WorldWideScience

Sample records for risk factors analysis

  1. [Risk factors for preeclampsia. Multivariate analysis].

    Science.gov (United States)

    González, A L; Ulloa Galván, G; Alpuche, G; Romero Arauz, J F

    2000-08-01

    To determine in multivariate analysis the clinical, social, and demographic factors for preeclampsia. A case-control study was designed. Three hundred patients were included, divided in two groups. 150 cases with criteria diagnosis for preeclampsia. 150 patients with normal pregnancy and deliveries. The main variables analyzed were age, schooling, marital status, employment, socioeconomic status, smoking and alcohol consumption, body mass index, familiar history of preeclampsia, history of preeclampsia in previous pregnancy, parity and type of pregnancy (single or multiple). For comparison of cases and controls on categorical variables, odds ratios and 95% confidence intervals were calculated, and multiple logistic regression analyses. Multiple logistic regression analysis showed that history of preeclampsia in previous pregnancy has OR 23.7, 95% p < 0.001, familiar history of preeclampsia OR 1.62, p < 0.08, high body mass has OR 1.60. The knowledge of the most important risk factors in our population could be useful for the clinical to pre-detect the patient who will develop preeclampsia.

  2. Risk Factor Analysis In Oral Cancers

    Directory of Open Access Journals (Sweden)

    Bharti A.R

    1992-01-01

    Full Text Available A case-control study involving 54 cases and 108 matched controls was conducted to find out the association of risk factors like smoking, chewing paan and tobacco and the occurrence of cancers of the oral cavity. More than 80% of the cases were over 40 years of age, with a male: female ratio of 2:1, paan and tobacco chewing were significantly related to the oral cancers (Odds Ratio of 9.3 and 7.8 respectively. Smoking showed a statistically significant relationship with oral cancers among male patients. In addition, the study also established dose-response and time-response relationship these risk factors and oral cancer.

  3. ANALYSIS OF RISK FACTORS ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Budi Santoso

    2017-04-01

    Full Text Available Introduction: Ectopic pregnancy is a pregnancy with extrauterine implantation. This situation is gynecologic emergency that contributes to maternal mortality. Therefore, early recognition, based on identification of the causes of ectopic pregnancy risk factors, is needed. Methods: The design descriptive observational. The samples were pregnant women who had ectopic pregnancy at Maternity Room, Emergency Unit, Dr. Soetomo Hospital, Surabaya, from 1 July 2008 to 1 July 2010. Sampling technique was total sampling using medical records. Result: Patients with ectopic pregnancy were 99 individuals out of 2090 pregnant women who searched for treatment in Dr. Soetomo Hospital. However, only 29 patients were accompanied with traceable risk factors. Discussion:. Most ectopic pregnancies were in the age group of 26-30 years, comprising 32 patients (32.32%, then in age groups of 31–35 years as many as 25 patients (25.25%, 18 patients in age group 21–25 years (18.18%, 17 patients in age group 36–40 years (17.17%, 4 patients in age group 41 years and more (4.04%, and the least was in age group of 16–20 years with 3 patients (3.03%. A total of 12 patients with ectopic pregnancy (41.38% had experience of abortion and 6 patients (20.69% each in groups of patients with ectopic pregnancy who used family planning, in those who used family planning as well as ectopic pregnancy patients with history of surgery. There were 2 patients (6.90% of the group of patients ectopic pregnancy who had history of surgery and history of abortion. The incidence rate of ectopic pregnancy was 4.73%, mostly in the second gravidity (34.34%, whereas the nulliparous have the highest prevalence of 39.39%. Acquired risk factors, i.e. history of operations was 10.34%, patients with family planning 20.69%, patients with history of abortion 41.38%, patients with history of abortion and operation 6.90% patients with family and history of abortion was 20.69%.

  4. Retinopathy risk factors in type II diabetic patients using factor analysis and discriminant analysis.

    Science.gov (United States)

    Tazhibi, Mahdi; Sarrafzade, Sheida; Amini, Masoud

    2014-01-01

    Diabetes is one of the most common chronic diseases in the world. Incidence and prevalence of diabetes are increasing in developing countries as well as in Iran. Retinopathy is the most common chronic disorder in diabetic patients. In this study, we used the information of diabetic patients' reports that refer to endocrine and metabolism research center of Isfahan University of Medical Sciences to determine diabetic retinopathy risk factors. We used factor analysis to extract retinopathy's factors. Factor analysis is using to analyze multivariate data, in which a large number of dependent variables summarize into the fewer independent factors. Factor analysis is applied, in both diabetic and nondiabetic patients, separately. To investigate the efficacy of factor analysis, we used discriminant analysis. We investigated 3535 diabetic patients whose prevalence of retinopathy was 53.4%. Six factors were extracted in each group (i.e. diabetic and nondiabetic groups). These six factors were explained 69.5% and 69.6% of total variance in diabetic and nondiabetic groups, respectively. Using original variables such as sex, weight, blood sugar control method, and some laboratory variables, the correct classification rate of discriminant analysis was identified as 67.4%. However, it decreased to 49.5% by using extracted factors. Retinopathy is one of the important disorders in diabetic patients that involves a large number of variables and can affect its incidence. By the method of factor analysis, we summarize diabetic retinopathy risk factors. Factor analysis is applied separately, in two diabetic and nondiabetic group. In this way, 10 variables were summarized into the six factors. Discriminant analysis was used to investigate the efficacy of factor analysis. Although factor analysis is a powerful way to reduce the number of variables, in this study did not worked very well.

  5. Risk factor analysis of equine strongyle resistance to anthelmintics

    Directory of Open Access Journals (Sweden)

    G. Sallé

    2017-12-01

    Full Text Available Intestinal strongyles are the most problematic endoparasites of equids as a result of their wide distribution and the spread of resistant isolates throughout the world. While abundant literature can be found on the extent of anthelmintic resistance across continents, empirical knowledge about associated risk factors is missing. This study brought together results from anthelmintic efficacy testing and risk factor analysis to provide evidence-based guidelines in the field. It involved 688 horses from 39 French horse farms and riding schools to both estimate Faecal Egg Count Reduction (FECR after anthelmintic treatment and to interview farm and riding school managers about their practices. Risk factors associated with reduced anthelmintic efficacy in equine strongyles were estimated across drugs using a marginal modelling approach. Results demonstrated ivermectin efficacy (96.3% ± 14.5% FECR, the inefficacy of fenbendazole (42.8% ± 33.4% FECR and an intermediate profile for pyrantel (90.3% ± 19.6% FECR. Risk factor analysis provided support to advocate for FEC-based treatment regimens combined with individual anthelmintic dosage and the enforcement of tighter biosecurity around horse introduction. The combination of these measures resulted in a decreased risk of drug resistance (relative risk of 0.57, p = 0.02. Premises falling under this typology also relied more on their veterinarians suggesting practitionners play an important role in the sustainability of anthelmintic usage. Similarly, drug resistance risk was halved in premises with frequent pasture rotation and with stocking rate below five horses/ha (relative risk of 0.53, p < 0.01. This is the first empirical risk factor analysis for anthelmintic resistance in equids. Our findings should guide the implementation of more sustained strongyle management in the field. Keywords: Horse, Nematode, Anthelmintic resistance, Strongyle, Cyathostomin

  6. Infectious complications in bullous pemphigoid: an analysis of risk factors.

    Science.gov (United States)

    Phoon, Yee Wei; Fook-Chong, Stephanie M C; Koh, Hong Yi; Thirumoorthy, Thamotharampillai; Pang, Shiu Ming; Lee, Haur Yueh

    2015-05-01

    Infections are common in bullous pemphigoid and contribute to significant mortality. We sought to define the spectrum of infectious complications and to identify associated risk factors in a bullous pemphigoid cohort. A retrospective cohort study conducted at an academic medical center. In all, 97 patients were included. Infectious complications occurred in 54 patients (56%) and the median duration from diagnosis to first episode of infection was 3 months. Bacteremia occurred in 14 patients (26%) and 26 of 30 deaths (87%) were attributable to infections. On univariate analysis, significant risk factors include low Karnofsky score (risk factors for infectious complications include functional impairment and the presence of dementia, which may allow for better risk stratification and individualized treatment of bullous pemphigoid. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Analysis OfProductivity And Risk Factors In Commercial Poultry ...

    African Journals Online (AJOL)

    The study examined the resource usc efficiency nnd occurrence of risk factors in poultry production in osun state, nigeria using the prouuction function nnd bayesian decision model analysis. Data were collected using a set of questionnaire from. 200 poultry farmers selected from five local government areas of the state ...

  8. Meta-analysis of modifiable risk factors for Alzheimer's disease.

    Science.gov (United States)

    Xu, Wei; Tan, Lan; Wang, Hui-Fu; Jiang, Teng; Tan, Meng-Shan; Tan, Lin; Zhao, Qing-Fei; Li, Jie-Qiong; Wang, Jun; Yu, Jin-Tai

    2015-12-01

    The aetiology of Alzheimer's disease (AD) is believed to involve environmental exposure and genetic susceptibility. The aim of our present systematic review and meta-analysis was to roundly evaluate the association between AD and its modifiable risk factors. We systematically searched PubMed and the Cochrane Database of Systematic Reviews from inception to July 2014, and the references of retrieved relevant articles. We included prospective cohort studies and retrospective case-control studies. 16,906 articles were identified of which 323 with 93 factors met the inclusion criteria for meta-analysis. Among factors with relatively strong evidence (pooled population >5000) in our meta-analysis, we found grade I evidence for 4 medical exposures (oestrogen, statin, antihypertensive medications and non-steroidal anti-inflammatory drugs therapy) as well as 4 dietary exposures (folate, vitamin E/C and coffee) as protective factors of AD. We found grade I evidence showing that one biochemical exposure (hyperhomocysteine) and one psychological condition (depression) significantly increase risk of developing AD. We also found grade I evidence indicative of complex roles of pre-existing disease (frailty, carotid atherosclerosis, hypertension, low diastolic blood pressure, type 2 diabetes mellitus (Asian population) increasing risk whereas history of arthritis, heart disease, metabolic syndrome and cancer decreasing risk) and lifestyle (low education, high body mass index (BMI) in mid-life and low BMI increasing the risk whereas cognitive activity, current smoking (Western population), light-to-moderate drinking, stress, high BMI in late-life decreasing the risk) in influencing AD risk. We identified no evidence suggestive of significant association with occupational exposures. Effective interventions in diet, medications, biochemical exposures, psychological condition, pre-existing disease and lifestyle may decrease new incidence of AD. Published by the BMJ Publishing Group

  9. Genetic analysis of emerging risk factors in coronary artery disease.

    Science.gov (United States)

    van Iperen, Erik P A; Sivapalaratnam, Suthesh; Holmes, Michael V; Hovingh, G Kees; Zwinderman, Aeilko H; Asselbergs, Folkert W

    2016-11-01

    Type 2 diabetes (T2D), low-density lipoprotein-cholesterol (LDL-c), body mass index (BMI), blood pressure and smoking are established risk factors that play a causal role in coronary artery disease (CAD). Numerous common genetic variants associating with these and other risk factors have been identified, but their association with CAD has not been comprehensively examined in a single study. Our goal was to comprehensively evaluate the associations of established and emerging risk factors with CAD using genetic variants identified from Genome-wide Association Studies (GWAS). We tested the effect of 60 traditional and putative risk factors with CAD, using summary statistics obtained in GWAS. We approximated the regression of a response variable onto an additive multi-SNP genetic risk score in the Coronary Artery DIsease Genomewide Replication And Meta-analysis (CARDIoGRAM) consortium dataset weighted by the effect of the SNP on the risk factors. The strongest association with risk of CAD was for LDL-c SNPs (p = 3.96E-34). For non-established CAD risk factors, we found significant CAD associations for coronary artery calcification (CAC), Lp(a), LP-PLA2 activity, plaque, vWF and FVIII. In an attempt to identify independent associations between risk factors and CAD, only SNPs with an effect on the target trait were included. This identified CAD associations for Lp(a)(p = 1.77E-21), LDL-c (p = 4.16E-06), triglycerides (TG) (p = 1.94E-05), height (p = 2.06E-05), CAC (p = 3.13E-23) and carotid plaque (p = 2.08E-05). We identified SNPs associated with the emerging risk factors Lp(a), TG, plaque, height and CAC to be independently associated with risk of CAD. This provides further support for-ongoing clinical trials of Lp(a) and TG, and suggests that CAC and plaque could be used as surrogate markers for CAD in clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Retinopathy of prematurity: screening, incidence and risk factors analysis.

