Sample records for related clinical factors

  1. Assisted Reproductive Technology and Related Clinical Factors

    Zuan-chong FENG; Zhong-mei LI


    @@ As a widely-applied clinical therapy for infertility and sterility, ART has its own merits compared to other techniques and operations; however, the outcome of ART is influenced by various factors ranging from age, endometrial receptivity, reproductive system condition (e.g.uterus, fallopian tube and pelvic factors, etc.), immune system and so on. From our clinical experience and the literatures reviewd, it is strongly recommended that the situation of every infertile couple be evaluated thoroughly before applying therapy.

  2. Prognosis related clinical and molecular factors in malignant pleural mesothelioma



    Objective To identify potential prognosis related clinical and molecular factors in malignant pleural mesothelioma(MPM).Methods Seventy-nine patients with MPM treated in Beijing Cancer Hospital from June 1996

  3. Clinical features and related factors to anxiety disorders in adolescents



    Objective To explore the social and psychological risk factors to anxiety disorders in adolescents,and to screen protective factors and risk factors and establish the prediction model.Methods The Screen for Child Anxiety

  4. Clinical analysis of risk factors for ERCP-related perforation

    ZHOU Haihua


    Full Text Available ObjectiveTo evaluate the causes, diagnostic and therapeutic principles, and prevention of the perforation related to endoscopic retrograde cholangiopancreatography (ERCP. MethodsAll patients who developed perforation after ERCP in the Central Hospital of Shanghai Jiading District from January 2009 to December 2013 were recruited. The causes, types, and diagnosis and treatment of perforation were analyzed retrospectively. ResultsERCP was done in 459 cases during the 4 years, and 6 (1.3% of them developed perforation. The causes of perforation were as follows: endoscope insertion (3 cases, catheterization or sphincterotomy (2 cases, and guide wire or Dormia basket (1 case. Two cases received conservative management successfully and were discharged; four cases underwent surgical treatment, and one of them died. Conclusion Patients with ERCP-related perforation can achieve ideal prognosis through individualized treatment based on the causes and types of perforation. Careful and cautious operation, especially for the elderly or the patients with a history of upper abdominal operation, will reduce the incidence of ERCP-related perforation.

  5. Negative Mood and Obsessive-Compulsive Related Clinical Constructs: An Examination of Underlying Factors

    Gary I. Britton


    Full Text Available Emerging evidence suggests that many of the clinical constructs used to help understand and explain obsessive-compulsive (OC symptoms, and negative mood, may be causally interrelated. One approach to understanding this interrelatedness is a motivational systems approach. This approach suggests that rather than considering clinical constructs and negative affect as separable entities, they are all features of an integrated threat management system, and as such are highly coordinated and interdependent. The aim of the present study was to examine if clinical constructs related to OC symptoms and negative mood are best treated as separable or, alternatively, if these clinical constructs and negative mood are best seen as indicators of an underlying superordinate variable, as would be predicted by a motivational systems approach. A sample of 370 student participants completed measures of mood and the clinical constructs of inflated responsibility, intolerance of uncertainty, not just right experiences, and checking stop rules. An exploratory factor analysis suggested two plausible factor structures, one where all construct items and negative mood items loaded onto one underlying superordinate variable, and a second structure comprising of five factors, where each item loaded onto a factor representative of what the item was originally intended to measure. A confirmatory factor analysis showed that the five factor model was preferential to the one factor model, suggesting the four constructs and negative mood are best conceptualized as separate variables. Given the predictions of a motivational systems approach were not supported in the current study, other possible explanations for the causal interrelatedness between clinical constructs and negative mood are discussed.

  6. Factors related to discontinued clinic attendance by patients with podoconiosis in southern Ethiopia: a qualitative study

    Tora Abebayehu


    Full Text Available Abstract Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of ‘special’ aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma require substantial expansion of services or liaison with village-level government health services.

  7. Risk factors for treatment related clinical fluctuations in Guillain-Barré syndrome. Dutch Guillain-Barré study group

    L.H. Visser (Leendert); F.G.A. van der Meché (Frans); J. Meulstee (Jan); P.A. van Doorn (Pieter)


    textabstractThe risk factors for treatment related clinical fluctuations, relapses occurring after initial therapeutic induced stabilisation or improvement, were evaluated in a group of 172 patients with Guillain-Barre syndrome. Clinical, laboratory, and electrodiagnostic features

  8. Quality management and job related factors predicting satisfaction of dental clinic staff in Estonia.

    Merisalu, Eda; Männik, Georg; Põlluste, Kaja


    The aim of the study was to explore the role of managerial style, work environment factors and burnout in determining job satisfaction during the implementation of quality improvement activities in a dental clinic. Quantitative research was carried out using a prestructured anonymous questionnaire to survey 302 respondents in Kaarli Dental Clinic, Estonia. Dental clinic staff assessed job satisfaction, managerial style, work stress and burnout levels through the implementation period of ISO 9000 quality management system in 2003 and annually during 2006-2009. Binary logistic regression was used to explain the impact of satisfaction with management and work organisation, knowledge about managerial activities, work environment and psychosocial stress and burnout on job satisfaction. The response rate limits were between 60% and 89.6%. Job satisfaction increased significantly from 2003 to 2006 and the percentage of very satisfied staff increased from 17 to 38 (pmanagerial support, information about results achieved and progress to goals, work organisation and working environment, as well as factors related to career, security and planning. The average scores of emotional exhaustion showed significant decrease, correlating negatively with job satisfaction (p<0.05). The implementation of quality improvement activities in the Kaarli Dental Clinic has improved the work environment by decreasing burnout symptoms and increased job satisfaction in staff.

  9. Comprehensive analysis of clinical significance of stem-cell related factors in renal cell cancer

    Zhou Libin


    Full Text Available Abstract Background C-MYC, LIN28, OCT4, KLF4, NANOG and SOX2 are stem cell related factors. We detected whether these factors express in renal cell carcinoma (RCC tissues to study their correlations with the clinical and pathological characteristics. Methods The expressions of c-MYC, LIN28, SOX2, KLF4, OCT4 and NANOG in 30 RCC patients and 5 non-RCC patients were detected with quantitative real-time reverse transcription-PCR (qRT-PCR. The data were analyzed with Wilcoxon signed rank sum test and x2 test. Results In RCC group, c-MYC expression was significantly higher in RCC tissues compared with normal tissues (P 0.05. Also the expression levels of all above factors were not significantly changed in non-RCC group (P > 0.05. Conclusions The present analysis strongly suggests that altered expression of several stem cell related factors may play different roles in RCC. C-MYC may function as an oncogene and OCT4, KLF4, NANOG and SOX2 as tumor suppressors.

  10. Clinical and psychosocial factors predicting health-related quality of life in hemodialysis patients.

    Kang, Gun Woo; Lee, In Hee; Ahn, Ki Sung; Lee, Jonghun; Ji, Yunmi; Woo, Jungmin


    Many patients with end-stage renal disease have significant impairment in health-related quality of life (HRQoL). Most previous studies have focused on clinical factors; however, quality of life can also be affected by psychosocial factors. The aim of this study was to identify the possible predictors of HRQoL among clinical and psychosocial factors in hemodialysis (HD) patients. The study included 101 patients who were undergoing HD. Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also assessed laboratory and clinical factors, including albumin, Kt/V as a marker of dialysis adequacy, normalized protein catabolic rate, and duration of HD. The Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D) was used to evaluate HRQoL. The mean EQ-5D index score was 0.704 ± 0.199. The following variables showed a significant association with the EQ-5D index: age (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), support from friends (P < 0.001), cognitive function (P < 0.001), duration of HD (P = 0.034), triglyceride (P = 0.031), total iron-binding capacity (P = 0.036), and phosphorus (P = 0.037). Multiple regression analysis showed that age (95% confidence interval [CI] -0.008 to -0.002), anxiety (95% CI -0.025 to -0.009), and support from friends (95% CI 0.004 to 0.018) were independent predictors of impaired HRQoL. This study explored determinants of impaired HRQoL in HD patients. We found that impaired HRQoL was independently associated with age, anxiety, and support from friends. We should consider psychosocial as well as clinical factors when evaluating ways to improve HRQoL in HD patients.

  11. Nutrition-Related Cardiovascular Disease Risk Factors In Chronic Kidney Disease: Relationship With Clinical Outcome

    Emma McMahon


    Traditional CV-risk factors in this CKD population were not associated with clinical outcome. Despite being within clinical reference range, serum phosphate and albumin were independently associated with clinical outcome. This may highlight a potential therapeutic target for risk management to delay or prevent renal end-points in CKD.

  12. Halitosis and related factors in patient referred to the Clinic of Dentistry, Zahedan

    Tahereh Nosratzehi


    Full Text Available Background: Halitosis is defined as unpleasant odor from the mouth .In %87 of cases the cause of halitosis are located in the oral cavity. It is a medico-social problem that affect a many number of people. purpose of this study was to determine factors involved in halitosis patients were referred to the dental clinic Zahedan. Materials and Methods : 320 people were attending the halitosis or halitophobia for this survey were selected . Selected individuals from eating, drinking, smoking, chewing gum, about 24 hours before sampling was forbidden , and also noted that on examination of brushing, flossing and mouthwash brands do not use . Regarding gingival index periodontal used, in terms of smoking were divided into two groups, consumer and non- consumer - reviews decay and bad restorations through clinical examination and bitewing radiography was performed and the diagnosis of patients with the prosthesis or any the corresponding table were recorded . Crowding teeth were considered . Organoleptic method was used to check for bad breath . Results: The findings of factors such as tooth decay (72%, periodontal disease (47.5%, tounge  coating (17.5% are artificial teeth (13.75% and food impaction, were signficantly  related with halitosis. Conclusion: diagnosis and treatment of halitosis are pramily the responsibility of dentists. It is important for the dentist to have a proper understanding of halitosis and provide correct treatment.




    Full Text Available Age related macular degeneration (AMD is a leadi ng cause of irreversible blindness among the elderly worldwide affecting 30 - 50 million individuals. AMD is more common in developed world. AMD is characterized by central visual loss. Advanced AMD can be classified in broadly into two types: dry and wet fo rm. Several clear risk factors for the development and progression of age related macular degeneration have been established are advancing age, genetic factors, history of smoking ,white race, obesity, high dietary intake of vegetable fat, low dietary inta ke of antioxidants and zinc. This prospective non - interventional study was conducted from February 2011 to October 2012 in the Regional Institute of Ophthalmology, Hamidia Hospital, Bhopal, included patients who attended the eye OPD, retina clinic and eye ward and were diagnosed as a case of AMD. Present study included 174 patients out of which patients 79(45.39% were above the age of 70 years, with 51 (29.31% patients between 61 - 70 years and 44 cases (25.28% in the sixth decade. Male: female ratio was 0 .75: 1. 21 (12.06% patients have a positive family history of AMD. Most common risk factor identified in our study was chronic sun exposure (49.42% followed by hypertension in 41.8% patients. 25.26% cases gave history of smoking and raised serum cholest erol levels were seen in 14.28% cases. History of alcoholism was positive in 19.54% patients. Of the 174 cases in our present study 90 patients (51.72% were hypermetropic. Conclusion: Age related macular degeneration is a disease of elderly with risk fact ors, most of them are preventable. If timely proper measures are taken, a major cause of blindness can be prevented in elderly age group.

  14. Acute upper gastrointestinal bleeding in octogenarians: Clinical outcome and factors related to mortality

    George J Theocharis; Vassiliki Arvaniti; Stelios F Assimakopoulos; Konstantinos C Thomopoulos; Vassilis Xourgias; Irini Mylonakou; Vassiliki N Nikolopoulou


    AIM: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians.METHODS: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (>80 years old).RESULTS: Four hundred and sixteen patients over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B147 patients. Co-morbidity was more common in octogenarians (P=0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P=0.05) and more patients died in the group of octogenarians compared to the younger age group (P=0.02). Inability to perform endoscopic examination (P=0.002), presence of high risk for rebleeding stigmata (P=0.004), urea on admission (P=0.036), rebleeding (P=0.004) and presence of severe co-morbidity (P<0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P=0.032).CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

  15. Factors related to the incidence of clinical encephalomyocarditis virus (EMCV) infection on Belgian pig farms.

    Maurice, H; Nielen, M; Vyt, Ph; Frankena, K; Koenen, F


    We set up a matched case-control study of potential risk factors for clinical encephalomyocarditis virus (EMCV) in 58 pig farms in West Flanders (Belgium). In total, 29 farms experienced a clinical outbreak of EMCV confirmed by EMC virus isolation. Mortality was seen only among suckling piglets (18 case farms), in piglets and other age-groups (4 case farms), or only among fattening pigs (7 case farms). Five farms had reproductive problems among the sows. Control farms were matched geographically on farm size and farm type and were selected on the absence of clinical signs. A questionnaire on potential risk factors for EMCV was developed to collect data at both case and control farms. The exploration of the data used clusters of factors associated with clinical EMCV infection: (a) rodents, (b) general farm set up and (c) general hygiene. The multivariable relationships between clinical appearance of EMCV and potential risk factors were tested with conditional logistic regression. The final model on all farms contained presence of mice (OR=8.3) as a risk factor for clinical EMCV infection while the flow of manure up through the slatted floor (OR=0.11) and movement of manure between manure pits in the pig stable (OR=0.14) were protective.

  16. Chiari-related hydrocephalus: assessment of clinical risk factors in a cohort of 297 consecutive patients.

    Guan, Jian; Riva-Cambrin, Jay; Brockmeyer, Douglas L


    OBJECTIVE Patients treated for Chiari I malformation (CM-I) with posterior fossa decompression (PFD) may occasionally and unpredictably develop postoperative hydrocephalus. The clinical risk factors predictive of this type of Chiari-related hydrocephalus (CRH) are unknown. The authors' objective was to evaluate their experience to identify risk factors that may predict which of these patients undergoing PFD will develop CRH after surgery. METHODS The authors performed a retrospective clinical chart review of all patients who underwent PFD surgery and duraplasty for CM-I at the Primary Children's Hospital in Utah from June 1, 2005, through May 31, 2015. Patients were dichotomized based on the need for long-term CSF diversion after PFD. Analysis included both univariate and multivariable logistic regression analyses. RESULTS The authors identified 297 decompressive surgeries over the period of the study, 22 of which required long-term postoperative CSF diversion. On multivariable analysis, age < 6 years old (OR 3.342, 95% CI 1.282-8.713), higher intraoperative blood loss (OR 1.003, 95% CI 1.001-1.006), and the presence of a fourth ventricular web (OR 3.752, 95% CI 1.306-10.783) were significantly associated with the need for long-term CSF diversion after decompressive surgery. CONCLUSIONS Younger patients, those with extensive intraoperative blood loss, and those found during surgery to have a fourth ventricular web were at higher risk for the development of CRH. Clinicians should be alert to evidence of CRH in this patient population after PFD surgery.

  17. Relations between Behavioral Inhibition, Big Five Personality Factors, and Anxiety Disorder Symptoms in Non-Clinical and Clinically Anxious Children

    Vreeke, Leonie J.; Muris, Peter


    This study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6-13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form, the Big Five Questionnaire for Children, and the Screen for…

  18. Socio-clinical factors related to the perinatal outcome of teenage ...



    Feb 25, 2013 ... Introduction. Globally, teenage or school-age pregnancies have been a ... The cases and the controls were compared for social and clinical factors .... shame and loss of self esteem, the role of social and wel- fare workers is ...

  19. Health Related Quality of Life in Children with Autism Spectrum Disorders: The Clinical and Demographic Related Factors in Turkey

    Kose, Sezen; Erermis, Serpil; Ozturk, Onder; Ozbaran, Burcu; Demiral, Nagehan; Bildik, Tezan; Aydin, Cahide


    We aimed to investigate the Health Related Quality of Life and related clinical variables (HRQoL) of children with Autism Spectrum Disorders (ASD). We included 102 children with ASD (46 with autism, 38 with pervasive developmental disorder not otherwise specified (PDD-NOS) and 18 with Asperger's syndrome (AS)) and 39 typically developing children…

  20. Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population

    Yap ZL


    Full Text Available Zhu Li Yap,1,2 You Chuen Chin,1 Judy Yu-Fen Ku,1 Tat Keong Chan,1,2 Gillian Teh,1,2 Monisha Esther Nongpiur,2,3 Tin Aung,1,2 Shamira A Perera1–3 1Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, Singapore; 3Duke NUS Graduate Medical School, Singapore Purpose: Comparison of the demographic, ocular, systemic and microbiological characteristics of eyes with bleb related infection (BRI and bleb related endophthalmitis (BRE. Methods: Retrospective chart review of patients with BRI from January 1996–July 2013. Identification done via the center’s longstanding endophthalmitis audit, BRI audit and laboratory database identifying all conjunctival swabs from blebs. Blebitis was defined as anterior segment inflammation with mucopurulent material in or around the bleb, with anterior chamber cells but no hypopyon. BRE was defined by the presence of hypopyon or vitreous inflammation. Results: Twenty-nine patients with blebitis and 10 with BRE were identified. Mean age of subjects (n=39 was 68.4 (±13.3 with a preponderance of men (74.4% and Chinese ethnicity (74.4%. BRE patients were 10.7 years older than blebitis patients (P=0.026. 28 (71.8% subjects had primary open angle glaucoma. The presenting intraocular pressure (IOP dropped in blebitis but almost doubled in BRE (P=0.011 compared to average preinfective IOP. Two weeks after treatment, IOPs in both groups returned to close to preinfective levels. Subjects with blebitis more often had an avascular bleb (88.0% while those with BRE trended toward a moderately vascular bleb (50%. The distribution of causative microorganisms between the groups was similar. Conclusion: Our study indicates that risk factors are similar in both groups even though the visual outcome and clinical course, in the form of IOP findings and bleb vascularity, can diverge significantly. The decreased IOP in blebitis subjects represents objective evidence of subclinical leaks or bleb sweating. Keywords

  1. Clinical symptoms and related factors of obstructive sleep apnea among overweight and obese taxi drivers

    Agus D. Susanto


    Full Text Available Background: Obstructive sleep apnea (OSA is common condition in commercial drivers while overweight and obesity as the most important risk factors. This study aimed to know the clinical symptoms and risk factors of OSA in overweight and obese taxi drivers in Jakarta, Indonesia. Methods: A cross-sectional study was done in 103 taxi drivers in Jakarta from November 2011–September 2013, by systematic random sampling from 10 taxi stations. Inclusion criteria were taxi drivers with body mass index (BMI which 23–29.9 and mild or moderate OSA. Portable polysomnography (PSG test was used to diagnose OSA. Parametric and nonparametric test were used in bivariate analysis. Logistic regression multivariable was used to final evaluate risk factors of OSA.Results: There were 54 (52.4% of 103 drivers with OSA and 49 (47.6% without OSA. Clinical symptoms found significantly (p<0.05 were snoring, unrefreshing sleep, occasional sleep while driving, and headache or nausea on waking up in the morning. Risk factors for OSA were increased BMI (OR=0.60, 95% CI=0.45–0.79, p=0.001, snoring history in the family (OR=4.92, 95% CI=1.82–13.31, p=0.002 and sleep duration <7 hours within 24 hours (OR=5.14, 95% CI=1.37–19.23, p=0.015.Conclusion: Clinical symptoms of OSA were snoring, unrefreshing sleep, occasional sleep while driving and headache or nausea on waking up in the morning. Risk factors of OSA were increased BMI, snoring history in the family and sleep duration <7 hours within 24 hours.

  2. Clinical and socio-medical factors related to anemia in pregnant women: prevalence study in Mara Township, Venezuela, 2013

    Ayari Guadalupe Ávila


    Full Text Available Anemia during pregnancy is a frequent finding and can increase morbidity and mortality in both mother and child. This paper aims to identify clinical, social and healthcare-related factors that affect the incidence of anemia in pregnant patients in a primary care prenatal clinic in Mara municipality. This is a descriptive field study that took place between November and December, 2013. Sixty-two patients were selected through non-probability sampling among four primary care clinics in the municipality of Mara. A high prevalence of anemia (76% was found, with normal MCV (mean corpuscular volume, normal MCH (mean corpuscular hemoglobin, and normal MCHC (mean corpuscular hemoglobin concentration. In only 36% of cases serum iron levels fell below 50 ug/dl. Some clinical factors found to be related to anemia in pregnancy are multiparity (69.9%, infections before or during pregnancy (77.5%, low protein intake (91.8%, less than a year birth interval (63.3%, and gestational age (89.8%. The main socioeconomic factor related to anemia is poverty (89.8%. Prenatal checkup schedule needs to be adjusted in primary care clinics in the municipality of Mara taking into consideration clinical and socioeconomic factors in order to lower the prevalence of anemia during pregnancy in this population.

  3. [Clinical and socio-medical factors related to anemia in pregnant women: prevalence study in Mara Township, Venezuela, 2013].

    Avila, Ayari Guadalupe; García, Lenis; Gómez, María; Villanueva, Nixon; Benítez, Betty; Fuentes, Belkis


    Anemia during pregnancy is a frequent finding and can increase morbidity and mortality in both mother and child. This paper aims to identify clinical, social and healthcare-related factors that affect the incidence of anemia in pregnant patients in a primary care prenatal clinic in Mara municipality. This is a descriptive field study that took place between November and December, 2013. Sixty-two patients were selected through non-probability sampling among four primary care clinics in the municipality of Mara. A high prevalence of anemia (76%) was found, with normal MCV (mean corpuscular volume), normal MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). In only 36% of cases serum iron levels fell below 50 ug/dl. Some clinical factors found to be related to anemia in pregnancy are multiparity (69.9%), infections before or during pregnancy (77.5%), low protein intake (91.8%), less than a year birth interval (63.3%), and gestational age (89.8%). The main socioeconomic factor related to anemia is poverty (89.8%). Prenatal checkup schedule needs to be adjusted in primary care clinics in the municipality of Mara taking into consideration clinical and socioeconomic factors in order to lower the prevalence of anemia during pregnancy in this population.

  4. The Course of Nonspecific Work-Related Upper Limb Disorders and the Influence of Demographic Factors, Psychologic Factors, and Physical Fitness on Clinical Status and Disability

    van Eijsden-Besseling, Marjon D.; van den Bergh, Karien A.; Staal, J. Bart; de Bie, Rob A.; van den Heuvel, Wim J.


    Objective: To assess the course of nonspecific work-related upper limb disorders (WRULD) and the influence of sociodemographic factors, psychologic factors, and physical fitness on clinical status and functional disability. Design: Retrospective cohort study with cross-sectional analysis among compu

  5. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus


    Background Evidence consistently shows that diabetes is a risk factor for increased prevalence of gingivitis and periodontitis. But there is a controversy about the relationship between diabetes related factors and periodontal health. The aim of the present study is to explore the relationship between diabetes related factors such as glycosylated hemoglobin, fasting blood glucose, duration of diabetes and compliance to diabetes self management and periodontal health status. Methods Periodontal health of 125 participants with type-2 diabetes mellitus was measured by the number of missing teeth, community periodontal index (CPI), Russell’s periodontal index and papillary bleeding index. Information on sociodemographic factors, oral hygiene behavior, duration and compliance to self management of diabetes, levels of glycosylated hemoglobin(HbA1c) and fasting blood glucose(FBG) were collected by interview and hospital medical records. Statistically, independent t-test, an analysis of variance (ANOVA), chi-squared test and multiple regression analyses were used to assess the association between diabetes-related factors and periodontal health. Results Periodontal parameters including the number of missing teeth and papillary bleeding index were significantly influenced by duration of diabetes, FBG and compliance to self management of diabetes. CPI was significantly influenced by duration of diabetes, FBG and HbA1C. And Russell’s periodontal index was significantly influenced by duration of diabetes, FBG, HbA1C and compliance to self management of diabetes. Results of multiple linear regression analysis showed that the duration of diabetes showed significant positive correlation with all of the periodontal health parameters, except for missing teeth. HbA1c was correlated with Russell's periodontal and papillary bleeding index. FBG and compliance to self management of diabetes were correlated with missing teeth and papillary bleeding index respectively. Conclusions

  6. Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus.

    Kim, Eun-Kyong; Lee, Sang Gyu; Choi, Youn-Hee; Won, Kyu-Chang; Moon, Jun Sung; Merchant, Anwar T; Lee, Hee-Kyung


    Evidence consistently shows that diabetes is a risk factor for increased prevalence of gingivitis and periodontitis. But there is a controversy about the relationship between diabetes related factors and periodontal health. The aim of the present study is to explore the relationship between diabetes related factors such as glycosylated hemoglobin, fasting blood glucose, duration of diabetes and compliance to diabetes self management and periodontal health status. Periodontal health of 125 participants with type-2 diabetes mellitus was measured by the number of missing teeth, community periodontal index (CPI), Russell's periodontal index and papillary bleeding index. Information on sociodemographic factors, oral hygiene behavior, duration and compliance to self management of diabetes, levels of glycosylated hemoglobin(HbA1c) and fasting blood glucose(FBG) were collected by interview and hospital medical records. Statistically, independent t-test, an analysis of variance (ANOVA), chi-squared test and multiple regression analyses were used to assess the association between diabetes-related factors and periodontal health. Periodontal parameters including the number of missing teeth and papillary bleeding index were significantly influenced by duration of diabetes, FBG and compliance to self management of diabetes. CPI was significantly influenced by duration of diabetes, FBG and HbA1C. And Russell's periodontal index was significantly influenced by duration of diabetes, FBG, HbA1C and compliance to self management of diabetes. Results of multiple linear regression analysis showed that the duration of diabetes showed significant positive correlation with all of the periodontal health parameters, except for missing teeth. HbA1c was correlated with Russell's periodontal and papillary bleeding index. FBG and compliance to self management of diabetes were correlated with missing teeth and papillary bleeding index respectively. Diabetes-related factors such as duration of

  7. The clinical expression of hereditary protein C and protein S deficiency: : a relation to clinical thrombotic risk-factors and to levels of protein C and protein S

    Henkens, C. M. A.; van der Meer, J.; Hillege, J. L.; Bom, V. J. J.; Halie, M. R.; van der Schaaf, W.

    We investigated 103 first-degree relatives of 13 unrelated protein C or protein S deficient patients to assess the role of additional thrombotic risk factors and of protein C and protein S levels in the clinical expression of hereditary protein C and protein S deficiency. Fifty-seven relatives were

  8. [Autoimmune hepatitis: clinical forms and related factors to their response to treatment].

    Dávalos, Milagros; Román, Rossana; Bustios, Carla; Zumaeta, Eduardo; Yabar, Alejandro


    Chronic liver disease is a clinical entity of different origins. It is most frequently caused by viral infection and alcohol consumption. The entities of immunological origin are listed in third place including autoimmune hepatitis, primary biliar cirrhosis, primary sclerosing cholangitis, as well as superposition syndromes. In Peru report of cases relating to autoimmune hepatitis are very few and its frequency is unknown. In 2002, autoimmune etiology represented 13% of all the cases admitted in the Hepathology Unit of Edgardo Rebagliati Martins National Hospital ("HNERM") for chronic hepatic disease. In this article, 30 cases of autoimmune hepatitis clinically and serologically diagnosed are reported. Biopsy was performed on 97% of the cases, of which 70% showed cirrhosis. The relationship F/M was 5/1, the average age was 48.59 years, and in 6.7% of the cases the initial picture was acute hepatic insufficiency. Antinuclear antibodies were found in 73.33%, smooth antimuscle antibodies in 43.33%, and antimitochondrial antibodies in 16.7%, with a coexistence of autoantibodies in 40%. The endoscopy performed revealed the presence of varices in 20% of the cases, but only one case of variceal hemorrhage. In most cases, therapy was initiated based on prednisone and azathioprine. Of 26 cases that were treated, 80% had an initial remission, 2 responded partially, and 3 did not respond. There were complications related to the treatment with immunosuppressants in 16.7% of the cases, and especially severe infections in 3 cases. In conclusion, autoimmune hepatitis is a substantial cause of chronic hepatic disease that has similar clinical characteristics to those reported in international medical journals. In most cases it responds to treatment with immunosuppressants. However, adequate follow-up is recommended to detect secondary complications in the treatment with immunosuppressants, especially in infections which represent a high risk of mortality in the immunosuppressed

  9. Review of clinical EMG studies related to muscle and occlusal factors in healthy and TMD subjects.

    Suvinen, T I; Kemppainen, P


    Several electronic instruments have been developed as adjuncts to objectively record the dysfunctional features of temporomandibular disorders and to study the effectiveness of various treatment interventions. The aim of this review was to assess the value and contribution of clinical electromyographic research in the understanding of asymptomatic and dysfunctional muscle function and the therapeutic effects of interocclusal appliances. For this purpose MedLine and PubMed searches were conducted with the following main keywords alone and in various combinations: electromyography, muscles of mastication, masseter, temporalis, temporomandibular, TMD, utility, validity, repeatability, rest, postural, vertical dimension, occlusal, splint, treatment. The review includes critical evaluation, discussion and conclusions regarding electromyographic studies in asymptomatic and dysfunctional muscles, rest position, occlusal parameters and interocclusal appliances, as well as a critical summary and proposals for further research. Much of earlier critique of many electromyographic studies still applies regarding comparative sample selections, research designs, analyses and conclusions. The areas not well-understood include normal biological variation, capacity for adaptation, fluctuations regarding the clinical course and multidimensional features of temporomandibular disorders and long-term follow-up data, especially in studies that evaluate the effectiveness of therapeutic measures. Considering the required improvements in technical and research designs features and critical appraisal electromyographic research could have value as an adjunct research tool to study features of craniofacial muscle-related dysfunction. Until electromyographic measures are correlated with other multidimensional, especially subjective and pain-related methods, the clinical use of this method for diagnostic purposes of temporomandibular disorders remains in doubt, and is not at present recommended.

  10. Clinical and biologic factors related to oral implant failure: a 2-year follow-up study.

    Moheng, Patrick; Feryn, Jean-Marc


    The purpose of this study is to evaluate urinary biomarkers of bone formation and resorption as predictive factors for oral implant failure, and to contribute to the knowledge of factors related to oral implant failure. A total of 93 patients between 18 and 85 years old, with an indication of oral implant, were eligible in this 2-year prospective, open, and nonrandomized study. Patients who had bone graft before implantation or presented with prosthetic difficulties (implant-to-crown ratio coating. Serum osteocalcin, and urinary pyridinoline and deoxypyridinoline were measured, together with bone density at implant location. The primary endpoint (implant failure) was the implant removal (radiographic evidence of peri-implant bone loss and/or pockets). Factors related to implant failure were analyzed using multilevel logistic regression models to consider within-patient effects. Of the 93 patients included, 61% were female, and 16% were current smokers. A total of 266 oral implants were placed and analyzed, with a mean number of 3.1 implants by patient. Eleven and 15% of bone locations scored at D1 and D4, respectively, for the Misch bone density scoring. The majority of implants (72%) were placed more than 3 months after tooth extraction, using a Frialit-2 system in 73% of cases. The mean of osteocalcin was 17.3 (+/-9.4) ng/L; those of pyridinoline and deoxypyridinoline were 33.2 (+/-15.8) and 10.2 (+/-11.9) mmol per creatinine mmol, respectively. At one-year, 95.5% (95% confidence interval 92.5-97.5) of implants have not been removed. One year later, no further implant failed. In both univariate and multivariate analysis, osteocalcin, pyridinoline, and deoxypyridinoline were not significant predictive factors of oral implant failure. In multilevel logistic regression analysis, only tobacco consumption and single-tooth replacement or removable prosthesis were independent and significant predictive factors of oral implant failure. Serum osteocalcin, and urinary

  11. Short sleep is a questionable risk factor for obesity and related disorders: statistical versus clinical significance.

    Horne, Jim


    Habitually insufficient sleep could contribute towards obesity, metabolic syndrome, etc., via sleepiness-related inactivity and excess energy intake; more controversially, through more direct physiological changes. Epidemiological studies in adult/children point to small clinical risk only in very short (around 5h in adults), or long sleepers, developing over many years, involving hundreds of hours of 'too little' or 'too much' sleep. Although acute 4h/day sleep restriction leads to glucose intolerance and incipient metabolic syndrome, this is too little sleep and cannot be sustained beyond a few days. Few obese adults/children are short sleepers, and few short sleeping adults/children are obese or suffer obesity-related disorders. For adults, about 7h uninterrupted daily sleep is 'healthy'. Extending sleep, even with hypnotics, to lose weight, may take years, compared with the rapidity of utilising extra sleep time to exercise and evaluate one's diet. The real health risk of inadequate sleep comes from a sleepiness-related accident.

  12. Clinical and demographic factors and outcome of amyotrophic lateral sclerosis in relation to population ancestral origin.

    Marin, Benoît; Logroscino, Giancarlo; Boumédiene, Farid; Labrunie, Anaïs; Couratier, Philippe; Babron, Marie-Claude; Leutenegger, Anne Louise; Preux, Pierre Marie; Beghi, Ettore


    To review how the phenotype and outcome of amyotrophic lateral sclerosis (ALS) change with variations in population ancestral origin (PAO). Knowledge of how PAO modifies ALS phenotype may provide important insight into the risk factors and pathogenic mechanisms of the disease. We performed a systematic review and meta-analysis of the literature concerning differences in phenotype and outcome of ALS that relate to PAO. A review of 3111 records identified 78 population-based studies. The 40 that were included covered 40 geographical areas in 10 subcontinents. Around 12,700 ALS cases were considered. The results highlight the phenotypic heterogeneity of ALS at time of onset [age, sex ratio (SR), bulbar onset], age at diagnosis, occurrence of comorbidities in the first year after diagnosis, and outcome (survival). Subcontinent is a major explanatory factor for the variability of the ALS phenotype in population-based studies. Some markers of ALS phenotype were homogeneously distributed in western countries (SR, mean age at onset/diagnosis) but their distributions in other subcontinents were remarkably different. Other markers presented variations in European subcontinents (familial ALS, bulbar onset) and in other continents. As a consequence, ALS outcome strongly varied, with a median survival time from onset ranging from 24 months (Northern Europe) to 48 months (Central Asia). This review sets the scene for a collaborative study involving a wide international consortium to investigate, using a standard methodology, the link between ancestry, environment, and ALS phenotype.

  13. Clinical characteristics, hospital outcome and prognostic factors of patients with ventilator-related pneumothorax.

    Hsu, C-W; Sun, S-F; Lee, D L; Chu, K-A; Lin, H-S


    Mechanical ventilation is a common cause of iatrogenic pneumothorax in intensive care units (ICU). Most of the patients with ventilator-related pneumothorax (VRP) have underlying lung diseases and is associated with increased morbidity and mortality. The prognostic factors of VRP are not clear. The objective of this study was to find the possible prognostic factors. Analysis of retrospectively collected data of patients with pneumothorax induced by mechanical ventilation. Data were obtained concerning demographics, acute physiology and chronic health evaluation (APACHE) II score, organ failure, underlying diseases, interval between the start of mechanical ventilation and pneumothorax, arterial blood gas, respiratory parameters and patient outcomes. One hundred and twenty-four patients with VRP were included for analysis. The incidence rate of VRP was 0.4% (124/31,660), and the mortality rate was 77.4%. The patients with VRP had higher hospital mortality rate than that of mechanically ventilated patients without pneumothorax (77.4% vs. 13.7%, PVRP occurred in the early phase of mechanical ventilation, and 8.9% of the patients had a later episode of pneumothorax on the opposite lung. The interval between two episodes of VRP was short, at a median time of 2 days. Cox regression analysis showed that tension pneumothorax (P=0.001), PaO2/FiO2VRP patients with tension pneumothorax or PaO2/FiO2VRP patients with PaO2/FiO2≥200 mmHg.

  14. Prognostic Factors Related to Clinical Response in Patients with Metastatic MelanomaTreated by CTL-Associated Antigen-4 Blockade

    Downey, Stephanie G.; Klapper, Jacob A.; Smith, Franz O.; C.Yang, James; Sherry, Richard M.; Royal, Richard E.; Kammula, Udai S.; Hughes, Marybeth S.; Allen, Tamika E.; Levy, Catherine L.; Michael, Yellin; Nichol, Geoffrey; E.White, Donald; Steinberg, Seth M.; Rosenberg, Steven A.


    Purpose CTL-associated antigen 4 (CTLA-4) can inhibit T-cell activation and helps maintain peripheral self-tolerance. Previously, we showed immune-related adverse events (IRAE) and objective, durable clinical responses in patients with metastatic melanoma treated with CTLA-4 blockade.We have now treated139 patients in two trials and have sufficient follow-up to examine factors associated with clinical response. Experimental Design A total of 139 patients with metastatic melanoma were treated: 54 patients received ipilimumab in conjunction with peptide vaccinations and 85 patients were treated with intrapatient dose escalation of ipilimumab and randomized to receive peptides in accordance with HLA-A*0201status. Results Three patients achieved complete responses (CR; ongoing at 29+, 52+, and 53+ months); an additional 20 patients achieved partial responses (PR) for an overall objective response rate of 17%. The majority of patients (62%, 86 of 139) developed some form of IRAE, which was associated with a greater probability of objective antitumor response (P = 0.0004); all patients with CR had more severe IRAEs. Prior therapy with IFNα-2b was a negative prognostic factor, whereas prior high-dose interleukin-2 did not significantly affect the probability of response. There were no significant differences in the rate of clinical response or development of IRAEs between the two trials. The duration of tumor response was not affected by the use of high-dose steroids for abrogation of treatment-related toxicities (P = 0.23). There were no treatment-related deaths. Conclusion In patients with metastatic melanoma, ipilimumab can induce durable objective clinical responses, which are related to the induction of IRAEs. PMID:17982122

  15. Comparative usefulness of inflammatory markers to indicate bacterial infection-analyzed according to blood culture results and related clinical factors.

    Nishikawa, Hirokazu; Shirano, Michinori; Kasamatsu, Yu; Morimura, Ayumi; Iida, Ko; Kishi, Tomomi; Goto, Tetsushi; Okamoto, Saki; Ehara, Eiji


    To assess relationships of inflammatory markers and 2 related clinical factors with blood culture results, we retrospectively investigated inpatients' blood culture and blood chemistry findings that were recorded from January to December 2014 using electronic medical records and analyzed the data of 852 subjects (426 culture-positive and 426 culture-negative). Results suggested that the risk of positive blood culture statistically increased as inflammatory marker levels and the number of related factors increased. Concerning the effectiveness of inflammatory markers, when the outcome definition was also changed for C-reactive protein (CRP), the odds ratio had a similar value, whereas when the outcome definition of blood culture positivity was used for procalcitonin (PCT), the greatest effectiveness of that was detected. Therefore, the current results suggest that PCT is more useful than CRP as an auxiliary indication of bacterial infection.

  16. Socio-demographic and clinical factors related to mortality among the geriatric suicide attempters admitted to the emergency department

    Yılmaz Zengin


    Full Text Available Objective: The ratio of elderly people in Turkey is rapidly growing. Accordingly, psychiatric problems and suicidality among elderly people are growing concerns. In this study, we aimed to investigate the socio-demographic characteristics of older people who attempted suicide by drug and to identify risk factors affecting mortality. Methods: Patients who were over 65 years old and admitted to the emergency department of a university hospital due to drug-related suicide attempt between January 1, 2004 and December 30, 2014, were included into this retrospective cross-sectional study. Relationship between suicide attempt and mortality was investigated in regard to socio-demographic and clinical factors. Patients were divided into two groups according to whether they survived or died. Results: Of the 107 patients included in the study, 68.2% were female and 31.8% were male; 34.6% were married. Common reasons for suicide attempt were depression (34.6% and domestic violence (30.8%. Analgesics (33.6% were the most common drugs used in suicide attempts. The analysis of the factors related to suicide attempt and mortality revealed that significant factors were loneliness, being widowed, being retired, having adjustment disorder and anxiety disorder. Conclusion: Loneliness, being widowed, being retired, adjustment disorder, and anxiety disorder were found as the risk factors affecting mortality in geriatric suicide attempts.

  17. Factors Related to Healthy Diet and Physical Activity in Hospital-Based Clinical Nurses.

    Albert, Nancy M; Butler, Robert; Sorrell, Jeanne


    Hospitals often promote healthy lifestyles, but little is known about nurses' actual diet and physical activity. Greater understanding about these lifestyle choices for clinical nurses may improve existing hospital-based programs and/or create desirable services. This article discusses a study that considered diet and physical activity of clinical nurses, using elements of Pender's self-care theory as a conceptual framework. Study methods included a cross-sectional, correlational design and a convenience sample of 278 nurses who worked on units with 24 hours/day and seven days-per-week responsibilities. Participants completed diet and exercise questionnaires about perceptions of attitudes and opinions, barriers, diet benefits/exercise motivators, self-efficacy, and locus of control, and personal and work characteristics. Diet and activity categories were created. Study results demonstrated that over 50% of nurses had moderately healthy diets but were insufficiently active. Healthy diet and physical activity levels were associated with higher self-efficacy, more diet benefits and physical activity motivators, fewer perceived barriers, and confidence in body image. The article discussion and conclusion sections note areas for future research and suggest that focused interventions that address benefits, motivators, and self-efficacy may increase participation in hospital-based programs and enhance healthy lifestyle for hospital-based clinical nurses.

  18. Clinical Prediction Making: Examining Influential Factors Related to Clinician Predictions of Recidivism among Juvenile Offenders

    Calley, Nancy G.; Richardson, Emily M.


    This study examined factors influencing clinician predictions of recidivism for juvenile offenders, including youth age at initial juvenile justice system involvement, youth age at discharge, program completion status, clinician perception of strength of the therapeutic relationship, and clinician perception of youth commitment to treatment.…

  19. Individual and socio-demographic factors related to presenting problem and diagnostic impressions at a pediatric sleep clinic.

    Rubens, Sonia L; Patrick, Kristina E; Williamson, Ariel A; Moore, Melisa; Mindell, Jodi A


    Individual and socio-demographic factors have been found to be associated with sleep disturbances in children. Few studies have examined these factors among children presenting for care at pediatric sleep clinics. This study examined individual and socio-demographic factors in association with presenting problems and diagnostic impressions for new patients at an interdisciplinary pediatric sleep clinic. Data were collected from electronic medical records of 207 consecutive patients (54% male, 59% White, Meanage = 7.73, SD = 5.62). Older age, female gender, and White race were associated with higher likelihood of presenting with difficulty falling asleep; younger age, male gender, and Black race were associated with higher likelihood of presenting with obstructive sleep apnea (OSA)-related concerns. Older age was associated with diagnostic impressions of inadequate sleep hygiene, insufficient sleep, circadian rhythm disorder/delayed sleep phase disorder, periodic limb movement disorder/restless legs syndrome, and insomnia, while younger age was associated with provisional OSA and behavioral insomnia of childhood (BIC) diagnoses. Male gender was associated with provisional OSA. White race was associated with BIC. Age-based analyses were also conducted to further understand the findings within a developmental context. Age- and gender-related findings converged with prevalence literature on pediatric sleep disorders. Race was only associated with presenting concern and BIC, and one association for neighborhood disadvantage was found within the age-based analysis. Results suggest a potential service delivery gap, with racial/ethnic minority youth being less likely to present for sleep services, despite prevalence data on the increased likelihood of sleep disturbances among these youth. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Epidermal growth factor receptor mutation in adenocarcinoma lung in a North Indian population: Prevalence and relation with different clinical variables

    Kasana, Basharat Ahmad; Dar, Waseem Raja; Aziz, Sheikh Aijaz; Lone, Abdul Rashid; Sofi, Najeeb Ullah; Dar, Imtiyaz Ahmad; Latief, Muzamil; Arshad, Faheem; Hussain, Moomin; Hussain, Mir


    Introduction: Lung cancer is one of the most common causes of cancer deaths worldwide. Adenocarcinoma is taking over squamous cell lung cancer as the predominant histological subtype. Several cytotoxic drugs are available for the treatment of lung cancer, but side effects limit their use. Recently, targeted therapies for cancers have come into clinical practice. Aims and Objectives: To determine the prevalence of epidermal growth factor receptor (EGFR) mutation in adenocarcinoma lung in a North Indian population and its relation with different clinical variables. Materials and Methods: A total of 57 patients who met inclusion criteria were recruited into the study. Relevant history, clinical examination and investigations were done. EGFR mutation was done in all patients. Results: A total of twenty patients tested positive for EGFR mutation. EGFR was more frequently detected in female patients (53.8%), while as only 19.4% of the male patients expressed EGFR mutation, which was statistically very significant (P = 0.007). EGFR mutation was more frequently detected in nonsmokers (52%) as compared to smokers (21.9%) which also was statistically significant (P value of 0.018). EGFR mutation was more common in Stage III and IV adenocarcinomas (48%) as compared to Stage I and II (21.4%) which was statistically significant (P value 0.034). Conclusion: EGFR mutation should be routinely done in all patients of adenocarcinoma lung particularly non-smoker females with Stage III and IV disease. PMID:27688613

  1. Determining the agent factors related with time management of responsible doctors and nurses in clinics at Ankara University hospitals.

    Acuner, Ahmet Munir; Nilgun, Sarp; Cifteli, F Gulay


    This research has been planned and conducted as a descriptive scanning model field study in order to determine the agent factors related with time management of doctors and nurses in positions of responsibility at Ankara University hospitals. As data collection instruments; the "Personal Information Form" which has been developed to determine the socio-demographical characteristics of the research group, the questionnaire of "Determining the Time Management Attitudes and Behaviour of Managers, Time Management Opportunities of the Managers, Prodcutive Working Times of the Managers and the Factors Causing Them to Lose Time", developed by Erdem has been used. It has been determined that the time management attitudes and behaviour of doctors, nurses and nurse assistants responsible for clinics are all different. It was found that nurse assistants graduated from pre-undergraduate or high schools are the least conscious of time management. In particular, nurse assistants of 36 years old and over with 21 years of work experience and 11 years of management experience show little awareness of time management. The time losing factors of the research group were found to be unnecessary visitors, lack of materials and the excessive amount of time spent on obtaining the necessary equipment.

  2. Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn's Disease Patients: Results from the CONNECT Study.

    Chang Mo Moon

    Full Text Available Diagnostic delay frequently occurs in Crohn's disease (CD patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years (p = 0.014, concomitant upper gastrointestinal (UGI disease (p = 0.012 and penetrating disease behavior at diagnosis (p = 0.001 were positively associated with long diagnostic delay (≥18 months. During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017, internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011, and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016. However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CD-related complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

  3. Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types.

    Cooper, Alethea F; Hankins, Matthew; Rixon, Lorna; Eaton, Emma; Grunfeld, Elizabeth A


    Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynaecological, head and neck, and urological cancer. A 12-month prospective questionnaire study was conducted with 290 patients. Cox regression analyses were conducted to calculate hazard ratios (HR) for time to RTW. Between 89-94% of cancer survivors returned to work. Breast cancer survivors took the longest to return (median 30 weeks), and urology cancer survivors returned the soonest (median 5 weeks). Earlier return among breast cancer survivors was predicted by a greater sense of control over their cancer at work (HR 1.2; 95% CI: 1.09-1.37) and by full-time work (HR 2.1; CI: 1.24-3.4). Predictive of a longer return among gynaecological cancer survivors was a belief that cancer treatment may impair ability to work (HR 0.75; CI: 0.62-0.91). Among urological cancer survivors constipation was predictive of longer RTW (HR 0.99; CI: 0.97-1.00), whereas undertaking flexible working was predictive of returning sooner (HR 1.70; CI: 1.07-2.7). Head and neck cancer survivors who perceived greater negative consequences of their cancer took longer to return (HR 0.27; CI: 0.11-0.68). Those reporting better physical functioning returned sooner (HR1.04; CI: 1.01-1.08). A different profile of predictive factors emerged for the four cancer types. In addition to optimal symptom management and workplace adaptations, the findings suggest that eliciting and challenging specific cancer and treatment-related perceptions may facilitate RTW. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Health-related quality of life in Russian adults with epilepsy: the effect of socio-demographic and clinical factors.

    Melikyan, Elina; Guekht, Alla; Milchakova, Larisa; Lebedeva, Anna; Bondareva, Irina; Gusev, Eugeny


    The aim of this study was to evaluate socio-demographic and clinical factors influencing the health-related quality of life (HRQOL) of adult patients with epilepsy in a naturalistic treatment setting in Russia. The QOLIE-31 questionnaire and the Beck Depression Inventory (BDI) were completed by 208 patients with a broad clinical spectrum of epilepsy (the mean age was 31.49±13.20 years and ranged from 18 to 74 years). In Russian adult patients with epilepsy, lower mean QOLIE-31 scores were obtained compared with previously published international data for overall HRQOL, emotional well-being, and cognitive functioning and social functioning subscales (pfactor associated with all HRQOL domains, except for medication effects and emotional well-being, whereas gender, education, family status, seizure type, employment, lateralization of epileptic foci, number of antiepileptic drugs, and the reported adverse events did not significantly affect HRQOL. The present study has revealed that longer duration of epilepsy, older age, higher seizure frequency, and depression are the potential predictors of worse HRQOL in adult Russian patients with epilepsy. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Rheumatoid Factors: Clinical Applications

    Francesca Ingegnoli


    Full Text Available Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy.


    LUNA, Leonardo Duarte Sobreira; SOARES, Douglas de Sousa; JUNIOR, Geraldo Bezerra da SILVA; CAVALCANTE, Malena Gadelha; MALVEIRA, Lara Raissa Cavalcante; MENESES, Gdayllon Cavalcante; PEREIRA, Eanes Delgado Barros; DAHER, Elizabeth De Francesco


    SUMMARY Background: The aim of this study is to describe clinical characteristics, outcomes and risk factors for death among patients with HIV-related acute kidney injury (AKI) admitted to an intensive care unit (ICU). Methods: A retrospective study was conducted with HIV-infected AKI patients admitted to the ICU of an infectious diseases hospital in Fortaleza, Brazil. All the patients with confirmed diagnosis of HIV and AKI admitted from January 2004 to December 2011 were included. A comparison between survivors and non-survivors was performed. Risk factors for death were investigated. Results: Among 256 AKI patients admitted to the ICU in the study period, 73 were identified as HIV-infected, with a predominance of male patients (83.6%), and the mean age was 41.2 ± 10.4 years. Non-survivor patients presented higher APACHE II scores (61.4 ± 19 vs. 38.6 ± 18, p = 0.004), used more vasoconstrictors (70.9 vs. 37.5%, p = 0.02) and needed more mechanical ventilation - MV (81.1 vs. 35.3%, p = 0.001). There were 55 deaths (75.3%), most of them (53.4%) due to septic shock. Independent risk factors for mortality were septic shock (OR = 14.2, 95% CI = 2.0-96.9, p = 0.007) and respiratory insufficiency with need of MV (OR = 27.6, 95% CI = 5.0-153.0, p < 0.001). Conclusion: Non-survivor HIV-infected patients with AKI admitted to the ICU presented higher severity APACHE II scores, more respiratory damage and hemodynamic impairment than survivors. Septic shock and respiratory insufficiency were independently associated to death. PMID:27410912

  7. Prognostic factors related to clinical outcome following thrombectomy in ischemic stroke (RECOST Study). 50 patients prospective study

    Costalat, V., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Lobotesis, K., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Machi, P., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Mourand, I., E-mail: [CHU Montpellier, Neurology, Montpellier (France); Maldonado, I., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Heroum, C., E-mail: [CHU Montpellier, Neurology, Montpellier (France); Vendrell, J.F., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Milhaud, D., E-mail: [CHU Montpellier, Neurology, Montpellier (France); Riquelme, C., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Bonafé, A., E-mail: [CHU Montpellier, Neuroradiology, Montpellier (France); Arquizan, C., E-mail: [CHU Montpellier, Neurology, Montpellier (France)


    Background and aims: New thrombectomy devices allow successful and rapid recanalization in acute ischemic stroke. Nevertheless prognostics factors need to be systematically analyzed in the context of these new therapeutic strategies. The aim of this study was to analyze prognostic factors related to clinical outcome following Solitaire FR thrombectomy in ischemic stroke. Methods: Fifty consecutive ischemic stroke patients with large vessel occlusion were included. Three treatment strategies were applied; rescue therapy, combined therapy, and standalone thrombectomy. DWI ASPECT score < 5 was the main exclusion criterion after initial MRI (T2, T2*, TOF, FLAIR, DWI). Sexes, age, time to recanalization were prospectively collected. Clinical outcome was assessed post treatment, day one and discharge by means of a NIHSS. Three months mRS evaluation was performed by an independent neurologist. The probability of good outcome at 3 months was assessed by forward stepwise logistic regression using baseline NIHSS score, Glasgow score at entrance, hyperglycemia, dyslipidemia, blood–brain barrier disruption on post-operative CT, embolic and hemorrhagic post procedural complication, ischemic brain lesion extension on 24 h imaging, NIHSS at discharge, ASPECT score, and time to recanalization. All variables significantly associated with the outcome in the univariate analysis were entered in the model. The significance of adding or removing a variable from the logistic model was determined by the maximum likelihood ratio test. Odds-ratio (OR) and their 95% confidence intervals were calculated. Results: At 3 months 54% of patients had a mRS 0–2, 70% in MCA, 44% in ICA, and 43% in BA with an overall mortality rate of 12%. Baseline NIHSS score (p = 0.001), abnormal Glasgow score at entrance (p = 0.053) hyperglycemia (p = 0.023), dyslipidemia (p = 0.031), blood–brain barrier disruption (p = 0.022), embolic and hemorrhagic post procedural complication, ischemic brain lesion

  8. Investigation of critical inter-related factors affecting the efficacy of pulsed light for inactivating clinically relevant bacterial pathogens.

    Farrell, H P; Garvey, M; Cormican, M; Laffey, J G; Rowan, N J


    To investigate critical electrical and biological factors governing the efficacy of pulsed light (PL) for the in vitro inactivation of bacteria isolated from the clinical environment. Development of this alternative PL decontamination approach is timely, as the incidence of health care-related infections remains unacceptably high. Predetermined cell numbers of clinically relevant Gram-positive and Gram-negative bacteria were inoculated separately on agar plates and were flashed with pulses of broad-spectrum light under varying operating conditions, and their inactivation measured. Significant differences in inactivation largely occurred depending on the level of the applied lamp discharge energy (range 3.2-20 J per pulse), the amount of pulsing applied (range 0-60 pulses) and the distance between light source and treatment surface (range 8-20 cm) used. Greater decontamination levels were achieved using a combination of higher lamp discharge energies, increased number of pulses and shorter distances between treatment surface and the xenon light source. Levels of microbial sensitivity also varied depending on the population type, size and age of cultures treated. Production of pigment pyocynanin and alginate slime in mucoid strains of Pseudomonas aeruginosa afforded some protection against lethal action of PL; however, this was evident only by using a combination of reduced amount of pulsing at the lower lamp discharge energies tested. A clear pattern was observed where Gram-positive bacterial pathogens were more resistant to cidal effects of PL compared to Gram negatives. While negligible photoreactivation of PL-treated bacterial strains occurred after full pulsing regimes at the different lamp discharge energies tested, some repair was evident when using a combination of reduced pulsing at the lower lamp discharge energies. Strains harbouring genes for multiple resistances to antibiotics were not significantly more resistant to PL treatments. Slight temperature

  9. Pregnancy-related systemic lupus erythematosus: clinical features, outcome and risk factors of disease flares--a case control study.

    Huaxia Yang

    Full Text Available OBJECTIVE: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL. METHODS: Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. RESULTS: PRL cases were divided into active (a-PRL (n = 82, 53.0% and stable lupus (s-PRL (n = 73, 47.0%. Compared with nonpregnant active female systemic lupus erythematosus (SLE patients, a-PRL including new-onset lupus (n-PRL and flare lupus (f-PRL (n = 41 respectively, had a higher incidence of renal and hematological involvement but less mucocutaneous and musculoskeletal involvement (p<0.05. The incidence of preeclampsia/eclampsia, fetal loss, and preterm birth were significantly higher in a-PRL than in s-PRL (p<0.05. Despite receiving a more vigorous glucocorticoid treatment, a-PRL mothers had a poorer prognosis (p<0.001. Five (6.1% of them died and 13 (15.9% developed severe irreversible organ failure, whereas none of these events was observed in the s-PRL group. Multivariate logistic analysis indicated that a history of lupus flares and serological activity (hypocomplementemia and/or anti-dsDNA positivity at the time of conception were associated with lupus flares in PRL mothers. CONCLUSIONS: SLE patients with a flare history and serological activity at the time of conception were at an increased risk of disease flares during pregnancy and puerperium. a-PRL patients were more prone to renal and hematological involvement, pregnancy complications, and a poorer prognosis despite more vigorous glucocorticoid treatment.

  10. Factors associated with health-related quality of life among injection drug users at methadone clinics in Taipei, Taiwan

    Yung-Feng Yen


    Conclusion: Poor HRQOL was associated with a number of factors among IDUs at methadone clinics in Taipei, Taiwan. To improve HRQOL in this population, future programs should focus on IDUs with a history of drug overdose. In addition, methadone programs and social support should be integrated to improve HRQOL among this socially marginalized population.

  11. Limited polymorphism in Plasmodium falciparum ookinete surface antigen, von Willebrand factor A domain-related protein from clinical isolates

    Eisen Damon P


    Full Text Available Abstract Background As malaria becomes increasingly drug resistant and more costly to treat, there is increasing urgency to develop effective vaccines. In comparison to other stages of the malaria lifecycle, sexual stage antigens are under less immune selection pressure and hence are likely to have limited antigenic diversity. Methods Clinical isolates from a wide range of geographical regions were collected. Direct sequencing of PCR products was then used to determine the extent of polymorphisms for the novel Plasmodium falciparum sexual stage antigen von Willebrand Factor A domain-related Protein (PfWARP. These isolates were also used to confirm the extent of diversity of sexual stage antigen Pfs28. Results PfWARP was shown to have non-synonymous substitutions at 3 positions and Pfs28 was confirmed to have a single non-synonymous substitution as previously described. Conclusion This study demonstrates the limited antigenic diversity of two prospective P. falciparum sexual stage antigens, PfWARP and Pfs28. This provides further encouragement for the proceeding with vaccine trials based on these antigens.

  12. Clinical outcome of salvage neck dissections in head and neck cancer in relation to initial treatment, extent of surgery and patient factors

    van den Bovenkamp, K.; Noordhuis, M.G.; Oosting, S.F.; van der Laan, B.F.A.M.; Roodenburg, J.L.; Bijl, H.P.; Halmos, G.B.; Plaat, B.E.C.

    ObjectiveSalvage surgery has a higher complication rate compared to primary surgical treatment. We evaluated clinical outcome of salvage neck dissections in relation to initial treatment modality, extent of surgery and patient-related factors. DesignSingle institution consecutive case series.

  13. Growth of self-perceived clinical competence in postgraduate training for general practice and its relation to potentially influencing factors.

    Kramer, A.W.M.; Zuithoff, P.; Jansen, J.J.M.; Tan, L.H.; Grol, R.P.T.M.; Vleuten, C.P.M. van der


    OBJECTIVE: To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables. DESIGN: Cohort, 1995-1998. SETTING: Three-year Postgrad

  14. Growth of Self-Perceived Clinical Competence in Postgraduate Training for General Practice and Its Relation to Potentially Influencing Factors

    Kramer, A. W. M.; Zuithoff, P.; Jansen, J. J. M.; Tan, L. H. C.; Grol, R. P. T. M.; van der Vleuten, C. P. M.


    Objective: To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables. Design: Cohort, 1995-1998. Setting: Three-year Postgraduate Training for General practice in the…

  15. Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Na?ve Hospital in Northern Sweden

    Peterson, Cecilia; Gustafsson, Maria


    Background Polypharmacy and increased sensitivity to side effects cause adverse drug events, drug?drug interactions and medication errors in the elderly. Objective The objective of this study was to investigate the prevalence and type of drug-related problems and associated factors among patients admitted to a clinical pharmacist service-na?ve medical ward in an inland hospital in northern Sweden. Methods During September?November 2015 and February?April 2016, clinical pharmacists working as ...


    D. N. Andreev


    Full Text Available The article presents the results of a prospective clinical study in which 100 patients with H. pylori-associated peptic ulcer disease of stomach/duodenum were examined. The aim of the study was to assess the effect of concomitant anamnestic and clinical factors on the efficacy and safety of eradication therapy (ET. Type 2 diabetes mellitus is a factor that significantly reduces the efficiency of ET with OR 0.21 (95% CI 0,06-0,69, p = 0,0102. Using a macrolide antibiotics prior to ET during the previous 12 months is associated with a reduction in the effectiveness of H. pylori eradication with OR 0.27 (95% CI 0,08-0,90, p = 0,0342. Despite the lack of statistical significance observed negative effect on the efficiency of ET factors such as smoking and increased BMI. Smoking, female gender, age over 50 years and the presence of type 2 diabetes mellitus had no significant impact on the safety profile of ET. 

  17. Patient-related independent clinical risk factors for early complications following Nd: YAG laser resection of lung cancer

    Branislav Perin


    Full Text Available Introduction: Neodymium:yttrium aluminum garnet (Nd:YAG laser resection is one of the most established interventional pulmonology techniques for immediate debulking of malignant central airway obstruction (CAO. The major aim of this study was to investigate the complication rate and identify clinical risk factors for complications in patients with advanced lung cancer. Methods: In the period from January 2006 to January 2011, data sufficient for analysis were identified in 464 patients. Nd:YAG laser resection due to malignant CAO was performed in all patients. The procedure was carried out in general anesthesia. Complications after laser resection were defined as severe hypoxemia, global respiratory failure, arrhythmia requiring treatment, hemoptysis, pneumothorax, pneumomediastinum, pulmonary edema, tracheoesophageal fistulae, and death. Risk factors were defined as acute myocardial infarction within 6 months before treatment, hypertension, chronic arrhythmia, chronic obstructive pulmonary disease (COPD, stabilized cardiomyopathy, previous external beam radiotherapy, previous chemotherapy, and previous interventional pulmonology treatment. Results : There was 76.1% male and 23.9% female patients in the study, 76.5% were current smokers, 17.2% former smokers, and 6.3% of nonsmokers. The majority of patients had squamous cell lung cancer (70%, small cell lung cancer was identified in 18.3%, adenocarcinoma in 3.4%, and metastases from lung primary in 8.2%. The overall complication rate was 8.4%. Statistically significant risk factors were age (P = 0.001, current smoking status (P = 0.012, arterial hypertension (P < 0.0001, chronic arrhythmia (P = 0.034, COPD (P < 0.0001, and stabilized cardiomyopathy (P < 0.0001. Independent clinical risk factors were age over 60 years (P = 0.026, arterial hypertension (P < 0.0001, and COPD (P < 0.0001. Conclusion : Closer monitoring of patients with identified risk factors is advisable prior and immediately after

  18. Clinical factors, anticitrullinated peptide antibodies and MRI-detected subclinical inflammation in relation to progression from clinically suspect arthralgia to arthritis.

    van Steenbergen, Hanna W; Mangnus, Lukas; Reijnierse, Monique; Huizinga, Tom W J; van der Helm-van Mil, Annette H M


    Patients with clinically suspect arthralgia (CSA) have, according to their rheumatologists, an increased risk of rheumatoid arthritis (RA), but their actual outcome is unexplored. This longitudinal study investigated (1) progression from CSA to clinically detectable arthritis and (2) associations of clinical factors, serological factors (among which are anticitrullinated peptide antibodies (ACPAs)) and MRI-detected subclinical inflammation with arthritis development. 150 patients with CSA were followed for ≥6 months. At baseline, clinical and serological data were collected and unilateral 1.5 T-MRI of metacarpophalangeal (MCP), wrist and metatarsophalangeal (MTP) joints was made. MRI scoring was done according to the RA MRI scoring system. Subclinical MRI inflammation was defined based on MRI results of 193 symptom-free persons. During follow-up (median=75 weeks, IQR=41-106 weeks), 30 patients developed clinical arthritis; 87% did so <20 weeks after inclusion. In multivariable analyses, age, localisation of initial symptoms in small and large joints (compared with small joints only), C-reactive protein level, ACPA-positivity and subclinical MRI inflammation significantly associated with arthritis development; ACPA and MRI inflammation were most strongly associated (HR (95% CI) respectively, 6.43 (2.57 to 16.05) and 5.07 (1.77 to 14.50)). After 1-year follow-up, 31% of the patients with MRI inflammation and 71% of the ACPA-positive patients with MRI inflammation had progressed to arthritis. Forty-three per cent of the patients that developed arthritis within 1 year were ACPA-negative; 78% of them had subclinical MRI inflammation at baseline. When MRI inflammation was absent arthritis development was infrequent (6% in all patients with CSA and 3% in ACPA-negative patients with CSA). Subclinical MRI inflammation precedes clinical arthritis with a few months. Subclinical MRI inflammation is, independent of other factors such as ACPA, associated with




    We investigated 103 first-degree relatives of 13 unrelated protein C or protein S deficient patients to assess the role of additional thrombotic risk factors and of protein C and protein S levels in the clinical expression of hereditary protein C and protein S deficiency. Fifty-seven relatives were

  20. Cytokine profiles of seventeen cytokines, growth factors and chemokines in cord blood and its relation to perinatal clinical findings.

    Takahashi, Naoto; Uehara, Ritei; Kobayashi, Mami; Yada, Yukari; Koike, Yasunori; Kawamata, Ryou; Odaka, Jun; Honma, Yoko; Momoi, Mariko Y


    Few papers have investigated the cytokine profiles of multiple cytokines in cord blood. We obtained cord blood samples from 224 infants admitted to our neonatal intensive care unit. Cytokine profiles of 17 cytokines were investigated using cytometric bead array technology. We found a wide variety of cytokines of various levels which ranged from 0.59pg/ml (in Interleukin (IL)-4) to 222.0pg/ml (in macrophage inflammatory protein-1beta. Pro-inflammatory cytokines were highly correlated with each other and with granulocyte-colony stimulating factor and IL-8. On the contrary, IL-5, IL-13, and IL-17 did not show any significant correlation with other cytokines. Several maternal factors were strongly related to several cytokines in cord blood. IL-6, IL-8 and monocyte chemotactic protein-1 were closely related to certain neonatal diseases in preterm neonates. Some cytokines may be regulated independently of each other, while others appear to work as a network affecting physiological and pathological conditions in the fetus.

