another 21 in the reference lists of these papers. After applying the selection and exclusion criteria, only four articles were found to have extractable data. The risk of persistence of high-grade intraepithelial lesions after one year was 11.36 times greater (95% confidence interval, CI: 5.529-23.379, P < 0.0001 in patients with positive margins and after two years, was four times greater (95% CI: 0.996-16.164, although without statistical significance. CONCLUSION: This meta-analysis confirms the importance of positive margins as an indicator of incomplete treatment after the first year of follow-up and highlights the need for appropriately chosen electrosurgical techniques based on disease location and extent, with close surveillance of these patients.
Jensen, Kirsten Egebjerg; Schmiedel, Sven; Frederiksen, Kirsten
were also conducted. Hazard ratios (HRs) for a diagnosis of cervical intraepithelial neoplasia grade 3 or worse/high-grade squamous intraepithelial lesions or worse (CIN3+) and the corresponding 95% confidence intervals (CIs) were calculated in the 2 groups. RESULTS: Among high-risk HPV positive women......BACKGROUND: Smoking has been associated with cervical cancer. We examined whether smoking increases the risk for high-grade cervical lesions in women with high-risk human papillomavirus (HPV) infection. METHODS: In a population-based cohort study, 8,656 women underwent a structured interview......, and subsequently cervical cells were obtained for HPV DNA testing. Women with high-risk HPV infection and no prevalent cervical disease at baseline (n=1,353) were followed through the Pathology Data Bank for cervical lesions for up to 13 years. Separate analyses of women with persistent high-risk HPV infection...
van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J
The objective of this study is to determine risk factors for fatigue among airline pilots, taking into account person-, work-, health-, sleep-, and lifestyle-related characteristics. The study population consisted of 502 pilots who participated in the MORE Energy study. Included risk factors were either measured through an online questionnaire or provided by the company. The outcome of this study, fatigue, was assessed using the Checklist Individual Strength (CIS), and was defined as scoring more than 76 points on this questionnaire. The association of the risk factors with fatigue was determined using univariate and multivariate logistic regression analyses. Of the participating pilots, 29.5 % scored more than 76 points on the CIS and were classified as being fatigued. The fully adjusted regression model showed that person-, work-, health-, and lifestyle-related characteristics were associated with fatigue. Pilots who were aged 31 to 40 (OR 3.36, 95 % CI 1.32-8.53) or 41 to 50 (OR 4.19, 95 % CI 1.40-12.47), an evening type (OR 2.40, 95 % CI 1.38-4.16), scored higher on work-life balance disturbance (OR 1.22, 95 % CI 1.10-1.36), scored higher on need for recovery (OR 1.02, 95 % CI 1.01-1.04), scored lower on general health perception (OR 0.31, 95 % CI 0.20-0.47), were less physically active (OR 0.77, 95 % CI 0.66-0.89), and had a moderate alcohol consumption (OR 3.88, 95 % CI 1.21-12.43), were at higher risk for fatigue. Higher age, being an evening type, disturbance of the work-life balance, more need for recovery, a lower perceived health, less physical activity, and moderate alcohol consumption were shown to be risk factors for fatigue. Further longitudinal research is needed to elucidate the direction of the associations found and to evaluate the effects of possible countermeasures in airline pilots.
Mehta, Shobha H; Sokol, Robert J
Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.
Sally N. Adebamowo
Full Text Available BackgroundThe prevalence, persistence, and multiplicity of human papillomavirus (HPV infection appears different comparing HIV-positive to HIV-negative women. In this study, we examined prevalent, persistent, and multiple low- and high-risk cervical HPV infections in HIV-negative and HIV-positive women.MethodsWe studied 1,020 women involved in a study of HPV infection using SPF25/LiPA10. Two study visits were scheduled, at enrollment and 6 months afterward. At each study visit, research nurses used a cervical brush to collect samples of exfoliated cervical cells from the cervical os, from all the study participants. Exact logistic regression models were used to estimate associations between HIV and HPV infections.ResultsThe mean (SD age of the study participants was 38 (8 years, 56% were HIV-negative and 44% were HIV-positive. Among HIV-negative women at baseline, single low-risk HPV (lrHPV infections occurred in 12%; multiple lrHPV in 2%; single high-risk human papillomavirus (hrHPV infections in 9%, and multiple hrHPV infections in 2%. Single lrHPV infections were persistent in 6%, but there was no persistent multiple lrHPV infections. Single hrHPV infections were persistent in 4% while multiple hrHPV infections were persistent in 0.3%. Among HIV-positive women at baseline, single lrHPV infections occurred in 19%, multiple lrHPV in 6%, single hrHPV infections in 17%, and multiple hrHPV infections occurred in 12%. Single lrHPV infections were persistent in 9%, multiple lrHPV infections in 0.6%, single hrHPV infections in 13%, while multiple hrHPV were persistent in 3%. Prevalent, persistent, and multiple infections were more common in HIV-positive women, compared to HIV-negative women. In multivariate models adjusted for age, marital status, socioeconomic status, age at sexual initiation, and douching, the odds ratios comparing HIV-positive to HIV-negative women, were 2.09 (95% CI 1.47–2.97, p < 0.001 for prevalent lrHPV, 1.26 (95% CI
Andrade, J A; Moreira, C; Fagundes Neto, U
INTRODUCTION: Persistent diarrhea has high impact on infantile morbidity and mortality rates in developing countries. Several studies have shown that 3 to 20% of acute diarrheal episodes in children under 5 years of age become persistent. DEFINITION: Persistent diarrhea is defined as an episode that lasts more than 14 days. ETIOLOGY: The most important agents isolated in persistent diarrhea are: Enteropathogenic E. coli (EPEC), Salmonella, Enteroaggregative E. coli (EAEC), Klebisiella and Cryptosporidium. CLINICAL ASPECTS: In general, the clinical characteristics of patients with persistent diarrhea do not change with the pathogenic agent. Persistent diarrhea seems to represent the final result of a several insults a infant suffers that predisposes to a more severe episode of diarrhea due to a combination of host factors and high rates of enviromental contamination. Therefore, efforts should be made to promptly treat all episodes of diarrhea with apropriate follow-up. THERAPY: The aim of the treatment is to restore hydroelectrolytic deficits and to replace losses until the diarrheal ceases. It is possible in the majority of the cases, using oral rehydration therapy and erly an appropriate type of diet. PREVENTION: It is imperative that management strategies also focus on preventive aspects. The most effective diarrheal prevention strategy in young infants worldwide is promotion of exclusive breast feeding.
Guedeney, Antoine; Marchand-Martin, Laetitia; Cote, Sylvana J; Larroque, Béatrice
The objectives of the study were (1) to assess prevalence of social withdrawal behaviour in infants aged 12 months included in the French Perinatal Risk Factor Study Eden; (2) To study the correlation between relational withdrawal and several perinatal and parental factors assessed in the EDEN study. A longitudinal study using the ADBB scale was conducted within the Eden Cohort in the year 2008. 1,586 infants were included in the study. Fourteen percent of the children who had an ADBB assessment had a score at 5 and over on the ADBB, a scale designed to assess social withdrawal behaviour at age 0-24 months. Social withdrawal at 12 months was associated with low birth weight, low gestational age and with intra uterine growth retardation. Social withdrawal was independently associated with several maternal and paternal risk factors. The level of social withdrawal behaviour increased with a score of maternal difficulties. This study on a large longitudinally followed volunteer sample demonstrate a clear association of social withdrawal behaviour at age one with low birth weight and preterm birth, possibly mediated by parental vulnerabilities. Social withdrawal behaviour seems to be an important alarm signal to detect early on particularly in premature and small for date babies. © Springer-Verlag 2012
Lobo Pereira, J. A.; Ferreira, Maria Cristina; Oliveira, Teresa
Multivariate statistical analysis is indispensable to assess the associations and interactions between different factors and the risk of periodontitis. Among others, regression analysis is a statistical technique widely used in healthcare to investigate and model the relationship between variables. In our work we study the impact of socio-demographic, medical and behavioral factors on periodontal health. Using regression, linear and logistic models, we can assess the relevance, as risk factors for periodontitis disease, of the following independent variables (IVs): Age, Gender, Diabetic Status, Education, Smoking status and Plaque Index. The multiple linear regression analysis model was built to evaluate the influence of IVs on mean Attachment Loss (AL). Thus, the regression coefficients along with respective p-values will be obtained as well as the respective p-values from the significance tests. The classification of a case (individual) adopted in the logistic model was the extent of the destruction of periodontal tissues defined by an Attachment Loss greater than or equal to 4 mm in 25% (AL≥4mm/≥25%) of sites surveyed. The association measures include the Odds Ratios together with the correspondent 95% confidence intervals.
Liu, Wei-Xiao; Lang, Jun-Feng; Zhang, Qin-Feng
To investigate the risk factors for anorexia in children, and to reduce the prevalence of anorexia in children. A questionnaire survey and a case-control study were used to collect the general information of 150 children with anorexia (case group) and 150 normal children (control group). Univariate analysis and multivariate logistic stepwise regression analysis were performed to identify the risk factors for anorexia in children. The results of the univariate analysis showed significant differences between the case and control groups in the age in months when supplementary food were added, feeding pattern, whether they liked meat, vegetables and salty food, whether they often took snacks and beverages, whether they liked to play while eating, and whether their parents asked them to eat food on time (Panorexia in children. Liking of meat (OR=0.093) and vegetables (OR=0.272) and eating on time required by parents (OR=0.079) were protective factors against anorexia in children. Timely addition of supplementary food, a proper diet, and development of children's proper eating and living habits can reduce the incidence of anorexia in children.
Bodekaer, M.; Faurschou, A.; Philipsen, P.A.
BACKGROUND/PURPOSE: The persistence of sunscreens during a day with physical activity and bathing is often debated. We wished to examine the durability of the protection achieved by one sunscreen application. METHODS: Seven areas were marked on the back of 24 volunteers. One area was phototested ...
Lint, Anna H.
This quantitative study evaluated and investigated the theoretical underpinnings of the Kember's (1995) student progress model that examines the direct or indirect effects of student persistence in online education by identifying the relationships between variables. The primary method of data collection in this study was a survey by exploring the…
Gavin, Russell B.
The purpose of this study was to explore the experiences of students (N = 26) in an undergraduate music education degree program in an attempt to identify commonalities among students persisting to degree completion. All participants were in their final year of the music education degree at the time of the study. Multiple data collection methods…
Joo, Young Ju; Joung, Sunyong; Kim, Nam Hee; Chung, Hyun Min
This study aimed to investigate the structural relationships among teaching presence, cognitive presence, usage, learning flow, satisfaction, and learning persistence in corporate e-learners. The research participants were 462 e-learners registered for e-lectures through an electronics company in South Korea. First, the sense of teaching presence,…
Background: Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk ...
Roberta Flores Marquezini FRAGAS
Full Text Available ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.
Full Text Available INTRODUCTION Osteoarthritis (OA, also often called “osteoarthrosis” or “degenerative joint disease” is the most common form of arthritis. MATERIALS AND METHODS Present retrospective statistical study was conducted at the Department of orthopaedics in a tertiary care hospital (Catering to a largely agricultural population over a period of 2 years from January 2012 to December 2014. RESULTS Prevalence of osteoarthritis common in farmers accounting to 70%. Other occupations at risk of OA of knee were, Teachers 12%, Housewives 08%, Athletes 04%, Policemen 04% and Drivers 02%. It is in conformity with most previous studies reviewed. CONCLUSION Osteoarthritis of Knee is a major health issue and important cause of disability in elderly population. Occupational risk factors are important in development of osteoarthritis.
Kocić Sanja S.
Full Text Available Background/Aim. World Health Organization (WHO in its plan for health policy until the year 2010, has taken reduction of risk factors of suicide as its 12th aim. Because of the fact that the problem of suicide is also significant health problem in our society, the aim of this study was to examine the influence of life period as a risk factor for suicide in the area of the town of Kragujevac. Methods. In total 211 persons, both sexes, aged between 17 and 91 years, from the area of the town of Kragujevac, who had been committed a suicide during the period from 1996 to 2005, were included in a retrospective study. This study included the analysis of: conditions prior to suicide, locations of suicide, motives for suicide, the ways of committing suicide. For statistical analysis χ2 test and univariante regression model were used. Results. Average rate of suicide, in analyzed period, moved from 8.7 to 27 with a mean value of 14.6± 6.9. Suicide rates were the lowest in the age group from 15 to 24 years and the highest in the age group above 65 years (p < 0.05. Among the presuicidal conditions, within any age groups the presence of mental disease dominated as a factor for suicide, but within the oldest one in which organic diseases prevailed as a factor for suicide (p < 0.05. Statistically significant fact is that a house (flat was the main location for committing suicide in any age groups. Motives for suicide were significantly different within the groups and they were mostly unknown. Committing suicide by hanging was the most frequent way of suicide among any age groups. Univariant regression analysis failed to show any impact of age on the analyzed factors. Conclusion. Because of the fact that an average rate of suicide in elderly increases it is obligatory to primarily determine risk factors for suicide among people more than 65 years of age. Physicians should play the most important role in that.
Hegmann, Kurt T; Thiese, Matthew Steven; Kapellusch, Jay; Merryweather, Andrew S; Bao, Stephen; Silverstein, Barbara; Wood, Eric M; Kendall, Richard; Wertsch, Jacqueline; Foster, James; Garg, Arun; Drury, David L
The aim of the study was to ascertain if cardiovascular (CVD) risk factors are carpal tunnel syndrome (CTS) risk factors. Analysis of pooled baseline data from two large prospective cohort studies (n = 1824) assessed the relationships between a modified Framingham Heart Study CVD risk score both CTS and abnormal nerve conduction study prevalence. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratio and 95% confidence intervals were calculated for individual risk scores. There was a strong relationship between CVD risk score and both CTS and abnormal nerve conduction study after adjustment for confounders, with odds ratios as high as 4.16 and 7.35, respectively. Dose responses were also observed. In this workplace population, there is a strong association between CVD risk scores and both CTS and abnormal nerve conduction study that persisted after controlling for confounders. These data suggest a potentially modifiable disease mechanism.
Smith, Andrew; Smith, Hugo
Research has identified a number of risk factors for road traffic accidents. Some of these require education of drivers and a first step in this process is to assess perceptions of these risk factors to determine the current level of awareness. An online survey examined risk perception with the focus being on driver behavior, risk taking and fatigue. The results showed that drivers’ perceptions of the risk from being fatigued was lower than the perceived risk from the other factors.
Zhang, Jixiang; Song, Jianwei; Wang, Jing
This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.