    Science.gov (United States)

    Yang, C S; Chen, S J; Lee, F L; Hsu, W M; Liu, J H

    2001-12-01

    The sequela of retinopathy of prematurity (ROP) is an important cause of infant blindness. This study was designed to screen the high-risk premature infants and investigate the incidence and risk factors associated with the development of ROP. From October 1997 to October 1998, all premature infants with birth body weight (BBW) less than 2000 gm or gestational age (GA) less than 36 weeks were enrolled and underwent ophthalmologic examination at 4 to 6 weeks of age at Taipei Veterans General Hospital. The perinatal variables were analyzed to evaluate their correlation with the development of ROP. In totally 108 premature infants, the incidence for development of ROP was 25% (27 in 108 patients). The threshold ROP occurred in 15 eyes (7%). The average BBW and GA (1267+/-341 gm and 29.7+/-2.7 weeks) were significantly lower in ROP group than in the non-ROP group (1703+/-368 gm and 32.3+/-2.2 weeks). The artificial ventilation for more than 5 days, chronic lung disease and periventricular leukomalacia were significant risk factors associated with highest rate of ROP. The respiratory distress syndrome, intraventricular hemorrhage, congenital heart disease and sepsis were significant risk factors accompanied by moderate rate of ROP. Low birth body weight and young gestational age are the most important risk factors in the development of ROP. The analysis of risk factors will be helpful in understanding and prediction of ROP formation in high-risk neonates. The timely clinical screening retina examination of high-risk premature infants is important to prevent the development of advanced ROP.

  11. Path analysis of risk factors leading to premature birth.

    Science.gov (United States)

    Fields, S J; Livshits, G; Sirotta, L; Merlob, P

    1996-01-01

    The present study tested whether various sociodemographic, anthropometric, behavioral, and medical/physiological factors act in a direct or indirect manner on the risk of prematurity using path analysis on a sample of Israeli births. The path model shows that medical complications, primarily toxemia, chorioammionitis, and a previous low birth weight delivery directly and significantly act on the risk of prematurity as do low maternal pregnancy weight gain and ethnicity. Other medical complications, including chronic hypertension, preclampsia, and placental abruption, although significantly correlated with prematurity, act indirectly on prematurity through toxemia. The model further shows that the commonly accepted sociodemographic, anthropometric, and behavioral risk factors act by modifying the development of medical complications that lead to prematurity as opposed to having a direct effect on premature delivery. © 1996 Wiley-Liss, Inc. Copyright © 1996 Wiley-Liss, Inc.

  12. [Incidence and risk factor analysis of retinopathy of prematurity].

    Science.gov (United States)

    Yin, Hong; Li, Xiao-Xin; Li, Hui-Ling; Zhang, Wei

    2005-04-01

    Retinopathy of prematurity (ROP) is a leading cause of infant blindness. This study was designed to screen the high-risk premature infants and investigate the incidence and risk factors associated with the development of ROP. From July 1 2002 to June 30 2003, all premature infants born in Beijing Maternal and Children Healthcare Hospital with birth body weight (BBW) less than 2000 gm or gestational age (GA) less than 34 weeks were enrolled and underwent ophthalmologic examination. The perinatal variables were analyzed to evaluate their correlation with the development of ROP. In 98 premature infants, the incidence of ROP was 17.3% (17 in 98 patients). Four cases with 7 eyes (4.1%) developed threshold ROP. There was significant difference in birth body weight, gestational age, maximal oxygen tension, oxygen use for more than 5 days and sepsis between ROP and Non-ROP groups. Logistic regression analysis indicated that long time use of oxygen was a significant risk factor associated with the development of ROP. GA and BBW were protective factors of ROP. Low birth body weight, young gestational age and long time oxygen usage are the most important risk factors in the development of ROP.

  13. Cardiometabolic Risk Variables in Preadolescent Children: A Factor Analysis.

    Science.gov (United States)

    Stoner, Lee; Weatherall, Mark; Skidmore, Paula; Castro, Nicholas; Lark, Sally; Faulkner, James; Williams, Michelle A

    2017-10-11

    Atherosclerosis begins during preadolescence and is occurring at an accelerated rate. This acceleration has been linked to poor lifestyle behaviors and subsequent cardiometabolic complications. Although the clustering of cardiometabolic risk factors has been recognized for over 2 decades, previous studies in children have predominantly examined the relationships between atherosclerosis and individual cardiometabolic risk factors or have grouped together preadolescent and adolescent children. Further, no known studies have included glycated hemoglobin or central hemodynamic measures such as central systolic blood pressure and augmentation index. Principal component analysis was performed on a cross-sectional sample of 392 children (aged 9.5 years, 50% girls) from 3 representative sample sites across New Zealand. Four factors explained 60% of the variance in the measured variables. In order of variance explained, the factors were: blood pressure (central systolic blood pressure and peripheral systolic and diastolic blood pressure), adiposity (waist circumference, body mass index, and glycated hemoglobin), lipids (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), and vascular (augmentation index, heart rate, and fasting blood glucose). In accordance with previous findings in adults and adolescents, one common factor is unlikely to define cardiometabolic health in preadolescent children. Each of the factors, except vascular, which was predominantly explained by augmentation index, are in agreement with previous findings in adolescents. An additional novel finding was that glycated hemoglobin and fasting blood glucose loaded onto different factors, supporting previous work suggesting that fasting blood glucose indicates short-term glycemic control, whereas glycated hemoglobin reflects chronic glycemic control. URL: www.anzctr.org.au/. ID: ACTRN12614000433606. © 2017 The Authors. Published on behalf of the American Heart

  14. [Risk factors of coronary heart disease in various occupational groups. I. Analysis of risk factor incidence].

    Science.gov (United States)

    Gałuszka, Z; Grzelec, T; Hudzik, A; Jodłowski, J; Pokorska, M; Kolarzyk, E

    1990-01-01

    The subjects of investigation in a standard clinical conditions were 4 groups of workers: blast furnace workers (n = 121), operators (n = 131), persons from managic staff (n = 73) and monks (n = 81). In all subjects 8 factors enhancing ischemic heart disease were estimated: treating family history, habit of smoking, male sex, blood hypertension, obesity, increased cholesterol concentration in blood serum and small physical activity. It was found that investigated groups were significantly different as to frequency of occurrence of ischemic heart disease risk factors.

  15. 49 CFR Appendix D to Part 172 - Rail Risk Analysis Factors

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Rail Risk Analysis Factors D Appendix D to Part... REQUIREMENTS, AND SECURITY PLANS Pt. 172, App. D Appendix D to Part 172—Rail Risk Analysis Factors A. This... safety and security risk analyses required by § 172.820. The risk analysis to be performed may be...

  16. Analysis of risk factors and risk assessment for ischemic stroke recurrence

    Directory of Open Access Journals (Sweden)

    Xiu-ying LONG

    2016-08-01

    Full Text Available Objective To screen the risk factors for recurrence of ischemic stroke and to assess the risk of recurrence. Methods Essen Stroke Risk Score (ESRS was used to evaluate the risk of recurrence in 176 patients with ischemic stroke (96 cases of first onset and 80 cases of recurrence. Univariate and multivariate stepwise Logistic regression analysis was used to screen risk factors for recurrence of ischemic stroke.  Results There were significant differences between first onset group and recurrence group on age, the proportion of > 75 years old, hypertension, diabetes, coronary heart disease, peripheral angiopathy, transient ischemic attack (TIA or ischemic stroke, drinking and ESRS score (P < 0.05, for all. First onset group included one case of ESRS 0 (1.04%, 8 cases of 1 (8.33%, 39 cases of 2 (40.63%, 44 cases of 3 (45.83%, 4 cases of 4 (4.17%. Recurrence group included 2 cases of ESRS 3 (2.50%, 20 cases of 4 (25% , 37 cases of 5 (46.25% , 18 cases of 6 (22.50% , 3 cases of 7 (3.75% . There was significant difference between 2 groups (Z = -11.376, P = 0.000. Logistic regression analysis showed ESRS > 3 score was independent risk factor for recurrence of ischemic stroke (OR = 31.324, 95%CI: 3.934-249.430; P = 0.001.  Conclusions ESRS > 3 score is the independent risk factor for recurrence of ischemic stroke. It is important to strengthen risk assessment of recurrence of ischemic stroke. To screen and control risk factors is the key to secondary prevention of ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2016.07.011

  17. Smoking among American adolescents: a risk and protective factor analysis.

    Science.gov (United States)

    Scal, Peter; Ireland, Marjorie; Borowsky, Iris Wagman

    2003-04-01

    Cigarette smoking remains a substantial threat to the current and future health of America's youth. The purpose of this study was to identify the risk and protective factors for cigarette smoking among US adolescents. Data from the National Longitudinal Study of Adolescent Health was used, comparing the responses of all non-smokers at Time 1 for their ability to predict the likelihood of smoking at Time 2, one year later. Data was stratified into four gender by grade group cohorts. Cross-cutting risk factors for smoking among all four cohorts were: using alcohol, marijuana, and other illicit drugs; violence involvement; having had sex; having friends who smoke and learning problems. Having a higher grade point average and family connectedness were protective across all cohorts. Other gender and grade group specific risk and protective factors were identified. The estimated probability of initiating smoking decreased by 19.2% to 54.1% both in situations of high and low risk as the number of protective factors present increased. Of the factors that predict or protect against smoking some are influential across all gender and grade group cohorts studied, while others are specific to gender and developmental stage. Prevention efforts that target both the reduction of risk factors and enhancement of protective factors at the individual, family, peer group and community are likely to reduce the likelihood of smoking initiation.

  18. Risk factors for deep vein thrombosis and pulmonary embolism after traumatic injury: A competing risks analysis.

    Science.gov (United States)

    Van Gent, Jan-Michael; Calvo, Richard Yee; Zander, Ashley L; Olson, Erik J; Sise, C Beth; Sise, Michael J; Shackford, Steven R

    2017-12-01

    Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different. We examined all adult trauma patients admitted to our Level I trauma center from July 2006 to December 2011 who received at least one surveillance duplex ultrasound of the lower extremities and who were at high risk or greater for DVT. Outcomes included DVT and PE events, and time-to-event from admission. We used competing risks analysis to evaluate risk factors for DVT while accounting for PE as a competing event, and vice versa. Of 2,370 patients, 265 (11.2%) had at least one venous thromboembolism event, 235 DVT only, 19 PE only, 11 DVT and PE. Within 2 days of admission, 38% of DVT cases had occurred compared with 26% of PE. Competing risks modeling of DVT as primary event identified older age, severe injury (Injury Severity Score, ≥ 15), mechanical ventilation longer than 4 days, active cancer, history of DVT or PE, major venous repair, male sex, and prophylactic enoxaparin and prophylactic heparin as associated risk factors. Modeling of PE as the primary event showed younger age, nonsevere injury (Injury Severity Score, < 15), central line placement, and prophylactic heparin as relevant factors. The risk factors for PE and DVT after injury were different, suggesting that they are clinically distinct events that merit independent consideration. Many DVT events occurred early despite prophylaxis, bringing into question the preventability of postinjury DVT. We recommend trauma center quality reporting program measures be revised to account for DVT and PE as unique events. Epidemiologic

  19. Retrospective analysis of the risk factors for developing phacomorphic glaucoma

    Directory of Open Access Journals (Sweden)

    Jacky W Y Lee

    2011-01-01

    Full Text Available Aim : To determine the risk factors for developing phacomorphic glaucoma in eyes with mature cataracts. Materials and Methods : This is a case-control study comprising of 90 eyes with phacomorphic glaucoma and 90 age- and sex-matched control eyes with mature cataracts without phacomorphic glaucoma. Patients with pre-existing glaucoma, previous intraocular surgery and /or absence of documented axial lengths were excluded from this study. Binary logistic regression analysis of the variables, axial length and anterior chamber depth, was performed. Anterior chamber depth of the contralateral eye was used as a proxy measure of the pre-phacomorphic state in the eye with phacomorphic glaucoma as majority of them first presented to our center during the phacomorphic attack without prior measurements of the pre-phacomorphic ACD or lens thickness; therefore, their anterior chamber depth would not be representative of their pre-phacomorphic state. Axial length of 23.7 mm was selected as a cut-off for dichotomized logistic regression based on the local population mean from published demographic data. Results : The mean age was 73.1 ± 10.2 years. All phacomorphic and control eyes were ethnic Chinese. The mean presenting intraocular pressures were 49.5 ± 11.8 mmHg and 16.7 ± 1.7 mmHg in the phacomorphic and control eyes respectively (P 23.7 mm (P = 0.003. Conclusion : Axial length less than ≤ 23.7 mm was a risk factor for developing phacomorphic glaucoma. Eyes with AL shorter than the population mean were 4.3 times as likely to develop phacomorphic glaucoma compared with eyes with longer than average AL. In an area where phacomorphic glaucoma is prevalent and medical resources are limited, patients with AL shorter than their population mean may be considered for earlier elective cataract extraction as a preventive measure.