  1. Relations of nuclear factor-kappa B activity in the kidney of children with primary nephrotic syndrome to clinical manifestations, pathological types, and urinary protein excretion

    ZHAO Hong-yang; SUN Ruo-peng; DONG Jun-hua; ZHEN Jun-hui


    @@ The pathogenesis of childhood primary nephrotic syndrome (PNS) is unclear. However, an immune mechanism has generally been accepted as a cause. Imbalance of T lymphocyte and a variety of inflammatory cytokines, chemotactic and transcription factors are involved in the pathophysiology and manifestations of PNS,1,2 and nuclear factor kappa B (NF-κB) transcriptionally regulates the expression of these factors.3 Research has been focused on NF-κB and inflammatory regulated mediators of renal diseases, but seldom on different clinical manifestations and histopathological changes. In order to explore a potential mechanism for the pathogenesis of PNS in children and a basis for preventing its advance, we determined NF-κB activity in the kidney of children with PNS in vitro using immunohistochemical staining and the multimedia coloured pathological image analysis system and its relations to clinical manifestations, histopathological changes and 24-hour urinary protein excretion.

  2. Evaluation of relative distribution and risk factors in patients with dry socket referring to Yazd dental clinics

    Hasan Momeni


    Conclusion: The results of our study suggested that trauma during surgery or extraction and poor oral hygiene are important factors that increase the incidence of dry socket, these factors should be considered before and after tooth extractions.

  3. Factores asociados al empleo de varios antibióticos en pacientes clínicos Factors related to the use of several antibiotics in clinical patients

    Ioanna Mir Narbona


    Full Text Available Objetivo: identificar factores asociados con el empleo de varios antibióticos en pacientes clínicos. Métodos: se realizó un estudio de casos y controles en pacientes con infección, egresados de los servicios clínicos en el Hospital Docente Clínicoquirúrgico "Joaquín Albarrán" entre mayo de 2008 y diciembre de 2011. Se consideró caso al paciente que utilizó tres o más antibióticos. Se obtuvo la siguiente información: edad, sexo, antecedentes patológicos personales, tiempo de inicio de los síntomas sugestivos de un proceso infeccioso, uso previo de antibióticos, signos vitales y estado de conciencia al ingreso, resultados de estudios hematológicos y de química sanguínea, estudios radiográficos de tórax, diagnóstico de infección nosocomial y uso inadecuado de antimicrobianos. Se compararon las frecuencias mediante las pruebas de homogeneidad y prueba exacta de Fisher, pruebas t y de Wilcoxon. Se empleó la regresión logística para la identificación de los factores de riesgo. Resultados: Se estudiaron 92 casos y 184 controles. El riesgo de empleo de varios antibióticos se incrementó 2,68 veces por cada grado centígrado que se encontró elevada la temperatura del paciente (OR= 2,68; IC 95 % 1,21-5,94, 7 veces si existió alteración del nivel de conciencia (OR= 7,32; IC 95 % 1,88-28,55, 3,88 veces si se diagnosticó infección nosocomial y 9,98 veces si se consideró inadecuado el uso de antimicrobianos. Conclusiones: Los factores de riesgo para el uso de varios antibióticos identificados pueden contribuir a elaborar estrategias de control de la calidad de prescripción de antimicrobianos.Objective: to identify the factors associated to the use of several antibiotics in clinical patients. Methods: a case-control study of patients with infection, who were discharged from the clinical services at "Joaquín Albarrán" hospital from May, 2008 to December 2011. The patient who used three or more antibiotics was considered

  4. "Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors - a validation study in primary care.

    Post Sennehed, Charlotte; Gard, Gunvor; Holmberg, Sara; Stigmar, Kjerstin; Forsbrand, Malin; Grahn, Birgitta


    Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short "Blue flags" questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace. From the original"The General Nordic Questionnaire" (QPSNordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPSNordic content areas and organised in a short questionnaire "Blue flags". These 14 items were validated towards the 51 QPSNordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial. The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong rs = 0.87 (p development of the "Blue flags" questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

  5. Epidemiology and Changes in Patient-Related Factors from 1997 to 2009 in Clinical Yeast Isolates Related to Dermatology, Gynaecology, and Paediatrics

    Viktor Czaika


    Full Text Available From 1997 to 2009, 1,862 dermatology, gynaecology, and paediatrics (DGP associated clinical yeast isolates were analysed for species occurrence, specimen origin and type, (multi- resistance pattern, and testing period. The top seven of the isolated DGP-associated species remained the same as compared to total medical wards, with Candida albicans (45% as most frequent pathogen. However, the DGP wards and DGP ICUs showed species-specific profiles; that is, the species distribution is clinic-specific similar and however differs in their percentage from ward to ward. By applying the “one fungus one name” principle, respectively, the appropriate current taxonomic species denominations, it has been shown that no trend to emerging species from 1998 to 2008 could be detected. In particular the frequently isolated non-Candida albicans species isolated in the DGP departments have already been detected in or before 1997. As yeasts are part of the cutaneous microbiota and play an important role as opportunistic pathogens for superficial infections, proper identification of the isolates according to the new nomenclature deems to be essential for specific and calculated antifungal therapy for yeast-like DGP-related infectious agents.

  6. Patient-Related Factors Influencing Satisfaction in the Patient-Doctor Encounters at the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

    Ndifreke E. Udonwa


    Full Text Available Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their doctor-patient encounter and the patient-related factors that affected patients’ satisfaction with the consultation process. A clinic-based, cross-sectional study using a modified version of the General Practice Assessment Questionnaire (GPAQ, which employed a systematic sampling technique, was used. The questionnaires were administered on 430 patients within the ages of 18 years and 65 years. Among the 430 subjects within the ages of 18 years and 65 years studied, 200 (46.5% were males and 230 (53.5% were females. Only 59.3% were satisfied with their patient-doctor encounter. The patient’s perception of time spent in the consultation, illness understanding after the visit, ability to cope with the illness after the visit, and ability to maintain health after visit were the only factors that affected patient’s satisfaction with the consultation. In our environment, nonsatisfaction with the patient-doctor encounter is high. Only few factors considered to encourage a patients satisfaction at primary care consultation contributed to end-of-consultation satisfaction. This calls for refocusing so as to improve the overall patient care in our cultural context and meet the patient needs in our environment.

  7. Clinical implications of adipocytokines and newly emerging metabolic factors with relation to insulin resistance and cardiovascular health

    Sung Hee eChoi


    Full Text Available Adipose tissue is known to secrete hormones actively and produces many biologically active proteins called adipocytokines. Typically, obesity is followed by low-grade inflammation, which is characterized by increased circulating levels of pro-inflammatory cytokines. Macrophages play a role in the inflammatory process by secreting many cytokines such as tumour necrosis factor-alpha, interleukin-6, resistin and retinol binding protein-4. These cytokines and chemokines participate in low grade pro-inflammatory processes leading to insulin resistance, metabolic impairment and cardiovascular diseases. More metabolic regulators, such as fibroblast growth factor (FGF21, FGF19, FGF1, vaspin and visfatin have now been discovered but their exact roles in human diseases are still unclear. This review focuses on recent research regarding the role of adipokines and new metabolic factors in metabolic derangement or cardiovascular disease.

  8. Latent Autoimmune Diabetes in Adults in the United Arab Emirates: Clinical Features and Factors Related to Insulin-Requirement.

    Ernesto Maddaloni

    Full Text Available To describe and to characterize clinical features of latent autoimmune diabetes in adults (LADA compared to type 1 and type 2 diabetes in the UAE.In this cross-sectional study a dataset including 18,101 subjects with adult-onset (>30 years diabetes was accessed. 17,072 subjects fulfilled the inclusion/exclusion criteria. Data about anthropometrics, demographics, autoantibodies to Glutamic Acid Decarboxylase (GADA and to Islet Antigen 2 (anti-IA2, HbA1c, cholesterol and blood pressure were extracted. LADA was diagnosed according to GADA and/or anti-IA2 positivity and time to insulin therapy.437 (2.6% patients were identified as LADA and 34 (0.2% as classical type 1 diabetes in adults. Mean age at diagnosis, BMI, waist circumference, systolic blood pressure and HbA1c significantly differed between, LADA, type 2 and type 1 diabetes, LADA showing halfway features between type 2 and type 1 diabetes. A decreasing trend for age at diagnosis and waist circumference was found among LADA subjects when subdivided by positivity for anti-IA2, GADA or for both antibodies (p=0.013 and p=0.011 for trend, respectively. There was a gradual downward trend in autoantibody titre in LADA subjects requiring insulin within the first year from diagnosis to subjects not requiring insulin after 10 years of follow-up (p<0.001.This is the first study describing the clinical features of LADA in the UAE, which appear to be different from both type 1 and type 2 diabetes. Furthermore, we showed that the clinical phenotype of LADA is dependent on different patterns of antibody positivity, influencing the time to insulin requirement.

  9. The status quo of job performance and its related factors among clinical nurses%护士工作绩效现状及其影响因素

    王欣欣; WipadaKunaviktiku; PetsuneeThungjaroenkul; 郑爽; 王合


    Objective: To explore the status quo of job performance and its related factors among clinical nurses. Method: 375 nurses from a general hospital completed a questionnaire which included Job Performance Measure (JPM) and the Nursing Stress Scale (NSS). Result: Job performance perceived by nurses in the general hospital was at moderate level while job stress was at high level. There was a significant negative correlation between job performance and job stress among nurses. Lack of support was considered as a related factor via multiple regression analysis. Conclusion: The level of job stress among clinical nurses was relatively high. It could relate to their job performance. The results of this study suggest the management team to improve job performance and give more support to decrease job stress so that nurses could work more effectively.%目的:探讨护士工作绩效的现状及其影响因素.方法:采用护理工作绩效量表(JPM)和工作压力量表(NSS),对某三级甲等综合医院的375位护士进行调查.结果:护士的工作绩效处于中等水平,工作压力处于高水平,工作绩效和工作压力呈负相关,经多元回归分析,进入回归方程的变量为缺乏支持.结论:护士承受的工作压力较高,过高的工作压力对工作绩效产生负面影响.减轻护士的工作压力,给予其更多的支持和帮助,可以提高护士的工作绩效,促进其更有效地工作.




    Full Text Available BACKGROUND: Herpes zoster (HZ is a common viral disorder with characteristic rashes and pain. Postherpetic neuralgia (PHN is most common complication of HZ. There may be increased chances of PHN in the presence of various risk factors. AIM: To study the clinical and epidemiological data of HZ and assess the relation between risk factors and developement of PHN. MATERIAL AND METHODS: In this prospective study cases of HZ attending the outdoor of dermatology department were included irrespective of age and sex. Relevant demographic and clinical findings of all the cases were recorded in a predesigned performa. Cases were followed up for next 6 months for the development of any complication and recorded the same if occurred. Relevant risk factors in cases of PHN were observed, recorded and analysed. RESULTS: 123 cases were included in the study. Most common age group affected was 31-40 years, slightly more common in female sex and commonly occurred in immunocompromised cases. Most common dermatome affected was thoracic. PHN occurred in 23 (18.7% cases. About 61% of PHN cases were above the age of 50 years and it occurred in 45.45% cases of HZ with ophthalmic involvement. CONCLUSION: HZ is a common disease in the cases attending the dermatology OPD. PHN is most common complication which is more commonly associated with older age, female sex, presence of prodrome, severe rash and pain within 3 days and involvement of ophthalmic division of trigeminal nerve. But ther is no significant relation between occurrence of PHN and antiviral drug treatment.

  11. Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey*

    Salman, Kubra Esen; Altunay, Ilknur Kivanc; Kucukunal, Nihal Asli; Cerman, Asli Aksu


    BACKGROUND Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations. PMID:28225954

  12. Factors related to clinical pregnancy after vitrified-warmed embryo transfer: a retrospective and multivariate logistic regression analysis of 2313 transfer cycles.

    Shi, Wenhao; Zhang, Silin; Zhao, Wanqiu; Xia, Xue; Wang, Min; Wang, Hui; Bai, Haiyan; Shi, Juanzi


    What factors does multivariate logistic regression show to be significantly associated with the likelihood of clinical pregnancy in vitrified-warmed embryo transfer (VET) cycles? Assisted hatching (AH) and if the reason to freeze embryos was to avoid the risk of ovarian hyperstimulation syndrome (OHSS) were significantly positively associated with a greater likelihood of clinical pregnancy. Single factor analysis has shown AH, number of embryos transferred and the reason of freezing for OHSS to be positively and damaged blastomere to be negatively significantly associated with the chance of clinical pregnancy after VET. It remains unclear what factors would be significant after multivariate analysis. The study was a retrospective analysis of 2313 VET cycles from 1481 patients performed between January 2008 and April 2012. A multivariate logistic regression analysis was performed to identify the factors to affect clinical pregnancy outcome of VET. There were 22 candidate variables selected based on clinical experiences and the literature. With the thresholds of α entry = α removal= 0.05 for both variable entry and variable removal, eight variables were chosen to contribute the multivariable model by the bootstrap stepwise variable selection algorithm (n = 1000). Eight variables were age at controlled ovarian hyperstimulation (COH), reason for freezing, AH, endometrial thickness, damaged blastomere, number of embryos transferred, number of good-quality embryos, and blood presence on transfer catheter. A descriptive comparison of the relative importance was accomplished by the proportion of explained variation (PEV). Among the reasons for freezing, the OHSS group showed a higher OR than the surplus embryo group when compared with other reasons for VET groups (OHSS versus Other, OR: 2.145; CI: 1.4-3.286; Surplus embryos versus Other, OR: 1.152; CI: 0.761-1.743) and high PEV (marginal 2.77%, P = 0.2911; partial 1.68%; CI of area under receptor operator characteristic

  13. FACTORES CLÍNICOS Y DEL PROCEDIMIENTO RELACIONADOS CON LA TROMBOSIS DE STENT / Clinical and procedural factors related to stent thrombosis

    Ronald Aroche Aportela


    Full Text Available Resumen Introducción y objetivos: La trombosis del stent es una de las complicaciones posterior al intervencionismo coronario percutáneo, asociada a una elevada mortalidad y morbilidad. A pesar del uso de la doble terapia antiplaquetaria (aspirina y clopidogrel y la optimización de la técnica, su incidencia no ha desaparecido. El objetivo de esta investigación fue determinar los factores de riesgo de trombosis de los stent metálicos convencionales. Método: Se realizó un estudio descriptivo-retrospectivo. De las 2.014 arterias revascularizadas en el Centro de Investigaciones Médico-Quirúrgicas de La Habana, Cuba; entre agosto de 1997 y febrero de 2009, se seleccionaron las 289 reestudiadas. Resultados: La trombosis de los stent metálicos convencionales estuvo presente en 20 arterias, de las cuales 11 resultaron ser la descendente anterior, y su mayor incidencia se presentó en las primeras 24 horas y después de los 30 días. La diabetes mellitus se comportó como un factor de riesgo de trombosis (OR* = 3,06, así como la presión de liberación de menos de 10 atmósferas (OR = 3,70 y las lesiones complejas de los tipos B2 y C (OR = 8,80, todos con significación estadística (p < 0,05. Conclusiones: La mayor incidencia de trombosis de los stent metálicos convencionales fue en el primer día de la revascularización, después de la terminación de la doble terapia de antiagregación plaquetaria y en la arteria descendente anterior. La diabetes mellitus, las lesiones complejas y las bajas presiones de liberación del stent, se comportaron como factores de riesgo de trombosis con resultados estadísticamente significativos. Abstract Introduction and Objectives: Stent thrombosis is a complication after percutaneous coronary intervention associated with high mortality and morbidity. Despite the use of dual antiplatelet therapy (aspirin and clopidogrel and optimization of the technique, its incidence has not disappeared. The objective of




    Background. At present, there is extensive knowledge on the clinical course of coronary artery disease (CAD), whereas data on the underlying anatomical changes and their relation to clinical events are still limited. Methods and Results. We investigated progression and regression of CAD prospectivel

  15. Hypnosis and related clinical behavior.

    Frankel, F H


    The essential aspect in the experience of the hypnotized person is the altered or distorted perception that is suggested to him. Not all people are capable of the experience, but it is possible that spontaneous distortions occur in those with high hypnotizability. These distortions are frequently experienced as frightening symptoms. The author draws attention to the similarity between hysterical symptoms and events in hypnosis and to the high hypnotic responsivity in hysterical subjects reported in the clinical literature of the nineteenth century. Phobic patients have relatively high hypnotic responsivity. The author believes that it is sometimes possible to predict hypnotizability from clinical behavior, and that hypnotic responsivity can be utilized in psychodynamically sensitive therapy to teach such patients that they can learn to gain control of their symptoms.

  16. Risk Factors and Relation Between Clinical,Biochemical Marker and Stenosis Extent of Coronary Artery in Young Adults With Acute Myocardial Infarction

    Weiping Zhang; Zuyi Yuan; Yan Liu; Prabindra Maharjan; Yan Zhao


    Objectives To analyze risk factors and the relation between clinical,biochemical marker and the stenosis extent of coronary artery in patients below the age of 45 years with acute myocardial infarction (AMI).Methods A retrospective investigation was performed on 92 patients below the age of 45 with AMI at the First Affiliated Hospital of Medical School of Xi'an Jiaotong University in 2003~2007.The etiology,morbidity,risk factors,clinical features and results of coronary angiography were studied.Various clinical and biochemical markers were assessed to find out what were associated with the stenosis extent of coronary artery.Meanwhile,the differences between one-vessel disease (group A)and two-vessel or multi-vessel disease (group B) patients with AMI were comparatively analyzed.Results Risk factors analysis revealed that a history of cigarette smoking,metabolic disorders and abusive drinking were mainly found in young AMI patients below the age of 45 years,and metabolic disorder mainly consists of decreased high-density lipoprotein cholesterol (HDL-C) and hypertriglyceridemia.AMI in patients below the age of 45 years account for 10.3%of all AMI.Angiographically,the incidence of one-vessel affected was most frequent in the young adults (73.75%).The most committed vessel was LAD(80.00% ).A higher incidence with history of hypertension and diabetes or impaired glucose tolerance was found in group B,but a history of preceding angina 1 month earlier was more frequently found in group A.Improved Genisi scores of coronary angiography was lower in group A than in group B (7.49±3.63vs 15.08±6.08).Correlation analysis showed that Iog(LDL-C/HDL-C) (r=0.238,P=0.037),TC/HDL-C(r=0.232,P=0.046) were directly correlated with angiographic scores,and HDL-C(r=-0.202,P=0.042) was inversely correlated.Multielement gradual linear regression analysis showed log(LDL-C/HDL-C),TC/HDL-C were associated with the extent of stenosis of coronary artery.Furthermore,the correlation was linear

  17. Clinical Analysis of Related Factors With Postterm Pregnancy%过期妊娠相关因素临床分析



    目的:研究探讨过期妊娠的相关因素及对孕妇和围生儿的影响,为临床过期妊娠人群筛查提供有效依据。方法随机抽取我院2012年7月~2014年7月收治的过期妊娠分娩孕妇60例(观察组)和同期我院正常足月分娩的孕妇60例(对照组)为研究对象。研究分析临床过期妊娠的相关因素。结果分析结果发现,造成孕妇过期妊娠的因素主要有经产妇、孕前体重指数高(超重和肥胖)、孕期体重增加过多、胎盘成熟度III级和男性胎儿,两组数据具有统计学意义(P<0.05);在分析中还发现剖宫产、巨大儿、胎儿窘迫和新生儿窒息的发生概率,观察组产妇发生概率高于对照组产妇,两组数据具有统计学意义(P<0.05)。结论在孕产妇分娩的过程中,妊娠前体重指数高、妊娠期体重增加过多、男性胎儿和胎盘成熟度III级以及经产妇是过期妊娠的相关因素。其中剖宫产和软产道损伤以及产后出血对产妇造成的影响最为明显。针对过期妊娠的相关因素,及时采取有效的措施,能够有效避免过期妊娠的发生。%Objective To study the related factors of postterm pregnancy and efect in pregnant women and perinatal infant,provide efective basis for the clinical screening of postterm pregnancy.Methods Randomly selected 60 cases of postterm pregnancy women (observation group) and 60 cases of normal term delivery in our hospital during the same period of the pregnant women (control group) as the research object.Results Theanalysis results show that the factors, resulting in prolonged pregnancy pregnant women are mainly by maternal pre pregnancy body mass index,high(overweight and obesity),excessive weight gain during pregnancy,placental maturity and III level of male fetuses,two groups of data with statistical significance(P<0.05); in the analysis also found that cesarean section,great infant,fetal distress and neonatal

  18. Disc degeneration-related clinical phenotypes.

    Battié, Michele C; Lazáry, Aron; Fairbank, Jeremy; Eisenstein, Stephen; Heywood, Chris; Brayda-Bruno, Marco; Varga, Péter Pál; McCall, Iain


    The phenotype, or observable trait of interest, is at the core of studies identifying associated genetic variants and their functional pathways, as well as diagnostics. Yet, despite remarkable technological developments in genotyping and progress in genetic research, relatively little attention has been paid to the equally important issue of phenotype. This is especially true for disc degeneration-related disorders, and the concept of degenerative disc disease, in particular, where there is little consensus or uniformity of definition. Greater attention and rigour are clearly needed in the development of disc degeneration-related clinical phenotypes if we are to see more rapid advancements in knowledge of this area. When selecting phenotypes, a basic decision is whether to focus directly on the complex clinical phenotype (e.g. the clinical syndrome of spinal stenosis), which is ultimately of interest, or an intermediate phenotype (e.g. dural sac cross-sectional area). While both have advantages, it cannot be assumed that associated gene variants will be similarly relevant to both. Among other considerations are factors influencing phenotype identification, comorbidities that are often present, and measurement issues. Genodisc, the European research consortium project on disc-related clinical pathologies has adopted a strategy that will allow for the careful characterisation and examination of both the complex clinical phenotypes of interest and their components.

  19. Clinical study on HAT and SEDAN score scales and related risk factors for predicting hemorrhagic transformation following thrombolysis in acute ischemic stroke

    Heng WEI


    Full Text Available Objective To investigate the value of HAT and SEDAN score scales in predicting hemorrhagic transformation (HT following the recombinant tissue-type plasminogen activator (rt-PA intravenous thrombolysis in acute ischemic stroke patients and risk factors affecting HT.  Methods A total of 143 patients with acute ischemic stroke underwent rt-PA intravenous thrombolysis within 4.50 h of onset and their clinical data were collected. According to head CT after thrombolysis, patients were divided into HT group (18 cases and non-HT group (125 cases. Single factor analysis was used to assess differences in HAT and SEDAN score scales and related risk factors of ischemic stroke in 2 groups, and further Logistic regression analysis was used to investigate independent predictors of HT. Receiver operating characteristic (ROC curve was used to evaluate the sensitivity and specificity of HAT and SEDAN score scales in predicting HT.  Results Univariate Logistic regression analysis showed that history of atrial fibrillation (AF, admission systolic blood pressure (SBP, admission blood glucose level, early low density of head CT, thrombolytic time window, National Institute of Health Stroke Scale (NIHSS, HAT and SEDAN scores were all risk factors for HT after thrombolysis (P < 0.05, for all. Multivariate Logistic regression analysis showed that history of AF (OR = 1.677, 95% CI: 1.332-2.111; P = 0.000, admission SBP (OR = 1.102, 95% CI: 1.009-1.204; P = 0.031, admission blood glucose level (OR = 1.870, 95% CI: 1.119-3.125; P = 0.017, thrombolysis time window (OR = 1.030, 95%CI: 1.009-1.052; P = 0.005, NIHSS score (OR = 1.574, 95%CI: 1.186-2.090; P = 0.002, HAT score (OR = 2.515, 95%CI: 1.273-4.970;P = 0.008 and SEDAN score (OR = 2.413, 95%CI: 1.123-5.185; P = 0.024 were risk factors for HT after thrombolysis. ROC curve analysis showed that HAT score could predict HT with 94.40% sensitivity and 41.60% specificity, and area under curve (AUC was 0.70. SEDAN

  20. Clinical predictive factors of pathologic tumor response

    Choi, Chi Hwan; Kim, Won Dong; Lee, Sang Jeon; Park, Woo Yoon [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)


    The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used. Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.

  1. Relational agents in clinical psychiatry.

    Bickmore, Timothy; Gruber, Amanda


    Relational agents are computational artifacts, such as animated, screen-based characters or social robots, that are designed to establish a sense of rapport, trust, and even therapeutic alliance with patients, using ideal therapeutic relationships between human counselors and patients as role models. We describe the development and evaluation of several such agents designed for health counseling and behavioral-change interventions, in which a therapeutic alliance is established with patients in order to enhance the efficacy of the intervention. We also discuss the promise of using such agents as adjuncts to clinical psychiatry, a range of possible applications, and some of the challenges and ethical issues in developing and fielding them in psychiatric interventions.

  2. Survey on related factors of compassion fatigue in clinical nurses%临床护士同情心疲乏的相关因素调查

    胡晓莹; 赵允兰; 闵瑰


    Objective To investigate the status of compassion fatigue in clinical nurses,and explore the related factors.Methods Convenience sampling was adopted,and a total of 644 nurses were investigated by self-designed demographic questionnaire and professional quality of life scale.The contents of demographic questionnaire included gender,age,marital status,years of working experience,personnel,professional title,level of education,department of working,years of working in current department and post.Professional quality of life scale consisted of 30 questions in 3 subscales:compassion satisfaction,secondary traumatic stress and burnout.Univariate and multivariate analysis was employed respectively to explore the influencing factors of compassion fatigue in nurses.Results Five hundred and ninety-two questionnaires were recovered,with the response rate of 91.9%,and there were 566 valid questionnaires,with the effective rate of 95.6%.Among the 566 nurses,60 were nurses with standardized training,and the other 506 were clinical nurses.The survey of 506 clinical nurses revealed that the scores of compassion satisfaction,secondary traumatic stress and burnout were 3.15 ± 0.57,2.73 ± 0.54 and 2.78 ± 0.55 respectively.Univariate analysis indicated that there were significant differences in the scores of compassion satisfaction among nurses with different age,marital status,professional title,years of working experience,years of working in current department,and post (P < 0.05 or P < 0.01),there were significant differences in the scores of secondary traumatic stress among nurses with different department of working and years of working in current department (P < 0.05),and there were significant differences in the scores of burnout among nurses with different age,years of working experience,department of working and post (P < 0.05 or P < 0.01).Multivariate analysis demonstrated that factors significantly influencing compassion satisfaction of clinical nurses were

  3. 临床分析影响破伤风治疗护理的相关因素%Clinical analysis of related factors influencing tetanus care



    Objective:To study the importance of tetanus patients and nursing related factors.Methods:our department were retro-spectively analyzed the clinical data of 12 cases tetanus patients nursing.Results:antibiotics and T the AT use time and the length of hos-pital stay, efficacy had close relations, observation group of patients with fewer complications, good curative effect, short of such confine-ment, all hospital cure;Control group much complications and poorer prognosis, such confinement was longer, 1 case death, the rest were for improved or cured discharged from hospital.Conclusion:tetanus patients difficult, fast development, treatment, care, early and effec-tive application of antibiotics on the basis of nursing might be an important guarantee of treated patients with tetanus.%目的:探讨破伤风患者治疗与护理相关因素的重要性。方法:回顾性分析我科12例破伤风患者治疗护理的临床资料。结果:抗生素与T AT使用时间和住院时间的长短、疗效有着密切关系,观察组患者并发症少、疗效好、住院日短,全部治愈出院;对照组并发症多、预后差、住院日较长、1例死亡、其余为好转出院或治愈出院。结论:破伤风患者病情重、发展快、治疗护理难度大、及早的应用抗生素和有效的做好各项基础护理工作是救治破伤风患者的重要保证。

  4. 异位妊娠发生的危险因素分析%Clinical analyses of risk factors related to ectopic pregnancy

    陈静; 邱骏; 滕银成; 邹文燕; 杨弋


    Objective To conduct an epidemiological survey on the relevant risk factors of ectopic pregnancy (EP) and provide scientific rationales for prevention and reducing its incidence.Methods During June 2010 to December 2011 at three local hospitals,a total of 800 patients with a diagnosis of EP responded to a questionnaire survey for understanding the risk factors of EP.And another 700 cases of normal early pregnancy women were selected as control group.Both multi and uni-factorial regression analyses were performed for the acquired clinical data.And the high-risk factors of EP were screened.Results Among them,the age distribution was ≤ 25 years (n =175,25.5%),26-30 years (n =302,37.8%) and 31-35 years (n =213,26.6%).No contraceptive measure was adopted for 259 women (32.4%).The risk factors related to EP included oral emergency contraceptives,intrauterine device (IUD),pelvic inflammatory disease,infertility history,previous EP,smoking and age,etc.Based upon multivariate Logistic regression analysis of screening results,the decreasing odds rations were infertility,EP history,smoking history,emergency contraceptive use,history of EP,IUD,pelvic inflammatory disease and age.Conclusion The risks of EP are affected by many factors,including infertility,EP history,smoking history,emergency contraceptive use,history of EP,IUD,pelvic inflammatory disease and age.%目的 调查异位妊娠发生的相关危险因素,为进一步预防及减少异位妊娠的发病提供科学依据.方法 对2010年6月至2011年12月在上海市三家医院确诊为异位妊娠的800例住院患者,通过问卷调查的方式,了解异位妊娠的相关发病因素.并随机选取700例同期正常早期妊娠者作为对照组,采集相关临床资料分别进行单因素、多因素回归分析,筛选出异位妊娠发病的高危因素.结果 800例中年龄≤25岁175例,占25.5%;26—30岁302例,占37.8%;31~ 35岁213例,占26.6%;无避孕措施259例,占32.4%;异位

  5. Factores clínicos relacionados con la hipertensión arterial en pacientes con trastornos de tolerancia a los carbohidratos Clinical factors related to arterial hypertension in patients with impaired carbohydrate tolerance

    Marelys Yanes Quesada


    Full Text Available La hipertensión arterial constituye una de las enfermedades más frecuentes en el momento actual. Su asociación con trastornos del metabolismo de la glucosa, acelera el grado de intolerancia y de sus complicaciones. Con el objetivo de identificar algunos factores clínicos asociados a ella en pacientes con trastornos de la tolerancia a la glucosa, se realizó un estudio descriptivo, transversal, con 329 pacientes con antecedentes de una hiperglucemia previa, a los que se les realizó una prueba de tolerancia a la glucosa para medir glucemia. Se les recogieron los datos siguientes: edad, sexo, peso, talla, se calculó el índice de masa corporal y tensión arterial. Se encontró una asociación significativa de la hipertensión arterial con el incremento de la edad, el sexo masculino y un mayor índice de masa corporal. La frecuencia de hipertensión arterial fue de un 59,9 %, y se incrementó hasta un 76,2 % en los pacientes con mayor número de factores de riesgo. La hipertensión arterial tiene una elevada prevalencia en pacientes con trastornos de tolerancia a la glucosa, la edad avanzada, el sexo masculino y el índice de masa corporal elevado, que a su vez se relacionan con su incremento, y cuando los sujetos presentan varios factores de riesgo asciende la frecuencia de hipertensión arterial.Arterial hypertension is one of the most common diseases at present. Its association with glucose metabolism disorders speeds up the intolerance degree and its complications. In order to identify some clinical factors associated with it in patients with impaired glucose tolerance, a descriptive cross-sectional study was conducted among 329 patients with previous history of hyperglycemia. A glucose tolerance test was performed to measure glycemia. The following data were collected: age, sex, weight and height. The body mass index and the arterial hypertension were calculated. The arterial hypertension frequency had an elevated prevalence of patients

  6. 乳腺癌骨转移临床相关因素的研究%Clinical factors related to bone metastases from breast cancer

    张卫红; 田钢龙; 何继民; 周凤飞; 关宏霞; 高聪明; 吕平欣


    目的 研究乳腺癌骨转移的临床和影像学资料,寻找影响骨转移的相关因素,为早期诊断提供依据.方法 对334例乳腺癌患者全身骨显像、临床分期、病理、免疫组织化学及血清学检-查结果进行回顾性分析,并对数据行χ2检验.结果 有淋巴结转移者骨转移率71.0%(152/214),没有淋巴结转移者骨转移率为22.5%(27/120),两者比较差异有统计学意义(χ2=72.80,P=0.000);浸润性非特殊性癌骨转移率69.0%(203/294),浸润性特殊性癌骨转移率41.7%(5/12),两者比较差异有统计学意义(χ2=3.97,P=0.046);骨转移中碱性磷酸酶(ALP)升高者占28.5%(51/179),非骨转移中ALP升高者占14.9%(11/74),两者比较差异也有统计学意义(χ2=5.25,P=0.022);而骨转移中肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)15-3、CA125、CA19-9]升高者占68.7%(123/179),非骨转移中肿瘤标志物升高者占27.0%(20/74)(χ2=37.03,P=0.000).结论 乳腺癌骨转移的发生率与原发灶的病理类型、发病时有无淋巴结转移有关,浸润性非特殊性癌或有淋巴结转移者骨转移率较高.动态监测血清ALP、CEA、CA15-3、CA125、CA19-9有助于早期诊断.%Objective To study the clinical and imaging features of patients with bone metastases from breast cancer and identify the factors related to the incidence of bone metastases. Methods Three hundred and thirty-four patients with breast cancer were recruited into this study. Whole-body 99Tcm-methylene disphosphonate (MDP) bone scan, clinical staging, pathological, immunohistochemical and serological test results were analyzed retrospectively. χ2 test was used for statistical analysis. Results The incidence rate of bone metastases for patients with and without lymph node metastases was 71% (152/214) and 22. 5% (27/120), respectively (χ2 =72.80, P =0.000). The incidence rate of bone metastases from infiltrated non-specified and specified breast cancer was 69% (203/294) and 41.7% (5

  7. Related factors of dilated cardiomyopathy

    Guangyong Huang; Hang Gao; Xiangang Meng; Zhonghua Yan; Xiangquan Kong; Lexin Wang


    Objective To investigate the etiology and relative factors of dilated cardiomyopathy (DCM) in Chinese patients. Methods A case-control study was conducted to compare 233 patients with DCM in high-incidence areas (case group) and 150 patients with stable angina pectoris (control group). Life styles and history of diseases information was collected by questionaire; human anti-myocardial antibody IgG (AMA- IgG), human Coxsackie B virus IgG (CBV- IgG) and human adenovirus antibody IgG (ADV- lgG) were measured with ELISA. General chemical and toxicological indicators in drink water from high and low prevalence areas and serum trace elements also were compared. Results 1 ) Compared with the control group, the case group had more farmers (P < 0.01), with low average incomes (P < 0.01), higher alcohol consumption (P < 0.01) and higher incidence of the history of myocarditis (P < 0.01 ). 2) AMA-IgG, CBV-IgG and ADV-IgG levels were low and the positive rates ofAMA-IgG, CBV-IgG and ADV-IgG of patients with DCM were respectively 7.78%, 6.67% and 6.67%, no statistical significance comparing with those in the control group. 3) The content of iron (1.36±2.18 vs 0.39±0.67 mg/L, P<0.05) and manganese (0.384±0.35 vs 0.15±0.14, P<0.01 ) in drinking water of high-incidence areas was significantly higher than that in low-incidence areas. 4) The content of serum iron (69.14±57.8 vs 20.04±17.5 μ mol/L, P<0.01 ) and copper (25.74±4.2 vs 19.7±4.5 μmol/L, P<0.01) in the case group evidently exceeded the normal range and obviously higher than that in the control group. Conclusions 1) The incidence of some DCM is related with low incomes, high alcohol consumption and myocarditis. 2) These data do not support that DCM is related with persistent virus infection and autoimmunization; 3) Iron and manganese contents exceeding standards in drinking water and the high content of serum iron and copper is comparatively related with the incidence of DCM.

  8. Research on factors related to clinical effects of veneer restorations%贴面修复临床效果的相关因素研究

    李中杰; 谢翠柳; 孟玉坤


      贴面修复在口腔科美学领域中占有重要的地位,相比于全冠修复,其具有诸多的优势,在国内外的临床工作中已得到了广泛应用。大量的临床研究显示:折裂、失粘接和颜色差异是贴面修复失败最常见的3种类型。本文就影响贴面远期效果的各个相关因素展开讨论。%  Veneer restoration plays an important role in esthetic dentistry, and due to the various advantages over full crown restoration, veneers is widely applied both home and abroad. A number of clinical studies demon-strate that fracture, debonding and color mismatch are the three most common failure types for veneer restorations. This paper holds a discussion on factors which could influence long-term outcomes.

  9. Happiness and related factors in pregnant women.

    Jayasvasti, Kanthika; Kanchanatawan, Buranee


    Pregnancy is a crisis in the human life cycle as an important turning point in aspects of anatomical, physiological and psychosocial changes. An unhappy pregnanus could influence the fetal growth and development and sense of maternal competence as well as bonding with the fetus which profoundly affect the nurture of the infant after delivery. The authors'purposes were to study happiness and related factors in pregnant women having antenatal care at King Chulalongkorn Memorial Hospital. Four hundred and thirty-eight pregnant women from the antenatal clinic at King Chulalongkorn Memorial Hospital were randomly selected to complete a set of questionnaires that consisted of personal information, pregnant information, The Oxford Happiness Questionnaire (OHQ), The Maudsley Personality Inventory (MPI) and The Marital Satisfaction Scale (MSS). Prevalence of happiness level was classified by descriptive analysis. Unpaired t-test, ANOVA and Pearson's Product Moment Correlation analyzed related factors to happiness in pregnant woman. Also Stepwise Multiple Regression Analysis was used to define predictive factors for happiness in pregnant women. The sample had a high level of happiness of 57.3%. Significant related factors to happiness were age between 31-35 years, high education level, high individual and family income, having saving deposition, no drug abuse, improved marital relationship, no conflict with relatives, extrovert and stable personality types and no concerns about post-partum body image. Four predictive factors for happiness in pregnant women were extrovert personality, stable personality, high family income and improved marital relationship. Level of happiness in pregnant women could be predicted by type of personality, family income and marital relationship.

  10. Implementing human factors in clinical practice

    Timmons, Stephen; Baxendale, Bryn; Buttery, Andrew; Miles, Giulia; Roe, Bridget; Browes, Simon


    Objectives To understand whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice. Methods Qualitative, longitudinal study using semi-structured interviews and focus groups, of a multiprofessional group of UK NHS staff (from the emergency department and operating theatres) who have received aviation-derived human factors training. Results The human factors training was evaluated positively, and thought to be both acceptable and relevant to practice. However, the staff found it harder to implement what they had learned in their own clinical areas, and this was principally attributed to features of the informal organisational cultures. Conclusions In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice. PMID:24631959

  11. Clinical study status epilepticus related factors%癫痫持续状态相关因素的临床研究

    付海红; 范卫明


    目的:探讨癫痫持续状态发病的相关危险因素,为癫痫持续状态的治疗提供参考。方法回顾性分析2013年1月至2015年1月滨州医学院附属医院神经内科住院治疗的癫痫持续状态患者,共纳入72例,收集患者的临床资料。对所有患者进行随访,采用格拉斯哥预后评分评价患者预后情况,分析与预后相关的危险因素。结果患者男女性别之比为4.54:1,男性发病率显著高于女性(X2=43.581,P<0.01);儿童占29.17%,成人占70.83%,成人的发病率显著高于儿童(X2=42.335,P<0.01);CSE63例,NCSE9例,CSE的发病率显著高于NCSE,差异有统计学意义(X2=46.611,P<0.01);颅脑损伤、病毒性脑炎急性期和脑血管病变是癫痫持续状态发病的危险因素。结论癫痫持续状态在各年龄段均可见,成人发病率高于儿童,男性高于女性,颅脑损伤、病毒性脑炎急性期和脑血管病变是癫痫持续状态发病的危险因素。%Objective To investigate the status epilepticus associated risk factors, provide a reference for the treatment of status epilepticus. Methods A retrospective analysis of epilepsy from January 2013 to January 2015, Affiliated Hospital of Binzhou Medical College, Department of Neurology, continued state of patients hospitalized, 72 cases were included collecting clinical data. All patients were followed up, using the Glasgow Outcome Scale evaluate the prognosis of patients and to analyze the risk factors associated with prognosis. Results Patients gender ratio of 4.54: 1, male incidence was significantly higher than women (X2= 43.581, P <0.01); children account for 29.17%, accounting for 70.83 percent of adult incidence was significantly higher than adult children (X2=42.335 , P<0.01);CSE63 cases, NCSE9 example, CSE incidence was significantly higher than NCSE, the difference was statistically significant (X2=46.611, P<0.01);traumatic brain injury, acute

  12. A study of insight and its relative factors in schizophrenia.


    Objective: To determine the clinical value of the insight and its relative factors in schizophrenic patients. Methods: The insight, the brief psychiatric rating scale (BPRS), the scale for the assessment of negative symptoms (SANS), the scale for the assessment of

  13. Clinical research on related factors of poststroke sleep disturbances%脑卒中后睡眠障碍的临床相关因素研究

    王娇; 梅丽; 孟会红; 梅风君


    目的研究脑卒中后睡眠障碍的相关因素,为临床诊断和防治提供依据.方法采用美国国立卫生院神经功能缺损评分(NIHSS)和阿森斯失眠量表(AIS)对61例住院脑卒中患者进行测评.结果睡眠障碍组与非睡眠障碍组性别、平均年龄、卒中部位比较无差别;但各年龄段中,< 50岁发生4例,50~60岁发生6例,61~ 70岁发生8例,>70岁发生8例(P<0.05).睡眠障碍组在既往病史、卒中性质、神经功能缺损程度与非睡眠障碍组比较差异有统计学意义.结论脑卒中后患者睡眠障碍较为常见,其与性别、卒中部位无相关性,但与年龄、既往病史(高血压、糖尿病、冠心病)、卒中性质及神经功能缺损程度有关.脑卒中后睡眠障碍的发生与诸多因素有关,及时发现其相关因素并积极预防、治疗,有利于加快脑卒中后患者机体康复及改善患者睡眠质量.%Objective The related factors of poststroke sleep disturbances were studied in order to provided the rationale for the diagnosis,prophylaxis and treatment.Methods National Institutes of Health Stroke Scale and Athens insomnia scale were used to evaluate the 61 stroke patients who were hospitalized.Results Comparing the gender,apoplectic part and mean age in sleep disorder group with the control group,it showed no statistical differences.But in the different age group,there were statistical differences.About the anamnesis,apoplectic type and the damage degree of nervous functions,the two groups had statistical differences.Conclusion Sleep disorder after stroke is rather common,it is not related to the gender and apoplectic part,but it is connected with the age,anamnesis,apoplectic type and the damage degree of nervous functions.Sleep disorder after stroke is connected with many factors,and the mechanism is complexity.Discovered the risk factors timely,positive prevent and treat are maked for speed up the patients' recovery and improve their sleep


    Comrey, A L; Duffy, K E


    The Eysenck Personality Inventory, the Cattell 16 PF Inventory, and the Comrey Personality Inventory were administered to 272 volunteers. Eysenck and Cattell factor scores were correlated with scores over homogeneous item groups (FHIDs) which define the Comrey test factors. This matrix was factor analyzed to relate the Eysenck and Cattell factor scores to the factor structure underlying the Comrey test. The Eysenck Neuroticism, Comrey Neuroticism, and Cattell second-order Anxiety factors appeared to match. The Eysenck Introversion and the Comrey Shyness factors also matched. The 16 Cattell primary factors overlapped but did not match with the Comrey factors.

  15. Diffuse slow washout pattern (DSWO) on exercise stress thallium-201 myocardial SPECT; Correlative study with coronary arteriography and the related clinical factors

    Wang, Qian; Nakanishi, Fumiko; Sone, Shusuke (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine) (and others)


    Diffuse slow washout pattern (DSWO) was shown on bull's eye images of 98 of 1234 patients suspected of having coronary artery disease and examined with thallium-201 myocardial SPECT imaging. Fifty-eight of these 98 patients underwent coronary arteriography, and comparison studies were performed between the bull's eye SPECT images, the results of coronary arteriography and the laboratory data. DSWO was found in 11 of 58 cases (19.0%) of single vessel disease (1VD), 18 of 58 cases (31.0%) of double vessel disease (2VD) and 21 of 58 cases (36.2%) of triple vessel disease (3VD). Three of 58 cases (5.2%) of stenosis of a coronary artery less than 75% of its normal diameter (N group) also showed DSWO. DSWO was closely related with multiple vessel disease, as has been indicated by previous reports, but we also found another patient group that showed minor coronary arterial change (IVD and N group) and manifested DSWO. Based on the study of laboratory data, we clarified that this group of patients tended to show accompanying hypertension and hyperlipidemia as factors influencing the appearance of DSWO. DSWO was accompanied by hypertension and hyperlipidemia in 54.5% and 45.5% in 1VD. These values were higher than those in the 2VD and 3VD cases, which were 33.3% and 38.9% in 2VD, and 19.0% and 28.6% in 3VD, respectively. Hypertension and hyperlipidemia appeared to play an important role in causing DSWO by interferring with coronary circulation. (author).

  16. Recurrent acute pancreatitis and its relative factors

    Wei Zhang; Hong-Chao Shan; Yan Gu


    AIM: To evaluate the causes and the relative factors of recurrent acute pancreatitis.METHODS: From 1997 to 2000, acute pancreatitis relapsed in 77 of 245 acute pancreatitis patients. By reviewing the clinical treatment results and the follow-up data, we analyzed the recurrent factors of acute pancreatitis using univariate analysis and multivariate analysis.RESULTS: Of the 245 acute pancreatitis patients, 77 were patients with recurrent acute pancreatitis. Of them, 56 patients relapsed two times, 19 relapsed three times, each patient relapsed three and four times. Forty-seven patients relapsed in hospital and the other 30 patients relapsed after discharge. Eighteen patients relapsed in 1 year, eight relapsed in 1-3 years, and four relapsed after 3 years. There were 48 cases of biliary pancreatitis, 3 of alcohol pancreatitis, 5 of hyperlipidemia pancreatitis, 21 of idiopathic pancreatitis. Univariate analysis showed that the patients with local complications of pancreas, obstructive jaundice and hepatic function injury were easy to recur during the treatment period of acute pancreatitis (P = 0.022<0.05, P = 0.012<0.05 and P = 0.002<0.05, respectively). Multivariate analysis showed that there was no single factor related to recurrence. Of the 47 patients who had recurrence in hospital, 16 had recurrence in a fast period, 31 after refeeding. CONCLUSION: Acute pancreatitis is easy to recur even during treatment. The factors such as changes of pancreas structure and uncontrolled systemic inflammatory reaction are responsible for the recurrence of acute pancreatitis. Early refeeding increases the recurrence of acute pancreatitis. Defining the etiology is essential for reducing the recurrence of acute pancreatitis.

  17. Factors Associated with Veterinary Clinical Faculty Attrition.

    Furr, Martin


    Faculty attrition and recruitment for veterinary clinical faculty positions have been reported as significant problems in veterinary medical education. To investigate the factors that may be important in veterinary clinical faculty retention, the perceptions and views of veterinary clinical academic faculty were determined using a web-distributed electronic survey. Responses were dichotomized by whether the respondent had or had not left an academic position and were analyzed for their association with faculty attrition. A total of 1,226 responses were recorded and results demonstrated that factors other than compensation were associated with veterinary clinical faculty attrition, including departmental culture, work-life balance, and recognition and support of clinical medicine by the administration. Forty-four percent of respondents who had held a faculty appointment reported leaving academia either voluntarily or for non-voluntary reasons such as failure to achieve tenure, retirement, or having their position closed. Attention to correcting deficiencies in workplace culture and professional rewards could be a beneficial means by which to decrease the faculty attrition rates currently observed in clinical academic veterinary medicine.

  18. Analysis of Related Clinical Factors and Clinical Characteristics of Neonatal Blood Loss Anemia%新生儿失血性贫血的相关临床因素及临床特点分析

    曹清勇; 陈坤东; 潘开国


    目的:探讨新生儿失血性贫血的相关因素及临床特点。方法选取2012-11~2014-05间我院收治的80例新生儿失血性贫血的患儿,回顾性分析患儿的临床资料,根据患儿不同失血病因,比较其病情轻重程度、日龄、是否为早产儿等情况。结果胎-母输血、新生儿颅内出血、胎胎输血综合征、新生儿出血症所致的出血性贫血的患儿所占比例较高,其中重度贫血所占比例明显高于轻中度贫血患儿,差异有统计学意义( P<0.05)。胎-母输血、新生儿出血症、胎儿-胎盘输血及前置胎盘所致的新生儿贫血中,<3 d的新生儿所占比例明显多于3~7 d的新生儿,差异有统计学意义( P<0.05)。在所有发生新生儿失血性贫血的患儿中,足月儿所占比例明显高于早产儿,以新生儿出血症为病因的患儿早产儿所占比例明显高于足月儿,差异均有统计学意义(P<0.05)。结论新生儿早期失血性贫血以胎-母输血、新生儿颅内出血、胎胎输血综合征、新生儿出血症等疾病为主要病因,重度贫血的患儿所占比例较高,要引起重视,尤其是<3d的新生儿,其发生新生儿早期失血性贫血的比率更大,同时要注意足月儿与早产儿发生早期失血性贫血的病因有所差别。%Objective To discuss the related factors and clinical characteristics of neonatal blood loss anemia .Methods Selecting 80 children with neonatal blood loss anemia from November , 2012 to May, 2014 in the hospital, retrospectively analyzing the clinical data of children, comparing the degree of illness weight , age, whether for premature infants etc .according to different blood loss causes .Results Tire-mother, neonatal anemia , fetal blood transfusion -placenta in neonatal anemia caused by hemorrhagic anemia of children propor-tion were higher , and severe anemia was significantly higher than the

  19. Factors influencing radiation therapy student clinical placement satisfaction

    Bridge, Pete; Carmichael, Mary-Ann [School of Clinical Sciences, Queensland University of Technology, Brisbane (Australia)


    Introduction: Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods: This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results: The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions: The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

  20. The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and to "neutralizing' life events.

    Tennant, C; Bebbington, P; Hurry, J


    A longitudinal study of neurotic disorder in the community showed that half the cases identified at first interview had remitted one month later. Remission was significantly related to four variables: recency of onset and of peak of the disorders, the occurrence of recent threatening life events and the occurrence of subsequent "neutralizing' life events. A neutralizing event was defined a priori as one which neutralized the impact of an earlier threatening life event or difficulty. One third of all remissions were caused by such an event. Remission of disorder was not significantly related to demographic variables, symptom severity, syndrome type, medical consultation or psychotropic drug prescription. The implications for neurotic disorder in the community are discussed, in particular its relation to life events and the favourable outcome in the absence of treatment.

  1. Clinical and Histological Prognostic Factors in Axillary Node-Negative BreastCancer: Univariate and Multivariate Analysis with Relation to 5-Year Recurrence.

    Khanna; Tokuda; Shibuya; Tanaka; Sekine; Tajima; Osamura; Mitomi


    In the recent years several studies have shown that about 30% of cases with axillary node-nagative breast cancer suffer relapse of the disease. Our attempt was made to evaluate the most significant prognostic factors to predict this high risk group which may be benefited from adjuvant treatment. For this purpose, we selected 9 patients out of 80 cases of node-negative breast cancer who had been followed up at least for 5 years and had the recurrence of the disease. For comparison, 16 patients from the same group who did not have relapse were selected on a random basis. Histology, receptor status, AgNOR, DNA flow cytometry and various immunohistochemical parameters were compared between the groups with recurrence and that without recurrence. On univariate analysis, tumor size, immunohistochemical expressions of PCNA, MIB-1, c-erbB-2 and S-phase fraction were significantly different between the above two groups. By multivariate analysis, immunohistochemical c-erbB-2 expression (more than 50% of cancer cells) was an independent parameter. As a summary from our studies, c-erbB-2 immunohistochemical staining on paraffin sections might be the best independent prognostic factor in axillary node-negative breast cancers.

  2. A dynamic clinical dental relational database.

    Taylor, D; Naguib, R N G; Boulton, S


    The traditional approach to relational database design is based on the logical organization of data into a number of related normalized tables. One assumption is that the nature and structure of the data is known at the design stage. In the case of designing a relational database to store historical dental epidemiological data from individual clinical surveys, the structure of the data is not known until the data is presented for inclusion into the database. This paper addresses the issues concerned with the theoretical design of a clinical dynamic database capable of adapting the internal table structure to accommodate clinical survey data, and presents a prototype database application capable of processing, displaying, and querying the dental data.

  3. Suicide During Perinatal Period: Epidemiology, Risk Factors and Clinical Correlates

    Laura Orsolini


    Full Text Available Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide and infanticide have been considered relatively rare events during the perinatal period. However, in some mental disorders (i.e. postpartum depression, bipolar disorder, postpartum psychosis, etc. have been reported a higher risk of suicidal ideation, suicide attempt or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk and protective factors and an overview about the main clinical correlates associated with the suicidal behaviour during the pregnancy and postpartum period.

  4. Blood pressure level and relation to other cardiovascular risk factors in male hypertensive patients without clinical evidence of ischemic heart disease

    Larsen, C T; Sørum, C; Hansen, J F


    was independently associated with DBP. Office SBP was above 140 mmHg in 83% and above 160 mmHg in 44% of patients. During ambulatory blood pressure monitoring (AMBP), SBP was above 135 mmHg in 40% and above 155 mmHg in 15% of patients. In addition to male sex and hypertension there was a high percentage of other...... and the blood pressure (BP), and to evaluate the percentage of patients who had achieved a BP level as recommended by the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). BP was evaluated in relation to age, body mass index......, duration of hypertension, cholesterol and triglyceride level, smoking status, information of regular exercise, a family history of ischemic heart disease (IHD) and drug treatment, in 220 men treated for arterial hypertension. In the univariate analyses we found a higher systolic blood pressure (SBP...

  5. 社区与门诊老年人牙科焦虑症及其相关因素的研究%The incidence and related factors of dental anxiety among the elders in community and dental clinic



    目的:调查社区和牙科门诊老年人牙科焦虑症的发生情况及其相关的因素. 方法:使用汉化Coarh's牙科焦虑量表(Dental Anxiety Scale,DAS)评定来自社区和口腔门诊的各700名老年人的牙科焦虑症(DA)情况,通过自行设计的一般情况表,收集可能与老年人DA发生有关的变量,采用多因素Logistic回归方法分析与社区、口腔门诊老年人DA发生有关因素.结果:DA的发生率在社区老人和口腔门诊老人中分别为23.86%、34.10%.Logistic回归分析显示,社区和口腔门诊老年人牙科焦虑症的共同影响因素包括性别、自我健康评价、亲友看牙经历、生活有焦虑;影响社区老年人牙科焦虑症的因素还包括看牙医的频率和既往就诊满意度. 结论:老年人DA的发生在社区和口腔门诊中均普遍存在,但影响因素有所不同. 减少DA对老年人口腔甚至身心健康的不良影响需要多方面共同努力.%Objective:To investigate the incidence and related factors of dental anxiety among the elders in communi-ty and dental clinic,and to provide certain reference for oral health and mental health of the elders. Method:1400 elders from community and dental clinic were selected and evaluated DA by Coarh's dental anxiety scale (DAS) .Then use the lo-gistic regression to analyze the related factors of dental anxiety. Result:The incidence of DA among elders in community and dental clinic was 23.86 % and 34.10 % respectively. The logistic regression analysis showed that sex ,self-health assess-ment,experiences of dental care of relatives and friends,feel anxious in daily life were the related factors of dental anxiety in community and dental clinic commonly. The related factors also included frequency and satisfaction of see a dentist. Con-clusion:DA is a universal phenomenon among elders in both community and dental clinic. We should make common efforts to reduce the bad influence of DA for elders'dental health and physical

  6. Clinical related factors of healthcare-associated Candida infection%假丝酵母菌属医院感染临床相关因素调查

    赵娟; 江应安; 杨丽华; 蔡旋; 施金玲


    Objective To realize the clinical characteristics of healthcare-associated Candida infection in a hospital. Methods Case histories of inpatients who were infected with Candida from 2008 to 2009 were analyzed retrospectively. Results One hundred and seventy-six patients developed Candida infection from 2008 to 2009, which accounting for 7. 73% of the total healthcare-associated infection; the most common infection site was lower respiratory tract (55. 68%), the next was urinary tract( 18. 75%); the main fungi were Candida albicans and Candida trop-icalis, which accounting for 58. 52% and 23. 86% respectively. The main underlying diseases before infection were respiratory (30. Ll%)and urological diseases (21. 59%). The length of hospital stay, medical expense and mortality of patients infected with Candida were significantly longer or higher than that of the other patients during the same hospitalization period (P<(). 05). Conclusion For patients with the risk of Candida infection, it is important to use antimicrobial agents rationally, manipulate sterilely, and treat the primary disease actively; early diagnosis and early treatment is important measure for preventing and controlling the infection of Candida.%目的 了解某院住院患者假丝酵母菌属感染的临床相关因素.方法 回顾性分析该院2008-2009年住院患者中发生假丝酵母菌属感染者的病历资料.结果 2008-2009年共176例患者发生假丝酵母菌属感染,占医院感染总人次的7.73%;发生感染的部位以下呼吸道最多(55.68%),其次为泌尿道(18.75%);感染的菌种主要为白假丝酵母菌和热带假丝酵母菌,分别占58.52%和23.86%.发生假丝酵母菌属感染前的基础疾病以呼吸系统(30.11%)和泌尿系统(21.59%)疾病多见.发生假丝酵母菌属感染患者住院时间、住院费用、病死率均显著长于或高于同期住院患者(P<0.05).结论 对于有假丝酵母菌属感染相关危险因素的患者,

  7. Factors influencing nurses' participation in clinical research.

    Jacobson, Ann F; Warner, Andrea M; Fleming, Eileen; Schmidt, Bruce


    Clinical research is necessary for developing nursing's body of knowledge and improving the quality of gastroenterology nursing care. The support and participation of nursing staff are crucial to conducting interventional research. Identification of characteristics of nurses and their work settings that facilitate or impede participation in research is needed. The purpose of this descriptive correlational study was to examine the effect of personal and professional characteristics and attitudes about nursing research on staff nurses' participation in a clinical nursing research project. A questionnaire measuring nurses' attitudes, perceptions of availability of support, and research use was distributed to staff nurses working on an endoscopy lab and two same-day surgery units where a nursing research study had recently been conducted. Investigator-developed items measured nurses' attitudes about the utility and feasibility of the interventions tested in the original study. A total of 36 usable questionnaires comprised the sample. Factor analysis of the two questionnaires resulted in three-factor (Importance of Research, Interest in Research, and Environment Support of Research) and two-factor (Value of Cognitive-Behavioral Interventions [CBIs] and Participation in Study) solutions, respectively. There were no statistically significant differences in mean scores for the five factors between nurses who did (n = 19) and those who did not (n = 17) participate in the original study. The Participation in Research Factor was significantly negatively correlated with years in nursing (r = -.336, p body of knowledge about factors that facilitate or impede staff nurses' involvement in research. This knowledge will be useful for nurse researchers planning intervention studies to forecast and foster staff nurse involvement in their projects. Findings may also be useful to nurse managers, nurse educators, and staff development personnel in assessing and promoting staff nurses

  8. Clinical, immunological and treatment-related factors associated with normalised CD4+/CD8+ T-cell ratio: effect of naive and memory T-cell subsets.

    Willard Tinago

    Full Text Available BACKGROUND: Although effective antiretroviral therapy(ART increases CD4+ T-cell count, responses to ART vary considerably and only a minority of patients normalise their CD4+/CD8+ ratio. Although retention of naïve CD4+ T-cells is thought to predict better immune responses, relationships between CD4+ and CD8+ T-cell subsets and CD4+/CD8+ ratio have not been well described. METHODS: A cross-sectional study in a cohort of ambulatory HIV+ patients. We used flow cytometry on fresh blood to determine expanded CD4+ and CD8+ T-cell subsets; CD45RO+CD62L+(central memory, CD45RO+CD62L-(effector memory and CD45RO-CD62L+(naïve alongside routine T-cell subsets(absolute, percentage CD4+ and CD8+ counts, HIVRNA and collected demographic and treatment data. Relationship between CD4+/CD8+ T-cell ratio and expanded T-cell subsets was determined using linear regression analysis. Results are median[IQR] and regression coefficients unless stated. RESULTS: We recruited 190 subjects, age 42(36-48 years, 65% male, 65.3% Caucasian, 91% on ART(52.6% on protease inhibitors, 78.4% with HIVRNA1. Of the expanded CD4+ T-cell subsets, 27.3(18.0-38.3% were naïve, 36.8(29.0-40.0% central memory and 27.4(20.0-38.5% effector memory. Of the CD8+ T-cells subsets, 16.5(10.2-25.5% were naïve, 19.9(12.7-26.6% central memory and 41.0(31.8-52.5% effector memory. In the multivariable adjusted analysis, total cumulative-ART exposure(+0.15,p = 0.007, higher nadir CD4+ count(+0.011,p1 had significantly higher median %CD8+ naive T-cells; 25.4(14.0-36.0% versus 14.4(9.4-21.6%, p<0.0001, but significantly lower absolute CD8+ count; 464(384.5-567 versus 765(603-1084 cells/mm3, p<0.001. CONCLUSIONS: Study suggests important role for naïve CD8+ T-cell populations in normalisation of the immune response to HIV-infection. How these findings relate to persistent immune activation on ART requires further study.

  9. Related clinical factors of acute renal injury in MODS patients%MODS并发急性肾损伤相关临床因素探讨

    胡家昌; 王瑞兰; 俞康龙


    Objective:To investigate the risk factors of acute kidney injury (AKI)in patients with multiple organ dysfunction syndrome (MODS). Method:Eighty four patients with MODS were divided into non-acute renal injury group (NO-AKI group,56 cases) and acute renal injury group (AKI group,28 cases). The prognosis , and-relationship with the other organs were observed. Further,and the impact of mechanical ventilation fluid resuscitation, nosocomial infections,gastrointestinal bleeding on the AKI was also evaluated. Result: APACHE Ⅱ score of AKI group was significantly higher than that of NO-AKI group. The ratio of mechanical ventilation,nosocomial infections, gastrointestinal bleeding in AKI group were significantly higher than that in NO-AKI group,and the incidence of completion target of early fluid resuscitation,intensive insulin therapy was decreased, with no statistically significant difference. Alanine aminotransferase, white blood cells,blood glucose increased,Glasgow coma score ox-ygenation index (PaO2/FiO2 ), serum albumin, platelet were significantly lower than that of NO-AKI group. Though shock index and total bilirubin were higher than that of NO-AKI group, no statistical difference was shown. Kendall's correlation analysis showed that the incidence of nosocomial infection with RIFLE classification has a significant positive correlation (P<0. 05). Delayed occurrence of renal injury and mechanical ventilation,nosocomial infections,gastrointestinal bleeding have a positive correlation relationship. While the completion of early goal and liquid recovery, intensive insulin therapy had no significant negative correlations AKI. Conclusion: The AKI may increase the mortality of patients with MODS. The treatments for respiratory failure, gastrointestinal bleeding and nosocomial infection may reduce the degree of renal injury.%目的:观察ICU病房多器官功能障碍综合征(MODS)并发急性肾损伤(AKI)的患者,探讨AKI与各脏器功能障碍之间的关系及

  10. Emphysematous pyelonephritis: clinical characteristics and prognostic factors.

    Lu, Yu-Chuan; Chiang, Bing-Juin; Pong, Yuan-Hung; Chen, Chung-Hsin; Pu, Yeong-Shiau; Hsueh, Po-Ren; Huang, Chao-Yuan


    Emphysematous pyelonephritis is a severe necrotizing infection of the renal parenchyma and perirenal tissues that is caused by gas-producing bacterial pathogens. The aim of the present study was to determine the clinical characteristics and prognostic factors of patients with emphysematous pyelonephritis. We retrospectively analyzed the clinical and laboratory data, imaging findings, and outcomes of 32 patients with emphysematous pyelonephritis. Receiver operating characteristic curve analysis was carried out on variables that were significantly associated with patient mortality. The overall survival rate was 87.5% (28/32). Escherichia coli (43.6%) was the most common organism cultured from urine and blood specimens. Hypoalbuminemia, shock as the presenting feature, bacteremia, need for hemodialysis and polymicrobial infection were significantly more common in cases resulting in death. The area under the receiver operating characteristic curve was 0.96. The cut-off point determined by the maximum Youden index (0.93) for three of these five factors yielded a sensitivity of 1.00 and specificity of 0.93. Shock as an initial presentation (P = 0.039) and polymicrobial infection (P = 0.010) were significantly associated with poor outcome. There were no significant differences in the clinical or laboratory features of the patients who did or did not undergo nephrectomy. Hypoalbuminemia, shock as an initial presentation, bacteremia, indications for hemodialysis and polymicrobial infection represent prognostic factors for mortality in patients with emphysematous pyelonephritis. Patients presenting with more than two of these prognostic factors carry the highest risk of mortality, and they require timely diagnosis and aggressive management. © 2013 The Japanese Urological Association.

  11. Factors Related to Intimidation During Oxytocin Administration.

    Beckmann, Claudia A; Cannella, Barbara L


    Patient's safety and quality are foremost issues in healthcare today and are often adversely influenced by communication and issues of perceived intimidation. Labor and delivery nurses are responsible for managing oxytocin infusions, but disagreements between providers and nurses related to the administration have been shown to cause tension and affect patient's care. The purpose of this study was to survey registered nurses in labor and delivery about perceived intimidation and how intimidation influenced actions and decisions. A total of 913 registered nurses who were members of the Association of Women's Health, Obstetric, and Neonatal Nurses and identified labor and delivery comprised the sample as their clinical focus. Nurses who met the inclusion criteria were invited to participate in the survey via e-mail invitation. An online survey assessing workplace intimidation by providers while managing oxytocin inductions, as well as demographic information was completed. Participants reported past issues with intimidation that influenced how they administered oxytocin. Nurses reported that past experiences with intimidation influenced their care and that they had been involved with medication errors where intimidation played a role. Organizational factors perceived supportive management, presence of an organizational code of conduct, and environment where collaboration was encouraged were associated with decreased reports of intimidation.