Leigh, J Paul; Du, Juan
Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages-the largest category within income-are risk factors. We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25-65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25-44 and 45-65 years) and genders. Hypertension incidence was self-reported based on physician diagnosis. Our study was prospective since data from three base years (1999, 2001, 2003) were used to predict newly diagnosed hypertension for three subsequent years (2001, 2003, 2005). In separate analyses, data from the first base year were used to predict time-to-reporting hypertension. Logistic regressions with random effects and Cox proportional hazards regressions were run. Negative and strongly statistically significant correlations between wages and hypertension were found both in logistic and Cox regressions, especially for subsamples containing the younger age group (25-44 years) and women. Correlations were stronger when three health variables-obesity, subjective measures of health and number of co-morbidities-were excluded from regressions. Doubling the wage was associated with 25-30% lower chances of hypertension for persons aged 25-44 years. The strongest evidence for low wages being risk factors for hypertension among working people were for women and persons aged 25-44 years.
Ondrusova, M.; Ondrus, D.
Testicular cancer is a rare malignancy, that affects 1-2 % of male population. Trends of testicular cancer mortality are stable for a long period of time, even that incidence shows a rapid growth. This paper deals with national trends in testicular cancer incidence and mortality in Slovakia from 1968 to 2007 by using the join-point regression analysis to propose potential changes in health care. The authors noted a statistically significant increase in the values of incidence and improvement in mortality after 1975. Paper also deals with the etiology and risk factors of this malignancy. (author)
Marino, Monica; Battaglia, Eliana; Massimino, Marta; Aguglia, Eugenio
It is commonly believed that pregnancy is a time of good mental health. However it has been observed, until recently, that many pregnant women, above all in post partum period, manifest depressive symptoms like sadness, social withdrawal and lack of motivation. The consequences are enormous, for mother mental health and for the psychical development of the baby. It becomes therefore necessary to screening and to precociously intervene on these pathological conditions and thanks also to the suitable knowledge of the risk factors for the potential development of depression post partum.
Roxana Maria BĂDÎRCEA
Full Text Available The costs and benefits of adopting a unique currency have been studied and outlined by the optimum currency areas theory. This theory of Mundell has suffered modifications, a series of economists identifying and introducing a series of subsequent or additional criteria in the analysis. Starting from the costs indicated by the optimum currency areas theory and its further developments, I have identified a series of factors that I believe to represent future risks for the Romanian economy within the process of adopting the unique euro currency.
Schémann, J-F; Sacko, D; Malvy, D; Momo, G; Traore, L; Bore, O; Coulibaly, S; Banou, A
Prior to commencing a campaign to eliminate blinding trachoma in Mali, a national disease prevalence survey was conducted from March 1996 to June 1997. The prevalence of trachoma was estimated and potential risk factors were studied. In each of Mali's seven regions (excluding the capital Bamako), a sample of 30 clusters was taken from the general population, in accordance with the principle of probability proportional to the size of the community. All children under 10 years of age were examined. The simplified clinical coding system proposed by the World Health Organization was used. The position of each village was established and subsequently related to the nearest meteorological station. Socioeconomic and environmental information was collected at both village and household level. The mother or caretaker of each child was questioned about availability and use of water for washing the child. At the time of examination, facial cleanliness and the presence of flies on the face were noted. A total of 15,187 children under 10 years of age were examined. The prevalence of active trachoma (follicular [TF] or intense trachoma [TI]) was 34.9% (95% CI : 32.3-37.6) and the prevalence of TI was 4.2% (95% CI : 3.5-5.0). Aridity/environmental dryness appears to be a risk factor influencing the current geographical distribution of trachoma. Small villages had considerably higher trachoma prevalence than their larger neighbours. The proximity of a medical centre and the existence of social organizations such as a women's association were associated with lower levels of trachoma. Crowded living conditions increased the risk. Using a monetary marker of wealth, we observed a linear inverse relation between wealth and trachoma prevalence. The presence of a dirty face was strongly associated with trachoma (odds ratio [OR] = 3.67) as was the presence of flies on the child's face (OR = 3.62). Trachoma prevalence increased with distance to a water source. Disease prevalence decreased
Dentists are at the forefront for screening oral cancer. In addition to the well known carcinogenic potential of tobacco and alcohol, betel nut chewing and human papilloma virus are important risk factors in the development of oral cancer. To aid in screening and decreasing morbidity and mortality from oral cancer, a variety of techniques have been developed. These techniques show promise but they require additional investigations to determine their usefulness in oral cancer detection. Dentists need to be well educated and vigilant when dealing with all patients they encounter. Early detection, diagnosis and treatment are critical for the effective management of oral cancers.
Williams, Paul T
Test whether inadequate exercise is related to sepsis mortality. Mortality surveillance of an epidemiological cohort of 155,484 National Walkers' and Runners' Health Study participants residing in the United States. Deaths were monitored for an average of 11.6-years using the National Death index through December 31, 2008. Cox proportional hazard analyses were used to compare sepsis mortality (ICD-10 A40-41) to inadequate exercise (<1.07 METh/d run or walked) as measured on their baseline questionnaires. Deaths occurring within one year of the baseline survey were excluded. Sepsis was the underlying cause in 54 deaths (sepsis(underlying)) and a contributing cause in 184 deaths (sepsis(contributing)), or 238 total sepsis-related deaths (sepsis(total)). Inadequate exercise was associated with 2.24-fold increased risk for sepsis(underlying) (95%CI: 1.21 to 4.07-fold, P = 0.01), 2.11-fold increased risk for sepsis(contributing) (95%CI: 1.51- to 2.92-fold, P<10(-4)), and 2.13-fold increased risk for sepsis(total) (95%CI: 1.59- to 2.84-fold, P<10(-6)) when adjusted for age, sex, race, and cohort. The risk increase did not differ significantly between runners and walkers, by sex, or by age. Sepsis(total) risk was greater in diabetics (P = 10(-5)), cancer survivors (P = 0.0001), and heart attack survivors (P = 0.003) and increased with waist circumference (P = 0.0004). The sepsis(total) risk associated with inadequate exercise persisted when further adjusted for diabetes, prior cancer, prior heart attack and waist circumference, and when excluding deaths with cancer, or cardiovascular, respiratory, or genitourinary disease as the underlying cause. Inadequate exercise also increased sepsis(total) risk in 2163 baseline diabetics (4.78-fold, 95%CI: 2.1- to 13.8-fold, P = 0.0001) when adjusted, which was significantly greater (P = 0.03) than the adjusted risk increase in non-diabetics (1.80-fold, 95%CI: 1.30- to 2.46-fold, P = 0
The proximal risk factors are male gender, age < 2 years, 2nd birth order and positive family nd history. The social status of families is a distal risk factor. The second year of life and 2 birth order are the strongest predisposing factors to the development of FC. Key words: Febrile convulsions, Risk factors, Benin City, Nigeria ...
Tabbara, Khalid F; Kotb, Amgad A
To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.
Full Text Available Background and aims :Prevalence of musculoskeletal disorders (MSDs is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the objectives of determination of prevalence rate, ergonomics assessment of working conditions and determination of factors associated with MSDs among office workers. Methods:In this study 400 randomly selected office workers participated. Nordic musculoskeletal disorders questionnaire was applied to determine prevalence rate of MSDs. Working conditions were assessed by the designed ergonomics checklist and ergonomic risk factors were identified. Data were analyzed using statistical tests including t-test, Chi-square and test of proportion by SPSS software (Version 12.0. Results:The highest prevalence rates of MSDs were reported in lower back and neck regions (49% and 47%, respectively. Statistical analysis revealed that there were significant association between occurrence of MSDs and calculated ergonomics indices (P<0.05. The mean of ergonomics index among those suffered from MSDs were less than other healthy workers indicating inappropriate ergonomics conditions. Calculation of OR also revealed that ergonomics conditions was associated with MSDs occurrence among workers (P<0.05. Totally, 53.3% of the office workers studied had poor working conditions. Awkward working posture and inappropriate workstation design were recognized as the main risk factors in the office workplace. Conclusion:Most ergonomics problems were originated from bad postures and inappropriate design of workstation. Any interventional program for working conditions improvement should
Silvia Di Legge
Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.
Full Text Available E Duron, Olivier HanonBroca Hospital, Paris, FranceAbstract: Dementia is one of the most important neurological disorders in the elderly. Aging is associated with a large increase in the prevalence and incidence of degenerative (Alzheimer’s disease and vascular dementia, leading to a devastating loss of autonomy. In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge. In the past decade, several vascular risk factors have been found to be associated with vascular dementia but also Alzheimer’s disease. Some longitudinal studies, have found significant associations between hypertension, diabetus mellitus, and metabolic syndrome, assessed at middle age, and dementia. Studies assessing the link between hypercholesterolemia, atrial fibrillation, smoking, and dementia have given more conflicting results. Furthermore, some studies have highlighted the possible protective effect of antihypertensive therapy on cognition and some trials are evaluating the effects of statins and treatments for insulin resistance. Vascular risk factors and their treatments are a promising avenue of research for prevention of dementia, and further long-term, placebo-controlled, randomized studies, need to be performed.Keywords: dementia, hypertension, diabetus mellitus, hypercholesterolemia, metabolic syndrome
Bayat, Mohamad; Shariati, Mahsa; Rakhshan, Vahid; Abbasi, Mohsen; Fateh, Ali; Sobouti, Farhad; Davoudmanesh, Zeinab
Previous studies on risk factors of obstructive sleep apnea (OSA) are highly controversial and mostly identifying a few cephalometric risk factors. OSA diagnosis was made according to the patients' apnea-hypopnea index (AHI). Included were 74 OSA patients (AHI > 10) and 52 control subjects (AHI ≤ 10 + free of other OSA symptoms). In both groups, 18 cephalometric parameters were traced (SNA, SNB, ANB, the soft palate's length (PNS-P), inferior airway space, the distance from the mandibular plane to the hyoid (MP-H), lengths of mandible (Go-Gn) and maxilla (PNS-ANS), vertical height of airway (VAL), vertical height of the posterior maxilla (S-PNS), superior posterior airway space (SPAS), middle airway space, distances from hyoid to third cervical vertebra and retrognathion (HH1), C3 (C3H), and RGN (HRGN), the maximum thickness of soft palate (MPT), tongue length (TGL), and the maximum height of tongue). These parameters were compared using t-test. Significant variables were SPAS (p = 0.027), MPT, TGL, HH1, C3H, HRGN, PNS-P, S-PNS, MP-H, VAL, and Go-Gn (all p values ≤ 0.006). OSA patients exhibited thicker and longer soft palates, hyoid bones more distant from the vertebrae, retrognathion, and mandibular plane, higher posterior maxillae, longer mandibles, and smaller superior-posterior airways.
Kelly Vasconcelos Chaves Martins
Full Text Available Objective: To identify risk factors related to sensorineural hearing loss in elderly. Methods: The sample consisted of 60 selected elderly, divided into two groups: the Case Group, composed by 30 individuals, 21 females and 9 males, aged at least 60 years, presenting sensorineural hearing loss, and the Control Group, composed by 30 individuals matched on gender and age, with normal hearing. The patients were submitted to audiological anamnesis and tonal audiometry. The hearing impairment was defined according to average threshold greater than 35dBNA, in the frequencies of 1,000; 2,000 and 4,000 Hz, in the best ear. Results: Statistically significant odds ratios were: a to audiological history: noise exposure and family history of deafness; b to situations involving hearing difficulty: television, church, telephone, silent environment, spatial location of sound, difficulty with voices and noisy environment; c to otologic history: tinnitus, otorrhea and nausea; and d to medical history: visual problems, smoke, alcohol, thyroid problems and kidney disease. Conclusion: The findings of this study highlighted, for sensorineural hearing loss, risk factors related to audiologic, otologic and medical history, and to situations involving hearing difficulty.
Estrella de la Caridad Armenteros Espino
Full Text Available Background: cervix cancer constitutes the second cause of death worldwide, with new diagnosis each year. Objective: to determine the risk factors of cervical intraepithelial neoplasia in the municipality of Cruces. Methods: it was developed an analytical research with case and control design from November 2013 to November 2014. The group of cases was formed of the 34 women with this diagnosis. There were selected 64 females from the same environment with the same age for the control group. The data obtained by surveys and clinical records reviews were presented in absolute numbers and percentages. It was used Chi-squared test and odd ratio. Results: 52 % of women with neoplasia were less than 25 years old. Significant differences were found which associate neoplasia with early sexual intercourse, sexually transmitted infections by Papilloma virus, Plane genital condyloma, and the use of oral contraceptive pills. Multiple sex partner was a frequent antecedent. Conclusion: risk factors associated to cervical intraepithelial neoplasia in the group of women studied in the Cruces municipality were early sexual intercourse, mainly before 15 years old, multiple sex partner, sexually communicated diseases and the use of oral contraceptive pills for more than 5 years.
Cinthia Tomasa Mercado Contreras
Full Text Available The advance of the technology in communications has led to social networking sites fulfill an important role in society. Among the most used and known is Facebook, that social network allows to make public certain information and provides the opportunity to hold private conversations. This new trend of talks, and the natural desire to explore sexuality has led young people interested at phenomenon known as sexting. This phenomenon, from some of the negative consequences became public, has attracted the interest from parents, teachers, researchers and health workers, however, have not been universally well defined. This lack of unanimous conceptualization has led to confusion within the psychological, social and legal area. That is why in the present article presents results of a systematic review of articles that speak about sexting. The select articles were those that were published from 2009 to 2014, in which work was focused to adolescents and speak about risk factors and consequences of the phenomenon. The articles were analyzed by looking at the similarities and differences in their definition of sexting and their results, identifying risk factors and consequences related considered. With the analysis was possible to categorize their limitations and finally offer a possible definition of sexting.
Full Text Available The study of the adolescent pregnancy has been historically centered in the mother, the preponderant focus has been considers the maternity in this stage of the vital cycle as a factor of risk. Nowadays, have begun some studies that focus the problem of the adolescent pregnancy being centered in the father’s figure to appear and proposing a healthy focus, starting from the introduction of such concepts like Resilience. The present article, is a theoretical work, it is carried out to leave of secondary data. The objective is the compilation of studies and information on the subject of adolescent fatherhood from a less explored focus, considering the factors of risk and resilience. Different studies are raised with Latin American youths. Also are analyzed the access possibilities to the sanitary system from the youths, the knowledge of birth-control methods and the participation in programs of reproductive health. It outlines the importance of including the males in the whole process of procreation and the boy’s upbringing.