  20. Analysis of ectasia after laser in situ keratomileusis: risk factors.

    Science.gov (United States)

    Binder, Perry S

    2007-09-01

    To examine a database of laser in situ keratomileusis (LASIK) procedures for preoperative and operative factors assumed to increase the risk for developing post-LASIK ectasia. Private clinical practice. A computer database was queried for eyes that had LASIK for myopic refractive errors with the following characteristics: preoperative corneal thickness 500 microm or less, mean keratometry greater than 47.0 diopters (D), patient age 25 years or younger, attempted correction greater than -8.0 D, refractive astigmatism not with-the-rule and greater than 2.0 D, and residual stromal bed thickness (RST) 250 microm or less. Flap thickness and RST were measured using ultrasound pachymetry. All recorded information was exported to MS Excel and analyzed for eyes that had ectasia. Of the 9700 eyes in the database, none with the above characteristics developed ectasia over mean follow-up periods exceeding 2 years. Seven eyes had multiple risk factors without ectasia. Three eyes with abnormal preoperative topography developed ectasia. Individual preoperative and operative factors did not in and of themselves increase the risk for ectasia. Unmeasured and unknown factors that affect the individual cornea's biomechanical stability, in combination with some suspected risk factors as well as the current inability to identify corneas at risk for developing ectatic disorders, probably account for most eyes that develop ectasia today.

  1. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

    Directory of Open Access Journals (Sweden)

    Ali Harlak

    2010-01-01

    Full Text Available PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001. With an adjusted odds ratio of 1.3 (p<.001, body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

  2. Analysis of genetics and risk factors of Alzheimer's Disease.

    Science.gov (United States)

    Panpalli Ates, M; Karaman, Y; Guntekin, S; Ergun, M A

    2016-06-14

    Alzheimer's Disease is the leading neurodegenerative cause of dementia. The pathogenesis is not clearly understood yet, is believed to be the complex interaction between genetic and environmental factors. Consequently vascular risk factors and Apolipoprotein E genotyping are increasingly gaining importance. This study aimed at assessing the relationships between Alzheimer's Disease and Apolipoprotein E phenotype and vascular risk factors. Patients diagnosed with "possible Alzheimer's Disease" in the Gazi University, Department of Neurology, were included in the study and age-matched volunteer patients who attended the polyclinic were included as a control group. In this study, the risk factors including low education level, smoking, hyperlipidemia, higher serum total cholesterol levels, and hyperhomocysteinemia were found to be statistically significantly more common in the Alzheimer's Disease group in comparison to the Control Group, while all Apolipoprotein E ε4/ε4 genotypes were found in the Alzheimer's Disease group. The presence of the Apolipoprotein E ε4 allele is believed to increase vascular risk factors as well as to affect Alzheimer's Disease directly. The biological indicators which are used in identifying the patients' genes will be probably used in the treatment plan of the patients in the future. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  3. Risk Factor Analysis in Operated Abdominal Aortic Aneurysm Patients

    Directory of Open Access Journals (Sweden)

    Hasan Sunar

    2011-08-01

    Full Text Available Background : Abdominal aortic aneurysm (AAA is a common disease of the elderly, with a complex etiology. The known risk factors for abdominal aortic aneurysm is age, male gender, presence of family history of AAA, presence of aneurysms elsewhere (especially at the femoral and popliteal artery, smoking, diabetes mellitus, atherosclerosis and hypertension. The aim of this study was to evaluate risk factors associated with operated abdominal aortic aneurysm in our center. Patients and Method : Our study population consisted of 210 patients who had been performed abdominal aortic aneurysm surgery between January 1998 and January 2010 in our clinic. The study was designed in a retrospective manner and all data were collected from hospital records. The patients were searched for diabetes mellitus, hypertension, age, gender, hyperlipidemia, atherosclerosis and smoking. Results : 187 of 210 patients male and 23 of 210 patients female. The mean age was 64,4±8,9. The most common risk factors were diabetes mellitus (10.1%, hypertension (67.6%, hyperlipidemia (30.9%, chronic obstructive pulmonary disease (35.7% and smoking (76.7% for abdominal aortic aneurysm. Conclusion: Smoking was found be as the most important risk factor for abdominal aortic aneurysm. To our knowledge, high rate of smoking in our society has a direct link with abdominal aortic aneurysm. The effective implementation of social campaigns to prevent smoking may be promising for reducing the incidence of abdominal aortic aneurysm in our society.

  4. Phantom pain and risk factors : A multivariate analysis

    NARCIS (Netherlands)

    Dijkstra, PU; Geertzen, JHB; Stewart, R; van der Schans, CP

    2002-01-01

    Phantom pain has been given considerable attention in literature. Phantom Pain reduces quality of life, and patients suffering from phantom pain make heavy use of the medical system. Many risk factors have been identified for phantom Pain in univariate analyses, including phantom sensations, stump

  5. Analysis OfProductivity And Risk Factors In Commercial Poultry ...

    African Journals Online (AJOL)

    The study examined the resource usc efficiency nnd occurrence of risk factors in poultry production in osun state, nigeria ... enterprises. Poultry has the highest feed conversion rates and produces the cheapest, commonest and best sources of animal protein (Orji et a) 1981 ). ... by adopting better management practices.

  6. Risk Factors for Gambling Problems: An Analysis by Gender.

    Science.gov (United States)

    Hing, Nerilee; Russell, Alex; Tolchard, Barry; Nower, Lia

    2016-06-01

    Differences in problem gambling rates between males and females suggest that associated risk factors vary by gender. Previous combined analyses of male and female gambling may have obscured these distinctions. This study aimed to develop separate risk factor models for gambling problems for males and for females, and identify gender-based similarities and differences. It analysed data from the largest prevalence study in Victoria Australia (N = 15,000). Analyses determined factors differentiating non-problem from at-risk gamblers separately for women and men, then compared genders using interaction terms. Separate multivariate analyses determined significant results when controlling for all others. Variables included demographics, gambling behaviour, gambling motivations, money management, and mental and physical health. Significant predictors of at-risk status amongst female gamblers included: 18-24 years old, not speaking English at home, living in a group household, unemployed or not in the workforce, gambling on private betting, electronic gaming machines (EGMs), scratch tickets or bingo, and gambling for reasons other than social reasons, to win money or for general entertainment. For males, risk factors included: 18-24 years old, not speaking English at home, low education, living in a group household, unemployed or not in the workforce, gambling on EGMs, table games, races, sports or lotteries, and gambling for reasons other than social reasons, to win money or for general entertainment. High risk groups requiring appropriate interventions comprise young adults, especially males; middle-aged female EGM gamblers; non-English speaking populations; frequent EGM, table games, race and sports gamblers; and gamblers motivated by escape.

  7. Risk factors for embolism in cardiac myxoma: a retrospective analysis.

    Science.gov (United States)

    He, Deng-Ke; Zhang, Yu-Feng; Liang, Yin; Ye, Shi-Xing; Wang, Chong; Kang, Bo; Wang, Zhi-Nong

    2015-04-22

    Myxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma. In this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients. No significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications. Tumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.

  8. Asthenopia in bankers: identification and analysis of risk factors

    OpenAIRE

    Comério, Rowena Siqueira; Saraiva, Patricia Grativol Costa; Martins, Paula Silva dos Santos; Rodrigues, Mariana Zatta; Saager, Silene Batista de Freitas; Saraiva, Fábio Petersen

    2017-01-01

    Abstract Objective: To evaluate the prevalence of asthenopia in a cohort of bank employees and identify possible associated risk factors. Methods: Cross-sectional study based on information supplied by bankers in response to a standardized electronic questionnaire. Results: The questionnaire was responded by 945 bankers. The frequency of asthenopic symptoms was positively associated with female gender, age over 50 years, and reading or using the computer >6 hours a day. Conclusion: Asthen...

  9. Postpartum Depression in Women: A Risk Factor Analysis.

    Science.gov (United States)

    Zaidi, Farheen; Nigam, Aruna; Anjum, Ruby; Agarwalla, Rashmi

    2017-08-01

    Postpartum Depression (PPD) is a known entity affecting not only the women but the whole family. It affects women more harshly and chronically due to their increased stress sensitivity, maladaptive coping strategies and multiple social roles in the community. To estimate the commonly associated risk factors of PPD among the women coming to a tertiary hospital in New Delhi, India. It was a longitudinal study conducted at the antenatal clinic for a period of one year. Total 260 women were screened at > 36 weeks of gestation, of which 149 postnatal women completed the questionnaire for PPD at six weeks of their delivery. The inform consent, demographical data and obstetrical details from each participant was taken before commencing the screening. Various risk factors and their association were determined by odds-ratio and significant association was accepted at women as it was found in 12.75% (19 out of 149) of subjects at six weeks of their delivery. Moreover, it has significant association with the young maternal age (p-value=0.040), birth of the female child (p-value=0.015), previous stressful life events (p-value= 0.003), low self-esteem and feeling of loneliness (p-value=0.007). This study provides important information regarding the risk factors associated with development of PPD in this region of India. Female sex of the new born and the younger age play an important role in the development of PPD.

  10. Risk Factors of Mortality from All Asbestos-Related Diseases: A Competing Risk Analysis

    Science.gov (United States)

    Rodriguez-Blanco, Teresa; Garcia-Allas, Isabel; Rosell-Murphy, Isabel-Magdalena; Albertí-Casas, Constança; Tarrés, Josep; Krier-Günther, Illona; Martinez-Artés, Xavier; Orriols, Ramon; Grimau-Malet, Isidre; Canela-Soler, Jaume

    2017-01-01

    Background The mortality from all malignant and nonmalignant asbestos-related diseases remains unknown. The authors assessed the incidence and risk factors for all asbestos-related deaths. Methods The sample included 544 patients from an asbestos-exposed community in the area of Barcelona (Spain), between Jan 1, 1970, and Dec 31, 2006. Competing risk regression through a subdistribution hazard analysis was used to estimate risk factors for the outcomes. Results Asbestos-related deaths were observed in 167 (30.7%) patients and 57.5% of these deaths were caused by some type of mesothelioma. The incidence rate after diagnosis was 3,600 per 100,000 person-years. In 7.5% of patients death was non-asbestos-related, while pleural and peritoneal mesothelioma were identified in 87 (16.0%) and 18 (3.3%) patients, respectively. Conclusions Age, sex, household exposure, cumulative nonmalignant asbestos-related disease, and single malignant pathology were identified as risk factors for asbestos-related death. These findings suggest the need to develop a preventive approach to the community and to improve the clinical follow-up process of these patients. PMID:28680295

  11. Analysis of Hepatitis B Transmission Risk Factors in HIV Patients

    Directory of Open Access Journals (Sweden)

    Iman Ghasemzadeh

    2016-09-01

    Full Text Available Co-infection with Hepatitis B (HBV virus and HIV is common due to similarity of their transmission methods. However, the prevalence of concurrent infection in different societies, shows the crucial role of various risk factors in different populations. Therefore, the present study was performed to examine risk factors of transmission of HBV in patients with HIV in a care center for AIDS patients in Rasht City. This case-control study was carried out on 60 HIV positive patients, who visited the Infectious Diseases Center of Razi Hospital of Rasht from November, 2015 to March, 2016. Participants were assigned to two 30-member experiment and control groups. They were adjusted in terms of age group (18-30, 30-40, 40-50, and 50-60, gender (male and female, and marital status (married, single, divorced, and widowed and visited by an infectious diseases specialist according to routine examinations. Data was recorded in a questionnaire for each subject. The mean age for the experimental group was 35±6.1, and for control group was 36.6± 5.7 years. Both univariate and multivariate analyses of development of HBV infection and variables including Illegitimate sexual intercourse, use of intravenous injection drugs, positive history of imprisonment, and tattooing (p value < 0.05 showed existence of significant relationships. Injection of illegal intravenous drugs, history of imprisonment, illegitimate sexual intercourse, and tattooing are four important risk factors for transmission of HBV infection to HIV patients. In addition, the master risk reduction program may include provision of clean disposable tools for intravenous injection of drugs and tattooing.