  12. 产科临床护理带教中的相关危险因素及风险管理%The related risk factors and risk management of obstetric clinical nursing teaching

    胡巧; 吴淑芬; 洪士璇


    目的::探讨产科临床护理带教中的相关危险因素及风险管理方法。方法:分析产科临床护理带教中的相关危险因素,实施相应的风险管理措施,考核护生护理风险知识、理论知识及操作情况。结果:护生护理风险知识的掌握水平较好,优秀人数(评分超过80分)60名,占95.24%;理论知识优秀人数(评分超过80分)58名,占92.06%;操作技能优秀人数(评分超过80分)50名,占79.37%。结论:产科临床护理带教工作中存在产科环境复杂、产科专业性强、带教老师因素、实习护生因素、患者不配合等危险因素,给予风险管理后,有效提高了护生的临床护理综合能力。%Objective:To explore the related risk factors and risk management effect of obstetric clinical nursing teaching. Methods:To analyze the fisk factors in obstetric clinical nursing teaching,and implements the risk management. To assess the results of nursing risk knowledge,theoretical knowledge and opera-tion for nurse students. Results:Among the nurse students,excellent knowledge of nursing risk of 60 cases (95. 24% ),excellent theoretical knowledge ex-amination 58 cases (92. 06% ),and excellent operation skill 50 cases (79. 37% ). Conclusion:The obstetric environment complex,obstetrics professional strong,teaching teachers,practice nurses,and patients incompatibility were with risk factors in obstetric clinical nursing teaching. Risk management could improve nurse student′s clinical comprehensive ability effectively.

  13. Clinical pearls: factors affecting reported contraceptive efficacy rates in clinical studies.

    Burkman, Ronald T


    Current combination oral contraceptives (OCs) are among the most popular, safe, and effective methods of reversible contraception. There are, however, many factors that can affect contraceptive failure rates as reported in clinical trials, including subject characteristics, factors related to study methodology and data analysis, and publication biases. The variability of these factors among clinical trials makes meaningful comparisons of contraceptive efficacy data across studies difficult, if not misleading or erroneous. It is even more difficult to reconcile the differences between clinical trial efficacy rates and everyday use rates; for instance, the National Survey of Family Growth reported that the rate of OC failure is close to 8% in the United States, which is higher than rates reported in clinical trials. Thus, it is important for the clinician to consider the many factors that can influence reporting of contraceptive failure rates in clinical trials and be aware of the limitations in differentiating OCs on the basis of contraceptive efficacy derived from clinical trial data. Furthermore, clinical trial data may not accurately predict contraceptive efficacy in everyday use.

  14. Related risk factors analysis and clinical diagnosis and treatment discussion of ectopic pregnancy%宫外孕相关危险因素分析及临床诊治探讨



    目的:分析宫外孕的相关危险因素,探讨临床诊治。方法:200例宫外孕患者作为观察组,同期200例正常妊娠孕产妇作为对照组,筛选影响宫外孕的相关因素,探讨对应的临床措施。结果:观察组的年龄(是否≥30岁)、妇科炎症、宫内节育器、人工流产、药物流产、剖宫产≥2次、妊娠次数≥2次、腹部手术史、人工受孕等数据比例明显高于对照组(P<0.05)。结论:妇科炎症、人工流产、药物流产、宫内节育器、妊娠次数、剖宫产次数是导致发生宫外孕的因素,应该避免这些因素,降低宫外孕的发病率。%Objective:To analyze the related risk factors of ectopic pregnancy,and to discuss the clinical diagnosis and treatment. Methods:200 patients with ectopic pregnancy were as the observation group.200 normal pregnant women were as the control group at the same time.The related factors of ectopic pregnancy were screened.The corresponding clinical measures were explored. Results:In the age (whether was greater than or equal to 30 years old),gynecological inflammation,intrauterine device,artificial abortion,medical abortion and cesarean section was more than or equal to 2 times,pregnancy number was more than or equal to 2 times,abdominal surgery history,artificial insemination,the data proportions of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:The gynecological inflammation,artificial abortion,medical abortion,intrauterine device,pregnancy number,cesarean section number are the factors leading to the occurrence of ectopic pregnancy.We should avoid these factors to reduce the incidence rate of ectopic pregnancy.

  15. Clinical analysis on the related factors of cerebral edema after surgery for acute epidural hematoma%硬膜外血肿术后脑水肿的相关因素分析

    赵鹏洲; 罗江兵; 吴敬伦; 欧英雄; 余瑞钿


    Objective To analyze the related factors of cerebral edema after surgery for acute epidural hema-toma. Methods The clinical data of patients with cerebral edema after surgery for acute epidural hematoma from April 2007 to April 2011 were collected and analyzed. The correlation between the incidence & prognosis of cerebral edema and the following factors were investigated: age, sex, surgery preconscious level, clinical status, hematoma volume, hematoma, midline shift level, pupil size, Glasgow coma Scale (GCS), and time from injury to surgery. Results A total of 30 patients suffered cerebral edema after the surgery. ANOVA showed that coma, age, and location of hematoma showed no significant correlation with cerebral edema (P>0.05); Preoperative GCS score, clinical status, time from injury to surgery, shift of midline structures, hematoma volume, and pupil size were significantly related to postoperative cerebral edema (P<0.05); Preoperative pupil size is a relative high risk independent factor of postoperative cerebral edema. Conclusion Patients with acute epidural hematoma may have different degrees of cerebral edema. Therefore, patients should be carefully evaluated before and after surgery for the related factors of cerebral edema, in order to reduce the incidence of this disease.%目的 探讨硬膜外血肿术后脑水肿的相关因素.方法 收集2007年4月至2011年4月硬膜外血肿术后发生脑水肿的30例患者的资料,分析患者术后脑水肿发生及预后与年龄、性别、术前意识水平、临床状态、血肿体积、血肿部位、中线移位程度、瞳孔大小、格拉斯哥昏迷评分(GCS)、受伤至手术时间的关系.结果 63例硬膜外血肿患者术后共有30例患者出现脑水肿,经单因素方差分析显示是否有昏迷、年龄及血肿的部位与术后脑水肿无明显相关(P>.05);术前GCS评分、临床状态、受伤至手术时间、脑中线结构移位程度、血肿量、瞳孔大小、临床

  16. Developing an instrument to measure effective factors on clinical learning



    Full Text Available Introduction: Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. Methods: This is a mixed methods study performed in 2 steps. First, the researchers defined “clinical learning” in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. Results: To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55% was defined by the first 3 factors while the rest of the total variance percentage (59.45% was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93 confirmed the high internal consistency of the questionnaire. Conclusion: Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it

  17. Business factors related to manufacturing firms' performance

    Stergios Vranakis


    Full Text Available Purpose: The main goal is to understand the way many factors affect the investment decision making process and business performance. Design/methodology/approach: This study proposes a new conceptual framework for examining the reasons that manufacturing firms decide to invest on the acquisition of new machinery and equipment in order to improve their infrastructure. It incorporates various factors related to the internal business environment (quality management, investment decisions etc. Findings and Originality/value: A new conceptual framework, establishing the relations between many factors, has been developed, allowing the determinants of adoption of many implications to be discussed and to relate them to the peculiarities of the Greek manufacturing industry. Originality/value: This study presents an overview of the impact of machinery and equipment investment on firm’s performance, giving grasp for further research of the inter-organizational relationships that exist between them. 

  18. Analysis of the dry eye syndrome-related factors and outcomes of clinical intervention%眼干燥综合征相关因素分析及临床干预的效果

    张莉莉; 周莉; 徐唐; 周群


    目的 探讨眼干燥综合征(干眼症)的相关因素和临床干预效果.方法 干眼症患者218例,随机均分为干预组(A组,常规给予病因治疗、泪液治疗及系统的临床干预)和对照组(B组,仅常规给予病因治疗和泪液治疗),比较两组治疗2周后的泪液功能试验( SIT)、泪膜破裂时间(TBUT)、角膜荧光染色检查(FL)和自我测评等指标.结果 视频终端综合征或看书为干眼症相关的主要因素,占45.41%(99/218),其次分别为闭经或泪腺萎缩老化占37.16%(81/218),眼表手术或用药占33.49%(73/218),户外工作或户外运动者占29.36%(64/218),佩戴隐形眼镜占21.56%(47/218),饮食结构(维生素A缺乏)占7.34%(16/218).A组SIT、TBUT、FL和自我测评评分均明显高于B组(P<0.05).结论 干眼症的相关因素是多方面的,科学、有效的实施临床干预能减轻干眼症患者的症状.%Objective To investigate the dry eye-related factors and the outcomes of clinical intervention. Methods A total of 218 patients with dry eye was randomly divided into two groups of A (given clinical interventions of etiological treatment, tear treatment and the system clinical intervention) and B(treated with etiological treatment and tear treatment only as the control). After treated for two weeks,the Schirmer I test(SIT),tear film break-up time(TBUT),fluorescin staining of cornea(FL) and self-assessment scores were compared between two groups. Results Of the factors related to dry eye syndrome, Vidio end syndrome or reading acounted for 45.41% (99/218), menisschesis and lacrimal atrophy for 37.16%(81/218),surgery or drug administration on the eye surface for 33. 49% (73/218), outdoor working or exercise for 29. 36% (64/218), contact glasses wearing for 21. 56% (47/218), lack of vitamine A for 7. 34% (16/218). The SIT, TBUT, FL and self-assessment scores were all significantly higher in group A than those in group B ( P<0. 05 ) . Conclusion The factors related to

  19. The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia : A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users


    The objectives of this case-control study, investigating 51 in-patient women with acute pelvic inflammatory disease (PID) and 50 healthy women attending for routine gynecological check-up, were to investigate the background and reproductive history of women, who are considered at low risk of sexually transmitted infection presenting with PID, to examine whether intrauterine device (IUD) use per se and long use affects the microbiology and clinical course of the disease, to identify risk facto...

  20. Clinical outcomes in patients with ICU-related pancreatitis

    Chia-Cheng Tseng; Wen-Feng Fang; Yu-Hsiu Chung; Yi-Hsi Wang; Ivor S Douglas; Meng-Chih Lin


    AIM: To identify risk factors predictive of intensive care unit (ICU) mortality in patients with ventilatorrelated pancreatitis. The clinical outcomes of patients with ventilator-related pancreatitis were compared with those of patients with pancreatitis-related respiratory failure as well as controls.METHODS: One hundred and forty-eight patients with respiratory failure requiring mechanical ventilation and concomitant acute pancreatitis were identified from a prospectively collected dataset of 9108 consecutive patients admitted with respiratory failure over a period of five years. Sixty patients met the criteria for ventilator-related pancreatitis, and 88 (control patients), for pancreatitis-related respiratory failure.RESULTS: Mortality rate in ventilator-related pancreatitis was comparable to that in ICU patients without pancreatitis by case-control methodology ( P = 0.544). Multivariate logistic regression analysis identified low PaO_2/FiO_2 (OR: 1.032, 95% CI: 1.006-1.059, P = 0.016) as an independent risk factor for mortality in patients with ventilator-related pancreatitis. The mortality rate in patients with ventilator-related pancreatitis was lower than that in patients with acute pancreatitis-related respiratory failure ( P < 0.001).CONCLUSION: We found that low PaO_2/FiO_2 was an independent clinical parameter predictive of ICU mortality in patients with ventilator-related pancreatitis.

  1. Job strain as a risk factor for clinical depression

    Madsen, I. E. H.; Nyberg, S. T.; Magnusson Hanson, L. L.


    BACKGROUND: Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain...... as a risk factor for clinical depression. METHOD: We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD...... unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1...

  2. Risk Factors for SARS-Related Deaths in 2003, Beijing



    Objective To study the potential risk factors for severe acute respiratory syndromes (SARS)-related deaths in Beijing. Methods Epidemiological data were collected among the confirmed SARS patients officially reported by Beijing Centers for Disease Control and Prevention (BCDC), and information was also supplemented by a follow-up case survey. Chi-square test and multivariate stepwise logistic regression analysis were performed. Results Old age (over 60 years) was found to be significantly associated with SARS-related deaths in the univariate analysis. Also, history of contacting SARS patients within 2 weeks prior to the onset of illness, health occupation, and inferior hospital ranking as well as longer interval of clinic consulting (longer than 1 day) were the risk factors for SARS-related deaths. Multivariate stepwise logistic regression analysis found four risk factors for SARS-related deaths. Conclusion Old age (over 60 years) is the major risk factor for SARS-related deaths.Moreover, hospital health workers, the designated hospitals for SARS clinical services and the interval of consulting doctors (less than 1 day) are protective factors for surviving from SARS.

  3. Clinical symptoms and risk factors in cerebral microangiopathy patients.

    Sandra Okroglic

    Full Text Available 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 retrospectively in a cohort of CM patients. METHODS: Patients treated at the Department of Neurology, University of Bonn for CM (n = 223; 98m, 125f; aged 77.32±9.09 from 2005 to 2010 were retrospectively enrolled. Clinical symptoms, blood chemistry, potential risk factors, demographic data and ratings of vascular pathology in the brain based on the Wahlund scale were analyzed using Pearson's chi square test and one-way ANOVA. RESULTS: Progressive cognitive decline (38.1%, gait apraxia (27.8%, stroke-related symptoms and seizures (24.2%, TIA-symptoms (22% and vertigo (17% were frequent symptoms within the study population. Frontal lobe WMLs/lacunar infarcts led to more frequent presentation of progressive cognitive decline, seizures, gait apraxia, stroke-related symptoms, TIA, vertigo and incontinence. Parietooccipital WMLs/lacunar infarcts were related to higher frequencies of TIA, seizures and incontinence. Basal ganglia WMLs/lacunar infarcts were seen in patients with more complaints of gait apraxia, vertigo and incontinence. Age (p = .012, arterial hypertension (p<.000, obesity (p<.000 and cerebral macroangiopathy (p = .018 were positively related to cerebral lesion load. For increased glucose level, homocysteine, CRP and D-Dimers there was no association. CONCLUSION: This underlines the association of CM with neurological symptoms upon admission in a topographical manner. Seizures and vertigo are symptoms of CM which may have been missed in previous studies. In addition to confirming known risk factors such as aging and arterial hypertension, obesity appears to increase the risk as well. Since the incidence of CM is increasing, future

  4. Factors Related to Parenting Practices in Taiwan.

    Chen, Fu-Mei; Luster Tom


    This study examined factors related to authoritarian and authoritative parenting practices among 463 Chinese mothers with preschoolers in Taiwan. Questionnaire findings suggested that maternal depression, child temperament, and degree of parenting daily hassles might have cross-culturally universal influence on parenting practices. Chinese…

  5. Relationship between clinical biochemical detection indexes of fatty liver and related effect factors%脂肪肝临床生化检测指标与影响因素间的关系研究



    Objective To investigate the relationship between the clinical biochemical detection indexes of fatty liver and related effect factors .Methods A total of 73 fatty liver patients from April 2013 to April 2014 were select‐ed as the observation group ,and another 80 healthy persons were selected as the healthy control group .The related clinical biochemical indexes were detected ,and the clinical basic materials of them were observed .Results The levels of triacylglycerol ,total cholesterol ,alanine aminotransferase ,aspartate transaminase ,cholinesterase ,total bile acid ,to‐tal bilirubin in the observation group were significant higher than those of the healthy control group ,the differences were statistical significant(P< 0 .05) .Further more ,the incidence rate of obesity ,high blood pressure ,high blood sugar and high cholesterol ratios of the observation group were significantly higher than those of the healthy control group ,and the behaviors of limiting alcohol consumption ,regular exercise ,limit high‐fat food and regular medical ex‐aminations ratios were significant less than those of the healthy control group ,the differences were statistical signifi‐cant(P<0 .05) .Conclusion The clinical lipids and liver function biochemical indexes detection has good diagnosed value for the fatty liver ,and the reasonable intervention of the related factors is helpful to the improvement of bio‐chemical indexes ,which has good prevention and cured effects for this disease .%目的:探讨脂肪肝的相关生化检测指标与其影响因素的相关性。方法选取该院2013年4月至2014年4月收治的脂肪肝患者73例作为观察组,同期选取80例健康体检者作为健康对照组,分别对两组开展相关生化指标检测,同时观察患者临床基本资料。结果观察组患者三酰甘油、总胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、胆碱酯酶、总胆汁酸、总胆红素检测结果

  6. Quantitative relations between corruption and economic factors

    Shao, Jia; Podobnik, Boris; Stanley, H Eugene


    We report quantitative relations between corruption level and economic factors, such as country wealth and foreign investment per capita, which are characterized by a power law spanning multiple scales of wealth and investments per capita. These relations hold for diverse countries, and also remain stable over different time periods. We also observe a negative correlation between level of corruption and long-term economic growth. We find similar results for two independent indices of corruption, suggesting that the relation between corruption and wealth does not depend on the specific measure of corruption. The functional relations we report have implications when assessing the relative level of corruption for two countries with comparable wealth, and for quantifying the impact of corruption on economic growth and foreign investments.

  7. Investigation of the related factors and management countermeasures of clinical nursing security risks%临床护理安全事件相关因素及对策分析

    胡仙琴; 张美丽; 项灵斐


    Objective To investigate the related factors and management countermeasures of clinical nursingsecurity risks. Methods From March, 2011 to March, 2014, 136 nursing safety events were analyzed. The security event analysis group was established. The reasons for the development, processing methods and other related security incidents were researched. Results Within the security event, nurses were the main factor. Within the moderated nursing security events, 21 cases were attributed to nurses, 3 cases were attributed to doctors and 2 cases were attributed to other factors. Conclusions Nurses, patients, doctors, hospital administrators, and infrastructure should be strengthenedto meet the need of security risk management. The communication skills, responsibility and skills training are needed to prevent the occurrence of nursing safety incidents.%目的:探讨临床护理工作中存在的护理安全隐患及其管理对策相关因素。方法统计136例护理安全事件,成立护理安全事件分析小组,查阅关于护理安全事件的发生原因、处理方法等相关记录,并从护士、患者及其家属、医生、医院等相关因素,对护理安全事件产生的影响进行归类分析,着重分析中度护理安全事件的起因。结果临床护理安全事件相关因素中,护士因素占主导。中度护理安全事件原因护士因素占21例,医生因素占3例,其他因素有2例。结论应从护士自身、患者、医生、医院管理人员、基础设施各个方面加强护理安全隐患管理,着重加强护士沟通技能、责任心、专业技能的培训,有效预防护理安全事件的发生。

  8. Clinical Analysis of 900 Cases of Female Breast Disease Related Factors%女性乳腺疾病900例相关影响因素临床分析



    Objective To analyze the related factors affecting female breast disease. Methods Choose the hospital breast clinic 2012 to 2014 to hospital for 900 cases of physical examination of patients as the research object, the of clinical examination and questionnaire, impact of female breast disease related factors. Results 900 patients in found to have breast disease were 305 cases, belonging to the hyperplasia of mammary glands have 99 cases, belonging to the breast masses with 96 cases, belonging to the mammary gland fibroma have 45 cases, 15 cases belong to malignant breast lesions, 50 cases of other diseases. Among them, 246 is married, age in the 30 - to 60 year old has 259. The factors influence the incidence of female breast disease are age, age of menarche, age of menopause, abortion etc. Conclusion Relatively high probability of breast disease, the elderly women, age at menarche early, the number of abortion, age at menopause are the cause of breast disease. Through health examination, can effectively detect breast disease and breast cancer prevention, early diagnosis and early treatment, reduce the probability of the incidence of breast disease and to improve women's health has important significance.%目的:分析影响女性乳腺疾病的相关影响因素。方法选用本院乳腺门诊2012~2014年来院接受体检的患者900例作为研究对象,对其进行临床检查和问卷调查,研究影响女性乳腺疾病的相关因素。结果900例患者中查出有乳腺疾病的有305例,属于乳腺增生的有99例,属于乳腺肿块的有96例,属于乳腺纤维瘤的有45例,15例属于乳腺恶性病变,其他病变50例;其中有246例是已婚,年龄在30~60岁的有259例。影响女性乳腺疾病的发病的因素有年龄、月经初潮年龄、流产史、绝经年龄等。结论中老年女性、月经初潮年龄早、流产次数多、绝经年龄晚等均是导致乳腺疾病发病的原因。通过健康体检,

  9. Analysis on clinical factors related to artificial insemination with husband sperm in 1 382 cycles%1382周期宫腔内夫精人工授精临床因素分析

    孙婧; 权孝珍; 谢明霞; 徐蓓; 曾丹; 刘玉芹; 艾继辉


    目的:对官腔内夫精人工授精患者的临床资料进行分析,评估相关因素对夫精人工授精妊娠率的影响.方法:选择2007年1月~2009年3月因不孕于同济医院生殖医学中心进行官腔内人工授精(IUI)治疗的夫妇943对,共1 382个周期.分析女性年龄、不孕年限、不孕原因、IUI治疗周期数及促排卵方案等临床因素和妊娠率之间的关系.结果:①年龄超过40岁妊娠率明显下降(P<0.05);不孕年限超过10年的妊娠率明显下降(P<0.05).②继发性不孕的妊娠率高于原发性不孕的妊娠率(P<0.05).③女方因素中,妊娠率最高的是多囊卵巢综合征,最低的是子宫内膜异位症;男方因素中,以性功能障碍和精液液化不良的妊娠率最高,畸精症的妊娠数为0.④促排卵周期的妊娠率高于自然周期,但差异无统计学意义.结论:在夫精人工授精中,患者年龄、不孕年限、不孕类型、不孕原因和促排方案均可影响妊娠率,治疗时应综合考虑多种因素的影响.%Objective: To analyze the clinical data of patients receiving intrauterine insemination with husband sperm, evaluate the effect of relative factors on pregnancy rate after intrauterine insemination. Methods: 943 infertile couples who received intrauterine insemination in the hospital from January 2007 to March 2009 were selected, 1 382 cycles were included. The relationship between clinical factors including maternal age, infertile time, infertile causes, cycles of intrauterine insemination, ovulation induction protocol and pregnancy rate was analyzed. Results: The pregnancy rate of the patients more than 40 years decreased significantly ( P < 0. 05 ) . The pregnancy rate of the patients with infertile time > 10 years decreased significantly ( P < 0. 05 ) . The pregnancy rate of the patients with secondary infertility was significantly higher than that of the patients with primary infertility (P < 0. 05) . Among female factors, the

  10. Baltic Factor in Russia-France Relations

    Maltsev Leonid A.


    Full Text Available The article aims to identify the role of the Baltic factor in Russia-France relations. Despite the fact that the Baltic Sea region (BSR no longer plays an important role in Russia-France bilateral relations, the authors attach significance to analysing the dynamics and changes of the BSR role in European politics in the post- Napoleonic period. The authors compare the Russian and the July Monarchies (1830—1848 in the context of the current Vienna system of international relations. The article describes the role of the 1830—1831 uprising in Poland, which was an event of particular importance. The monarchies of the two countries had to take into account new social phenomena, which were more pronounced in France. After the suppression of the uprising in the Polish part of the Russian Empire, Polish emigrants residing in France became the stumbling block for the development of Russia- France relations. The article explores the role of P. de Barante, Ambassador of France to Russia and describes France and Russia’s trade and economic interests in the Baltic Sea region. The authors conclude that the specificity of Russia-France bilateral relations became more apparent during the First and Second World Wars. However, the Baltic factor has lost its relevance over time.


    Richard Metcalf


    Methodologies to determine the proliferation resistance (PR) of nuclear facilities often rely on either expert elicitation, a resource-intensive approach without easily reproducible results, or numeric evaluations, which can fail to take into account the institutional knowledge and expert experience of the nonproliferation community. In an attempt to bridge the gap and bring the institutional knowledge into numeric evaluations of PR, a survey was conducted of 33 individuals to find the relative importance of a set of 62 nonproliferation factors, subsectioned into groups under the headings of Diversion, Transportation, Transformation, and Weaponization. One third of the respondents were self-described nonproliferation professionals, and the remaining two thirds were from secondary professions related to nonproliferation, such as industrial engineers or policy analysts. The factors were taken from previous work which used multi-attribute utility analysis with uniform weighting of attributes and did not include institutional knowledge. In both expert and non-expert groups, all four headings and the majority of factors had different relative importance at a confidence of 95% (p=0.05). This analysis and survey demonstrates that institutional knowledge can be brought into numeric evaluations of PR, if there is a sufficient investment of resources made prior to the evaluation.

  12. Clinical investigation of risk factors in ectopic pregnancy

    Ling-yun HU


    Full Text Available Objective  To discuss the relative and independent risk factors in ectopic pregnancy. Methods  The clinical data of 870 patients with ectopic pregnancy, admitted from 2005 to 2012, were retrospectively analyzed, with 800 cases of normal pregnancy serving as control. Monofactorial correlation analysis was used to analyze the related risk factor, and logistic regression analysis was used to analyze the independent risk factor. Results  Pelvic adhesion, previous operation, cesarean section delivery, number of pregnancy, artificial abortion, medical abortion, in vitrofertilization and embryo replacement (IVF-ER, and placement of intrauterine device (IUD are the risk factors of ectopic pregnancy, pelvic adhesion, artificial abortion, operation, number of pregnancies and IUD are the independent risk factors, and pelvic adhesion is the major risk factor. Conclusion  Avoidance of unexpected pregnancy as possible, reduction of the number of artificial abortion, prevention and treatment of genital duct inflammation, and standardization of pelvic operation may reduce the incidence of ectopic pregnancy.

  13. Study on the clinical relativity of glial cell growth factor and prolactin pituitary tumor%胶质细胞生长因子与泌乳素垂体瘤的临床相关性研究

    刘永军; 高翔; 刘吉祥; 李建华


    目的:探讨胶质细胞生长因子(GGF)与泌乳素垂体瘤临床的相关性,并分析其预测临床复发的价值。方法研究对象为本院收治的71例泌乳素垂体瘤(PRL )患者,采用免疫组织化学检测GGF在肿瘤组织中的表达情况,分析GGF表达水平与PRL水平、肿瘤大小、微血管密度(MVD)及肿瘤侵袭性的关系,并进一步分析GGF表达水平与泌乳素垂体腺瘤复发的临床联系,最后采用多因素Cox生存风险模型寻求可能的预后影响因素。结果不同PRL水平、肿瘤大小、M VD及肿瘤侵袭性的患者其GGF表达水平也具有明显差异,且差异有统计学意义(P<0.05);3年无复发生存分析显示,GGF高表达组患者的3年无复发生存率(71.4%)和生存期(28.0±2.2)个月均明显低于低表达GGF组88.9%和(32.8±1.5)个月,但差异无统计学意义(P>0.05);多因素Cox生存风险模型分析提示GGF可能是预测泌乳素垂体瘤患者复发预后的独立生物学指标( P<0.05)。结论 GGF与泌乳素垂体瘤患者临床基线资料密切相关,且可能成为预测患者复发预后的重要生物学指标。%Objective To explore clinical relevance of the glial cell growth factor (GGF) and pro‐lactin pituitary tumor ,and to analyze clinical value of its predicting recurrence .Methods Research ob‐ject for the records of 71 cases in our hospital ,prolactin (PRL ) of pituitary adenoma patients using immunohistochemical detection GGF expression in tumor tissue ,analysis GGF expression level and the level of PRL ,tumor size ,microvascular density (MVD) and the relationship between tumor invasive , and further analysis GGF expression level and prolactin pituitary adenoma recurrence of clinical rela‐tion ,finally using multiariable Cox survival risk model for possible prognostic factors .Results The dif‐ferent levels of PRL ,tumor size ,tumor MVD and expression level

  14. Digoxin and its related endogenous factors.

    Jortani, S A; Valdes, R


    The digitalis drugs are plant-derived cardenolide compounds used medicinally for several hundred years. These drugs elicit inotropic and chronotropic effects on the heart, but they also affect many other tissues. The mechanism of action involves inhibition of the ion-transport activity of a membrane-associated protein called Na, K-ATPase (sodium pump). Present theory holds that the sodium pump is the principal molecular receptor for the digitalis drugs. Recent evidence indicates the presence of naturally occurring digitalis-like compounds in mammals. It is believed these compounds, collectively known as either digitalis-like (DLF) or ouabain-like (OLF) factors, may be endogenous hormones regulating the biological activity of the sodium pump and its isoforms. The presence of deglycosylated and other congeners of one specific DLF, the digoxin-like immunoreactive factor (DLIF), has very recently been described in humans. Digoxin as a drug is the most widely prescribed digitalis in the U.S., and its measurement in serum has established a model for present-day therapeutic drug monitoring (TDM). Historically, the accurate measurement of digoxin in blood has been difficult. This article focuses on the present understanding of the clinical use of digoxin, factors that affect the accuracy of measuring digoxin, the principle of measuring metabolically active species of digoxin, and the effects of DLIF and other interfering substances in digoxin immunoassay.

  15. 子宫内膜异位症的发病特点、临床治疗及相关发病因素分析%Pathogenesis, clinical treatment and analysis of related risk factors associated with endometriosis

    张宣东; 吴蕾; 张兵


    Objective To investigate pathogenesis and progress in clinical treatment of endometriosis (EM).In accordance with the clinical experience,the incidence of EM among females in different age catogeries was investigated and risk factors associated with EM were also summarized.Methods The research was conducted through a case control study.Data of 127 EM cases (the experiemental group) and 122 non-EM cases (the control group) were collected from January,2012 to June,2014.With regard to menstrual features and reproductive activities,the subjects were asked to fill the gynecopathy form for questionnaire and then related risk factors were calculated,analyzed and evaluated.Results EM occurred mostly in the age between 20 and 50,with those in their thirties and forties having the highest incidence.Single factor analysis indicated that menarche below the age of 11,menstrual cycle of less than 24 days,menstrual length of over 8 days,dysmenorrheal were all closely correlated with high incidence of EM (P < 0.05 or P < 0.01).Age of primary pregnancy greater than 29 and abortion were all risk factors of EM (P < 0.05 or 0.01).Conclusions EM seemed to be associated with early menarche,short menstrual cycles,long menstrual length,late pregnancy and abortion.%目的 探讨子宫内膜异位症(endometriosis,EM)的发病特点和临床治疗进展,结合笔者临床经验研究不同年龄阶段EM的发病情况,总结EM发病的危险因素.方法 采用病例-对照研究,收集我院2012年1月至2014年6月127例EM患者(研究组)和122例非EM患者(对照组)的相关资料,针对患者月经状况和生殖活动等,填写相关调查表,并对相对危险度进行计算、分析与评价.结果 EM发病年龄多在20 ~ 50岁之间,其中31~40岁发病率最高.单因素分析显示,月经初潮年龄≤11岁、月经周期≤24 d、经期≥8 d及痛经与EM发病率增高显著相关(P<0.05或P<0.01);生殖活动方面,初孕年龄≥29岁、做过人工流产

  16. Holography, chiral Lagrangian and form factor relations

    Zuo, Fen


    We perform a detailed study of mesonic properties in a class of holographic models of QCD, which is described by the Yang-Mills plus Chern-Simons action. By decomposing the 5 dimensional gauge field into resonances and integrating out the massive ones, we reproduce the Chiral Perturbative Theory Lagrangian up to ${\\cal O}(p^6)$ and obtain all the relevant low energy constants (LECs). The numerical predictions of the LECs show minor model dependence, and agree reasonably with the determinations from other approaches. Interestingly, various model-independent relations appear among them. Some of these relations are found to be the large-distance limits of universal relations between form factors of the anomalous and even-parity sectors of QCD.

  17. The current status and relating factors of soft skills among nursing students in clinical practice%实习护生护理软技能现状及其相关因素分析

    李潘; 孙晓晶; 申海艳; 段功香


    Objective To investigate the current status and relating factors of soft skills among nursing students in clinical practice, so as to improve the soft skills of nursing students. Method A total of 311 nursing students from two affiliated hospitals of a medical university were investigated by the Nursing Soft Skills Scale. Results The mean score of nursing soft skills was ( 3.35 ± 0.27 ). The dimension score of professionalism (3.50 ± 0.34 ) was the highest and the dimension score of organization management ( 3.24 ± 0.37 ) was the lowest. The educational background of parents, class leader and rank of exam results were relating factors of soft skills ( P < 0.05 ). Conclusion The soft skills of nursing students are at upper middle level. It is suggested that the nursing schools and teaching hospitals should take measures to provide opportunity so as to further improve their soft skills.%目的 了解实习护生的护理软技能现状及其相关因素,以提高护生护理软技能水平.方法 采用护理软技能测评量表对某医科大学2所附属医院311名实习护生进行调查.结果 实习护生护理软技能总均分为(3.35±0.27)分,其中职业情操维度得分最高(3.50±0.34)分,组织管理技能维度得分最低(3.24±0.37)分.父母文化程度、是否班团干部以及成绩排名是影响护生护理软技能的相关因素(P<0.05).结论 实习护生护理软技能处于中等偏上水平,建议护理院校及实习医院采取有针对性的措施,为进一步提高护生的护理软技能提供机会.

  18. 频发腹膜透析相关性腹膜炎的临床特征和危险因素的探讨%Clinical features and risk factors study of peritonitis related with frequent peritoneal dialysis

    杨素琼; 陈艳桃; 温梅花; 李小梅


    ABSTRACT:Objective To analyze and study clinical features and risk factors of peritonitis relatedwith frequent peritoneal dialysis.Method choose 80 cases uremia patients received in our hospital during August 2011 and February 2015 treated by continuous peritoneal dialysis out of bed with peritoneal dialysis catheter. 38 cases were selected as control group suffered peritonitis once during 1 year, and 42 cases as observation group suffered peritonitis more than once during 1 year,Result in observation group, blood pressure of patients with peritonitis was significantly higher, and edema patientsincreased, HGB and ALB was significantly decreased, bacillus and fungus increased significantly. And patients of extubation significantly increased for invalid treatment, and the difference was significant with statistical significance (P<0.05).Conclusion:risk factors of peritonitis related with frequent peritoneal dialysis are mainly severe anemia and low protein, so treating anemia and low protein carefully may significantly reduce incidence of peritonitis related with peritoneal dialysis.%目的:对频发腹膜透析相关性腹膜炎的临床特征和危险因素进行分析探讨。方法选取于2011年8月至2015年2月期间在我院接受腹膜透析置管行持续性非卧床腹膜透析的80例尿毒症患者,将1年内发生1次腹膜炎的38例患者作为对照组,将1年内发生多次腹膜炎的42例患者作为观察组。结果观察组患者腹膜炎发生时血压明显升高、水肿患者例数增加、HGB以及ALB显著降低、杆菌+真菌显著增加,并且治疗无效拔管患者显著增加,差异显著,具有统计学意义(P<0.05)。结论频发腹膜透析相关性腹膜炎的危险因素主要有较严重的贫血和低蛋白,要积极治疗患者的贫血和低蛋白血症状才能显著降低腹膜透析相关性腹膜炎的发生情况。

  19. Relation between depression and sociodemographic factors

    Akhtar-Danesh Noori


    Full Text Available Abstract Background Depression is one of the most common mental disorders in Western countries and is related to increased morbidity and mortality from medical conditions and decreased quality of life. The sociodemographic factors of age, gender, marital status, education, immigrant status, and income have consistently been identified as important factors in explaining the variability in depression prevalence rates. This study evaluates the relationship between depression and these sociodemographic factors in the province of Ontario in Canada using the Canadian Community Health Survey, Cycle 1.2 (CCHS-1.2 dataset. Methods The CCHS-1.2 survey classified depression into lifetime depression and 12-month depression. The data were collected based on unequal sampling probabilities to ensure adequate representation of young persons (15 to 24 and seniors (65 and over. The sampling weights were used to estimate the prevalence of depression in each subgroup of the population. The multiple logistic regression technique was used to estimate the odds ratio of depression for each sociodemographic factor. Results The odds ratio of depression for men compared with women is about 0.60. The lowest and highest rates of depression are seen among people living with their married partners and divorced individuals, respectively. Prevalence of depression among people who live with common-law partners is similar to rates of depression among separated and divorced individuals. The lowest and highest rates of depression based on the level of education is seen among individuals with less than secondary school and those with "other post-secondary" education, respectively. Prevalence of 12-month and lifetime depression among individuals who were born in Canada is higher compared to Canadian residents who immigrated to Canada irrespective of gender. There is an inverse relation between income and the prevalence of depression (p Conclusion The patterns uncovered in this

  20. Factors Related to Suicide in LGBT Populations.

    Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego


    There is evidence of heightened vulnerability to nonfatal suicidal behaviors among LGBT populations yet a paucity of studies into fatal behaviors. The specific aim of this article was to identify factors related to suicide in LGBT individuals in Australia. The psychological autopsy (PA) method with a matched case-control study design was used. PA interviews were conducted with 27 next-of-kin of an LGBT person that had died by suicide. Three living LGBT controls per suicide case, matched by age and gender, were also interviewed. The key factors relating to suicide in LGBT people were a lack of acceptance by family and self (reflected in higher internalized homophobia and shame), negative feelings about own sexuality/gender, and dissatisfaction with appearance. LGBT people who died by suicide also tended to go through coming out milestones 2 years earlier than controls. There was a higher prevalence of aggressive behaviors and a more predominant history of physical and sexual abuse. Additionally, there was greater incidence of depression and anxiety and alcohol and substance use disorders. Specific predictive factors for suicide in LGBT populations in Australia were identified, including significantly poorer mental health outcomes and more violence across an array of measures.

  1. Risk factors for age-related maculopathy.

    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.

  2. Cerebrovascular risk factors and clinical classification of strokes.

    Pinto, Antonio; Tuttolomondo, Antonino; Di Raimondo, Domenico; Fernandez, Paola; Licata, Giuseppe


    Cerebrovascular risk represents a progressive and evolving concept owing to the particular distribution of risk factors in patients with ischemic stroke and in light of the newest stroke subtype classifications that account for pathophysiological, instrumental, and clinical criteria. Age represents the strongest nonmodifiable risk factor associated with ischemic stroke, while hypertension constitutes the most important modifiable cerebrovascular risk factor, confirmed by a host of epidemiological data and by more recent intervention trials of primary (HOT, Syst-Eur, LIFE) and secondary (PROGRESS) prevention of stroke in hypertensive patients. To be sure, a curious relationship exists between stroke and diabetes. Although the Framingham Study, The Honolulu Heart Program, and a series of Finnish studies reported a linear relationship between improved glucose metabolism and cerebral ischemia, the clinical and prognostic profile of diabetic patients with ischemic stroke remains to be fully understood. Our group, on the basis of TOAST classification--a diagnostic classification of ischemic stroke developed in 1993 that distinguishes five different clinical subtypes of ischemic stroke: large-artery atherosclerosis (LAAS), cardioembolic infarct (CEI), lacunar infarct (LAC), stroke of other determined origin (ODE), and stroke of undetermined origin (UDE), and now extensively used in clinical and scientific context--analysed the prevalence of cerebrovascular risk factors and the distribution of TOAST subtypes in more 300 patients with acute ischemic stroke in two consecutives studies that reported the significant association between diabetes and the lacunar subtype and a better clinical outcome for diabetic patients, most likely related to the higher prevalence of the lacunar subtype. Well-confirmed are the roles of cigarette smoking, atrial fibrillation, and asymptomatic carotid stenosis as cerebrovascular risk factors. Particularly interesting seems to be the function of

  3. Factoring Algebraic Error for Relative Pose Estimation

    Lindstrom, P; Duchaineau, M


    We address the problem of estimating the relative pose, i.e. translation and rotation, of two calibrated cameras from image point correspondences. Our approach is to factor the nonlinear algebraic pose error functional into translational and rotational components, and to optimize translation and rotation independently. This factorization admits subproblems that can be solved using direct methods with practical guarantees on global optimality. That is, for a given translation, the corresponding optimal rotation can directly be determined, and vice versa. We show that these subproblems are equivalent to computing the least eigenvector of second- and fourth-order symmetric tensors. When neither translation or rotation is known, alternating translation and rotation optimization leads to a simple, efficient, and robust algorithm for pose estimation that improves on the well-known 5- and 8-point methods.

  4. 手术治疗痔疮临床疗效及发病相关因素分析%Clinical effect and oncome related factors analysis of operation treatment of hemorrhoids



    目的:探讨分析手术治疗痔疮临床疗效及发病相关因素。方法:2010年1月-2013年12月收治痔疮患者60例,将患者随机分为非手术治疗组和手术治疗组,各30例,比较两组患者的治疗有效率。对60例痔疮患者和60例非痔疮患者的饮酒、辛辣饮食、便秘、遗传及久坐情况进行整理。比较痔疮患者与非痔疮患者在饮酒、辛辣饮食、便秘、遗传及久坐方面的差异。结果:手术治疗组有效率86.7%,明显高于非手术治疗组66.7%,其差异具有统计学意义(P<0.05)。Logistic回归分析模型分析表明饮酒、辛辣饮食、便秘、遗传及久坐均为痔疮发病的危险因素,其中辛辣饮食的风险系数最大(OR=2.156)。结论:痔疮的发病因素包括饮酒、辛辣饮食、便秘、遗传及久坐,临床治疗应以积极手术为主。%Objective:To explore the clinical effect and oncome related factors analysis of operation treatment of hemorrhoids. Methods:60 patients with hemorrhoids were selected from January 2010 to December 2013.The patients were randomLy divided into the non operation treatment group and operation treating group with 30 cases in each.The treatment effective rates of two groups were compared.The alcohol,spicy food,constipation,genetic and sedentariness conditions of 60 patients with hemorrhoids and 60 patients without hemorrhoids were systemized.The differences of alcohol,spicy food,constipation,genetic and sedentariness conditions between patients with hemorrhoids and patients without hemorrhoids were compared.Results:The effective rates of the operation treating group was 86.7%,which was significantly higher than 66.7% of non operation treatment group,and the difference was statistically significant(P<0.05).Logistic regression analysis model analyzed that alcohol,spicy food,constipation, genetic and sedentariness were the risk factors for occurrence of hemorrhoids,and the risk priority number of spicy

  5. The clinical effect and related factors analysis of Cosjet TR laser on 82 cases of melasma%双模式Nd:YAG激光治疗黄褐斑82例疗效及相关因素分析

    夏栩琼; 费烨; 沈征宇; 陈向东


    目的:观察双模式Nd:YAG激光治疗黄褐斑的临床疗效以及相关影响因素.方法:应用双模式Nd:YAG激光治疗82例女性黄褐斑患者,总治疗次数为5次,每次间隔2周,治疗结束后由医生及受试者本人对激光治疗进行疗效评价,并随访12周记录复发情况,对各相关影响因素与治疗疗效进行统计学分析.结果:82例患者治疗前黄褐斑平均面积及严重程度指数(MASI)评分(12.58±6.55)分,5次激光治疗后降为(7.72±5.13)分,随访12周后的平均MASI评分为(8.14±5.82)分.Logistic回归分析显示Wood灯下分型(P=0.003,OR=6.062)、心境情况(P=0.027,OR=3.791)、防晒霜使用情况(P=0.003,OR=3.544)与疗效相关;而表皮型(P=0.025,OR=9.223)、心境平和(P=0.030,OR=6.757)、防晒霜使用情况(P=0.001,OR=9.702)、起病年龄(P=0.004,OR=8.937)与复发情况相关.结论:双模式Nd:YAG激光是治疗黄褐斑的有效手段.皮损表浅、保持心境平和、养成良好的防晒习惯是黄褐斑激光治疗疗效及降低复发的有利因素,起病年龄早是降低复发的有利因素.%Objective: The clinical effect and related factors analysis of Cosjet TR laser on 82 cases of melasma. Methods: 82 female patients with melasma were given Cosjet TR laser every 1-2 weeks for 5 times. After 12 weeks follow梪p, the results of treatment were assessed by retrospective analysis of clinical photographs and patient satisfaction rates. Results: After laser treatment, the average of MASI score reduced from 12.58 (±6.55) to 7.72 (±5.13), After 12 weeks of follow-up the average MASI score was 8.14 (±5.82). Logistic regression analysis showed the associations of efficacy with Wood lamp type (P = 0.003, OR = 6.062), mood conditions (P= 0.027, OR = 3.791), sunscreen used conditions (P = 0.003, OR = 3.544). The recurrence was associated with epidermal type (P = 0.025, OR = 9.223), good mood conditions (P = 0.030, OR = 6.757), sunscreen used conditions (P = 0.001, OR = 9

  6. 护理实习生人际交往效能感的调查分析%The level and influencing factors of nursing students' sense of interpersonal relations efficacy during clinical practice

    乔祎; 戈晓华; 章雅青


    Objective To investigate the level and influencing factors of nursing students' interpersonal relations efficacy during clinical practice. Method Totally 81 full-time baccalaureate nursing students in grade four and 91 full-time associate degree nursing students in grade three were recruited from 8 universities by convenience sampling method. They were investigated with the College Students Sense of Interpersonal Relations Efficacy Questionnaire. Results The average score of interpersonal relations efficacy was (14428± 1537) points. There was significant difference between male and female students(P0,05). Conclusion Nursing students need to shape good individual characters and the teachers should improve the curriculum design to train nurses with skills in interpersonal interaction.%目的 调查护理实习生人际交往效能感现状,并分析其在性别、学历等一般资料上的差异.方法 方便抽取8所护理院校(系)全日制四年级本科生81名和三年级大专生91名,采用大学生人际交往效能感问卷对其进行调查.结果 护理实习生人际交往效能感得分为(144.28±15.37)分;人际交往效能感得分在学历、生源地、家庭来源、临床实习时间等方面差异无统计学意义(P>0.05),但在性别上差异有统计学意义(P<0.05).结论 护理实习生人际交往效能感有待提高.护理实习生应注重塑造良好的个性品质,而学校应完善课程设置,培养学生人际交往的相关技巧.

  7. Sex-related clinical aspects in insect venom anaphylaxis.

    Nittner-Marszalska, Marita; Liebhart, Jerzy; Dor-Wojnarowska, Anna


    Experimental studies, epidemiological data, and clinical observations suggest that the gender factor is involved in the development and manifestation of IgE-dependent allergic diseases. We intend to answer the question if sex-related factors may play a role in Hymenoptera venom allergy (HVA). In the majority of recent studies the frequency of HVA symptoms with respect to both LL and SYS reactions is similar for men and women, while proven sensitization to insect venom is less frequent in women. Studies assessing clinical reactivity in HVA indicate that male sex and vespid venom allergy are factors increasing the risk of severe allergic reactions. Regarding the risk of adverse events associated with gender in the course of venom immunotherapy (VIT), the results of two large EAACI multicenter studies are discordant. In the first study, women showed increased risk of VIT adverse events. In the latter, systemic allergic side effects were not associated with gender. Despite theoretical premises and certain clinical observations indicating an important role of estrogens in allergic diseases, their influence on stinging insects' venom hypersensitivity is not unequivocal and remains still open. Further studies on the safety of VIT in females seem to be advisable. © The Author(s) 2015.

  8. Investigation of osteoporosis prevalence and osteoporosis-related clinical risk factors among healthy elderly male%老年健康男性骨质疏松患病的危险因素分析

    张效栋; 林吉生; 杨秀全; 费琦; 王炳强; 杨雍; 李锦军; 马钊; 赵凡


    目的 调查健康老年男性骨密度(BMD)变化规律并分析和原发性骨质疏松症(OP)相关的危险因素.方法 采用横断面研究,对2014年1至10月北京市丰台区王佐社区50岁以上健康老年男性346例进行双能X线骨密度检查和自制《北京市老年男性原发性骨质疏松症高危人群临床危险因素调查问卷》的调查,记录腰椎总(L14)、左侧股骨颈和左髋总的BMD数值和年龄、体重、既往脆性骨折史、吸烟史、饮酒史等临床危险因素;根据世界卫生组织(WHO)诊断标准将研究对象分为骨质疏松组和非骨质疏松组,分析各临床危险因素与骨质疏松症发生的相关性.结果 346例老年健康男性总体骨质疏松患病率18.5%(64/346),骨量减少者55.5%(192/346),骨量正常者26.0%(90/346);股骨颈及股骨总BMD水平随增龄呈逐渐降低趋势,腰椎总BMD水平随增龄变化规律不明显,从50岁起髋部BMD水平明显低于同年龄组腰椎BMD(P<0.05).既往脆性骨折史、体重指数、体重及吸烟史在骨质疏松组和非骨质疏松组间差异有统计学意义(P<0.05).结论 老年男性骨质疏松患病情况不容忽视,既往脆性骨折史、低体重及低体重指数、吸烟史可能是王佐镇社区老年男性OP的临床危险因素.%Objective To investigate the osteoporosis prevalence and osteoporosis-related clinical risk factors among healthy elderly male.Methods A cross-sectional study was conducted from January 2014 to October 2014.Healthy elderly male aged 50 and above from Beijing WangZuo Community who had completed the questionnaire we made were enrolled in this study and accepted bone mineral density (BMD) testing by dual energy X-ray absorptiometry.Subjects were classified as the osteoporosis group (OP group) and the non-osteoporosis group (Non-OP group) according to the WHO criteria,of which osteoporosis was defined arbitrarily when any T-score was-2.5 standard deviations or less at femoral

  9. Modeling Relational Data via Latent Factor Blockmodel

    Gao, Sheng; Gallinari, Patrick


    In this paper we address the problem of modeling relational data, which appear in many applications such as social network analysis, recommender systems and bioinformatics. Previous studies either consider latent feature based models but disregarding local structure in the network, or focus exclusively on capturing local structure of objects based on latent blockmodels without coupling with latent characteristics of objects. To combine the benefits of the previous work, we propose a novel model that can simultaneously incorporate the effect of latent features and covariates if any, as well as the effect of latent structure that may exist in the data. To achieve this, we model the relation graph as a function of both latent feature factors and latent cluster memberships of objects to collectively discover globally predictive intrinsic properties of objects and capture latent block structure in the network to improve prediction performance. We also develop an optimization transfer algorithm based on the general...

  10. 狼疮肾炎的病理和免疫学指标及临床相关性分析%Clinical pathology and immunological features in patients with LN and related factors

    魏玉翠; 列才华; 黄海; 王卫; 梁兰青


    Objective To analyze the clinical pathology and immunological features and related factors of Chinese patients with lupus nephritis (LN).Methods The clinical data,including age,sex, clinical renal and extrarenal damage,pathological category,and quantitation of urinary protein,blood routine,serum creatinine,cystatin C,serum albumin and immune indexes,including C3 and C4 comple-ments,antinuclear antibody (ANA),anti-double-stranded DNA antibody (AdsDNA),anti-smooth muscle antibody (Asm),anti-nucleosome antibody (AnuA),anti-histone antibody (AHA),were retro-spectively analyzed in 1 23 patients with LN.Results (1 ) Of 1 23 cases,there were 1 06 females (86.38%)and 17 males (13.82%)with age ranging from 14 to 60 years (mean 32.51 ±11.10 years);(2)Clinical renal damage occurred in 48 cases of nephritis syndrome type (39.02%),42 cases of nephrotic syndrome (34.14%),33 cases of asymptomatic type (26.01%),and 20 cases of renal in-sufficiency (16.26%);(3)The renal histological classes showed there were 59 cases of type Ⅳ(47.97%),44 cases of type Ⅱ (35.77%),18 cases of type Ⅴ (14.63%),and 2 cases of type Ⅲ(1.63%).The renal histological classes of male patients mainly showed there were 14 cases of type Ⅳand Ⅴ (82.35%).The proportion of type Ⅱ in females was higher than that in males (39.62%vs.11.76%,P0.05), and there were 30 cases (90.91%)with SLEDAI score ≥15.Conclusions (1)This group of LN pa-tients are still dominated by women,nephritic syndrome and nephrotic syndrome are commonly seen clinically,and types Ⅳ and Ⅱ are the mainly pathological damage.(2)There is certain relationship be-tween clinical features and pathological classifications in LN.Men,massive proteinuria,anemia,and el-evated cystatin C are the independent risk factors of the renal pathological lesions in patients with LN. (3)SLEDAI correlates with multiple system injury,but not with pathological types.(4)AdsDNA, AnuA and AHA are markers for disease activity,and combined detection of the 3

  11. Angiogenic factors in relation to embryo implantation

    Azadeh Bagheri


    Full Text Available Disturbances in uterine blood supply are associated with higher perinatal morbidity and mortality caused by preterm delivery, preeclampsia or intrauterine growth restriction. Adaptation of the uterine vasculature to the rising needs of the fetus occurs through both vasodilation and development of new vessels. Angiogenesis is the process of neovascularization from pre-existing blood vessels in response to hypoxic condition of tissues. The endometrium, decidua and placenta are rich sources of angiogenic growth factors. In general, the angiogenic process is initiated by growth factors such as VEGF, placental growth factor (PlGF or bFGF. Through a complex signal transduction machinery mediated by respective receptor-tyrosine kinases, an increase in the permeability of the maternal vessels is achieved to permit growth and invasion of endothelial cells. Their chemotactic migration, formation of a vessel lumen, and functional maturation of new capillaries complete the angiogenic process that involves the expression of specific adhesion receptors and extracellular matrix-degrading proteases. During vasculogenesis, endothelial progenitor cells--angioblasts--form a primitive vascular network. This process occurs mainly during fetal development, although recruitment of angioblasts from bone marrow and peripheral blood in response to ischemic insult have been described in adults. In this review article we have described a recent complication related to angiogenic involvement in embryo implantation. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 872-879

  12. Factors related to attempted suicide in Davanagere

    Nagendra Gouda M


    Full Text Available Research Question: What are the factors responsible for suicidal attempts? Objectives: To study the socio-demographic factors, methods and reasons for suicidal attempts. Type of Study: Cross-sectional study. Setting: Bapuji and C.G. Hospitals attached to J.J.M. Medical College, Davanagere. Participants: A total of 540 suicidal attempters admitted to emergency wards. Methodology: A pretested proforma was administered to the subjects relating the factors responsible for the attempt. The data thus obtained was compiled and analyzed. Statistical Analysis: Proportions, Z -test and Chi-square test. Results: In this study, 61.3% were males and 38.7% were females. Peak occurrence of suicidal attempts was found in the second and third decades (15-29 years. Hindus constituted about 94.6% of the total suicidal attempters. Almost half (52.2% of the subjects had education below or up to matriculation and 83% of them were from the lower (classes IV and V socio-economic groups. Agriculturists, housewives and unskilled workers represented 75% of the total subjects. Fifty-five percent of the subjects were from nuclear families and most (62.4% of them were married; frequent mode of attempting suicides was by organo-phosphorus compounds (66.3% followed by overdosage of tablets (17.8%. Common cause was family problem (27.2% followed by illness (27%.

  13. Assessing poverty and related factors in Turkey.

    Saatci, Esra; Akpinar, Ersin


    Poverty, a complex, multidimensional, and universal problem, has been conceptualized as income and material deprivation. In this article, we discuss poverty and related factors in Turkey. The absolute poverty line for Turkey was US$ 4 per capita per day. Turkey was ranked 92nd out of 177 countries with moderate human development in the 2006 Human Development Report. The individual food poverty rate was 1.35% and the non-food poverty rate was 25.6%. The highest poverty rate was among primary school graduates (42.5%; 38.5% for women and 46.8% for men). The rate for this group was higher in urban than in rural areas. Among poor people, 57.2% were married. The highest poverty rate was among agricultural workers (46.6%) and in Eastern and Southeastern Anatolia. Factors related to poverty were crowded households, unemployment, immigration, working for a daily wage in the agricultural and construction sector, low educational status, female sex or married status, lacking social insurance, and living in rural areas or in Eastern and Southeastern Anatolia.

  14. 结直肠癌术后发生医院感染的临床分析%Clinical Analysis on Related Factors of Nosocomial Infection after Colorectal Cancer Surgery

    杨晓宏; 陶小君


    目的:探讨结直肠癌术后切口感染的相关因素和病原菌的分布情况,以进一步提高结直肠癌术后切口感染的防治效果。方法回顾性分析自2010年8月至2014年8月在江油市第二人民医院普外科接受手术治疗的结直肠癌患者294例。根据有无发生术后切口感染将其分为感染组(49例)和未感染组(245例)。采集感染组患者的术口分泌物行病原学检测以分析结直肠癌术后切口感染的病原菌分布情况。同时对比两组患者的临床资料,以探讨造成结直肠癌术后切口感染的因素。结果本研究患者结直肠癌术后切口感染率为16.7%,共培养出病原菌59株。革兰阴性菌占66.1%,革兰阳性菌占30.5%。革兰阴性菌中,大肠埃希菌最多,有16株,其次为铜绿假单胞菌,有9株;革兰阳性菌中,金黄色葡萄球菌最多,有13株。感染组和未感染组患者的性别、年龄、有无合并肠梗阻的对比,差异均无统计学意义( P>0.05);感染组体质指数≥23 kg/m2的患者比例为30.6%,显著高于未感染组( P<0.05),感染组合并糖尿病患者的比例为26.5%,显著高于未感染组( P <0.05)。结论结直肠癌术后切口感染病原菌以革兰阴性菌为主,肥胖和合并糖尿病是术后切口感染的相关因素。临床应加强血糖的管理,规范使用抗菌药物以提高术口感染的防治效果。%Objective To explore the related factors of nosocomial infection after colorectal cancer sur-gery and the distribution of pathogenic bacteria,in order to further enhance the prevention and treatment of infection after colorectal cancer surgery.Methods Clinical data of 294 patients with colorectal cancer received surgeries in Jiangyou Second Pepole′s Hospital from Aug.2010 to Aug.2014 were retrospectively analyzed.According to the presence of wound infections after surgery,all the cases were

  15. 中毒患者急诊临床表现及死亡的相关因素分析%Clinical manifestations of acute intoxication in emergency department and analysis on related factors of poisoned death



    Objective To provide basis for emergency treatment on patients with poisoning and reduce the mortality by un-derstanding the clinical manifestation of the poisoning patients in emergency department.Methods 204 emergency patients with poisoning in our hospital from June 2012 to June 2014 were studied.Results The emergency patients with poisoning were mainly young adults.The poisoning occurrence rate in rural areas was significantly higher than that in urban areas( P<0.05) . The highest incidence of poisoning occurred in the occupation engaged in agricultural labor(37.8%).The main reason for the accidents of poisoning was incidents(73.0%).Chemical poison was the main toxic substance causing poisoning (55.9%). Poisoning events almost exclusively happened at home(76.0%),and influenced by seasons.Age,pesticides and drugs were the main influencing factors that caused deaths of poisoning patients.Conclusion Analysis of clinical manifestations of poisoning patients in emergency department and studying related factors of poisoned death may contribute to coping with emergency inci-dence of poisoning and to improving the survival rate.%目的:了解中毒患者急诊临床表现,为中毒患者急诊治疗、降低死亡率提供依据。方法将我院2012年6月-2014年6月204例急诊中毒患者作为研究对象,对其临床资料进行分析。结果急诊中毒患者主要发生于青壮年,且农村人群中毒发生率显著高于城市人群(P<0.05),从事农业劳动为中毒发生率最高的职业(37.8%)。意外事故为发生急诊中毒事件的主要原因(73.0%),化学品中毒是引起中毒的主要毒性物质(55.9%),且中毒事件多发生于家中(76.0%),并具有一定的季节性。年龄、农药以及毒品是导致中毒患者急诊治疗死亡的主要影响因素。结论通过对中毒患者急诊临床表现及死亡的相关因素分析研究,有助于更有效的应对中毒患者

  16. Clinical, Molecular, and Environmental Risk Factors for Hodgkin Lymphoma

    Alison Maggioncalda


    Full Text Available Epidemiological studies suggest unique occurrence patterns of Hodgkin lymphoma (HL worldwide. In most Western countries there is a clear bimodal age distribution with an early peak in young adults followed by a second peak in older adults, particularly among males. In the Middle East and Asia, HL is more common in early childhood. There also are marked racial differences in the presentations of HL and HL subtypes, and particular single nucleotide polymorphisms (SNPs have been identified as etiological factors suggesting that gene-gene and gene-environment interactions are involved. Personal health choices such as exercise and smoking may modify an individual's chances of developing HL. Numerous studies highlight the impact that exposure to Epstein-Barr virus and other environmental factors have on HL risk. Understanding the relative importance of each of these findings and their links to HL development and survival will help clinical researchers expand curative therapies and create preventative strategies for HL.

  17. Consequences of Contextual Factors on Clinical Reasoning in Resident Physicians

    McBee, Elexis; Ratcliffe, Temple; Picho, Katherine; Artino, Anthony R., Jr.; Schuwirth, Lambert; Kelly, William; Masel, Jennifer; van der Vleuten, Cees; Durning, Steven J.


    Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe what impact the presence of contextual factors have…

  18. [Analysis and discussion of clinical relativity between virulent heat-evils and thrombosis-related diseases].

    Liang, Ai-Hua; Timothy, M Chan


    The pathogeny and the pathogenesis of thrombosis-related diseases are complicated, and family heredity, hypertension, hyperlipoidaemia diabetes and smoking are traditionally considered to be the risky factors. In recent years, various evidences have indicated that infection and inflammation which are defined as virulent heat-evils in traditional Chinese medicine (TCM) are also the risky factors for thrombosis-related diseases. This article analyzed the clinical relativity between virulent heat-evils and thrombosis-related diseases from epidemiology and clinical evidences and the therapeutical practices of TCM on the treatment of thrombosis by using clear away heat-evil and toxic materials principle. Based on the analysis, it can be concluded that dispelling of virulent heat-evils is important for the treatment thrombosis-related diseases. Now the essential of virulent heat-evils associated with thrombosis-related diseases and the nosogenesis of virulent heat-evils are still difficult to be rationally elucidated, and the anti-thrombosis activity of Chinese medicine which functioned as clearing away heat-evil and toxic materials can not be objectively screened and evaluated because no proper thrombosis animal model with virulent heat-evils basis is available at present. Thus, it is necessary to establish a suitable virulent heat-evil-induced thrombosis animal model.

  19. 产妇产后尿失禁相关因素与防治的临床研究%Clinical research and on the related factors of postpartum urinary incontinence

    李小平; 王晓丽


    Objective To explore the clinical research and on the related factors of postpartum urinary incontinence. Methods 120 cases of maternal choice in 2013 April-2014 April in my hospital income homeswere all collected and its related factors of maternal morbidity of postpartum urinary incontinence were observed. Results The maternal urinary incontinence of Less than 30 years age occurred significantly below than the age 30 years(including 30 years)of the maternal(P < 0.05),fetal birth weight less than 4000g of the maternal urinary incontinence rate was lower than that of fetal birth weight greater than 4000g(contains 4000g of maternal)(P < 0.05);the maternal urinary incontinence rate of second stage of labor was less than 30 minutes of was lower than that of the second stage of labor for more than 30 minutes of the maternal(P < 0.05).Birth time less than 2 parity groups of maternal urinary incontinence occurred significantly less than the parity of 2 above(including 2 parity,maternal parity)(P < 0.05). The incidence of urinary incontinence,urinary incontinence and age during pregnancy,birth weight,the second stage of labor and birth time was positively correlated(P < 0.05).Vaginal delivery group maternal urinary incontinence was significantly higher than that of cesarean section group(P <0.05). Conclusion The risk factors of postpartum urinary incontinence include age,mode of delivery,maternal urinary incontinence,birth weight,the second stage of labor and birth inferior,clinical should take corresponding prevention measures in the above link, reduce the incidence of postpartum urinary incontinence.%目的:探讨产妇产后尿失禁发生的相关因素及其预防办法。方法选择2013年4月~2014年4月在我医院收入院的120例产妇,分析产妇产后发生尿失禁的发病率及相关影响因素。结果年龄小于30岁的产妇尿失禁发生率显著低于年龄30岁以上(包含30岁)的产妇(P<0.05),胎儿出生时体重小于4000

  20. Complement factor H related proteins (CFHRs).

    Skerka, Christine; Chen, Qian; Fremeaux-Bacchi, Veronique; Roumenina, Lubka T


    Factor H related proteins comprise a group of five plasma proteins: CFHR1, CFHR2, CFHR3, CFHR4 and CFHR5, and each member of this group binds to the central complement component C3b. Mutations, genetic deletions, duplications or rearrangements in the individual CFHR genes are associated with a number of diseases including atypical hemolytic uremic syndrome (aHUS), C3 glomerulopathies (C3 glomerulonephritis (C3GN), dense deposit disease (DDD) and CFHR5 nephropathy), IgA nephropathy, age related macular degeneration (AMD) and systemic lupus erythematosus (SLE). Although complement regulatory functions were attributed to most of the members of the CFHR protein family, the precise role of each CFHR protein in complement activation and the exact contribution to disease pathology is still unclear. Recent publications show that CFHR proteins form homo- as well as heterodimers. Genetic abnormalities within the CFHR gene locus can result in hybrid proteins with affected dimerization or recognition domains which cause defective functions. Here we summarize the recent data about CFHR genes and proteins in order to better understand the role of CFHR proteins in complement activation and in complement associated diseases.

  1. Analysis of related factors of panic disturbance consulted in out-patient clinic%惊恐障碍患者门诊咨询相关因素分析

    杨晓玉; 盛宝英; 乔香兰; 杨晏清; 丛桂红


    @@ INTRODUCTION With increasing of social mentality stress factors, anxiety has becomean important mental health problem that people face. It was reportedthat patients with anxiety neurosis consists 2% - 5% of people. Butin mental counseling out-patient clinic of multiple hospital, only13.7% are diagnosed as anxiety neurosis, among which were manypatients with panic disturbance. Patients search for medical servicefor chest pain, palpitation and dying feeling in department of neu-rology or emergeny department. No evidence identifying ischemicheart disease is found after repeated examination and correspondingtreatment can' t effectively alleviate symptoms. The effective rate byantianxiety treatment might be 80. 65%.

  2. Associations of pain intensity and pain-related disability with psychological and socio-demographic factors in patients with temporomandibular disorders: a cross-sectional study at a specialised dental clinic.