Slavíček, Jaroslav; Kittnar, Otomar; Fraser, Gary E.; Medová, Eva; Konečná, Jana; Žižka, Robert; Dohnalová, Alena; Novák, Vladimír
Summary The morbidity and mortality of the cardiovascular diseases is high in the developed countries. The lifestyle changes are capable to decrease it by 50%. The aim of the present study was to measure the parameters of some risk factors before and after a one-week NEW START rehabilitative retreat. 1,349 volunteers, 320 men, 1,029 woman, mean age 51±14.5 (SD) years participated in 30 rehabilitative retreats from 1999–2006 in the Czech Republic, using a low-fat, low-energy, lacto-ovo-vegetarian diet and exercise, in a stress-free environment. Body weight, height, BMI, blood pressure, heart rate, serum cholesterol and blood glucose were measured. Body weight decreased in 1,223 measured persons from 71.2±14.38 (SD) to 70.6±14.02 kg (pSeventh-day Adventists than in controls who never observed the diet and avail the lifestyle programs. The parameters were nonsignificantly changed one year after finishing the retreat in the sample of 68 persons showing the positive effect of retreats. Our results showed, that the intake of a low-fat, low-energy diet, over the course of one week in a stress-free environment, had positive impact on the risk factors of cardiovascular diseases. PMID:19256282
Full Text Available Objectives : To study tile socio-economic and maternal risk factors associated with low birth weight babies and to measure the strength of association. Study Design : Hospital based case-control study. Setting : Shri Sayajirao General Hospital, Vadodara. Sample size : 312 cases and 312 controls. Participants : Cases Mothers who delivered single, live baby less than 2500 gms i.e. low birth weight. Controls:- Mothers who delivered single live baby more than 2500 gms. Study Variable : Maternal age, literacy, anaemia, outcome of last pregnancy. Statistical Analysis : Chi-square test and odd’s ratio. Result : Among cases, 14.5% mothers had age less titan 20 yrs as compared to 7.3% mothers in control group. 68.6% mothers amongst cases were illiterate against 46.5% mothers in control group. 53.8% mothers had haemoglobin level 10gm% or less amongst cases and no statistically significant difference was found between low birth weight and outcome of last pregnancy Conclusion : The maternal risk factors associated with low birth weight in mothers attending S.S.G. hospital age maternal anaemia (OR 2.66, illiteracy (OR 2.51, maternal age less than 20 yrs. (OR 2.OS. No association was found between low birth rate and outcome of last pregnancy
Tuggy, M L; Ong, R
We performed a population survey of telemark skiers over two ski seasons to determine specific risk factors for injury. The survey inquired about the skier's sex, experience, equipment used, injuries, and number of days skied in each season. The respondents completed the surveys whether or not they were injured while skiing. We received 677 responses from telemark skiing clubs, with 19,962 skier-days of data. The number of self-reported injuries was 178, for an overall self-reported injury rate of 8.9 per 1000 skier-days. Knee injuries (N = 48) were the most common injury (27%), followed by thumb (N = 32, 18%) and shoulder (N = 21, 12%) injuries. Specific risk factors for injury were identified with multivariate regression and survival analysis. The skill level of the skier had a significant injury-sparing effect, as did the use of plastic telemark boots. The protective effect of the plastic boots was likely due to the increased stability they provided compared with traditional leather boots. There were fewer knee injuries with the recently available releasable bindings for telemark skis. Sex and age had no significant impact on injury rates in this study population. As all reported deaths associated with telemark sking were due to environmental hazards, skiers must continue to pay close attention to these hazards in the backcountry.
Full Text Available Weather and climate risk factors for tourism are surveyed and illustrated with regard to the expected climate changes in Hungary. These changes are not at all advantageous and which affect the business in question both directly and indirectly. These are the summer resort tourism (characterised by bioclimatic indices. Green tourism is the next one to characterise, including skiing, mountain climbing and eco-tourism, as well. Here both day-to-day weather extremes and long-lasting effects on the biota (e.g. drought, or inundation for plain-area eco-tourism. Last, but not least the urban (cultural- and shopping- tourism is presented, since the large towns exhibit their special climate and different risks. The paper intends to specify these meteorological factors and effects also in terms of the different types of touristic activities. The general statements on the effect of weather and climate on tourism are illustrated by a few individual parameters and also by the so called Physiologically Equivalent Temperature. Annual and diurnal course of this parameter are presented, together with various trends in this variable at different sites and in different (hot and cold extremities of the occurring values. Other examples, helping the tourism industry are presented in various climate conditions of the country. They include high precipitation and high relative humidity information. The paper also lists the possible adaptation measures to extreme events and also their likely changes in time.
Full Text Available Aim: Many etiological factors play a role in the occurrence of postoperative empyema. We aimed to define the effects of these factors on the development of empyema. Material and Method: Two hundred and eighty-eight cases from our clinic who underwent tube thoracostomy and/or were operated due to any cause out of the primary empyema between August 2009 and May 2010 were prospectively studied in terms of empyema development. Data comprised gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, sharing the same room with other cases with empyema, primary disease, additional comorbidity, operation duration, drain number, complication, number of patients in the room, and drain discontinuation and hospitalization duration. Blood leukocyte-neutrophil count was ordered in all cases at 3-day intervals, and fluid culture specimens were simultaneously collected from cases with drains. Drainage fluid culture specimens were evaluated with “Automated Identification and Antibiotic Susceptibility Testing” using standard procedures. Empyema cases who developed clinical manifestation and/or with bacterial growth in culture specimens were studied in terms of risk factors. The findings were analyzed using SPSS (version 16. Results: The results showed that gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, and sharing a same room with other empyema cases were not significantly correlated with the risk of empyema development. Contribution of the primary disease (p<0.05, additional comorbidity (p<0.05, operation duration (p<0.05, drain number (p<0.05, complication (p<0.05, number of people in the room (p<0.05, drain discontinuation time (p<0.05 and hospitalization duration (p<0.05 were found to be significant in the development of postoperative empyema. Discussion: Postoperative development of empyema is one
Majeed, R.; Rajar, U.D.M.
To identify the risk factors associated with childhood asthma, in children attending Isra University Hospital, Hyderabad. The study included 398 age-matched children (200 asthmatic and 198 non-asthmatic). Information was collected concerning their familial history of atopy, birth weight, environment, breastfeeding, disease and treatment history. Odds ratio was calculated for determining the risk. The children were aged between 12 months and 8 years and 60% were male. The asthmatic children were hospitalized more frequently than the non-asthmatic children (p < 0.0001). Most of the asthmatic children lived in the urban areas of Hyderabad (odd ratio (OR) 16.7, 95% CI = 3.1-14.6, p < 0.0001), had a parental history of asthma (OR 26.8, 95% CI = 10.8-68.2, p < 0.0001) or allergic rhinitis (OR 4, 95% CI 1.2-13.4, p= 0.01), 38.5% had at least one person who smoked, and were weaned earlier than the non-asthmatic children (OR =12.4, 95% CI 1.3-4.4, p < 0.01). Childhood asthma was strongly associated with a family history of asthma and allergic rhinitis, the urban place of residence, having smokers as parents and early weaning from maternal breast milk. The results highlight the need to educate the parents about the risk of smoking and early weaning in the development of asthma. (author)
Florian Joachim Raabe
Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.
Full Text Available Falls are the leading accidental cause of death among elderly people in their homes. Falls and their consequences are the primary reason in 40% of admissions to hospitals for people older than 65 years. The study population consisted of 77 randomly selected patients of both genders older then 65 years. Each patient was tested in his/her home and was completely informed about the methodology and the goals of investigation. Based on the exclusion criteria, three patients were excluded from the study, which means the investigation was conducted on 27 males (35.06% and 50 females (64.94% with the average age being 71.23 ± 5.63 years.For each patient, a specially prepared questionnaire about risk factors was filled in. The sum of affirmative answers represented a relative index of fall risk. All patients were evaluated through Folstein’s Mini-Mental State Examination Test that is suitable for on-sight use in patient’s home. The score value over 20 excludes dementias, delirium, schizophrenia and affective disorders.Considering the values of the risk factor, scores obtained by the questionnaire and MMSE test scores, statistically significant differences were found between males and females (p < 0.005, respectively p < 0.01, “fallers” and “non-fallers” (p < 0.001, respectively p < 0.01, while considering the relation to the way of living (alone or with family, there were no statistically significant differences (p > 0.05.
Peralta, Claudia; Caspary, Melissa; Boothe, Diane
This study investigates how Latina/Latino youth resist, conform to, and persist in schooling, and explores their preparation for an education in science, technology, engineering and math (STEM) fields. Using Latino Critical Race Theory as a framework, evidence of the "sticky mess" of racial inequalities (Espinoza and Harris in Calif Law Rev 10:499-559, 1997) and the concept of community cultural wealth (Yosso in Race Ethn Educ 8:69-91, 2005) will be used to understand how Latina/o students successfully persist in college. Quantitative and qualitative findings collected at two public universities in 2007-2012 show that Latina/o parents play a significant role in influencing their children's decision to attend college; family, friend and community support and hard work have also been instrumental in college success. This is evident through parents' encouragement to persist, expectations to do well and students serving as role models for siblings and peers. As policy makers in the educational arena emphasize STEM fields, there is a significant opportunity for Latino students to make valuable contributions.
Lígia da Silva Leroy
Full Text Available Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001, multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009, gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02 and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035. CONCLUSION: Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent.
Mahmood, K.; Samo, A.H.; Jairamani, K.L.; Talib, A.
To assess the severity and frequency of hepatotoxicity caused by different antituberculosis (ATT) drugs and to evaluate whether concurrence of risk factors influence the antituberculosis drug induced hepatotoxicity. This prospective cohort study was conducted in Medical Unit-V and OPD department of Civil Hospital Karachi from July 2004 to July 2005. A total of 339 patients diagnosed of active tuberculosis infection with normal pretreatment liver function were monitored clinically as well as biochemically. Their data were collected on proforma and patients were treated with Isoniazid, Rifampicin and Pyrazinamide. Duration after which derangement in function, if any, occurred and time taken for normalization was noted. Treatment was altered as needed, with exclusion of culprit drug. Finally data was analyzed by SPSS version 10.0. ATT induced hepatotoxicity was seen in 67 (19.76%) out of 339 patients. Females were more affected as compared to males (26.3% vs. 19.7%). BMI (kg/m2) of 91% of diseased group were less than 18.5 (p<0.01) most of them were anemic having low albumin level suggestive of lean body mass. Hepatotoxicity was more severe in AFB smear positive patients. Concomitant use of alcohol, paracetamol and low serum cholesterol were proved as predisposing factors. Isoniazid (37 patients (55.21%), p<0.01) was the main culprit followed by Rifampicin (23 patients, 34.21%) and Pyrazinamide (7 patients, 10.5%). Most of the patients (61%) developed the hepatotoxicity within two weeks of starting antituberculosis therapy with mild to moderate alteration in ALT and AST. ATT-induced hepatitis is significantly more frequent and more severe in patients with hepatotoxicity risk factors. (author)
Full Text Available Background/Aim. Recurrent vulvovaginal candidiasis is relatively frequent condition, and may have serious health consequences, like chronic vulvovaginal pain syndrome. The aim of our study was to determine possible risk factors for recurrent vulvovaginal candidiasis in non-pregnant females within the reproductive age. Methods. The design of our study was of a case-control type. Case and control patients were selected from the gynecological patients at six primary care facilities in Serbia and in Montenegro. The data on the patients' health condition, concomitant therapy and diseases were taken from their records, and the data on habits were obtained by unstructured interview. For potential risk factors crude odds ratios were calculated, and then adjusted by logistic regression. Results. A total of fifty-one patients had four or more episodes of vulvovaginal candidiasis during the last year (cases, and 132 patients with one to three episodes of vulvovaginal candidiasis were sampled as controls, matched by age. The only two significant associations were found between recurrent vulvovaginal candidiasis and continual wearing of panty liners during the last year (Odds ratio - ORadjusted: 3.97; confidence interval - CI: 1.57-10.02; p = 0.004, and between recurrent vulvovaginal candidiasis and predominant use of vaginal tampons during menstruation in the last year (ORadjusted: 4.25; CI: 1.11-16.27; p = 0.035. The synergistic effect was observed for the concurrent continual wearing of panty liners during the last year and selfmedication with antimycotics. Conclusions. Local factors, like wearing of panty liners or use of tampons during menstruation, may promote recurrence of vulvovaginal candidiasis, especially in patients who practice selfmedication with antimycotics.
Chawes, Bo L; Bønnelykke, Klaus; Stokholm, Jakob; Vissing, Nadja H; Bjarnadóttir, Elín; Schoos, Ann-Marie M; Wolsk, Helene M; Pedersen, Tine Marie; Vinding, Rebecca K; Thorsteinsdóttir, Sunna; Arianto, Lambang; Hallas, Henrik W; Heickendorff, Lene; Brix, Susanne; Rasmussen, Morten A; Bisgaard, Hans
Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of vitamin D supplementation to pregnant women is unknown. To determine whether supplementation of vitamin D3 during the third trimester of pregnancy reduces the risk of persistent wheeze in the offspring. A double-blind, single-center, randomized clinical trial conducted within the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort. Enrollment began March 2009 with a goal of 708 participants, but due to delayed ethical approval, only 623 women were recruited at 24 weeks of pregnancy. Follow-up of the children (N = 581) was completed when the youngest child reached age 3 years in March 2014. Vitamin D3 (2400 IU/d; n = 315) or matching placebo tablets (n = 308) from pregnancy week 24 to 1 week postpartum. All women received 400 IU/d of vitamin D3 as part of usual pregnancy care. Age at onset of persistent wheeze in the first 3 years of life. Secondary outcomes included number of episodes of troublesome lung symptoms, asthma, respiratory tract infections, and neonatal airway immunology. Adverse events were assessed. Of the 581 children, persistent wheeze was diagnosed during the first 3 years of life in 47 children (16%) in the vitamin D3 group and 57 children (20%) in the control group. Vitamin D3 supplementation was not associated with the risk of persistent wheeze, but the number of episodes of troublesome lung symptoms was reduced, and the airway immune profile was up-regulated (principal component analysis, P = .04). There was no effect on additional end points. Intrauterine death was observed in 1 fetus (vitamin D3 group vs 3 fetuses (1%) in the control group and congenital malformations in 17 neonates (5%) in the vitamin D3 group vs 23 neonates (8%) in the control group. [table: see text]. The use of 2800 IU/d of vitamin D3 during the third trimester of pregnancy
Opal, S; Garg, S; Jain, J; Walia, I
This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease. © 2015 Australian Dental Association.
Risk factors for multidrug resistant tuberculosis patients in Amhara National ... risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia. ... strict adherence to directly observed therapy, appropriate management of TB ...
Conclusions: skipping breakfast is associated with increased risk of MetS and other cardiometabooic factors in children and adolescents. Promoting the benefit of eating breakfast could be a simple and important implication to prevent these risk factors.