  12. Obesity-associated Breast Cancer: Analysis of risk factors.

    Science.gov (United States)

    Engin, Atilla

    2017-01-01

    Several studies show that a significantly stronger association is obvious between increased body mass index (BMI) and higher breast cancer incidence. Furthermore, obese women are at higher risk of all-cause and breast cancer specific mortality when compared to non-obese women with breast cancer. In this context, increased levels of estrogens due to excessive aromatization activity of the adipose tissue, overexpression of pro-inflammatory cytokines, insulin resistance, hyperactivation of insulin-like growth factors (IGFs) pathways, adipocyte-derived adipokines, hypercholesterolemia and excessive oxidative stress contribute to the development of breast cancer in obese women. While higher breast cancer risk with hormone replacement therapy is particularly evident among lean women, in postmenopausal women who are not taking exogenous hormones, general obesity is a significant predictor for breast cancer. Moreover, increased plasma cholesterol leads to accelerated tumor formation and exacerbates their aggressiveness. In contrast to postmenopausal women, premenopausal women with high BMI are inversely associated with breast cancer risk. Nevertheless, life-style of women for breast cancer risk is regulated by avoiding the overweight and a high-fat diet. Estrogen-plus-progestin hormone therapy users for more than 5 years have elevated risks of both invasive ductal and lobular breast cancer. Additionally, these cases are more commonly node-positive and have a higher cancer-related mortality. Collectively, in this chapter, the impacts of obesity-related estrogen, cholesterol, saturated fatty acid, leptin and adiponectin concentrations, aromatase activity, leptin and insulin resistance on breast cancer patients are evaluated. Obesity-related prognostic factors of breast cancer also are discussed at molecular basis.

  13. Analysis on the risk factors of second fracture in osteoporosis-

    Directory of Open Access Journals (Sweden)

    RUAN Wen-dong

    2011-04-01

    Full Text Available 【Abstract】 Objective: To explore the clinical characteristics and risk factors of refracture in patients suffering from osteoporosis-related fractures as well as effective interventions. Methods: From January 2006 to January 2008, both out-patients and in-patients in our hospital who were over 50 years old and suffered from osteoporosis-related fractures were selected for this research. They were divided into fracture group and refracture group. The refracture rate was followed up for 2 years, during which 11 patients developed refracture, thus were included in the refracture group. Therefore, 273 patients, 225 first-fracture cases, aged (67.7± 8.5 years, and 48 refracture cases, aged (72.7±9.5 years, were included in this study. General data including age and sex, fracture types, femoral neck bone mineral density (BMD T-scores tested by dual-energy X-rays absorptiometry (DEXA, Charlson index, time-frame between two fractures as well as mobility skill assessment were collected and analyzed by single-factor and multivariate statistical methods. Results: Females accounted for 70.2% of the fracture group and 77.1% of the refracture group. The most common refracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup. The second fracture happened 3.7 years after the first one on average. The refracture rate was 2.12% within one year, and 4.66% within two years. Risk factors for a second fracture in osteoporotic fracture patients included age (>75 years, HR=1.23, 95%CI 1.18-1.29; >85 years, HR=1.68, 95% CI 1.60-1.76, female sex (HR=1.36, 95%CI 1.32-1.40, prior vertebral fractures (HR=1.62, 95%CI 1.01-2.07, prior hip fractures (HR=1.27, 95%CI 0.89-2.42, BMD T-score<-3.5 (HR=1.38, 95%CI 1.17-1.72 and weakened motor skills (HR=1.27, 95%CI 1.09-1.40. Conclusions: The risks of second fracture among patients with initial brittle fracture are substantial. There is adequate time between the

  14. Asthenopia in bankers: identification and analysis of risk factors

    Directory of Open Access Journals (Sweden)

    Rowena Siqueira Comério

    Full Text Available Abstract Objective: To evaluate the prevalence of asthenopia in a cohort of bank employees and identify possible associated risk factors. Methods: Cross-sectional study based on information supplied by bankers in response to a standardized electronic questionnaire. Results: The questionnaire was responded by 945 bankers. The frequency of asthenopic symptoms was positively associated with female gender, age over 50 years, and reading or using the computer >6 hours a day. Conclusion: Asthenopic symptoms were found to be significantly associated with gender, age and time spent reading. The most frequently reported symptoms were headache and sore eyes.

  15. Risk factor analysis for metaplastic gastritis in Koreans

    Science.gov (United States)

    Choi, Soonami; Lim, Yun Jeong; Park, Sue Kyung

    2006-01-01

    AIM: To conduct a retrospective study to determine the risk factors for development of metaplastic gastritis in Korean population. METHODS: The database of 113 449 subjects who underwent a gastroscopy for the purpose of a regular check-up at center for health promotion, Samsung medical center during 5 years was collected and retrospectively analyzed. Among them, 5 847 subjects who had endoscopically diagnosed as a metaplastic gastritis or 10 076 normal as well as answered to questionnaire were included for present study. The subjects were divided into 2 groups; Group I, normal and Group II, metaplastic gastritis. Age, gender, Helicobacter pylori (H pylori) seropositivity, body mass index (BMI), family history of cancer, smoking, alcohol consumption, total daily calories, folate and salt intake and dietary habit (out-eating, overeating, irregular eating) were retrieved from questionnaire or electronic medical record and compared between group I and group II. RESULTS: The prevalence of group II was 11% (13 578/113 449) increasing its prevalence with age (P = 0.000). But, there was no significant association between 2 groups in BMI, family history of cancer, alcohol consumption, total daily calories, folate and salt intake and dietary habit (out-eating, overeating, irregular eating). Old age (P = 0.000), male gender (P = 0.000), H pylori seropositivity (P = 0.010) and current smoker (P = 0.000) were significantly more common in group II at multiple logistic regression model. CONCLUSION: Our data suggested that old age, male gender, H pylori seropositivity and smoking were risk factors for metaplastic gastritis, precancerous lesion of gastric cancer. PMID:16688806

  16. Risk analysis of the thermal sterilization process. Analysis of factors affecting the thermal resistance of microorganisms.

    Science.gov (United States)

    Akterian, S G; Fernandez, P S; Hendrickx, M E; Tobback, P P; Periago, P M; Martinez, A

    1999-03-01

    A risk analysis was applied to experimental heat resistance data. This analysis is an approach for processing experimental thermobacteriological data in order to study the variability of D and z values of target microorganisms depending on the deviations range of environmental factors, to determine the critical factors and to specify their critical tolerance. This analysis is based on sets of sensitivity functions applied to a specific case of experimental data related to the thermoresistance of Clostridium sporogenes and Bacillus stearothermophilus spores. The effect of the following factors was analyzed: the type of target microorganism; nature of the heating substrate; pH, temperature; type of acid employed and NaCl concentration. The type of target microorganism to be inactivated, the nature of the substrate (reference or real food) and the heating temperature were identified as critical factors, determining about 90% of the alteration of the microbiological risk. The effect of the type of acid used for the acidification of products and the concentration of NaCl can be assumed to be negligible factors for the purposes of engineering calculations. The critical non-uniformity in temperature during thermobacteriological studies was set as 0.5% and the critical tolerances of pH value and NaCl concentration were 5%. These results are related to a specific case study, for that reason their direct generalization is not correct.

  17. Empirical analysis of farmers' drought risk perception: objective factors, personal circumstances, and social influence.

    Science.gov (United States)

    Duinen, Rianne van; Filatova, Tatiana; Geurts, Peter; Veen, Anne van der

    2015-04-01

    Drought-induced water shortage and salinization are a global threat to agricultural production. With climate change, drought risk is expected to increase as drought events are assumed to occur more frequently and to become more severe. The agricultural sector's adaptive capacity largely depends on farmers' drought risk perceptions. Understanding the formation of farmers' drought risk perceptions is a prerequisite to designing effective and efficient public drought risk management strategies. Various strands of literature point at different factors shaping individual risk perceptions. Economic theory points at objective risk variables, whereas psychology and sociology identify subjective risk variables. This study investigates and compares the contribution of objective and subjective factors in explaining farmers' drought risk perception by means of survey data analysis. Data on risk perceptions, farm characteristics, and various other personality traits were collected from farmers located in the southwest Netherlands. From comparing the explanatory power of objective and subjective risk factors in separate models and a full model of risk perception, it can be concluded that farmers' risk perceptions are shaped by both rational and emotional factors. In a full risk perception model, being located in an area with external water supply, owning fields with salinization issues, cultivating drought-/salt-sensitive crops, farm revenue, drought risk experience, and perceived control are significant explanatory variables of farmers' drought risk perceptions. © 2014 Society for Risk Analysis.

  18. Risk analysis-based food safety policy: scientific factors versus socio-cultural factors

    NARCIS (Netherlands)

    Rosa, P.; Knapen, van F.; Brom, F.W.A.

    2008-01-01

    The purpose of this article is to illustrate the importance of socio-cultural factors in risk management and the need to incorporate these factors in a standard, internationally recognized (wto) framework. This was achieved by analysing the relevance of these factors in 3 cases
    The purpose of

  19. Risk factor analysis for oral precancer among slum dwellers in Delhi ...

    African Journals Online (AJOL)

    Association of oral precancer with smokeless tobacco was higher than that with smoking or chewing betel leaf/nut alone. Conclusion: Practicing combination of habits with alcohol was found to be the most strongly associated risk factor for oral precancer. Keywords: Oral cancer, Risk factor analysis, Slum dwellers ...

  20. Female- and Male-Specific Risk Factors for Stroke: A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Poorthuis, M.H.; Algra, A.M.; Kappelle, L.J.; Klijn, C.J.M.

    2017-01-01

    Importance: The incidence of stroke is higher in men than in women. The influence of sex-specific risk factors on stroke incidence and mortality is largely unknown. Objective: To conduct a systematic review and meta-analysis of female- and male-specific risk factors for stroke. Data Sources: PubMed,

  1. Female- and Male-Specific Risk Factors for Stroke : A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Poorthuis, Michiel H F; Algra, Annemijn M; Algra, Ale; Kappelle, L Jaap; Klijn, Catharina J M

    2017-01-01

    Importance: The incidence of stroke is higher in men than in women. The influence of sex-specific risk factors on stroke incidence and mortality is largely unknown. Objective: To conduct a systematic review and meta-analysis of female- and male-specific risk factors for stroke. Data Sources: PubMed,

  2. An Analysis of the Role of Service Specific Risk Factors in Active Duty Navy Suicides

    Science.gov (United States)

    2014-03-01

    risk among teenagers and older adults); furthermore, the age bracket results coincide with the crude suicide numbers in the dataset (the 17–19 age...ROLE OF SERVICE–SPECIFIC RISK FACTORS IN ACTIVE DUTY NAVY SUICIDES by James D. Golliday March 2014 Thesis Co-Advisors: Yu-Chu Shen...COVERED Master’s Thesis 4. TITLE AND SUBTITLE AN ANALYSIS OF THE ROLE OF SERVICE–SPECIFIC RISK FACTORS IN ACTIVE DUTY NAVY SUICIDES 5. FUNDING

  3. [Risk factors associated with hypertension. Analysis of the 2009-2010 Chilean health survey].

    Science.gov (United States)

    Petermann, Fanny; Durán, Eliana; Labraña, Ana María; Martínez, María Adela; Leiva, Ana María; Garrido-Méndez, Alex; Poblete-Valderrama, Felipe; Díaz-Martínez, Ximena; Salas, Carlos; Celis-Morales, Carlos

    2017-08-01

    High blood pressure is one of the major risk factors for the development of cardiovascular disease, affecting 27% of the Chilean population in 2010. To determine the risk factors associated with the development of hypertension. Analysis of the database of the 2009-2010 National Health Survey in which 4,901 participants were included. Socio-demographic factors, physical activity, eating habits, well-being and comorbidities were analyzed. Women had a lower risk of developing hypertension than men (Odds ratio (OR): 0.69, 95% confidence intervals (CI): 0.59-0.81, p risk is greater over the age of 25 years (OR: 2.90, 95% CI: 1.55-5.43, p risk is greater in subjects who were overweight (OR: 1.61, 95% CI: 1.31-1.98, p hypertension and diabetes also have a higher risk. Identifying the risk factors associated with hypertension allows public health policies to be tailored to its prevention.

  4. Complicated appendicitis: Analysis of risk factors in children | Singh ...

    African Journals Online (AJOL)

    Background: Acute appendicitis (AA) is the most common surgical emergency in childhood. The risk of rupture is negligible within the first 24 h, climbing to 6% after 36 h from the onset of symptoms. Because of difficulty in accurate diagnosis of AA a significant number of children still are being managed when it is already ...

  5. Risk factors analysis and implications for public health of bovine ...

    African Journals Online (AJOL)

    Bovine tuberculosis (TB) is a neglected zoonosis of cattle that is prevalent but under-investigated in Cameroon. Based on epidemiological data of the disease, this study was designed to assess the risks and public health implications for zoonotic M. bovis infection in cattle and humans in the highlands of Cameroon.