    Su, N; Lobbezoo, F; van Wijk, A; van der Heijden, G J M G; Visscher, C M


    The study assessed whether psychological and socio-demographic factors, including somatisation, depression, stress, anxiety, daytime sleepiness, optimism, gender and age, are associated with pain intensity and pain-related disability in patients with temporomandibular disorders (TMDs). In total, 320 TMD patients were involved in the study. The psychological status of each patient was assessed with questionnaires, including the Symptom Checklist-90 (SCL-90), Epworth Sleeping Scale (ESS), stress questionnaire and Life Orientation Test-Revised (LOT-R). TMD pain, including pain intensity and pain-related disability, was assessed with characteristic pain intensity (CPI) and disability points scales. The associations of psychological and socio-demographic factors with pain intensity and pain-related disability were assessed through logistic regression analyses. Higher pain intensity was significantly associated with more severe anxiety (P = 0·004), more severe somatisation (P socio-demographic factors in this study, somatisation was the best predictor of pain intensity, while depression was the best predictor of pain-related disability. © 2016 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.

  3. Spontaneous ipsilateral subconjunctival hemorrhage and the related risk factors

    Nikolas Ziakas


    Full Text Available The aim of the report is to assess the risk factors among patients with spontaneous ipsilateral subconjunctival hemorrhage (SCH who presented to the outpatients’ department in General Hospital of Veria, Veria, Greece. Thirty-five patients with SCH participated in the study. A thorough case history was taken and a full ophthalmic examination was performed to identify the risk factors related to the clinical finding. The common hematological parameters associated with the coagulation profile of each patient were evaluated. With the exception of SCH, the ophthalmic examination was normal in all patients. Identified risk factors include history of systemic hypertension (21 patients [60%], mean systolic value: 170 mmHg±15 mmHg, strenuous exercise [19 patients (54%] and minor ocular trauma [5 patients (14%]. Other risk factors [each in 2 patients (6%] included: diabetes mellitus, smoking, severe cough, straining at stool, and weight lifting. Seven patients (20% were under medication related to bleeding diathesis. The values of the blood coagulation parameters were within the normal limits in all patients. Twenty-nine patients (83% had elevated blood pressure during the ophthalmological examination. Our study provides documentation regarding the potential risk factors associated with SCH. It is interesting to observe the high incidence of hypertension among the patients with SCH. Therefore, it is highly recommended that the blood pressure be checked in all patients with SCH and that the patients be referred to a general practitioner for further management if indicated.

  4. [Activated protein C resistance and factor V Leiden: clinical interest].

    Guermazi, S; Znazen, R


    Activated protein C resistance (APCR) is a coagulation abnormality often linked to FV Leiden mutation, a single nucleotide G1691A substitution resulting in arginine 506→glutamine missense factor V mutation. FV Leiden has a frequency of 20 to 30% in groups of patients with venous thrombosis while it is of 4 to 10% in normal subjects. FV Leiden is considered as a weak risk factor of thrombosis except in homozygote. FV Leiden is implicated in deep venous thrombosis occurrence. Duration of oral anticoagulant treatment is six months in patients developing a first venous thrombosis except in patients with combined defects or a clinical context suggesting a high risk of severe relapse. Detection of APCR by coagulation methods is often used in first intention with a high specificity if plasmas tested are diluted in factor V deficient plasma. Genotyping study is essential to establish the heterozygote or homozygote statute and certain teams perform it directly. Nevertheless, APCR not related to FV Leiden could be an independent thrombosis risk factor. APCR and FV Leiden are included in laboratory investigations of thrombophilic markers in patients less than 50 years with venous thrombosis. In arterial thrombosis, FV Leiden implication is weak or absent. FV Leiden increases the risk of thrombosis in other situations as in patients with cancer. An association with recurrent miscarriages and other vasculoplacental complications is also reported in many studies but the data concerning the efficacy of antithrombotic treatment to prevent recurrence are currently insufficient. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  5. Sex Disparities in Effects of Cystic Fibrosis-Related Diabetes on Clinical Outcomes: A Matched Study

    Robert J Miller


    Full Text Available BACKGROUND: Cystic fibrosis-related diabetes (CFRD is an increasingly prevalent comorbidity factor for patients with cystic fibrosis (CF. CFRD has been associated with an accelerated decline in clinical parameters and an increased mortality rate.



    performance of every organization, whether large or small, in today's ... improvement of labour productivity should be a major and ... factors based on the theory of motivation. Durdyev and ..... of required work is one of the factors affecting.

  7. Towards a framework of success factors for clinical trials

    Buonansegna, Erika; Salomo, Søren; Maier, Anja


    of success factors. This paper creates the new framework by combining success factors from NPD literature and from empirical evidence collected through 11 semi-structured interviews with experts in clinical trials. The framework of success factors provides managerial guidelines for practitioners to optimize...... clinical trials reducing failures and increasing profits. The framework directs managerial focus on the most important factors for success and helps managers in decision-making of operational tasks. The framework can also be applied as a checklist for assessing the status of a clinical trial and later......Clinical trials in the pharmaceutical industry are the most critical part of the drug development process with respect to obtaining the market approval from the authorities. Clinical trials are highly expensive, time-consuming and often unsuccessful. While new product development (NPD) literature...

  8. Clinically important factors influencing endothelial function.

    Vapaatalo, H; Mervaala, E


    The endothelium, a continuous cellular monolayer lining the blood vessels, has an enormous range of important homeostatic roles. It serves and participates in highly active metabolic and regulatory functions including control of primary hemostasis, blood coagulation and fibrinolysis, platelet and leukocyte interactions with the vessel wall, interaction with lipoprotein metabolism, presentation of histocompatibility antigens, regulation of vascular tone and growth and further of blood pressure. Many crucial vasoactive endogenous compounds like prostacyclin, thromboxane, nitric oxide, endothelin, angiotensin, endothelium derived hyperpolarizing factor, free radicals and bradykinin are formed in the endothelial cells to control the functions of vascular smooth muscle cells and of circulating blood cells. These versatile and complex systems and cellular interactions are extremely vulnerable. The balances may be disturbed by numerous endogenous and exogenous factors including psychological and physical stress, disease states characterized by vasospasm, inflammation, leukocyte and platelet adhesion and aggregation, thrombosis, abnormal vascular proliferation, atherosclerosis and hypertension. The endothelial cells are also the site of action of many drugs and exogenous toxic substances (e.g. smoking, alcohol). As markers and assays for endothelial dysfunction, direct measurement of nitric oxide, its metabolites from plasma and urine, functional measurement of vascular nitric oxide dependent responses and assay of different circulating markers have been used. In numerous pathological conditions (e.g. atherosclerosis, hypertension, congestive heart failure, hyperhomocysteinemia, diabetes, renal failure, transplantation, liver cirrhosis) endothelial dysfunction has been described to exist. Some of them, as well as hormonal and nutritional factors and drug treatment will be discussed in this short review.

  9. [The factor analysis results of the relationship of socio-demographic, clinical and functional indicators with the likelihood of identifying age-related disorders in the population in North-Western Russia].

    Kupriianova, V A; Zakharchuk, A G; Zherebtsov, S V; Spivak, I M; Spivak, D L


    By using the method of factor analysis (principal component method) the determinants of disease in elderly and senile patients were searched with an estimate of their influence degree in the population of the North-West Russia. The data from medical records of 712 patients of both sexes aged 59 to 98 years were analyzed. The factor 1 proved to be associated with: marital status, living conditions, family relationships, bad habits, appearance, cough, diet, hearing and vision, laxatives, joint health, ability to move and sleep disturbances. Factor 2 combined diseases of older: cerebral stroke, myocardial infarction, cardiac arrhythmia, diabetes, kidney disease, obesity, thyroid disease, Parkinson's disease, lung disease, anemia, arthritis, osteoporosis, the number of surgeries and joint diseases. The factor 3 was found to self-association ability before and after admission to the assessment of the patients' mental state for MMSE test after admission. It is concluded that the development of age-related (especially the musculoskeletal system pathology) is associated with social characteristics and living conditions of patients, and treatment of the most age-related diseases requires consideration of comorbidity.

  10. Psychological Factors related to traffic accidents

    Serafín Aldea Muñoz


    Full Text Available Automobile drivers fine themselves affected by series psychological factors which are directly related to traffic accidents. In this study we intend to investigate these variables, basing our work on the most convenient sources of information, coming from the police, the General Direction of Traffic, the courts, insurance companies, the Red Cross, Social Security, and forensics. Neither could we ignore the influence which certain forces hold over people´s mental health; this can sometimes intensely affect how they drive. In fact, in the most diverse situations we can observe the way in which a person carries out a task can be conditioned by the presence of other person who may have no direct relationship to him. Society has established its limitations and rules, but speed itself feels omnipotence when imposing controls over the most profound behavior in others; man in usually not conscious of these controls. People generally drive their automobiles in a way similar to their habitual behavior and their personality traits. Nevertheless, it is also important to consider the adaptation of their way of driving to their state of mind at any given moment. The majority of subjects tend to adapt their driving to their emotional state.

  11. Psychological Factors related to traffic accidents

    Serafín Aldea Muñoz


    Full Text Available Automobile drivers fine themselves affected by series psychological factors which are directly related to traffic accidents. In this study we intend to investigate these variables, basing our work on the most convenient sources of information, coming from the police, the General Direction of Traffic, the courts, insurance companies, the Red Cross, Social Security, and forensics.Neither could we ignore the influence which certain forces hold over people´s mental health; this can sometimes intensely affect how they drive. In fact, in the most diverse situations we can observe the way in which a person carries out a task can be conditioned by the presence of other person who may have no direct relationship to him. Society has established its limitations and rules, but speed itself feels omnipotence when imposing controls over the most profound behavior in others; man in usually not conscious of these controls. People generally drive their automobiles in a way similar to their habitual behavior and their personality traits. Nevertheless, it is also important to consider the adaptation of their way of driving to their state of mind at any given moment. The majority of subjects tend to adapt their driving to their emotional state.

  12. 影响胎儿大脑中动脉血流峰速的临床相关因素%Related clinical effect factors of peak velocity of blood flow of fetal middle cerebral artery

    凌奕; 金松; 南瑞霞; 华少萍; 张宏玉; 胡春霞; 莫秀兰


    Objective: To analyze the related clinical effect factors of peak velocity of blood flow of fetal middle cerebral artery ( MCA) , provide a basis for predicting fetal anemia by peak velocity of blood flow of MCA. Methods; 140 fetuses from the hospital were analyzed and divided into normal control group (85 fetuses), uncomplicated twin group (22 fetuses) , thalassemia group (IS fetuses) and fetal anomaly group (18 fetuses) , all the fetuses received color Doppler examination of peak velocity of blood flow of MCA and hemoglobin detection. MOM value was used as the unit, the differences of peak velocities of blood flow of MCA and fetal hemoglobin contents among the four groups were analyzed. Results; There was no significant difference in peak velocity of blood flow of MCA and fetal hemoglobin content between uncomplicated twin group and single pregnancy group. In thalassemia group, the peak velocity of blood flow of MCA increased significantly , while fetal hemoglobin content decreased. Compared with normal single pregnancy group, the peak velocity of blood flow of MCA in fetal anomaly group increased significantly (P < 0. 05 ) , but after exclusing anemia fetuses, there is no significant difference in the peak velocity of blood flow of MCA between fetal anomaly non - anemia group and normal single pregnancy group. Conclusion: The peak velocity of blood flow of MCA is significantly related to fetal anemia, but there was no correlation between peak velocity of blood now of MCA and un-complicated twin pregnancy; the study shows that there is no significant difference in the peak velocity of blood flow of MCAbetween fetal anomaly non - anemia group and normal single pregnancy group after exclusing anemia fetuses, a further study with large samples is needed.%目的:分析影响胎儿大脑中动脉血流峰速(MCA-PSV)的临床相关因素,为应用MCA-PSV预测胎儿贫血提供依据.方法:对海南医学院附属医院140例胎儿进行临

  13. Digital communication to support clinical supervision: considering the human factors.

    Mather, Carey; Marlow, Annette; Cummings, Elizabeth


    During the last three years the School of Nursing and Midwifery at the University of Tasmania has used a needs assessment survey to explore the needs of organizations and nursing professionals that facilitate and clinically supervise Bachelor of Nursing students in the workplace. Findings from the survey indicated that staff at healthcare organizations wanted a communication strategy that was easily accessible by clinicians who supervised students during work integrated learning placements. In particular they wanted to receive timely information related to the role and function of supervisors in practice. The development of the digital strategy to strengthen the development of a community of practice between the University, organizations, facilities and clinical supervisors was identified as the key method of improving communication. Blogging and micro blogging were selected as methods of choice for the implementation of the digital strategy because they were easy to set up, use and enable equity of access to geographically dispersed practitioners in urban and rural areas. Change champions were identified to disseminate information about the strategy within their workplaces. Although clinicians indicated electronic communication as their preferred method, there were a number of human factors at a systems and individual level identified to be challenges when communicating with clinical supervisors who were based off-campus. Information communication technology policies and embedded culture towards social presence were impediments to using this approach in some organizations. Additionally, it was found that it is necessary for this group of clinicians to be educated about using digital methods to undertake their role as clinical supervisors in their varied clinical practice environments.

  14. Clinical presentation and risk factors of osteoradionecrosis

    Chronopoulos, Aristeidis


    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

  15. [Acupuncture clinical trials published in high impact factor journals].

    Hu, Min; Liu, Jian-Ping; Wu, Xiao-Ke


    Acupuncture clinical trials are designed to provide reliable evidence of clinical efficacy, and SCI papers is one of the high-quality clinical efficacy of acupuncture research. To analyze these papers published in high impact factor journals on acupuncture clinical trials, we can study clinical trials from design to implementation, the efficacy of prevention and cure, combined with international standard practices to evaluate the effectiveness and safety of acupuncture. That is the core of acupuncture clinical trials, as well as a prerequisite for outstanding academic output. A scientific and complete acupuncture clinical trial should be topically novel, designed innovative, logically clear, linguistically refining, and the most important point lies in a great discovery and solving the pragmatic problem. All of these are critical points of papers to be published in high impact factor journal, and directly affect international evaluation and promotion of acupuncture.

  16. 影响慢性阻塞性肺疾病急性加重相关危险因素临床研究%Clinical Research of Risk Factors Related to Affect Chronic Obstructive Pulmonary Disease Exacerbations

    王琦; 许西琳


    Objective:To investigate the ef ects of chronic obstructive pulmonary disease (COPD) risk factors associated with acute exacerbation. Methods: the ef ect of the First Af iliated Hospital of Xinjiang Medical Col ege of Shihezi UniversityRespiratory Department of internal medicine due to acute exacerbation of COPD (AECOPD) in 100 cases of patients were col ected, the general data, clinical manifestation, care factors andthe past year due to acute exacerbation of admission times,determination of acute exacerbation and stable stage of lung function and blood cellanalysis. Results: univariate correlation analysis showed: severe and extremely severe pulmonary function, complications of COPD, smoking, shortness of breathand the degree of acute exacerbation of COPD were positively correlated (P<0.05), regular vaccination, long-term inhalationand long-term oxygen inhalation and acute exacerbation were negatively correlated (P< 0.05); multivariate correlation analysis shows: severe and extremely severe pulmonary function(OR=6.360), smoking (OR= 3.411) and acute exacerbation of COPD was significantly positive correlation (P< 0.05), long-term home oxygen therapy (OR=0.122), long-term inhalation (OR=0.095) with acute exacerbation of COPD showed a significant negative correlation (P< 0.05). Conclusions:theseverity of COPD (smoking, lung function severity, with no complications, the degree of shortness of breath) is the related risk factors of acute exacerbation of COPD, regular vaccination,long-term inhalation of drugs, long-term home oxygen therapy was protective factor, can ef ectively reduce the acute at ack times.%目的:探讨影响慢性阻塞性肺疾病(COPD)急性加重的相关危险因素。方法观察新疆石河子大学医学院第一附属医院呼吸内科因 COPD急性加重(AECOPD)入院患者100例,收集患者的一般资料、临床表现、照料因素和过去一年中因急性加重入院的次数,测定急性加重期血球分析及其稳定

  17. Acute clinical recovery from sport-related concussion.

    Nelson, Lindsay D; Janecek, Julie K; McCrea, Michael A


    Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury's defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.

  18. Towards a framework of success factors for clinical trials

    Buonansegna, Erika; Salomo, Søren; Maier, Anja


    Clinical trials in the pharmaceutical industry are the most critical part of the drug development process with respect to obtaining the market approval from the authorities. Clinical trials are highly expensive, time-consuming and often unsuccessful. While new product development (NPD) literature...... clinical trials reducing failures and increasing profits. The framework directs managerial focus on the most important factors for success and helps managers in decision-making of operational tasks. The framework can also be applied as a checklist for assessing the status of a clinical trial and later...... as a benchmarking tool to compare clinical trial processes. Dependencies among the identified factors seem to exist, thus a set of propositions, can be developed from the success factors and be the basis for future empirical testing....

  19. 已治疗帕金森病患者的精神病性障碍特点及相关因素分析%The clinical characteristics and related factors of psychosis in patients with Parkinson's disease

    刘琦; 苏闻; 陈海波


    目的 探讨帕金森病(PD)患者精神病性障碍的患病率及症状学特点,并分析其相关因素. 方法 应用简明精神病量表、神经精神问卷对82例PD患者和69例正常对照进行调查,分析PD患者起病年龄、抗PD药物种类和剂量、运动功能、Hoehn-Yahr分级、认知损害、抑郁、睡眠障碍等与PD精神病性障碍(PDPsy)的相关性. 结果 患者组PDPsy患病率为36.6%,对照组精神病性障碍患病率为2.9%,差异具有统计学意义(P<0.0001).在具有PDPsy的30例患者中,错觉、错误的存在性感觉、幻觉、妄想的患病率分别为22.0%,14.6%、29.3%、7.3%.单因素分析显示,具有PDPsy患者的年龄(71.1±6.2)岁、服用的左旋多巴等效剂量(628.7±283.2)mg、帕金森病致残量表睡眠部分(SCOPA-SLEEP)评分(15.3±7.3)分,快速眼动期睡眠行为障碍(RBD)的患病率(60.0%),均显著高于无精神病性障碍的PD患者(66.6±9.3)岁、(461.1±317.2)、(9.7±7.6)分、28.9% (P<0.05).多因素分析结果显示:Hoehn-Yahr分级是PDPsy的保护因素(OR=0.039,95%CI:0.004~0.402);睡眠障碍是危险因素(OR=1.157,95%CI:1.015~1.320).精神病性症状数量多的PD患者年龄大、SCOPA-SLEEP评分高(P=0.0042、0.0112). 结论 PD患者精神病性障碍的患病率明显高于正常人群.PDPsy的发生和高龄、高左旋多巴等效剂量、严重的睡眠障碍及RBD相关.%Objective To discuss the clinical features and related factors of psychosis in patients with Parkinson's disease (PD) and assess the prevalence of psychosis.Methods A total of 82 patients with Parkinson's disease and 69 healthy controls were evaluated by Brief Psychiatric Rating Scale and neuropsychiatric questionnaire.For the PD group,the age at PD onset,type and dose of PD medications,and rapid eye movement (REM) sleep behavior disorder (RBD) were recorded.Unified Parkinson's disease rating scale (UPDRS,parts Ⅱ and Ⅲ) and Hoehn-Yahr staging were used for

  20. Factors associated with clinical inertia: an integrative review

    Aujoulat, Isabelle; Jacquemin, Patricia; Rietzschel, Ernst; Scheen, André; Tréfois, Patrick; Wens, Johan; Darras, Elisabeth; Hermans, Michel P


    Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. PMID:24868181

  1. Analysis of Treatment-Related Factors Affecting Mortality in Patients with Severe Necrotizing Acute Pancreatitis

    Praznik Ivan


    Full Text Available The aim of the paper was to determine the factors related to the initial therapy that may contribute to death from severe necrotizing acute pancreatitis and to analyze their clinical importance as well as possible additive effects.

  2. Factors related to drug approvals: predictors of outcome?

    Liberti, Lawrence; Breckenridge, Alasdair; Hoekman, Jarno; McAuslane, Neil; Stolk, Pieter; Leufkens, Hubert


    There is growing interest in characterising factors associated with positive regulatory outcomes for drug marketing authorisations. We assessed empirical studies published over the past 15 years seeking to identify predictive factors. Factors were classified to one of four 'factor clusters': evidentiary support; product or indication characteristics; company experience or strategy; social and regulatory factors. We observed a heterogeneous mix of technical factors (e.g., study designs, clinical evidence of efficacy) and less studied social factors (e.g., company-regulator interactions). We confirmed factors known to be of relevance to drug approval decisions (imperative) and a cohort of less understood (compensatory) social factors. Having robust supportive clinical evidence, addressing rare or serious illness, following scientific advice and prior company experience were associated with positive outcomes, which illustrated the multifactorial nature of regulatory decision making and factors need to be considered holistically while having varying, context-dependent importance. Copyright © 2017 Elsevier Ltd. All rights reserved.




    Mar 4, 2013 ... Several Literatures in construction management support the view that procurements have impacts on project performance. .... size, cost, flexibility, complexity, site risk factors ... of the procurement process to client charges are.

  4. Age-Related Factors That Influence Fertility

    ... can be found at the NICHD Pregnancy Loss topic page . Committee on Gynecologic Practice of American College of ... 2012, from [top] « Lifestyle Factors That Influence Fertility ...

  5. 多发性骨髓瘤肾病的临床特点及其相关因素分析%Multiple myeloma kidney disease clinical characteristics and related factors

    潘志兰; 张永梅; 张志敏; 杨彦; 冯丽倩; 邢英杰


    Objective Research the clinical characteristics and the etiological factor of Multiple myeloma. Methods The clinical data of 48 cases of multiple myeloma nephropathy were analyzed retrospectively. Results In 48 patients,male 27 cases,female 21 cases,median age 58 years. The clinical manifestations are different degrees of anaemia,albuminuria and os-teolytic lesions. There was significant correlation between the number of plasma cells and renal function damage in bone mar-row. Multiple myeloma kidney damage was associated with Anemia,hypercalcemia,high β2-microglobulin level,high level of serum uric acid and high uric acid. Conclusion Clinical manifestations of Multiple myeloma kidney damage are varied,and it was associated with Anemia,hypercalcemia,high β2-microglobulin level,high level of serum uric acid and high uric acid.%目的:观察多发性骨髓瘤(MM)的临床特点,研究 MM 肾病发生的相关因素。方法对医院收治的48例 MM 肾病患者的临床资料进行总结分析。结果48例患者,男27例,女21例,中位年龄为58岁,临床表现为不同程度的贫血、蛋白尿、溶骨性损害。骨髓液中浆细胞数与肾功能损害有明显相关性( P ﹤0.01),贫血、高钙血症、高β2微球蛋白水平及高血尿酸与 MM 肾脏损害有相关关系。结论 MM 肾病的临床表现多样性,浆细胞数量、贫血、高钙血症、高β2微球蛋白水平及高尿酸可能与 MM 肾病发生有关。

  6. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide

    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...... 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......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...

  7. Analysis on Clinical Features and Related Risk Factors of 127 Elderly Patients with Bronchial Asthma%127例老年支气管哮喘患者临床特点及相关危险因素分析



    目的:探讨支气管哮喘临床特点以及其发作危险因素,为预防和控制哮喘发作,减少其发病率提供借鉴。方法收集127例老年支气管哮喘患者(观察组)和同期就诊的112例非支气管哮喘呼吸道疾病患者(对照组)为研究对象,对患者的临床特点以及发作危险因素进行对比分析。结果支气管哮喘患者多在夜间发病,常反复发作,以轻、中度为主。单因素分析发现支气管哮喘发作与过敏史、家族史、吸烟、感染、气候变化、接触有害气体等因素有关(P<0.05),多因素分析发现家族史(P=0.037, OR =1.795)、吸烟(P=0.007, OR =5.027)、感染(P=0.021, OR =2.719)、接触有害气体(P=0.012, OR =5.016)是支气管哮喘的独立危险因素。结论尽量减少或者避免引起哮喘发作的危险因素,对减少哮喘急性哮喘发作、改善患者的预后具有重要意义。%Objective To investigate the clinical features and risk factors of bronchial asthma, so as to provide a theoretical basis for preventing and controlling the asthmatic attack, and reducing the incidence of asthma. Methods 127 elderly patients with bronchial asthma were set as observation group, 112 elderly patients with respiratory diseases and without bronchial asthma in same period were set as control group. The clinical features and risk factors of patients in two groups were analyzed and compared. Results Bronchial asthma were mainly mild and moderate level, and easily occurred at night, with recurrent attacks. Single factor analysis showed that the incidence of bronchial asthma was correlated with allergic history, family history of asthma, smoking, change of weather contact of harmful gas (P <0.05). Multivariate analysis showed that the independent risk factors included family history of asthma (P = 0.037, OR = 1.795), smoking (P =0.007, OR=5.027), infection (P=0.021, OR=2.719) and contract of harmful gas (P=0.012, OR=5.016). Conclusions The prognosis of patients

  8. Clinical factors adversely affecting early outcome after brain infarction

    Charles André


    Full Text Available PURPOSE AND METHODS: One-hundred-and-nine consecutive patients admitted during the acute phase of a CT-confirmed brain infarction (BI were studied. Putative adverse influence of demographic and stroke risk factors, previous medical history, clinical presentation, initial and follow-up neurological examination, initial general evaluation, laboratory findings, chest X-ray and electrocardiographic findings, treatment, and topography and etiology of the ischemic insult was analysed. The end-point for assessment was early death (within 30 days. Statistical analysis was performed with univariate analysis and multiple regression. RESULTS: The main adverse factors related to an increased death risk during the first 30 days were, in decreasing order of importance: coma 48-72 hours after admission; stroke occuring in already hospitalized patients; Babinski sign on admission; minor degrees of impairment of consciousness 48-72 hours after admission; stroke related to large artery atherothrombosis and to embolism; a history of early impairment of consciousness; cardiac failure on admission. In 53 lucid patients on admission, only a history of congestive heart failure (CHF was associated with a reduced survival rate. In 56 patients with impaired consciousness, the presence of a Babinski sign increased death risk, but the main factor predicting a high case-fatality rate was the persistence of consciousness disturbances after48-72 hours. CONCLUSIONS: The presence of impairment of consciousness, especially coma, 2-3 days after disease onset, and a history of CHF greatly increase the early case fatality rate in patients with acute BI presenting with or without consciousness disturbances at admission, respectively. The use of a prognostic algorythm considering these few variables seems to predict the approximate 30-day fatality rates.

  9. Clinical features and related factors of severe functional constipation%重度功能性便秘的临床特点和相关因素分析

    黄智慧; 赵岚; 储华; 马可云; 朱力芬; 汪丽; 戴宁; 龙艳芹


    Objective To analyze the clinical characteristics and related factors of severe functional constipation (FC) and explore the correlation between the severity of FC and colonic motility and anorectal function of patients.Methods From March 2010 to March 2012,patients with FC met Rome Ⅲ criteria were selected.A questionnaire survey was carried out and gastrointestinal transit test (GITT),anorectal manometry (ARM) and defecography were examined.The measurement data were analyzed by t test or rank sum and chi-square test was used for rate compare.Results Among 242 FC patients (male 69,female 173),179 cases (74.0%) were severe FC.The body mass index (BMI) of severe FC patients was (21.52±2.55) kg/m2,which was higher than that of non-severe FC patients ((20.72±2.46) kg/m2) and the difference was statistically significant (t=2.148,P=0.033).The rate of natural delivery in severe FC patients was 80.2% (89/111),which was higher than that of non-severe FC patients (63.6%,21/33),and the difference was statistically significant (x2 =3.860,P=0.049).There were no significant differences in GITT,ARM and defecography between severe FC patients and non-severe FC patients (all P>0.05).The weekly frequency of defecation of patients with abnormal GITT was 1.0 (0.5,2.0),which was less than that of patients with normal GITT (1.5(0.9,2.9)),and the difference was significant (Z=-2.612,P=0.009).Conclusions Severe FC is related to BMI and natural delivery.There is no correlation between anorectal function and severity of FC.The defecation frequency is correlated with colonic transit time.%目的 分析重度功能性便秘(FC)患者的临床特点和影响因素,探讨重度FC患者结肠动力和肛门直肠功能与便秘严重程度的相关性.方法 选择2010年3月至2012年3月符合罗马Ⅲ标准的FC患者,进行问卷调查、胃肠传输试验(GITT)、肛门直肠测压(ARM)和排粪造影检查.计量资料采用t检验或秩和检验,率的

  10. Osteoporosis in childhood: related factors and prevention

    Emilio González-Jiménez


    Full Text Available Osteoporosis is defined as a reduction in bone mass. This loss is more important in states of malnutrition, physical inactivity, and with a poor dietary intake of vitamin D and calcium. Bone mineralization depends on both genetic and nutritional factors, as well as endocrine, metabolic, and mechanical factors. Several studies in children have shown that the development of osteoporosis in adulthood may be influenced by the nutritional status during childhood, especially with regard to the contributions of calcium and vitamin D. However, currently there are many questions regarding its pathogenesis and diagnosis and its treatment, some of which are reviewed in this paper. The aim of this work has been to provide an update on the main factors associated with the development of osteoporosis and its prevention in infancy.

  11. Unitarily invariant norms related to factors

    Fang, Junsheng


    Let $\\M$ be a semi-finite von Neumann algebra and $\\J(\\M)$ be the set of operators in $\\M$ with finite range projections. In this paper we obtain a representation theorem for unitarily invariant norms on $\\J(\\M)$ of semi-finite factors $\\M$ in terms of Ky Fan norms. As an application, we prove that the class of unitarily invariant norms on $\\J(\\M)$ of a type ${\\rm II}\\sb \\infty$ (or type ${\\rm I}\\sb \\infty$) factor $\\M$ coincides with the class of symmetric gauge norms on $\\J(L^\\infty[0,\\infty))$ (or $\\J(l^\\infty(\

  12. The Success Factor Profile for clinical computer innovation.

    Lorenzi, Nancy M; Smith, Janis B; Conner, Susan R; Campion, Thomas R


    Fifty to seventy percent of information system projects fail. Most of the failures are not the victims of flawed technology, but rather organizational and people related issues. When Vanderbilt University Medical Center began an intensive electronic health record (EHR) effort, a process was carefully designed to select the clinical areas where new tools could be developed and pilot tested. The Success Factor Profile was created to guide the selection of sites most likely to have innovation success. This paper describes both the tools and the processes used to select clinical sites for new computer tools development and pilot implementation. Early results demonstrated that the tools provided structure for the decision making process, permitting side-by-side comparison of "apples and oranges." Selecting the site most likely to succeed with computer application innovation and early implementation has broad applicability in healthcare informatics. Failure to succeed with early system users is not only costly, but also discourages users and developers alike, and may damage the reputation of the tools and systems across the institution.

  13. Factores de riesgo de asma bronquial en niños y su relación con la severidad de las manifestaciones clínicas Risk factors of bronchial asthma in children and its relation to severity of clinical manifestations

    Tatiana de la Vega Pazitková


    Full Text Available Introducción: el asma bronquial es una enfermedad psicosomática que constituye un importante problema de salud mundial. La prevalencia estimada en Cuba es de 8,2 %. La identificación y el control de los factores de riesgo constituyen un pilar importante en el manejo de esta entidad. Objetivos: establecer la relación entre algunos de los factores de riesgo de asma bronquial y la severidad de las manifestaciones clínicas. Métodos: se realizó un estudio descriptivo, de corte transversal, que incluyó la totalidad de los niños menores de 15 años de edad, diagnosticados como asmáticos, pertenecientes a cinco consultorios médicos del policlínico "Ana Betancourt" cuya cifra asciende a 76 pacientes, durante el período de abril de 2007 a marzo de 2008. Resultados: Los niños se agruparon según la clasificación Global Initiative for Asthma 2007 en leve intermitente:15, leve persistente:19, moderado persistente:28 y severos:14. El total de los pacientes estudiados tenía antecedentes familiares de atopia y desencadenaban las crisis de asma con los cambios climáticos. El 95 % fue sensible a inhalantes respiratorios. En el 64 % de los hogares se detectó la presencia de fumadores. Solo el 36 % de los pacientes cumplía parcialmente el tratamiento intercrisis. Conclusiones: existe relación directa entre la severidad de las manifestaciones clínicas del asma bronquial y el número de factores de riesgo que la condicionan.Introduction: bronchial asthma is a psychosomatic disease that is a significant problem of world health. In Cuba its prevalence is of 8.2 %. Its identification and the risk factor control are a very essential base in management of this entity. Objectives: to establish the relation among some risk factors of bronchial asthma and the severity of clinical manifestations. Methods: a cross-sectional and descriptive study was conducted including all children aged under 15, diagnosed with asthma seen in 5 consulting rooms of "Ana

  14. Clinical Analysis of Related Factors and Prevention Countermeasures on Dental Caries in Preschool Children%学龄前儿童龋病相关因素临床分析及预防对策



    Objective:To explore the related factors and prevention countermeasures of dental caries in preschool children. Methods:Retrospective analysis of the relevant data of 240 cases medical preschool children,comparison related factors difference of dental caries and no dental caries preschool children.Results:240 cases preschool children have caries 110 cases(45.83%), dental caries 1~6, mean (2.24±1.76), dental caries children group non breast feeding, parents lack caries prevention knowledge, not brush their teeth every day, malnutrition, sweet tooth, living in rural areas than non caries dental caries group (P<0.05), is dangerous factors of dental caries in preschool children. Conclusion:The incidence of dental caries in preschool children was high, with a variety of factors, implementation the corresponding countermeasures to avoid reducing the incidence of dental caries.%目的:探讨引起学龄前儿童龋病相关因素及预防对策。方法:回顾性分析240例我院体检学龄前儿童相关资料,比较龋病组及无龋病两组学龄前儿童相关因素方面差异。结果:240例体检学龄前儿童存在龋病110例(45.83%),龋齿1~6个,平均(2.24±1.76)个,龋病组儿童非母乳喂养、家长缺少龋病预防知识、未每天刷牙、营养不良、嗜好甜食、居住农村高于无龋病组(P<0.05),是引起学龄前儿童龋病的危险因素。结论:学龄前儿童龋病发生率较高,与多种因素有关,实施相应的对策避免减少龋病的发生。

  15. Cow-specific risk factors for clinical mastitis in Brazilian dairy cattle

    Oliveira, C S F; Hogeveen, H; Botelho, A M; Maia, P V; Coelho, S G; Haddad, J P A


    Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which ris

  16. 腹膜透析清除钠的相关因素分析及其临床意义%Factors relating to sodium clearance in peritoneal dialysis and their clinical significance

    单亦升; 丁小强; 吉俊


    Objective To explore the factors relating to sodium clearance in peritoneal dialysis patients.Methods A total of 156 maintenance peritoneal dialysis patients who had completed the modified peritoneal equilibrium test (PET) and dialysis adequacy test were enrolled in this study.Multifactor regression analysis was used for data analysis.Results This study firstly disclosed the influence factors relating to the peritoneal sodium removal,including infusion volume and ultrafiltration every day, sodium dip during modified PET, and sodium concentration difference between serum and flesh dialysate.The influence factors relating to total sodium clearance included ultrafiltration every day, urine volume every day, sodium dip during modified PET, and sodium concentration difference between serum and fresh dialysate.Multifactor regression analysis indicated the presence of significant relationships.Conclusions (1) Sufficient fluid removal is necessary for adequate sodium removal when traditional dialysate is used; (2) Low sodium dialysate may be useful for the relief of sodium retention; (3) Index of sodium clearance should be included in the evaluation of dialysis adequacy.%目的 揭示腹膜透析患者钠清除的相关因素.方法 156例维持性腹膜透析患者,行改良腹膜平衡试验和透析充分性检查,对结果 做多元线性回归分析.结果 揭示了腹膜对钠清除的影响因素有透析剂量、每日净超滤量、血钠与新鲜透析液钠浓度差值和钠沉降率,总钠清除的影响因素有每日净超滤量、每日尿量、血钠与新鲜透析液钠浓度差值和钠沉降率.多元线性回归分析显示有显著相关性(P<0.01).结论 使用传统的腹膜透析液和足够的液体清除量是保证足够的钠清除量的最重要条件;使用低钠透析液应该是解决钠潴留的有效办法;评价透析充分性应包含钠清除的指标.

  17. Genomic Features of Environmental and Clinical Vibrio parahaemolyticus Isolates Lacking Recognized Virulence Factors Are Dissimilar

    Ronholm, J.; Petronella, N.; Chew Leung, C.; Pightling, A. W.; Banerjee, S. K.


    Vibrio parahaemolyticus is a bacterial pathogen that can cause illness after the consumption or handling of contaminated seafood. The primary virulence factors associated with V. parahaemolyticus illness are thermostable direct hemolysin (TDH) and Tdh-related hemolysin (TRH). However, clinical strains lacking tdh and trh have recently been isolated, and these clinical isolates are poorly understood. To help understand the emergence of clinical tdh- and trh-negative isolates, a genomic approac...

  18. 溃疡性结肠炎患者皮肤表现及影响因素分析%Clinical analysis of cutaneous manifestations and related factors in patients with ulcerative colitis

    田原; 李俊霞; 王化虹; 李若瑜; 刘新光


    Objective To investigate the cutaneous manifestations in patients with ulcerative colitis (UC) and related factors.Methods Patients admitted to Department of Gastroenterology Peking University First Hospital from January 1994 to December 2014 and diagnosed as UC were retrospectively enrolled in this study.Skin disorders were confirmed by the dermatologists.Clinical data were collected and compared between patients with and without cutaneous manifestations.Results Among the total 373 UC patients,there were 34 cases (9.1%) with cutaneous manifestations,including 11 pyoderma gangrenosum,8 erythema nodosum,6 eczema,3 psoriasis,2 pemphigus,1 granulomatous cheilitis,1 ichthyosis,1 acne rosacea,and 1 impetigo.The skin manifestations may occur after the diagnosis,simultaneously or even before the diagnosis of UC,which were 24,7 and 3 patients respectively.The mean age in patients with skin lesions was (47.2 ± 12.1) years,male to female ratio 0.79∶ 1.More patients with skin manifestations had severe activity of UC compared with non-skin group [50.0% (17/34) vs 25.1% (85/339),P =0.01].In addition,the proportion of extensive colitis in skin lesion group was significantly higher than that in non-skin group [76.5% (26/34) vs 54.6% (185/339),P =0.04].Conclusions The cutaneous manifestations associated with UC are polymorphic,erythema nodosums and pyoderma gangrenosums are the most common skin lesions seen in UC patients.Skin lesions occur concurrently,pre or post the diagnosis of UC.Skin lesions in UC patients suggest more severe disease activity.Clinicians need to pay more attention to this group.%目的 分析具有皮肤异常表现的溃疡性结肠炎(UC)患者皮肤损害的临床特征,探讨患者性别、年龄、吸烟史、疾病活动度、肠道病变范围与皮肤表现的相关性.方法 收集1994年1月至2014年12月北京大学第一医院门诊及住院诊断为UC患者373例,所有患者均符合2012年炎症性肠病诊断与治疗的共识

  19. Clinical trials in "emerging markets": regulatory considerations and other factors.

    Singh, Romi; Wang, Ouhong


    Clinical studies are being placed in emerging markets as part of global drug development programs to access large pool of eligible patients and to benefit from a cost effective structure. However, over the last few years, the definition of "emerging markets" is being revisited, especially from a regulatory perspective. For purposes of this article, countries outside US, EU and the traditional "western countries" are discussed. Multiple factors are considered for placement of clinical studies such as adherence to Good Clinical Practice (GCP), medical infrastructure & standard of care, number of eligible patients, etc. This article also discusses other quantitative factors such as country's GDP, patent applications, healthcare expenditure, healthcare infrastructure, corruption, innovation, etc. These different factors and indexes are correlated to the number of clinical studies ongoing in the "emerging markets". R&D, healthcare expenditure, technology infrastructure, transparency, and level of innovation, show a significant correlation with the number of clinical trials being conducted in these countries. This is the first analysis of its kind to evaluate and correlate the various other factors to the number of clinical studies in a country.

  20. The interaction of ethnicity, sociocultural factors, and gender in clinical psychopharmacology.

    Dawkins, K


    There is increased interest in the role that ethnicity, sociocultural factors, and gender play in research, health care delivery, and response to intervention. The impact of these factors on AIDS awareness programs, on the phenomenology of suicide and anorexia nervosa, and on clinical psychopharmacology in a homogeneous population is discussed. Risky sex practices can be related to cultural norms that stigmatize condom use and sex education; economic deprivation; and male dominance. Gender, cultural, and ethnic demographics can identify high-risk groups as well as influence effective interventions. Suicide rates and risk factors are compared in African-American, Canadian Native, and South Korean adolescents. Academic stress was a differential risk factor for the Koreans. Anorexia nervosa predominantly affects women and has cultural differences in prevalence. The homogeneous population in Hong Kong illustrates the impact of ethnicity, sociocultural factors, and gender on clinical psychopharmacology. Attention to ethnicity, sociocultural factors, and gender can individualize and improve the effectiveness of clinical psychopharmacology.

  1. Relation between acute kidney injury and pregnancy-related factors

    Monchai Siribamrungwong; Pawadee Chinudomwong


    Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, le...

  2. Cerebral microbleeds: their associated factors, radiologic findings, and clinical implications.

    Kim, Beom Joon; Lee, Seung-Hoon


    Cerebral microbleeds (CMBs) are tiny, round dark-signal lesions that are most often detected on gradient-echo MR images. CMBs consist of extravasations of blood components through fragile microvascular walls characterized by lipohyalinosis and surrounding macrophages. The prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke. Development of CMBs is closely related to various vascular risk factors; in particular, lobar CMBs are thought to be associated with cerebral amyloid angiopathy. The presence of CMBs has been hypothesized to reflect cerebral-hemorrhage-prone status in patients with hypertension or amyloid microangiopathy. Stroke survivors with CMBs have been consistently found to have an elevated risk of subsequent hemorrhagic stroke or an antithrombotic-related hemorrhagic complication, although studies have failed to establish a link between CMBs and hemorrhagic transformation after thrombolytic treatment. A large prospective study is required to clarify the clinical significance of CMBs and their utility in a decision-making index.

  3. 缺血性结肠炎所致溃疡的危险因素及临床特征分析%Related factors and clinical features of ulcer in patients with ischemic colitis

    屈海燕; 张晓梅


    目的:探讨缺血性结肠炎(IC)患者溃疡发生的危险因素及其临床特点。方法选取我院2009年2月至2014年5月收治的60例IC患者作为研究对象,根据是否发生溃疡分为溃疡组(25例)和非溃疡组(35例),对两组患者的临床资料进行比较,采用单因素方差分析及多因素Logistic回归分析分别对缺血性结肠炎患者发生溃疡的临床特征及危险因素进行分析。结果(1)溃疡组患者平均年龄比非溃疡组明显增加(P<0.05),且出现腹部压痛及长期服用阿司匹林肠溶片的患者人数明显增加,而出现腹泻的人数明显减少,组间比较差异均具有统计学意义(P<0.05);经多因素Logistic回归分析显示,长期服用阿司匹林肠溶片以及出现腹部压痛是IC患者发生溃疡的独立危险因素(P<0.05);(2)溃疡组患者镜下主要表现为肠黏膜溃疡,而非溃疡组患者镜下则主要以肠黏膜充血、水肿、糜烂、瘀斑血泡以及活动性渗血为特点,而CT下溃疡组患者腹部血管病变人数比非溃疡组患者明显增加,差异具有统计学意义(P<0.05)。结论长期服用阿司匹林肠溶片是影响IC患者发生溃疡的独立危险因素;腹部动脉病变会显著增加溃疡发生的风险,而IC患者临床症见腹部压痛则可能提示伴有溃疡形成。%Objective To study the risk factors and clinical characteristics of ulcer in patients with ischemic coli-tis. Methods Sixty patients with ischemic colitis treated in our hospital from February 2009 to May 2014 were selected as research objects, which were divided into ulcer group (25 cases) and non-ulcer group (35 cases) according to whether with ulcer. The clinical data of two groups were compared. The risk factors and clinical features of ischemic colitis patients with ulcer were analyzed by univariate analysis and multivariate logistic regression analysis. Results (1) The average age of patients in ulcer group was

  4. Two Factors Related to Effective Voice Interpreting.

    Hurwitz, T. Alan


    Thirty-two interpreters for the deaf were measured on accuracy and quality of voice interpreting of the same story in two different sign language types: Pidgin Signed English and American Sign Language. Results indicated that previous experience interpreting was significantly related to the effectiveness of voice interpreting both languages.…

  5. [Enviromental factors related to depressive disorders].

    Hernández-Benítez, Catalina Teresa; García-Rodríguez, Alfonso; Leal-Ugarte, Evelia; Peralta-Leal, Valeria; Durán-González, Jorge


    Introducción: debido a su alta prevalencia, la depresión mayor, episodio único (DMEU); la depresión mayor recurrente (DMR); y la distimia son consideradas un problema importante de salud pública. El objetivo de este estudio fue identificar y relacionar los factores ambientales en pacientes con DMEU, DMR y distimia. Métodos: 121 pacientes procedentes del Hospital General de Subzona del Instituto Mexicano del Seguro Social (IMSS) de San Andrés Tuxtla, Veracruz, fueron cuestionados mediante una historia clínica con las variables de riesgo. Resultados: 16 pacientes presentaron DMEU, 72 DMR y 33 distimia. En todos prevaleció el sexo femenino. Los trastornos depresivos se observaron con más frecuencia en personas de más de 40 años, casadas, con un nivel de estudios medio o bajo, provenientes de una familia disfuncional, víctimas de violencia familiar, además de ser hijos intermedios. Las comorbilidades que se presentaron fueron trastornos gastrointestinales, obesidad e hipertensión arterial. Conclusión: los principales factores de riesgo que se identificaron para desarrollar trastornos depresivos fueron: ser mujer, tener más de 40 años de edad y estar casada. Las diferencias obtenidas en este estudio respecto a otros probablemente se deban al tamaño de la muestra, los criterios de selección y el origen de la etnia.

  6. Risk factors of HIV-related oral lesions in adults

    Maria Noel Marzano Rodrigues Petruzzi


    Full Text Available OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001, alcohol consumption (p = 0.011 and female gender (p = 0.031 were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029 a viral load above 5,000 copies/mm³ (p = 0.003 and smoking (p = 0.005. CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

  7. Risk Factors Related to Low Birth Weight in Cienfuegos Municipality

    Juan Rafael Zerquera Rodriguez


    Full Text Available Background: the low birth weight still constitutes a complex a complex health problem. It is determined by some factors and it is the most important predictive index of infantile mortality. Objective: identifying the risk factors related to low birth weight. Methods: a descriptive study was conducted. There were analyzed the 77 birth of children with inferior weigh to 2500g, occurred in 2010 at the municipality of Cienfuegos, puerperas were included, mothers of those children. The pregnancy's follow-up cards, patient’s clinical records and municipal and provincial statistics were checked. In addition to the socio-demographic characteristics, the nutritional state, numbers of pregnancies, heavy profit during pregnancy, age, toxic habits and diseases correlated to pregnancy were analyzed. Results: the index of low birth weigh oscillated between 3.6 and 6.7 per month. The 52% of low birth weight newborn’s mothers had school university level. The 74 % of mothers work. The 70.1 % were smokers and the 57, 1 % developed a gravidum hypertensive disease. Conclusions: the most associated factors to low birth weight were, the mother’s habit to smoke, as well as the diseases that affected them during pregnancy, fundamentally the hypertensive disease and the vaginal sepsis.

  8. Clinical outcome of 371 episodes of peritoneal dialysis related peritonitis



    Objective To analyze the clinical outcome of PD related peritonitis in our center.Methods All patients who developed PD related peritonitis between January 2004and December 2010 in Renji Hospital of Shanghai Jiao Tong University School of Medicine were included.Outcomes of PD related peritonitis were analyzed.Results A total of 220 patients developed 371

  9. Clinical study on IgG4-related autoimmune pancreatitis



    Objective To investigate the clinical features of IgG4-related autoimmune pancreatitis(IgG4-related AIP). Methods A prospective cohort study on IgG4 related disease(IgG4-RD) was carried out in Peking Union Medical College Hospital during December 2010 to June

  10. Relation between acute kidney injury and pregnancy-related factors

    Monchai Siribamrungwong; Pawadee Chinudomwong


    Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic micro-angiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.

  11. Relation between acute kidney injury and pregnancy-related factors

    Monchai Siribamrungwong


    Full Text Available Acute kidney injury (AKI is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic microangiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.

  12. 影响抑郁症患者精神专科门诊治疗的相关因素研究%Research on relatively factors which influence depressions' therapy in psychosis clinic

    刘霞; 杨金华; 高玉娥


    目的 探讨影响抑郁症患者在精神专科门诊治疗的相关因素,为提高治疗依从性提供科学依据.方法 采用简明精神病量表(BPRS)和自制问卷调查79例精神专科医院门诊就诊的抑郁症患者,分析影响在专科治疗的因素,进行健康指导,采取预约复诊或电话回访随访1年.结果 63.29%的抑郁症患者首诊选择非精神科诊治;53.16%的患者未到精神科就诊的原因是不知道患抑郁症;首诊于精神专科的患者诊断、首次连续治疗时间、用药、疗效均明显优于首诊于非精神科患者(P<0.01);系统健康教育后治疗依从性提高,差异有统计学意义(P<0.01).结论 对医护人员、患者及家属开展积极有效的精神卫生知识宣传与普及是提高早期诊断、早期治疗、提高疗效、防止复发的关键.%Objective To investigate the factors which influence the depressions' therapy in psychosis clinic,provide Scientific basis for improving the level of treatment compliance.Methods The Brief Psychiatric Rating Scale and home-made questionnaire were used to investigate 79 depressions patients who took treatment in psychosis clinic,to analyse the influencing factors,and to give them the Health guide.Appointment for further consultation or call to follow up were carried out for 1 year.Results There were 63.29% depressions chose the general hospital to see the doctor at first time,53.16% patients did not go to the psychiatric hospital because they didn' t know their disease feature;the diagnosis,treatment session,medication,effect are obviously prior in the patients seeing the psychiatrists at first time(P < 0.01);patients' therapeutic compliance improved after Systemic health education,the discrepancy is statistically significant.(P < 0.01).Condnsions To make active and valid propaganda on mental healthy is the key points to diagnosis and therapy prophase,can also prevent the recrudesce.

  13. Clinical application of growth factors and cytokines in wound healing.

    Barrientos, Stephan; Brem, Harold; Stojadinovic, Olivera; Tomic-Canic, Marjana


    Wound healing is a complex and dynamic biological process that involves the coordinated efforts of multiple cell types and is executed and regulated by numerous growth factors and cytokines. There has been a drive in the past two decades to study the therapeutic effects of various growth factors in the clinical management of nonhealing wounds (e.g., pressure ulcers, chronic venous ulcers, diabetic foot ulcers). For this review, we conducted an online search of Medline/PubMed and critically analyzed the literature regarding the role of growth factors and cytokines in the management of these wounds. We focused on currently approved therapies, emerging therapies, and future research possibilities. In this review, we discuss four growth factors and cytokines currently being used on and off label for the healing of wounds. These include granulocyte-macrophage colony-stimulating factor, platelet-derived growth factor, vascular endothelial growth factor, and basic fibroblast growth factor. While the clinical results of using growth factors and cytokines are encouraging, many studies involved a small sample size and are disparate in measured endpoints. Therefore, further research is required to provide definitive evidence of efficacy.

  14. Relational Learning via Collective Matrix Factorization


    random variables. J. Multi. Anal ., 11(4):581– 598, 1981. [3] D. J. Aldous. Exchangeability and related topics, chapter 1. Springer, 1985. 14 [4] K. S...administration of its programs or activities on the basis of race, color, national origin, sex or handicap in violation of Title VI of the Civil Rights...pursue," excludes openly gay , lesbian and bisexual students from receiving ROTC scholarships or serving in the military. Nevertheless, all ROTC classes at

  15. Pediatric Multi-Resistant Infections Related Factors Analysis and Clinical Care Management Research%儿科多重耐药菌感染的相关因素分析与临床护理管理的研究

    谭汉梅; 甘萍; 何扬帆; 秦弦


    Objective In order to investigate the cause of the multi-resistant ogannism infection and strengthen pediatric care measures to reduce the rate of infection,by summerizing some multi-resistant organism infection distribution and analysis of related factors. Methods There are 2904 children with bacterial infections were included in pathogen detection,bacterial susceptibility testing and analysis of the related factors of multi-resistant ogannism infection. Meanwhile,strengthen the nursing intervention in the children with multi-resistant ogannism infection and the concept of zero tolerance is applied to the multi-drug management. Results The multi-resistant ogannism infection are connected with risk factors,duration of hospitalization,invasive procedures and abuse of antibiotics. The nursing interventions can ef ectively control the spread of multi-resistant organnism in the hospital and protect the children,s medical safety. Conclusion According to the results of the analysis of the risk factors, strengthening the management of the children with multi-resistant ogannism infection can reduce the morbidity in children,and ensure the children with a speedy recovery.%目的总结我院多重耐药菌感染的分布及相关因素分析,探讨发生多重耐药菌感染的原因,以及多重耐药菌感染患儿的护理,以降低感染率。方法对儿童医院收治的2904里细菌感染性疾病的患儿进行病原学检测,同时做相应的药物敏感试验,分析发生多重耐药的相关因素,并进行护理干预,建立预防和控制措施,严格实施隔离措施,建立监督和处罚制度,把零宽容理念应用于多重耐药菌感染防控中。结果多重耐药菌感染与易感因素、住院时间,侵袭性操作,抗生素的滥用有关。通过护理干预,有效地预防和控制了多重耐药菌在医院内的传播,保障了患儿医疗安全。结论根据相关危险因素的分析结果,加强多重耐药

  16. Clinical Profile & Risk Factors in Acute Coronary Syndrome

    P Yadav, D Joseph, P Joshi, P Sakhi, RK Jha, J Gupta


    Full Text Available Coronary Artery Disease (CAD is becoming a major cause of morbidity & mortality burden in the developing world. Indians have been associated with a more severe form of CAD that has its onset at a younger age group with a male predominance. A prospective study was carried out to identify the risk factors and to know the emerging clinical profile in acute coronary syndrome (ACS including S T elevation & Non S T elevation myocardial infarction. We enrolled 200 consecutive patients with typical ECG changes & clinical history, admitted in emergency department from January 2009 to December 2009. A predefined Performa was completed in every patient with a detailed clinical history, physical examinations, and investigation studies. The clinical history revealed information about age, gender, risk factors, and modes of presentation and duration of symptoms. The details of physical examination including anthropometric data, vital signs and complete systemic evaluation were recorded. The regions of infarction and rhythm disturbances were also documented. Our study showed a significant male predominance with mean age being 56 years. Tobacco was identified as major risk factors (65% & obesity (BMI more than 25 is least common risk factor (13%.Patients had typical chest pain (94% and ECG showed anterior wall changes in54%. Forty percent patients developed complications, majority being arrhythmias (60% and least common is mechanical complication (2.5% Thus we conclude that ACS is more common in adult male with tobacco being major risk factors in our population.

  17. Clinical Judgement in Context: A Review of Situational Factors in Person Perception during Clinical Interviews.

    Cline, Tony


    Argues that the basic psychological processes involved in clinical judgment can be compared with those involved in everyday social judgment. Summarizes evidence on the sophistication and complexity of clinical judgment and on the likely impact on it of several factors. (Author/RH)

  18. National Database for Clinical Trials Related to Mental Illness (NDCT)

    U.S. Department of Health & Human Services — The National Database for Clinical Trials Related to Mental Illness (NDCT) is an extensible informatics platform for relevant data at all levels of biological and...

  19. Clinical Exploration of Factors Related to Recurrence of Febrile Convulsion in Children%小儿热性惊厥复发相关因素的临床探析



    Objective:To explore the factors related to the recurrence of febrile convulsion in children. Methods:Select 6 9 cases of child patient in relapse of febrile convulsion as the treatment group and 6 9 cases of concurrent non-recurrent child patient as the control group.Compare their differences on gender ,age,the condition and temperature when convulsion recurs,anomalies during perinatal period ,family history, weight,preictal complications and otherwise.Results:Compare some of the factors of the patients in the two groups,the number of male,age,weight,convulsion times,EEG anomaly,convulsion duration,family his-tory and complications and other factors in treatment group was found to be obviously different from that in the control group,P0.05.Conclusion:The recurrence rate of febrile convulsion is quite high,some may even transform to epilepsia,scientific and effective measures would prevent sequela in nervous system and lower the recurrence effectively.%目的::对小儿热性惊厥复发相关因素进行研究分析。方法:从某院小儿热性惊厥复发患者中选取69例为治疗组,选取同期没有复发的69例小儿热性惊厥患者为对照组,对比分析两组患者在性别、年龄、惊厥发作情况、体温、围生期异常、家族史、体重和发作前合并症等因素之间的差异性。结果:对比两组患者部分因素,治疗组患者男性比率、年龄、体温、惊厥次数、复杂型、脑电图异常、惊厥发作时间、家族史和合并症等因素同对照组患者间存在显著差异性,P0.05。结论:热性惊厥疾病具有较高复发率,部分患者会转化为癫痫,科学有效的处理措施可有效避免患者出现神经系统后遗症,降低患者出现复发现象发生率。

  20. Factors Related to Successful Engineering Team Design

    Nowaczyk, Ronald H.; Zang, Thomas A.


    The perceptions of a sample of 49 engineers and scientists from NASA Langley Research Center toward engineering design teams were evaluated. The respondents rated 60 team behaviors in terms of their relative importance for team success. They also completed a profile of their own perceptions of their strengths and weaknesses as team members. Behaviors related to team success are discussed in terms of those involving the organizational culture and commitment to the team and those dealing with internal team dynamics. The latter behaviors included the level and extent of debate and discussion regarding methods for completing the team task and the efficient use of team time to explore and discuss methodologies critical to the problem. Successful engineering teams may find their greatest challenges occurring during the early stages of their existence. In contrast to the prototypical business team, members on an engineering design share expertise and knowledge which allows them to deal with task issues sooner. However, discipline differences among team members can lead to conflicts regarding the best method or approach to solving the engineering problem.

  1. Factors associated with clinical inertia: an integrative review

    Aujoulat I


    Full Text Available Isabelle Aujoulat,1 Patricia Jacquemin,1 Ernst Rietzschel,2 André Scheen,3 Patrick Tréfois,4 Johan Wens,5 Elisabeth Darras,1 Michel P Hermans6 1Université Catholique de Louvain, Institute of Health and Society, Brussels, 2Ghent University, Department of Cardiovascular Diseases and Department of Public Health, Faculty of Medicine and Health Sciences, Ghent, 3University of Liège, Division of Diabetes, Nutrition and Metabolic Disorders and Clinical Pharmacology Unit, CHU Liège, Liège, 4Société Scientifique de Médecine Générale, Brussels, 5University of Antwerp, Faculty of Medicine and Health Sciences, Primary and Interdisciplinary Care Antwerp, 6Université Catholique de Louvain, Institute of Experimental and Clinical Research and Cliniques Universitaires Saint-Luc, Department of Endocrinology and Nutrition, Brussels, Belgium Abstract: Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. Keywords: clinical inertia, evidence-based medicine, clinical decision, integrative review, concept clarification, physician adherence to guidelines

  2. Clinical features and the related factors of primary Sjogren's syndrome in elderly patients%老年干燥综合征患者临床特点及相关因素分析

    程永静; 王芳; 张春媚; 高利云; 郑利; 徐华; 高明; 黄慈波


    .3%respectively in the old group. And they were all significantly higher than in young and middle-aged group (57.4%, 51.9% and 20.4%, all P<0. 05). The positive rates of rheumatoid factor (RF)elevation, antiRo/SSA and antiLa/SSB antibodies were 13. 0%, 36.7% and 16.7% in the old group,and significantly lower than in young and middle-age group (44.4%, 59.3% and 42.6%, all P<0.05). The incidences of leukopenia and thyroid gland involvement were much lower in the aged group (13.3% and 10.0%) than in the young and middle-age group (48. 1% and 37.0%, P<0. 05). The percentage of patients receiving hydroxychloroquine as the main medicine was much lower in the aged group than in the young and middle-age group (16.7% vs. 40. 7%, P<0. 05), while percentage of treatment with exclusive glucosides of Paeony Capsules was much higher (33.3% vs. 14.8%, P<0.05). There were no statistical differences between two groups in ophthalmological examination,immunoglobulin level and sialography. Conclusions Those pSS patients with late onset exhibit more abnormalities in clinical parameters, but fewer in immunological parameters, which may be helpful in estimating prognosis and pathogenetic factors in pSS.

  3. Clinical study of the oral manifestations and related factors in type 2 diabetics patients Estudo clínico das manifestações orais e fatores relacionados em pacientes diabéticos tipo 2

    Maria Goretti de Menezes Sousa


    Full Text Available Diabetes Mellitus (DM is reported with and associated to oral alterations, with conflicting results. The aim of this study was to identify the prevalence of oral soft tissue alterations in type 2 diabetes mellitus patients. MATERIAL AND METHODS: Socioeconomic variables, gender, heredity, capillary glucose control and local factors (prosthesis, dry mouth sensation were analyzed in 196 diabetic and non-diabetic patients enrolled in HIPERDIA, at 41 Health units of Natal, Brazil. STUDY DESIGN: A case study. RESULTS: The last blood glucose mean was 177.0 mg/dl for diabetics and 89.46 mg/dl for non-diabetics. Mean capillary blood glucose was elevated in diabetics (215.95 mg/dl; it was 102.31 mg/dl in non-diabetics. The family history confirmed the heredity nature of the disease in 68.8% of diabetic patients (n = 66 (p < 0.001; salivary flow was 49% (n = 47 in diabetics, and 34% (n = 34 in non-diabetics. Candidiasis was present in 30.5% of diabetic patients (n=29 and 36% of non-diabetics (n=36. Both groups had lesions in the palate - 81.4% (n = 35 in diabetics, and 71.1% in non-diabetics (n = 27 (p = 0.68. CONCLUSION: The alterations are not related to diabetes and are present independently of having or not type 2 Diabetes Mellitus.

  4. 毛细支气管炎患儿临床严重程度与哮喘发生的相关因素分析%Relationship between clinical severity of infants with bronchiolitis and asthma and related factors

    丁涛; 张士辉


    Objective To explore the relationship between clinical severity of capillary bronchitis in children and asthma and high risk factors for the development of asthma.Methods A retrospective analysis was conducted on the clinical data of 120 cases of capillary bronchitis in children admitted in Qihe County People ’ s Hospital from July 2012 to July 2104 to analyze the relationship between the incidence of asthma and the types of capillary bronchitis.Logistic analysis was carried out to analyze the high risk factors of asthma in children with capillary bronchitis.Results The incidence of asthma in children was 28.33%.It was 25.00% in children with mild capillary bronchitis and 39.29%in those with severe bronchitis, and the difference was significant (χ2 =4.03,P<0.05).Severe capillary bronchitis, parental smoking, allergic original positive, allergic rhinitis and family history of asthma were significantly correlated with asthma (χ2 value was 0.579, 8.774, 9.146, 5.704 and 36.729, respectively,OR value was 3.821, 5.830, 6.531, 4.321 and 26.592, respectively,95%CI was 1.157-12.498, 1.775-18.221, 1.720-18.231, 1.281-109.251 and 8.014-111.251, respectively, all P<0.05).Conclusion Passive smoking, family history of asthma and allergic constitution may be high risk factors for severe capillary bronchitis developing asthma, so they should be paid much attention to reduce the incidence of asthma fundamentally.%目的:分析毛细支气管炎患儿临床严重程度与哮喘发生的关系及其高危因素。方法回顾性分析齐河县人民医院自2012年7月至2104年7月收治的120例毛细支气管炎患儿的临床资料,分析其哮喘的发生率与毛细支气管炎疾病类型的关系,同时应用Logistic法分析毛细支气管炎患儿发生哮喘的高危因素。结果该组患儿哮喘发生率为28.33%,其中轻型毛细支气管炎患儿哮喘发生率为25.00%,重型毛细支气管炎患儿哮喘发生率为39.29%,两者哮喘

  5. 产后早期产妇骨质疏松相关因素的临床研究%Clinical study of early postpartum maternal factors related to osteoporosis

    李珍; 李璐琳


    对产后早期产妇骨质疏松相关因素情况进行研究性分析。方法:选择2010年1月-2012年12月在我院产科单胎足月分娩的健康产妇作为研究对象,根据产后早期是否存在骨质增生情况分成观察组(存在骨量减少)50例,对照组(骨密度正常)50例,分析产妇年龄、孕次、产次、孕期钙、维生素D摄入情况、体重指数、运动以及骨质疏松家族史等因素与骨质疏松的相关性情况。结果:观察组在产妇年龄、孕次、骨质疏松家族史占比方面显著高于对照组, P<0.05;而在平均每日摄入钙量、平均每日摄入维生素D量、体重指数、平均每日运动时间方面显著低于对照组,P<0.05。建立多因素回归分析确定产次、孕期钙、维生素D摄入情况、体重指数、运动以及骨质疏松家族史为发生产后早期骨质疏松的主要影响因素。结论:多产次、孕期补钙不足、维生素D摄入不足、体重指数偏低、运动量少以及存在骨质疏松家族史是为产后早期发生骨质疏松的危险因素。%the early postpartum maternal factors related to osteoporosis research analysis of the situation. Method: select January 2010-December 2012 in I homes obstetric single tire term delivery of health maternal as research object, according to postpartum early whether exists bone hyperplasia situation into observation group (exists bone hyperplasia) 50 cases, control ed group (bone density normal) 50 cases, analysis maternal age, and pregnancy times, and produced times, and pregnancy calcium, and vitamin d intake situation, and weight index, and movement and bone loose family history, factors and bone loose of correlation situation. Results: the observer groups in maternal age, family history of osteoporosis, pregnancy percentage significantly higher than the control group, P<0.05, while average daily average daily intake of calcium, vitamin d intake, body mass index, average daily

  6. Development of a questionnaire to assess the factors associated with clinical learning of nursing students: A Delphi study

    M Emami Maybodi; M. Mirzaei; T Farajkhoda; Soltani-Arabshahi, K


    Introduction : Inhibiting factors in clinical learning of nursing students cause a huge gap between the optimum and the current situation in performance of the graduates . Due to the lack of a comprehensive and reliable tool for the identification of these factors in Iran , this study aimed to develop a scale to assess the related items to nursing students’ clinical learning.   Methods : This descriptive study used Delphi approach to assess factors associated with clinical learning of nursing...