Ostergaard, Lars; Børrestad, Line A B; Tarp, Jakob
To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children.......To investigate whether bicycling to school improves cardiometabolic risk factor profile and cardiorespiratory fitness among children....
Hollnagel, Hanne; Malterud, Kirsti
autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis......autonomy, communication, empowerment, epidemiology, general practice, healing, health resources, informed consent, preventive medicine, risk factors, salutogenesis...
ifiable risk factors for the infection in humans in post conflict Northern Uganda. Methods: The .... models. Goodness of fit for the final model was assessed using Hosmer and Lemeshow goodness of fit test. Results .... Quantifying risk factors.
Okroglic, S.; Widmann, C.N.; Urbach, H.; Scheltens, P.; Heneka, M.T.
Objective: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated
Risk factors for surgical site infections following clean orthopaedic operations. ... the host and environmental risk factors for surgical site infections following clean ... Materials and Methods: Consecutive patients who satisfied the inclusion ...
... Risk Factors for Bone Loss Bed Rest and Immobilization: Risk Factors for Bone Loss Like muscle, bone ... complications of pregnancy; and those who are experiencing immobilization of some part of the body because of ...
ISSN: 1596-5996 (print); 1596-9827 (electronic) ... Abstract. Purpose: To explore the literature regarding prevalance, risk factors and the involvement of ..... Cigarette smoking and other vascular risk factors in vasculogenic impotence. Urology.
Gurgel, Léia Gonçalves; Vidor, Deisi Cristina Gollo Marques; Joly, Maria Cristina Rodrigues Azevedo; Reppold, Caroline Tozzi
To conduct a systematic review of literature production related to risk factors for proper oral language development in children. We used the terms "child language," "risk factors," and "randomized controlled trial" in MEDLINE (accessed via PubMed), Lilacs, SciELO, and The Cochrane Library from January 1980 to February 2014. Randomized controlled trials involving the study of some risk factors related to child language were included. Works with individuals who were not from the age group 0-12 years and presented no reliable definition of risk factors were excluded. The research findings were classified according to their theme and categorized methodological aspects. We observed the lack of a standardized list of risk factors for language available for health professionals. The main risk factor mentioned was family dynamics, followed by interaction with parents, immediate social environment, and encouragement given to the child in the first years of life. It was also observed that organic hazards such as brain injury, persistent otitis media, and cardiac surgery, besides the type of food and parental counseling, may be related to language disorders. More randomized controlled trials involving the evaluation of risk factors for child language and the creation of further studies involving children above 6 years of age and males are needed.
Full Text Available This paper present review and analysis of risk factors, which could affect successful implementation of ERP system, for project performed in project oriented organizations. Presented risk breakdown structure and the list of common risk factors, are well-suited for ERP implementation projects. Considered risk categories allow for complex risk analysis. Additionally, mapping of risk importance for particular implementation phases is presented. Making presented model an important input for project risk management process, especially for the beginning phases which require identification of risk factors.
Hvelplund, Carolina; Hansen, Bo Mølholm; Koch, Susanne Vinkel
OBJECTIVE: To describe the incidence, age at diagnosis, and associations between perinatal risk factors of feeding and eating disorders (FED) diagnosed at hospital in children aged 0 to 3 years. METHODS: A nationwide cohort of 901 227 children was followed until 48 months of age in the national...... in the clinical management of young children with persistent problems of feeding, eating, and weight faltering....
Наталья Витальевна Батырева
Full Text Available The aim of the research – assess risk factors for very preterm delivery in the Omsk region. Materials and methods. The main group comprised women with very preterm delivery (n = 64; сomparison group – pregnant women with a threat of interruption in terms of 22-27 weeks and successful preserving therapy (n = 63; control group – pregnant women in whom this pregnancy was taking place without the threat of interruption (n = 62. Results. Risk factors for very preterm delivery were bacterial vaginosis, specific vaginitis, kidney disease and the threat of interruption. There was a significant lead in streptococci (32.3 ± 5.8 %, especially group B (19.0 ± 4.9 % in the main group. The risk factor for very preterm delivery was infectious viral diseases transferred during pregnancy, observed in 12.7 ± 4.2 % of women in the main group, in 7.8 ± 3.3 % in the comparison group (p < 0.01 and in 4.8 ± 2,7 % – control (p < 0,001. In the main group, placental insufficiency was 2 times more common than in the comparison group and 13 times than in the control group. Every sixth pregnant of the main group had manifestations of gestosis. Such complications of gestation as the premature detachment of the normally inserted placenta (7.8 ± 3.3 % and inborn malformations of a fruit (1.6 ± 1.6 % were observed only in the main group. Conclusion. The results of the research and literature data showed that the significant influence on the level of very early premature births is due to: the age of the parents, the abuse of nicotine, alcohol, drugs, abortion, preterm birth, urinary tract and genital tract infections, severe somatic diseases, multiple pregnancies. In the structure of complications of gestation during miscarriages, placental insufficiency predominates, the threat of abortion, fetal growth retardation, and polyhydramnios.
Full Text Available Introduction: Ectopic pregnancy is a pregnancy with extrauterine implantation. This situation is gynecologic emergency that contributes to maternal mortality. Therefore, early recognition, based on identification of the causes of ectopic pregnancy risk factors, is needed. Methods: The design descriptive observational. The samples were pregnant women who had ectopic pregnancy at Maternity Room, Emergency Unit, Dr. Soetomo Hospital, Surabaya, from 1 July 2008 to 1 July 2010. Sampling technique was total sampling using medical records. Result: Patients with ectopic pregnancy were 99 individuals out of 2090 pregnant women who searched for treatment in Dr. Soetomo Hospital. However, only 29 patients were accompanied with traceable risk factors. Discussion:. Most ectopic pregnancies were in the age group of 26-30 years, comprising 32 patients (32.32%, then in age groups of 31–35 years as many as 25 patients (25.25%, 18 patients in age group 21–25 years (18.18%, 17 patients in age group 36–40 years (17.17%, 4 patients in age group 41 years and more (4.04%, and the least was in age group of 16–20 years with 3 patients (3.03%. A total of 12 patients with ectopic pregnancy (41.38% had experience of abortion and 6 patients (20.69% each in groups of patients with ectopic pregnancy who used family planning, in those who used family planning as well as ectopic pregnancy patients with history of surgery. There were 2 patients (6.90% of the group of patients ectopic pregnancy who had history of surgery and history of abortion. The incidence rate of ectopic pregnancy was 4.73%, mostly in the second gravidity (34.34%, whereas the nulliparous have the highest prevalence of 39.39%. Acquired risk factors, i.e. history of operations was 10.34%, patients with family planning 20.69%, patients with history of abortion 41.38%, patients with history of abortion and operation 6.90% patients with family and history of abortion was 20.69%.
Perez-Nieves, Magaly; Kabul, Samaneh; Desai, Urvi; Ivanova, Jasmina I; Kirson, Noam Y; Cummings, Alice Kate; Birnbaum, Howard G; Duan, Ran; Cao, Dachuang; Hadjiyianni, Irene
To assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in the US. People aged ≥18 years diagnosed with T2DM initiating basal insulin between April 2006 and March 2012 (index date), no prior insulin use, and continuous insurance coverage for 6 months before (baseline) and 24 months after index date (follow-up period) were selected using de-identified administrative claims data in the US. Based on whether there were ≥30 day gaps in basal insulin use in the first year post-index, patients were classified as continuers (no gap), interrupters (≥1 prescription after gap), and discontinuers (no prescription after gap). Factors associated with persistence - assessed using multinomial logistic regression model; annual healthcare resource use and costs during follow-up period - compared separately between continuers and interrupters, and continuers and discontinuers. Of the 19,110 people included in the sample (mean age: 59 years, ∼60% male), 20% continued to use basal insulin, 62% had ≥1 interruption, and 18% discontinued therapy in the year after initiation. Older age, multiple antihyperglycemic drug use, and injectable antihyperglycemic use during baseline were associated with significantly higher likelihoods of continuing basal insulin. Relative to interrupters and discontinuers, continuers had fewer emergency department visits, shorter hospital stays, and lower medical costs (continuers: $10,890, interrupters: $13,674, discontinuers: $13,021), but higher pharmacy costs (continuers: $7449, interrupters: $5239, discontinuers: $4857) in the first year post-index (p US. In addition, persistence patterns were assessed using administrative claims as opposed to actual medication-taking behavior and did not account for measures of glycemic control. Further research is needed to understand the reasons behind basal insulin persistence and the implications thereof, to help
CV risk profile of the group according to the risk score system developed by the ... an individual has about CVD, and the possible risk factors contributing to the .... levels in the lowest tertile of CVD knowledge versus the highest tertile of CVD ..... CV risk factors and health behavior counseling, much can be done to prevent ...
Søborg, Bolette; Andersen, Aase Bengaard; Melbye, Mads
To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection.......To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection....
Vascular access complications and risk factors in hemodialysis patients: A single center study. ... Stenosis was the most common risk factor for vascular failure as it occurred in (29%) of patients. ... Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.
de Borst, Martin H.; de Boer, Rudolf A.; Stolk, Ronald P.; Slaets, Joris P. J.; Wolffenbuttel, Bruce H. R.; Navis, Gerjan
In the Western world, the majority of morbidity and mortality are caused by multifactorial diseases. Some risk factors are related to more than one type of disease. These so-called universal risk factors are highly relevant to the population, as reduction of universal risk factors may reduce the
Conclusion: DCM and cardiac sarcoidosis were identified as risk factors for amiodarone-induced hyperthyroidism. Risk factors for amiodarone-induced hypothyroidism included higher baseline TSH level and lower baseline free T4 level, suggesting that subclinical hypothyroidism may be a potential risk factor for the development of amiodarone-induced hypothyroidism.
Cursoux, Pauline; Lehucher-Michel, Marie-Pascale; Marchetti, Hélène; Chaumet, Guillaume; Delliaux, Stéphane
The burnout syndrome is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment in individuals professionally involved with others. The burnout syndrome is poorly recognized, particularly in France, as a distinct nosology from adaptation troubles, stress, depression, or anxiety. Several tools quantifying burnout and emotional exhaustion exist, the most spread is the questionnaire called Maslach Burnout Inventory. The burnout syndrome alters cardiovascular function and its neuroregulation by autonomic nervous system and is associated with: increased sympathetic tone to heart and vessels after mental stress, lowered physiological post-stress vagal rebound to heart, and lowered arterial baroreflex sensitivity. Job strain as burnout syndrome seems to be a real independent cardiovascular risk factor. Oppositely, training to manage emotions could increase vagal tone to heart and should be cardio-protective. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Full Text Available 150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain guidelines are offered which may be of value in decision making, in prophylactic detachment surgery. Tractional breaks in the superior temporal quadrant especially when symptomatic. mandate prophylactic treatment. Urgency is enhanced it′ the patient is aphakic. Associated myopia adds to the urgency. The higher incidence of initial right e′ e involvement in all groups suggests a vascular original possibly ischaemic.
Full Text Available Cholangiocarcinoma (CCA is a very aggressive and lethal tumor, which arises from the epithelial cells of bile ducts. CCA comprises about 3% of all gastrointestinal malignancies and its incidence is on the rise in the recent years. Anatomically, it is classified into intrahepatic, perihilar, or extrahepatic (distal CCA. There are a number of risk factors associated with CCA including primary sclerosing cholangitis, fibropolycystic liver disease, parasitic infection, viral hepatitis, chronic liver disease, and genetic disorders like Lynch syndrome. Autoimmune hepatitis is also recently reported to have an association with development of CCA. We report an interesting case of perihilar CCA in the setting of autoimmune hepatitis along with a literature review. This case highlights the importance of early treatment and close clinical follow-up of patients with autoimmune hepatitis for development of CCA.
Abad, Neetu; Malik, Tasneem; Ariyarajah, Archchun; Ongpin, Patricia; Hogben, Matthew; McDonald, Suzanna L R; Marrinan, Jaclyn; Massaquoi, Thomas; Thorson, Anna; Ervin, Elizabeth; Bernstein, Kyle; Ross, Christine; Liu, William J; Kroeger, Karen; Durski, Kara N; Broutet, Nathalie; Knust, Barbara; Deen, Gibrilla F
During the 2014-2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants' individual test results. The behavioral counseling protocol enabled study staff to translate the study's body fluid test results into individualized information for study participants. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries.
Kurzenhäuser, S; Epp, A
This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals.
Suarez-Munoz, Miguel Angel; Fernandez-Aguilar, Jose Luis; Sanchez-Perez, Belinda; Perez-Daga, Jose Antonio; Garcia-Albiach, Beatriz; Pulido-Roa, Ysabel; Marin-Camero, Naiara; Santoyo-Santoyo, Julio
Cholangiocarcinoma is the second most common primary malignant tumor of the liver. Perihilar cholangiocarcinoma or Klatskin tumor represents more than 50% of all biliary tract cholangiocarcinomas. A wide range of risk factors have been identified among patients with Perihilar cholangiocarcinoma including advanced age, male gender, primary sclerosing cholangitis, choledochal cysts, cholelithiasis, cholecystitis, parasitic infection (Opisthorchis viverrini and Clonorchis sinensis), inflammatory bowel disease, alcoholic cirrhosis, nonalcoholic cirrhosis, chronic pancreatitis and metabolic syndrome. Various classifications have been used to describe the pathologic and radiologic appearance of cholangiocarcinoma. The three systems most commonly used to evaluate Perihilar cholangiocarcinoma are the Bismuth-Corlette (BC) system, the Memorial Sloan-Kettering Cancer Center and the TNM classification. The BC classification provides preoperative assessment of local spread. The Memorial Sloan-Kettering cancer center proposes a staging system according to three factors related to local tumor extent: the location and extent of bile duct involvement, the presence or absence of portal venous invasion, and the presence or absence of hepatic lobar atrophy. The TNM classification, besides the usual descriptors, tumor, node and metastases, provides additional information concerning the possibility for the residual tumor (R) and the histological grade (G). Recently, in 2011, a new consensus classification for the Perihilar cholangiocarcinoma had been published. The consensus was organised by the European Hepato-Pancreato-Biliary Association which identified the need for a new staging system for this type of tumors. The classification includes information concerning biliary or vascular (portal or arterial) involvement, lymph node status or metastases, but also other essential aspects related to the surgical risk, such as remnant hepatic volume or the possibility of underlying disease.