  6. Risk factors for infectious complications after open fractures; a systematic review and meta-analysis.

    Science.gov (United States)

    Kortram, Kirsten; Bezstarosti, Hans; Metsemakers, Willem-Jan; Raschke, Michael J; Van Lieshout, Esther M M; Verhofstad, Michael H J

    2017-10-01

    The purpose of this study was to identify risk factors for the development of infection after open fracture fixation. A comprehensive search in all scientific literature of the last 30 years was performed in order to identify patient-, trauma-, diagnosis- and treatment-related risk factors. Studies were included when infectious complications were assessed in light of one or more risk factors. A meta-analysis was performed. Risk ratios (RR) or risk differences (RD) with 95% confidence intervals were calculated. A total of 116 manuscripts were included. Male gender (RR 1.42), diabetes mellitus (DM) (RR 1.72), smoking (RR1.29), a lower extremity fracture (RR 1.94), Gustilo-Anderson grade III open fracture (RR 3.01), contaminated fracture (RR 7.85) and polytrauma patients (RR 1.49) were identified as statistically significant risk factors for the development of infectious complications. Of the treatment-related risk factors, only pulsatile lavage was associated with a higher infectious complication rate (RR 2.70). A number of risk factors for the development of infections after open fractures have been identified in the available literature. These factors should still be tested for independence in a multivariable model. Prospective, observational studies are needed to identify and quantify individual risk factors for infection after open fracture fixation.

  7. Risk Factors

    Science.gov (United States)

    ... Many things in our genes , our lifestyle, and the environment around us may increase or decrease our risk ... Being exposed to chemicals and other substances in the environment has been linked to some cancers: Links between ...

  8. Risk Factors for Surgical Results of Hirayama Disease: A Retrospective Analysis of a Large Cohort.

    Science.gov (United States)

    Song, Jian; Wang, Hong-Li; Zheng, Chao-Jun; Jiang, Jian-Yuan

    2017-09-01

    To explore risk factors affecting surgical results of Hirayama disease. A retrospective analysis of 210 patients was performed to identify risk factors affecting surgical results of Hirayama disease by using univariate and multivariate analyses. A receiver operating characteristic curve and area under the curve were applied to evaluate the significant results of the multivariate analysis and the optimal reference value. The mean follow-up period was 27.3 months (range, 14-45 months), and 194 patients with clinical and radiographic data completed the final follow-up. Multivariate analysis identified age of patients (cutoff value 22.5 years), duration of the disease (cutoff value 33 months), physiologic reflex, and pathologic reflex as independent risk factors for surgical results of Hirayama disease. The receiver operating characteristic curve analysis and area under the curve showed that good reference value was obtained for the risk factors. Age of patient, duration of the disease, physiologic reflex, and pathologic reflex are the main risk factors affecting surgical results of Hirayama disease. Receiver operating characteristic analysis shows that good reference value was obtained for the risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Stakeholder consultations and opportunities for integrating socio-behavioural factors into the pesticide risk analysis process.

    Science.gov (United States)

    Calliera, Maura; Marchis, Alex; Sacchettini, Gabriele; Capri, Ettore

    2016-02-01

    The pesticide risk analysis process is well regulated in the EU, especially in relation to placing on the market authorisation procedures, but in order to avoid risks for human health and environment in the use phase, information on how these substances are employed and on socio-behavioural factors that can influence the exposure have to be taken into account. To better explore reasons about the gap between risk assessment and risk management, within the EU FP7 Health and Environmental Risks: Organisation, Integration and Cross-fertilisation of Scientific Knowledge (HEROIC) project, a stepwise stakeholder's consultation process was developed using a mixed approach in two different phases (survey and roundtable). We elicited stakeholder views regarding factors that could limit the pesticide risk assessment phase linked on how the knowledge is produced and the way the data are used in risk management and in risk communication, also taking into account qualitative factors such as responsibility, trust and behaviours, which could have impact on risk assessment policies. Activities deployed indicate that some changes and interaction are needed to better define the problems at the formulation stage, and the type of information risk assessor has to provide, to better inform risk manager in addressing different societal needs, to strengthen the credibility of the process of risk assessment and improve the effectiveness of policies. Integrations between disciplines may initially increase the complexity but in turn will provide a better and more useful estimation of the risk, reinforce transparency and drive a more efficient use of risk management resources.

  10. Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hee Young; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Park, Min Jung; Kim, Young Kon; Kim, Seong Hyun; Lim, Hyo Keun [Samsung Medical Center, Sungkyunwan University, School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of)

    2013-01-15

    To evaluate the risk factors affecting early diffuse recurrence within 1 year of percutaneous ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Out of 146 patients who received transcatheter arterial chemoembolisation (TACE) for treatment of recurrent HCC after percutaneous ultrasound-guided RFA, we selected 23 patients with early diffuse recurrence. Early diffuse recurrence was defined as three or more new recurrent HCCs within 1 year of initial RFA. As a control group, we selected 23 patients, matched exactly for age and sex, in which there was no local tumour progression or new recurrence after RFA. To analyse the risk factors, we examined patient factors and tumour factors. Recurrent tumours occurred from 30 to 365 days after RFA (median time, 203 days). Univariate analysis indicated that larger tumour size and poorly defined margin were significant risk factors (P < 0.05). Multivariate analysis indicated that poorly defined margin was a significant risk factor (P < 0.05). Larger tumour size and poorly defined margin may be risk factors for early diffuse recurrence of HCC within 1 year of RFA. Tumours with such risk factors should be treated with a combination of TACE to minimise the potential for therapeutic failure. (orig.)

  11. Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury.

    Science.gov (United States)

    Jadhav, Rohan; Achutan, Chandran; Haynatzki, Gleb; Rajaram, Shireen; Rautiainen, Risto

    2016-01-01

    Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

  12. Political risk factors in South Africa: Sources, analysis and insurance flexibility

    Directory of Open Access Journals (Sweden)

    Rudolf Essel

    2013-03-01

    Full Text Available Political risk factors are of prime importance to business operations around the world, as they may impact negatively on the financial performance thereof and may even lead to the financial failure of enterprises and industries. As political risk factors are often abundant in developing countries with emerging market economies, this study is undertaken in South Africa which is classified accordingly. The objective of this research focuses on the improvement of financial decision-making concerning the sources, analysis and insurance flexibility of political risk factors. To achieve the objective of the paper, a literature study and an empirical survey, involving the agents of political risk insurance in South Africa, were undertaken. Due attention is paid to identifying the most important sources of political risk factors, as well as the analysis of the political risk factors by the underwriters concerned. The importance of flexibility concerning the various aspects of political risk insurance is also addressed. The perceptions of the agents of political risk insurance in South Africa provide a valuable contribution to the empirical results and conclusions of this paper.

  13. Analysis of risk factors in the development of retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Knežević Sanja

    2011-01-01

    Full Text Available Introduction. Retinopathy of prematurity (ROP is a multifactorial disease that occurs most frequently in very small and very sick preterm infants, and it has been identified as the major cause of childhood blindness. Objective. The aim of this study was to evaluate ROP incidence and risk factors associated with varying degrees of illness. Methods. The study was conducted at the Centre for Neonatology, Paediatric Clinic of the Clinical Centre Kragujevac, Serbia, in the period from June 2006 to December 2008. Ophthalmologic screening was performed in all children with body weight lower than 2000 g or gestational age lower than 36 weeks. We analyzed eighteen postnatal and six perinatal risk factors and the group correlations for each of the risk factors. Results. Out of 317 children that were screened, 56 (17.7% developed a mild form of ROP, while 68 (21.5% developed a severe form. Univariate analysis revealed a large number of statistically significant risk factors for the development of ROP, especially the severe form. Multivariate logistical analysis further separated two independent risk factors: small birth weight (p=0.001 and damage of central nervous system (p=0.01. Independent risk factors for transition from mild to severe forms of ROP were identified as: small birth weight (p=0.05 and perinatal risk factors (p=0.02. Conclusion. Small birth weight and central nervous system damage were risk factors for the development of ROP, perinatal risk factors were identified as significant for transition from mild to severe form of ROP.

  14. multi variate analysis of risk factors for caesarean section in the ...

    African Journals Online (AJOL)

    section rate at a teaching hospital. Method: Retrospective analysis of the made of delivery within a 5 year period as contained in patients' medical records using frequency distribution and cross tabulations of the risk factor. Logistic regression analysis was used to determine the predictors of. Caesarean section.

  15. Multi Variate Analysis Of Risk Factors For Caesarean Section In The ...

    African Journals Online (AJOL)

    Method: Retrospective analysis of the mode of delivery within a 5 year period as contained in patients' medical records using frequency distribution and cross tabulations of risk factors. Logistic regression analysis was used to determine the predictors of Caesarean section. Result: Caesarean section rate was 22%.

  16. Statistical Analysis of Risk Factors for Cardiovascular disease in Malakand Division

    Directory of Open Access Journals (Sweden)

    Salahud Din

    2006-01-01

    Full Text Available Several studies have been conducted to investigate the incidence of cardiovascular disease and to determine the possible risk factors for the disease. In this study, a Statistical method of odds ratio analysis was performed to look at the association of one of the type of cardiovascular disease known as myocardial infarction with various risk factors such as diabetes, cholesterol, hypertension, sex, smoking, obesity, family history and age in Malakand division. A total of 700 patients were examined and their personal and medical data were collected. For each patient, the phenomenon of myocardial infarction was studied in relation to different risk factors. The analyses suggest that hypertension, smoking, diabetes, cholesterol level and family history were important risk factors for the occurrence of myocardial infarction.

  17. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels.

    Science.gov (United States)

    Danaei, Goodarz; Andrews, Kathryn G; Sudfeld, Christopher R; Fink, Günther; McCoy, Dana Charles; Peet, Evan; Sania, Ayesha; Smith Fawzi, Mary C; Ezzati, Majid; Fawzi, Wafaie W

    2016-11-01

    Stunting affects one-third of children under 5 y old in developing countries, and 14% of childhood deaths are attributable to it. A large number of risk factors for stunting have been identified in epidemiological studies. However, the relative contribution of these risk factors to stunting has not been examined across countries. We estimated the number of stunting cases among children aged 24-35 mo (i.e., at the end of the 1,000 days' period of vulnerability) that are attributable to 18 risk factors in 137 developing countries. We classified risk factors into five clusters: maternal nutrition and infection, teenage motherhood and short birth intervals, fetal growth restriction (FGR) and preterm birth, child nutrition and infection, and environmental factors. We combined published estimates and individual-level data from population-based surveys to derive risk factor prevalence in each country in 2010 and identified the most recent meta-analysis or conducted de novo reviews to derive effect sizes. We estimated the prevalence of stunting and the number of stunting cases that were attributable to each risk factor and cluster of risk factors by country and region. The leading risk worldwide was FGR, defined as being term and small for gestational age, and 10.8 million cases (95% CI 9.1 million-12.6 million) of stunting (out of 44.1 million) were attributable to it, followed by unimproved sanitation, with 7.2 million (95% CI 6.3 million-8.2 million), and diarrhea with 5.8 million (95% CI 2.4 million-9.2 million). FGR and preterm birth was the leading risk factor cluster in all regions. Environmental risks had the second largest estimated impact on stunting globally and in the South Asia, sub-Saharan Africa, and East Asia and Pacific regions, whereas child nutrition and infection was the second leading cluster of risk factors in other regions. Although extensive, our analysis is limited to risk factors for which effect sizes and country-level exposure data were

  18. Application of classification algorithms for analysis of road safety risk factor dependencies.

    Science.gov (United States)

    Kwon, Oh Hoon; Rhee, Wonjong; Yoon, Yoonjin

    2015-02-01

    Transportation continues to be an integral part of modern life, and the importance of road traffic safety cannot be overstated. Consequently, recent road traffic safety studies have focused on analysis of risk factors that impact fatality and injury level (severity) of traffic accidents. While some of the risk factors, such as drug use and drinking, are widely known to affect severity, an accurate modeling of their influences is still an open research topic. Furthermore, there are innumerable risk factors that are waiting to be discovered or analyzed. A promising approach is to investigate historical traffic accident data that have been collected in the past decades. This study inspects traffic accident reports that have been accumulated by the California Highway Patrol (CHP) since 1973 for which each accident report contains around 100 data fields. Among them, we investigate 25 fields between 2004 and 2010 that are most relevant to car accidents. Using two classification methods, the Naive Bayes classifier and the decision tree classifier, the relative importance of the data fields, i.e., risk factors, is revealed with respect to the resulting severity level. Performances of the classifiers are compared to each other and a binary logistic regression model is used as the basis for the comparisons. Some of the high-ranking risk factors are found to be strongly dependent on each other, and their incremental gains on estimating or modeling severity level are evaluated quantitatively. The analysis shows that only a handful of the risk factors in the data dominate the severity level and that dependency among the top risk factors is an imperative trait to consider for an accurate analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. [A Meta analysis of family risk factors for attention deficit hyperactivity disorder].