  7. Relationship between oral health in children and poverty related factors.

    Squassi, Aldo; Mauro, Silvia; Mauro, María José; Sánchez, Gabriel; Bordoni, Noemí


    The aim of this investigation was to analyze the variables related to poverty and its influence on oral health in children living in a suburban area ofBuenos Aires, Argentina. The study population consisted of 1,049 children. 579 children at social risk (Group I) were recruited from five neighborhoods with critical lacks (Katzman, 1989) and divided into 2 subgroups according to age: (A) preschool children and (B) school children. 470 preschool and school children from the same district but living in homes without critical lacks served as controls (Group II). The following variables associated with poverty were analyzed: (a) parents' instructional level, (b) employment conditions, and (c) accessibilty to regular oral health care. Group I comprised children from five neighborhoods categorized according to the incidence rate of each variable. Clinical examinations were performed under similar conditions by three calibrated investigators. DMFS, dmfs, total DMFS + dmfs, DS + ds, Care Index and Loe & Silness plaque index were recorded and analyzed using Students t test, ANOVA and Chi square test (level of significance p poverty-related variables rose. The highest number of children with high cariogenic risk was observed in neighborhoods with the highest social risk (c2 = 30.48; p poverty-related variables seemed to be associated with factors that play a role in the dental caries development process in school and preschool children living in the Metropolitan area of Buenos Aires.

  8. Factors contributing to therapeutic effects evaluated in acupuncture clinical trials

    Shi Guang-Xia


    Full Text Available Abstract Acupuncture treatment has been widely used for many conditions, while results of the increasing numbers of randomized trials and systematic reviews remain controversial. Acupuncture is a complex intervention of both specific and non-specific factors associated with therapeutic benefit. Apart from needle insertion, issues such as needling sensation, psychological factors, acupoint specificity, acupuncture manipulation, and needle duration also have relevant influences on the therapeutic effects of acupuncture. Taking these factors into consideration would have considerable implications for the design and interpretation of clinical trials.

  9. Infertility factors at the Groote Schuur Hospital Fertility Clinic


    Jul 15, 1989 ... the rest between 2 and 5 factors contributed to the infertility of the couple. ... The selection criteria at the Fertility Clinic at Groote Schuur. Hospital .... explained by the fact that most of the patients were referred by private ...

  10. Factors affecting clinical reasoning of occupational therapists: a qualitative study

    Shafaroodi, Narges; Kamali, Mohammad; Parvizy, Soroor; Mehraban, Afsoon Hassani; O’Toole, Giyn


    Background: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists. Methods: Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. Results: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual attributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the workplace environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- working in an inter-professional team; 3- limited clinical facilities and resources. Conclusion: In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies. PMID:25250253

  11. Typhoid fever in children: Clinical presentation and risk factors ...

    Typhoid fever in children: Clinical presentation and risk factors. ... Objective: The diagnosis of typhoid fever based on widal test is on the rise despite its set back. ... (71.4%), typhoid psychosis 3 (8.6%) and 4 (11.4%) had intestinal perforation.

  12. Job strain as a risk factor for clinical depression

    Madsen, I E H; Nyberg, S T; Magnusson Hanson, L L;


    as a risk factor for clinical depression. METHOD: We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD.......94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). CONCLUSIONS: Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.......BACKGROUND: Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain...

  13. Phenotypic factor analysis of psychopathology reveals a new body-related transdiagnostic factor.

    Pezzoli, Patrizia; Antfolk, Jan; Santtila, Pekka


    Comorbidity challenges the notion of mental disorders as discrete categories. An increasing body of literature shows that symptoms cut across traditional diagnostic boundaries and interact in shaping the latent structure of psychopathology. Using exploratory and confirmatory factor analysis, we reveal the latent sources of covariation among nine measures of psychopathological functioning in a population-based sample of 13024 Finnish twins and their siblings. By implementing unidimensional, multidimensional, second-order, and bifactor models, we illustrate the relationships between observed variables, specific, and general latent factors. We also provide the first investigation to date of measurement invariance of the bifactor model of psychopathology across gender and age groups. Our main result is the identification of a distinct "Body" factor, alongside the previously identified Internalizing and Externalizing factors. We also report relevant cross-disorder associations, especially between body-related psychopathology and trait anger, as well as substantial sex and age differences in observed and latent means. The findings expand the meta-structure of psychopathology, with implications for empirical and clinical practice, and demonstrate shared mechanisms underlying attitudes towards nutrition, self-image, sexuality and anger, with gender- and age-specific features.

  14. System-related factors contributing to diagnostic errors.

    Thammasitboon, Satid; Thammasitboon, Supat; Singhal, Geeta


    Several studies in primary care, internal medicine, and emergency departments show that rates of errors in test requests and result interpretations are unacceptably high and translate into missed, delayed, or erroneous diagnoses. Ineffective follow-up of diagnostic test results could lead to patient harm if appropriate therapeutic interventions are not delivered in a timely manner. The frequency of system-related factors that contribute directly to diagnostic errors depends on the types and sources of errors involved. Recent studies reveal that the errors and patient harm in the diagnostic testing loop have occurred mainly at the pre- and post-analytic phases, which are directed primarily by clinicians who may have limited expertise in the rapidly expanding field of clinical pathology. These errors may include inappropriate test requests, failure/delay in receiving results, and erroneous interpretation and application of test results to patient care. Efforts to address system-related factors often focus on technical errors in laboratory testing or failures in delivery of intended treatment. System-improvement strategies related to diagnostic errors tend to focus on technical aspects of laboratory medicine or delivery of treatment after completion of the diagnostic process. System failures and cognitive errors, more often than not, coexist and together contribute to the incidents of errors in diagnostic process and in laboratory testing. The use of highly structured hand-off procedures and pre-planned follow-up for any diagnostic test could improve efficiency and reliability of the follow-up process. Many feedback pathways should be established so that providers can learn if or when a diagnosis is changed. Patients can participate in the effort to reduce diagnostic errors. Providers should educate their patients about diagnostic probabilities and uncertainties. The patient-safety strategies focusing on the interface between diagnostic system and therapeutic

  15. 2型糖尿病患者缺牙及义齿修复相关因素临床研究%Clinical study on tooth loss and restoring and their related factors in patients with diabetes mellitus

    周嫣; 彭利辉; 刘红燕; 欧晓丽; 韦艺; 陈燕; 张大灵; 李菊; 卢其芳


    目的:探讨2型糖尿病患者缺牙及义齿修复的相关因素。方法选取126例研究对象,其中2型糖尿病63例作为糖尿病组,非糖尿病人63例作为对照组,比较两组缺牙数、牙周病牙数及龋病牙数等相关指标的差异。调查两组牙列缺损及义齿修复情况,分析糖尿病人缺牙的相关因素。结果糖尿病组缺牙数、牙周病牙数及复杂牙列缺损病例数均较对照组增多,差异有统计学意义( P<0.05)。 Logistic多元逐步回归分析表明,两组在牙周病牙数、复杂牙列缺损病例数及定期口腔健康检查例数方面的差异也具有统计学意义( P<0.05)。结论糖尿病组缺牙数、牙周病牙数及复杂牙列缺损病例数较对照组明显增多,多因素分析结果表明牙周病牙数、复杂牙列缺损例数及定期口腔健康检查与糖尿病缺牙关联密切。%Objective To explore the related factors of tooth loss and dentine restoration in patients with type 2 diabetes .Methods One hundred and twenty -six individuals were divided into experimental group and control group according to whether with diabetes mellitus .The tooth loss and restoring between two groups wewe compared to find the relationship between tooth loss and related factors of periodontal disease in patients with type 2 diabetes.Re-sults Experimental group showed a significantly higher in the number of tooth loss , periodontal problems and severe defect of dentition ( P<0.05 ) .Logistic multiple regression analysis came to the result that patients with type 2 diabe-tes showed a significantly higher in the number of tooth loss and a significantly increase in number of tooth with perio -dontal problems, severe defect of dentition and lack of regular oral health examination (P all <0.05).Conclusion These study results revealed that the tooth loss in patients with diabetes has a close correlation with the number of tooth with periodontal disease , severe

  16. Gait speed and related factors in Parkinson’s disease

    Paker, Nurdan; Bugdayci, Derya; Goksenoglu, Goksen; Demircioğlu, Demet Tekdöş; Kesiktas, Nur; Ince, Nurhan


    [Purpose] The aim of this study was to investigate the relationship between gait speed and various factors in ambulatory patients with idiopathic Parkinson’s disease. [Subjects] Fifty ambulatory patients with idiopathic Parkinson’s disease who were admitted to an outpatient clinic were included in this cross-sectional study. [Methods] The Hoehn and Yahr Scale was used for measurement of the disease severity. Gait speed was measured by the 10-Meter Walk Test. Mobility status was assessed by Timed Up and Go Test. The Hospital Anxiety and Depression Scale was used for evaluation of emotional state. Cognitive status was examined with the Mini-Mental State Examination. The Downton Index was used for fall risk assessment. Balance was evaluated with the Berg Balance Scale. Comorbidity was measured with the Cumulative Illness Rating Scale. The 36-Item Short Form Health Survey was completed for measurement of quality of life. [Results] The mean age was 66.7 (47–83) years. Twenty-eight (56%) patients were men. Gait speed was correlated positively with height, male gender, Mini-Mental Examination score, Berg Balance Scale score and physical summary scores of the 36-Item Short Form Health Survey. On the other hand, there was a negative correlation between gait speed and age, disease severity, TUG time, Downton Index, fear of falling, previous falls and the anxiety and depression scores of the Hospital Anxiety and Depression Scale. There was no correlation between gait speed and comorbidity. [Conclusion] The factors related with the slower gait speed are, elder age, clinically advanced disease, poor mobility, fear of falling, falling history, higher falling risk, and mood disorder. PMID:26834330

  17. Obesity-related glomerulopathy: pathogenesis, pathologic, clinical characteristics and treatment.

    Xu, Tianhua; Sheng, Zitong; Yao, Li


    In light of the rapid increase in the number of obesity incidences worldwide, obesity has become an independent risk factor for chronic kidney disease. Obesity-related glomerulopathy (ORG) is characterized by glomerulomegaly in the presence or absence of focal and segmental glomerulosclerosis lesions. IgM and complement 3 (C3) nonspecifically deposit in lesions without immune-complex-type deposits during ORG immunofluorescence. ORG-associated glomerulomegaly and focal and segmental glomerulosclerosis can superimpose on other renal pathologies. The mechanisms under ORG are complex, especially hemodynamic changes, inflammation, oxidative stress, apoptosis, and reduced functioning nephrons. These mechanisms synergize with obesity to induce end-stage renal disease. A slow increase of subnephrotic proteinuria ( < 3.5 g/d) is the most common clinical manifestation of ORG. Several treatment methods for ORG have been developed. Of these methods, renin-angiotensin-aldosterone system blockade and weight loss are proven effective. Targeting mitochondria may offer a novel strategy for ORG therapy. Nevertheless, more research is needed to further understand ORG.

  18. Factors Related to Sustained Implementation of Schoolwide Positive Behavior Support

    McIntosh, Kent; Mercer, Sterett H.; Hume, Amanda E.; Frank, Jennifer L.; Turri, Mary G.; Mathews, Susanna


    The purpose of this study was to identify factors associated with sustainability of school-based interventions and the relative contributions of those factors to predicting sustained implementation of Schoolwide Positive Behavior Support (SWPBS). Participants were respondents from 217 schools across 14 U.S. states. Sustainability factors were…

  19. Analysis of clinical effect of McDonald cervical cerclage and the related risk factors%McDonald子宫颈环扎术的临床疗效及其影响因素分析

    孙笑; 丁秀萍; 时春艳; 杨慧霞; 金燕志


    Objective To investigate the clinical effect of McDonald cervical cerclage and the affecting factors. Methods Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups. Results (1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group,there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded;the preoperative cervical os in failure group [ (21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P0.05). Conclusions The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of

  20. Clinical factors influencing mortality risk in hospital acquired sepsis.

    López-Mestanza, Cristina; Andaluz-Ojeda, David; Gómez-López, Juan Ramón; Bermejo Martín, Jesús F


    Identification of factors that confer an increased risk of mortality in hospital acquired sepsis (HAS) is necessary to help prevent, and improve the outcome of, this condition. To evaluate the clinical characteristics and factors associated with mortality in patients with HAS. Retrospective study of patients with HAS in a major Spanish Hospital from 2011 to 2015. Data from adults receiving any of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes associated with sepsis were collected. Those fulfilling the SEPSIS-2 definition with no evidence of infection during the first 48 hours following hospitalization were included (n=196). A multivariate analysis was employed to identify the risk factors of mortality. HAS patients were found to have many of the risk factors associated with cardiovascular disease (male sex, ageing, antecedent of cardiac disease, arterial hypertension, dyslipemia, smoking habit) and cancer. Vascular disease or chronic kidney disease were associated with 28 day mortality. Time from hospital admission to sepsis diagnosis, and the presence of organ failure were risk factors for 28-day and hospital mortality. Experiencing more than one episode of sepsis increased the risk of hospital mortality. "Sepsis Code" for the early identification of sepsis was protective against hospital mortality. We have identified a number of major factors associated to mortality in patients suffering from HAS. Implementation of surveillance programmes for the early identification and treatment of sepsis translate into a clear benefit. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet

    Weiland, Tracey J.; Jelinek, George A.; Claudia H. Marck; Emily J Hadgkiss; van der Meer, Dania M.; Pereira, Naresh G.; Taylor, Keryn L.


    Background Fatigue contributes a significant burden of disease for people with multiple sclerosis (PwMS). Modifiable lifestyle factors have been recognized as having a role in a range of morbidity outcomes in PwMS. There is significant potential to prevent and treat fatigue in PwMS by addressing modifiable risk factors. Objectives To explore the associations between clinically significant fatigue and demographic factors, clinical factors (health-related quality of life, disability and relapse...

  2. Clinical reports for peritoneal dialysis-related peritonitis



    Objective To investigate causes and risk factors of peritoneal dialysis-related peritonitis,explore the pathogenic bacteria and drug sensitivity.Methods CAPD patients suffered peritoneal dialysis-related peritonitis were recruited in the First Affiliated Hospital of Nanjing Medical University in 2012.Gender,age and possible risk factors were analyzed by unvaried and multivariate logistic regression analysis.The causes,pathogenic bacteria,

  3. Factors influencing emergency medicine physicians' management of sports-related concussions: a community-wide study.

    Giebel, Stephen; Kothari, Rashmi; Koestner, Amy; Mohney, Gretchen; Baker, Robert


    Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions. To evaluate the current practice of EP evaluation and management of sports-related concussions. All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding their management of sports-related concussions. The surveys obtained demographic data, participants' use of guidelines, and the importance of clinical and non-clinical factors in deciding when to allow a player to return to play. Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no significant difference between attending and resident EPs. The symptomatic complaints of loss of consciousness, amnesia of the event, and difficulty concentrating were ranked most important by EPs in assessing patients with sports-related concussions. Among non-clinical factors, residents were significantly more likely than attendings to report that medical-legal, parental, and players' concerns were more likely to influence their decision in allowing a patient to return to play. EPs take into consideration important clinical factors in assessing patients with sports-related concussion. However, almost 75% do not use any nationally recognized guideline in their evaluation. Residents are more likely than attendings to be influenced by non-clinical factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Clinical Risk Factors for Infective Endocarditis in Staphylococcus aureus Bacteremia

    Chapagain, Bikash; Joshi, Astha; Brennessel, Debra J.


    Crucial to the management of staphylococcal bacteremia is an accurate evaluation of associated endocarditis, which has both therapeutic and prognostic implications. Because the clinical presentation of endocarditis can be nonspecific, the judicious use of echocardiography is important in distinguishing patients at high risk of developing endocarditis. In the presence of high-risk clinical features, an early transesophageal echocardiogram is warranted without prior transthoracic echocardiography. The purpose of this study was to investigate the clinical risk factors for staphylococcal infective endocarditis that might warrant earlier transesophageal echocardiography and to describe the incidence of endocarditis in cases of methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteremia. A retrospective case-control study was conducted by means of chart review of 91 patients consecutively admitted to a community hospital from January 2009 through January 2013. Clinical risk factors of patients with staphylococcal bacteremia were compared with risk factors of patients who had definite diagnoses of infective endocarditis. There were 69 patients with bacteremia alone (76%) and 22 patients with endocarditis (24%), as verified by echocardiography. Univariate analysis showed that diabetes mellitus (P=0.024), the presence of an automatic implantable cardioverter-defibrillator/pacemaker (P=0.006) or a prosthetic heart valve (P=0.003), and recent hospitalization (P=0.048) were significantly associated with developing infective endocarditis in patients with S. aureus bacteremia. The incidence of methicillin-resistant and methicillin-sensitive S. aureus bacteremia was similar in the bacteremia and infective-endocarditis groups (P=0.437). In conclusion, identified high-risk clinical factors in the presence of bacteremia can suggest infective endocarditis. Early evaluation with transesophageal echocardiography might well be warranted. PMID:28265207

  5. Prognostic factors influencing clinical outcomes of glioblastoma multiforme

    LI Shou-wei; QIU Xiao-guang; CHEN Bao-shi; ZHANG Wei; REN Huan; WANG Zhong-cheng; JIANG Tao


    Background Glioblastoma multiforme (GBM) is the most malignant kind of astrocytic tumors and is associated with a poor prognosis. In this retrospective study, we assessed the clinical, radiological, genetic molecular and treatment factors that influence clinical outcomes of patients with GBM.Methods A total of 116 patients with GBM who received surgery and radiation between January 2006 and December 2007 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patients' progression free survival (PFS) time and overall survival (OS) time.Results Age, preoperative Kamofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 expression level and adjuvant chemotherapy were statistically significant factors (P <0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ≤50 years, preoperative KPS score ≥80, KPS score change after operation ≥0, involvement of single frontal lobe,non-eloquent area or deep structure involvement, low Ki-67 expression and adjuvant chemotherapy were independent favorable factors (P <0.05) for patients' clinical outcomes.Conclusions Age at diagnosis, preoperative KPS score, KPS score change at 2 weeks postoperation, involvement of brain lobe, involvement of eloquent cortex or deep structure, Ki-67 expression level and adjuvant chemotherapy correlate significantly with the prognosis of patients with GBM.

  6. Analysis of high risk factors related to acute respiratory distress syndrome following severe thoracoabdominal injuries

    ZHENG Guo-shou; BAI Xiang-jun; ZHAN Cheng-ye


    Objective: To investigate the high risk factors related to acute respiratory distress syndrome ( ARDS ) following serious thoracoabdominal injuries.Methods: The clinical data of 282 patients with serious thoracoabdominal injuries were retrospectively studied. Univariate and Cox multivariate regression analysis were used to determine the risk factors related to ARDS following serious thoracoabdominal injuries.Results: The incidence of ARDS was 31.9% (90/282) in patients with serious thoracoabdominal injuries.The mortality caused by ARDS was 37.8% (34/90). The univariate analysis and multivariate analysis demonstrated that the clinical conditions such as elder age, shock,dyspnea, abnormal arterial blood gas, hemopneumothorax,pulmonary contusion, flail chest, coexisting pulmonary diseases, multiple abdominal injury and high ISS score were the independent high risk factors related to ARDS.Conclusion: There are many high risk factors related to ARDS following severe thoracoabdominal injuries, which should be detected early and treated timely to decrease the incidence and mortality of ARDS.

  7. Clinical features and related factors to anxiety disorders in adolescents%青少年焦虑障碍的临床特征及社会心理学影响因素

    杨帆; 高维佳; 冯哲; 马静; 丁军; 苏林雁


    Objective To explore the social and psychological risk factors to anxiety disorders in adolescents,and to screen protective factors and risk factors and establish the prediction model.Methods The Screen for Child Anxiety Related Emotional Disorders (SCARED),Behavioral Inhibition Scale (BIS),Parental Bonding Instrument(PBI),Adolescent Self-rating Life Event Checklist(ASLEC),Resilience Scale (RS),Strength and Difficulty Questionnaire (SDQ) were filled by participants from both cases group (80 cases) and control group (92 cases).Then,adolescents with anxiety disorders were interviewed by the Development and Well-Being Assessment (DAWBA).Results (1) In case group,30 of 80 (37.5%) adolescents met criteria for a second anxiety disorder,25% met two different anxiety disorders,20% met three and 17.5% of them met even more.The rate of depression and anxiety co-morbidity was 48.8% in the study.(2) Compared with normal control group,adolescents with anxiety disorders had higher scores in SCARED and its subscales(all P < 0.001),and higher scores in BIS(P < 0.05) and Father Protection and Mother Protection score,but lower in Father Care score,in PBI(all P < 0.01),and higher scores in ASLEC total and subscales such as Interpersonal Relationship,Study Stress,By the Punishment,Healthy Adjustment and (all P < 0.001).As to RS scale,case group had lower scores in total scores,Personal Competence and Self Acceptance than control ones(all P < 0.001),and adolescents with anxiety disorders had higher scores in SDQ Total Difficulties,Emotional Symptoms,Conduct Problems,InattentionHyperactive and Peer Problems (all P < 0.05) but lower score in Prosocial Sore than control group (P <0.05).(3) BI(OR =1.67,P =0.000),ASLEC-healthy & accommodation (OR =1.34,P =0.001) were risk factors of adolescents' anxiety,but RS-self-acceptance(OR =0.87,P =0.000) was protective factor of adolescents anxiety disorders.Conclusion The rates of co-morbidity across the different anxiety

  8. Factors shaping how clinical educators use their educational knowledge and skills in the clinical workplace: a qualitative study.

    Kumar, Koshila; Greenhill, Jennene


    In order to consolidate their educational knowledge and skills and develop their educational role, many clinicians undertake professional development in clinical education and supervision. It is well established that these educationally-focussed professional development activities have a positive impact. However, it is less clear what factors within the clinical workplace can shape how health professionals may use and apply their educational knowledge and skills and undertake their educational role. Looking through the lens of workplace affordances, this paper draws attention to the contextual, personal and interactional factors that impact on how clinical educators integrate their educational knowledge and skills into the practice setting, and undertake their educational role. Data were gathered via a survey of 387 clinical educators and semi-structured interviews with 12 clinical educators and 6 workplace managers. In this paper, we focus on analysing and reporting the qualitative data gathered in this study. This qualitative data were subject to a thematic analysis and guided by theoretical constructs related to workplace affordances. Three key themes were identified including contextual, personal and interactional factors. Contextual elements referred to organisational structures and systems that impact on participants' educational role, how participants' clinical education role was articulated and configured within the organisation, and how the organisation shaped the educational opportunities available to clinicians. Personal factors encompassed clinicians' personal motivations and goals to teach and be involved in education, develop their own educational skills and function as a role model for students. Interactional factors referred to the professional interactions and networks through which clinicians shared their educational knowledge and skills and further consolidated their profile as educational advocates in their workplace. There are a number of

  9. Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables

    Garaigordobil, Maite; Bernarás, Elena; Jaureguizar, Joana; Machimbarrena, Juan M.


    The study had two goals: (1) to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2) to identify predictor variables of childhood depression. Participants were 420 students aged 7–10 years old (53.3% boys, 46.7% girls). Results revealed: (1) positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and...

  10. Factors related to orthodontic treatment time in adult patients

    Ana Camila Esteves de Oliveira Melo


    Full Text Available INTRODUCTION: The length of time that it takes an orthodontist to treat adult patients varies widely. OBJECTIVE: The aim of this study was to investigate how different variables influence treatment time. METHODS: Seventy clinical case reports of successfully treated adult patients were examined. The patients were selected from 4,723 records held by three experienced orthodontists. The influence exerted by the following variables on treatment time was assessed: age, sex, facial pattern, severity of malocclusion (measured by the PAR index, sagittal relationship of canines, type of brackets (ceramic or metal, tooth extractions, missed appointments and orthodontic appliance issues/breakages, the latter being the dependent variable. Assessment was performed by multiple linear regression analysis, followed by the stepwise method with P < 0.05. RESULTS: The number of times a patient missed their appointment (no-show (R² = 14.4%, p < 0.0001 and the number of appliance issues/breakages (R² = 29.71%, p = 0.0037 significantly affected variability in treatment time, and these two variables together can predict 43.75% (R² total of the overall variability in treatment time. Other factors, such as canine relationship at the beginning of treatment, bracket type (metal or ceramic, tooth extractions, age at start of treatment, severity of the initial malocclusion, sex and facial pattern had no significant bearing on treatment time. CONCLUSIONS: The duration of orthodontic treatment in adults, when performed by experienced orthodontists, is mainly influenced by factors related to patient compliance. However, several factors which were not included in this study may contribute to variability in orthodontic treatment time.

  11. Current situation related to antiretroviral therapy and related influential factors on HIV infected injection drug users in the methadone maintenance treatment clinics%云南和广西地区部分美沙酮门诊HIV感染者抗病毒治疗现状及其影响因素

    程晓青; 庞琳; 曹晓斌; 王常合; 罗巍; 张波; 王华; 李荣健; 柔克明


    Objective To find out the current coverage of antiretroviral therapy (ART) among HIV positive subjects and to identify the major influential factors associated with the participation in ART among them.Methods 291 HIV positive subjects from 6 methadone maintenance treatment (MMT) clinics in Guangxi and Yunnan province were surveyed by questionnaires.Results 217 males (74.6%) and 74 females (25.4%) were under investigation,with the average age of 38.4 ± 5.9.Most of them received less than senior high school education,married and unemployed.Results from the single factor logistic regression analysis showed that:working status,living alone,self-reported history of drinking alcohol in the last month,negative attitude towards MMT among family members,poor self-reported compliance to MMT in the last month,lack of incentives in the MMT clinics,reluctance on disclosure of their own HIV status,good self-perception on their health status,lack of communication on ART related topics among family members in the last 6 months,lack of correct attitude and knowledge on ART etc.appeared as the main factors that influencing the participation in ART program among the patients.Data from the multivariate logistic regression analysis showed that factors as:living alone,unwilling to tell others about the status of HIV infection,poor self-perception on HIV infection,lack of discussion of ART related topics within family members in the last 6 months and poor awareness towards ART among the family members etc.,were associated with the low participation rate of ART.Conclusion Strengthening the publicity and education programs on HIV positive patients and their family members at the MMT clinics seemed to be effective in extending the ART coverage.Attention should also be paid to increase the family support to the patients.%目的 了解参加美沙酮维持治疗(MMT)的HIV感染者接受抗病毒治疗(ART)现况及影响因素.方法 在云南和广西地区6个MMT门诊中选取291

  12. Risk factors of HIV-related oral lesions in adults

    Petruzzi, Maria Noel Marzano Rodrigues; Cherubini, Karen; Salum, Fernanda Gonçalves; Figueiredo, Maria Antonia Zancanaro De


    .... Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection...

  13. Clinical Analysis of Related Factors of Microalbuminuria in Patients with Diabetic Nephropathy%糖尿病肾病患者尿微量清蛋白相关因素研究

    热衣汉·西里甫; 帕提古丽·阿斯讨拜; 桑晓红


    目的 探讨糖尿病肾病(DN)患者尿微量清蛋白(MAU)的相关因素.方法 选择2009年在新疆医科大学第一附属医院住院的377例DN患者为研究对象,回顾性分析患者的一般资料[性别、年龄、民族、糖尿病病程、身高、体质量、体质指数(BMI)等]及实验室检查结果[包括尿酸(BUA)、空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)、脂蛋白].根据尿MAU将患者分为低值蛋白尿组、高值蛋白尿组和极高值蛋白尿组,比较3组患者上述指标间的差异,并分析各指标与尿MAU的相关性.结果 (1)与低值蛋白尿组比较,高值蛋白尿组、极高值蛋白尿组患者年龄大、病程长,BMI、FBG、BUA、TG、TC、LDL、脂蛋白水平更高,而GFR降低,差异均有统计学意义(P<0.05).(2)多元相关分析显示,年龄、糖尿病病程、BMI、BUA、FBG、HbA1c、TG、TC、LDL、脂蛋白均与MAU呈正相关(P<0.05).(3)Logistic回归分析显示,糖尿病病程、HbA1c、TC、LDL、BUA、FBG是尿MAU的独立危险因素.结论 糖尿病病程、HbA1c、TC、LDL、BUA、FBG与DN患者尿MAU排泄增加有关.%Objective To investigate related factors of microalbuminuria ( MAU ) in patients with diabetic nephropathy ( DN ) . Methods 377 DN patients admitted to the First Affiliated Hospital of Xinjiang Medical University in 2009 were selected. The general information [ gender, age, nationality, duration of diabetes, height, body mass and body mass index ( BMI) ] and laboratory examination results [ uric acid ( BUA), fasting plasma glucose ( FBG), triglycerides ( TG), total cholesterol ( TC ), high density lipoprotein ( HDL ), low density lipoprotein ( LDL ), glycosylated hemoglobin ( HbA1c ) and lipoprotein ] of the patients were retrospectively analyzed. The patients were divided into low value of proteinuria group, high value of proteinuria group and very high value of

  14. Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings.

    Ilves, Pilvi; Laugesaar, Rael; Loorits, Dagmar; Kolk, Anneli; Tomberg, Tiiu; Lõo, Silva; Talvik, Inga; Kahre, Tiina; Talvik, Tiina


    It is unknown why some infants with perinatal stroke present clinical symptoms late during infancy and will be identified as infants with presumed perinatal stroke. The risk factors and clinical and radiological data of 42 infants with presumed perinatal stroke (69% with periventricular venous infarction and 31% with arterial ischemic stroke) from the Estonian Pediatric Stroke Database were reviewed. Children with presumed perinatal stroke were born at term in 95% of the cases and had had no risk factors during pregnancy in 43% of the cases. Children with periventricular venous infarction were born significantly more often (82%) vaginally (P = .0213) compared to children with arterial stroke (42%); nor did they require resuscitation (P = .0212) or had any neurological symptoms after birth (P = .0249). Periventricular venous infarction is the most common type of lesion among infants with the presumed perinatal stroke. Data suggest that the disease is of prenatal origin.

  15. Portal vein thrombosis; risk factors, clinical presentation and treatment

    Sogaard, Kirstine K; Astrup, Lone B; Vilstrup, Hendrik


    BACKGROUND: Portal vein thrombosis (PVT) is increasingly frequently being diagnosed, but systematic descriptions of the natural history and clinical handling of the condition are sparse. The aim of this retrospective study was to describe risk factors, clinical presentation, complications...... and treatment of portal vein thrombosis in a single-centre. METHODS: Sixty-seven patients were identified in the electronic records from 1992 to 2005. All data were obtained from the patient records. RESULTS: One or more risk factors (e.g. prothrombotic disorder or abdominal inflammation) were present in 87......%. Symptoms were abdominalia, splenomegaly, fever, ascites, haematemesis, and weight loss. Abdominalia and fever occurred more frequently in patients with acute PVT. Frequent complications were splenomegaly, oesophageal- and gastric varices with or without bleeding, portal hypertensive gastropathy and ascites...

  16. Clinical and blood bank factors in the management of platelet refractoriness and alloimmunization.

    Friedberg, R C; Donnelly, S F; Boyd, J C; Gray, L S; Mintz, P D


    Numerous independent and interdependent factors are involved in the posttransfusion platelet response. Factors such as ABO match and platelet age are related to circumstances potentially under the control of the blood bank physician and therefore may permit circumvention by an active transfusion service. On the other hand, factors such as fever or sepsis may be unavoidable, being related more to the individual patient or clinical condition. To evaluate which factors could be circumvented, we prospectively followed the 1-hour corrected count increments (CCIs) for 962 single-donor apheresis platelet transfusions to 71 refractory hematologic oncology inpatients, with concomitant recording of implicated factors. Stepwise regression analysis allowed for determination of which concurrent and confounding clinical-, patient-, and blood bank-related factors significantly affected the CCIs. Although many implicated factors proved to be independently associated with an increased or decreased CCI, we found that no single variable consistently explained the CCI variation across the patient population. Each patient appeared sensitive to one or a few particular factors, but because of marked intraindividual variation, it was not possible to identify a priori which factors were important for a given patient. The single exception was a solid-phase red blood cell adherence assay used to cross-match platelets, but only for alloimmunized patients. We also evaluated the utility of requesting HLA-matched platelets from the local suppliers and maintained a clear distinction between platelets simply ordered as HLA matched and actually HLA-identical platelets. Accounting for the confounding clinical-, patient-, and blood bank-related factors, the cross-match assay was a better predictor of an adequate CCI than ordering platelets as HLA matched.

  17. Macro- and micro-environmental factors in clinical HCC

    Pancoska, Petr; Carr, Brian I.


    We previously developed a network phenotyping strategy (NPS), a graph theory-based transformation of clinical practice data, for recognition of two primary subgroups of hepatocellular cancer (HCC), called S and L, which differed significantly in their tumor masses. In the current study, we have independently validated this result on 641 HCC patients from another continent. We identified the same HCC subgroups with mean tumor masses 9 cm×n (S) and 22 cm×n (L), penvironment factors, identifying four subtypes for S- and five subtypes for L-phenotypes, respectively. In L phenotype, all reference patterns were PVT (portal vein thrombosis) positive, all platelet/AFP levels were high, and all were chronic alcohol consumers. L had phenotype landmarks with worst survival. S phenotype interaction patterns were PVT negative, with low platelet/AFP levels. We demonstrated that tumor-clinical environment interaction patterns explained how a given parameter level can have a different significance within a different overall context. Thus, baseline bilirubin is low in S1 and S4, but high in S2 and S3, yet all are S subtype patterns, with better prognosis than in L. Gender and age, representing macro-environmental factors, and bilirubin, INR and AST levels representing micro-environmental factors, had a major impact on subtype characterization. Clinically important HCC phenotypes are therefore represented by complete parameter relationship patterns and cannot be replaced by individual parameter levels. PMID:24787292

  18. Macro- and micro-environmental factors in clinical hepatocellular cancer.

    Pancoska, Petr; Carr, Brian I


    We previously developed a network phenotyping strategy (NPS), a graph theory-based transformation of clinical practice data, for recognition of two primary subgroups of hepatocellular cancer (HCC), called S and L, which differed significantly in their tumor masses. In the current study, we have independently validated this result on 641 HCC patients from another continent. We identified the same HCC subgroups with mean tumor masses 9 cm x n (S) and 22 cm x n (L), Penvironment factors, identifying four subtypes for S and five subtypes for L phenotypes, respectively. In L phenotype, all reference patterns were portal vein thrombosis (PVT)-positive, all platelet/alpha fetoprotein (AFP) levels were high, and all were chronic alcohol consumers. L had phenotype landmarks with worst survival. S phenotype interaction patterns were PVT-negative, with low platelet/AFP levels. We demonstrated that tumor-clinical environment interaction patterns explained how a given parameter level can have a different significance within a different overall context. Thus, baseline bilirubin is low in S1 and S4, but high in S2 and S3, yet all are S subtype patterns, with better prognosis than in L. Gender and age, representing macro-environmental factors, and bilirubin, prothrombin time, and AST levels representing micro-environmental factors, had a major impact on subtype characterization. Clinically important HCC phenotypes are therefore represented by complete parameter relationship patterns and cannot be replaced by individual parameter levels. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

    Kazim Duman


    Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232




    Full Text Available `INTRODUCTION: Stroke is the third leading cause of death in developed countries after cardiovascular disease and cancer. In India Community Surveys have shown a crude prevalence rate for hemiplegia 200 per 1, 00, 000 population. It accounts for nearly 1.5% of all urban admissions, 4.5 % of all medical and about 20% of neurological cases. AIMS AND OBJECTIVE: Identification of risk factors and evaluation of clinical profile of acute stroke. MATERIAL AND METHOD: INCLUSION CRITERIA: Cases of acute stoke admitted in SGMH hospital were selected for the study. EXCLUSION CRITERIA: Brain injury cases, infective, neoplastic cases producing stroke were excluded. RESULTS: Stroke was more common in male, 58 % patients were male and 42% patients were female. It was more common in 5th and 6th decade. Most common etiology was infarction. Most common risk factor was hypertension followed by smoking. In addition to limb weakness, headache and vomiting were most common presenting symptoms followed by convulsion. These symptoms were more common in hemorrhagic stroke. Right sided hemiplegia was more common than left sided. Middle cerebral artery was involved in majority of cases in atherothrombotic stroke whereas basal ganglion was most common site of bleed in hemorrhagic stroke. Coma and mortality were more in hemorrhagic stroke. CONCLUSION: The risk factors and clinical profile of acute stroke in India are similar to that of Western countries. Common risk factors are hypertension, smoking, diabetes mellitus and hyperlipidemia

  1. Work-related risk factors for suicidal behaviour, protective factors and possibilities for prevention

    Tina Podlogar


    Work is an important part of adult life. As such it is closely connected to health and mental health. Aspects of occupation, work and employment can represent risk factors for suicidal behaviour or protective factors against it. Aim of this article is to present the known work-related risk factors for suicidal behaviour, protective factors and possibilities for preventive activities in this context. An important risk factor for suicidal behaviour is unemployment. Connection between unemployme...

  2. Assessing relations between PTSD's dysphoria and reexperiencing factors and dimensions of rumination.

    Meredith A Claycomb

    Full Text Available The purpose of the present study was to investigate the relations between posttraumatic stress disorder's (PTSD dysphoria and reexperiencing factors and underlying dimensions of rumination. 304 trauma-exposed primary care patients were administered the Stressful Life Events Screening Questionnaire, PTSD Symptom Scale based on their worst traumatic event, and Ruminative Thought Style Questionnaire (RTSQ. Confirmatory factor analyses (CFAs were conducted to determine the dysphoria and reexperiencing factors' relationships with the four factors of rumination. Results revealed that both the dysphoria and reexperiencing factors related more to problem-focused thinking and anticipatory thoughts than counterfactual thinking. Additionally, the reexperiencing factor related more to anticipatory thinking than repetitive thinking. Clinical and theoretical implications are discussed.

  3. Related factors of comprehensive treatment effect on anisometropic amblyopia children

    Ai-Xin Jiang


    Full Text Available AIM: To study the related factors of comprehensive treatment effect on anisometropic amblyopia children, and to provide a theoretical basis for clinical intervention. METHODS: Totally 100 cases of anisometropic amblyopia children in our hospital from October 2013 to October 2014 were selected and were divided into groups A, B and C according to curative effect after 6~18mo's treatment. Fifty-four cases of group A were judged to be cured, 34 cases of group B were judged to be improved, and 12 cases of group C was invalid. The age, compliance, anisometropia degree, anisometropia type, amblyopia degree and fixation behavior were analyzed. RESULTS: Anisometropia type among the three groups of patients showed no significant difference(P>0.05. While the age, compliance, anisometropia degree, amblyopia degree and fixation behavior among three groups of patients had statistically significant differences(PCONCLUSION: There are closed relationship between comprehensive treatment effect and age, compliance, anisometropia degree, amblyopia degree, fixation behavior, but there is no significant correlation between anisometropia type and comprehensive treatment effect.

  4. Factors related to depression and anxiety in adults with bronchiectasis

    Özgün Niksarlioglu EY


    Full Text Available Elif Yelda Özgün Niksarlioglu,1 Gülcihan Özkan,2 Gülşah Günlüoğlu,1 Mehmet Atilla Uysal,1 Sule Gül,1 Lütfiye Kilic,1 Ayse Yeter,1 Güngör Çamsarı1 1Department of Chest Disease, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, 2Department of Chest Disease, Yeniyüzyıl University Gaziosmanpasa Hospital, Istanbul, Turkey Introduction and background: Patients with chronic lung diseases frequently have depressive and anxiety symptoms, but there are very few studies looking at this in patients with bronchiectasis. Aim: This study aimed to investigate depression and anxiety and related factors among patients with non-cystic fibrosis bronchiectasis.Patients and methods: This was a prospective study of 133 patients with bronchiectasis. Patients with confirmed diagnosis of bronchiectasis with high-resolution computed tomography were enrolled in the study. Patients that were clinically stable in the previous 4 weeks were evaluated with the Hospital Depression and Anxiety scale. Symptoms, pulmonary function tests, and medical treatments were recorded.Results: The mean age of patients was 49.5±14.5 years (range, 18–77 years, and 81 (60.9% patients were females. Twenty-eight (21.1% patients had depression, and 53 (39.8% had anxiety. Depression score was related to family situation (living with a partner, previous depression history and admission to an emergency department within the last year. Anxiety score was related to female gender, the family situation (living with a partner, previous depression history, and admission to an emergency department within the last year (P<0.05. Depression was positively correlated with hemoptysis, admission to an emergency department within the last year and living with a partner. Anxiety was positively correlated with education level, previous depression history, admission to an emergency department within the last year, and living with a partner.Conclusion: Patients with non

  5. Nutritional knowledge,attitude,behavior and related factors of gestational diabetes mellitus women in perinatal nutrition clinic in Beijing%北京市妊娠期糖尿病孕妇营养认知行为调查

    陶旻枫; 游川; 于敬龙; 姜莹; 李东阳; 丁辉


    Objective:To investigate the knowledge,attitude and practice of diabetes mellitus in pregnant women with gestational diabetes mellitus (GDM)in perinatal nutrition clinic in Beijing.Methods:From January to August in 2016,according to the representative method of stratified random sampling,extraction,comprehensive urban and suburban hospitals of maternal and child health hospitals,a total of 8 perinatal nutrition clinics were entrolled.Women of 242 cases,24-28 weeks of pregnancy and diagnosed as GDM were in GDM group,other 228 cases of pregnant women with normal glucose tolerance were in control group.Two groups of pregnant women were questionnaired and the answers were compared and analyzed.Results:Pregnancy nutrition KAP score of GDM group(31.16±2.21)was lower than that of the control group(36.72±2.4,P<0.05).The nutrition knowledge score,nutrition professional knowledge score and nutrition behavior score of GDM group were significantly lower than those of the control group (all P<0.05).Significant differences were also seen in both groups about access to nutrition knowledge and their willingness.They want to obtain nutrition knowledge from hospital,WeChat and pregnant women school nutrition clinic lectures etc.Conclusion:GDM pregnant women in perinatal nutrition clinic in Beijing generally pay attention to nutrition during pregnancy,but their professional knowledge of nutrition and nutritional behavior need to be improved.Perinatal nutrition clinics need to provide a variety of forms and precise health education guidance for GDM pregnant women.%目的:了解北京市围产营养门诊妊娠期糖尿病(GDM)孕妇对糖尿病相关知识的态度和行为.方法:2016年1月~8月按照地区代表性分层随机抽样方法,抽取城区、郊区妇幼保健院、综合医院共8家围产营养门诊中孕24~28周,首次诊断GDM孕妇和糖耐量正常孕妇,进行间卷调查.结果:收回问卷共470份,GDM组242例、糖耐量正常孕妇(对照组)228

  6. Scientific articles recommendation with topic regression and relational matrix factorization

    Ming YANG; Ying-ming LI; Zhongfei(Mark)ZHANG


    In this paper we study the problem of recommending scientifi c articles to users in an online community with a new perspective of considering topic regression modeling and articles relational structure analysis simultane-ously. First, we present a novel topic regression model, the topic regression matrix factorization (tr-MF), to solve the problem. The main idea of tr-MF lies in extending the matrix factorization with a probabilistic topic modeling. In particular, tr-MF introduces a regression model to regularize user factors through probabilistic topic modeling under the basic hypothesis that users share similar preferences if they rate similar sets of items. Consequently, tr-MF provides interpretable latent factors for users and items, and makes accurate predictions for community users. To incorporate the relational structure into the framework of tr-MF, we introduce relational matrix factorization. Through combining tr-MF with the relational matrix factorization, we propose the topic regression collective matrix factorization (tr-CMF) model. In addition, we also present the collaborative topic regression model with relational matrix factorization (CTR-RMF) model, which combines the existing collaborative topic regression (CTR) model and relational matrix factorization (RMF). From this point of view, CTR-RMF can be considered as an appropriate baseline for tr-CMF. Further, we demonstrate the efficacy of the proposed models on a large subset of the data from CiteULike, a bibliography sharing service dataset. The proposed models outperform the state-of-the-art matrix factorization models with a signifi cant margin. Specifi cally, the proposed models are effective in making predictions for users with only few ratings or even no ratings, and support tasks that are specifi c to a certain fi eld, neither of which has been addressed in the existing literature.

  7. Community-related factors militating against effective management ...

    Community-related factors militating against effective management of ... high rates of out-of-hospital delivery,many affected babies often reach the health facility ... such as female education, mass media campaigns, development of national ...

  8. Perceived health and environment related factors associated with ...

    Perceived health and environment related factors associated with urban ... as an important resource for meeting the challenges of rapidly growing cities, such ... to livelihood, it also has health and environmental problems associated with it.

  9. School Related Factors as Predictors of Internal Efficiency of Public ...

    Nneka Umera-Okeke

    Key Words: School related factors, Internal Efficiency, Public University student,. South-West ... cycle as it will show the promotion rate, repetition rate and drop-out rate. Many ..... School-based variables and internal efficiency of colleges of.

  10. Relation of Trigger Factors to Migraine with Aura

    J. Gordon Millichap


    Full Text Available Researchers from the University of Copenhagen, Denmark studied the relation between natural trigger factors and migraine with aura (MA in 27 patients who reported that bright or flickering light or strenuous exercise would trigger their attacks.

  11. Clinical factors associated with lithium response in bipolar disorders.

    Sportiche, Sarah; Geoffroy, Pierre Alexis; Brichant-Petitjean, Clara; Gard, Sebastien; Khan, Jean-Pierre; Azorin, Jean-Michel; Henry, Chantal; Leboyer, Marion; Etain, Bruno; Scott, Jan; Bellivier, Frank


    Bipolar disorder is a common chronic illness characterized by high levels of morbidity and all-cause mortality. Lithium is one of the gold standard mood stabilizer treatments, but the identification of good, partial and non-responders in clinical settings is inconsistent. We used an established rating scale (the Alda scale) to classify the degree of lithium response (good response, partial response, non-response) in a large, multicentre clinically representative sample of well-characterized cases of bipolar disorders I and II. Next, we examined previously reported clinical predictors of response to determine which factors significantly differentiated between the three response groups. Of 754 cases, 300 received lithium, for at least 6 months, as a treatment for bipolar disorder (40%). Of these cases, 17% were classified as good response, 52% as partial response and 31% as non-response. Lifetime history of mixed episodes ( p = 0.017) and alcohol use disorders ( p = 0.015) both occurred in >20% of partial response and non-response groups but bipolar disorder I was of borderline statistical significance, being more frequent in the good response group (38%) compared with the non-response group (18%). There was a trend ( p = 0.06) for bipolar disorder II to be associated with non-response. Only three factors previously identified as predictors of lithium response significantly differentiated the response groups identified in our sample. Interestingly, these factors have all been found to co-occur more often than expected by chance, and it can be hypothesized that they may represent a shared underlying factor or dimension. Further prospective studies of predictors and the performance of the Alda scale are recommended.

  12. The relative importance of performance factors in Korean archery.

    Kim, Han-Byul; Kim, Sae-Hyung; So, Wi-Young


    This study explored the factors affecting archery performance by calculating their relative importance in Korean archery. This study used the Delphi technique and the analytic hierarchy process (AHP). After reviewing the literature and collecting data on performance factors in archery, the importance of factors affecting archery performance was calculated by holding meetings with experts (20 archery experts) and conducting confirmatory factor analysis (463 archers) and the AHP (36 archery experts). Performance factors were divided into mental, skill, and fitness categories. Fitness factors affecting performance included "drawing a bow without an arrow," "lower-body weight training," and "upper-body weight training." Skill factors affecting performance included "extending by maintaining left and right shoulder balance during aiming," "shooting skill over a regular clicker time," "maintaining pace and direction at release," and "drawing skill by maintaining left and right shoulder balance." Mental factors affecting performance were "confidence," "concentration," "emotion control," and "positive thinking." "Confidence" was identified as the most important factor among the 11 subfactors. The performance factors identified in this study and their relative importance in determining successful performance can be used in training for optimal archery performance worldwide.

  13. Factor analysis of the interrelationships between clinical variables in horses with colic.

    Thoefner, M B; Ersbøll, A K; Jensen, A L; Hesselholt, M


    A prospective survey of horses with colic referred to the Large Animal Hospital at the Royal Veterinary and Agricultural University of Copenhagen, Denmark, was undertaken between August 1994 and December 1997. The interrelationships between 17 clinical variables were analysed using factor analysis. Factor analysis uncovers the structure of the variability in data and therefore detects multicollinearity. A total of 528 horses were admitted in the study period. Of these, 16 were excluded from the analysis as a result of miscellaneous conditions. Only 205 horses had observations for all 17 variables. Because no major change occurred in the main diagnostic categories, this population was considered as a representative subset. Factor analysis confirmed the clinical impression of correlation between variables, but the multicollinearity turned out not to be strong. Four factors were extracted, and these accounted for 51% of the total variance. The retained factors were interpreted by integrating previously reported clinical research. The first factor, which was interpreted as endotoxaemia, had high loadings on capillary refill time, mucous-membrane colour, degree of pain, heart rate, packed-cell volume and abdominal sounds. In the second factor, cecal decompression, admission month and gastric reflux had the predominant influence, and this factor was explained as cecal tympany. The third factor was simply interpreted as age because it had high loadings on gender, age and temperature. In the fourth factor, the interpretation was not straightforward, although breed had the greatest influence in the formation of this factor. Subsequently, the extracted factors were used in a logistic-regression analysis to determine their association with outcome (survival/death). The two factors interpreted as endotoxaemia and age were related to the outcome.

  14. Mooren ulcer in South India: serology and clinical risk factors.

    Zegans, M E; Srinivasan, M; McHugh, T; Whitcher, J P; Margolis, T P; Lietman, T; Jennette, J C; Cunningham, E T


    To investigate the rate of undiagnosed rheumatologic diseases and hepatitis C infection among patients with the clinical diagnosis of Mooren ulcer seen at Aravind Eye Hospital, Madurai, South India. Twenty-one patients with the clinical diagnosis of Mooren ulcer and 44 control patients underwent a complete ophthalmic history and examination, as well as serologic testing for antinuclear antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies, herpes simplex virus 1 antibodies, and hepatitis C virus antibodies. There were no statistically significant differences in the rates of seropositivity for antinuclear antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies, herpes simplex virus 1 antibodies, and hepatitis C virus antibodies between patients with Mooren ulcer and control patients. Two patients with Mooren ulcer and four control patients were found to have a rheumatoid factor titer of greater than 1:20. One of the control patients, but none of the patients with Mooren ulcer, was found to have serologic evidence of hepatitis C infection. A history of corneal trauma, surgery, or infection was reported by 68% of patients with Mooren ulcer, compared with 20% of control patients (P infection.

  15. Women and vulnerability to depression: some personality and clinical factors.

    Carrillo, Jesús M; Rojo, Nieves; Staats, Arthur W


    The purpose of this study is to explore the role of sex differences and personality in vulnerability to depression. Sex differences in personality and some clinical variables are described. We also assess the value of the variables that revealed significant sex differences as predictors of vulnerability to depression. In a group of adult participants (N = 112), 50% males and 50% females (mean age = 41.30; SD = 15.09; range 17-67), we studied sex differences in the three-factor personality model, using the Eysenck Personality Questionnaire, Form A (EPQ-A; Eysenck & Eysenck, 1975), and in the Five-Factor Personality Model, with the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985). The following clinical scales were used: the Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979), the Schizotypy Questionnaire (STQ; Claridge & Broks, 1984; Spanish version, Carrillo & Rojo, 1999), the THARL Scales (Dua, 1989, 1990; Spanish version, Dua & Carrillo, 1994) and the Adjustment Inventory (Bell, 1937; Spanish version, Cerdá, 1980). Subsequently, simple linear regression analysis, with BDI scores as criterion, were performed to estimate the value of the variables as predictors of vulnerability to depression. The results indicate that a series of personality variables cause women to be more vulnerable to depression than men and that these variables could be explained by a negative emotion main factor. Results are discussed within the framework of the psychological behaviorism theory of depression.

  16. Clinical characteristics of aortic dissection and analysis of factors related to misdiagnosis%主动脉夹层临床特点及误诊因素分析

    沈洪; 康瑜; 姚志峰; 陈永乐; 史静; 姚晨玲; 童朝阳; 魏来; 王春生


    回顾分析2003年1月至2008年6月中山医院收治的主动脉夹层361例的临床特点,并着重分析其中误诊的51例资料,探讨误诊相关因素.结果显示,361例患者中男273例,女88例,年龄16 ~ 77岁,临床主要表现为疼痛(87.8%).误诊51例(14.1%),其中男43例,女8例,年龄25 ~ 77岁.主要表现为疼痛症状者误诊疾病主要有急性冠状动脉综合征、急性胰腺炎、急性胆囊炎或胆囊结石;主要表现为非疼痛症状者误诊疾病主要为肺部感染、心力衰竭.提示,主动脉夹层临床症状表现多样,易引起误诊;心包积液是诊断主动脉夹层的有利因素.%The clinical data of 361 patients aged from 16-77 y with aortic dissection (AD) admitted from January 2003 to June 2008,including 273 males and 88 females,were retrospectively reviewed.The symptoms and physical signs of the AD were diverse,major clinical manifestation was pain (87.8%) and the painless diseases were seen in 12.2% of cases.The misdiagnosis occurred in 51 patients (14.1%),including 43 male patients and 8 females,aged from 25-77 y before admission ; 45 painful cases (88.2%) were misdiagnosed as acute coronary syndrome,acute pancreatitis,acute cholecystitis and cholelithiasis and 6 painless patients (11.8%) were misdiagnosed as pulmonary infection and congestive heart failure.The data indicate that AD may demonstrate diverse manifestations and severity leading to misdiagnosis and the symptom of pericardial effusion is helpful for accurate diagnosis.

  17. [Preditive clinical factors for epileptic seizures after ischemic stroke].

    Fukujima, M M; Cardeal, J O; Lima, J G


    Preditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1) were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2). The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p < 0.05). Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  18. Dispersion Relation for the Nucleon Electromagnetic Form Factors

    Furuichi, Susumu; Watanbe, Keiji


    Elastic electromagnetic form factors of nucleons are investigated both for the time-like and the space-like momentums by using the unsubtracted dispersion relation with QCD constraints. It is shown that the calculated form factors reproduce the experimental data reasonably well; they agree with recent experimental data for the neutron magnetic form factors for the space-like data obtained by the CLAS collaboration and are compatible with the ratio of the electric and magnetic form factors for the time-like momentum obtained by the BABAR collaboration.

  19. Clinical factors associated with subclinical spread of in situ melanoma.

    Shin, Thuzar M; Etzkorn, Jeremy R; Sobanko, Joseph F; Margolis, David J; Gelfand, Joel M; Chu, Emily Y; Elenitsas, Rosalie; Shaikh, Waqas R; Miller, Christopher J


    Subclinical spread of in situ melanoma occurs at a wide frequency, ranging from 12% to 71%. To identify clinical factors associated with subclinical spread of in situ melanoma. We used a retrospective, cross-sectional study of 674 consecutive in situ melanomas to examine 627 patients treated with Mohs surgery and melanoma antigen recognized by T cells 1 immunostaining. The presence of subclinical spread was correlated with clinical characteristics. Univariate and multivariate logistic regression analyses were performed to generate odds ratios (ORs) and 95% confidence intervals (CIs). Both univariate and multivariate analyses demonstrated significantly increased odds for subclinical spread of in situ melanomas when they were located on the head or neck, at acral sites, or on the pretibial leg (OR 1.97, 95% CI 1.41-3.40); in persons with a history of prior treatment (OR 2.77, 95% CI 1.74-4.420); melanomas of preoperative size >1 cm (OR 1.74, 95% CI 1.23-2.46, P = .002); or in persons ≥60 years old (OR 1.47, 95% CI 1.01-2.13, P = .042). A count prediction model demonstrated that the risk for subclinical spread increased with the number of clinical risk factors. We used a single-site, retrospective study design. Clarifying the risk factors for subclinical spread might help to refine triage of in situ melanomas to the appropriate surgical techniques for margin assessment prior to reconstruction. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Clinical and radiologic predictive factors of septic hip arthritis.

    Kung, Justin W; Yablon, Corrie; Huang, Edward S; Hennessey, Hooman; Wu, Jim S


    The purpose of our study was to identify the clinical and radiologic factors associated with a positive culture during image-guided hip joint aspiration. We performed a retrospective analysis of 167 consecutive hip aspirations for septic arthritis at a large tertiary medical center. Chart review was performed on the following clinical factors: serum WBC count≥11×10(3)/μL, serum erythrocyte sedimentation rate (ESR)≥20 mm/h, C-reactive protein (CRP)≥100 mg/L, synovial fluid WBC count, synovial fluid polymorphonuclear (PMN) leukocytes≥90%, fever, immunosuppression, antibiotic use, diabetes, presence of a prosthesis, and IV drug use (IVDU). Radiologic studies were reviewed for the following imaging and technical factors: presence of a sinus tract, fluid turbidity, volume of fluid (mL) aspirated, and whether the fluid analyzed was primarily aspirated or reaspirated after lavage. Logistic regression was used to calculate odds ratio (OR) and 95% CI. Of the 167 aspirations, 29 (17.4%) had positive cultures; 6 of 29 (20.7%) positive cultures occurred in reaspirated lavage fluid. On multivariate analysis using logistic regression with stepwise backward elimination, the significant clinical and radiologic predictors were elevated WBC (OR, 4.4; 95% CI, 1.1-17.3), high percentage of synovial fluid PMN leukocytes (OR, 10.6; 95% CI, 2.9-39.8), IVDU (OR, 9.0; 95% CI, 1.3-64.7), and fluid turbidity (OR, 20.5; 95% CI, 6.9-61.4). Positive hip cultures are associated with elevated serum WBC, IVDU, high percentage of synovial fluid PMN leukocytes, and fluid aspirate turbidity. Reaspiration of lavage fluid with either nonbacteriostatic saline or contrast material can yield positive cultures.

  1. Clinical analysis on the related factors of female postmenopausal osteoporosis%绝经后骨质疏松症发病相关因素临床分析

    孟宏霞; 刘洁冰; 张升红


    [Objective] To find out the important risk factors of postmenopausal osteoporosis and explore the role of these factors in the pathogenesis of postmenopausal osteoporosis. [ Methods] Case-control study was selected serum E2 ,IGF-1 ,IL-6 ,BGP ,AKP. Blood calcium and blood phosphorous were determined in 150 osteoporosis cases and 150 control cases. Bom mineral density of finger,proximal end of femur and lumbar vertebra were determined. [ Results] There was no significant difference in hight (P>0.05) but with significant difference in occupation (P<0.05).There were significant difference in body weight ,body mass index (BMI), age of menopause, number of gravid, milk drinking, strong tea taking ,out door exercises (or value<1.0) and last child-bearing age≥45 (P<0.05). [Conclusion] Last child-bearing age ≥ 45-year-old seems to be the independent risk factor for post-menopausal osteoporosis and was not reported previously. Milk drinking and outdoor exercises(or value<1.0) is possibly one of the protective measure for postmenopausal osteoporosis.%[目的]通过观察对比绝经后骨质疏松症患者与对照组的各项指标,筛选出骨质疏松发生的重要危险因素,并探讨这些因素在绝经后骨质疏松症发病机制中的作用.[方法]采用病例对照研究方法,随机选取骨质疏松症病例组及对照组各150例,所有研究对象统一检测血清E2、IGF-1、IL-6、BGp、AKp、以及血钙、血磷的含量;所有对象用双能骨密度仪检测手指、股骨近端、腰椎骨密度,进行骨质疏松症的相关性分析.[结果]两组患者的身高无显著性差异(P>0.05),体重、体重指数、绝经年龄、孕产个数,有显著性差异(P<0.05);两组间比较差异无统计学意义(P>0.05);两组的职业构成有统计学意义(P<0.05).常喝牛奶、常喝浓茶、户外运动、末次生育年龄≥45岁两组比较差异有统计学意义(P<0.05).[结论]末次生育年龄≥45岁成为绝经期

  2. Factors influencing the participation of gastroenterologists and hepatologists in clinical research

    Zekry Amany


    Full Text Available Abstract Background Although clinical research is integral to the advancement of medical knowledge, physicians face a variety of obstacles to their participation as investigators in clinical trials. We examined factors that influence the participation of gastroenterologists and hepatologists in clinical research. Methods We surveyed 1050 members of the American Association for the Study of Liver Diseases regarding their participation in clinical research. We compared the survey responses by specialty and level of clinical trial experience. Results A majority of the respondents (71.6% reported involvement in research activities. Factors most influential in clinical trial participation included funding and compensation (88.3% and intellectual pursuit (87.8%. Barriers to participation were similar between gastroenterologists (n = 160 and hepatologists (n = 189 and between highly experienced (n = 62 and less experienced (n = 159 clinical researchers. These barriers included uncompensated research costs and lack of specialized support. Industry marketing was a greater influence among respondents with less trial experience, compared to those with extensive experience (15.7% vs 1.6%; P Conclusion This study suggests that the greatest barrier to participation in clinical research is lack of adequate resources. Respondents also favored industry-sponsored research with less complex trial protocols and studies of relatively short duration.

  3. Clinical risk factors for the development of consecutive exotropia: a comparative clinical study

    Taylan Sekeroglu, Hande; Erkan Turan, Kadriye; Karakaya, Jale; Sener, Emin Cumhur; Sanac, Ali Sefik


    AIM To compare a group of patients with consecutive exotropia with patients who had ≤10 prism diopters (PD) esotropia or no deviation postoperatively in terms of probable clinical risk factors for the development of consecutive exotropia. METHODS The study recruited fourteen patients who developed consecutive exodeviation during follow-up period after the correction of esotropia who were categorized as group 1 and thirty-one patients who had still ≤10 PD esotropia or no deviation at the final visit that were considered as group 2. Clinical risk factors leading the development of consecutive deviation were analyzed as the main outcome measures. RESULTS The mean age of patients was 4.57±3.11y in group 1 and 5.10±3.52y in group 2 (P=0.634). There was no significant difference of preoperative near and distant deviations among two groups (P=0.835, 0.928 respectively). The mean amount of medial rectus recession and lateral rectus resection was similar in both groups (P=0.412, 0.648 respectively). Convergence insufficiency and neurological diseases were more frequent in group 1 (P=0.007, 0.045). Accompanying neurological disease was found to be as a significant factor increasing the risk of the development of consecutive exotropia significantly [odds ratios (OR): 5.75 (1.04-31.93)]. CONCLUSION Accompanying neurological disease appears to be a significant clinical risk factor for the development of consecutive exodeviation during postoperative follow-up after the correction of esotropia. However, larger studies are needed in order to interpret the results to the clinical practice and to ascertain other concurrent risk factors. PMID:27366693

  4. Clinical relative factors analysis of imatinib on treatment of chronic myeloid leukemia%伊马替尼治疗慢性髓系白血病临床疗效的相关影响因素分析

    陈莹莹; 曾庆曙; 杨明珍; 王永庆; 夏海龙; 江慧敏; 安福润


    Objective To analyse the relationship between the clinical efficacy of imatinib treatment on chronic myeloid leukemia in chronic phaseand risk stratification. Methods 98 imatinib-treated patients were enrolled, and before taking imatinib Sokal and Hasford score were used to assess risk stratification to compare if it has statistical significance between different groups. Results In the 98 cases, 89 cases (97.8%) achieved complete hematologic remission(CHR),76 cases(86.4%) achieved partial cytogenetic remission(PCyR) after three months, 63 cases (82.9%) achieved complete cytogenetic response(CCyR) after six months and 24 cases(54.5%) achieved major molecular response ( MMR ) after twelve months. Risk stratification was assessed according to Sokal score. After three months the rate of groups at low, intermediate and high risk categories which achieved PCyR were 94.4%, 82.6% and 66.7%, respectively(P=0.104), after six months the rate of different groups which achieved CCyR were 88.2%,76.9% and 100%, respectively(P=0.319), and after twelve months the rate of different groups at low and intermediate risk categories which achieved MMR were 52.4% and 65.0%( P=0.412 ).According to the patients' condition, before taking imatinib,46 patients were stratified by Hasford, among which 21 at low risk cate-gorie,23 at intermediate risk categorie and 2 at high risk categorie.After three months the rate of groups at low, in-termediate and high risk categories which achieved PCyR were 90.5%, 91.3% and 50%, respectively ( P =0.191),after six months the rate of different groups which achieved CCyR were 83.3%,94.4% and 100%,respec-tively(P=0.528),and after twelve months the rate of different groups at low and intermediate risk categories which achieved MMR were 45.5% and 58.3% ( P=0.842 ) . Conclusion Imatinib mesylate treatment of chronic mye-loid leukemia is good. Patients belonged to low and intermediate risk groups are more likely to get better clinical ef-ficacy than the high

  5. Study on the mortality in Ecuador related to dietary factors

    Juan Alejandro Neira-Mosquera; Fernando Pérez-Rodríguez; Sungey Sánchez-Llaguno; Rafael Moreno Rojas


    Diet is an important factor related to the development of numerous diseases. In developing countries like Ecuador, this aspect is not considered as priority however, the study of the incidence of certain diet-related diseases could help to assess consumption habits of a country from a Public Health perspective and support national nutrition policies and programs. The objective the present study is to investigate the mortality rate of certain diet-related diseases in Ecuador and its possible r...