Monma, Takafumi; Ando, Akira; Asanuma, Tohru; Yoshitake, Yutaka; Yoshida, Goichiro; Miyazawa, Taiki; Ebine, Naoyuki; Takeda, Satoko; Omi, Naomi; Satoh, Makoto; Tokuyama, Kumpei; Takeda, Fumi
To clarify sleep disorder risk factors among student athletes, this study examined the relationship between lifestyle habits, competition activities, psychological distress, and sleep disorders. Student athletes (N = 906; male: 70.1%; average age: 19.1 ± 0.8 years) in five university sports departments from four Japanese regions were targeted for analysis. Survey items were attributes (age, gender, and body mass index), sleep disorders (recorded through the Pittsburgh Sleep Quality Index), lifestyle habits (bedtime, wake-up time, smoking, drinking alcohol, meals, part-time jobs, and use of electronics after lights out), competition activities (activity contents and competition stressors), and psychological distress (recorded through the K6 scale). The relation between lifestyle habits, competition activities, psychological distress, and sleep disorders was explored using logistic regression analysis. Results of multivariate logistic regression analysis with attributes as adjustment variables showed that "bedtime," "wake-up time," "psychological distress," "part-time jobs," "smartphone/cellphone use after lights out," "morning practices," and "motivation loss stressors," were risk factors that were independently related to sleep disorders. Sleep disorders among student athletes are related to lifestyle habits such as late bedtime, early wake-up time, late night part-time jobs, and use of smartphones/cellphones after lights out; psychological distress; and competition activities such as morning practices and motivation loss stressors related to competition. Therefore, this study suggests the importance of improving these lifestyle habits, mental health, and competition activities. Copyright © 2017 Elsevier B.V. All rights reserved.
Gentile, Douglas A; Berch, Olivia N; Choo, Hyekyung; Khoo, Angeline; Walsh, David A
Mass media have numerous effects on children, ranging from influencing school performance to increased or reduced aggression. What we do not know, however, is how media availability in the bedroom moderates these effects. Although several researchers have suggested that bedroom media may influence outcomes by displacing other activities (the displacement hypothesis) or by changing the content of media consumed (the content hypothesis), these have rarely been tested directly. This study tested both hypotheses using several outcomes that are associated with bedroom media and some of the underlying mediating mechanisms. The hypotheses were tested using 3 longitudinal samples of varying methods, age, duration, and country. The results indicate that children who have bedroom media are likely to watch larger amounts of screen time which displaced important activities, such as reading and sleeping, which mediated later negative outcomes such as poor school performance. Bedroom media also influence risk for obesity and video game addiction. Children with bedroom media are also likely to be exposed to more media violence. The violent content increased normative beliefs about aggression, which increased physical aggression, providing support for the content hypothesis. This study demonstrates that media can have effects not just from what they show, but also because of what children are not exposed to. Bedroom media are therefore a robust risk factor for several aspects of child development. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Full Text Available Objectives. To investigate a prevalence of caries, filled permanentand extracted permanent teeth, as well as caries risk factors inschool children aged 7, 9 and 11.Methods. The survey included 800 children (296 children aged7; 254 children aged 9 and 250 children aged 11 from the MostarMunicipality, 400 of them living in both rural and urban areas.A dental mirror and standard light of dental chair were used forexamination. The DMF index (Dental Caries, Missing Teeth andFilled Teeth was determined, as well as failure in keeping teethhygiene, sugar intake with food, and incidence of oral cavity infection.Results. The dental state of permanent teeth in children aged 7and 9 has shown significant difference between the children fromrural and urban areas (p < 0,001. Out of 2,698 and 2,790 permanentteeth in children aged 11 from rural and urban areas, 1,086(40,25 % and 884 (31.68 % had caries, respectively (p < 0.01.The difference between these groups of children has been foundin relation to the index of oral hygiene too (p < 0.05.Conclusion. An identification of risk groups for getting caries wasvery important and could help health and social structures to maintaintheir programs in order to improve oral health.
Alijahan, Rahele; Kordi, Masoumeh
Background: Detection of women at risk for dystocia will allow physicians to make preparations and treatment decisions that can minimize maternal and neonatal morbidity. We aimed to determine the risk factors for dystocia in nulliparous women. Methods: This case series enrolled 447 nulliparous women who presented with a single pregnancy in the vertex presentation and gestational age of 38-42 weeks. Maternal anthropometric measurements were obtained upon admission. We defined dystocia as a cesarean section or vacuum delivery for abnormal progression of labor as evidenced by the presence of effective uterine contractions, cervical dilation of less than 1 cm/h in the active phase for 2 h, duration of the second stage beyond 2 h, or fetal head descent less than 1 cm/h. Data were analyzed by SPSS software version 11.5. Kruskal-Wallis, logistic regression, chi-square, Student’s t test and the Mann-Whitney tests were used as appropriated. Results: The state anxiety score (OR=10.58, CI: 1.97-56.0), posterior head position (OR=9.53, CI: 4.68-19.36), fetal head swelling in the second stage of labor (OR=6.85, CI: 2.60-18.01), transverse diagonal of Michaelis sacral ≤9.6 cm (OR=6.19, CI: 2.49-15.40), and height to fundal ratio dystocia. Conclusion: Critical care during labor and delivery in women who have a height to fundal height ratio of dystocia. PMID:24850982
Jahromi, Alireza Hamidian; Roozbeh, Jamshid; Raiss-Jalali, Ghanbar Ali; Dabaghmanesh, Alireza; Jalaeian, Hamed; Bahador, Ali; Nikeghbalian, Saman; Salehipour, Mehdi; Salahi, Heshmat; Malek-Hosseini, Ali
It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperparathyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism. (author)
Montalva-Iborra, A; Alcanyis-Alberola, M; Grao-Castellote, C; Torralba-Collados, F; Giner-Pascual, M
In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as Pinjury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.
Full Text Available The World Health Organization (WHO recognized diabetes as one of the four most important and priority health issues out of non-communicable diseases. According to a report by the WHO with the year 2016 the prevalence of diabetes for 3 decades and continues to grow, this problem applies to the entire world. In 2014. the number of diabetes patients brought the 422 million, by comparison, in 1980. It was 108 million. A badly aligned metabolically diabetes contributes to the development of numerous complications of micro-and macro-angiopathic, which are related to adverse prognosis and increase the risk of cardiovascular disease. Striving for the best possible alignment of the carbohydrate economy reduces both the mortality and cardiovascular. However, some patients with diabetes intensive glucose control is not effective and increases the incidence of severe hypoglycemia, which in turn some patients increases cardiovascular mortality. The aim of the work is the appearance of hypoglycemia as a factor that increases the risk of death in cardiovascular diseases. The work also emphasises the importance of cardiovascular diseases in diabetes, which are the most common complication of diabetes and the most common cause of death in this group of patients.
Chrubasik, Sigrun A; Chrubasik, Cosima A; Piper, Jörg; Schulte-Moenting, Juergen; Erne, Paul
In models and scores for estimating cardiovascular risk (CVR), the relative weightings given to blood pressure measurements (BPMs), and biometric and laboratory variables are such that even large differences in blood pressure lead to rather low differences in the resulting total risk when compared with other concurrent risk factors. We evaluated this phenomenon based on the PROCAM score, using BPMs made by volunteer subjects at home (HBPMs) and automated ambulatory BPMs (ABPMs) carried out in the same subjects. A total of 153 volunteers provided the data needed to estimate their CVR by means of the PROCAM formula. Differences (deltaCVR) between the risk estimated by entering the ABPM and that estimated with the HBPM were compared with the differences (deltaBPM) between the ABPM and the corresponding HBPM. In addition to the median values (= second quartile), the first and third quartiles of blood pressure profiles were also considered. PROCAM risk values were converted to European Society of Cardiology (ESC) risk values and all participants were assigned to the risk groups low, medium and high. Based on the PROCAM score, 132 participants had a low risk for suffering myocardial infarction, 16 a medium risk and 5 a high risk. The calculated ESC scores classified 125 participants into the low-risk group, 26 into the medium- and 2 into the high-risk group for death from a cardiovascular event. Mean ABPM tended to be higher than mean HBPM. Use of mean systolic ABPM or HBPM in the PROCAM formula had no major impact on the risk level. Our observations are in agreement with the rather low weighting of blood pressure as risk determinant in the PROCAM score. BPMs assessed with different methods had relatively little impact on estimation of cardiovascular risk in the given context of other important determinants. The risk calculations in our unselected population reflect the given classification of Switzerland as a so-called cardiovascular "low risk country".
Roberts, James J; Fausch, Kurt D; Peterson, Douglas P; Hooten, Mevin B
Impending changes in climate will interact with other stressors to threaten aquatic ecosystems and their biota. Native Colorado River cutthroat trout (CRCT; Oncorhynchus clarkii pleuriticus) are now relegated to 309 isolated high-elevation (>1700 m) headwater stream fragments in the Upper Colorado River Basin, owing to past nonnative trout invasions and habitat loss. Predicted changes in climate (i.e., temperature and precipitation) and resulting changes in stochastic physical disturbances (i.e., wildfire, debris flow, and channel drying and freezing) could further threaten the remaining CRCT populations. We developed an empirical model to predict stream temperatures at the fragment scale from downscaled climate projections along with geomorphic and landscape variables. We coupled these spatially explicit predictions of stream temperature with a Bayesian Network (BN) model that integrates stochastic risks from fragmentation to project persistence of CRCT populations across the upper Colorado River basin to 2040 and 2080. Overall, none of the populations are at risk from acute mortality resulting from high temperatures during the warmest summer period. In contrast, only 37% of populations have a ≥90% chance of persistence for 70 years (similar to the typical benchmark for conservation), primarily owing to fragmentation. Populations in short stream fragments <7 km long, and those at the lowest elevations, are at the highest risk of extirpation. Therefore, interactions of stochastic disturbances with fragmentation are projected to be greater threats than warming for CRCT populations. The reason for this paradox is that past nonnative trout invasions and habitat loss have restricted most CRCT populations to high-elevation stream fragments that are buffered from the potential consequences of warming, but at risk of extirpation from stochastic events. The greatest conservation need is for management to increase fragment lengths to forestall these risks. © 2013
Mercer, James B.
Cardiovascular diseases (CVD) are responsible for around 20% of all deaths worldwide (approximately 14 million) and are the principal cause of death in all developed countries, accounting for 50% of all deaths. Variations in the annual per capita death rates in different countries are well documented. Less well known are seasonal variations in death rates, with the highest levels occurring during the colder winter months, which have been described in many countries. This phenomenon is referred to as excess winter mortality. CVD-related deaths account for the majority of excess winter deaths (up to 70% in some countries), while about half of the remaining are due to increases in respiratory diseases. Paradoxically, CVD mortality increases to a greater extent with a given fall in temperature in regions with warm winters. While much of the indirect evidence points to the notion that cold is somehow involved in explaining excess winter deaths, the mechanism by which seemingly mild exposure to cold ambient conditions can increase the risk of death remains unclear. The strong indirect epidemiological evidence coupling cold climate to mortality may be related to indoor rather than outdoor climatic conditions (e.g., cold/damp houses versus arm/dry houses) coupled with a plethora of factors including health status, ageing-related deterioration in physiological and behavioral thermoregulation, toxicology, and socioeconomic factors
Full Text Available Over the last two decades, the amount of evidence corroborating an association between dental plaque bacteria and coronary diseases that develop as a result of atherosclerosis has increased. These findings have brought a new aspect to the etiology of the disease. There are several mechanisms by which dental plaque bacteria may initiate or worsen atherosclerotic processes: activation of innate immunity, bacteremia related to dental treatment, and direct involvement of mediators activated by dental plaque and involvement of cytokines and heat shock proteins from dental plaque bacteria. There are common predisposing factors which influence both periodontitis and atherosclerosis. Both diseases can be initiated in early childhood, although the first symptoms may not appear until adulthood. The formation of lipid stripes has been reported in 10-year-old children and the increased prevalence of obesity in children and adolescents is a risk factor contributing to lipid stripes development. Endothelium damage caused by the formation of lipid stripes in early childhood may lead to bacteria penetrating into blood circulation after oral cavity procedures for children as well as for patients with aggressive and chronic periodontitis.
From the point of view of occupational health, the field of voice disorders is very poorly developed as compared, for instance, to the prevention and diagnostics of occupational hearing disorders. In fact, voice disorders have not even been recognized in the field of occupational medicine. Hence, it is obviously very rare in most countries that the voice disorder of a professional voice user, e.g. a teacher, a singer or an actor, is accepted as an occupational disease by insurance companies. However, occupational voice problems do not lack significance from the point of view of the patient. We also know from questionnaires and clinical studies that voice complaints are very common. Another example of job-related health problems, which has proved more successful in terms of its occupational health status, is the repetition strain injury of the elbow, i.e. the "tennis elbow". Its textbook definition could be used as such to describe an occupational voice disorder ("dysphonia professional is"). In the present paper the effects of such risk factors as vocal loading itself, background noise and room acoustics and low relative humidity of the air are discussed. Due to individual factors underlying the development of professional voice disorders, recommendations rather than regulations are called for. There are many simple and even relatively low-cost methods available for the prevention of vocal problems as well as for supporting rehabilitation.
Objectives. To investigate the causes of persistent, apparently permanent hypernasal speech following adenoidectomy in 10 subjects without overt cleft palates, and to establish a protocol to be followed before this operation is perfonmed. Design. Retrospective and descriptive design. Participants. Ten subjects, fulfilling the ...
Sánchez-Rodríguez, Martha A; Zacarías-Flores, Mariano; Arronte-Rosales, Alicia; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel
The aim of this study was to determine the influence of menopause (hypoestrogenism) as a risk factor for oxidative stress. We carried out a cross-sectional study with 187 perimenopausal women from Mexico City, including 94 premenopausal (mean ± SD age, 44.9 ± 4.0 y; estrogen, 95.8 ± 65.7 pg/mL; follicle-stimulating hormone, 13.6 ± 16.9 mIU/mL) and 93 postmenopausal (mean ± SD age, 52.5 ± 3.3 y; estrogen, 12.8 ± 6.8 pg/mL; follicle-stimulating hormone, 51.4 ± 26.9 mIU/mL) women. We measured lipoperoxides using a thiobarbituric acid-reacting substance assay, erythrocyte superoxide dismutase and glutathione peroxidase activities, and the total antioxidant status with the Randox kit. An alternative cutoff value for lipoperoxide level of 0.320 μmol/L or higher was defined on the basis of the 90th percentile of young healthy participants. All women answered the Menopause Rating Scale, the Athens Insomnia Scale, and a structured questionnaire about pro-oxidant factors, that is, smoking, consumption of caffeinated and alcoholic beverages, and physical activity. Finally, we measured weight and height and calculated body mass index. The lipoperoxide levels were significantly higher in the postmenopausal group than in the premenopausal group (0.357 ± 0.05 vs 0.331 ± 0.05 μmol/L, P = 0.001). Using logistic regression to control pro-oxidant variables, we found that menopause was the main risk factor for oxidative stress (odds ratio, 2.62; 95% CI, 1.35-5.11; P menopause rating score, insomnia score, and lipoperoxides, and this relationship was most evident in the postmenopausal group (menopause scale, r = 0.327 [P = 0.001]; insomnia scale, r = 0.209 [P < 0.05]). Our findings suggest that the depletion of estrogen in postmenopause could cause oxidative stress in addition to the known symptoms.