    Science.gov (United States)

    Zhang, Ya-Feng; Sun, Gui-Xiang

    2015-07-01

    To investigate the risk factors for attention deficit hyperactivity disorder (ADHD) and to provide a basis for future prevention and treatment of this disease. Following a systematic search for case-control studies on the risk factors for ADHD in China between 2000 and 2014, relevant family risk factors were extracted accordingly. The quality of selected studies was evaluated according to the NOS scale. A Meta analysis on the selected studies was conducted using Stata 12.0 software. A total of 16 studies were selected, involving 2 167 children with ADHD and 2 148 normal controls. Results of Meta analysis showed that good parenting (OR=0.32, 95% CI: 0.26-0.40), nuclear family (OR=0.56, 95% CI: 0.41-0.76), high education level of father (OR=0.56, 95% CI: 0.41-0.76), high education level of mother (OR=0.65, 95% CI: 0.47-0.89), and extroversion of mother (OR=0.33, 95% CI: 0.18-0.61) are favorable factors for ADHD. Poor parental relationship (OR=1.90, 95% CI: 1.17-3.06) and family history of ADHD (OR=5.86, 95% CI: 3.67-9.35) are risk factors for ADHD. Good parenting, nuclear family, high education level of parents, and mother with extroversion are protective factors for ADHD, whereas poor parental relationship and family history of ADHD are associated with an increased risk for ADHD.

  20. Risk factor profiles among intravenous drug using young adults: a latent class analysis (LCA) approach.

    Science.gov (United States)

    James, Sigrid; McField, Edward S; Montgomery, Susanne B

    2013-03-01

    Using data from a cross-sectional study that examined health risk behaviors among urban intravenous drug-using (IDU) adolescents and young adults, this study investigated risk profiles among a high-risk sample (n=274). Risk profiles were empirically derived through latent class analysis based on indicators of engagement in health-risking behaviors, experience of abuse and violence as well as individual and family risk factors. The best fitting model was a 3-class model. Class 1 (n=95) captured participants with the lowest risk across all indicators. Compared to Class 1, Class 2 (n=128) and Class 3 (n=51) had elevated rates of engagement in health-risking behaviors as well as individual and family risk factors; however, Class 3 had the highest rate of engagement in sexual risk behavior, and backgrounds of substantial abuse and violence as well as familial psychopathology. Class 2 was the group most socioeconomically disadvantaged, with the highest percentage of participants coming from poor backgrounds, spending the longest time homeless and working the fewest months. Identifying subgroups of IDU has the potential to guide the development of more targeted and effective strategies for prevention and treatment of this high-risk population. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Meta-analysis of tumor necrosis factor alpha -308 polymorphism and knee osteoarthritis risk.

    Science.gov (United States)

    Kou, Suotang; Wu, Yaochi

    2014-11-15

    Several case-control studies have been conducted to clarify the association between the tumor necrosis factor alpha (TNF-α) -G308A polymorphism and risk of osteoarthritis (OA); however, the results are inconsistent. This meta-analysis was performed to clarify this issue using all the available evidence. Eligible articles were retrieved by searching PubMed, Web of science and Google scholar. The strength of the association between the TNF-α -G308A polymorphism and risk of OA was assessed by odds ratios (ORs) with the corresponding 95% confidence interval (CI) for each study. Seven studies were included in the meta-analysis, which included 983 OA cases and 1355 controls. The pooled analysis based on all included studies showed a significantly increased OA risk in the recessive genetic model analysis (OR = 11.08, 95% CI = 4.75-25.86, p risk of OA.

  2. Risk factors for cerebrovascular disease mortality among the elderly in Beijing: a competing risk analysis.

    Directory of Open Access Journals (Sweden)

    Zhe Tang

    Full Text Available OBJECTIVE: To examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases (CBVD mortality, after accounting for competing risk events, including death from cardiovascular diseases, cancers and other diseases. METHODS: Data on 2010 subjects aged over 55 years were finally analyzed using competing risk models. All the subjects were interviewed by the Beijing Longitudinal Study of Aging (BLSA, in China, between 1 January 1992 and 30 August 2009. RESULTS: Elderly females were at a lower risk of death from CBVD than elderly males (HR = 0.639, 95% CI = 0.457-0.895. Increasing age (HR = 1.543, 95% CI = 1.013-2.349, poor self-rated health (HR = 1.652, 95% CI = 1.198-2.277, hypertension (HR = 2.201, 95% CI = 1.524-3.178 and overweight (HR = 1.473, 95% CI = 1.013-2.142 or obesity (HR = 1.711, 95% CI = 1.1754-2.490 was associated with higher CBVD mortality risk. Normal cognition function (HR = 0.650, 95% CI = 0.434-0.973 and living in urban (HR = 0.456, 95% CI = 0.286-0.727 was associated with lower CBVD mortality risk. Gray's test also confirmed the cumulative incidence (CIF of CBVD was lower in the 'married' group than those without spouse, and the mortality was lowest in the 'nutrition sufficient' group among the 'frequent consumption of meat group' and the 'medial type group' (P value<0.001. CONCLUSIONS: CBVD mortality was associated with gender, age, blood pressure, residence, BMI, cognitive function, nutrition and the result of self-rated health assessment in the elderly in Beijing, China.

  3. Breast Cancer Risk From Modifiable and Non-Modifiable Risk Factors among Women in Southeast Asia: A Meta-Analysis

    Science.gov (United States)

    Nindrea, Ricvan Dana; Aryandono, Teguh; Lazuardi, Lutfan

    2017-12-28

    Objective: The aim of this study was to determine breast cancer risk from modifiable and non-modifiable factors among women in Southeast Asia. Methods: This meta-analysis was performed on research articles on breast cancer risk factors in PubMed, ProQuest and EBSCO databases published between 1997 and October 2017. Pooled odds ratios (OR) are calculated using fixed and random-effect models. Data were processed using Review Manager 5.3 (RevMan 5.3). Results: From a total of 1,211 articles, 15 studies (1 cohort and 14 case control studies) met the criteria for systematic review. Meta-analysis results showed that of the known modifiable risk factors for breast cancer, parity (nulipara) had the highest odd ratio (OR = 1.85 [95% CI 1.47-2.32]) followed by body mass index (overweight) (OR = 1.61 [95% CI 1.43-1.80]) and use of oral contraceptives (OR = 1.27 [95% CI 1.07-1.51]). Of non-modifiable risk factors, family history of breast cancer had the highest odd ratio (OR = 2.53 [95% CI 1.25-5.09]), followed by age (≥ 40 years) (OR = 1.53 [95% CI 1.34-1.76]) and menopausal status (OR = 1.44 [95% CI 1.26-1.65]). Conclusion: This analysis confirmed associations between both modifiable risk factors (parity, body mass index and use of oral contraceptives) and non-modifiable risk factors (family history of breast cancer, age and menopausal status) with breast cancer. Creative Commons Attribution License

  4. Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Ellervik, Christina; Yazdanyar, Shiva

    2013-01-01

    BACKGROUND: The possible connection between psoriasis with cardiovascular disease and associated risk factors has been implied, but inconsistent results have been reported. OBJECTIVE: We sought to create an overview and statistical summary of the previous literature with elucidating subgroup...... analysis. METHODS: This was a meta-analysis of observational studies using random effect statistics. A systematic search of observational studies of psoriasis as study variable and cardiovascular disease and associated risk factors as outcome, published before October 25, 2012, was conducted. RESULTS...... significant associations, with the exception of dyslipidemia. LIMITATIONS: The heterogeneity of the studies makes clinical interpretation challenging. CONCLUSIONS: In aggregate, psoriasis was associated with ischemic heart disease and cardiovascular risk factors. The association was only significant...

  5. Risk Factors for Scleroderma

    Science.gov (United States)

    ... You are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is ... what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does not tend to run in families ...

  6. Risk Factors and Prevention

    Science.gov (United States)

    ... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...

  7. Risk factors for acute endophthalmitis following cataract surgery: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    He Cao

    Full Text Available BACKGROUND: Acute endophthalmitis is one of the most serious complications of cataract surgery and often results in severe visual impairment. Several risk factors for acute postoperative endophthalmitis (POE following cataract surgery have been reported but the level of evidence and strength of association is varied. The purpose of this study was to critically appraise published reports on and to summarize clinical risk factors associated with acute POE which could be easily assessed by ophthalmologists for the introduction and implementation of preventive measure. METHODS: A systematic review and meta-analysis of observational studies was performed. Six databases were searched with no limits on the year or language of publication. Study-specific odds ratios (Ors or relative risk (RR of each risk factor were pooled using a random effect model. RESULTS: A total of 6 686 169 participants with 8 963 endophthalmitis in 42 studies were analyzed. Of the nine risk factors identified in our systematic review and meta-analysis, extra- or intracapsular cataract extraction, a clear corneal incision, without intracameral cefazolin (1 mg in 0.1 ml solution, without intracameral cefuroxime (1 mg in 0.1 ml solution, post capsular rupture, silicone intraocular lenses and intraoperative complications were found strongly associated with acute endophthalmitis. Other significant factors with a lower strength of association (risk estimates generally 1.5 or less were male gender and old age (85 years and older. CONCLUSIONS: Our study provides summary data on the risk factors for acute POE. Identifying patients at high risk of this sight-threatening eye disease is important from both the public health and clinical perspectives as this would facilitate detection of disease before the onset of irreversible visual loss enabling earlier intervention.

  8. Risk Factors for Post-stroke Depression: A Meta-analysis

    Directory of Open Access Journals (Sweden)

    Yu Shi

    2017-07-01

    Full Text Available Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD, as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent.Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine.Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016.Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software.Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years, neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD.Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.

  9. Risk factors for chronic and recurrent otitis media-a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    Full Text Available Risk factors associated with chronic otitis media (COM and recurrent otitis media (ROM have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13-1.64; P = 0.001. An upper respiratory tract infection (URTI significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13-13.89; P<0.00001. Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78-2.16; P<0.00001. A patient history of acute otitis media (AOM/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06-116.44; P = 0.04. Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02-1.89 P = 0.04. Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11-13.15; P = 0.03. Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.

  10. Risk Factors for the Perpetration of Child Sexual Abuse: A Review and Meta-Analysis

    Science.gov (United States)

    Whitaker, Daniel J.; Le, Brenda; Hanson, R. Karl; Baker, Charlene K.; McMahon, Pam M.; Ryan, Gail; Klein, Alisa; Rice, Deborah Donovan

    2008-01-01

    Objectives: Since the late 1980s, there has been a strong theoretical focus on psychological and social influences of perpetration of child sexual abuse. This paper presents the results of a review and meta-analysis of studies examining risk factors for perpetration of child sexual abuse published since 1990. Method: Eighty-nine studies published…

  11. Risk factors for radiation-induced hypothyroidism: A Literature-Based Meta-Analysis

    DEFF Research Database (Denmark)

    Vogelius, Ivan R; Bentzen, Søren; Maraldo, Maja V

    2011-01-01

    BACKGROUND: A systematic overview and meta-analysis of studies reporting data on hypothyroidism (HT) after radiation therapy was conducted to identify risk factors for development of HT. METHODS: Published studies were identified from the PubMed and Embase databases and by hand-searching published...

  12. Contribution of biopsychosocial risk factors to nonspecific neck pain in office workers: A path analysis model.

    Science.gov (United States)

    Paksaichol, Arpalak; Lawsirirat, Chaipat; Janwantanakul, Prawit

    2015-01-01

    The etiology of nonspecific neck pain is widely accepted to be multifactorial. Each risk factor has not only direct effects on neck pain but may also exert effects indirectly through other risk factors. This study aimed to test this hypothesized model in office workers. A one-year prospective cohort study of 559 healthy office workers was conducted. At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data were collected every month for the incidence of neck pain. A regression model was built to analyze factors predicting the onset of neck pain. Path analysis was performed to examine direct and indirect associations between identified risk factors and neck pain. The onset of neck pain was predicted by female gender, having a history of neck pain, monitor position not being level with the eyes, and frequently perceived muscular tension, of which perceived muscular tension was the strongest effector on the onset of neck pain. Gender, history of neck pain, and monitor height had indirect effects on neck pain that were mediated through perceived muscular tension. History of neck pain was the most influential effector on perceived muscular tension. The results of this study support the hypothesis that each risk factors may contribute to the development of neck pain both directly and indirectly. The combination of risk factors necessary to cause neck pain is likely occupation specific. Perceived muscular tension is hypothesized to be an early sign of musculoskeletal symptoms.