  6. Platelet-activating factor in liver injury: A relational scope

    Nikolaos P Karidis; Gregory Kouraklis; Stamatios E Theocharis


    The hepatocyte, the main cellular component of the liver, exhibits variable susceptibility to different types of injury induced by endogenous or exogenous factors.Hepatocellular dysfunction or death and regeneration are dependent upon the complicated interactions between numerous biologically active molecules. Plateletactivating factor (PAF) seems to play a pivotal role as the key mediator of liver injury in the clinical and experimental setting, as implied by the beneficial effects of its receptor antagonists. A comprehensive up-todate overview of the specific functional and regulatory properties of PAF in conditions associated with liver injury is attempted in this review.

  7. Analysis of related risk factors for pancreatic fistula after pancreaticoduodenectomy

    Qi-Song Yu; He-Chao Huang; Feng Ding; Xin-Bo Wang


    Objective:To explore the related risk factors for pancreatic fistula after pancreaticoduodenectomy to provide a theoretical evidence for effectively preventing the occurrence of pancreatic fistula.Methods:A total of 100 patients who were admitted in our hospital from January, 2012 to January, 2015 and had performed pancreaticoduodenectomy were included in the study. The related risk factors for developing pancreatic fistula were collected for single factor and Logistic multi-factor analysis.Results:Among the included patients, 16 had pancreatic fistula, and the total occurrence rate was 16% (16/100). The single-factor analysis showed that the upper abdominal operation history, preoperative bilirubin, pancreatic texture, pancreatic duct diameter, intraoperative amount of bleeding, postoperative hemoglobin, and application of somatostatin after operation were the risk factors for developing pancreatic fistula (P<0.05). The multi-factor analysis showed that the upper abdominal operation history, the soft pancreatic texture, small pancreatic duct diameter, and low postoperative hemoglobin were the dependent risk factors for developing pancreatic fistula (OR=4.162, 6.104, 5.613, 4.034,P<0.05).Conclusions:The occurrence of pancreatic fistula after pancreaticoduodenectomy is closely associated with the upper abdominal operation history, the soft pancreatic texture, small pancreatic duct diameter, and low postoperative hemoglobin; therefore, effective measures should be taken to reduce the occurrence of pancreatic fistula according to the patients’own conditions.

  8. Small Renal Masses: Incidental Diagnosis, Clinical Symptoms, and Prognostic Factors

    F. M. Sánchez-Martín


    Full Text Available Introduction. The small renal masses (SRMs have increased over the past two decades due to more liberal use of imaging techniques. SRMs have allowed discussions regarding their prognostic, diagnosis, and therapeutic approach. Materials and methods. Clinical presentation, incidental diagnosis, and prognosis factors of SRMs are discussed in this review. Results. SRMs are defined as lesions less than 4 cm in diameter. SRM could be benign, and most malignant SMRs are low stage and low grade. Clinical symptoms like hematuria are very rare, being diagnosed by chance (incidental in most cases. Size, stage, and grade are still the most consistent prognosis factors in (RCC. An enhanced contrast SRM that grows during active surveillance is clearly malignant, and its aggressive potential increases in those greater than 3 cm. Clear cell carcinoma is the most frequent cellular type of malign SRM. Conclusions. Only some SRMs are benign. The great majority of malign SRMs have good prognosis (low stage and grade, no metastasis with open or laparoscopic surgical treatment (nephron sparing techniques. Active surveillance is an accepted attitude in selected cases.

  9. Factors related to treatment intensity in Swiss primary care

    Künzi Beat


    Full Text Available Abstract Background Questions about the existence of supplier-induced demand emerge repeatedly in discussions about governing Swiss health care. This study therefore aimed to evaluate the interrelationship between structural factors of supply and the volume of services that are provided by primary care physicians in Switzerland. Methods The study was designed as a cross-sectional investigation, based on the complete claims data from all Swiss health care insurers for the year 2004, which covered information from 6087 primary care physicians and 4.7 million patients. Utilization-based health service areas were constructed and used as spatial units to analyze effects of density of supply. Hierarchical linear models were applied to analyze the data. Results The data showed that, within a service area, a higher density of primary care physicians was associated with higher mortality rates and specialist density but not with treatment intensity in primary care. Higher specialist density was weakly associated with higher mortality rates and with higher treatment intensity density of primary care physicians. Annual physician-level data indicate a disproportionate increase of supplied services irrespective of the size of the number of patients treated during the same year and, even in high volume practices, no rationing but a paradoxical inducement of consultations occurred. The results provide empirical evidence that higher densities of primary care physicians, specialists and the availability of out-patient hospital clinics in a given area are associated with higher volume of supplied services per patient in primary care practices. Analyses stratified by language regions showed differences that emphasize the effect of the cantonal based (fragmented governance of Swiss health care. Conclusion The study shows high volumes in Swiss primary care and provides evidence that the volume of supply is not driven by medical needs alone. Effects related to the

  10. Risk factors for central venous catheter-related thrombosis in children: a retrospective analysis.

    Chen, Kai; Agarwal, Arnav; Tassone, Maria Cristina; Shahjahan, Nadia; Walton, Mark; Chan, Anthony; Mondal, Tapas


    Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines. Data on clinical and catheter-related risk factors were collected from patient charts. Statistical analysis using Pearson's χ tests, independent samples t-test, and odds ratios were used to assess potential risk factors for thrombosis. Neither insertion site (subclavian vein or otherwise), left- vs. right-sided insertion, nor catheter type were significant risk factors for thrombosis. There were no thrombotic events reported at the superior vena cava (SVC)-right atrium junction and no significant differences in thrombotic risk with initial tip placement in the SVC-right atrium junction vs. the SVC, right atrium, or inferior vena cava. Acute lymphoblastic leukaemia was a major clinical risk factor for thrombosis. Tip movement was common and may have been an important factor in the development of CVC-related thrombi. Prospective studies can yield insight into the role of follow-up imaging in the prevention of catheter-related thrombosis in children.

  11. Can Psychological, Social and Demographical Factors Predict Clinical Characteristics Symptomatology of Bipolar Affective Disorder and Schizophrenia?

    Maciukiewicz, Malgorzata; Pawlak, Joanna; Kapelski, Pawel; Łabędzka, Magdalena; Skibinska, Maria; Zaremba, Dorota; Leszczynska-Rodziewicz, Anna; Dmitrzak-Weglarz, Monika; Hauser, Joanna


    Schizophrenia (SCH) is a complex, psychiatric disorder affecting 1 % of population. Its clinical phenotype is heterogeneous with delusions, hallucinations, depression, disorganized behaviour and negative symptoms. Bipolar affective disorder (BD) refers to periodic changes in mood and activity from depression to mania. It affects 0.5-1.5 % of population. Two types of disorder (type I and type II) are distinguished by severity of mania episodes. In our analysis, we aimed to check if clinical and demographical characteristics of the sample are predictors of symptom dimensions occurrence in BD and SCH cases. We included total sample of 443 bipolar and 439 schizophrenia patients. Diagnosis was based on DSM-IV criteria using Structured Clinical Interview for DSM-IV. We applied regression models to analyse associations between clinical and demographical traits from OPCRIT and symptom dimensions. We used previously computed dimensions of schizophrenia and bipolar affective disorder as quantitative traits for regression models. Male gender seemed protective factor for depression dimension in schizophrenia and bipolar disorder sample. Presence of definite psychosocial stressor prior disease seemed risk factor for depressive and suicidal domain in BD and SCH. OPCRIT items describing premorbid functioning seemed related with depression, positive and disorganised dimensions in schizophrenia and psychotic in BD. We proved clinical and demographical characteristics of the sample are predictors of symptom dimensions of schizophrenia and bipolar disorder. We also saw relation between clinical dimensions and course of disorder and impairment during disorder.

  12. Clinical characteristics and prognostic factors of severe acute pancreatitis

    Lei Kong; Nn Santiago; Tian-Quan Han; Sheng-Dao Zhang


    AIM: To investigate the clinical characteristics and prognostic factors of a consecutive series of patients with severe acute pancreatitis (SAP).METHODS: Clinical data of SAP patients admitted to our hospital from January 2003 to January 2004 were retrospectively reviewed. Collected data included the age, gender, etiology,length of hospitalization, APACHE Ⅱ score at admission,local and organ/systemic complications of the patients.RESULTS: Of the 268 acute pancreatitis patients, 94 developed SAP. The mean age of SAP patients was 52 years, the commonest etiology was cholelithiasis (45.7%), the mean length of hospitalization was 70 d, the mean score of APACHE Ⅱ was 7.7. Fifty-four percent of the patients developed necrosis, 25% abscess, 58% organ/systemic failure. A total of 23.4% (22/94) of the SAP patients died. Respiratory failure was the most common organ clysfunction (90.9%) in deceased SAP patients, followed by cardiovascular failure (86.4%),renal failure (50.0%). In the SAP patients, 90.9% (20/22)developed multiple organ/systemic failures. There were significant differences in age, length of hospitalization,APACHE Ⅱ score and incidences of respiratory failure, renal failure, cardiovascular failure and hematological failure between deceased SAP patients and survived SAP patients.By multivariate logistic regression analysis, independent prognostic factors for mortality were respiratory failure,cardiovascular failure and renal failure.CONCLUSION: SAP patients are characterized by advanced age, high APACHE Ⅱ score, organ failure and their death is mainly due to multiple organ/systemic failures. In patients with SAP, respiratory, cardiovascular and renal failures can predict the fatal outcome and more attention should be paid to their clinical evaluation.

  13. Physical fitness of 9 year olds in England: related factors.

    Kikuchi, S; Rona, R J; Chinn, S


    STUDY OBJECTIVE--To examine the influence of social factors, passive smoking, and other parental health related factors, as well as anthropometric and other measurements on children's cardiorespiratory fitness. DESIGN--This was a cross sectional study. SETTING--The analysis was based on 22 health areas in England. PARTICIPANTS--The subjects were 299 boys and 282 girls aged 8 to 9 years. Parents did not give positive consent for 15% of the eligible sample. A further 25% of the eligible sample ...

  14. Acute renal infarction: Clinical characteristics and prognostic factors.

    Caravaca-Fontán, Fernando; Pampa Saico, Saúl; Elías Triviño, Sandra; Galeano Álvarez, Cristina; Gomis Couto, Antonio; Pecharromán de las Heras, Inés; Liaño, Fernando


    Acute renal infarction (ARI) is an uncommon disease, whose real incidence is probably higher than expected. It is associated with poor prognosis in a high percentage of cases. To describe the main clinical, biochemical and radiologic features and to determine which factors are associated with poor prognosis (death or permanent renal injury). The following is a retrospective, observational, single-hospital-based study. All patients diagnosed with ARI by contrast-enhanced computed tomography (CT) over an 18-year period were included. Patients were classified according to the cardiac or non-cardiac origin of their disease. Clinical, biochemical and radiologic features were analysed, and multiple logistic regression model was used to determine factors associated with poor prognosis. A total of 62 patients were included, 30 of which had a cardiac origin. Other 32 patients with non-cardiac ARI were younger, had less comorbidity, and were less frequently treated with oral anticoagulants. CT scans estimated mean injury extension at 35%, with no differences observed between groups. A total of 38% of patients had an unfavourable outcome, and the main determinants were: Initial renal function (OR=0.949; IC 95% 0.918-0.980; p=0.002), and previous treatment with oral anticoagulants (OR=0.135; IC 95% 0.032-0.565; p=0.006). ARI is a rare pathology with non-specific symptoms, and it is not associated with cardiological disease or arrhythmias in more than half of cases. A substantial proportion of patients have unfavourable outcomes, and the initial renal function is one of the main prognostic factors. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Job-related motivational factors among Malaysian employees.

    Manshor, Amat Taap; Abdullah, Adilah


    This study identified job-related motivational factors among Malaysian employees in several telecommunication companies. Responses were obtained from 1,179 employees at all levels up to senior managers and six different functional divisions, sales and marketing, human resources, finance, technical, information, technology, and support division. All employees were asked to rate the importance of Kovach's 10 job-motivational factors. These factors were good wages, job security, opportunity for career growth in the organization, good working conditions, interesting work, company loyalty to employees, tactful discipline, full appreciation of work done, sympathetic help with personal problems, and feeling of being involved in the organization. The top five factors employees identified as motivating them in their jobs were good wages, job security, company loyalty to employees, good working conditions, and full appreciation for work done. Findings were in accordance with Kovach for U.S. employees, in which the top motivational factors were good wages and job security.

  16. Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer

    Havelund, Birgitte Mayland; Spindler, Karen-Lise Garm; Sørensen, Flemming Brandt;

    to a standardized scheme. 2. The prognostic value of HIF-1α is investigated by SNP analysis and HIF-1α expression in tissue from 300 patients operated for colorectal cancer and the results is validated in a prospectively population of 200 patients. 3. The predictive value of HIF-1α will be investigated in patients......Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer   Birgitte Mayland Havelund1,4 MD, Karen-Lise Garm Spindler1,4 MD, PhD, Flemming Brandt Sørensen2,4 MD, DMSc, Ivan Brandslund3 MD, DMSc, Anders Jakobsen1,4 MD, DMSc. 1Department of Oncology, 2Pathology and 3Biochemistry, Vejle...... Hospital, Vejle, Denmark 4Institute of Regional Health Services Research, University of Southern Denmark, Odense Denmark Background Prognostic and predictive markers are needed for individualizing the treatment of colorectal cancer. Hypoxia-inducible factor 1α (HIF-1α) is a transcription-inducing factor...

  17. Infrapopliteal Percutaneous Transluminal Balloon Angioplasty: Clinical Results and Influence Factors

    Song, Jang Hyeon; Lee, Seung Jin; Jung, Hye Doo; Lim, Jae Hoon; Chang, Nam Kyu; Yim, Nam Yeol; Kim, Jae Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Lee, Keun Bae [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)


    To assess the efficacy of percutaneous transluminal angioplasty (PTA) in patients with infrapopliteal arterial disease, and to determine the influencing factor for prognosis. A total of 55 patients (60 limbs) with infrapopliteal arterial stenosis or occlusion underwent PTA. Atherosclerotic risk factors, clinical symptoms, TransAtlantic Inter-Society Consensus (TASC) classification, and vascular wall calcification were evaluated before PTA. The number of patent infrapopliteal arteries was estimated, and the outcome was evaluated by symptom relief and limb salvage. Technical success was achieved in 53/60 limbs (88.3%) and 81/93 arteries (87.1%), TASC classification (p = 0.038) and vascular calcification (p = 0.002) influenced on technical failure. During follow-up, 26 of 55 limbs (47%) achieved symptom relief and 42/55 limbs (76%) underwent limb salvage. Non-diabetic patients (9/12, 75%) were superior to diabetic patients (17/43, 40%) in terms of symptom relief (p = 0.024). TASC classification and vascular wall calcification influenced on symptom relief and limb salvage. The number of patent infrapopliteal arteries after PTA influenced symptom relief (p < 0.001) and limb amputation (p = 0.003). PTA in patients with chronic critical limb ischemia is worthwhile as a primary treatment. The influence factors should be considered before PTA, and PTA should be performed in as many involved arteries as possible.

  18. Clinical and pathological features of alcohol-related brain damage.

    Zahr, Natalie M; Kaufman, Kimberley L; Harper, Clive G


    One of the sequelae of chronic alcohol abuse is malnutrition. Importantly, a deficiency in thiamine (vitamin B(1)) can result in the acute, potentially reversible neurological disorder Wernicke encephalopathy (WE). When WE is recognized, thiamine treatment can elicit a rapid clinical recovery. If WE is left untreated, however, patients can develop Korsakoff syndrome (KS), a severe neurological disorder characterized by anterograde amnesia. Alcohol-related brain damage (ARBD) describes the effects of chronic alcohol consumption on human brain structure and function in the absence of more discrete and well-characterized neurological concomitants of alcoholism such as WE and KS. Through knowledge of both the well-described changes in brain structure and function that are evident in alcohol-related disorders such as WE and KS and the clinical outcomes associated with these changes, researchers have begun to gain a better understanding of ARBD. This Review examines ARBD from the perspective of WE and KS, exploring the clinical presentations, postmortem brain pathology, in vivo MRI findings and potential molecular mechanisms associated with these conditions. An awareness of the consequences of chronic alcohol consumption on human behavior and brain structure can enable clinicians to improve detection and treatment of ARBD.

  19. Clinical and microbiologic features of dacryocystitis-related orbital cellulitis.

    Wladis, Edward J; Shinder, Roman; LeFebvre, Daniel R; Sokol, Jason A; Boyce, Michelle


    Dacryocystitis-related orbital cellulitis is a relatively rare condition, and large case series of this clinical entity have been reported. This study was undertaken to identify a larger cohort of patients with this ailment, with the intent of defining its clinical and microbiologic features. Case logs from four institutions were reviewed to identify patients that suffered from dacryocystitis-related orbital cellulitis. A retrospective chart review was then performed to identify clinical features, management strategies, microbiologic features, and outcomes. A dedicated statistical software package was utilized to identify correlations between these variables. 13 patients (7 females, 6 males; mean age = 57.2 years, range = 7-89 years) were identified. One patient carried a diagnosis of immunosuppressive disease. All patients underwent emergent surgical drainage and received intravenous antibiotics. Primary acquired nasolacrimal duct obstruction was found to be the underlying etiology in nine cases (69.2%), whereas four patients suffered from specific causes of their obstructions. An average of 1.07 organisms/patient (standard deviation = 0.49 organisms/patient) were recovered from microbiologic cultures, and Gram-positive bacteria represented the majority of cultured organisms. All patients experienced either stable or improved vision upon discharge. The relationships between a specific etiology and the possibility of vision loss or the number of organisms cultured, between the number of organisms cultured and vision loss, and immunosuppression and vision loss or the number of organisms cultured were all not statistically significant (p > 0.05). Dacryocystitis-related orbital cellulitis most commonly occurs in adult patients who do not carry immunosuppressive diagnoses and suffer from primary obstructions. Multiple microbiologic species may cause this problem, although Gram-positive organisms are most common. With appropriate management, stable or improved vision

  20. Related factors of co-occurring mood disorders among heroin-dependent patients



    Objective To explore related factors of co-occurring mood disorders among heroin-dependent patients.Methods A cross-sectional study was conducted.Subjects were 1002 heroin-dependent patients who were consecutively admitted into three drug rehabilitation institutes in Hunan Province.A questionnaire was developed to get demographic and drug use-related information of the subjects.The Structured Clinical Interview for

  1. Logistic regression analysis on clinical features and related risk factors of primary gout in the northeastern area of China%川东北地区原发性痛风的临床特点及发病危险因素分析

    李玲琴; 青玉凤; 周畅; 周京国


    目的:探讨川东北地区原发性痛风的临床特点及发病危险因素。方法采用统一调查表,对583例原发性痛风患者及459例健康体检者进行临床调查及相关实验室指标检测,采用Logistic回归分析痛风的发病危险因素。结果①94.9%的患者首次发作时累及一个关节,其中累及第一跖趾关节者占68.6%。②痛风发作无诱因者占37.6%;有诱因者占62.4%,其中88.2%与饮食因素有关。③痛风并发痛风石者占12.2%,高血压者占35.7%,高脂血症者占66.9%。④并发痛风石者多发生于痛风后3~8年,其病程长于无痛风石患者,血尿酸(sUA)水平高于无痛风石患者(P均<0.01)。⑤Logistic回归分析发现,高sUA、饮酒、BMI、高TG、高嘌呤饮食、高血压及吸烟均与痛风发病相关(P<0.01或<0.05)。结论原发性痛风发病受多因素影响,高sUA、饮酒、BMI、高TG、高嘌呤饮食、高血压及吸烟均可能增加其发病风险。%Objective To explore the clinical features and related risk factors of primary gout in the northeastern area of China .Methods A clinical investigation and related laboratory indicator detections of primary gout were made on 583 cases of patients with primary gout and 459 healthy persons by a unified questionnaire .Then, logistic regression analysis was applied in analyzing related risk factors .Results (1) Only a joint was involved in the first attack of 94.9% of pa-tients, while the first metatarsophalangeal joint accounted for 68.6%.(2) 37.6%of patients didn't have predisposing fac-tors, 62.4%of patients had predisposing factors , during which 88.2%of 364 patients was related with beer, sea food and other dietary factors.(3) The rates of patients complicated with tophus , hypertension and hyperlipidemia were 12.2%, 35.7%and 66.9%.(4) Tophus occurred in the 3-8 years after the gout, when we compared with patients without

  2. Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors.

    Liu, Gao; Fu, Zhi-Qing; Zhu, Ping; Li, Shi-Jun


    Central venous catheterization (CVC)-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases (6.17%) of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization (Pvenous thrombosis history (Prisk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

  3. How Transdiagnostic Factors of Personality and Psychopathology Can Inform Clinical Assessment and Intervention.

    Rodriguez-Seijas, Craig; Eaton, Nicholas R; Krueger, Robert F


    Research suggests that many mental disorders-mood and anxiety, substance use, and personality psychopathology-are related through relatively few latent transdiagnostic factors. With regard to the comorbidity of personality disorders and common mental disorders, factor structures such as internalizing-externalizing have been replicated in numerous samples, across the life span, and around the globe. One critical feature of transdiagnostic factors is that they serve as a point of intersection between personality and psychopathology, making them particularly relevant phenomena for applied clinical work. Although numerous studies have supported the significance of transdiagnostic factors for research and classification purposes, there has been comparatively less articulation of how such factors might be of benefit to practicing assessment clinicians. Herein, we present an overview of transdiagnostic factor research findings, and we apply these findings to the clinical topics of assessment, diagnosis, and treatment. For clinicians as well as researchers, the use of transdiagnostic constructs presents positive implications for efforts to understand, characterize, and ameliorate psychopathology-including its manifestations as personality disorder-in a valid, effective, and efficient way.

  4. Clinical outcomes and risk factors for perforation in gastric endoscopic submucosal dissection: A prospective pilot study.

    Watari, Jiro; Tomita, Toshihiko; Toyoshima, Fumihiko; Sakurai, Jun; Kondo, Takashi; Asano, Haruki; Yamasaki, Takahisa; Okugawa, Takuya; Ikehara, Hisatomo; Oshima, Tadayuki; Fukui, Hirokazu; Miwa, Hiroto


    To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation and "silent" free air without endoscopically visible perforation detected only by computed tomography. Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air.

  5. Clinical application of the five-factor model.

    Widiger, Thomas A; Presnall, Jennifer Ruth


    The Five-Factor Model (FFM) has become the predominant dimensional model of general personality structure. The purpose of this paper is to suggest a clinical application. A substantial body of research indicates that the personality disorders included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood as extreme and/or maladaptive variants of the FFM (the acronym "DSM" refers to any particular edition of the APA DSM). In addition, the current proposal for the forthcoming fifth edition of the DSM (i.e., DSM-5) is shifting closely toward an FFM dimensional trait model of personality disorder. Advantages of this shifting conceptualization are discussed, including treatment planning.

  6. Malignant multiple sclerosis: clinical and demographic prognostic factors

    Fabrício Hampshire-Araújo

    Full Text Available ABSTRACT Patients with malignant multiple sclerosis (MMS reach a significant level of disability within a short period of time (Expanded Disability Status Scale score of 6 within five years. The clinical profile and progression of the disease were analyzed in a Brazilian cohort of 293 patients. Twenty-five (8,53% patients were found to have MMS and were compared with the remaining 268 (91,47%. Women, non-white patients, older age at disease onset, shorter intervals between the first attacks, and more attacks in the first two years of the disease were all more common in the MMS group. These findings could serve as prognostic factors when making therapeutic decisions.


    Olesya Suntsova


    Full Text Available This paper analyzes the main factors that affect the strategies to reduce airlines costs. These costs factors were presented to experts from the airline industry through two rounds of questionnaires in sense tobe weighed. It was applied a method based on the structure of the AHP (Analytic Hierarchy Process and the results show that the main important factors for a cost-related airlines strategy are, in importance: routestructure and mesh; type and characteristics of the aircraft; cost of labor and management quality. This hierarchycan help the decision maker when facing the need of defining priorities in reduction costs. past decades despitethe increase in air transportation and significant decrease in average operation costs, it is observed that airlineshave low profitability. The liberalization of the markets and increase opportunities for competition diminishesprices, even when airlines face increasing costs. Considering that advantage in costs is an important strategy forcarriers to remain in the market, this paper analyzes the main factors that affect the strategies to reduce airlinescosts. These costs factors were presented to experts from the airline industry through two rounds ofquestionnaires in sense to be weighed. It was applied a method based on the structure of the AHP (AnalyticHierarchy Process and the results show that the main important factors for a cost-related airlines strategy are, inorder of importance: route structure and mesh; type and characteristics ofthe aircraft; cost of labor andmanagement quality. This hierarchy can help the decision maker when facing the need of defining priorities inreduction costs.

  8. Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

    Kim, Sun Woo; Ahn, Ji Hoon; Yim, Sang Un; Cho, Yang Hyun; Shin, Bo Sung; Chung, Ho Seok; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung


    Purpose This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi. Materials and Methods From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis. Results A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15–7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis. Conclusions Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis. PMID:27617316

  9. Four factors Constituting Friendly Tang-Tubo Relations

    WuFengzhen; ChenQuan


    During the 200 or more years of Tang-Tubo bilateral relations, and despite the wars that often occurred owing to conflict between the ruling classes of each side, harmony and friendliness nevertheless prevailed. So what were the reasons behind this friendly Tang-Tubo relationship? This article attempts to generalize four factors and briefly discuss each one.

  10. Factors Related to Union Formation among Single Mothers in Canada.

    Le Bourdais, Ciline; And Others


    Using data on 1,257 women from a 1984 survey, attempts to identify factors associated with union formation among single mothers in Canada. Found that the age of mothers at the beginning of their first episode of single parenthood appears closely related to their chances of forming a union. Other results are discussed. (RJM)

  11. Behavioural factors related to metabolic control in patients with phenylketonuria

    Crone, MR; van Spronsen, FJ; Oudshoorn, K; Bekhof, J; van Rijn, G; Verkerk, PH


    Background. The objective of this study was to determine the importance of parental factors possibly related to dietary control in early and continuously treated patients with phenylketonuria (PKU). Methods. A questionnaire was disseminated among parents of 238 patients with PKU born after the natio

  12. Factors Affecting the Relative Efficiency of General Acid Catalysis

    Kwan, Eugene E.


    A simple framework for evaluating experimental kinetic data to provide support for Specific Acid Catalysis (SAC) and General Acid Catalysis (GAC) is described based on the factors affecting their relative efficiency. Observations reveal that increasing the SAC-to-GAC rate constant ratio reduces the effective pH range for GAC.

  13. The Relative Importance of Job Factors: A New Measurement Approach.

    Nealey, Stanley M.

    This paper reports on a new two-phase measurement technique that permits a direct comparison of the perceived relative importance of economic vs. non-economic factors in a job situation in accounting for personnel retention, the willingness to produce, and job satisfaction. The paired comparison method was used to measure the preferences of 91…

  14. Cultural Factors Related to Smoking in San Francisco's Irish Bars

    Satterlund, Travis D.; Antin, Tamar M. J.; Lee, Juliet P.; Moore, Roland S.


    California's Smoke-Free Workplace Act was extended to include bars in 1998. While the majority of bars in the state have become smoke free, in many bars patrons and staff continue to smoke despite the law. The authors present findings from a study which assessed cultural factors related to continued smoking in bars in the city of San Francisco. In…

  15. Complement factor d in age-related macular degeneration

    Stanton, C.M.; Yates, J.R.W.; Hollander, A.I. den; Seddon, J.M.; Swaroop, A.; Stambolian, D.; Fauser, S.; Hoyng, C.B.; Yu, Y.; Atsuhiro, K.; Branham, K.; Othman, M.; Chen, W.; Kortvely, E.; Chalmers, K.; Hayward, C.; Moore, A.T.; Dhillon, B.; Ueffing, M.; Wright, A.F.


    Purpose. To examine the role of complement factor D (CFD) in age-related macular degeneration (AMD) by analysis of genetic association, copy number variation, and plasma CFD concentrations. Methods. Single nucleotide polymorphisms (SNPs) in the CFD gene were genotyped and the results analyzed by

  16. Dimethyl fumarate-associated lymphopenia: Risk factors and clinical significance

    Longbrake, Erin E; Naismith, Robert T; Parks, Becky J; Wu, Gregory F; Cross, Anne H


    Background Dimethyl fumarate (DMF), a disease-modifying therapy for multiple sclerosis (MS), causes lymphopenia in a fraction of patients. The clinical significance of this is unknown. Several cases of progressive multifocal leukoencephalopathy in lymphopenic fumarate-treated patients have raised concerns about drug safety. Since lymphocytes contribute to MS pathology, lymphopenia may also be a biomarker for response to the drug. Objective The objective of this manuscript is to evaluate risk factors for DMF-induced lymphopenia and drug failure in a real-world population of MS patients. Methods We conducted a retrospective cohort study of 221 patients prescribed DMF at a single academic medical center between March 2013 and February 2015. Results Grade 2–3 lymphopenia developed in 17% of the total cohort and did not resolve during DMF treatment. Older age (>55), lower baseline absolute lymphocyte count and recent natalizumab exposure increased the risk of developing moderate to severe lymphopenia while on DMF. Lymphopenia was not predictive of good clinical response or of breakthrough MS activity on DMF. Conclusions Lymphopenia develops in a significant minority of DMF-treated patients, and if grade 2 or worse, is unlikely to resolve while on the drug. Increased vigilance in lymphocyte monitoring and infection awareness is particularly warranted in older patients and those switching from natalizumab. PMID:26550483

  17. Childhood Depression: Relation to Adaptive, Clinical and Predictor Variables

    Maite Garaigordobil


    Full Text Available The study had two goals: (1 to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2 to identify predictor variables of childhood depression. Participants were 420 students aged 7–10 years old (53.3% boys, 46.7% girls. Results revealed: (1 positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and childhood stress; and (2 negative correlations between depression and personal adaptation, global self-concept, social skills, and resilience (sense of competence and affiliation. Linear regression analysis including the global dimensions revealed 4 predictors of childhood depression that explained 50.6% of the variance: high clinical maladjustment, low global self-concept, high level of stress, and poor social skills. However, upon introducing the sub-dimensions, 9 predictor variables emerged that explained 56.4% of the variance: many internalizing problems, low family self-concept, high anxiety, low responsibility, low personal self-assessment, high social stress, few aggressive behaviors toward peers, many health/psychosomatic problems, and external locus of control. The discussion addresses the importance of implementing prevention programs for childhood depression at early ages.

  18. Environmental and Clinical Risk Factors for Delirium in a Neurosurgical Center: A Prospective Study.

    Matano, Fumihiro; Mizunari, Takayuki; Yamada, Keiko; Kobayashi, Shiro; Murai, Yasuo; Morita, Akio


    Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging fluid attenuated inversion recovery images. We prospectively enrolled 253 patients admitted to our neurosurgical center between December 2014 and June 2015 and analyzed 220 patients (100 male patients; mean age, 64.1 years; age range, 17-92 years). An Intensive Care Delirium Screening Checklist score ≥4 points indicated delirium. We evaluated patient factors consisting of baseline characteristics and related factors, such as white matter lesions (WMLs), as well as the surrounding environment. Delirium occurred in 29/220 cases (13.2%). Regarding baseline characteristics, there were significant statistical correlations between delirium and age (P = 0.0187), Hasegawa Dementia Scale-Revised score (P = 0.0022) on admission, and WMLs (P delirium and stay in a neurosurgical care unit (P = 0.0245). Multivariate logistic regression analyses showed statistically significant correlations of delirium with WMLs (P delirium (P = 0.026). WMLs in patients and the surrounding environment are risk factors for delirium in a neurosurgical center. To prevent delirium, clinicians must recognize risk factors, such as high-grade WMLs, and manage environmental factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. FOXO Transcription Factors: Their Clinical Significance and Regulation

    Yu Wang


    Full Text Available Members of the class O of forkhead box transcription factors (FOXO have important roles in metabolism, cellular proliferation, stress resistance, and apoptosis. The activity of FOXOs is tightly regulated by posttranslational modification, including phosphorylation, acetylation, and ubiquitylation. Activation of cell survival pathways such as phosphoinositide-3-kinase/AKT/IKK or RAS/mitogen-activated protein kinase phosphorylates FOXOs at different sites which regulate FOXOs nuclear localization or degradation. FOXO transcription factors are upregulated in a number of cell types including hepatocytes, fibroblasts, osteoblasts, keratinocytes, endothelial cells, pericytes, and cardiac myocytes. They are involved in a number of pathologic and physiologic processes that include proliferation, apoptosis, autophagy, metabolism, inflammation, cytokine expression, immunity, differentiation, and resistance to oxidative stress. These processes impact a number of clinical conditions such as carcinogenesis, diabetes, diabetic complications, cardiovascular disease, host response, and wound healing. In this paper, we focus on the potential role of FOXOs in different disease models and the regulation of FOXOs by various stimuli.

  20. Factors influencing the relation between alcohol and cardiovascular disease

    Grønbaek, Morten


    PURPOSE OF REVIEW: Light-to-moderate alcohol intake is known to have cardioprotective properties in some subsets of the population. This review focuses on factors that modify the relation between alcohol and cardiovascular disease. RECENT FINDINGS: Several large American studies have shown...... that the J-shaped relation is influenced by age and coronary heart disease risk-factor status since only middle-aged and elderly and those already at risk of developing coronary heart disease seem protected by drinking alcohol. It has also been suggested that only those who have a steady - in contrast...... to a binge - intake of alcohol have benefits with regard to cardiovascular disease. Prospective studies from the UK, Sweden and Denmark have further suggested that wine drinkers have a lower mortality than beer and spirits drinkers. SUMMARY: The J-shaped relation between alcohol intake and cardiovascular...

  1. Substance-related coping, HIV-related factors, and mental health among an HIV-positive sexual minority community sample.

    Cramer, Robert J; Colbourn, Scholar L; Gemberling, Tess M; Graham, James; Stroud, Caroline H


    HIV-positive status poses a unique set of social stressors, especially among lesbian, gay, and bisexual (LGB) persons. Among these difficulties are the internalization of HIV-related stigma and poor mental health. Unfortunately, substance use as a coping mechanism is also common, dependent on other demographic factors, among HIV-positive and LGB samples. The present study integrates these bodies of literature by examining main and interactive effects of HIV-related experiences (i.e., disclosure of HIV-positive status, fear of disclosure, HIV-related victimization, and internalized HIV-related stigma) and substance-related coping with discrimination as they impact mental health (i.e., stress, anxiety, depressive symptoms, and suicide and self-injury proneness). Participants were 216 HIV-positive LGB community members from an urban community medical clinic. Prominent results included: (1) robust negative effects of internalized HIV-related stigma on all mental health indicators when controlling for other HIV-related experiences and (2) a significant interaction in which substance-related coping significantly increases suicide proneness, only for those who have disclosed HIV-positive status to family or friends. Results are discussed with respect to theoretical perspectives of internalized stigma, implications for clinical work with LGB persons of HIV-positive status, and future research.

  2. Lessons learned in a clinical trial for military sexual trauma-related posttraumatic stress disorder

    Alina Surís, PhD


    Full Text Available A large body of literature exists describing the challenges associated with implementing randomized controlled clinical trials (RCTs [1]. However, when clinical trials are conducted within Department of Veterans Affairs (VA Medical Center (VAMC settings, several additional and unique factors contribute to the difficulty of conducting RCTs. The challenges and strategies to address them, described in this editorial, are based on an RCT conducted to determine the effectiveness of an evidence-based therapy to treat Veterans with military sexual trauma (MST–related posttraumatic stress disorder (PTSD [2].

  3. An automatic system to identify heart disease risk factors in clinical texts over time.

    Chen, Qingcai; Li, Haodi; Tang, Buzhou; Wang, Xiaolong; Liu, Xin; Liu, Zengjian; Liu, Shu; Wang, Weida; Deng, Qiwen; Zhu, Suisong; Chen, Yangxin; Wang, Jingfeng


    Despite recent progress in prediction and prevention, heart disease remains a leading cause of death. One preliminary step in heart disease prediction and prevention is risk factor identification. Many studies have been proposed to identify risk factors associated with heart disease; however, none have attempted to identify all risk factors. In 2014, the National Center of Informatics for Integrating Biology and Beside (i2b2) issued a clinical natural language processing (NLP) challenge that involved a track (track 2) for identifying heart disease risk factors in clinical texts over time. This track aimed to identify medically relevant information related to heart disease risk and track the progression over sets of longitudinal patient medical records. Identification of tags and attributes associated with disease presence and progression, risk factors, and medications in patient medical history were required. Our participation led to development of a hybrid pipeline system based on both machine learning-based and rule-based approaches. Evaluation using the challenge corpus revealed that our system achieved an F1-score of 92.68%, making it the top-ranked system (without additional annotations) of the 2014 i2b2 clinical NLP challenge. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Mediterranean diet and age-related cognitive decline: a randomized clinical trial

    Valls Pedret, Cinta; Sala Vila, Aleix; Serra Mir, Mercè; Corella, Dolores; Torre Fornell, Rafael de la; Martínez-González, Miguel A.; Martínez Lapiscina, Elena H.; Fitó Colomer, Montserrat; Pérez Heras, Ana; Salas-Salvadó, Jordi; Estruch, Ramón; Ros, Emilio


    IMPORTANCE: Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline, a strong risk factor for development of dementia. Epidemiologic studies suggest that a Mediterranean diet, an antioxidant-rich cardioprotective dietary pattern, delays cognitive decline, but clinical trial evidence is lacking. OBJECTIVE: To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet....

  5. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management.

    Kotchen, Theodore A


    The prevalence of obesity, including childhood obesity, is increasing worldwide. Weight gain is associated with increases in arterial pressure, and it has been estimated that 60-70% of hypertension in adults is attributable to adiposity. Centrally located body fat, associated with insulin resistance and dyslipidemia, is a more potent determinant of blood pressure elevation than peripheral body fat. Obesity-related hypertension may be a distinct hypertensive phenotype with distinct genetic determinants. Mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of renin-angiotensin-aldosterone, and altered vascular function. In overweight individuals, weight loss results in a reduction of blood pressure, however, this effect may be attenuated in the long term. An increasing number of community-based programs (including school programs and worksite programs) are being developed for the prevention and treatment of obesity. Assessment and treatment of the obese hypertensive patient should address overall cardiovascular disease (CVD) risk. There are no compelling clinical trial data to indicate that any one class of antihypertensive agents is superior to others, and in general the principles of pharmacotherapy for obese hypertensive patients are not different from nonobese patients. Future research directions might include: (i) development of effective, culturally sensitive strategies for the prevention and treatment of obesity; (ii) clinical trials to identify the most effective drug therapies for reducing CVD in obese, hypertensive patients; (iii) continued search for the genetic determinants of the obese, hypertensive phenotype.

  6. Clinical assessment of thyroid related orbitopathy: a review.

    Vardizer, Y; Tomkins, O; Briscoe, D


    This review follows the process of evaluation of thyroid related orbitopathy (TRO) patients from diagnosis to treatment decision. We will attempt to define the criteria for referring TRO patients to the ophthalmologist and establish a common basis for orbital examination and TRO patient assessment. This should help classify TRO patients and achieve the best treatment regime. Thyroid related orbitopathy (TRO) is an endocrine disorder with orbital manifestations. Though most patients are first seen by an endocrinologist because of thyroid function disturbance symptoms, approximately 10% will first be seen by an ophthalmologist due to orbitopathy symptoms and signs (1). In the majority of cases the time interval between the appearance of dysthyroid symptomatology and orbital signs is less than a year. Among patients with thyroid endocrine dysfunction, 25% to 50% will gradually develop TRO. Most will have mild orbital manifestations, 28% will develop moderate to severe signs and only 3-5% will have the severe form (2). In this review we will follow the TRO patient through his first steps in the orbital clinic and emphasize the importance of clinical assessment as a crucial phase in determining the appropriate therapeutic approach.

  7. Health related quality of life and influencing factors among welders.

    Jingxiang Qin

    Full Text Available BACKGROUND: Occupational exposure to welding fumes is a serious occupational health problem all over the world. Welders are exposed to many occupational hazards; these hazards might cause some occupational diseases. The aim of the study was to assess the health related quality of life (HRQL of electric welders in Shanghai China and explore influencing factors to HRQL of welders. METHODS: 301 male welders (without pneumoconiosis and 305 non-dust male workers in Shanghai were enrolled in this study. Short Form-36 (SF-36 health survey questionnaires were applied in this cross-sectional study. Socio-demographic, working and health factors were also collected. Multiple stepwise regress analysis was used to identify significant factors related to the eight dimension scores. RESULTS: Six dimensions including role-physical (RP, bodily pain (BP, general health (GH, validity (VT, social function (SF, and mental health (MH were significantly worse in welders compared to non-dust workers. Multiple stepwise regress analysis results show that native place, monthly income, quantity of children, drinking, sleep time, welding type, use of personal protective equipment (PPE, great events in life, and some symptoms including dizziness, discomfort of cervical vertebra, low back pain, cough and insomnia may be influencing factors for HRQL of welders. Among these factors, only sleep time and the use of PPE were salutary. CONCLUSIONS: Some dimensions of HRQL of these welders have been affected. Enterprises which employ welders should take measures to protect the health of these people and improve their HRQL.

  8. Risk factors of age-related macular degeneration in Argentina

    María Eugenia Nano


    Full Text Available PURPOSES: To assess the risk factors of age-related macular degeneration in Argentina using a case-control study. METHODS: Surveys were used for subjects' antioxidant intake, age/gender, race, body mass index, hypertension, diabetes (and type of treatment, smoking, sunlight exposure, red meat consumption, fish consumption, presence of age-related macular degeneration and family history of age-related macular degeneration. Main effects models for logistic regression and ordinal logistic regression were used to analyze the results. RESULTS: There were 175 cases and 175 controls with a mean age of 75.4 years and 75.5 years, respectively, of whom 236 (67.4% were female. Of the cases with age-related macular degeneration, 159 (45.4% had age-related macular degeneration in their left eyes, 154 (44.0% in their right eyes, and 138 (39.4% in both eyes. Of the cases with age-related macular degeneration in their left eyes, 47.8% had the dry type, 40.3% had the wet type, and the type was unknown for 11.9%. The comparable figures for right eyes were: 51.9%, 34.4%, and 13.7%, respectively. The main effects model was dominated by higher sunlight exposure (OR [odds ratio]: 3.3 and a family history of age-related macular degeneration (OR: 4.3. Other factors included hypertension (OR: 2.1, smoking (OR: 2.2, and being of the Mestizo race, which lowered the risk of age-related macular degeneration (OR: 0.40. Red meat/fish consumption, body mass index, and iris color did not have an effect. Higher age was associated with progression to more severe age-related macular degeneration. CONCLUSION: Sunlight exposure, family history of age-related macular degeneration, and an older age were the significant risk factors. There may be other variables, as the risk was not explained very well by the existing factors. A larger sample may produce different and better results.

  9. Determination of risk factors for drug-related problems: a multidisciplinary triangulation process.

    Kaufmann, Carole P; Stämpfli, Dominik; Hersberger, Kurt E; Lampert, Markus L


    Drug-related problems (DRPs) constitute a frequent safety issue among hospitalised patients leading to patient harm and increased healthcare costs. Because many DRPs are preventable, the specific risk factors that facilitate their occurrence are of considerable interest. The objective of our study was to assess risk factors for the occurrence of DRPs with the intention to identify patients at risk for DRPs to guide and target preventive measures where they are needed most in patients. Triangulation process using a mixed methods approach. We conducted an expert panel, using the nominal group technique (NGT) and a qualitative analysis, to gather risk factors for DRPs. The expert panel consisted of two consultant hospital physicians (internal medicine and geriatrics), one emergency physician, one independent general practitioner, one clinical pharmacologist, one clinical pharmacist, one registered nurse, one home care nurse and two independent community pharmacists. The literature was searched for additional risk factors. Gathered factors from the literature search and the NGT were assembled and validated in a two-round Delphi questionnaire. The NGT resulted in the identification of 33 items with 13 additional risk factors from the qualitative analysis of the discussion. The literature search delivered another 39 risk factors. The 85 risk factors were refined to produce 42 statements for the Delphi online questionnaire. Of these, 27 risk factors were judged to be 'important' or 'rather important'. The gathered risk factors may help to characterise and identify patients at risk for DRPs and may enable clinical pharmacists to guide and target preventive measures in order to limit the occurrence of DRPs. As a further step, these risk factors will serve as the basis for a screening tool to identify patients at risk for DRPs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  10. The Relation of Socio-Ecological Factors to Adolescents' Health-Related Behaviour: A Literature Review

    Aura, Annamari; Sormunen, Marjorita; Tossavainen, Kerttu


    Purpose: The purpose of this paper is to identify and describe adolescents' health-related behaviours from a socio-ecological perspective. Socio-ecological factors have been widely shown to be related to health behaviours (smoking, alcohol consumption, physical activity and diet) in adolescence and to affect health. The review integrates evidence…

  11. Cardiotoxicity of antineoplasic agents: onset, risk factors and clinical manifestation

    Maria L. Rădulescu


    Full Text Available The continuously growing incidence of the neoplasic disease, estimated to be in 2020 themain cause of death in developed countries, has imposed an increasing research to discover newclasses of antineoplasic agents, which alone or in combination with classical chemotherapy agents,may turn cancer into a curable disease for the most of the patients. All these drugs affect the heart inrelation to the presence of risk factors: physiological (age, sex, race, general (malaise, pre-existingchronic diseases, pre-existing cardiovascular affections, previous mediastinal radiation therapy,association with other cardiotoxic substances, as well as in relation to factors related to medication(high daily dose, high cumulative dose, short interval between administrations, bolus injection. Themechanism that produces cardiotoxicity is incompletely elucidated, it appears to be plurifactorial, theproduction of oxygen free radicals being the main cause of morphological alterations. Anthracyclinescardiotoxicity is better known, with its two forms (acute/subacute and late or chronic or even thedelayed cardiotoxicity form in survivors of childhood cancers. There are also presented some cardiacdamage modalities after treatment with alkylating agents, antimetabolites, taxanes, monoclonalantibodies (trastuzumab.

  12. Relative deprivation and risk factors for obesity in Canadian adolescents.

    Elgar, Frank J; Xie, Annie; Pförtner, Timo-Kolja; White, James; Pickett, Kate E


    Research on socioeconomic differences in overweight and obesity and on the ecological association between income inequality and obesity prevalence suggests that relative deprivation may contribute to lifestyle risk factors for obesity independently of absolute affluence. We tested this hypothesis using data on 25,980 adolescents (11-15 years) in the 2010 Canadian Health Behaviour in School-aged Children (HBSC) study. The Yitzhaki index of relative deprivation was applied to the HBSC Family Affluence Scale, an index of common material assets, with more affluent schoolmates representing the comparative reference group. Regression analysis tested the associations between relative deprivation and four obesity risk factors (skipping breakfasts, physical activity, and healthful and unhealthful food choices) plus dietary restraint. Relative deprivation uniquely related to skipping breakfasts, less physical activity, fewer healthful food choices (e.g., fruits, vegetables, whole grain breads), and a lower likelihood of dieting to lose weight. Consistent with Runciman's (1966) theory of relative deprivation and with psychosocial interpretations of the health consequences of income inequality, the results indicate that having mostly better off schoolmates can contribute to poorer health behaviours independently of school-level affluence and subjective social status. We discuss the implications of these findings for understanding the social origins of obesity and targeting health interventions. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Clinical features and risk factors of patients with fatty liver in Guangzhou area

    Qi-Kui Chen; Hai-Ying Chen; Kai-Hong Huang; Ying-Qiang Zhong; Ji-Ao Han; Zhao-Hua Zhu; Xiao-Dong Zhou


    AIM: There is still no accepted conclusion regarding the clinical features and related risk factors of patients with fatty liver. The large-scale clinical studies have not carried out yet in Guangzhou area. The aim of the present study was to investigate the clinical features and related risk factors of patients with fatty liver in Guangzhou area. METHODS: A total of 413 cases with fatty liver were enrolled in the study from January 1998 to May 2002. Retrospective case-control study was used to evaluate the clinical featuresand related risk factors of fatty liver with logistic regression.RESULTS: Obesity (OR: 21.204), alcohol abuse (OR: 18.601),type 2 diabetes mellitus (OR: 4.461), serum triglyceride (TG)(OR: 3.916), serum low-density lipoprotein cholesterol (LDL-C)(OR: 1.840) and fasting plasma glucose (FPG) (OR: 1.535)were positively correlated to the formation of the fatty liver. The levels of serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) increased mildly in the patients withfatty liver and were often less than 2-fold of the normal limit.The higher abnormalities of aspartate aminotransferase (AST)levels (42.9%) with Asr/ALT more than 2(17.9%) were found in patients with alcoholic fatty liver (AFL) than those with nonalcoholic fatty liver (NAFL) (16.9% and 5.0% respectively). The elevation of serum TG, cholesterol (CHOL), LDL-C was more common in patients with NAFL than with AFL.CONCLUSION: Obesity, alcohol abuse, type 2 diabetes mellitus and hyperlipidemia may be independent risk factors of fatty liver. The mildly abnormal hepatic functions can be found in patients with fatty liver. More obvious damages of liver function with AST/ALT usually more than 2 were noted in patients with AFL.

  14. Risk Factors Associated with Peritoneal-Dialysis-Related Peritonitis

    Julia Kerschbaum


    Full Text Available Background. Peritonitis represents a major complication of peritoneal dialysis (PD. The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990–2012 and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient’s choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.

  15. Study on the mortality in Ecuador related to dietary factors

    Juan Alejandro Neira-Mosquera


    Full Text Available Diet is an important factor related to the development of numerous diseases. In developing countries like Ecuador, this aspect is not considered as priority however, the study of the incidence of certain diet-related diseases could help to assess consumption habits of a country from a Public Health perspective and support national nutrition policies and programs. The objective the present study is to investigate the mortality rate of certain diet-related diseases in Ecuador and its possible relationship with Ecuadorian consumption habits. For that, mortality rates (2001-2008 associated with five different disease groups related to dietary factors (cancer of colon, cerebrovascular diseases, cardiovascular diseases, diabetes mellitus and liver diseases were collected, analyzed and compared to consumption patterns in Ecuador. According to results, Ecuador has a low level of cancer of colon in comparison with developed countries (e.g. Spain. The group with the highest number of deaths corresponded to cardiovascular diseases followed by cerebrovas-cular diseases. The mortality study per province revealed that Amazonian provinces showed few deaths in relation to other provinces in Ecuador. This could be due to different factors including fails in the disease surveillance information systems, environmental factors and consumption patterns. In this sense, further investigation on native products consumption such as "chontaduro" might help to find valuable foods contributing to healthier Ecuadorian diet. These results, though preliminary, evidence that a major effort should be made by national and international organisations to collect data on consumption patterns and nutritional aspects of the Ecuadorian population in order to better support the development of effective food security and nutrition policies.

  16. Study on the mortality in Ecuador related to dietary factors.

    Neira-Mosquera, Juan Alejandro; Pérez-Rodríguez, Fernando; Sánchez-Llaguno, Sungey; Moreno Rojas, Rafael


    Diet is an important factor related to the development of numerous diseases. In developing countries like Ecuador, this aspect is not considered as priority however, the study of the incidence of certain diet-related diseases could help to assess consumption habits of a country from a Public Health perspective and support national nutrition policies and programs. The objective the present study is to investigate the mortality rate of certain diet-related diseases in Ecuador and its possible relationship with Ecuadorian consumption habits. For that, mortality rates (2001-2008) associated with five different disease groups related to dietary factors (cancer of colon, cerebrovascular diseases, cardiovascular diseases, diabetes mellitus and liver diseases) were collected, analyzed and compared to consumption patterns in Ecuador. According to results, Ecuador has a low level of cancer of colon in comparison with developed countries (e.g. Spain). The group with the highest number of deaths corresponded to cardiovascular diseases followed by cerebrovascular diseases. The mortality study per province revealed that Amazonian provinces showed few deaths in relation to other provinces in Ecuador. This could be due to different factors including fails in the disease surveillance information systems, environmental factors and consumption patterns. In this sense, further investigation on native products consumption such as "chontaduro" might help to find valuable foods contributing to healthier Ecuadorian diet. These results, though preliminary, evidence that a major effort should be made by national and international organisations to collect data on consumption patterns and nutritional aspects of the Ecuadorian population in order to better support the development of effective food security and nutrition policies.

  17. Cow-specific risk factors for clinical mastitis in Brazilian dairy cattle.

    Oliveira, C S F; Hogeveen, H; Botelho, A M; Maia, P V; Coelho, S G; Haddad, J P A


    Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which risk factors were associated with the occurrence of the most common pathogens involved in Brazilian CM infections. The analyses were based on 65 months of data from 9,789 dairy cows and 12,464 CM cases. Cow-specific risk factors that could easily be measured in standard Brazilian dairy farms were used in the statistical analyses, which included logistic regression and multinomial logistic regression. The first month of lactation, high somatic cell count, rainy season and history of clinical mastitis cases were factors associated with CM for both primiparous and multiparous cows. In addition, parity and breed were also associated risk factors for multiparous cows. Of all CM cases, 54% showed positive bacteriological culturing results from which 57% were classified as environmental pathogens, with a large percentage of coliforms (35%). Coagulase-negative Staphylococcus (16%), Streptococcus uberis (9%), Streptococcus agalactiae (7%) and other Streptococci (9%) were also common pathogens. Among the pathogens analyzed, the association of cow-specific risk factors, such as Zebu breed (OR=5.84, 95%CI 3.77-10.77) and accumulated history of SCC (1.76, 95%CI 1.37-2.27), was different for CM caused by Coagulase-negative Staphylococcus and S. agalactiae in comparison to CM caused by coliforms. Our results suggest that CM control programs in Brazil should specially consider the recent history of clinical mastitis cases and the beginning of the lactations, mainly during the rainy season as important risk factor for mastitis.

  18. Building-related risk factors and work-related lower respiratory symptoms in 80 office buildings

    Mendell, M.J.; Naco, G.M.; Wilcox, T.G.; Sieber, W.K.


    We assessed building-related risk factors for lower respiratory symptoms in office workers. The National Institute for Occupational Safety and Health in 1993 collected data during indoor environmental health investigations of workplaces. We used multivariate logistic regression analyses to assess relationships between lower respiratory symptoms in office workers and risk factors plausibly related to microbiologic contamination. Among 2,435 occupants in 80 office buildings, frequent, work-related multiple lower respiratory symptoms were strongly associated, in multivariate models, with two risk factors for microbiologic contamination: poor pan drainage under cooling coils and debris in outside air intake. Associations tended to be stronger among those with a history of physician-diagnosed asthma. These findings suggest that adverse lower respiratory health effects from indoor work environments, although unusual, may occur in relation to poorly designed or maintained ventilation systems, particularly among previously diagnosed asthmatics. These findings require confirmation in more representative buildings.

  19. Factors Associated with Clinical and Topographical Features of Laryngeal Tuberculosis

    Reis, João Gustavo Corrêa; Reis, Clarissa Souza Mota; da Costa, Daniel César Silva; Lucena, Márcia Mendonça; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhaes; Rolla, Valéria Cavalcanti; Conceição-Silva, Fátima; Valete-Rosalino, Cláudia Maria


    Introduction Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. Objective To identify factors associated with clinical and topographical features of LTB. Method a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. Results Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. Conclusions Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement. PMID:27077734

  20. Socio-Demographic Factors Related to Oral Cancer

    Abdoul Hossain Madani


    Full Text Available Problem statement: The aim of this study was to identify factors related to cancer of oral cavity considering individual socio-demographic characteristics of a hospital based study in Pune. Approach: A case-control study was conducted. The cases were 350 with squamous-cell carcinoma of oral cavity diagnosed between 2005 and 2006 in Morbai, Narandia, Budharani Cancer Institute, Pune, India. Similar number of controls matched for age and sex selected from the background population. Cases and controls were interviewed for general characteristics; age, gender, education and possible socio-demographic factors. Results: Chi-square test in uni-variate analysis and estimate for risk showed that education, occupation and monthly household income were significantly different between cases and controls (pConclusion/Recommendations: Socio-demographic factors such as education, occupation and income do play an important role in development oral cancer.

  1. On factors related to car accidents on German Autobahn connectors.

    Garnowski, Martin; Manner, Hans


    We make an attempt to identify factors that explain accidents on German Autobahn connectors. To find these factors we perform an empirical study making use of count data models with fixed and random coefficients. The findings are based on a set of 197 ramps, which we classify into three distinct types of ramps. For these ramps, accident data is available for a period of 3 years (January 2003 until December 2005). The negative binomial model with some random coefficients proved to be an appropriate model in our cross-sectional setting for detecting factors that are related to accidents. The most significant variable is a measure of the average daily traffic. For geometric variables, not only continuous effects were found to be significant, but also threshold effects indicating the exceedance of certain values. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Study on the clinical features and the related factors of transient tachypnea of newborn (TTN) in term infants%足月儿湿肺的临床特点及病情轻重影响因素的研究

    王刚; 侯珊珊; 李玉梅


    目的:分析比较足月儿湿肺临床特点及病情轻、重组的影响因素.方法:对吉林大学新生儿疾病诊治中心收治的足月儿湿肺患儿744例的基本资料、围产期因素、临床表现、辅助检查、治疗情况等进行回顾分析,并根据是否应用呼吸支持分为病情重组及病情轻组,分析比较影响病情轻、重的因素.结果:湿肺患儿以男性为主占67.1%,选择性剖宫产占61.8%,存在妊娠并发症者共447例占60.1%;入院呼吸频率≥60次/min 363例占48.8%,存在呼吸系统并发症者78例占10.5%.病情轻、重组间分娩方式、妊娠并发症、呼吸系统并发症及入院呼吸频率差异均有统计学意义(P<0.05).结论:男性患儿、妊娠并发症、选择性剖宫产可能为湿肺发生的危险因素,妊娠并发症、选择性剖宫产、呼吸系统并发症可能为足月儿病情严重的危险因素,入院呼吸频率高可能为足月儿湿肺病情严重的预测因素.%Objective: To analyze the clinical features and the related factors of transient tachypnea of the newborn (TTN) in term infants. Methods: Some information of 744 term infants diagnosed with TTN at Neonatal, Treatment Center of Jilin University were analyzed in the study, including the basic information, perinatal factors, clinical manifestations, accessory examination and therapy of them. Further more, they were divided into mild group and severe group depending to whether application of respiratory support, and the factors related severity of disease were analyzed. Results: Male infants were more (67. 1% ), and elective caesarean section was 61. 8% . 447 cases (60.1%) had pregnancy complications; 78 cases (10.5%) with respiratory complications, the initial respiratory rate of 363 cases (48. 8% ) were more than 60 times per minute. The delivery mode, pregnancy complications, respiratory complications and initial respiratory rate were all significantly difference (P<0.05) between the

  3. Cosmological General Relativity With Scale Factor and Dark Energy

    Oliveira, Firmin J


    In this paper the four-dimensional space-velocity Cosmological General Relativity of Carmeli is developed by a general solution to the Einstein field equations. The metric is given in the Tolman form and the vacuum mass density is included in the energy-momentum tensor. The scale factor redshift equation is obtained, forming the basis for deriving the various redshift-distance relations of cosmological analysis. A linear equation of state dependent on the scale factor is assumed to account for the effects of an evolving dark energy in the expansion of the universe. Modeling simulations are provided for a few combinations of mass density, vacuum density and state parameter values over a sample of high redshift SNe Ia data. Also, the Carmeli cosmological model is derived as a special case of the general solution.

  4. Lifestyle-related factors and access to medically assisted reproduction.

    Dondorp, W; de Wert, G; Pennings, G; Shenfield, F; Devroey, P; Tarlatzis, B; Barri, P


    Lifestyle is increasingly recognized as an outcome-determining factor in assisted reproduction, not only with regard to the cost-effectiveness but also in view of the balance of benefits and risks, including risks related to the welfare of the future child. This document briefly summarizes the evidence concerning the impact of three lifestyle-related factors (obesity, tobacco smoking and alcohol consumption) on both natural and assisted reproduction (IVF) and discusses the implications of this for the practice of medically assisted reproduction in the light of relevant ethical principles. The central question is whether and to what extent fertility treatment of obese, smoking or drinking patients should be made conditional on prior lifestyle changes.

  5. Associations between generic substitution and patient-related factors

    Østergaard Rathe, Jette

    Associations between generic substitution and patient-related factors Jette Østergaard Rathe1, Pia V. Larsen1, Morten Andersen2, Janus L. Thomsen3, Maja S. Paulsen1, Jens Søndergaard1 1. Research Unit of General Practice, Institute of Public Health, University of Southern Denmark 2. Centre...... substitutable drug. Data were linked with a prescription database. Results We found no associations between generic substitution and, respectively, gender, age, drug group and polypharmacy. Earlier switches of the index drug are statistically significant associated with acceptance of generic substitution...... generics in the antiepileptic and antidepressant groups (antiepileptics OR 0.37 and antidepressants OR 0.53). Conclusion We did not find any patient-related factors associated with generic substitution; however, patients who have once experienced a generic substitution with a specific drug are more likely...

  6. Factors related to adherence to treatment for systemic hypertension

    Silvana Maria Coelho Leite Fava


    Full Text Available This study aimed to seek the evidence available in the literature regarding the factors related to adherence to treatment for systemic hypertension. It used the method of integrative review in the databases MEDLINE, CINAHL, and LILACS, using the keywords: hypertension, compliance, non-compliance, adherence, non-adherence, patient compliance, in the period 2004 – 2008, and articles in Portuguese, English and Spanish, with the use of a validated instrument and content analysis. 28 studies were selected, 64.3% of which had level of evidence VI. The following were identified as factors related to adherence to treatment: treatment costs, educational activities, sex, physician-patient relationship, physiological and behavioral aspects, drug therapy, attending checkups and lifestyle. The use of combined strategies is suggested in order to increase the individuals’ adherence to the treatment. Gaps point to the valorization of dialogic relationships for integrated and more efficacious health practices.

  7. Factor H-related proteins determine complement-activating surfaces.

    Józsi, Mihály; Tortajada, Agustin; Uzonyi, Barbara; Goicoechea de Jorge, Elena; Rodríguez de Córdoba, Santiago


    Complement factor H-related proteins (FHRs) are strongly associated with different diseases involving complement dysregulation, which suggests a major role for these proteins regulating complement activation. Because FHRs are evolutionarily and structurally related to complement inhibitor factor H (FH), the initial assumption was that the FHRs are also negative complement regulators. Whereas weak complement inhibiting activities were originally reported for these molecules, recent developments indicate that FHRs may enhance complement activation, with important implications for the role of these proteins in health and disease. We review these findings here, and propose that FHRs represent a complex set of surface recognition molecules that, by competing with FH, provide improved discrimination of self and non-self surfaces and play a central role in determining appropriate activation of the complement pathway.

  8. Factors influencing the relation between alcohol and cardiovascular disease

    Grønbaek, Morten


    PURPOSE OF REVIEW: Light-to-moderate alcohol intake is known to have cardioprotective properties in some subsets of the population. This review focuses on factors that modify the relation between alcohol and cardiovascular disease. RECENT FINDINGS: Several large American studies have shown...... to a binge - intake of alcohol have benefits with regard to cardiovascular disease. Prospective studies from the UK, Sweden and Denmark have further suggested that wine drinkers have a lower mortality than beer and spirits drinkers. SUMMARY: The J-shaped relation between alcohol intake and cardiovascular...... disease seems to be influenced by age, gender, drinking pattern and type of alcohol....

  9. Clinical trial allocation in multinational pharmaceutical companies - a qualitative study on influential factors.

    Dombernowsky, Tilde; Haedersdal, Merete; Lassen, Ulrik; Thomsen, Simon F


    Clinical trial allocation in multinational pharmaceutical companies includes country selection and site selection. With emphasis on site selection, the overall aim of this study was to examine which factors pharmaceutical companies value most when allocating clinical trials. The specific aims were (1) to identify key decision makers during country and site selection, respectively, (2) to evaluate by which parameters subsidiaries are primarily assessed by headquarters with regard to conducting clinical trials, and (3) to evaluate which site-related qualities companies value most when selecting trial sites. Eleven semistructured interviews were conducted among employees engaged in trial allocation at 11 pharmaceutical companies. The interviews were analyzed by deductive content analysis, which included coding of data to a categorization matrix containing categories of site-related qualities. The results suggest that headquarters and regional departments are key decision makers during country selection, whereas subsidiaries decide on site selection. Study participants argued that headquarters primarily value timely patient recruitment and quality of data when assessing subsidiaries. The site-related qualities most commonly emphasized during interviews were study population availability, timely patient recruitment, resources at the site, and site personnel's interest and commitment. Costs of running the trials were described as less important. Site personnel experience in conducting trials was described as valuable but not imperative. In conclusion, multinational pharmaceutical companies consider recruitment-related factors as crucial when allocating clinical trials. Quality of data and site personnel's interest and commitment are also essential, whereas costs seem less important. While valued, site personnel experience in conducting clinical trials is not imperative.

  10. Psychosocial Factors Related to Underuse of Medical Services.

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W


    In this longitudinal study, we applied structural equation modeling (SEM) to examine the historical, predisposing, enabling/barrier, and need factors as related to the underuse of medical services during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. The findings supported a mediational model: A mutually affectionate parent-child relationship in early adolescence was inversely related to underuse of medical services in early midlife via the mediational roles played by later predisposing factors (i.e., depressive mood and cigarette smoking), need factor (i.e., physical health problems), barriers (i.e., financial difficulty), and enabling factors (i.e., social support for health services in early midlife). In addition, satisfaction with medical services in the neighborhood had an association with less underuse of medical services in early midlife. Family therapy focused on an increase in the affectionate relationship between the adolescents and his/her parents and cognitive-behavioral treatment of depressive mood may lead to a decrease in the underuse of medical services.

  11. Nosocomial infections and related factors in southern khorasan hospitals


    Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission).Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patien...