Blaha, L.; Cupr, P.; Dusek, L.; Hilscherova, K.; Holoubek, I.; Klanova, J.
Substances that are persistent and bioaccumulative often posses toxic characteristics and cause adverse human health or environmental effects. Basic objective of the long-term research project INCHEMBIOL undertaken by the Centre RECETOX are the complex studies of interactions among chemical compounds present in environmental compartments and their biological effects and studies of the fate of mainly persistent chemical compounds in the environment, their effects on the environment and living organisms including human. Destiny in this concept consists of a summary of transport (from their input in the environment, transport within the environmental compartment, where they are discharged, transport among compartments and long-range transport in the environment) and transformation processes (abiotic and biotic transformations). It also includes study of distribution equilibriums, properties conditioning their environmental behaviour, study of the transformation processes and their products. This complex approach is a part of long-term research activities of the centre RECETOX. In the contribution methods used and results obtained in exploration of the causality among chemical (presence of chemical compounds in the environment) and biological (mechanisms of effects on the living organisms) are described.
Korn, Gustavo Polacow; Augusto de Lima Pontes, Antonio; Abranches, Denise; Augusto de Lima Pontes, Paulo
To characterize the presence of hoarseness and the risk factors in male and female university teachers in private institutions in the city of São Paulo, Brazil. Cross-sectional survey. Voice self-evaluation forms prepared by the Brazilian Ministry of Labor were administered to 846 university teachers in a private institution in the city of São Paulo, Brazil. Prevalence of hoarseness in the sample is 39.6%. Percentage of hoarseness is higher in females (51.8%) than in males (32.6%). Comparing hoarseness and time of teaching, it was observed that the percentage of hoarseness is lower in a time shorter or equal to 1 year, and it is higher in a time between 10 and 20 years. Percentage of hoarseness is lower in the maximum workload of one to three class hours per day compared with the other workloads. Percentage of hoarseness is lower when the maximum number of students per classroom is less than 30 than when it is between 101 and 150 students. Other factors like in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life are related to the presence of hoarseness. University teachers show high percentage of hoarseness. Factors, such as time of teaching, females, work organization, workplace, in terms of noise and sound competition, air pollution, and in terms of causing stress and anxiety, besides habits and style/quality of life, are related to the presence of hoarseness in this group. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Geoffrey M Jacquez
Full Text Available In case control studies disease risk not explained by the significant risk factors is the unexplained risk. Considering unexplained risk for specific populations, places and times can reveal the signature of unidentified risk factors and risk factors not fully accounted for in the case-control study. This potentially can lead to new hypotheses regarding disease causation.Global, local and focused Q-statistics are applied to data from a population-based case-control study of 11 southeast Michigan counties. Analyses were conducted using both year- and age-based measures of time. The analyses were adjusted for arsenic exposure, education, smoking, family history of bladder cancer, occupational exposure to bladder cancer carcinogens, age, gender, and race.Significant global clustering of cases was not found. Such a finding would indicate large-scale clustering of cases relative to controls through time. However, highly significant local clusters were found in Ingham County near Lansing, in Oakland County, and in the City of Jackson, Michigan. The Jackson City cluster was observed in working-ages and is thus consistent with occupational causes. The Ingham County cluster persists over time, suggesting a broad-based geographically defined exposure. Focused clusters were found for 20 industrial sites engaged in manufacturing activities associated with known or suspected bladder cancer carcinogens. Set-based tests that adjusted for multiple testing were not significant, although local clusters persisted through time and temporal trends in probability of local tests were observed.Q analyses provide a powerful tool for unpacking unexplained disease risk from case-control studies. This is particularly useful when the effect of risk factors varies spatially, through time, or through both space and time. For bladder cancer in Michigan, the next step is to investigate causal hypotheses that may explain the excess bladder cancer risk localized to areas of
Gante, Inês; Ferreira, Ana Carina; Pestana, Gonçalo; Pires, Daniela; Amaral, Njila; Dores, Jorge; do Céu Almeida, Maria; Sandoval, José Luis
Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.
Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos
factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD......Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD...
Martin-Martin, Sergio; Pascual-Fernandez, Angela; Alvarez-Colomo, Cristina; Calvo-Gonzalez, Raul; Muñoz-Moreno, Marife; Cortiñas-Gonzalez, Jose Ramon
To determine the prevalence of urinary incontinence (UI) before pregnancy, in the third trimester and postpartum. To analyze its influence on quality of life and associated potential risk factors and the efficacy of pelvic floor exercises. Prospective study in 413 pregnant women. The modified ICIQ-SF incontinence questionnaire was given to the pregnant women at the end of the third quarter. This questionnaire was administered by telephone at 3 and 6 months postpartum. The influence of several risk factors for UI in pregnancy and postpartum were analyzed. Patients with persistent UI at 6 months postpartum were trained to do pelvic floor exercises. Patients with UI before pregnancy were excluded from the study. UI in the third trimester was 31%. Analyzed risk factors did not condition a higher percentage of UI. Prevalence of UI was 11.3% at 3 months postpartum and 6.9% at 6 months. 70% of the incontinent patients already had it during pregnancy and it appeared de novo post-delivery in 30% of the patients. Prevalence of UI after delivery was higher in women with UI in pregnancy and lower in caesarean cases. Most women improved with pelvic floor exercises. Analysed risk factors did not significantly increase UI in pregnancy. Prevalence of UI after delivery is higher in women with UI in pregnancy and lower in caesarean cases. Postpartum pelvic floor exercises for three months in patients with persistent stress UI at 6 months postpartum clearly improved the degree of continence.
Indetermination of modern economy conditions and the lack of theoretical knowledge gained by domestic scientists about risk in factoring business actualize the research concerning the methodology and technique of factoring companies’ risk management. The article examines compliance which is the technology innovative for Ukrainian market of factoring risk management technologies. It is determined that the compliance is the risk management process directed to free will correspondence to sta...
Grace Vincent-Onabajo; Taritei Moses
Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...
Czerwińska, Maja; Hołowko, Joanna; Stachowska, Ewa
Professional driver is an occupation associated with high health risk. The factors which increase the risk of developing lifestyle diseases are closely related to working conditions. The aim of this study was to analyse the risk factors which are associated with professional drivers’ lifestyle. The material consisted of 23 articles from PubMed.gov. Risk factors related to drivers’ work have a signiicant impact on their health.
Full Text Available Patrick Olivieri,1 Bruce Solitar,2,* Michel Dubois3,*1NYU School of Medicine, New York, NY, USA; 2Department of Rheumatology, 3Department of Pain Management, New York University Langone Medical Center, New York, NY, USA*These authors contributed equally to this workBackground: Fibromyalgia is a disease process without an obvious etiology. While some evidence suggests that adverse experiences in childhood contribute to its development, specific evidence has been equivocal.Methods: A total of 36 patients with fibromyalgia from the greater New York area were recruited and surveyed using the Centers for Disease Control's Behavioral Risk Factor Surveillance System survey, and questions from the section on adverse childhood experiences were administered. The results were compared to those obtained from over 400,000 people surveyed by the Centers for Disease control each year, and were monitored for statistically significant differences.Results: A statistically significant difference was noted among the control group, suggesting that individuals reported growing up with someone who was depressed when the respondents were between the ages of 0 and 18 years old. Moreover, respondents reported that they were hit by their parents in some way, were insulted or cursed at by their parents, and had been forced to have sex with someone at least 5 years older than them or with an adult. No correlation was found with the following variables and the development of fibromyalgia: growing up with divorced or separated parents; growing up with someone sentenced to serve time in jail; or having parents that abused each other. Additionally, statistically significant differences were found for the following categories: lack of emotional support; life dissatisfaction; fair or poor health; physical, mental or emotional disability; and being divorced or not married.Discussion: Using this well-validated survey, it became clear that at least six specific adverse childhood
Raj Krishna Dangol
Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.
Stoll, C; Alembik, Y; Dott, B; Roth, M P
Risk factors were studied in 123 children with limb reduction defects (LRD) from 118,265 consecutive births of known outcome during the period from 1979 to 1987 in the area which is covered by our registry of congenital malformations. For each case a control was studied. The LRD was localised and classified according to the EUROCAT guide for the description and classification of limb defects. The prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0% were late spontaneous abortion or stillborn and termination was performed in 4.0% of the cases. The proportion of males was 0.55. The most common malformations in the 51.2% of children who had at least one other anomaly than LRD were associated cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was more often complicated by oligohydramnios, polyhydramnios and threatened abortion but there were no differences in parental characteristics. However, 9.7% of marriages were consanguineous (P less than 0.01) and the incidence of LRD in first-degree relatives of the children with LRD was high. First-degree relatives also had more non-limb malformations than did those of controls.
Webster, Joan; McGrail, Matthew; Marsh, Nicole; Wallis, Marianne C.; Ray-Barruel, Gillian; Rickard, Claire M.
Objective. To document the incidence of postinfusion phlebitis and to investigate associated risk factors. Design. Analysis of existing data set from a large randomized controlled trial, the primary purpose of which was to compare routine peripheral intravascular catheter changes with changing catheters only on clinical indication. Participants and Setting. Patients admitted to a large, acute general hospital in Queensland, Australia, and who required a peripheral intravenous catheter. Results. 5,907 PIVCs from 3,283 patients were studied. Postinfusion phlebitis at 48 hours was diagnosed in 59 (1.8%) patients. Fifteen (25.4%) of these patients had phlebitis at removal and also at 48 hours after removal. When data were analyzed per catheter, the rate was lower, 62/5907 (1.1%). The only variable associated with postinfusion phlebitis was placement of the catheter in the emergency room (P = 0.03). Conclusion. Although not a common occurrence, postinfusion phlebitis may be problematic so it is important for health care staff to provide patients with information about what to look for after an intravascular device has been removed. This trial is registered with ACTRN12608000445370. PMID:26075092
Full Text Available Objective. To document the incidence of postinfusion phlebitis and to investigate associated risk factors. Design. Analysis of existing data set from a large randomized controlled trial, the primary purpose of which was to compare routine peripheral intravascular catheter changes with changing catheters only on clinical indication. Participants and Setting. Patients admitted to a large, acute general hospital in Queensland, Australia, and who required a peripheral intravenous catheter. Results. 5,907 PIVCs from 3,283 patients were studied. Postinfusion phlebitis at 48 hours was diagnosed in 59 (1.8% patients. Fifteen (25.4% of these patients had phlebitis at removal and also at 48 hours after removal. When data were analyzed per catheter, the rate was lower, 62/5907 (1.1%. The only variable associated with postinfusion phlebitis was placement of the catheter in the emergency room (P=0.03. Conclusion. Although not a common occurrence, postinfusion phlebitis may be problematic so it is important for health care staff to provide patients with information about what to look for after an intravascular device has been removed. This trial is registered with ACTRN12608000445370.
Elflein, H M
Amblyopia is the main cause for mostly monocular, impaired vision in childhood. Treatment and prevention of amblyopia is only effective during childhood. Ophthalmological screening of children does not yet exist in Germany. The prevalence of amblyopia in Germany is 5.6%, which is higher than in reports from studies in Australia; however, the prevalence of amblyopia is not comparable in these studies due to different definitions of amblyopia and the inclusion/exclusion criteria of the study cohorts. At present it is unknown at what age ophthalmological screening should be carried out to prevent amblyopia and the appropriate frequency of screening examinations. Amblyopia is a disorder of the visual cortex that is due to suppression and deprivation of one eye leading to unilateral visual impairment. Approximately 50% of cases of amblyopia are caused by anisometropia, 25% by strabismus and in every sixth person by a combination of both. Other causes, such as unilateral congenital cataracts are relatively rare. A variety of factors, such as ocular pathologies, premature birth, familial disposition and general diseases are associated with an increased risk for amblyopia.
Dika, Sandra L.
While research literature suggests that socioeconomic factors play a role in predicting educational attainment, very little research has been done to examine these relationships using data from Puerto Rico. A logistic regression approach was adopted to investigate the extent to which family and school socioeconomic factors predict retention from…
Beyer, Ditte Maria; Faurschou, Annesofie; Philipsen, Peter Alshede
Recently, we showed that the sun protection factor (SPF) decreases by a constant factor to reach 55% during a day with activities. Organic sunscreens but not inorganic ones are absorbed through the skin. We wished to determine the SPF decrease caused by absorption by investigating the difference...
Leroy, Lígia da Silva; Lúcio, Adélia; Lopes, Maria Helena Baena de Moraes
To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, ppregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent. Investigar os fatores de risco para a incontinência urinária (IU) no puerpério e as suas características. Trata-se de estudo caso-controle com 344 puérperas (77 casos e 267 controles), com até 90 dias pós-parto. Foi aplicado, em um único momento, um questionário para os dados sociodemográficos e clínicos, e dois outros para avaliar a perda urinária, situações de perda e o tipo de IU. Apresentaram IU de esforço 45,5%, perda urinária diversas vezes ao dia 44,2%, sendo 71,4% em pequena quantidade e 57,1% ao tossir ou espirrar. Em 70,1% dos casos a IU iniciou-se na gestação e permaneceu no puerpério. Ao ajustar-se um modelo de regressão logística binária, apenas IU na gestação (OR 12,82, IC 95% 6,94 - 23,81, p<0,0001), multiparidade (OR 2,26, IC 95% 1,22 - 4,19, p=0,009), idade gestacional no parto maior ou igual a 37 semanas (OR 2,52, IC 95% 1,16 - 5,46, p=0,02) e constipação (OR 1,94, IC
Background: The prevalence of Type 2 diabetes mellitus (T2 DM) in children and ... had none of the risk factors while 272(30.9%) had at least one risk factor. Using the American Diabetes Association criteria for identification of those at risk for ...
Ahlehoff, Ole; Skov, Lone; Gislason, Gunnar Hilmar
Patients with psoriasis have increased prevalence of coronary risk factors and limited recent results have suggested that these risk factors are undertreated in patients with psoriasis. This may contribute to the increased risk of cardiovascular diseases observed in patients with psoriasis....
Objective: This study assessed the perception of risk of cervical cancer and existence of risk factors for cervical cancer based on five known risk factors among women attending the Tamale Teaching Hospital in Tamale, Ghana. Methods: A consecutive sample of 300 women was interviewed using a semi structured ...