  13. A Person-Centered Analysis of Risk Factors that Compromise Wellbeing in Emerging Adulthood.

    Science.gov (United States)

    Newcomb-Anjo, Sarah E; Barker, Erin T; Howard, Andrea L

    2017-04-01

    The transition to adulthood is a major life course transition that can pose risk to wellbeing. Research is needed to identify patterns of risk for compromised wellbeing, in order to best identify supports for individuals during this potentially vulnerable transition. The purpose of this study was to identify profiles of risk in an emerging adulthood sample, and to relate these profiles to mental health and subjective and academic wellbeing. Undergraduate emerging adults (N = 903, 82 % female), aged 18-25 years (M = 21.14, SD = 1.75), completed a series of questionnaires about risk factors, mental health, and academic variables. Results from a latent profile analysis identified four distinct risk profiles: Low Risk (76 %), Low Social Support Risk (4 %), Financial Risk (11 %), and Multiple Risk (8 %). The risk profiles were subsequently related to mental health and subjective and academic wellbeing outcomes, using a pseudo-class draws approach. Analyses indicated that the risk-pattern profiles differed in several ways across outcomes. Implications for targeted interventions are discussed.

  14. Fracture risk in patients with type 2 diabetes mellitus and possible risk factors: a systematic review and meta-analysis

    Science.gov (United States)

    Moayeri, Ardeshir; Mohamadpour, Mahmoud; Mousavi, Seyedeh Fatemeh; Shirzadpour, Ehsan; Mohamadpour, Safoura; Amraei, Mansour

    2017-01-01

    Aim Patients with type 2 diabetes mellitus (T2DM) have an increased risk of bone fractures. A variable increase in fracture risk has been reported depending on skeletal site, diabetes duration, study design, insulin use, and so on. The present meta-analysis aimed to investigate the association between T2DM with fracture risk and possible risk factors. Methods Different databases including PubMed, Institute for Scientific Information, and Scopus were searched up to May 2016. All epidemiologic studies on the association between T2DM and fracture risk were included. The relevant data obtained from these papers were analyzed by a random effects model and publication bias was assessed by funnel plot. All analyses were done by R software (version 3.2.1) and STATA (version 11.1). Results Thirty eligible studies were selected for the meta-analysis. We found a statistically significant positive association between T2DM and hip, vertebral, or foot fractures and no association between T2DM and wrist, proximal humerus, or ankle fractures. Overall, T2DM was associated with an increased risk of any fracture (summary relative risk =1.05, 95% confidence interval: 1.04, 1.06) and increased with age, duration of diabetes, and insulin therapy. Conclusion Our findings strongly support an association between T2DM and increased risk of overall fracture. These findings emphasize the need for fracture prevention strategies in patients with diabetes. PMID:28442913

  15. An Aggregated Analysis of Hormonal Factors and Endometrial Cancer Risk by Parity

    Science.gov (United States)

    Schonfeld, Sara J.; Hartge, Patricia; Pfeiffer, Ruth M.; Freedman, D. Michal; Greenlee, Robert T.; Linet, Martha S.; Park, Yikyung; Schairer, Catherine; Visvanathan, Kala; Lacey, JV

    2013-01-01

    Background Nulliparity is associated with an increased risk of endometrial cancer. Less clear is whether nulliparity modifies the association between other established hormone-related risk factors. The proportion of nulliparous women has increased since the mid-1970s, but most individual studies are too small to test the hypothesis that endometrial cancer risk factors may be more strongly associated with risk among nulliparous women compared with parous women. Methods We aggregated data on 26,936 postmenopausal, Caucasian nulliparous women (360 endometrial cancers) and 146,583 postmenopausal Caucasian parous women (1,378 endometrial cancers) from four U.S. prospective studies (1979–2006). We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) in stratified analyses. Results As expected, endometrial cancer risk was higher among nulliparous women than among parous women (HR, nulliparous vs. parous = 1.42, 95% CI 1.26 to 1.60). Stratified associations between endometrial cancer and hormone-related risk factors did not differ among nulliparous vs. parous women: among both groups, oral contraceptives and earlier menopause were associated with reduced risk. The highest HRs were for obesity; body mass index ≥30 kg/m2 (vs. endometrial cancer risk three-fold among nulliparous (HR= 3.04, 95% CI 2.34 to 3.94) and parous (HR= 2.88, 95% CI 2.52 to 3.29) women. Conclusions The results from this large, pooled analysis of data from four large prospective studies suggest that nulliparity does not modify endometrial cancer risks associated with established hormone-related risk factors. PMID:23280123

  16. Risk Factors for Surgical Site Infection After Spinal Surgery: A Meta-Analysis.

    Science.gov (United States)

    Fei, Qi; Li, Jinjun; Lin, JiSheng; Li, Dong; Wang, BingQiang; Meng, Hai; Wang, Qi; Su, Nan; Yang, Yong

    2016-11-01

    Surgical-site infection (SSI) after spinal surgery is the most common complication, which results in greater morbidity, mortality, and health care costs. Identifying risk factors of SSI is an important point for preventive strategies to reduce the incidence of SSI. The aim of this meta-analysis is to investigate the most important risk factors for SSI after spinal surgery. PubMed, Embase, and Web of Science were systematically searched to identify cohort or case-control studies that investigated the risk factors for SSI following spinal surgery. A fixed-effects or random-effects model was used to pool the estimates, depending on the heterogeneity among the included studies. Heterogeneity between the studies was assessed by I2 and Cochran's Q test. Twelve studies with a total of 13,476 patients met the inclusion criteria were included in this meta-analysis. Of them, 1 was a nested case-control studies, 7 were case-control studies, and 4 were cohort studies. The most important predictors of SSI were diabetes (risk ratio [RR] = 2.22, 95% confidence interval [95% CI] 1.38-3.60; P = 0.001), prolonged operative times (>3 hours) (RR = 2.16, 95% CI 1.12-4.19; P = 0.009), body mass index more than 35 (RR = 2.36, 95% CI 1.47-3.80; P = 0.000), and posterior approach (RR = 1.22, 95% CI 1.05-1.41; P = 0.009). Diabetes, prolonged operative times (>3 hours), body mass index more than 35, posterior approach, and number of intervertebral levels (≥7) are associated with an increased risk of SSI after spinal surgery. Almost all these risk factors are in line with the known risk factors for SSI in patients who underwent spinal surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Prevalence and risk factor analysis of lower extremity abnormal alignment characteristics among rice farmers

    Directory of Open Access Journals (Sweden)

    Karukunchit U

    2015-06-01

    Full Text Available Usa Karukunchit,1,2 Rungthip Puntumetakul,1,3 Manida Swangnetr,1,4 Rose Boucaut5 1Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, 2Faculty of Associated Medical Sciences, Khon Kaen University, 3School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 4Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand; 5School of Health Sciences (Physiotherapy, iCAHE (International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia Background: Rice farming activities involve prolonged manual work and human–machine interaction. Prolonged farming risk-exposure may result in lower limb malalignment. This malalignment may increase the risk of lower extremity injury and physical disabilities. However, the prevalence and factors associated with lower extremity malalignment have not yet been reported. This study aimed to investigate the prevalence and risk factors of lower extremity malalignment among rice farmers.Methods: A cross-sectional survey was conducted with 249 rice farmers. Lower extremity alignment assessment included: pelvic tilt angle, limb length equality, femoral torsion, quadriceps (Q angle, tibiofemoral angle, genu recurvatum, rearfoot angle, and medial longitudinal arch angle. Descriptive statistics were used to analyze participant characteristics and prevalence of lower extremity malalignment. Logistic regression analysis was used to identify risk factors.Results: The highest prevalence of lower extremity malalignment was foot pronation (36.14%, followed by the abnormal Q angle (34.94%, tibiofemoral angle (31.73%, pelvic tilt angle (30.52%, femoral antetorsion (28.11%, limb length inequality (22.49%, tibial torsion (21.29%, and genu recurvatum (11.24%. In females, the risk factors were abnormal Q angle, tibiofemoral angle, and genu recurvatum. Being overweight

  18. Factor analysis of risk variables associated with low-grade inflammation.

    Science.gov (United States)

    Aronson, Doron; Avizohar, Ophir; Levy, Yishai; Bartha, Peter; Jacob, Giris; Markiewicz, Walter

    2008-09-01

    Chronic subclinical inflammation, manifesting as elevated levels of inflammatory markers such as C-reactive protein (CRP), predicts future atherothrombotic events. The pathophysiology of low-grade inflammation is complex, and multiple intercorrelated conditions have been associated with elevated CRP. Principal factor analysis was used to investigate clustering of variables associated with elevated CRP using data from 1435 subjects without known coronary disease. Components of the metabolic syndrome, uric acid, liver enzymes, pulmonary function tests, smoking status, cardiorespiratory fitness (measured by maximal treadmill test), and high-sensitivity C-reactive protein were determined in each subject. Factor analysis identified three factors, which explained 51.0% of the total variance in the dataset (24.4% factor 1, 17.3% factor 2, and 9.3% factor 3). Based on factor loadings of >or=0.5, these factors were interpreted as (1) "metabolic factor" including BMI, fasting glucose, HDL cholesterol, triglycerides, systolic blood pressure, and uric acid; (2) a cardiorespiratory factor that included fitness level, forced expiratory volume in 1s and sex; and (3) "smoking" factor that included cigarette smoking and age. Each of these factors was significantly associated with the presence of high-risk CRP (>or=3mg/L) in the study population. The ability of a multivariate model that included these three factors to predict high-risk CRP was comparable to a model containing the original 10 variables (area under the receiver-operator characteristics curve 0.7 vs. 0.72, respectively). Metabolic perturbations, cardiorespiratory fitness, and smoking are separate and largely independent factors in the pathophysiology of chronic, low-grade inflammation.

  19. [Analysis of the risk factors for pesticide poisoning among children in countryside of Guigang city].

    Science.gov (United States)

    Li, Hai; Yang, Li; Feng, Qi-ming; Li, Chun-ling

    2011-12-01

    This study was to investigate the risk factors for pesticide poisoning among rural children in Guigang. A 1:4 matched case-control study was conducted. A total of 78 rural children who were hospitalized or visited the out-patient clinic due to pesticide poisoning in Guigang from January to December in 2009 were recruited as cases, and 312 matched controls were recruited during the same time. The children's parents or guardians were surveyed with a questionnaire. The questionnaire including general information and 21 possible risk factors concerned in family structure, guardian status, educational level of parents, average annual family income, family and school health education and dangerous behavior in children. The data were analyzed by conditional logistic regression analysis. Three risk factors and five protective factors were identified significantly associated with pesticide poisoning in rural children. The risk factors included inappropriate deposit of hydrocomion and contaminated working clothes (OR = 3.529, 95%CI: 1.408 - 8.848), playing outside frequently (OR = 2.846, 95%CI: 1.513 - 5.352), grandparents being children's guardian (OR = 2.187, 95%CI: 1.187 - 4.029). The protective factors included high frequency of guardianship (OR = 0.408, 95%CI: 0.205 - 0.811), knowledge for poisoning prevention (OR = 0.412, 95%CI: 0.224 - 0.758), washing working clothes in time (OR = 0.435, 95%CI: 0.212 - 0.893), taking health educational courses in school (OR = 0.448, 95%CI: 0.232 - 0.867) and teaching children non-access to toxic agents regularly (OR = 0.462, 95%CI: 0.227 - 0.939). Childhood pesticide poisoning accidence in countryside of Guigang was caused by multiple factors including children's risk behaviors, family factors, environmental factors and health education.

  20. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    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

  1. Risk factors for the prognosis of pediatric medulloblastoma: a retrospective analysis of 40 cases.

    Science.gov (United States)

    Yu, Jianzhong; Zhao, Rui; Shi, Wei; Li, Hao

    2017-05-01

    In this study, we evaluated the association of molecular subtypes, clinical characteristics and pathological types with the prognosis of patients with medulloblastoma. We analyzed forty patients with medulloblastoma who underwent surgical resection at our center between January 2004 and June 2014. Risk factors associated with survival, disease progression and recurrence were analyzed with a univariate Cox regression analysis, and the identified significant risk factors were further analyzed by Kaplan-Meier survival curves. Factors associated with overall survival included M stage (p=0.014), calcification (p=0.012), postoperative treatment, postoperative Karnofsky Performance Scale (KPS) score (p=0.015), and molecular subtype (p=0.005 for WNT and p=0.008 for SHH). Number of symptoms (p=0.029), M stage (p2 and ≥M1 stage without postoperative radiotherapy. The risk of recurrence increased with advanced M stage. Protective factors for recurrence included M0 stage and a combination of chemotherapy and radiotherapy. We identified the risk factors associated with survival, disease progression and recurrence of medulloblastoma patients. This information is helpful for understanding the prognostic factors related to medulloblastoma.