  12. Smoking and Its Related Factors Among Iranian High School Students

    Chaman, Reza; Khosravi, Ahmad; Sajedinejad, Sima; Nazemi, Saeed; Fereidoon Mohasseli, Khadije; Valizade, Behzad; Vahedi, Hamid; Hosseinzadeh, Ehsan; Amiri, Mohammad


    Background: In different studies, the prevalence of tobacco consumption has been growing in high schools boys. Objectives: This study was conducted to determine the prevalence of smoking and its related factors among Iranian high school students in 2011. Materials and Methods: In this cross-sectional study, 450 male students from 15 high schools of Shahroud (northeast of Iran) were selected for evaluation of the knowledge, attitude and practices (KAP) of students regarding tobacco consumption...



    This research focuses on exploring the factors which relate learner engagement with E-Learning.It tries to explorethe strength of the link between learner engagement and E-Learning.E-Learning in today’s world has become a common mode of study and knowledge dissemination. E-Learning is an educational, training and learning method which is spreading widely and becoming a popular method of delivery among both educational and corporate environments. Is it beneficial for educational institut...

  14. Angiopoietin-related growth factor level in preeclampsia


    Abstract Aim. Angiopoietin-related growth factor (AGF) is associated with angiogenesis but it can also affect glucose and energy metabolism. The aim of this study was to determine AGF levels in preeclampsia. Method. The study included 32 women with preeclampsia (preeclampsia group) and 32 non-preeclamptic, healthy, third trimester pregnant women (Control group). We analyzed serum levels of AGF and other biochemical and anthropometric markers in all subjects. Results. Serum AGF levels were sig...

  15. The relation between quality of clinical trials and acupuncture efficacy

    David Gonçalves Nordon


    Full Text Available Introduction: Clinical trials of acupuncture not always have concordant results, mostly due to their great heterogeneity. Two indexes have been developed to analyze the quality of acupuncture trials. This study hypothesizes that, the more adequate the intervention and the control techniques, the more efficacious the acupuncture. Methods: Both indexes were applied to 27 randomized clinical trials comparing acupuncture to placebo. Results were compared by using the Mann-Whitney test. Results: Studies favorable to acupuncture had a intervention score’s median of 11.5; for the unfavorable ones, it was 7, p: 0.0017. Articles with and without statistically significant differences, though, had the same median for their scores in the control index: 6. Discussion: There is a positive relation between a better score for acupuncture technique and a statistically significant difference between acupuncture and interventional control. However, due to the little heterogeneity in the degree of physiological effect from each article, the control index had no statistical significance. Conclusion: This study established that, among acupuncture RCT controlled by placebo or sham of moderate physiological effect, the adequacy of the technique is more important than the adequacy of control in establishing a statistically significant difference between acupuncture and interventional control.

  16. Patient factors that influence clinicians' decision making in self-management support: A clinical vignette study.

    Bos-Touwen, Irene D; Trappenburg, Jaap C A; van der Wulp, Ineke; Schuurmans, Marieke J; de Wit, Niek J


    Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current decision making of health professionals can support future tailoring of self-management interventions. The aim of this study is to identify the relative importance of patient factors in health professionals' decision making regarding self-management support. A factorial survey was presented to primary care physicians and nurses. The survey consisted of clinical vignettes (case descriptions), in which 11 patient factors were systematically varied. Each care provider received a set of 12 vignettes. For each vignette, they decided whether they would give this patient self-management support and whether they expected this support to be successful. The associations between respondent decisions and patient factors were explored using ordered logit regression. The survey was completed by 60 general practitioners and 80 nurses. Self-management support was unlikely to be provided in a third of the vignettes. The most important patient factor in the decision to provide self-management support as well as in the expectation that self-management support would be successful was motivation, followed by patient-provider relationship and illness perception. Other factors, such as depression or anxiety, education level, self-efficacy and social support, had a small impact on decisions. Disease, disease severity, knowledge of disease, and age were relatively unimportant factors. This is the first study to explore the relative importance of patient factors in decision making and the expectations regarding the provision of self-management support to chronic disease patients. By far, the most important factor considered was patient's motivation; unmotivated patients were less likely to receive self-management support

  17. Multivariate Analysis of Clinical Factors in Restenosis after Coronary Stenting

    Wen Shangyu; Mao Jieming; Guo Liiun; Zhao Yiming; Zhang Fuchun; Guo Jingxlan; Cheng Mingzhe


    Ojbective To find the independent predictors for restenosis after coronary stenting.Methods Quantitative angiography was performed on 60 cases (67 successfully dilated lesions) after angioplasty over 6-months follow-up, and both univariate and multivariate logistic regression analysis were done to identify the correlations of restenosis with clinical factors. Results The total restenosis rate was 31.3%(21 of 67 lesions), and according to univariate analysis the patients who underwent coronary stenting ≥3.5mm had a lower rate of restenosis ( P < 0. 01).Collateral circulation to the obstruction site, high maximal inflation pressure, smoking and the less minimal lumen diameter after PTCA made the rate of restenosis higherower ( P < 0.05) . Multivariate logistic regression analysis showed that coronary stenting ≥ 3.5mm had a low rate of restenosis, but high maximal inflation pressure and smoking made the restenosis rate higher. Conclusion Coronary stent size, maximal inflation pressure and. smoking were independent predictors for restenosis.

  18. Suction blister grafting for vitiligo: efficacy and clinical predictive factors.

    Gou, Darlene; Currimbhoy, Sharif; Pandya, Amit G


    Suction blister epidermal grafting (SBEG) is a well-established treatment modality for vitiligo, but predictive factors for outcomes are not well characterized. To determine the efficacy and predictive variables for response to SBEG in patients with vitiligo. A retrospective single-center review of all cases treated with SBEG was performed. Repigmentation was assessed by 2 independent reviewers by assessing pigment spread of grafts during the postoperative period. Repigmentation rates were then compared with patient demographics and transplant location. A total of 28 patients were enrolled in this study. The total number of grafts was 129, of which 86.8% (112/129) survived. Highest rate of graft survival was seen in patients younger than 20 years (100%) and the lowest in patients older than 40 years (75%-78%). Repigmentation was seen in 68% of patients. The highest degree of pigment spread was on the neck (283%) and face (231%), whereas the hands and feet had the least response (119%). Blister grafting is successful in most patients with vitiligo, with a high graft survival rate; however, the degree of pigment spread is variable and depends on clinical characteristics of the patient and graft site.

  19. Can we predict disease course with clinical factors?

    Vegh, Zsuzsanna; Kurti, Zsuzsanna; Golovics, Petra Anna; Lakatos, Peter Laszlo


    The disease phenotype at diagnosis and the disease course of Crohn's disease (CD) and ulcerative colitis (UC) show remarkable heterogeneity across patients. In recent population-based epidemiological and referral cohort studies, the evolution of disease phenotype of CD and UC varied significantly. Most CD and severe UC patients still requires hospitalization or surgery/colectomy during follow-up. A change in the natural history of IBD with improved outcomes in parallel with tailored positioning of aggressive immunomodulator and biological therapy has been suspected according to the recently available literature. Therefore it is of major importance to refer IBD cases at risk for adverse disease outcomes as early during the disease course as possible. This review aims to summarize the currently available evidence on clinical and some environmental predictive factors, which clinicians should evaluate in the everyday practice together with other laboratory and imaging data to prevent disease progression, enable a more personalized therapy, and avoid negative disease outcomes. Copyright© Bentham Science Publishers; For any queries, please email at

  20. Complementary feeding: clinically relevant factors affecting timing and composition.

    Krebs, Nancy F; Hambidge, K Michael


    Exclusive breastfeeding for the first 6 mo of life followed by optimal complementary feeding are critical public health measures for reducing and preventing morbidity and mortality in young children. Clinical factors, such as birth weight, prematurity, and illness, that affect the iron and zinc requirements of younger infants are discussed. Maternal diet and nutritional status do not have a strong effect on the mineral content of human milk, but physiologic changes in milk and the infants' status determine the dependence of the infant on complementary foods in addition to human milk to meet iron and zinc requirements after 6 mo. The nature of zinc absorption, which is suitably characterized by saturation response modeling, dictates that plant-based diets, which are low in zinc, are associated with low absolute daily absorbed zinc, which is inadequate to meet requirements. Foods with a higher zinc content, such as meats, are much more likely to be sufficient to meet dietary requirements. Current plant-based complementary feeding patterns for older fully breastfed infants in both developed and developing countries pose a risk of zinc deficiency. The strong rationale for the potential benefits of providing meat as an early complementary food, and the examples of successful intervention programs, provide potent incentives to pursue broader implementation programs, with concurrent rigorous evaluation of both efficacy and effectiveness.

  1. Prognostic factors for clinical failure of exacerbations in elderly outpatients with moderate-to-severe COPD

    Wilson R


    weeks posttherapy included wheezing at preexacerbation, mild or moderate (vs extreme sleep disturbances, lower body temperature at exacerbation, forced expiratory volume in 1 second <30%, lower body mass index, concomitant systemic corticosteroids for the current exacerbation, maintenance long-acting β2-agonist and long-acting anticholinergic treatments, and positive sputum culture at EOT.Conclusion: Several bacteriological, historical, treatment-related factors were identified as predictors of early (EOT and later (8 weeks posttherapy clinical failure in this older outpatient population with moderate-to-severe chronic obstructive pulmonary disease. These patients should be closely monitored and sputum cultures considered before and after treatment.Keywords: AECOPD, clinical failure, prognostic factor, long-term outcome, poor outcome

  2. Relation of anthropometric variables to coronary artery disease risk factors

    Virendra C Patil


    Full Text Available Background and Objectives: Anthropometric variables and their relation to conventional coronary artery disease (CAD risk factors in railway employees have been inadequately studied in India. This cross-sectional survey was carried out in the Solapur division of the Central railway in the year 2004, to assess the anthropometric variables in railway employees and their relation to conventional CAD risk factors. Materials and Methods: A total of 995 railway employees, with 872 males and 123 females participated in this cross-sectional study. All subjects underwent anthropometric measurements, fasting lipid profile, and blood sugar level. Various anthropometric indices were calculated for body mass index (BMI, waist circumference (WC, waist-to-hip ratio (WHR, waist-to-height ratio (WHtR, and abdominal volume index (AVI. Statistical analysis was done by EPI Info 6 statistical software. Results: Compared to all other obesity indices, WHtR was most prevalent in both genders. High WHtR was present in 699 (80.16% males and 103 (83.73% females. Age ≥45 years, high systolic BP, high diastolic BP, low HDL, high triglyceride, and diabetes mellitus were positively correlated with high BMI, high WC, high WHR, high WHtR, and high AVI. High BMI, high WC, high WHR, high WHtR, and high AVI were negatively associated with physical inactivity. Conclusions: Over all, anthropometric variables in both genders were significantly deranged in subjects with coronary risk factors. Compared to all other anthropometric variables, WHtR was statistically significantly associated with a majority of coronary artery risk factors. Hence we recommend inclusion of WHtR as a parameter of obesity to predict coronary artery disease risk factor along with WC, WHR, and BMI in epidemiologic studies.

  3. The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis.

    Wittkowski, Anja; Richards, Helen L; Griffiths, Christopher E M; Main, Chris J


    The aim of the study was to assess the influence of general and dermatitis-specific psychological and clinical factors on quality of life in adults with atopic dermatitis (AD). A total of 125 adults recruited through the National Eczema Society of U.K. (NES) completed a number of psychological and dermatological questionnaires, including the Dermatology Life Quality Index (DLQI), the Stigmatisation and Eczema Questionnaire (SEQ), the Hospital Anxiety and Depression Scale (HADS), the Fear of Negative Evaluation Scale (FNE) and the Rosenberg Self-Esteem Scale (RSE). Pearson's correlational analyses suggested that perceptions of stigma were significantly associated with psychological factors as well as quality of life (Ps<.01). An association was also found between perceived stigma and disease severity (-.28, P<.01). Almost 46% of participants were identified as having probable mood disorder. Regression analysis indicated that perceptions of stigma and depression accounted for 44.5% of the variance in quality of life in this sample [F(3,121)=34.18, P<.001], when disease severity was controlled for. Psychological factors and disease severity were strong predictors of quality of life in adults with AD. AD-related perceptions of stigma were of particular importance in predicting AD-related quality of life over and above more general psychological factors, such as depression. These findings have important implications for the psychological and clinical management of AD.

  4. Research misconduct and data fraud in clinical trials: prevalence and causal factors.

    George, Stephen L


    The disclosure of cases of research misconduct in clinical trials, conventionally defined as fabrication, falsification or plagiarism, has been a disturbingly common phenomenon in recent years. Such cases can potentially harm patients enrolled on the trials in question or patients treated based on the results of those trials and can seriously undermine the scientific and public trust in the validity of clinical trial results. Here, I review what is known about the prevalence of research misconduct in general and the contributing or causal factors leading to the misconduct. The evidence on prevalence is unreliable and fraught with definitional problems and with study design issues. Nevertheless, the evidence taken as a whole seems to suggest that cases of the most serious types of misconduct, fabrication and falsification (i.e., data fraud), are relatively rare but that other types of questionable research practices are quite common. There have been many individual, institutional and scientific factors proposed for misconduct but, as is the case with estimates of prevalence, reliable empirical evidence on the strength and relative importance of these factors is lacking. However, it seems clear that the view of misconduct as being simply the result of aberrant or self-delusional personalities likely underestimates the effect of other important factors and inhibits the development of effective prevention strategies.

  5. [Discussion on the influence of factors related organic on Deqi in acupuncture treatment].

    Li, Jing; Liu, Yu-Qi; Li, Chun-Hua; Yuan, Hong-Wen; Zhang, Peng; Lin, Chi; Xin, Si-Yuan; Guo, Zheng-Rong; Ma, Liang-Xiao; Zhu, Jiang


    To discuss the influence of factors related organic on deqi in acupuncture treatment and provide scientific evidence for further research on the influencing factors of deqi sensation. China National Knowledge Infrastructure (CNKI) database, VIP-Chinese scientific and technological journal database, Chinese biological medical (CBM) database and PubMed database were retrieved. There were 30 articles about the organic influencing factors of deqi and they were analyzed. The organic related factors which includes individual constitution, syndrome classification, physical condition, specificity of acupoint function, tolerance and psychological factors play an important part in deqi in acupancture treatment, which should be brought to the forefront for acupuncture practitioners and researchers. The organic factors are influencing the deqi sensation in many ways but most of the present studies are resting on the affirmation of the phenomenon. Further studies about organic related influencing factors on deqi should be carried out and scientific, objective indices of deqi sensation should be explored which may improve the clinical and research level of acupuncture.

  6. The forest and the trees: relational and specific factors in addiction treatment.

    Miller, William R; Moyers, Theresa B


    Increased expectations for the use of evidence-based methods in addiction treatment have fueled a debate regarding the relative importance of 'specific' versus 'common' factors in treatment outcome. This review explores the influence of these factors on addiction treatment outcome. The authors review and link findings from four decades of research on specific and general factors in addiction treatment outcome research. Although few would argue that what one does in addiction treatment is immaterial, outcome studies tend to find small to no difference when specific treatment methods are compared with each other or with treatment as usual. In contrast, there are usually substantial differences among therapists in client outcomes, and relational factors such as therapist empathy and therapeutic alliance can be significant determinants of addiction treatment outcome. In addiction treatment, relational factors such as empathy, which are often described as common, non-specific factors, should not be dismissed as 'common' because they vary substantially across providers and it is unclear how common they actually are. Similarly they should not be relegated to 'non-specific' status, because such important relational influences can be specified and incorporated into clinical research and training. © 2014 Society for the Study of Addiction.

  7. 我国首次临床营养师培训考核考生成绩相关因素分析%Analysis of the related factors on scores of the clinical dietitians' post-training exam in China

    王钢; 郑耀光; 王宁; 邹杰文; 张泉慧


    Objective Based on the analysis of relevant factors on scores of the first clinical dietitian post-training examination (CDPTE) in China,to explore the clinical dietitians' post competency evaluation basis.Method 108 students who completed the clinical nutritionist training (60 physicians,nurse or technician 48) were imposed comprehensive evaluation designed according to the concept of post competency.Through analysis and comparison,the correlation factors of the candidates' passing rate and their mastering rate of the module were studied.Results The results of all the candidates' comprehensive theoretical examination increased with the degree and the source of the candidates.Among them,the college students' pass rate was 76.47%,undergraduates' pass rate was 86.21%,Graduates' pass rate was 96.97%;the pass rate in western region was 85%,the central part was 85.71%,the eastern part was 89.55%.All the candidates' knowledge module mastery rate in the comprehensive examination of the theory from high to low in order was:for hospital diet (73.7%),enteral nutrition and parenteral nutrition (72.7%),public nutrition (70.7%),nutrition screening and assessment (66.7%),common nutrition related diseases (65.4%),clinical nutrition related health students regulations,medical psychology and ethics basic knowledge (40.0%).The examination pass rate was related to the educational level of the examinee and the source area,while the knowledge module mastery rate was closely related to the work of clinical nutrition.Conclusion We concluded that the CDPTE could objectively reflect the candidate's clinical competence and professionalism and it was designed on the basic principle of post competency.CDPTE has a positive significance for scientific assessment of clinical dietician,guide for training,and evaluation of training effects as well.The scores of CDPTE can objectively reflect the examinees' clinical competence and professionalism and CDPTE can achieve the

  8. Factors related to physical activity: a study of adolescents.

    Vilhjalmsson, R; Thorlindsson, T


    Although the consequences of physical activity have been carefully documented, less is known about its correlates, particularly among children and youth. Based on a representative national survey of 1131 Icelandic adolescents, the study examined various physical, psychological, social and demographic factors related to physical activity. Male sex, significant others' involvement in physical activity (father, friend and older brother), sociability, perceived importance of sport and of health improvement and satisfaction with mandatory gym classes in school, were all related to more involvement, whereas hours of paid work and TV-viewing were related to less. Furthermore, the data suggested that the influence of friend's participation in physical activity depends on his or her emotional significance. Influential others appeared to affect males and females in the same way. The meaning of the results and their implications for future research are discussed.

  9. Using local lexicalized rules to identify heart disease risk factors in clinical notes.

    Karystianis, George; Dehghan, Azad; Kovacevic, Aleksandar; Keane, John A; Nenadic, Goran


    Heart disease is the leading cause of death globally and a significant part of the human population lives with it. A number of risk factors have been recognized as contributing to the disease, including obesity, coronary artery disease (CAD), hypertension, hyperlipidemia, diabetes, smoking, and family history of premature CAD. This paper describes and evaluates a methodology to extract mentions of such risk factors from diabetic clinical notes, which was a task of the i2b2/UTHealth 2014 Challenge in Natural Language Processing for Clinical Data. The methodology is knowledge-driven and the system implements local lexicalized rules (based on syntactical patterns observed in notes) combined with manually constructed dictionaries that characterize the domain. A part of the task was also to detect the time interval in which the risk factors were present in a patient. The system was applied to an evaluation set of 514 unseen notes and achieved a micro-average F-score of 88% (with 86% precision and 90% recall). While the identification of CAD family history, medication and some of the related disease factors (e.g. hypertension, diabetes, hyperlipidemia) showed quite good results, the identification of CAD-specific indicators proved to be more challenging (F-score of 74%). Overall, the results are encouraging and suggested that automated text mining methods can be used to process clinical notes to identify risk factors and monitor progression of heart disease on a large-scale, providing necessary data for clinical and epidemiological studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Clinical outcomes of ERCP-related retroperitoneal perforations.

    Guerra, Francesco; Giuliani, Giuseppe; Coletta, Diego; Bonapasta, Stefano Amore; Levi Sandri, Giovanni Battista


    Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations represent rare but often severe conditions. While lesions with intraperitoneal perforation have an almost imperative indication to surgery, whether or not to manage retroperitoneal perforations surgically is still an area of debate. The aim of the present work was to review the available clinical evidence on the operatively and medically treated ERCP-related retroperitoneal perforations. From MEDLINE/PubMed databases 137 patients with retroperitoneal perforation were included from 12 studies that met the selection criteria for data investigation and analysis. Twenty-four patients were treated by prompt surgery; 113 were primarily managed conservatively and about 20% of these patients required surgery subsequently. Overall, the morbidity and mortality were 15.4% and 6.6%, respectively. Although most patients with retroperitoneal perforation may benefit from a non-operative management, a considerable number of patients fail to respond to medical treatment and require surgery afterwards. Identifying those patients who are at highest risk of poor outcome after conservative treatment should be considered a research priority.

  11. QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: importance of clinical, demographic and psychosocial factors



    Full Text Available Context Inflammatory bowel disease causes physical and psychosocial consequences that can affect the health related quality of life. Objectives To analyze the relationship between clinical and sociodemographic factors and quality of life in inflammatory bowel disease patients. Methods Ninety two patients with Crohn’s disease and 58 with ulcerative colitis, filled in the inflammatory bowel disease questionnaire (IBDQ-32 and a questionnaire to collect sociodemographic and clinical data. The association between categorical variables and IBDQ-32 scores was determined using Student t test. Factors statistically significant in the univariate analysis were included in a multivariate regression model. Results IBDQ-32 scores were significantly lower in female patients (P<0.001, patients with an individual perception of a lower co-workers support (P<0.001 and career fulfillment (P<0.001, patients requiring psychological support (P = 0.010 and pharmacological treatment for anxiety or depression (P = 0.002. A multivariate regression analysis identified as predictors of impaired HRQOL the female gender (P<0.001 and the perception of a lower co-workers support (P = 0.025 and career fulfillment (P = 0.001. Conclusions The decrease in HRQQL was significantly related with female gender and personal perception of disease impact in success and social relations. These factors deserve a special attention, so timely measures can be implemented to improve the quality of life of patients.

  12. Clinical analysis of characteristics and related factors of lung infections in patients with diabetic nephropathy undergoing hemodialysis%糖尿病肾病患者血液透析肺部感染临床特点与相关因素分析

    金洁娜; 林昭宇; 孙慧燕; 刘隽; 余玉慧


    目的:探讨糖尿病肾病血液透析合并肺部感染患者临床特征及危险因素,为临床诊治提供参考。方法回顾性分析2012年1月-2015年1月糖尿病肾病患者168例,所有患者临床资料完整,均实施血液透析治疗,统计患者感染率并分析病原学特点,对患者性别、年龄、透析时间、血红蛋白等相关因素实施单因素及多因素分析,总结危险因素。结果168例患者发生肺部感染40例,感染率为23.81%;共分离出51株病原菌,检出肺炎克雷伯菌及金黄色葡萄球菌最多,分别占33.33%及19.61%;相关因素分析显示,透析时间、血红蛋白、血清白蛋白、营养不良、空腹血糖、肾功能是糖尿病肾病血液透析患者发生肺部感染独立危险因素(P<0.05)。结论糖尿病肾病血液透析患者肺部感染率高,独立危险因素多,临床应加强营养补充、血糖控制、纠正贫血等措施,以降低感染率。%OBJECTIVE To investigate clinical characteristics and related factors of lung infections in hemodialysis for diabetic nephropathy ,so as to provide a reference for clinical treatment .METHODS A retrospective analysis was conducted on 168 cases of diabetic nephropathy treated from Jan .2012 to Jan .2015 .All patients had com-plete clinical data ,and hemodialysis treatment was performed .Statistical analysis of patient infection rate and etio-logical characteristics were made .Univariate and multivariate analyses of genders ,age ,duration of dialysis and hemoglobin were implemented to summarize risk factors .RESULTS Totally 40 cases out of 168 patients were diag-nosed with postoperative lung infections ,the infection rate was 23 .81% .The 40 patients were isolated with 51 pathogens , K lebsiella pneumoniae and Staphylococcus aureus were the main pathogen types accounting for 33 .33% and 19 .61% respectively .Univariate and multivariate analysis showed that the duration of

  13. [Vulvovaginitis: correlation with predisposing factors, clinical manifestations and microbiological studies].

    Fosch, S; Fogolín, N; Azzaroni, E; Pairetti, N; Dana, L; Minacori, H; Tita, I; Redona, M; Gribaudo, G


    Vaginitis (V) and bacterial vaginosis (BV) are one of the most common reasons the middle class patient has to consult a gynaecologist. The purpose of this work is to analyse samples of vaginal fluid targeting the infection etiology and its relationship to related factors: (intrauterine devices, contraceptive pills, condoms, use of antibiotics), symptoms and signs. From November 1, 2001 to October 30, 2003, a cross-section study was carried out of 400 nonpregnant, sexually active women in an age range of 15 to 55. Vaginal secretions were analysed by Gram and Giemsa stains and culturing was used. Interpreting: (1) normal--no observable changes, absence of the infecting agents studied here; (2) infected--changes observed: bacterial vaginosis, vaginal candidiasis (CV) and trichomoniasis (TC) and (3) imbalance in vagina ecology, with medium alterations (D). Results obtained: (1) normal: 209 (52.2%); infected: 115 (28.8%) including 13.5% VB, 12.5% CV, 2.8% TC, and (3) 76 (19%) with imbalance of vagina ecology. Bacterial vaginosis and flora imbalance were related to the use of intrauterine devices, and candidiasis to contraceptive pills and previous antibiotic use. The number of symptoms increased in patients with vaginal candidiasis and trichomoniasis.

  14. Loneliness and Its Related Factors among Elderly People in Yazd

    Mahmood Vakili


    Full Text Available Introduction: Old people appear to be most prone to loneliness and depression perhaps because of decrease in their ability in daily livings, increase in morbidity, loss of close ties caused by loss of friends and spouses. This study was conducted for investigation of the loneliness and its related factors in elderly people in Yazd. Methods: In this cross sectional study, 200 old people (over 60 years old from three zone; health centers, nursing home and retirement center by convenient sampling method. Data was collected by UCLA Loneliness Scale that was consisting of 20 items for loneliness measurement. Scores 41 and more defined as loneliness. Collected data was analyzed by proper statistical tests with SPSS software. Results: Results showed that 71 % of subjects had Not Feel Lonely, 24 % moderate and 5 % severe felling of loneliness. Factors such as level of education, marital status, numbers of daughter and sons, previous job, residence site, current job status, living in nursing home, insufficient income, place of praying, sleep quantity and quality of sleep and feeling of healthy were associated with  loneliness status (p < 0.05. Conclusion: Our findings showed loneliness is common in elderly that support needs for more investigations and attention to loneliness related factors, educational courses conduction for family to take care of their elders, preparing of recreational measures and social support groups to decrease the loneliness in old people and so they spend this period by good and healthy sensation. 

  15. Subjective sleep quality in perimenopausal women and its related factors

    Jianping Zhang; Fen Lia; Yongjie Lin; Qiu Sheng; Xuewen Yu; Xinwen Zhang


    Objective: To evaluate the sleep quality and its related factors among perimenopausal women. Methods: A self-designed questionnaire was administered to 506 perimenopausal women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scales (SDS), the Zung Self-Rating Anxiety (SAS) and the Modified Kupperman Index (KI). Data were analyzed by SPSS11.5. Results: The mean PSQI was 5.97±4.30.Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45~49 age group was the poorest and the 40~44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality. Conclusion:High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions should be taken to improve the sleep quality of perimenopausal women.

  16. Factors related to the performance of Specialized Dental Care Centers

    Flávia Christiane de Azevedo Machado


    Full Text Available The Specialized Dental Care Centers (SDCC have the mission to expand access to public medium complexity dental care and support the primary health care actions at this level of complexity. However, it is necessary to ensure the quality of services and to evaluate such services continuously to identify weaknesses and strengths that support the processes of leadership/management. Nevertheless, there is a dearth of studies on the assessment of oral health in specialized care that may indicate which factors should be investigated. Therefore, this integrated literature review sought to explore the plethora of publications on the evaluation of SDCC in the LILACS and MEDLINE data bases in October 2013 to identify factors possibly related to the performance of such health services. Thus, 13 references were included in this review pointing to forms of organization and management of work processes related to the creation of healthcare networks (operation of regulation centers and setting up of health consortiums. They include the contextual characteristics of the places where SDCCs are located (population size, Family Health Strategy coverage, Municipal Human Development Index, governance, governing capacity were factors that influenced the SDCCs performance.

  17. Factors relating to the perceived management of emergency situations

    Birkvad Rasmussen, Maria; Tolsgaard, Martin G; Dieckmann, Peter


    BACKGROUND: This study explored individual, team, and setting factors associated with the quality of management of in-hospital emergency situations experienced by former Advanced Life Support (ALS) course participants. METHODS: This study was a survey of former ALS course participants' long......-term experience of management of in-hospital, emergency situations. The survey was carried out in 2012 in Denmark and Norway. RESULTS: A questionnaire was send to 526 potential responders and (281/479 × 100) 58.7% responded. The results demonstrated that 75% of the emergency situations were perceived as "managed...... to apply ALS principles, the team atmosphere and communication. Responders' ratings of quality of management of emergency situations increased with intensity of setting. However, the 'clinical setting' was rated significantly lower as attributor to ability to apply ALS principles compared to 'co...

  18. Genomic Features of Environmental and Clinical Vibrio parahaemolyticus Isolates Lacking Recognized Virulence Factors Are Dissimilar.

    Ronholm, J; Petronella, N; Chew Leung, C; Pightling, A W; Banerjee, S K


    Vibrio parahaemolyticus is a bacterial pathogen that can cause illness after the consumption or handling of contaminated seafood. The primary virulence factors associated with V. parahaemolyticus illness are thermostable direct hemolysin (TDH) and Tdh-related hemolysin (TRH). However, clinical strains lacking tdh and trh have recently been isolated, and these clinical isolates are poorly understood. To help understand the emergence of clinical tdh- and trh-negative isolates, a genomic approach was used to comprehensively compare 4 clinical tdh- and trh-negative isolates with 16 environmental tdh- and trh-negative isolates and 34 clinical isolates positive for tdh or trh, or both, with the objective of identifying genomic features that are unique to clinical tdh- and trh-negative isolates. The prevalence of pathogenicity islands (PAIs) common to clinical isolates was thoroughly examined in each of the clinical tdh- and trh-negative isolates. The tdh PAI was not present in any clinical or environmental tdh- and trh-negative isolates. The trh PAI was not present in any environmental isolates; however, in clinical tdh- and trh-negative isolate 10-4238, the majority of the trh PAI including a partial trh1 gene was present, which resulted in reclassification of this isolate as a tdh-negative and trh-positive isolate. In the other clinical tdh- and trh-negative isolates, neither the trh gene nor the trh PAI was present. We identified 862 genes in clinical tdh- and trh-negative isolates but not in environmental tdh- and trh-negative isolates. Many of these genes are highly homologous to genes found in common enteric bacteria and included genes encoding a number of chemotaxis proteins and a novel putative type VI secretion system (T6SS) effector and immunity protein (T6SS1). The availability of genome sequences from clinical V. parahaemolyticus tdh- and trh-negative isolates and the comparative analysis may help provide an understanding of how this pathotype is able to

  19. Clinical profile of patients with nascent alcohol related seizures

    P Sandeep


    Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.

  20. Major Depression and Acute Coronary Syndrome-Related Factors

    Figueiredo, Jose Henrique Cunha; Silva, Nelson Albuquerque de Souza e; Pereira, Basilio de Bragança; de Oliveira, Glaucia Maria Moraes


    Background Major Depressive Disorder (MDD) is one of the most common mental illnesses in psychiatry, being considered a risk factor for Acute Coronary Syndrome (ACS). Objective To assess the prevalence of MDD in ACS patients, as well as to analyze associated factors through the interdependence of sociodemographic, lifestyle and clinical variables. Methods Observational, descriptive, cross-sectional, case-series study conducted on patients hospitalized consecutively at the coronary units of three public hospitals in the city of Rio de Janeiro over a 24-month period. All participants answered a standardized questionnaire requesting sociodemographic, lifestyle and clinical data, as well as a structured diagnostic interview for the DSM-IV regarding ongoing major depressive episodes. A general log-linear model of multivariate analysis was employed to assess association and interdependence with a significance level of 5%. Results Analysis of 356 patients (229 men), with an average and median age of 60 years (SD ± 11.42, 27-89). We found an MDD point prevalence of 23%, and a significant association between MDD and gender, marital status, sedentary lifestyle, Killip classification, and MDD history. Controlling for gender, we found a statistically significant association between MDD and gender, age ≤ 60 years, sedentary lifestyle and MDD history. The log-linear model identified the variables MDD history, gender, sedentary lifestyle, and age ≤ 60 years as having the greatest association with MDD. Conclusion Distinct approaches are required to diagnose and treat MDD in young women with ACS, history of MDD, sedentary lifestyle, and who are not in stable relationships. PMID:28443957

  1. Age-related distance esotropia: Clinical features and therapeutic outcomes.

    Gómez de Liaño Sánchez, P; Olavarri González, G; Merino Sanz, P; Escribano Villafruela, J C


    To describe the clinical characteristics and surgical outcomes of a group of patients with age-related distance esotropia (ARDE). A retrospective study was conducted on a consecutive case series of 16 adult patients diagnosed with ARDE between 2008 and 2015. The clinical features evaluated included mean age and gender, primary position deviations at distance and near, measured in prism dioptres (pd), treatment offered in each case, and post-surgical deviations. Ductions and versions were full, with no evidence of lateral rectus paresis. None of these patients had any obvious underlying neurological disorder, such as, high myopia or thyroid disease. A good result is considered to be the disappearance of diplopia in all positions of gaze. A total of 16 patients (11 females [68.8%]) were identified. The mean age at diagnosis was 78.19±6.77 years. The mean initial esodeviation was 2.25±3.08 pd at near (-4 to +8 pd) and 9.5±4.18 pd at distance (2 to 18 pd). Treatment was not necessary in 5 cases because the symptoms were intermittent or well-tolerated. Of the 11 patients with symptoms, one was corrected with an external base therapeutic prism. Botulinum toxin was administered in another patient, without satisfactory results. Unilateral medial rectus muscle recession was performed on one patient, and unilateral lateral rectus plication on 7 patients, indicating prisms before surgery. One patient refused surgery despite continuous diplopia in far vision. After a mean follow-up of 16.5 months, all operated patients were asymptomatic. Not all patients with ARDE require treatment, as the tolerance to diplopia varies from one subject to another. Both medial rectus weakening and lateral rectus strengthening provides excellent results. Crown Copyright © 2016. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis.

    Alvaro J Martínez-Valencia


    Full Text Available The determinants of parasite persistence or elimination after treatment and clinical resolution of cutaneous leishmaniasis (CL are unknown. We investigated clinical and parasitological parameters associated with the presence and viability of Leishmania after treatment and resolution of CL caused by L. Viannia.Seventy patients who were treated with meglumine antimoniate (n = 38 or miltefosine (n = 32 and cured, were included in this study. Leishmania persistence and viability were determined by detection of kDNA and 7SLRNA transcripts, respectively, before, at the end of treatment (EoT, and 13 weeks after initiation of treatment in lesions and swabs of nasal and tonsillar mucosa.Sixty percent of patients (42/70 had evidence of Leishmania persistence at EoT and 30% (9/30 13 weeks after treatment initiation. A previous episode of CL was found to be a protective factor for detectable Leishmania persistence (OR: 0.16, 95%CI: 0.03-0.92. kDNA genotyping could not discern differences between parasite populations that persisted and those isolated at diagnosis.Leishmania persist in skin and mucosal tissues in a high proportion of patients who achieved therapeutic cure of CL. This finding prompts assessment of the contribution of persistent infection in transmission and endemicity of CL, and in disease reactivation and protective immunity.

  3. Clinical, psychophysiological and psychological aspects of risk factors of periodontal disease development in clinically healthy persons

    I.N. Nikulina


    Full Text Available The research goal is to determine risk factors of periodontal disease development, psychophysiological personal types and their interrelations in clinically healthy persons. 47 first-year cadets of St.-Petersburg Military School of radio electronics have been examined. This group of respondents has been chosen by presence of such social stressor as change of place of living (97,9% cadets have arrived in St.-Petersburg from other cities and republics of the Russian Federation and strict disciplinary conditions. The research has revealed a low level of oral hygiene, cases of mild gingivitis in most respondents. The general mental state of group under study is characterized by raised level of personal anxiety and low indices of reactive anxiety. The examined group has demonstrated anxiety, tension, indecision and lowered stress stability. Clinically healthy persons are more liable to develop inflammatory and inflammatory-destructive periodontal diseases. It was possible to determine psychophysiological features correlated with physiological parameters of risk degree of periodontal diseases. It may have a great significance in defining of periodontal disease etiology and pathogenesis

  4. Functional state of knee arthritis patients and related factors

    Lee, Jiyeon; Kim, Jung-Hee; Chung, EunJung; Lee, Byoung-Hee


    [Purpose] The objective of this study is to provide a direction for efficient management of arthritis through the analysis of multiple factors related to the functional state of patients. [Subjects and Methods] The Visual Analog Scale, Knee Society Knee Score & Function Score, Hospital for Special Surgery, Short Form-36 Health Survey and Western Ontario McMaster Universities Osteoarthritis Index for a total of 135 patients with knee arthritis were determined with a survey. [Results] There is a significant correlation between age, pain, Knee Society Knee Score, Hospital for Special Surgery, Knee Society Function Score, and Western Ontario McMaster Universities Osteoarthritis Index score. [Conclusion] It is necessary to improve the factors that affect knee function and quality of life, and a study on knee joint muscle strength is suggested as a follow-up study. PMID:28265166

  5. Myocardin-related transcription factor regulates Nox4 protein expression

    Rozycki, Matthew; Bialik, Janne Folke; Speight, Pam


    TGFβ-induced expression of the NADPH oxidase Nox4 is essential for fibroblast-myofibroblast transition. Rho has been implicated in Nox4 regulation, but the underlying mechanisms are largely unknown. Myocardin-related transcription factor (MRTF), a Rho/actin polymerization-controlled coactivator...... translocation of MRTF. Because the Nox4 promoter harbors a serum response factor/MRTF cis-element (CC(A/T)6GG box), we asked if MRTF (and thus cytoskeleton organization) could regulate Nox4 expression. We show that Nox4 protein is robustly induced in kidney tubular cells exclusively by combined application...... of contact uncoupling and TGFβ. Nox4 knockdown abrogates epithelial-myofibroblast transition-associated reactive oxygen species production. Laser capture microdissection reveals increased Nox4 expression in the tubular epithelium also during obstructive nephropathy. MRTF down-regulation/inhibition suppresses...

  6. Clinical manifestations and prognostic factors of Morganella morganii bacteremia.

    Lin, T-Y; Chan, M-C; Yang, Y-S; Lee, Y; Yeh, K-M; Lin, J-C; Chang, F-Y


    Although Morganella morganii causes a variety of clinical infections, there are limited studies on M. morganii bacteremia after the year 2000. A total of 109 patients with M. morganii bacteremia at a medical center in Taiwan from 2003 to 2012 were studied. Among them, 30.3 % had polymicrobial bacteremia and 75.2 % had community-acquired infection. The most common underlying diseases were hypertension (62.4 %) and diabetes mellitus (38.5 %). The urinary tract (41.3 %) was the major portal of entry, followed by the hepatobiliary tract (27.5 %), skin and soft tissue (21.1 %), and primary bacteremia (10.1 %). Susceptibility testing of M. morganii isolates showed ubiquitous resistance to first-generation cephalosporins and ampicillin-clavulanate; resistance rates to gentamicin, piperacillin-tazobactam, and ciprofloxacin were 30.3 %, 1.8 %, and 10.1 %, respectively. Overall, the 14-day mortality was 14.7 %. Univariate analysis revealed that elevated blood urea nitrogen (BUN) values [p = 0.0137, odds ratio (OR) 5.26], intensive care unit (ICU) admission (p = 0.011, OR 4.4), and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (p < 0.001, OR 1.62) were significantly associated with mortality. The APACHE II score remained the only significant risk factor for mortality in multivariate analysis (p = 0.0012, OR 1.55). In conclusion, M. morganii bacteremia patients were mostly elderly, with one or more comorbidities. Most of the patients had community-acquired infection via the urinary and hepatobiliary tracts. Furthermore, prognosis can be predicted according to disease severity measured by the APACHE II score.

  7. Comparison of 5 health care professionals’ratings of the clinical significance of drug related problems

    Villesen, Christine; Hojsted, Jette; Kjeldsen, Lene Juel


    Background Patients have medicines reviews conducted by different health care professionals in different settings. Introducing a clinical panel to drug related problems (DRPs) to evaluate their clinical significance is common practice. The clinical panel discuss the potential consequences and com...

  8. Cultural Competence and Related Factors Among Taiwanese Nurses.

    Lin, Chin-Nu; Mastel-Smith, Beth; Alfred, Danita; Lin, Yu-Hua


    Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.

  9. Risk factors for osteoporosis and factors related to the use of DXA in Norway

    Høiberg, M. P.; Rubin, K. H.; Gram, J.


    UNLABELLED: To evaluate the case-finding strategy for osteoporosis in Norway, a questionnaire concerning risk factors for osteoporosis and history of osteodensitometry was mailed to a population-based cohort of 6000 men and 6000 women. Suboptimal examination rates among high risk and reallocation...... of scanning capacity to seemingly low-risk individuals was found. PURPOSE: In Norway, a case-finding strategy for osteoporosis has been used. No data exist regarding the efficacy of this approach. The aim was to examine the prevalence of risk factors for osteoporosis and factors related to the use of dual X......-ray absorptiometry (DXA) in Norway. METHODS: Questionnaires regarding previous history of DXA, risk factors for osteoporosis and fracture were sent to an age-stratified, nationwide cross-sectional sample of 6000 men and 6000 women aged 40-90 years, drawn from the Norwegian Civil Registration System. RESULTS: Valid...

  10. Mental Health Problems and Related Factors in Ecuadorian College Students

    Claudia Torres


    Full Text Available Although the mental health problems of college students have been the subject of increasing research, there are no studies about its prevalence in Ecuadorian college students. The aim of this study was to determine the mental health problems and their associated factors in Ecuadorian freshmen university students. A sample of 1092 students (53.7% women; mean age = 18.3 years were recruited from the Technical Particular University of Loja (Ecuador. Socio-demographic, academic, and clinical characteristics were gathered, as well as information on the participants’ mental health through a number of mental health screens. Prevalence of positive screens was 6.2% for prevalence of major depressive episodes, 0.02% for generalized anxiety disorders, 2.2% for panic disorders, 32.0% for eating disorders, 13.1% for suicidal risk. Mental health problems were significantly associated with sex, area of study, self-esteem, social support, personality and histories of mental health problems. The findings offer a starting point for identifying useful factors to target prevention and intervention strategies aimed at university students.

  11. The association of factor V Leiden with various clinical patterns of venous thromboembolism-the factor V Leiden paradox.

    Hirmerova, J; Seidlerova, J; Subrt, I


    Factor V Leiden (FVL) supposedly carries relatively higher risk of deep vein thrombosis (DVT), compared to the risk of pulmonary embolism (PE). To prove this paradox in a group of patients with various clinical presentation of venous thromboembolism (VTE). We retrospectively evaluated clinical pattern of VTE in patients who had been referred to vascular clinic shortly after an acute VTE event. In FVL positive and FVL negative groups we compared the prevalence of isolated symptomatic DVT (proximal or distal) and symptomatic PE with/without DVT, and, moreover, asymptomatic DVT or PE. Of 575 patients (mean age 57 years, 50.1% women), 120 were FVL positive and those had significantly higher prevalence of isolated symptomatic DVT, compared to symptomatic PE with/without DVT. Proximal DVT location was significantly more frequent in FVL carriers. The prevalence of asymptomatic PE did not differ between the two groups. The rate of asymptomatic DVT tended to be higher in FVL negative group. In a multivariate analysis, we confirmed FVL to be positively associated with isolated DVT presentation (odds ratio OR 1.757; 95% confidence interval (CI) 1.148-2.690). On the contrary, increasing age and unprovoked nature of VTE event carried a higher risk of symptomatic PE. We confirmed FVL to be significantly associated with isolated symptomatic DVT despite higher prevalence of proximal DVT in FVL carriers. The fact of relatively lower risk of PE in FVL positive patients might have clinical implication. However, mechanisms of FVL paradox remain to be elucidated. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email:

  12. Color-factor symmetry and BCJ relations for QCD amplitudes

    Brown, Robert W


    Tree-level $n$-point gauge-theory amplitudes with $n-2k$ gluons and $k$ pairs of (massless or massive) particles in the fundamental (or other) representation of the gauge group are invariant under a set of symmetries that act as momentum-dependent shifts on the color factors in the cubic decomposition of the amplitude. These symmetries lead to gauge-invariant constraints on the kinematic numerators. They also directly imply the BCJ relations among the Melia-basis primitive amplitudes previously obtained by Johansson and Ochirov.

  13. Celecoxib inhibits Helicobacter pylori colonization-related factors


    AIM:To investigate the effect of celecoxib,a selective COX-2 inhibitor,on Helicobacter pylori(H.pylori) colonization-related factors and its mechanism.METHODS:After co-incubation with celecoxib,morphology of H.pylori strain 26695 was observed under a transmission electron microscope.Flagella motility was assessed by stab agar motility test.Adherence of H.pylori to AGS cells was determined by enzyme linked immunosorbent assay.Levels of mRNA expression in flagellar genes(flaA,flaB),urease genes(ureA,ureB)and ...

  14. Auger relative sensitivivity factors for CdTe oxide

    P. Bartolo-Pérez; J. L. Peña; M.H. Farías


    The Auger lineshape of Te MNN in measurements of Auger spectra of CdTe oxide films with various degrees of oxidation was analyzed. By using standards from stoichiometric compounds, Auger relative sensitivity factors (RSF´s) of Cd, Te and O for CdTe oxide thin films were obtained. The value of the RFS of oxygen is about constant, 0.27-0.28, for the standard compound, CdO, TeO2 and CdTeO3 (considering the RSF of Cd as 1). However, the obtained RSF of Te changes from 0.69 in CdTe up to 0.87 in C...

  15. Work-related risk factors for suicidal behaviour, protective factors and possibilities for prevention

    Tina Podlogar


    Full Text Available Work is an important part of adult life. As such it is closely connected to health and mental health. Aspects of occupation, work and employment can represent risk factors for suicidal behaviour or protective factors against it. Aim of this article is to present the known work-related risk factors for suicidal behaviour, protective factors and possibilities for preventive activities in this context. An important risk factor for suicidal behaviour is unemployment. Connection between unemployment and suicidality is complex and can be explained in two ways: (i underlying vulnerability leads to both unemployment and suicidal behaviour, while (ii the connection is also thought be causal to some extent. The addressed topic is very important in the period of economic recession, when unemployment rates are high and adverse changes in terms of working conditions can occur. Different psycho-social and other working conditions are also connected to suicidal behaviour. Efficient preventive activities include approaches on multiple levels: active politics of solving economic crisis and improving the labour market conditions, creating and maintaining stimulating working conditions, raising awareness and mental health promotion among the employees, gatekeeper training, and restriction of means for suicide in occupations with access to them. Due to complexity of suicidal behaviour there is a need for further research, which would contribute to better understanding of specific risk factors and especially protective factors in vulnerable groups.

  16. Identification of Novel Clinical Factors Associated with Hepatic Fat Accumulation in Extreme Obesity

    Glenn S. Gerhard


    Full Text Available Objectives. The accumulation of lipids stored as excess triglycerides in the liver (steatosis is highly prevalent in obesity and has been associated with several clinical characteristics, but most studies have been based on relatively small sample sizes using a limited set of variables. We sought to identify clinical factors associated with liver fat accumulation in a large cohort of patients with extreme obesity. Methods. We analyzed 2929 patients undergoing intraoperative liver biopsy during a primary bariatric surgery. Univariate and multivariate regression modeling was used to identify associations with over 200 clinical variables with the presence of any fat in the liver and with moderate to severe versus mild fat accumulation. Results. A total of 19 data elements were associated with the presence of liver fat and 11 with severity of liver fat including ALT and AST, plasma lipid, glucose, and iron metabolism variables, several medications and laboratory measures, and sleep apnea. The accuracy of a multiple logistic regression model for presence of liver fat was 81% and for severity of liver fat accumulation was 77%. Conclusions. A limited set of clinical factors can be used to model hepatic fat accumulation with moderate accuracy and may provide potential mechanistic insights in the setting of extreme obesity.

  17. [Antibiotic resistance and virulence factors in clinical Salmonella enterica isolates].

    de Toro, María; Seral, Cristina; Rojo-Bezares, Beatriz; Torres, Carmen; Castillo, F Javier; Sáenz, Yolanda


    The increase of Salmonella enterica isolates multi-resistant to different antibiotics, including β-lactams and fluoroquinolones, is a problem of clinical importance. The dissemination of Salmonella Typhimurium resistant to ampicillin (AMP)-chloramphenicol (CHL)-streptomycin (STR)-sulphonamides and (SUL)-tetracycline (TET), that harbour the Salmonella Genomic Island type 1 (SGI1), and the acquisition of transferable genetic material have favoured the multi-resistance in this genus. A total of 114 clinical S.enterica isolates were studied (period 2009-2010). The susceptibility to 20 antibiotics was determined by disc diffusion and microdilution. The antimicrobial resistance mechanisms and the integrons were analysed by PCR, and sequencing in the AMP(R) isolates. In all the blaPSE-1-positive isolates, the clonal relationship was determined by PFGE, as well as the presence of SGI1 and 29 virulence genes by PCR. Eighteen different serotypes were found among the 114 isolates studied, Typhimurium (61%) and Enteritidis (16%) being the most prevalent. High percentages of resistance to SUL (68%), TET (58%), AMP (55%) and STR (46%) were observed. The great majority (92%) of 63 AMP(R) isolates were multi-resistant, with the AMP-STR-TET-SUL phenotype (19 isolates) being the most frequent one and associated with the blaTEM-1b+strA-strB+tet(B)+sul2 genotype. Class 1 integrons (7 different structures) were observed in 48% AMP(R) isolates, highlighting the blaOXA-1+aadA1 structure (8 isolates), one empty integron and non-classical integrons (5 isolates). The blaPSE-1 gene was detected inside the classical SGI1 structure in 13 clonally-related isolates that showed the same virulence profile. The high percentage of multi-resistant S.enterica isolates, especially associated to S.Typhimurium, to the AMP, STR, TET and SUL phenotype, and to the blaTEM-1b+strA-strB+tet(B)+sul2 genotype, shows an important risk of possible failures in the treatment of serious infections caused by this

  18. Clinical significance of soluble CD163 in polymyositis-related or dermatomyositis-related interstitial lung disease.

    Enomoto, Yasunori; Suzuki, Yuzo; Hozumi, Hironao; Mori, Kazutaka; Kono, Masato; Karayama, Masato; Furuhashi, Kazuki; Fujisawa, Tomoyuki; Enomoto, Noriyuki; Nakamura, Yutaro; Inui, Naoki; Suzuki, Daisuke; Ogawa, Noriyoshi; Nakashima, Ran; Mimori, Tsuneyo; Iwashita, Toshihide; Suda, Takafumi


    Macrophage activation is involved in the pathogenesis of polymyositis (PM)/dermatomyositis (DM). CD163, a scavenger receptor expressed on the surface of activated macrophages, mediates anti-inflammatory functions. This study aimed to evaluate the clinical significance of soluble CD163 (sCD163) in PM/DM-related interstitial lung disease (ILD). The main subjects were 48 patients with PM/DM-related ILD. As controls, 10 patients with PM/DM without ILD and 20 healthy volunteers were enrolled. In patients with PM/DM-related ILD, the baseline characteristics and clinical course were obtained through a review of patient medical records. Serum sCD163 levels at ILD diagnosis were quantified by enzyme-linked immunosorbent assay, which were compared with the other baseline clinical factors and evaluated for potential as a prognostic biomarker. In addition, immunohistochemistry analysis using anti-human CD163 antibody was performed on the lung sections of two patients with DM-related ILD (a survivor and non-survivor, respectively) and one patient with early-stage lung cancer as a normal control. The median value of serum sCD163 in patients with PM/DM-related ILD was 818 ng/mL, which was higher than that of PM/DM patients without ILD and healthy volunteers (716 ng/mL and 340 ng/mL, respectively). Significant but mild correlations with serum sCD163 levels were observed for serum C-reactive protein levels (r = 0.322) and % predicted forced vital capacity (r = -0.301) in patients with PM/DM-related ILD. A Cox proportional hazard model demonstrated that patients with PM/DM-related ILD and higher sCD163 levels had worse prognosis (age-adjusted and gender-adjusted hazard ratio per 100 ng/mL increase 1.27, 95% confidence interval 1.11-1.45, P CD163-positive macrophages was evident in the lungs of patients with DM-related ILD. Especially, the finding was more severe in the non-survivor's lung. Serum sCD163 might be a potential biomarker for predicting the severity and

  19. [Clinical application of neuroimaging to alcohol-related dementia].

    Matsui, Toshifumi; Sakurai, Hideki; Toyama, Tomomi; Yoshimura, Atsushi; Matsushita, Sachio; Higuchi, Susumu


    Alcohol-related dementia (ARD) is one of the most common dementing disorders in middle-aged people and occurs in heavy drinkers who are estimated to be 10 - 15 % of the adult men in a community. While the concept of ARD is multifactorial and includes all cognitive deficits in alcoholics, the central clinical manifestations are exemplified by Korsakoff's syndrome (KS), a persistent neuropsychiatric syndrome, characterized by amnesia and disorientation that is caused by thiamine deficiency along with excessive alcohol consumption. Antemortem detection of intracranial changes has been made possible by MRI and many studies have revealed that alcoholics have atrophic changes in frontal lobe, cerebellum, medial temporal lobe and hippocampus. However, these brain regions are vulnerable to excessive alcohol and seem to be independent of cognitive deficits in alcoholics. This review shows the regional differences in gray matter volumes between cognitively normal alcoholics and patients with KS. By employing a 3-dimensional MRI method for voxel-based morphometry that enables an automated, unbiased, comprehensive assessment, we demonstrate that parahippocampal/hippocampal atrophy is specific to KS and thalamic atrophy and the third ventricle enlargement are more severe in patients with KS than in cognitively normal alcoholics.

  20. Risk factors for pulmonary tuberculosis: a clinic-based case control study in The Gambia

    Adegbola Richard A


    Full Text Available Abstract Background The tuberculosis (TB epidemic in Africa is on the rise, even in low-HIV prevalence settings. Few studies have attempted to identify possible reasons for this. We aimed to identify risk factors for pulmonary tuberculosis in those attending a general outpatients clinic in The Gambia, a sub-Saharan African country with relatively low HIV prevalence in the community and in TB patients. Methods We conducted a case control study at the Medical Research Council Outpatients' clinic in The Gambia. Pulmonary TB cases were at least 15 years old, controls were age and sex matched clinic attendees. Participants were interviewed using a structured questionnaire. Results 100 sputum smear positive TB cases and 200 clinic controls were recruited. HIV prevalence was 6.1% in cases and 3.3% in controls. Multivariable assessment of host factors showed that risk of TB was increased among the Jola ethnic group and smokers, and decreased in those in a professional occupation. Assessment of environmental factors showed an increased risk with household crowding, history of household exposure to a known TB case, and absence of a ceiling in the house. In a combined multivariable host-environment model, the risk of TB increased with crowding, exposure to a known TB case, as well as amongst the Jola ethnic group. Conclusion In The Gambia, household crowding and past household exposure to a known TB case are the standout risk factors for TB disease. Further research is needed to identify why risk of TB seems to differ according to ethnicity.

  1. The Relation between Work-related Psychosocial Factors and the Development of Depression

    Netterstrøm, Bo; Conrad, Nicole; Bech, Per


    the evidence. Social support at work was associated with a decrease in risk for future depression, as all four studies dealing with this exposure showed  associations with relative risks of about 0.6. Even if this literature study has identified work-related psychosocial factors that in high......This review is based on a literature search made in January 2007 on request by the Danish National Board of Industrial Injuries. The search in PubMed, EMBASE, and PsycINFO resulted in more than 1,000 publications. This was reduced to 14 after the titles, abstracts, and papers were evaluated...... by using the following criteria: 1) a longitudinal study, 2) exposure to work-related psychosocial factors, 3) the outcome a measure of depression, 4) relevant statistical estimates, and 5) nonduplicated publication. Of the 14 studies, seven used standardized diagnostic instruments as measures...

  2. Infections caused by carbapenemase-producing Enterobacteriaceae: risk factors, clinical features and prognosis.

    Paño Pardo, José Ramón; Serrano Villar, Sergio; Ramos Ramos, Juan Carlos; Pintado, Vicente


    Infections caused by carbapenem-producing Enterobacteriaceae (CPE) can present as several infectious syndromes, but they primarily present as respiratory, urinary and blood stream infections (primary or catheter-related) that are usually found as nosocomial or healthcare-associated infections. The risk of CPE infection is influenced by individual factors, such as the length of the hospital stay and their exposure to invasive procedures and/or to antimicrobials. Of note, exposure to several antimicrobials, not only carbapenems, has been linked to CPE colonization; the duration of antibiotic exposure is one of the primary drivers of CPE acquisition. Individual risk factors must be considered jointly with the local epidemiology of these microorganisms in healthcare institutions. Overall, these infections have a high associated mortality. Mortality is influenced by host factors (e.g., age, comorbidity and immune deficiency), infection-related variables (e.g., type and severity of the infection) and treatment-related factors such as the delay in the initiation of appropriate antimicrobial therapy and the use or monotherapy or combined antimicrobial therapy. Gaining knowledge concerning the epidemiology, clinical features and prognostic features of CPE infection could be useful for improving infection prevention and for the management of patients with infections caused by these microorganisms.

  3. Factors associated with drug-related harms related to policing in Tijuana, Mexico.

    Volkmann, Tyson; Lozada, Remedios; Anderson, Christy M; Patterson, Thomas L; Vera, Alicia; Strathdee, Steffanie A


    To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs.

  4. Study Of Socio- Economic Factors In Relation To Leprosy

    Alam Mahjabeen


    Full Text Available Research question: what are the socio-economic factors in relation to leprosy and their implications? Objectives: (i To study the socio-economic factors in relation to leprosy.(ii To assess the impact of disease on patients’ job/income. Study design: Cross-sectional. Setting and Participants: Patients attending the dermatology OPD, J.N. Medical college hospital, A.M.U., Aligarh. Sample size: 200 leprosy patients. Study variables: education, occupation, social class, incapacitation, change in job, reduction in income. Statically analysis: Chi-square test Results: 46% of the leprosy patients were illiterate. A large majority of patients (78% were involved in heavy manual work as farmers and labourers. 68.5% patients belonged to low social classes (IV and V. More males (26.3% suffered from incapacitation than females (8.5%. 2.5% patients lost their job or were unable to work and 11.5% had to change their jobs due to the disease or disability caused by it. 17.5% patients had a history of reduction in their income after occurrence of leprosy.

  5. [Relations of landslide and debris flow hazards to environmental factors].

    Zhang, Guo-ping; Xu, Jing; Bi, Bao-gui


    To clarify the relations of landslide and debris flow hazards to environmental factors is of significance to the prediction and evaluation of landslide and debris flow hazards. Base on the latitudinal and longitudinal information of 18431 landslide and debris flow hazards in China, and the 1 km x 1 km grid data of elevation, elevation difference, slope, slope aspect, vegetation type, and vegetation coverage, this paper analyzed the relations of landslide and debris flow hazards in this country to above-mentioned environmental factors by the analysis method of frequency ratio. The results showed that the landslide and debris flow hazards in China more occurred in lower elevation areas of the first and second transitional zones. When the elevation difference within a 1 km x 1 km grid cell was about 300 m and the slope was around 30 degree, there was the greatest possibility of the occurrence of landslide and debris hazards. Mountain forest land and slope cropland were the two land types the hazards most easily occurred. The occurrence frequency of the hazards was the highest when the vegetation coverage was about 80%-90%.

  6. Age at Natural Menopause and Related Factors in Isfahan, Iran

    Golshiri, Parastoo; Abdollahzadeh, Mohammad Reza


    Objective This study was aimed to evaluate the age at natural menopause and related factors among women in a population based study in 2015 in Isfahan, Islamic Republic of Iran. Methods In this cross-sectional study 960 menopausal women were selected by cluster sampling. Demographic, socioeconomic, lifestyle behavior and reproductive history aspects were collected using a structured questionnaire. Woman and her husband's educational level and occupation with family income were the variables to construct socioeconomic status using principal component analysis. Results Mean and median of natural menopause age were 48.66 and 48 years, respectively. Women body mass index (BMI) more than 30 kg/m2 had significantly higher menopausal age than women with lower BMI (P value = 0.022). The mean of menopausal age was not statistically significant in regard to marital status, physical activity, smoking status, menarche age, age at first pregnancy and history of abortion. Menopause age with pregnancy numbers and age at last pregnancy had a significant positive association. Women with better socioeconomic status had significantly higher natural menopause age. Multiple linear regression shows significant relationship between lower age at menopause with higher age at marriage, higher number of pregnancy and lower socioeconomic status. Conclusion Age at menopause in our studied sample is similar to previous estimates reported for other Iranian populations. Age at marriage, higher number of pregnancy and lower socioeconomic status were the significant factors in relations to age at menopause. PMID:27617243

  7. Clinical characteristics and risk factors of symptomatic central venous catheter-related deep vein thrombosis in children%儿童中心静脉置管相关症状型深静脉血栓形成的临床特点和影响因素

    裴亮; 杨雨航; 杨妮; 文广富; 许巍; 刘春峰


    Objective To investigate the clinical features and risk factors in children with symptomatic central venous catheter-related deep vein thrombosis,and to provide guidence for clinical therapy.Methods The clinical data of 105 children with central venous catheter were retrospectively analyzed.According to the thrombosis or not,these children were classified into two groups:thrombosis group and non-thrombosis group.The risk factors influencing symptomatic central venous catheter-related deep vein thrombosis forming were identified by Logistic regression analysis.Results Among the 105 cases with central venous catheter,the male to female ratio was 68:37;age ranged from 8.5 months to 13 years old with average age(5.5 ±4.0) years old.There were 98 cases in non-thrombosis group and 7 cases in thrombosis group.Factors such as age[(5.7 ±4.1)years old vs.(2.5 ± 1.8) years old],central venous catheter dwell time[(6.1 ±2.3)d vs.(8.9 ± 2.1) d],more than 7 days parenteral nutrition application (11/98 cases vs.5/7 cases) and more than 7 days intravenous application of mannitol(7/98 cases vs.4/7 cases)were found significantly different between the thrombosis group and non-thrombosis group(P < 0.05).Multivariate Logistic regression analysis showed that more than 7 days parenteral nutrition application and intravenous mannitol were the risk factors of symptomatic central venous catheter-related deep vein thrombosis [OR =50.703 (95 % CI 3.258-789.056),OR =15.590 (95 % CI 1.196-203.146),P < 0.05].Conclusion Symptomatic central venous catheter-related deep vein thrombosis is a common complication of deep venous catheterization.It cause acute pulmonary embolism and some critical diseases,and influence the prognosis and prolong hospital stay.Application of intravenous nutrition more than 7 days and intravenous mannitol more than 7 days are the risk factors of symptomatic central venous catheter-related deep vein thrombosis.%目的 调查儿童中心静脉置管相关症状

  8. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Fuyou Guo


    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  9. Confirmatory Factor Analysis of WAIS-IV in a Clinical Sample: Examining a Bi-Factor Model

    Rachel Collinson


    Full Text Available There have been a number of studies that have examined the factor structure of the Wechsler Adult Intelligence Scale IV (WAIS-IV using the standardization sample. In this study, we investigate its factor structure on a clinical neuropsychology sample of mixed aetiology. Correlated factor, higher-order and bi-factor models are all tested. Overall, the results suggest that the WAIS-IV will be suitable for use with this population.

  10. Confirmatory Factor Analysis of WAIS-IV in a Clinical Sample: Examining a Bi-Factor Model

    Rachel Collinson; Stephen Evans; Miranda Wheeler; Don Brechin; Jenna Moffitt; Geoff Hill; Steven Muncer


    There have been a number of studies that have examined the factor structure of the Wechsler Adult Intelligence Scale IV (WAIS-IV) using the standardization sample. In this study, we investigate its factor structure on a clinical neuropsychology sample of mixed aetiology. Correlated factor, higher-order and bi-factor models are all tested. Overall, the results suggest that the WAIS-IV will be suitable for use with this population.

  11. Socio Demographic Factors Related to Smoking among Rural Adolescent

    Farzana Islam Khan


    Full Text Available Background: Smoking is one of the leading preventable causes of premature death, disease, and disability. Adolescence is the period of physical, psychological and social maturation from childhood to adulthood and adolescent smoking is a continuous process which is related to many disease factors. Objective: To find out the factors related to smoking among rural adolescents. Materials and method: One hundred and fifty one male adolescent aged 13 to 19 years from rural areas were interviewed with a semi-structured questionnaire during January to June 2013, at Dhamrai Upazilla Health Complex, Savar, Dhaka, Bangladesh. The socio demographic details, smoking and depression history were recorded. The Center for Epidemiologic Studies Depression (CES-D Scale was used to measure the presence of depression. Smoking behavior was measured by a number of questions. Results: Mean(±SD age of the study subjects was 16.8(±1.9 years. Most of the respondents started smoking around the average age of 14.3 years. The study shows that 64% respondents were smokers. Among smokers 80% were influenced by their friends about smoking. Seventy eight percent of the smokers were suffering from depression while 22% of nonsmokers were depressed (p<0.001. Majority (72% of the issues of the smoker parents were smoker (p<0.5. Domestic violence (p<0.001 and stressful events in life (p<0.05 also played significant roles for smoking. Conclusion: Depression, parent smoking and peer smoking, domestic violence, and stressful life events are important factors to start smoking in rural adolescents.

  12. Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review.