Background: Risk factor modification can reduce clinical events and premature death in people with established cardiovascular disease (CVD) as well as in those who are at high cardiovascular risk due to one or more risk factors. Obesity, a common nutritional disorder in industrialized countries is associated with an ...
Moye, Jennifer; June, Andrea; Martin, Lindsey Ann; Gosian, Jeffrey; Herman, Levi I; Naik, Aanand D
The Institute of Medicine documents a significant gap in care for long term side effects of cancer treatment, including pain. This paper characterizes age differences in the prevalence and predictive characteristics of pain to guide clinicians in identification and treatment. A sample of 170 adults with head and neck, esophageal, gastric, or colorectal cancers were recruited from two regional Veterans Administration Medical Centers. Face to face interviews were conducted 6, 12, and 18 months after diagnosis with the PROMIS scale to assess pain and PHQ-9 scale to assess depression. Descriptive statistics characterized incidence and prevalence of pain impact and intensity ratings. Multivariate linear hierarchical regression identified clinical characteristics associated with pain in older versus younger age groups. Clinically significant pain was endorsed in one third (32%) of the sample, with younger adults reporting higher levels of the impact of pain on daily activities and work, and also higher pain intensity ratings than older adults. In younger adults, pain ratings were most associated with lower social support and higher depression, as well as advanced cancer stage. In older adults, pain was multifactorial, associated with baseline comorbidities, adjuvant treatment, and both combat post-traumatic stress disorder (PTSD) and depression. Pain is a significant persisting problem for one in three cancer survivors, requiring ongoing assessment, even months later. Important differences in pain's determinants and impact are present by age group. Identification and treatment of pain, as well as associated conditions such as depression, may improve the quality of life in cancer survivors. Published by Elsevier Ltd.
Full Text Available We investigated and analysed the factors that women teachers consider as barriers to their advancement to headship positions in Zimbabwean primary schools. Specifically, we sought to identify the factors perceived by women school heads to be causes of persistent under-representation of women in school headship positions. Data were collected through structured face-to-face interviews and focus group discussions with 13 experienced women school heads. The findings revealed that although the majority of the women teachers in the study sample were qualified for promotion to school headship positions, they had not attempted to apply for them. The majority of the women teachers in the study sample were adequately qualified for promotion to school headship positions. Indeed, a large number of them either had a university degree or were pursuing degree studies and also had extensive experience. But most of them had not attempted to apply for school headship and hence were still class teachers. Gender stereotypes were shown to be one of the major causes of persistent under-representation of women in primary school headship. The influence of gender role stereotypes was found to manifest in the form of low self esteem; lack of confidence; women's perception that their role in the family overrides all other roles; and lack of support from the home and the workplace.
Suri, Pradeep; Delaney, Kristin; Rundell, Sean D; Cherkin, Daniel C
To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care. Secondary analysis of data from participants receiving usual care in a randomized clinical trial. Primary care clinics. Adults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included. Not applicable. The original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up. The STarT Back risk group was a significant predictor of persistent disabling back pain (PSTarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States. Published by Elsevier Inc.
Epidemiological studies have identified several modifiable risk factors for colorectal neoplasms in the general population. However, associations between modifiable risk factors, including body mass index (BMI), smoking, alcohol consumption and dietary patterns, and colorectal neoplasms in two
Sunjoo Boo, RN, PhD
Conclusion: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women.
Beyer, Ditte Maria; Faurschou, Annesofie; Philipsen, Peter Alshede
Recently, we showed that the sun protection factor (SPF) decreases by a constant factor to reach 55% during a day with activities. Organic sunscreens but not inorganic ones are absorbed through the skin. We wished to determine the SPF decrease caused by absorption by investigating the difference...... in SPF decreases between an organic and an inorganic sunscreen, assuming that the sunscreens are stable, and that the SPF decrease is time dependent if caused by absorption....
Trachsel, Manuel; Irwin, Scott A; Biller-Andorno, Nikola; Hoff, Paul; Riese, Florian
As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. Based on the WHO definition of palliative care, a, a working definition of palliative psychiatry is proposed. Palliative psychiatry focuses on mental health rather than medical/physical issues. We propose that the beneficiaries of palliative psychiatry are patients with severe persistent mental illness, who are at risk of therapeutic neglect and/or overly aggressive care within current paradigms. These include long-term residential care patients with severe chronic schizophrenia and insufficient quality of life, those with therapy-refractory depressions and repeated suicide attempts, and those with severe long-standing therapy-refractory anorexia nervosa. An explicitly palliative approach within psychiatry has the potential to improve quality of care, person-centredness, outcomes, and autonomy for patients with severe persistent mental illness. The first step towards a palliative psychiatry is to acknowledge those palliative approaches that already exist implicitly in psychiatry. Basic skills for a palliative psychiatry include communication of diagnosis and prognosis, symptom assessment and management, support for advance (mental health) care planning, assessment of caregiver needs, and referral to specialized services. Some of these may already be considered core skills of psychiatrists, but for a truly palliative approach they should be exercised guided by an awareness of the limited functional prognosis and lifespan of patients with severe persistent mental illness.
Rod, Naja Hulvej; Hansen, Ase Marie; Nielsen, Jens
Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI......Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI...
Nielsen, Karoline Kragelund; Damm, Peter; Kapur, Anil
. Objective: The aims of this observational study were to examine the role of potential risk factors for HIP, and to investigate whether any single or accumulated risk factor(s) could be used to predict HIP among women attending GDM screening at three centres in urban, semi-urban and rural Tamil Nadu, India...
Background: Factors associated with the development of hypertension can be categorized into modifiable and non‑modifiable risk factors. The modifiable risk factors include obesity, physical inactivity, high salt diet, smoking alcohol consumption and others. Aim: This study was aimed to determine the prevalence of ...
de Wolf, F.; Goudsmit, J.; Paul, D. A.; Lange, J. M.; Hooijkaas, C.; Schellekens, P.; Coutinho, R. A.; van der Noordaa, J.
One hundred and ninety eight men seropositive for human immunodeficiency virus (HIV) antibody and 58 HIV antibody seroconverters were studied for an average of 19.3 (SEM 0.5) months to assess the relation between HIV antigenaemia and the risk of developing the acquired immune deficiency syndrome
Human norovirus is a frequent cause of gastroenteritis worldwide, and viewed as the most common cause of foodborne disease. Numerous norovirus outbreaks associated with fresh produce, especially soft-berries and lettuce are described. Risk management strategies need to be improved in order to reduce
Full Text Available INTRODUCTION: Osteoarthritis of the hip is a degenerative disease of hip unknown origin, with pain, stiffness and diminished joint function. AIM: determine the influence of the load of the hip joint during professional activity and BMI as risk factors for the hip osteoarthritis. MATERIAL AND METHOD: We analysed 148 patients. Patients were divided into two groups ( I group with osteoarthritis of the hip, II group without osteoarthritis of the hip. In all, performed diagnostic procedure: anamnesis, physical examination (estimate of walking and hip joint movement, laboratory blood test and urine test radiological examination and taking data on the height and weight to calculated BMI. We assessed the data that is related to the load of the hip joint during professional activities (mostly sitting work and mostly standing job with carrying load. Statistical analysis was done using the software package SPSS 14.0, Microsoft Office Word 2003. RESULTS: In the first group, average age was 67.76 years, with females prevailing (67.6%. In this group the larger body mass was noted (81.82 ± 12.18, with statistically significant difference (T-test 2.923, p<0.01; the average BMI was higher the average BMI was higher (30.18 ± 4.6, with statistically significant difference (T-test 3.832, p<0.01. This group had more overweight patients (87.7%,with statistically significant difference (Fisher test, p<0.01. In I group 62,2% of patients were doing hard physical work (standing job with repeated carrying load and we found statistically significant difference between groups (Fisher test p<0,01. CONCLUSION: Patients with osteoarthritis of the hip had a higher body weight, higher BMI. Also we found the influence of hard physical labor at work, and they were performed mostly standing job with carrying load.
Richard, Edo; Moll van Charante, Eric P.; van Gool, Willem A.
Epidemiological studies have consistently shown that vascular risk factors including hypertension, diabetes, obesity, hypercholesterolemia, smoking, and lack of physical exercise are associated with an increased risk of cognitive decline and dementia. Neuroradiological and neuropathological studies
... we spend more time in front of computers, video games, TV, and other electronic pastimes, we have fewer ... no other risk factors. Overweight and obesity also increase the risks for diabetes, high blood pressure, high ...
Keywords: Genital human papilloma virus, Pap smear, Risk factors. Access this article online .... their Pap smears taken and questionnaires on sexual attitudes, .... the high‑risk types, which mediate the response of the enhancer to steroid ...
Behavioural risk factors for sexually transmitted infections and health ... sharing of personal effects, malnourishment and sexual harassment. ... Development of risk reduction and appropriate sexual health interventions targeted at prevention ...
... factor for heart attack? I've read that calcium supplements may increase the risk of heart attack. ... D. Some doctors think it's possible that taking calcium supplements may increase your risk of a heart ...
Apr 22, 2014 ... Recognition of diabetic individuals at greatest risk of developing coronary ..... Early detection of the disease and timely interventions can reduce the morbidity ..... additional risk factor of retinopathy in type 2 diabetes mellitus.
Full Text Available This study explores how audit firms in Jordan deal with the presence of fraud risk factors in audit clients. In doing so, the study seeks to explore which fraud risk factors are more important to Jordanianauditors, and how Jordanian auditors consider modifying their audit programmes when fraud risk factors are present in clients. The study uses a structured questionnaire that was administered to seniorlevel auditors in the largest Jordanian audit firms. The findings show that almost all of the 20 fraud risk factors included in the questionnaire were only slightly important (if not unimportant, a finding that is arguably alarming. The perceived importance of modifying the audit programme in the presence of each fraud risk factor was related to the perceived importance of the fraud risk factor itself. However, changes in the nature and extent of audit procedures were more important than changes in the timing of the procedures or the members of the audit team. The most important fraud risk factors were related to the characteristics of management and its attitude towards the audit, while the least important fraud risk factors were related to the difficulties in the client’s financial performance. Factor analysis found that the fraud risk factors could be classified into four separate groups. Possible interpretations of the findings were discussed, such as considering the Jordanian business environment characteristics, and the findings were compared to those of extant international studies.
Laurikka, Pilvi; Lindfors, Katri; Oittinen, Mikko; Huhtala, Heini; Salmi, Teea; Lähdeaho, Marja-Leena; Ilus, Tuire; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle
The aim of this study was to investigate the role of dietary factors, distinct small-bowel mucosal immune cell types, and epithelial integrity in the perpetuation of gastrointestinal symptoms in treated celiac disease patients. For unexplained reasons, many celiac disease patients suffer from persistent symptoms, despite a strict gluten-free diet (GFD) and recovered intestinal mucosa. We compared clinical and serological data and mucosal recovery in 22 asymptomatic and 25 symptomatic celiac patients on a long-term GFD. The density of CD3 and γδ intraepithelial lymphocytes (IELs), CD25 and FOXP3 regulatory T cells, and CD117 mast cells, and the expression of tight junction proteins claudin-3 and occludin, heat shock protein 60, interleukin 15, and Toll-like receptor 2 and 4 were evaluated in duodenal biopsies. All subjects kept a strict GFD and had negative celiac autoantibodies and recovered mucosal morphology. The asymptomatic patients had higher mean fiber intake (20.2 vs. 15.2 g/d, P=0.028) and density of CD3 IELs (59.3 vs. 45.0 cell/mm, P=0.045) than those with persistent symptoms. There was a similar but nonsignificant trend in γδ IELs (17.9 vs. 13.5, P=0.149). There were no differences between the groups in other parameters measured. Low fiber intake may predispose patients to persistent symptoms in celiac disease. There were no differences between the groups in the markers of innate immunity, epithelial stress or epithelial integrity. A higher number of IELs in asymptomatic subjects may indicate that the association between symptoms and mucosal inflammation is more complicated than previously thought.
Bolton Jennifer E
Full Text Available Abstract Background Given the costs associated with the management of musculoskeletal pain in primary care, predicting the course of these conditions remains a research priority. Much of the research into prognostic indicators however considers musculoskeletal conditions in terms of single pain sites whereas in reality, many patients present with pain in more than one site. The aim of this study was to identify prognostic factors for early improvement in primary care consulters with acute and persistent musculoskeletal conditions across a range of pain sites. Methods Consecutive patients with a new episode of musculoskeletal pain completed self-report questionnaires at baseline, and then again at the 4/5th treatment visit, and if they were still consulting, at the 10th visit. The outcome was defined as patient self-report improvement sufficient to make a meaningful difference. Independent predictors of outcome were identified using multivariate regression analyses. Results Acute (th visit. Several variables at baseline were associated with improvement at the 4/5th visit, but the predictive models were weak and unable to discriminate between patients who were improved and those who were not. In contrast, it was possible to elicit a predictive model for improvement later on at the 10th visit, but only in patients with persistent pain. Being employed, reporting a decline in work fear-avoidance behaviour at the 4/5th visit, and being better by the 4/5th visit, were all independently associated with improvement. This model accounted for 34.3% (p Conclusions We were unable to identify baseline characteristics that predicted early outcome in musculoskeletal pain patients. However, early self-reported improvement and decline in work fear-avoidance behaviour as predictors of later improvement highlighted the importance of speedy recovery in persistent musculoskeletal pain consulters. Our findings reinforce the elusive nature of baseline predictors, and
Guimarães-Pereira, Luís; Farinha, Filomena; Azevedo, Luís; Abelha, Fernando; Castro-Lopes, José
Cardiac surgery (CS) ranks among the most frequently performed interventions worldwide and persistent postoperative pain (PPP) has been recognized as a relevant clinical outcome in this context. We aimed to evaluate its incidence, characteristics, associated factors and patient's quality of life (QoL). Observational prospective study conducted in patients undergoing CS in a tertiary university hospital. PPP was defined as persistent pain after surgery with higher than 3 months' duration, after excluding other causes of pain. We used a set of questionnaires for data collection: Pain Catastrophizing Scale, Duke Health Profile, Brief Pain Inventory Short Form, McGill Pain Questionnaire Short Form, Douleur Neuropathique en 4 Questions and standardized questions regarding pain periodicity. A total of 288 patients have completed the study and 43% presented PPP assessed at 3 months (PPP3M); out of which 84% were not under any treatment. PPP patients reported significantly lower QoL, and a neuropathic pain (NP) component was present in 50% of them. Younger age, female gender, higher body mass index, catastrophizing, coronary artery bypass graft, osteoarthritis, history of previous surgery (excluding sternotomy) and moderate to severe acute postoperative pain were independent predictors of PPP3M. This is the first study comprehensively describing PPP after CS and identifying NP in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their lower QoL, which deserves the attention of health care professionals in order to improve prevention, assessment and treatment of these patients. WHAT DOES THIS STUDY ADD?: This study comprehensively describes persistent postoperative pain (PPP) after cardiac surgery (CS) and identifies neuropathic pain (NP) in half of them. Our results support the important role that PPP plays after CS in considering its interference in patients' daily life and their
Eklund, Mona; Ostman, Margareta
It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness. This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations. Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables. No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation. Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.
Mahmoodi, Bakhtawar K; Cushman, Mary; Næss, Inger Anne
Background: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). Methods: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk...... factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked VTE (ie, VTE occurring in the presence of 1 or more...
The decay of DDT and parathion deposits under the influence of temperature, rain and ultraviolet radiation was described. Temperature and solar radiation were the main factors limiting the residual effect. High mean temperatures were more important than high maxima.DDT residues were more
van Rooij, S J H; Kennis, M; Sjouwerman, R; van den Heuvel, M P; Kahn, R S; Geuze, E
BACKGROUND: Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether
Cerdá, Magdalena; Moffitt, Terrie E.; Meier, Madeline H.; Harrington, HonaLee; Houts, Renate; Ramrakha, Sandhya; Hogan, Sean; Poulton, Richie; Caspi, Avshalom
With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18–38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (n=1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence. PMID:28008372
Lord, Dana; Conlon, Helen Acree
The health of an airline pilot is imperative to the safe travels of millions of people worldwide. Medical providers evaluate the cardiovascular risks for airline pilots and the medical requirements to obtain and maintain licensure as an airline pilot. It is the role of the occupational health nurse practitioner to evaluate and reduce the risk of cardiovascular disease in this population.
Prevalence and risk factors for methicillin resistant Staphylococcus aureus carriage among emergency department workers and bacterial contamination on touch surfaces in Erciyes University Hospital, Kayseri, Turkey.
...: Reproductive factors and breast cancer risk Having started the process of working with these questions, we discovered a unique opportunity to differentiate the outcome variable of breast cancer...
Conclusion: Increased CVD risk factors are predictors of future overweight in childhood and adolescent and increased weight is linked significantly with dyslipidemia and hypertension in this age group.
Zheng, Rui; Shi, Kan; Li, Shu
Risk perception is one of important subjects in management psychology and cognitive psychology. It is of great value in the theory and practice to investigate the societal hazards that the public cares a lot especially in Socio-economic transition period. A survey including 30 hazards and 6 risk attributes was designed and distributed to about 2, 485 residents of 8 districts, Beijing. The major findings are listed as following: Firstly, a scale of societal risk perception was designed and 2 factors were identified (Dread Risk & Unknown Risk). Secondly, structural equation model was used to analyze the influence factors and mechanism of societal risk perception. Risk preference, government support and social justice could influence societal risk perception directly. Government support fully moderated the relationship between government trust and societal risk perception. Societal risk perception influenced life satisfaction, public policy preferences and social development belief.
Verónica ede la Fuente
Full Text Available Transcriptional regulation is an important molecular process required for long-term neural plasticity and long-term memory formation. Thus, one main interest in molecular neuroscience in the last decades has been the identification of transcription factors that are involved in memory processes. Among them, the NF-κB family of transcription factors has gained interest due to a significant body of evidence that supports a key role of these proteins in synaptic plasticity and memory. In recent years, the interest was particularly reinforced because NF-κB was characterized as an important regulator of synaptogenesis. This function may be explained by its participation in synapse to nucleus communication, as well as a possible local role at the synapse. This review provides an overview of experimental work obtained in the last years, showing the essential role of this transcription factor in memory processes in different learning tasks in mammals. We focus the review on the consolidation and reconsolidation memory phases as well as on the regulation of immediate-early and late genes by epigenetic mechanisms that determine enduring forms of memories.
de Wolf, F; Goudsmit, J; Paul, D A; Lange, J M; Hooijkaas, C; Schellekens, P; Coutinho, R A; van der Noordaa, J
One hundred and ninety eight men seropositive for human immunodeficiency virus (HIV) antibody and 58 HIV antibody seroconverters were studied for an average of 19.3 (SEM 0.5) months to assess the relation between HIV antigenaemia and the risk of developing the acquired immune deficiency syndrome (AIDS) and AIDS related complex. Forty (20.2%) of the 198 HIV antibody seropositive men were antigen positive at entry and remained so during follow up. Eight (13.8%) of the 58 HIV antibody seroconver...
Diploma thesis "Video game playing as a risk factor in adolescence?" deals with actuality of risks for children and youth linked to video games. This topic is currently intensively disscused because of cases of high school shootings. There are concerns that violence in video games is connected to rising of children and youth violence. Another risks refered to video games are addiction and obesity. This diploma thesis deals with these risk too. Goal of this thesis is find out if these risks ar...
Ionescu Iancu Octavian; Turlea Eugeniu
Risk is a fundamental concept in audit as well as in the business world at large. Yet, little is known about the personal factors that might influence the risk attitude of a decision maker. The business decision makers are usually faced with a degree of uncertainty when they have to assess risk and make decisions. This paper examines risk behaviour from an audit firm manager perspective and from an academic perspective. The emphasis is on the managerial risk behaviour in business decision mak...
Context: Risk factors for and survival of singleton preterm births may vary ... factors and survival‑to‑discharge rate for singleton preterm births at the University of ... Statistical analysis involved descriptive and inferential statistics at 95% level of ...
study aimed to describe the risk factors for TB in Lephalale local municipality. A quantitative .... (3) to describe environmental factors that contribute to the spread of TB in ... sample was reached, two sampling methods were utilised. First.
cardiovascular diseases (CVDs) by measuring such factors as blood pressure ... heart disease. Coexistence of these factors is known to have multiplier effect ... Bearing this changing trend in mind, continuous re-evaluation of these CVD risk ...
Incidence And Potential Risk Factors Of Low Birth Weight Among Full Term Deliveries. ... (LBW) is a reliable indicator in monitoring and evaluating the success of maternal and child ... Key words: Low birth weight- incidence- associated factors.
Anderson, Craig A; Suzuki, Kanae; Swing, Edward L; Groves, Christopher L; Gentile, Douglas A; Prot, Sara; Lam, Chun Pan; Sakamoto, Akira; Horiuchi, Yukiko; Krahé, Barbara; Jelic, Margareta; Liuqing, Wei; Toma, Roxana; Warburton, Wayne A; Zhang, Xue-Min; Tajima, Sachi; Qing, Feng; Petrescu, Poesis
Cultural generality versus specificity of media violence effects on aggression was examined in seven countries (Australia, China, Croatia, Germany, Japan, Romania, the United States). Participants reported aggressive behaviors, media use habits, and several other known risk and protective factors for aggression. Across nations, exposure to violent screen media was positively associated with aggression. This effect was partially mediated by aggressive cognitions and empathy. The media violence effect on aggression remained significant even after statistically controlling a number of relevant risk and protective factors (e.g., abusive parenting, peer delinquency), and was similar in magnitude to effects of other risk factors. In support of the cumulative risk model, joint effects of different risk factors on aggressive behavior in each culture were larger than effects of any individual risk factor.
Simbayi, Leickness C; Kalichman, Seth C; Jooste, Sean; Cherry, Charsey; Mfecane, Sakhumzi; Cain, Demetria
South Africa is in the midst of a devastating HIV-AIDS epidemic and most new HIV infections occur among young adults and adolescents. The current study examined risk behaviors and HIV risk factors among young people living in a Black South African township. Using community-based outreach methods of street intercept and facility-based surveying, 113 men and 115 women age 25 and younger responded to an anonymous survey. Results showed that men (68%) and women (56%) reported HIV-related high risk sexual behaviors. Although knowledge about HIV transmission was generally high, there was evidence that misconceptions about AIDS persist, particularly myths related to HIV transmission. For young men, HIV risk factors were associated with fewer years of education, lower levels of AIDS-related knowledge, condom attitudes, and Dagga (marijuana) use. Among young women, HIV risk factors were associated with beliefs that condoms get in the way of sex and rates of unprotected vaginal intercourse. Despite adequate general AIDS knowledge and risk sensitization, South African youth demonstrated high rates of sexual practices that place them at risk for HIV infection. There is an urgent need for behavioral interventions targeted to young South Africans living in the most economically disadvantaged areas.
... use of mammary gland assessments in developmental research studies, chemical test guidelines, and risk assessments. 7 X-ray and gamma radiation; alcoholic beverages; tobacco smoking; and the sterilizing agent, ethylene oxide. ...
Full Text Available To solve the problem of rational organization of accounting factoring activity the current research identifies the types of factoring operations typical for the accounting system of factoring company, and their place in this system. The recommended provisions, which must be fixed in the accounting policy of the enterprise-factor, are presented. Based on the identification of the most significant provisions of the factoring agreement, it is proposed to limit the amount of funding depending on the type of factoring. The risk factor matrix for factoring business is developed to improve the efficiency of their management and the accounting of operations due to risk management methods. The accounting of the factoring company is proposed taking into account the following components: 1 the moment of acceptance of the sold (deferred receivable to the accounting; 2 the features of factoring depending on its type; 3 the peculiarities of accounting registration of charges in factoring operations; 4 the procedure for inventorying factoring transactions.
Full Text Available To put public debt on a sustainable path, many governments face the task of enacting large fiscal consolidation followed by years of sustained primary surpluses. By estimating hazard functions for the duration of consolidations, we analyse the features of past consolidation efforts across a panel of advanced economies. Our contribution is to identify the factors that help to start and sustain consolidations, separately discussing governments’ “commitment” to the cause as well as their “capacity” for action. Our analysis suggests that longer consolidations are initiated when public debt is high, fiscal deficits are large, the interest burden heavy and long-term sovereign bond yields elevated. However, we also find that a countries’ “capacity” to change course is important. Higher initial private sector savings, a stronger external balance, a competitive position and stable financial conditions appear to provide more scope for governments to sustain longer-lasting consolidations. Once we have controlled for the initial macroeconomic conditions, there is a lesser role for governments’ commitment as reflected in factors such as the composition and the pace of the fiscal adjustment or the political cycle in explaining the duration of consolidation. However, commitment to permanent, rather than temporary, fiscal adjustment is key.
Chow, Clara Kayei; Lock, Karen; Teo, Koon; Subramanian, S V; McKee, Martin; Yusuf, Salim
It has long been known that cardiovascular disease (CVD) rates vary considerably among populations, across space and through time. It is now apparent that most of the attributable risk for myocardial infarction 'within' populations from across the world can be ascribed to the varying levels of a limited number of risk factors among individuals in a population. Individual risk factors (e.g. blood pressure) can be modified with resulting health gains. Yet, the persistence of large international variations in cardiovascular risk factors and resulting CVD incidence and mortality indicates that there are additional factors that apply to 'populations' that are important to understand as part of a comprehensive approach to CVD control. This article reviews the evidence on why certain populations are more at risk than others.
Jimenez, Carlos Mario; Polo, Jonathan; España, Julian Andres
To determine risk factors for intracranial infection secondary to penetrating craniocerebral gunshot wounds (PCGWs) in civilian practice, in patients who underwent surgery with removal of bullet fragments, wound debridement, and watertight dural closure. An observational, analytical, prospective, cohort-type study was conducted with follow-up in a group of patients with PCGWs caused by a low-velocity projectile admitted between January 2000 and November 2010. There were 160 patients, 59 of whom were administered prophylactic antibiotics based on the decision of the treating neurosurgeon. Average follow-up time was 39 months (range, 3-92 months). Infection occurred in 40 patients (25%); 20 patients received antibiotics (20 of 59 [33.9%]), and 20 patients did not receive antibiotics (20 of 101 [19.8%]). Three variables were independent risk factors for infection: (i) persistence of parenchymal osseous or metallic fragments after surgery (P projectile trajectory through a natural cavity with contaminating flora (P = 0.03, RR 2.84); and (iii) prolonged hospitalization time (P Projectile trajectory through potentially contaminating cavities, persistence of intraparenchymal osseous or metallic fragments after surgery, and prolonged hospital stay were independent risk factors for intracranial infection. Copyright © 2013 Elsevier Inc. All rights reserved.
Oosterhuis, Frans; Brouwer, Roy; Janssen, Martien; Verhoeven, Julia; Luttikhuizen, Cees
International chemicals legislation aims at adequately controlling persistent organic pollutants (POPs) and substances of very high concern (SVHCs), such as persistent, bioaccumulative, and toxic (PBT) and very persistent and very bioaccumulative (vPvB) substances, with a view to progressively
Filippopulos, Filipp M; Albers, Lucia; Straube, Andreas; Gerstl, Lucia; Blum, Bernhard; Langhagen, Thyra; Jahn, Klaus; Heinen, Florian; von Kries, Rüdiger; Landgraf, Mirjam N
To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.
Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W
Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.
Kanngiesser, Maike; Mair, Norbert; Lim, Hee-Young; Zschiebsch, Katja; Blees, Johanna; Häussler, Annett; Brüne, Bernhard; Ferreiròs, Nerea; Kress, Michaela; Tegeder, Irmgard
The present study assessed the functions of the transcription factor hypoxia-inducible factor (HIF) in sensory neurons in models of acute, inflammatory, ischemic, and neuropathic pain. The alpha subunit, HIF1α, was specifically deleted in neurons of the dorsal root ganglia by mating HIF1α(fl/fl) mice with SNScre mice. SNS-HIF1α(-/-) mice were more sensitive to noxious heat and cold pain stimulation than were HIF1α(fl/fl) control mice. They also showed heightened first-phase nociceptive responses in the formalin and capsaicin tests with increased numbers of cFos-positive neurons in the dorsal horn, and intensified hyperalgesia in early phases after paw inflammation and hind limb ischemia/reperfusion. The behavioral cold and heat pain hypersensitivity was explained by increased calcium fluxes after transient receptor potential channel activation in primary sensory neurons of SNS-HIF1α(-/-) mice and lowered electrical activation thresholds of sensory fibers. SNS-HIF1α(-/-) mice however, developed less neuropathic pain after sciatic nerve injury, which was associated with an abrogation of HIF1-mediated gene up-regulation. The results suggest that HIF1α is protective in terms of acute heat and cold pain but in case of ongoing activation in injured neurons, it may promote the development of neuropathic pain. The duality of HIF1 in pain regulation may have an impact on the side effects of drugs targeting HIF1, which are being developed, for example, as anticancer agents. Specifically, in patients with cancer neuropathy, however, temporary HIF1 inhibition might provide a welcome combination of growth and pain reduction.