    Le Floch, B; Bastiaens, H; Le Reste, J Y; Lingner, H; Hoffman, R D; Czachowski, S; Assenova, R; Koskela, T H; Klemenc-Ketis, Z; Nabbe, P; Sowinska, A; Montier, T; Peremans, L


    Looking at what makes General Practitioners (GPs) happy in their profession, may be important in increasing the GP workforce in the future. The European General Practice Research Network (EGPRN) created a research team (eight national groups) in order to clarify the factors involved in GP job satisfaction throughout Europe. The first step of this study was a literature review to explore how the satisfaction of GPs had been studied before. The research question was "Which factors are related to GP satisfaction in Clinical Practice?" Systematic literature review according to the PRISMA statement. The databases searched were Pubmed, Embase and Cochrane. All articles were identified, screened and included by two separate research teams, according to inclusion or exclusion criteria. Then, a qualitative appraisal was undertaken. Next, a thematic analysis process was undertaken to capture any issue relevant to the research question. The number of records screened was 458. One hundred four were eligible. Finally, 17 articles were included. The data revealed 13 subthemes, which were grouped into three major themes for GP satisfaction. First there were general profession-related themes, applicable to many professions. A second group of issues related specifically to a GP setting. Finally, a third group was related to professional life and personal issues. A number of factors leading to GP job satisfaction, exist in literature They should be used by policy makers within Europe to increase the GP workforce. The research team needs to undertake qualitative studies to confirm or enhance those results.

  13. Musculoskeletal Disorders and Their Related Risk Factors Among Iranian Nurses



    Full Text Available Background Work-related musculoskeletal disorders (MSDs are one of the most occupational problems among nurses and often cause many physical and psychological complications for nurses, and are a financial burden for health-care systems. Objectives The aim of this study was to determine the prevalence MSDs and their related risk factors among Iranian nurses. Patients and Methods This descriptive-correlational study included 240 hospital nurses, with a baccalaureate nursing degree, who worked at three public hospitals of the Ilam province of Iran. Data were collected through a validated self-administered questionnaire. Finally, 156 questionnaires were returned (response rate: 65% and 135 questionnaires qualified for subsequent analysis. The data were analyzed using the SPSS version 15.0 software. Descriptive and inferential statistics (logistic regression were used. Results Overall, 97 (71.9% hospital nurses experienced MSDs in at least one anatomical site within the last year. Low back pain was the most prevalent MSDs (40% and hip and thigh were the least (11.1% frequent sites. Most of the nurses with MSDs worked at surgery wards (17.8%, emergency (15.6% and intensive care units (12.6%. Pain (48.1% and cramps (31.9% were the most frequent symptoms of MSDs and loss of limbs control (5.9% was the least frequent symptom. Bend or twist at waist for performing nursing procedures, patient transfer from and to beds, working with the hands higher than shoulder height and changing position of patients in beds were the most frequent occupational factors that influenced MSDs. Increased age, weight, height, body mass index (BMI and gender had no significant association with MSDs. However, being single and involved in any kinds of physical activity were significantly associated with the prevalence of MSDs (P < 0.05. Conclusions The study findings indicated high prevalence of worked-related MSDs among Iranian hospital nurses. Accordingly, appropriate policies

  14. Somewhere in tertiary hospital clinical laboratory in pursuance of personnel sharp injury incidence status investigation and relative factor analysis%某地三级医院检验科采血人员锐器伤影响因素分析

    丁娥; 李卫华; 王萍; 菅向东


    目的 调查某地三级医院检验科采血人员锐器伤发病现况及影响因素,分析其原因并探讨其控制策略.方法 选择山东省10家三级医院检验科采血人员l 198人,用横断面调查的方法,调查采血人员的职业暴露因素、组织管理因素、个人认知情况等,以x2检验及多因素Logistic回归分析方法分析数据.结果 采血工作环境中存在接触注射针头、玻璃等锐器、接触噪音、接触化学物、接触患者的血液等生物标本、接触高危人群、患者及家属负面情绪、遭受患者及家属埋怨等相关的影响因素.在组织管理因素中,以工作强度大、防护用具不足为最不满意;医务人员对职业暴露的个人认知能力因素方面,未能遵守医疗护理规范操作及发生暴露后未能及时正确处理并上报发生率较高.三级医院检验科采血人员锐器伤的发生率与岗位、超负荷工作、锐器接触、防护用具是否完善、医疗废弃物安全处置5种因素.结论 三级医院检验科采血人员锐器伤的发生率与多种因素相关,医院应制定相应的规章制度,改善工作环境,规范安全操作,以降锐器伤的发生率.%Objective Investigation in tertiary hospital clinical laboratory in pursuance of the current state of the sharp injury incidence and influencing factors,analyze the causes and discuss the control strategy.Methods Application of cross-sectional survey method,according to the unified investigation questionnaire investigation,with chi-square test and the multi-factor Logistic regression analysis methods to analyze research data.Results The work environment exit contact with injection needles,glass and other sharps,contact with noise,contact with chemicals,contact the patient's blood and other biological specimens,high-risk groups,the patient and family to negative emotions,by patients and their families complain or abuse related influencing factors.In the organization and

  15. Clinical examination findings as prognostic factors in low back pain

    Hartvigsen, Lisbeth; Kongsted, Alice; Hestbaek, Lise


    BACKGROUND: There is a strong tradition of performing a clinical examination of low back pain (LBP) patients and this is generally recommended in guidelines. However, establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more...... been investigated in confirmatory studies and study quality is generally low. There is a need for hypothesis testing studies designed specifically to investigate the prognostic value of the clinical tests, and a need for standardization of the performance and interpretation of tests....

  16. Factors Related in Suicide Attempts in Admitted Poisoned Patients

    Bita Dadpour


    Full Text Available Introduction Suicide is considered as a public health problem. Approximately 0.9% of all deaths worldwide are due to suicide. This study was performed to identify risk factors of suicide attempts among patients who admitted in a medical toxicology centre during three months. Materials and Methods: A cross sectional study was carried out; all admitted patients in our medical toxicology centre due to suicidal attempt who completed consent form were included from December to March 2013. A researcher designed questionnaire was prepared and its validity and reliability was confirmed; it was fulfilled by a psychologist via clinical interview. Data were analyzed by SPSS software 11.5 and results were discussed. Results:198 participants included; of whom 67.2% were female and 94.9% were less than 45 year old. Among the patients, approximately 48% of the patients were married; 27.77% were employed. More than 96% suffered from severe depression, 3.53% of the patients had psychotic symptoms. Personality disorders, previous suicidal attempt, unemployment, full stressed family, family history of suicidal attempt, moderate to severe depression and a history of dependence on antipsychotic drugs and lack of family support were identified as risk factors for suicide. Conclusion: Attention to personality trait  and family environment can be mainly effective in long-term prevention of suicide, treatment of physical illness in patients with chronic health conditions, evaluation and treatment of psychiatric issues in addition to family and social problems, and organizing educational courses  to families with suicide history can be helpful.

  17. Delays and Factors Related to Cessation of Generalized Convulsive Status Epilepticus

    Leena Kämppi


    Full Text Available Introduction. This study was designed to identify the delays and factors related to and predicting the cessation of generalized convulsive SE (GCSE. Methods. This retrospective study includes 70 consecutive patients (>16 years diagnosed with GCSE and treated in the emergency department of a tertiary hospital over 2 years. We defined cessation of SE stepwise using clinical seizure freedom, achievement of burst-suppression, and return of consciousness as endpoints and calculated delays for these cessation markers. In addition 10 treatment delay parameters and 7 prognostic and GCSE episode related factors were defined. Multiple statistical analyses were performed on their relation to cessation markers. Results. Onset-to-second-stage-medication (p=0.027, onset-to-burst-suppression (p=0.005, and onset-to-clinical-seizure-freedom (p=0.035 delays correlated with the onset-to-consciousness delay. We detected no correlation between age, epilepsy, STESS, prestatus period, type of SE onset, effect of the first medication, and cessation of SE. Conclusion. Our study demonstrates that rapid administration of second-stage medication and early obtainment of clinical seizure freedom and burst-suppression predict early return of consciousness, an unambiguous marker for the end of SE. We propose that delays in treatment chain may be more significant determinants of SE cessation than the previously established outcome predictors. Thus, streamlining the treatment chain is advocated.

  18. Nurses’ working motivation sources and related factors: A questionnaire survey

    Said Bodur


    Full Text Available Background: Motivation is an important issue for personnel management in health care settings, as it is related to both performance and intention to quit. Objectives: The study was aimed to determine nurses’ working motivation sources and related factors in hospitals. Design: Descriptive study. Settings: A state university hospital and a public hospital in Turkey. Participants: Two hundred and two nurses were randomly selected from each department in a university and in a public hospital. Methods: Data were collected using a socio-demographic questionnaire and the Motivation Sources Inventory and were analyzed using descriptive and inferential statistics. Results: Among five motivation sources, internal self-concept-based motivation was the highest and intrinsic process motivation was the lowest in nurses. There was a significant relation between scores of some motivation sources and managerial experience, income level, satisfaction from the unit, staff roles, and perception of work stress. Conclusions: Intrinsic process motivation, instrumental motivation, and external self-concept-based motivation sources may be improved to increase nurses’ total motivation.

  19. Clinical risk factors, DNA variants, and the development of type 2 diabetes

    Lyssenko, Valeriya; Jonsson, Anna Elisabet; Almgren, Peter;


    Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts.......Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts....

  20. Time of elevation of head of bed for patients receiving mechanical ventilation and its related factors.

    Martí-Hereu, L; Arreciado Marañón, A


    The semirecumbent position is a widespread recommendation for the prevention of pneumonia associated with mechanical ventilation. To identify the time of elevation of head of bed for patients under mechanical ventilation and the factors related to such elevation in an intensive care unit. An observational, descriptive cross-sectional study. Conducted in an intensive care unit of a tertiary hospital from April to June 2015. The studied population were mechanically ventilated patients. Daily hours in which patients remained with the head of the bed elevated (≥30°), socio-demographic data and clinical variables were recorded. 261 head elevation measurements were collected. The average daily hours that patients remained at ≥30° was 16h28' (SD ±5h38'), equivalent to 68.6% (SD ±23.5%) of the day. Factors related to elevations ≥30° for longer were: enteral nutrition, levels of deep sedation, cardiac and neurocritical diagnostics. Factors that hindered the position were: sedation levels for agitation and abdominal pathologies. Sex, age and ventilation mode did not show a significant relationship with bed head elevation. Although raising the head of the bed is an easy to perform, economical and measurable preventive measure, its compliance is low due to specific factors specific related o the patient's clinical condition. Using innovations such as continuous measurement of the head position helps to evaluate clinical practice and allows to carry out improvement actions whose impact is beneficial to the patient. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Association of Serum Phosphate and Related Factors in ESRD-Related Vascular Calcification

    Cai-Mei Zheng


    Full Text Available Vascular calcification is common in ESRD patients and is important in increasing mortality from cardiovascular complications in these patients. Hyperphosphatemia related to chronic kidney disease is increasingly known as major stimulus for vascular calcification. Hyperphosphatemia and vascular calcification become popular discussion among nephrologist environment more than five decades, and many researches have been evolved. Risk factors for calcification are nowadays focused for the therapeutic prevention of vascular calcification with the hope of reducing cardiovascular complications.

  2. Oral health-related quality of life of removable partial denture wearers and related factors.

    Shaghaghian, S; Taghva, M; Abduo, J; Bagheri, R


    This study aims to investigate the oral health-related quality of life (OHRQoL) in a group of removable partial denture (RPD) wearers in Shiraz (Iran), using the Persian version of the Oral Health Impact Profile (OHIP-14). Two hundred removable partial denture wearers had completed a questionnaire regarding patients' demographic characteristics and denture-related factors. In addition, the OHIP-14 questionnaire was filled out by interviewing the patients. Two measures of interpreting the OHIP-14 scales were utilised: OHIP-14 sum and OHIP-14 prevalence. The relationship of the patients' demographic characteristics and denture-related factors, with their OHRQoL was investigated. The mean OHIP-14 sum and OHIP-14 prevalence of RPD wearers were 13·80 (±10·08) and 44·5%, respectively. The most problematic aspects of OHIP-14 were physical disability and physical pain. Twenty-seven percentage and 24% of participants had reported meal interruption and eating discomfort, respectively. OHIP-14 prevalence and OHIP-14 sum were found to be significantly associated with factors representing RPD wearer's oral health such as self-reported oral health and frequency of denture cleaning. Furthermore, OHIP-14 prevalence and OHIP-14 sum were significantly associated with factors related to frequency of denture use such as hours of wearing the denture during the day and wearing the denture while eating and sleeping. Therefore, it can be concluded that the OHRQoL of the patients of the study was generally not optimal and found to be strongly associated with oral health.

  3. [Quality-of-life-related factors in adolescents].

    Lima-Serrano, Marta; Martínez-Montilla, José Manuel; Guerra-Martín, María Dolores; Vargas-Martínez, Ana Magdalena; Lima-Rodríguez, Joaquín S


    To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools. Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05). The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index. The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Factors related to posttraumatic stress disorder in adolescence.

    Nooner, Kate B; Linares, L Oriana; Batinjane, Jessica; Kramer, Rachel A; Silva, Raul; Cloitre, Marylene


    Studies of posttraumatic stress disorder (PTSD) in adolescence published from 2000 to 2011 indicate that adolescents are at greater risk of experiencing trauma than either adults or children, and that the prevalence of PTSD among adolescents is 3-57%. Age, gender, type of trauma, and repeated trauma are discussed as factors related to the increased rates of adolescent PTSD. PTSD in adolescence is also associated with suicide, substance abuse, poor social support, academic problems, and poor physical health. PTSD may disrupt biological maturational processes and contribute to the long-term emotion and behavior regulation problems that are often evident in adolescents with the disorder. Recommendations are presented for practice and research regarding the promotion of targeted prevention and intervention services to maximize adolescents' strengths and minimize vulnerabilities. Public policy implications are discussed.

  5. Effect of allopurinol combined with Tongfengding capsule on inflammatory factors, hepatorenal functions and related indicators in gouty patients

    Li Tang


    Objective:To observe the effects of allopurinol combined with Tongfengding capsule on inflammatory factors, hepatorenal functions and the related indicators in gouty patients, for helping clinical treatment of gouty patients.Methods:A total of 180 gouty patients in our hospital were selected and randomly divided into observation group and control group, 90 cases in each group. Control group was treated with conventional therapy and allopurinol therapy, observation group was treated with allopurinol combined with Tongfengding capsule based on conventional therapy, the changes of inflammatory factors, hepatorenal functions and the related indicators were detected before and after treatment.Results:The difference of inflammatory factors, hepatorenal functions and the related indicators in the two groups before treatment was not statistically significant (P>0.05). Inflammatory factors (IL-6, IL-8, TNF-α and CRP), hepatorenal functions (ALT, AST, BUN and Cr) and gout related indicators (ESR, UA, 24 h urine protein and XOD) in observation group after treatment significantly decreased compared with that before treatment. Inflammatory factors, hepatorenal functions and gout related indicators in control group after treatment significantly decreased (P<0.05). Inflammatory factors, hepatorenal functions and gout related indicators in observation group after treatment decreased more significantly than that in control group (P<0.05).Conclusions:Allopurinol combined with Tongfengding capsule could improve inflammatory factors, hepatorenal functions and the related indicators in gouty patients, and help clinical treatment of gouty patients.

  6. Nosocomial infections and related factors in southern khorasan hospitals

    Bita Bijari


    Full Text Available Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission.Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patient with nosocomial infections diagnosis in hospitals with more than 100 beds in South Khorasan. This questionnaire conation demographic characteristic of patients, department, duration of admission, kind of pathogen and risk factors that was designed according to standard questionnaire of Iranian Nasocomial infections surveillance system (INIS of Center for communicable Disease Control, Ministry of Health. Data were analyzed with SPSS 16 software. Results and discussion: Number of patients with nosocomial infection was 358. The incidence of nosocomial infection was 0.9%. ICU had the highest incidence rate (17.3%. The most common nosocomial infection was pneumonia (43%, and urinary tract infection (UTI (15.1%. In 33.5% culture result were negative. In other cases, culture results showed klebsiella spp. (12.8% and Pseudomonas aeruginosa (9.8% were the most prevalent bacteria. Most factors associated with nosocomial infection in patients were urinary catheters (70.4%, suction (66.8% and tracheal tube (54.2%. 24% of patients expired. The results showed lower ratio of nosocomial infection, that the main reason is failure to detection and reporting of actual cases of nosocomial infection. Promoting detection and reporting system for Prevention and control of nosocomial infection was recommended

  7. Nursing Diagnosis of overweight and related factors in adolescents

    Caroline Evelin Nascimento Kluczynik Vieira


    Full Text Available Objective.The objective of the study was to compare the related factors to the nursing diagnosis (ND of overweight in adolescents with and without overweight. Methodology. Transversal study conducted in 2013 with 347 adolescents that attended public schools in Natal, Rio Grande do Norte, Brazil, answered a questionnaire and had anthroprometric evaluation. The subjects were divided into two groups, the group without ND (n=247 and the group with ND (n=100. Results. The prevalence of adolescents with ND overweight was 28.8%. The groups presented an unsatisfactory frequency of physical activity and a low consumption of healthy foods. The group with the ND overweight showed greater chance of consuming sweets and fried foods. The group with ND overweight had higher frequency of history family of illnesses. Conclusion. The prevalence of the ND overweight among adolescents in the public schools of Natal constitute a relevant nutritional deviance and the associated factors diet and family history disease are an alert for nursing in activities of prevention and follow-up for this population.

  8. Smoking and Its Related Factors Among Iranian High School Students

    Chaman, Reza; Khosravi, Ahmad; Sajedinejad, Sima; Nazemi, Saeed; Fereidoon Mohasseli, Khadije; Valizade, Behzad; Vahedi, Hamid; Hosseinzadeh, Ehsan; Amiri, Mohammad


    Background: In different studies, the prevalence of tobacco consumption has been growing in high schools boys. Objectives: This study was conducted to determine the prevalence of smoking and its related factors among Iranian high school students in 2011. Materials and Methods: In this cross-sectional study, 450 male students from 15 high schools of Shahroud (northeast of Iran) were selected for evaluation of the knowledge, attitude and practices (KAP) of students regarding tobacco consumption. Results: Overall, 51% (95% CI: 46.5 - 55.7) of the students had positive history of smoking for at least one time and 7.1% (95% CI: 5 - 10) of them were current smokers. The most prevalent source of information about smoking was TV and radio programs (48%) and friends were the second source (22%). Based on the students’ opinions, entertainment and smoker friends were the most important reasons for smoking tendency. There was significant statistical association between students smoking and positive family history of smoking (P value < 0.05). Conclusions: The prevalence of smoking experince was very high among high school students. The most prevalent source of information about smoking was Iranian broadcasting companies. Positive family history of smoking and smoker friends were the important motivating factors toward smoking. PMID:26834798

  9. Factors Related to Social Support in Neurological and Mental Disorders.

    Kamenov, Kaloyan; Cabello, Maria; Caballero, Francisco Félix; Cieza, Alarcos; Sabariego, Carla; Raggi, Alberto; Anczewska, Marta; Pitkänen, Tuuli; Ayuso-Mateos, Jose Luis


    Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality.

  10. Factors Related to Social Support in Neurological and Mental Disorders.

    Kaloyan Kamenov

    Full Text Available Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality.

  11. Post-operative pain after knee arthroscopy and related factors.

    Drosos, G I; Stavropoulos, N I; Katsis, A; Kesidis, K; Kazakos, K; Verettas, D-A


    The aim of this study was to explore the intensity of post-arthroscopy knee pain during the first 24 hours, and to study the influence of pre-operative pain, tourniquet time and amount of surgical trauma on post-arthroscopy pain. In 78 male patients that underwent elective arthroscopic menisectomy or diagnostic arthroscopy of the knee, preoperative and post-operative pain were registered using the Visual Analogue Scale. Variance for repeated measures and for independent observations was analysed. Supplementary analgesia was required for 23% of the patients, more often in the recovery room and between 2 and 8 hours postoperatively. Of all factors analyzed, only time was statistically significant in determining the level of post-operative pain. Supplementary analgesia was required only in patients that underwent operative arthroscopy, and more often in patients with tourniquet time of more than 40 minutes. In conclusions, post-operative time is the most significant factor related to the post-arthroscopy knee pain.

  12. Post-Operative Pain after Knee Arthroscopy and Related Factors

    Bharat Sutariya


    Full Text Available Objectives: The aim of this study was to explore the intensity of post-arthroscopy knee pain during the first 24 hours, and to study the influence of pre-operative pain, tourniquet time and amount of surgical trauma on post-arthroscopy pain. Methods: In 78 male patients that underwent elective arthroscopic menisectomy or diagnostic arthroscopy of the knee, preoperative and post-operative pain was registered using the Visual Analogue Scale. Variance for repeated measures and for independent observations was analysed. Results: Supplementary analgesia was required for 23% of the patients, more often in the recovery room and between 2 and 8 hours postoperatively. Of all factors analyzed, only time was statistically significant in determining the level of post-operative pain. Supplementary analgesia was required only in patients that underwent operative arthroscopy, and more often in patients with tourniquet time of more than 40 minutes. Conclusion: In conclusions, post-operative time is the most significant factor related to the post-arthroscopy knee pain. [Natl J Med Res 2014; 4(1.000: 75-78

  13. Clinical characteristics of cervicogenic-related dizziness and vertigo.

    Yacovino, Dario A; Hain, Timothy C


    Cervical vertigo has long been a controversial entity and its very existence as a medical entity has advocates and opponents. Supporters of cervical vertigo claim that its actual prevalence is underestimated due to the overestimation of other diagnostic categories in clinics. Furthermore, different pathophysiological mechanisms have been attributed to cervical vertigo. Here the authors discuss the clinical characteristics of rotational vertebral artery vertigo, postwhiplash vertigo, proprioceptive cervical vertigo, and cervicogenic vertigo of old age. A clinical entity named subclinical vertebrobasilar insufficiency appears in the context of cervical osteoarticular changes. Migraine-associated vertigo may explain why some patients suffering from cervical pain have vertigo while others do not.

  14. Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.

    Gómez-Gómez, E; Ramírez, M; Gómez-Ferrer, A; Rubio-Briones, J; Iborra, I; J Carrasco-Valiente; Campos, J P; Ruiz-García, J; Requena-Tapia, M J; Solsona, E


    To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain. Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain. A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure. Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Short-term mortality and prognostic factors related to status epilepticus

    Fernando Gustavo Stelzer


    Full Text Available Objective Status epilepticus (SE is associated with significant morbidity and mortality, and there is some controversy concerning predictive indicators of outcome. Our main goal was to determine mortality and to identify factors associated with SE prognosis. Method This prospective study in a tertiary-care university hospital, included 105 patients with epileptic seizures lasting more than 30 minutes. Mortality was defined as death during hospital admission. Results The case-fatality rate was 36.2%, which was higher than in previous studies. In univariate analysis, mortality was associated with age, previous epilepsy, complex focal seizures; etiology, recurrence, and refractoriness of SE; clinical complications, and focal SE. In multivariate analysis, mortality was associated only with presence of clinical complications. Conclusions Mortality associated with SE was higher than reported in previous studies, and was not related to age, specific etiology, or SE duration. In multivariate analysis, mortality was independently related to occurrence of medical complications.

  16. Conversion during thoracoscopic lobectomy: related factors and learning curve impact.

    Smith, David E; Dietrich, Agustin; Nicolas, Matias; Da Lozzo, Alejandro; Beveraggi, Enrique


    Video-assisted thoracoscopic surgery (VATS) lobectomy has become a standard procedure for lung cancer treatment. Conversion-related factors and learning curve impacts, were poorly described. The aim of this study was to review the reasons and related factor for conversion in VATS lobectomy and the impact on this of the surgeon's learning curve. From June 2009 to May 2014, 154 patients who underwent a VATS lobectomy were included in our study. Patients' characteristics, pathology background, operative times, overall length of stay, overall morbidity and type of major complications were recorded for all patients and compared between non converted (n = 133) and converted (n = 21) patients. To evaluate surgeon's learning curve, we analyzed rates and causes of conversion in the first period (first 77 patients) and in the last period (78-154 patients). Patients characteristics were similar between converted and non-converted groups. Patients who were converted to open thoracotomy presented more frecuently tumors >3 cms (P = 0.02). The average of operative times and the length of stay were not significantly different between groups. Overall morbidity and major complications were also similar in both groups. There were no impact of surgeon's learning curve in overall rate conversion in both groups. Emergency conversion was always secondary to vascular accidents, all in the first group (p = 0.059). Surgeons should be expecting to perform a conversion to a thoracotomy in patients who present in preoperative studies, tumors greater than 3 cms. Learning curve only affected the emergency conversion, occurred all in the first half of our series.

  17. Parkinson's disease-related fatigue: A case definition and recommendations for clinical research.

    Kluger, Benzi M; Herlofson, Karen; Chou, Kelvin L; Lou, Jau-Shin; Goetz, Christopher G; Lang, Anthony E; Weintraub, Daniel; Friedman, Joseph


    Fatigue is one of the most common and disabling symptoms in Parkinson's disease (PD). Since fatigue was first described as a common feature of PD 20 years ago, little progress has been made in understanding its causes or treatment. Importantly, PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. In response, the Parkinson Disease Foundation and ProjectSpark assembled an international team of experts to create recommendations for clinical research to advance this field. The working group identified several areas in which shared standards would improve research quality and foster progress including terminology, diagnostic criteria, and measurement. Terminology needs to (1) clearly distinguish fatigue from related phenomena (eg, sleepiness, apathy, depression); (2) differentiate subjective fatigue complaints from objective performance fatigability; and (3) specify domains affected by fatigue and causal factors. We propose diagnostic criteria for PD-related fatigue to guide participant selection for clinical trials and add rigor to mechanistic studies. Recommendations are made for measurement of subjective fatigue complaints, performance fatigability, and neurophysiologic changes. We also suggest areas in which future research is needed to address methodological issues and validate or optimize current practices. Many limitations in current PD-related fatigue research may be addressed by improving methodological standards, many of which are already being successfully applied in clinical fatigue research in other medical conditions (eg, cancer, multiple sclerosis). © 2016 International Parkinson and Movement Disorder Society.

  18. Clinical factors and biomarkers in ovarian tumors development.

    Vrabie, Camelia Doina; Petrescu, Angela; Waller, Maria; Dina, I


    Ovarian cancer is a disease difficult to detect in early stages due to nonspecific symptoms and has a rapid progression with frequent relapses after radical surgical procedure. For these reasons, ovarian cancer generally represents the fourth cause of death through cancer in females, while in our country it is surpassed only by cervix cancer. The reduced survival is associated with the absence of symptoms, especially in early stages. Therefore, the diagnosis is delayed, when the metastases are already present and the prognosis is poor. While the etiology of the ovarian cancer is less understood, the histopathological studies and experiments regarding ovarian cancer development suggest that the majority of the tumors refined to the surface epithelium, a cuboidal layer that lays the ovary. It is still unclear if the molecular changes in this layer generate a neoplastic precursor that can be used for establishing an early diagnosis. None of the changes of the involved genes (p53, k-Ras, Her-2/neu, c-Myc, etc.) does seem to follow certain steps. We analyzed histological and immunohistochemical a group of 60 female patients admitted during January 2004 and January 2005 in Surgery Clinic of "Sfantul Ioan" Emergency Hospital, Bucharest. Our study reveals that a high percent (68.33%) of females had a correct diagnosis at admission, only five patients (8.33%) being diagnosed with other diseases. In 86.66% of cases, total hysterectomy with bilateral anexectomy has been made, in two cases (3.33%) tumor resection was the only needed therapy and in 19 cases (31.66%) peritoneal implants were found. More than 75% were serous tumors, 20% mucinous carcinoma and 5% borderline ovarian tumors. We found three cases of borderline tumors (5%) that histopathological proved to be serous tumors. The analysis of hormone receptors showed estrogen receptors in 32 cases (71.1%) of serous ovarian adenocarcinoma, in seven cases (58.33%) of mucinous adenocarcinoma, all three cases (100%) of

  19. Runt-related transcription factor 2 in human colon carcinoma: a potent prognostic factor associated with estrogen receptor.

    Sase, Tomohiko; Suzuki, Takashi; Miura, Koh; Shiiba, Kenichi; Sato, Ikuro; Nakamura, Yasuhiro; Takagi, Kiyoshi; Onodera, Yoshiaki; Miki, Yasuhiro; Watanabe, Mika; Ishida, Kazuyuki; Ohnuma, Shinobu; Sasaki, Hiroyuki; Sato, Ryuichiro; Karasawa, Hideaki; Shibata, Chikashi; Unno, Michiaki; Sasaki, Iwao; Sasano, Hironobu


    Runt-related transcription factor 2 (RUNX2) belongs to the RUNX family of heterodimeric transcription factors, and is mainly associated with osteogenesis. Previous in vitro studies demonstrated that RUNX2 increased the cell proliferation of mouse and rat colon carcinoma cells but the status of RUNX2 has remained unknown in human colon carcinoma. Therefore, we examined clinical significance and biological functions of RUNX2 in colon carcinoma. RUNX2 immunoreactivity was examined in 157 colon carcinoma tissues using immunohistochemistry. RUNX2 immunoreactivity was evaluated as percentage of positive carcinoma cells [i.e., labeling index (LI)]. We used SW480 and DLD-1 human colon carcinoma cells, expressing estrogen receptor-β (ER) in subsequent in vitro studies. RUNX2 immunoreactivity was detected in colon carcinoma cells, and the median value of RUNX2 LI was 67%. RUNX2 LI was significantly associated with Dukes' stage, liver metastasis and ERβ status. In addition, RUNX2 LI was significantly associated with adverse clinical outcome of the colon carcinoma patients, and turned out an independent prognostic factor following multivariate analysis. Results of in vitro studies demonstrated that both SW480 and DLD-1 cells transfected with small interfering RNA against RUNX2 significantly decreased their cell proliferation, migration and invasive properties. In addition, RUNX2 mRNA level was significantly decreased by ER antagonist in these two cells. These findings all suggest that RUNX2 is a potent prognostic factor in human colon carcinoma patients through the promotion of cell proliferation and invasion properties, and is at least partly upregulated by estrogen signals through ERβ of carcinoma cells.

  20. Age-Related Differences in Clinical Features of Neurocysticercosis

    J Gordon Millichap


    Full Text Available Clinical, radiologic, and inflammatory features of neurocysticercosis (NC in 92 pediatric (<15 years and 114 adult Mexican patients were compared in a study at three hospitals in Mexico City.

  1. The major risk factors for delirium in a clinical setting

    Kim H


    Full Text Available Harin Kim, Seockhoon Chung, Yeon Ho Joo, Jung Sun Lee Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Objective: We aimed to determine the major risk factors for the development of delirium in patients at a single general hospital by comparison with a control group.Subjects and methods: We reviewed the medical records of 260 delirium patients and 77 control patients. We investigated age, sex, and risk factors for delirium in the total delirium group (n=260, the delirium medical subgroup (n=142, and the delirium surgical subgroup (n=118. Logistic regression analysis adjusting for age and sex was performed to identify the odds ratio.Results: The mean age and the percentage of males were significantly higher in the delirium group compared with the control group (68.9 vs 54.3 years and 70% vs 41.6%, respectively. Risk factors for the delirium group were lower plasma albumin, hypertension, mechanical ventilation, and antipsychotic drug use. Plasma sodium level and hypertension were important risk factors for the delirium medical subgroup. Stroke history, hypertension, ICU care, and medication were important risk factors for the delirium surgical subgroup.Conclusion: Lower plasma albumin, hypertension, mechanical ventilation, and antipsychotic drug use are important risk factors for delirium. Keywords: delirium, acute confusional state, psychiatric consultation, risk factor

  2. Surgical experimentation and clinical trials: differences and related ethical problems

    Carlo Petrini


    Surgical techniques are not introduced into clinical practice as the result of randomised clinical trials (RCT), but usually through the gradual evolution of existing techniques or, more rarely, through audacious departures from the norm that are decided by a surgical team on the basis of experience. Sham surgery is held by some to be not only an ethically acceptable procedure but also a perfectly fit and proper one, as it could endow surgical experiments with the strict methodological and st...

  3. ABO blood groups and malaria related clinical outcom

    Deepa, Vanamala A. Alwar, Karuna Rameshkumar & Cecil Ross


    Objectives: The study was undertaken to correlate the blood groups and clinical presentations in malaria patientsand to understand the differential host susceptibility in malaria.Methods: From October 2007 to September 2008, malaria positive patients’ samples were evaluated in thisstudy. Hemoglobin, total leukocyte count, and platelet count of each patient were done on an automated cellcounter. After determining the blood groups, malarial species and the severity of clinical course were corr...

  4. 老年2型糖尿病患者尿路感染的临床特点及相关因素分析%Clinical characteristics of elderly patients with type 2 diabetes complicated with urinary tract infections and related risk factors

    黄崇林; 金标; 潘宇平


    OBJECTIVE To explore the clinical characteristics of urinary tract infections in elderly patients with type 2 diabetes and analyze the related risk factors so as to provide guidance for clinical data .METHODS From Feb 2010 to Apr 2012 ,the clinical data of 1075 elderly patients with type 2 diabetes were retrospectively analyzed , then the patients complicated with urinary tract infections were assigned as the case group (132 cases) ,the patients without urinary tract infections were set as the control group (943 cases) ,the clinical and etiological char-acteristics were observed and compared between the two groups ,and the logistic regression analysis was per-formed to analyze the related risk factors .RESULTS Of the 1075 elderly patients with type 2 diabetes ,the urinary tract infections occurred in 132 cases with the incidence rate of 12 .3% .The difference in the age ,course of diabe-tes ,blood glucose ,glycated hemoglobin ,blood creatinine ,or proportion of urinary lithiasis between the case group and the control was statistically significant (P< 0 .05) .There were 48 (36 .3% ) cases of asymptomatic urinary tract infections .Totally 152 strains of pathogens have been isolated from urine culture ,including 95 (62 .5% ) strains of gram-negative bacteria ,49 (32 .2% ) strains of gram-positive bacteria ,and 8 (5 .3% ) strains of fungi .The multivariate logistic regression analysis indicated that the course of diabetes (OR=4 .209) ,level of blood glucose(OR=2 .254) ,and complication of urinary lithiasis (OR=1 .741) were the independent risk factors for the urinary tract infections in the patients with type 2 diabetes .CONCLUSION The incidence of urinary tract infections is high in the elderly patients with type 2 diabetes ,and some of the patients are with asymptomatic symptoms .The gram-negative bacteria are the most common pathogens .The high level of blood glucose ,long course of diabetes ,and urinary lithiasis are the independent risk factors for the urinary

  5. 社区老年健康男性骨质疏松患病率调查及临床危险因素分析%Survey on the prevence of osteoporosis and osteoporosis - related clinical risk factors among community - dwelling healthy elderly male population

    李东; 李健; 张效栋; 费琦; 李永锦; 林吉生; 孔令波; 马钊; 王炳强; 杨雍


    目的:调查健康老年男性的骨密度(BMD)变化规律并分析和原发性骨质疏松症(OP)相关的临床危险因素。方法在北京市朝阳区团结湖社区采用广告招募的抽样方法,对50岁以上健康老年男性接受自制《北京市老年男性原发性骨质疏松症高危人群临床危险因素调查问卷》调查的同时进行双能 X 线骨密度检查,记录腰椎总(L1-4)、左侧股骨颈(femoral neck)和左髋总(total hip)的 BMD 数值和年龄、体重、既往脆性骨折史、吸烟史、饮酒史等临床危险因素;根据世界卫生组织诊断标准将研究对象分为 OP 组和非 OP 组,分析各临床危险因素与 OP 发生的相关性。结果518例老年男性总体 OP 患病率14.3%(74/518),骨量减少者53.7%(278/518),骨量正常者32.0%(166/518)。既往脆性骨折史、体重指数、体重在 OP 组和非 OP 间存在显著差异性( P <0.05)。结论社区健康老年男性 OP 患病情况不容乐观,低体重及低体重指数、既往脆性骨折史可能是 OP 相关的临床危险因素,有待于进一步深入研究。%Objective To survey the prevalence of osteoporosis and osteoporosis - related clinical risk factors in community - dwelling healthy elderly male population. Methods By using sampling method of recruitment advertising,healthy elderly males aged 50 and above in Bei-jing Tuanjiehu community had completed our questionnaire were enrolled in this study and they had been accepted testing of bone mineral density (BMD)by using dual energy X - ray absorptiometry. These inhabitants had been classified as osteoporosis group(OP group)and non - osteoporo-sis group(Non - OP group)according to the WHO criteria. Osteoporosis was arbitrarily defined when any T - scores were - 2. 5 standard devia-tions or less at femoral neck,total hip or lumbar spine(L1 - 4 ). The clinical risk factors of each person including age,body weight,body mass in

  6. Patients with chronic whiplash-associated disorders. Relationship between clinical and psychological factors and functional health status

    Schmitt, M.A.; Meeteren, N.L. van; Wijer, A. de; Genderen, F.R. van; Graaf, Y.D. van; Helders, P.J.


    Schmitt MA, van Meeteren NL, de Wijer A, van Genderen FR, van der Graaf Y, Helders PJ: Patients with chronic whiplash-associated disorders: Relationship between clinical and psychological factors and functional health status. Am J Phys Med Rehabil 2009;88:231-238. Objectives: To examine the relative

  7. Patients with chronic whiplash-associated disorders. Relationship between clinical and psychological factors and functional health status

    Schmitt, M.A.; Meeteren, N.L. van; Wijer, A. de; Genderen, F.R. van; Graaf, Y.D. van; Helders, P.J.


    Schmitt MA, van Meeteren NL, de Wijer A, van Genderen FR, van der Graaf Y, Helders PJ: Patients with chronic whiplash-associated disorders: Relationship between clinical and psychological factors and functional health status. Am J Phys Med Rehabil 2009;88:231-238. Objectives: To examine the relative

  8. Surgeon-related factors and outcome in rectal cancer.

    Porter, G A; Soskolne, C L; Yakimets, W W; Newman, S C


    OBJECTIVE: To determine whether surgical subspecialty training in colorectal surgery or frequency of rectal cancer resection by the surgeon are independent prognostic factors for local recurrence (LR) and survival. SUMMARY BACKGROUND DATA: Variation in patient outcome in rectal cancer has been shown among centers and among individual surgeons. However, the prognostic importance of surgeon-related factors is largely unknown. METHODS: All patients undergoing potentially curative low anterior resection or abdominoperineal resection for primary adenocarcinoma of the rectum between 1983 and 1990 at the five Edmonton general hospitals were reviewed in a historic-prospective study design. Preoperative, intraoperative, pathologic, adjuvant therapy, and outcome variables were obtained. Outcomes of interest included LR and disease-specific survival (DSS). To determine survival rates and to control both confounding and interaction, multivariate analysis was performed using Cox proportional hazards regression. RESULTS: The study included 683 patients involving 52 surgeons, with > 5-year follow-up obtained on 663 (97%) patients. There were five colorectal-trained surgeons who performed 109 (16%) of the operations. Independent of surgeon training, 323 operations (47%) were done by surgeons performing < 21 rectal cancer resections over the study period. Multivariate analysis showed that the risk of LR was increased in patients of both noncolorectal trained surgeons (hazard ratio (HR) = 2.5, p = 0.001) and those of surgeons performing < 21 resections (HR = 1.8, p < 0.001). Stage (p < 0.001), use of adjuvant therapy (p = 0.002), rectal perforation or tumor spill (p < 0.001), and vascular/neural invasion (p = 0.002) also were significant prognostic factors for LR. Similarly, decreased disease-specific survival was found to be independently associated with noncolorectal-trained surgeons (HR = 1.5, p = 0.03) and surgeons performing < 21 resections (HR = 1.4, p = 0.005). Stage (p < 0

  9. Mechanistic basis and clinical relevance of the role of transforming growth factor-βin cancer

    Run-Long Lin; Lu-Jun Zhao


    Transforming growth factor-β(TGF-β) is a key factor in cancer development and progression. TGF-βcan suppress tumorigenesis by inhibiting cell cycle progression and stimulating apoptosis in early stages of cancer progression. However, TGF-βcan modulate cancer-related processes, such as cell invasion, distant metastasis, and microenvironment modiifcation that may be used by cancer cells to their advantage in late stages. Corresponding mechanisms include angiogenesis promotion, anti-tumor immunity suppression, and epithelial-to-mesenchymal transition (EMT) induction. hTe correlation between TGF-βexpression and cancer prognosis has also been extensively investigated. Results suggest that TGF-βpathway can be targeted to treat cancer;as such, the feasibility of this treatment is investigated in clinical trials.

  10. Factor structure of the SOCRATES in a clinical sample of adolescents.

    Maisto, Stephen A; Chung, Tammy A; Cornelius, Jack R; Martin, Christopher S


    This study investigated the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; W. R. Miller & J. S. Tonigan, 1996) in adolescents presenting for treatment of alcohol use disorder (AUD). The participants were 80 males and 43 females (mean age = 16.8 years) who presented for AUD treatment (95.1% outpatient, 4.9% inpatient). Participants completed assessments at baseline and 1 year and provided information on alcohol use and related variables monthly between these 2 assessments. Principal-components and confirmatory factor analyses of the baseline SOCRATES identified 2 factors, Taking Steps and Recognition, which showed good internal consistency and concurrent and predictive evidence of validity. The results were interpreted as supporting the use of the SOCRATES with clinical samples of adolescents.

  11. Early clinical outcome and complications related to balloon kyphoplasty

    Martin Bergmann


    Full Text Available The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7% and 81 males (27.3%. Average patient age was 76.21 years (±10.71, range 35-98 years. Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 pre-operative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06% of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a

  12. Evaluation of Risk Factors Related to Recidivism Among Sentenced Males

    Sinem Yıldız


    Full Text Available Risk assessment is taking the place of dangerousness in recent criminal research. Detection of static and dynamic risk factors related and/or interacting to recidivism in accordance with personality characteristics and crime types may help crime prevention strategies to improve. Out of all participants 35% (n=41 are sentenced for manslaughter/physical injury, 35% (n=41 sexual crime and 30% (n=35 theft. The mean age of the participants is 33.81 (sd=9-12 years. During the interview, a questionnaire which is prepared by the researcher by reviewing the literature, Symptom Checklist Short Form, aggression inventory was used. Interviews are conducted face to face by the researcher at the relevant correctional facilities with the permissions of Ministry of Justice and ethical committee. Recidivism is found related to having a period far away from nuclear family before age 18, criminal and drag-alcohol abusing friends, anti-social behaviors; abusing illegal drags, displaying disciplinary problems in prison and during military service. Discussion: Results are evaluated under demographics, relationships in family and close friends, childhood abuse by leaning on current literature. Key words: prevention and control, crime, risk assessment

  13. Clinical Factors Associated with Cerebral Metabolism in Term Neonates with Congenital Heart Disease.

    Harbison, Anna Lonyai; Votava-Smith, Jodie K; Del Castillo, Sylvia; Kumar, S Ram; Lee, Vince; Schmithorst, Vincent; Lai, Hollie A; O'Neil, Sharon; Bluml, Stefan; Paquette, Lisa; Panigrahy, Ashok


    To determine associations between patient and clinical factors with postnatal brain metabolism in term neonates with congenital heart disease (CHD) via the use of quantitative magnetic resonance spectroscopy. Neonates with CHD were enrolled prospectively to undergo pre- and postoperative 3T brain magnetic resonance imaging. Short-echo single-voxel magnetic resonance spectroscopy of parietal white matter was used to quantify metabolites related to brain maturation (n-acetyl aspartate, choline, myo- inositol), neurotransmitters (glutamate and gamma-aminobutyric acid), energy metabolism (glutamine, citrate, glucose, and phosphocreatine), and injury/apoptosis (lactate and lipids). Multivariable regression was performed to search for associations between (1) patient-specific/prenatal/preoperative factors with concurrent brain metabolism and (2) intraoperative and postoperative factors with postoperative brain metabolism. A total of 83 magnetic resonance images were obtained on 55 subjects. No patient-specific, prenatal, or preoperative factors associated with concurrent metabolic brain dysmaturation or elevated lactate could be identified. Chromosome 22q11 microdeletion and age at surgery were predictive of altered concurrent white matter phosphocreatine (P term infants with CHD, but not patient-specific, preoperative, or intraoperative factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Clinical analysis of the risk factors for recurrence of HCC and its relationship with HBV

    Di-Peng Ou; Lian-Yue Yang; Geng-Wen Huang; Yi-Ming Tao; Xiang Ding; Zhi-Gang Chang


    AIM: To comprehend the risk factors of recurrence of hepatocellular carcinoma (HCC) and its relationship with the infection patterns of hepatitis B virus (HBV). METHODS: All materials of 270 cases of postoperative HCC were statistically analyzed by SPSS software. Recurrence and metastasis were classified into early (≤2 years) and late phase (>2 years). Risk factors for recurrence and metastasis after surgery in each group were analyzed.RESULTS: Out of 270 cases of HCC, 162 cases were followed up in which recurrence and metastasis occurred in 136 cases. There were a lot of risk factors related to recurrence and metastasis of HCC; risk factors contributing to early phase recurrence were serum AFP level, vascular invasion, incisal margin and operative transfusion, gross tumor classification and number of intrahepatic node to late phase recurrence. The HBV infective rate of recurrent HCC was 94.1%, in which "HBsAg, HBeAb, HBcAb" positive pattern reached 45.6%. The proportion of HBV infection in solitary large hepatocellular carcinoma (SLHCC) evidently decreased compared to nodular hepatocellular carcinoma (NHCC) (P<0.05).CONCLUSION: The early and late recurrence and metastasis after hepatectomy of HCC were associated with different risk factors. The early recurrence may be mediated by vascular invasion and remnant lesion, the late recurrence by tumor's clinical pathology propert, as multicentric carcinogenesis or intrahepatic carcinoma denovo. HBV replication takes a great role in this process. From this study, we found that SLHCC has more satisfactory neoplasm biological behavior than NHCC.

  15. Risk factors associated with asbestos-related diseases: a community-based case–control study


    Background Asbestos is a first level carcinogen. However, few epidemiological studies analyse the risk and protective factors associated with asbestos-related diseases and follow up these conditions in the general population. Pleural mesothelioma, caused by inhalation of asbestos fibres at work, at home or in the environment, is the most representative asbestos-related disease. The objectives of this study are to analyse the risk and protective factors associated with asbestos-related diseases and to investigate the incidence of new clinical manifestations in patients already diagnosed with some form of ARD. Methods/Design We have designed a matched case–control study with follow up of both cohorts from a population of a health district of the Barcelona province that has been exposed to asbestos for a period of 90 years. Discussion A better understanding of asbestos-related diseases should improve i) the clinical and epidemiological follow up of patients with this condition; ii) the design of new treatment strategies; iii) and the development of preventive activities. At the end of the study, the two cohorts created in this study (affected cases and healthy controls) will constitute the basis for future research. PMID:23915043

  16. Mining heart disease risk factors in clinical text with named entity recognition and distributional semantic models.

    Urbain, Jay


    We present the design, and analyze the performance of a multi-stage natural language processing system employing named entity recognition, Bayesian statistics, and rule logic to identify and characterize heart disease risk factor events in diabetic patients over time. The system was originally developed for the 2014 i2b2 Challenges in Natural Language in Clinical Data. The system's strengths included a high level of accuracy for identifying named entities associated with heart disease risk factor events. The system's primary weakness was due to inaccuracies when characterizing the attributes of some events. For example, determining the relative time of an event with respect to the record date, whether an event is attributable to the patient's history or the patient's family history, and differentiating between current and prior smoking status. We believe these inaccuracies were due in large part to the lack of an effective approach for integrating context into our event detection model. To address these inaccuracies, we explore the addition of a distributional semantic model for characterizing contextual evidence of heart disease risk factor events. Using this semantic model, we raise our initial 2014 i2b2 Challenges in Natural Language of Clinical data F1 score of 0.838 to 0.890 and increased precision by 10.3% without use of any lexicons that might bias our results.

  17. Clinical Risk Factors For Central Line Associated Venous Thrombosis (CLAVT In Children

    Samir H Shah


    Full Text Available ABSTRACTBackground: Identifying risk factors related to Central Venous Line (CVL placement could potentially minimize Central Line-Associated Venous Thrombosis (CLAVT. We sought to identify the clinical factors associated with CLAVT in children. Methods: Over a 3-year period, 3,733 CVLs were placed at a tertiary-care children’s hospital. Data were extracted from the electronic medical records of patients with clinical signs and symptoms of venous thromboembolism (VTE, diagnosed using Doppler ultrasonography and/or echocardiography. Statistical analyses examined differences in CLAVT occurrence between groups based on patient and CVL characteristics (type, brand, placement site, and hospital unit. Results: Femoral CVL placement was associated with greater risk for developing CLAVT (OR 11.1, 95% CI 3.9-31.6, p<0.0001. CVLs placed in the NICU were also associated with increased CLAVT occurrence (OR 5.3, 95% CI 2.1-13.2, p=0.0003. CVL brand was also significantly associated with risk of CLAVT events. Conclusion: Retrospective analyses identified femoral CVL placement and catheter type as independent risk factors for CLAVT, suggesting increased risks due to mechanical reasons. Placement of CVLs in the NICU also led to an increased risk of CLAVT, suggesting that small infants are at increased risk of thrombotic events. Alternative strategies for CVL placement, thromboprophylaxis, and earlier diagnosis may be important for reducing CLAVT events.

  18. Anxiety Sensitivity and Its Factors in Relation to Generalized Anxiety Disorder among Adolescents.

    Knapp, Ashley A; Blumenthal, Heidemarie; Mischel, Emily R; Badour, Christal L; Leen-Feldner, Ellen W


    Anxiety psychopathology, one of the most prevalent classes of disorder among youth, is linked to detrimental outcomes. Accordingly, identifying factors that influence vulnerability to anxiety disorders is important. One promising factor, given emerging evidence for its transdiagnostic nature, is anxiety sensitivity (AS); however, relatively little is known about the linkage between AS and indicators of generalized anxiety disorder (GAD), particularly among youth. The aim of the current investigation was to address this gap in the literature using a community-based sample of adolescents aged 10-17 years (n = 165; M age  = 14.49 years, SD = 2.26). Results indicated global AS and the AS-physical concerns dimension were significantly associated with worry, generalized anxiety symptoms, and GAD diagnosis assessed via a structured clinical interview, above and beyond key theoretically-relevant covariates. These findings add to a growing body of work underscoring the relevance of AS for multiple types of anxiety-related disorders among youth.

  19. WISC-IV and Clinical Validation of the Four- and Five-Factor Interpretative Approaches

    Weiss, Lawrence G.; Keith, Timothy Z.; Zhu, Jianjun; Chen, Hsinyi


    The purpose of this study was to determine the constructs measured by the WISC-IV and the consistency of measurement across large normative and clinical samples. Competing higher order four- and five-factor models were analyzed using the WISC-IV normative sample and clinical subjects. The four-factor solution is the model published with the test…

  20. A method to adjust radiation dose-response relationships for clinical risk factors

    Appelt, Ane Lindegaard; Vogelius, Ivan R


    Several clinical risk factors for radiation induced toxicity have been identified in the literature. Here, we present a method to quantify the effect of clinical risk factors on radiation dose-response curves and apply the method to adjust the dose-response for radiation pneumonitis for patients...

  1. Clinical risk factors and urodynamic predictors prior to surgical treatment for stress urinary incontinence

    Bing, Mette Hornum; Gimbel, Helga; Greisen, Susanne


    INTRODUCTION AND HYPOTHESIS: Knowledge about clinical risk factors and the value of urodynamic testing is important to optimize treatment strategy and secure true informed consent. METHODS: We reviewed the relevant literature to clarify the evidence regarding clinical risk factors and the predict...

  2. Beyond Negative Pain-Related Psychological Factors: Resilience Is Related to Lower Pain Affect in Healthy Adults.

    Hemington, Kasey S; Cheng, Joshua C; Bosma, Rachael L; Rogachov, Anton; Kim, Junseok A; Davis, Karen D


    Resilience, a characteristic that enhances adaptation in response to stressful events, is a positive psychological factor that can predict and modulate health outcomes. However, resilience is rarely considered in pain research. Conversely, negative psychological factors (eg, anxiety, depression) are known to be related to the affective dimension of pain. It is critical to understand all potential psychological drivers of pain affect, a prominent component of chronic pain. We tested the hypothesis that higher resilience is associated with lower pain affect, above and beyond the predictive value of negative psychological factors. Healthy adults underwent psychophysical testing to acquire ratings of heat pain intensity and unpleasantness and completed the Resilience Scale, the State-Trait Anxiety Inventory (trait form), Beck Depression Inventory, Pain Catastrophizing Scale, and the Pain Vigilance and Attention Questionnaire. Multiple regression modeling (n = 68) showed resilience to be a negatively associated with pain affect (unpleasantness). Furthermore, in individuals with higher anxiety scores, resilience was protective against higher pain affect. This highlights the importance of resilience, a positive psychological factor, in the affective dimension of pain. This study is the first to assess a positive psychological factor and experimental pain affect, and has the potential to improve prediction of and treatment strategies for clinical pain. We report that resilience, a positive psychological factor, interacts with anxiety and is associated with heat pain affect (unpleasantness) in healthy individuals. Resilience may provide predictive value of chronic pain affect and treatment outcomes, and could be a target for behavioral therapy. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Incidence and risk factors for central venous catheter-related thrombosis in hematological patients.

    Joks, Monika; Czyż, Anna; Popławski, Dariusz; Komarnicki, Mieczysław


    Catheter-related thrombosis (CRT) is a serious complication in hematological patients, but the risk factors for its occurrence are not well established. The study objectives were to estimate the incidence of CRT and to identify the risk factors for developing CRT in hematological patients. In a prospective setting, 104 consecutive patients with 200 insertions of central venous catheters were enrolled into the study. The patients were screened for CRT by compression Doppler ultrasound every 10-14 days. Additionally, ultrasonography was performed in the case of clinical symptoms suggesting CRT. Over the course of 6,098 catheter days of follow-up, the incidence of CRT was 13.5 %. In 18/27 cases (66.6 %), radiological evidence of CRT was preceded by clinical symptoms. However, in 9/27 (33.3 %), CRT was clinically asymptomatic. The median times to symptomatic and asymptomatic CRT were 17 (range 1-49) and 8 (range 1-16) catheter days, respectively. In univariate analysis, the risk factors for CRT were exit-site infection (ESI) (P risk of CRT. The results of our study provide information regarding the characteristic features of the patients who are at high risk of thrombosis, for whom Doppler ultrasound screening should be considered.

  4. Childhood bruxism: Related factors and impact on oral health-related quality of life.

    Antunes, Lívia Azeredo Alves; Castilho, Thuanny; Marinho, Marcello; Fraga, Renato Silva; Antunes, Leonardo Santos


    This study aimed to assess childhood bruxism relating associated factors and the bruxism's impact on oral health-related quality of life (OHRQoL). A case-control study was performed with 3- to 6-year-old children obtained from public preschools in Brazil. The case and control groups had 21 and 40 children, respectively. Associations between bruxism and respiratory problems (p = 0.04, OR: 0.33, CI: 0.09 to 1.14), dental wear (p 0.05). The association between presence and absence of impact with bruxism or other variables showed no statistical relationship (p > 0.05). It could be concluded that childhood bruxism is related to respiratory problems, dental wear, dental caries, and malocclusion. Despite being a topic that demands special care in dentistry, bruxism does not significantly affect the OHRQoL.

  5. [The development of clinical reasoning skills and leadership: personal factors and organizational factors].

    Larue, Caroline; Dubois, Sylvie; Girard, Francine; Goudreau, Johanne; Dumont, Katia


    Continuing education of newly graduated nurses (NGN) depends on several factors related to the characteristics of skills to be developed, the target population and the organizational context. Few studies describe both how nurses develop their skills and how institutions promote this development. The objectives of this manuscript are to (1) describe the behaviors that the NGN use to develop their reasoning skills and leadership and (2) document the organizational elements that facilitate this development. Method. Individual interviews were conducted with nurses (n = 34) using a grid of semistructured interviews and two group interviews were conducted with nurses (n = 7) and managers (n = 19) in two teaching hospitals in eastern Canada. The results show that nurses develop mainly by reflecting on their professional practice in their workplace. However, the lack of time for reflection in the workspace is a considerable obstacle while managerial leadership is an important asset.

  6. 老年肝硬化患者营养状况及其与临床相关因素分析%Prevalence of malnutrition and nutritional risk in elderly liver cirrhosis patients:evaluation of nutritional status and clinical relative factors

    杨中菊; 胡乃中


    Objective To explore the relationship between the nutritional status of hospitalized elderly liver cirrhosis patients and clinical relative factors. Methods Subjective global assessment(SGA) and nutrition risk screen (NRS-2002) were used to identify malnutrition and nutrition risk of 200 liver cirrhosis patients from May 2010 to May 2011 retrospectively, then the clinical data of patients from different age groups were compared, and the relationship between nutritional status and Child-pugh score, complications, length of hospital stay and other clinical factors of the hospitalized elderly liver cirrhosis patients was analyzed. Results Overall prevalence of undernutrition and nutritional risk of hospitalized liver cirrhosis as defined by SGA and NRS-2002 was 31.5%% and 53.5% respectively. The prevalence of undernutrition and nutritional risk in elderly liver cirrhosis patients (age≥60 y) was significantly higher than that in younger cases (age 0.05), and so they were between malnutrition and well-nourished elderly liver cirrhosis patients (χ2= 0.525、 0.330, P> 0.05). Conclusion The prevalence of undernutrition and nutritional risk in elderly liver cirrhosis patients increase remarkably, and the hospital stay of patients with malnutrition or nutritional risk extends remarkably.%目的 探讨老年肝硬化患者营养状况及与各临床相关因素的关系.方法 采用SGA(主观全面评估)、NRS-2002(营养风险筛查)对2009年5月至2010年5月200例住院肝硬化患者进行营养评估和营养风险筛查,分析不同年龄组肝硬化患者营养状况及风险与并发症、住院时间、Child分级及临床各相关因素的关系.结果 住院肝硬化患者营养不良发生率、营养风险发生率老年组(≥60岁)均高于非老年组(<60岁),老年组肝硬化中有营养不良、营养风险的患者住院时间明显长(P<0.05);老年肝硬化患者Child分级、并发症发生率在有营养不良、营养风险与无营养

  7. Identification of occupational risk factors by interviewing injured workers in an out-patient clinic

    Johan Lund


    Full Text Available

    Background: To prevent injuries, identification of the involved risk factors is necessary. Two recent in-depth investigations were carried out in the health service of Oslo on workers seeking treatment of severe occupational injuries. The interviews were rather time-consuming, and hence rather costly. The aim of thepresent study was to find a less time-consuming method which nevertheless would identify preventable risk actors.

    Methods: In-depth investigations of 15 injuries with nail guns and 28 injuries related to scaffolding were onducted in an out-patient clinic in Trondheim, Norway. Patients were interviewed by health personnel just efore or after the treatment based on specifically designed questionnaires. A group of specialists analysed the information collected.

    Results: Some risk factors were identified: design weaknesses inherent in nail guns, presence of snow and ice at the injury location, foreign body in the eye and lack of control/inspection of scaffolding when erected. On average, about two man hours were used for each injury. The most relevant questions were those directly related to the narrative, in particular how the injury occurred, and if any special conditions were involved. Quite a few data elements require epidemiological representative studies in order to assess them as potential risk factors.

    Conclusions: This relatively low time-consuming method revealed some risk factors. However, it could be more effective if the interviews were conducted by telephone a few days after the treatment by a specialist in that particular injury type; such as an experienced labour inspector, in order to probe more deeply into the technical risk factors.

  8. Medical error and related factors during internship and residency.

    Ahmadipour, Habibeh; Nahid, Mortazavi


    It is difficult to determine the real incidence of medical errors due to the lack of a precise definition of errors, as well as the failure to report them under certain circumstances. We carried out a cross- sectional study in Kerman University of Medical Sciences, Iran in 2013. The participants were selected through the census method. The data were collected using a self-administered questionnaire, which consisted of questions on the participants' demographic data and questions on the medical errors committed. The data were analysed by SPSS 19. It was found that 270 participants had committed medical errors. There was no significant difference in the frequency of errors committed by interns and residents. In the case of residents, the most common error was misdiagnosis and in that of interns, errors related to history-taking and physical examination. Considering that medical errors are common in the clinical setting, the education system should train interns and residents to prevent the occurrence of errors. In addition, the system should develop a positive attitude among them so that they can deal better with medical errors.

  9. Meningococcal carriage: prevalence and sex-related risk factors.

    Tayal, S C; Rashid, S; Muttu, K M; Hildreth, A J


    A retrospective analysis was done to examine whether sexual behaviour was associated with meningococcal carriage. Over the 4 month period from January to April 1994, 136 (27.4%) of the 496 consecutive new/re-registered genito-urinary medicine clinic attenders showed meningococcal carriage. Two (15.4%) of 13 homosexual men compared with 134 (27.7%) of 484 heterosexual men and women had evidence of meningococcal carriage. Relative risk (RR) of meningococcal carriage was 1.8 with > 10 lifetime partners and 1.2 with 3-10 partners (P < 0.007). RR with age group of 16-25 was 4.2 and for 26-35 it was 3.5. There was no relationship with meningococcal carriage and pharyngeal symptoms, sexual orientation, intravenous drug use, number of partners per month and orogenital sex. Further longitudinal studies may be of value in order to determine whether a high number of sexual partners is a marker for meningococcal carriage. In addition, further study may show whether there is an increased risk of meningococcal carriage and disease in those who live with meningococcal carriers.

  10. A Research on Factors Influencing the Clinical Prognosis of Acute Stroke Patie.patients

    Luo Zuming; Li Manli


    Object: To search for the factors significantly influencing the clinical prognosis of acute stroke patients. Background: There are lack of prospective multivariate analysis research m acute stroke in the world. Method: We chose 17 factors possibly influencing the prognosis of acute patients, took Barthel′s Index at the end of 2 months after stroke onset and decreased percentage of neurological deficit scores (MESSS) between 72h after hospitalization and 2 months after onset as gold standard, to have a prospective, multivariate analysis research combined with univariate analysis. Results: Multivariate analysis of 106 acute stroke patients combined with univariate analysis showed the factors significantly influencing the clinical prognosis of acute stroke patients were: initial MESSS score、 age、 complication、 mass effect、 stroke location、 time of delay before emergency arrival (BDT). Time of delay after emergency arrival was not found to be a significant prognostic factor. Discussion: Barthel Index at the end of 1 month after stroke onset was strongly related to that at the end of 2 month after onset, as was the same with MESSS score. It showed there was no significant difference between 1 month and 2 months after stroke onset when we choose time interval in evaluating prognosis of acute stroke patients.Conclusion: BDT、 initial MESSS score、 age、 stroke location、 mass effect、 complication were important factors of acute stroke patients. Avoid the delay before emergency arrival after onset, prevent and treat complications after stroke, more carefully treat acute stroke patients with advanced age, advanced age, high initial MESSS scores and those with mass effect reported by CT, we can improve the outcome of stroke patients.

  11. Clinical characteristics and prognostic factors of patients with gastric neuroendocrine carcinoma treated with radical surgery

    Xu Xuefeng; Li Jian'ang; Han Xu; Shi Chenye; Jin Dayong; Lou Wenhui


    Background Gastric neuroendocrine carcinomas (g-NECs) are rare tumors that have aggressive biological behaviors and poor prognosis,but the prognostic factors of postoperative patients with g-NEC are still unclear.Our aim was to study and explore the clinical characteristics and prognostic factors of patients with g-NEC treated with radical surgery.Methods The clinical data of 43 g-NEC patients who underwent surgery from January 2002 to January 2011 at the Zhongshan Hospital of Fudan University were analyzed.Follow-up was conducted by telephone,mail,or returning visit survey.Results The sizes of the 43 neuroendocrine carcinomas (G3) were 1.5 cm × 1.5 cm × 0.5 cm to 7 cm × 8 cm × 1.5 cm.Eight NECs were localized,and 35 had lymph node involvement,of which 1 also had hepatic metastasis.At the end of the follow-up,the follow-up rate was 97.7% (42/43),and the median follow-up time was 22.2 months.The median overall survival of g-NEC patients was 36.5 months,and the 1-,3-,and 5-year overall survival rates were 86.0%,51.6%,and 36.7%,respectively.Sex (P <0.05) and lymph node involvement (P <0.05) were prognostic factors of postoperative g-NEC patients,among which sex was an independent prognostic factor (P <0.05),as a survival advantage of female patients over male was observed.Conclusions Most of the g-NECs were diagnosed at an advanced stage.The prognosis of g-NECs was related with sex and lymph node involvement,of which sex was an independent prognostic factor,with female patients having a survival advantage.

  12. Clinical Characteristics of Stoma-Related Obstruction after Ileal Pouch-Anal Anastomosis for Ulcerative Colitis.

    Okita, Yoshiki; Araki, Toshimitsu; Kondo, Satoru; Fujikawa, Hiroyuki; Yoshiyama, Shigeyuki; Hiro, Junichiro; Inoue, Mikihiro; Toiyama, Yuji; Kobayashi, Minako; Ohi, Masaki; Inoue, Yasuhiro; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato


    We defined small bowel obstruction occurring around the limbs of the ileostomy as stoma-related obstruction (SRO) and investigated the clinical characteristics and predictive factors of SRO. From January 2002 to March 2016, 309 consecutive patients who underwent ileal pouch-anal anastomosis (IPAA) for ulcerative colitis were enrolled. Two-stage IPAA with diverting ileostomy was analyzed. We assessed the possible associations between SRO and clinical factors. A total of 205 patients met the inclusion criteria. Fifty-three (25.8%) patients with SRO before ileostomy closure were identified for review. All patients with SRO were at least transiently resolved by intubation though orifice of ileostomy (98.1%) or nasally (3.7%). In 18 (33.9%) patients, the ileostomy was taken down ahead of schedule and the small bowel obstruction improved in all cases. Multivariate analysis revealed that age at surgery SRO (P = 0.013 and 0.0012, respectively). Younger age at surgery and low body mass index may be significant predictive factors for SRO after IPAA with diverting ileostomy in patients with ulcerative colitis.

  13. Factors shaping effective utilization of health information technology in urban safety-net clinics.

    George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard


    Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

  14. Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors.

    Köhler, Alkisti Anastassaki; Hugoson, Anders; Magnusson, Tomas


    The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trau