  2. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Sasa Nie

    2017-10-01

    Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

  3. An aggregated analysis of hormonal factors and endometrial cancer risk by parity.

    Science.gov (United States)

    Schonfeld, Sara J; Hartge, Patricia; Pfeiffer, Ruth M; Freedman, D Michal; Greenlee, Robert T; Linet, Martha S; Park, Yikyung; Schairer, Catherine; Visvanathan, Kala; Lacey, James V

    2013-04-01

    Nulliparity is associated with an increased risk of endometrial cancer. It is less clear whether nulliparity modifies the association between other established hormone-related risk factors. The proportion of nulliparous women has increased since the mid-1970s, but most individual studies to date have been too small to test the hypothesis that endometrial cancer risk factors may be associated more strongly with risk among nulliparous women compared with parous women. Data were aggregated on 26,936 postmenopausal, Caucasian, nulliparous women (360 endometrial cancers) and 146,583 postmenopausal, Caucasian, parous women (1378 endometrial cancers) from 4 US prospective studies (1979-2006). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated in stratified analyses. The risk of endometrial cancer was higher among nulliparous women than among parous women, as expected (nulliparous vs parous: HR, 1.42; 95% CI, 1.26-1.60). Stratified associations between endometrial cancer and hormone-related risk factors did not differ between nulliparous versus parous women: For both groups, oral contraceptives and earlier menopause were associated with reduced risk. The highest HRs were for obesity: A body mass index ≥30 kg/m(2) (vs endometrial cancer 3-fold among nulliparous women (HR, 3.04; 95% CI, 2.34-3.94) and parous women (HR, 2.88; 95% CI, 2.52-3.29). The results from this large, pooled analysis of data from 4 large prospective studies suggested that nulliparity does not modify the risks of endometrial cancer associated with established hormone-related risk factors. Copyright © 2012 American Cancer Society.

  4. Risk factors of incomplete Apgar score and umbilical cord blood gas analysis: a retrospective observational study.

    Science.gov (United States)

    van Tetering, Anne A C; van de Ven, Joost; Fransen, Annemarie F; Dieleman, Jeanne P; van Runnard Heimel, Pieter J; Oei, S Guid

    2017-11-01

    To investigate whether incomplete umbilical cord blood gas (UCBG) analysis occurs more often than the incomplete reporting of the Apgar score, and risk factors associated with the incomplete values. A total of 8824 infants born alive after 26 weeks' gestation between January 2009 and April 2013 were included. We extracted data on five-minute Apgar score, UCBG analysis, gestational age, mode of delivery, time of delivery and multiple pregnancy. Univariate and multivariable logistic regression analyses were performed. Five-minute Apgar score was incomplete in 15 cases (0.2%) and UCBG analysis in 1960 cases (22.2%), p Apgar score below seven (Odds ratio (OR) 1.68, 95% CI;1.29-2.19), gestational age between 26 to 27 6/7 and 28 to 31 6/7 weeks (OR 3.14, 95% CI; 2.13-4.62 and OR 1.91, 95% CI; 1.57-2.32), cesarean section (OR 1.31, 95% CI; 1.11-1.55), and multiple pregnancy (OR 2.02, 95% CI; 1.69-2.43). Deliveries during night time had a lower risk of incomplete UCBG analysis (OR 0.78, 95% CI; 0.69-0.88). Measuring five-minute Apgar score generated less incomplete data compared with UCBG analysis. The risk factors associated with incomplete UCBG analysis were noted. Study outcomes with UCBG analysis as neonatal assessment tool should be interpreted with caution.

  5. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies.

    Directory of Open Access Journals (Sweden)

    Katrina Witt

    Full Text Available Previous reviews on risk and protective factors for violence in psychosis have produced contrasting findings. There is therefore a need to clarify the direction and strength of association of risk and protective factors for violent outcomes in individuals with psychosis.We conducted a systematic review and meta-analysis using 6 electronic databases (CINAHL, EBSCO, EMBASE, Global Health, PsycINFO, PUBMED and Google Scholar. Studies were identified that reported factors associated with violence in adults diagnosed, using DSM or ICD criteria, with schizophrenia and other psychoses. We considered non-English language studies and dissertations. Risk and protective factors were meta-analysed if reported in three or more primary studies. Meta-regression examined sources of heterogeneity. A novel meta-epidemiological approach was used to group similar risk factors into one of 10 domains. Sub-group analyses were then used to investigate whether risk domains differed for studies reporting severe violence (rather than aggression or hostility and studies based in inpatient (rather than outpatient settings.There were 110 eligible studies reporting on 45,533 individuals, 8,439 (18.5% of whom were violent. A total of 39,995 (87.8% were diagnosed with schizophrenia, 209 (0.4% were diagnosed with bipolar disorder, and 5,329 (11.8% were diagnosed with other psychoses. Dynamic (or modifiable risk factors included hostile behaviour, recent drug misuse, non-adherence with psychological therapies (p values<0.001, higher poor impulse control scores, recent substance misuse, recent alcohol misuse (p values<0.01, and non-adherence with medication (p value <0.05. We also examined a number of static factors, the strongest of which were criminal history factors. When restricting outcomes to severe violence, these associations did not change materially. In studies investigating inpatient violence, associations differed in strength but not direction.Certain dynamic risk

  6. Prevalence, risk factors and spatial analysis of infections with liver flukes in Danish cattle herds

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Frankena, K.; Olsen, A.

    and the factors related to its occurrence and distribution are scarce in Denmark. A retrospective study was performed using liver inspection data of approximately 1.5 million cattle for the period 2011 to 2013. Spatial analysis was carried out to explore whether the data on F. hepatica infection was clustered...... in space as this could help understand whether or not the infection was driven by local environmental factors. Both global and local spatial autocorrelation techniques were used. Herd level and environmental risk factors were evaluated for their association with prevalence of F. hepatica infection using...

  7. Ecological analysis of social risk factors for Rotavirus infections in Berlin, Germany, 2007–2009

    Directory of Open Access Journals (Sweden)

    Wilking Hendrik

    2012-08-01

    Full Text Available Abstract Background Socioeconomic factors are increasingly recognised as related to health inequalities in Germany and are also identified as important contributing factors for an increased risk of acquiring infections. The aim of the present study was to describe in an ecological analysis the impact of different social factors on the risk of acquiring infectious diseases in an urban setting. The specific outcome of interest was the distribution of Rotavirus infections, which are a leading cause of acute gastroenteritis among infants and also a burden in the elderly in Germany. The results may help to generate more specific hypothesis for infectious disease transmission. Methods We analysed the spatial distribution of hospitalized patients with Rotavirus infections in Berlin, Germany. The association between the small area incidence and different socio-demographic and economic variables was investigated in order to identify spatial relations and risk factors. Our spatial analysis included 447 neighbourhood areas of similar population size in the city of Berlin. We included all laboratory-confirmed cases of patients hospitalized due to Rotavirus infections and notified between 01/01/2007 and 31/12/2009. We excluded travel-associated and nosocomial infections. A spatial Bayesian Poisson regression model was used for the statistical analysis of incidences at neighbourhood level in relation to socio-demographic variables. Results Altogether, 2,370 patients fulfilled the case definition. The disease mapping indicates a number of urban quarters to be highly affected by the disease. In the multivariable spatial regression model, two risk factors were identified for infants ( Conclusions Neighbourhoods with a high unemployment rate and high day care attendance rate appear to be particularly affected by Rotavirus in the population of Berlin. Public health promotion programs should be developed for the affected areas. Due to the ecological study

  8. Meta-analysis on clinicopathologic risk factors of leukoplakias undergoing malignant transformation.

    Science.gov (United States)

    Narayan, T V; Shilpashree, S

    2016-01-01

    Leukoplakia is classified under the term potentially malignant disorder. This term does not suggest the clinician or the patient about the severity of the disease to undergo a malignant transformation. Thus, there arises a need to identify the risk factors associated with malignant transformation (MT) to predict it at the earliest. To generate evidence regarding the clinicopathologic factors affecting MT in oral leukoplakias. Meta-analysis was done by extracting data from all the previous studies published. Articles were searched in PubMed databases. Mixed model by using the PROC MIXED (SAS 9.3) was performed to estimate the effect of different factors such as gender, type of habit (smoking tobacco, gutka, paan (with tobacco) and no habit association), clinical type and histopathology on MT. The lower specific mean for MT was also calculated with respect to the above-mentioned factors. Speckled leukoplakias also known as erythroleukoplakia confirmed to be at the highest risk. Lateral border of the tongue followed by gingiva, buccal mucosa, floor of the mouth, lesions involving tongue and floor of mouth showed increased risk. Smoking tobacco (cigarette and bidi) and idiopathic leukoplakia (without habit) carried almost equal risk. Gender had minimal influence on MT. Histopathologic correlation of grades showed an insignificant bearing on MT. The carcinogenic transformation of a preexisting lesion (leukoplakia) is multifactorial and patient specific. The protocol to delineate a high-risk lesion should include the clinical type and site.

  9. Risk Factors and Prevention

    Science.gov (United States)

    ... Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and free of ... as possible. Share: The Normal Heart Risk Factors & Prevention Heart Diseases & Disorders Substances & Heart Rhythm Disorders Symptoms & ...

  10. Hypertension might be a risk factor for erectile dysfunction: a meta-analysis.

    Science.gov (United States)

    Ning, L; Yang, L

    2017-05-01

    The study aimed to evaluate whether hypertension was a risk factor for erectile dysfunction (ED). Databases including PubMed and Embase were retrieved to identify studies related to hypertension in ED patients. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect size. Subgroup analyses stratified by total number of enrolled subjects and research regions were performed. Sensitivity analysis was performed by removing a single study at one time. Egger's test was used to evaluate the publication bias. Totally, 40 studies including 121,641 subjects were included in the meta-analysis. As a result, hypertension was closely related to ED (OR = 1.74, 95% CI, 0.63-0.80, p analysis indicated hypertension was the risk factor for ED whatever the participants numbers. When stratified by different regions, hypertension was a risk factor for ED in Africa (OR = 3.35, 95% CI, 1.45-7.77, p factor for ED. © 2016 Blackwell Verlag GmbH.

  11. Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis?

    Science.gov (United States)

    He, Xiu-Jie; Qin, Feng-Yun; Hu, Chuan-Lai; Zhu, Meng; Tian, Chao-Qing; Li, Li

    2015-04-01

    The aim of our meta-analysis was to explore whether gestational diabetes mellitus (GDM) is an independent risk factor for macrosomia or not. Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published epidemiological studies (cohort and case-control studies) comparing whether GDM was associated with macrosomia. Calculations of pooled estimates were conducted in random-effect models. Heterogeneity was tested by using Chi square test and I (2) statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). Twelve studies met the inclusion criteria, including five cohort studies and seven case-control studies. The meta-analysis showed that GDM was associated with macrosomia independent of other risk factors. The adjusted odds ratio was 1.71, 95% CI (1.52, 1.94) in random-effect model, stratified analyses showed no differences regarding different study design, quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test. Our findings indicate that GDM should be considered as an independent risk factor for newborn macrosomia. To adequately evaluate the clinical evolution of GDM need to be carefully assessed and monitored.

  12. Study of risk factors for gastric cancer by populational databases analysis.

    Science.gov (United States)

    Ferrari, Fangio; Reis, Marco Antonio Moura

    2013-12-28

    To study the association between the incidence of gastric cancer and populational exposure to risk/protective factors through an analysis of international databases. Open-access global databases concerning the incidence of gastric cancer and its risk/protective factors were identified through an extensive search on the Web. As its distribution was neither normal nor symmetric, the cancer incidence of each country was categorized according to ranges of percentile distribution. The association of each risk/protective factor with exposure was measured between the extreme ranges of the incidence of gastric cancer (under the 25(th) percentile and above the 75(th) percentile) by the use of the Mann-Whitney test, considering a significance level of 0.05. A variable amount of data omission was observed among all of the factors under study. A weak or nonexistent correlation between the incidence of gastric cancer and the study variables was shown by a visual analysis of scatterplot dispersion. In contrast, an analysis of categorized incidence revealed that the countries with the highest human development index (HDI) values had the highest rates of obesity in males and the highest consumption of alcohol, tobacco, fruits, vegetables and meat, which were associated with higher incidences of gastric cancer. There was no significant difference for the risk factors of obesity in females and fish consumption. Higher HDI values, coupled with a higher prevalence of male obesity and a higher per capita consumption of alcohol, tobacco, fruits, vegetables and meat, are associated with a higher incidence of gastric cancer based on an analysis of populational global data.

  13. Risk factors for non-alcoholic fatty liver disease: a multivariate analysis

    Directory of Open Access Journals (Sweden)

    PANG Xueqin

    2014-09-01

    Full Text Available ObjectiveTo investigate the risk factors for non-alcoholic fatty liver disease (NAFLD and to provide a basis for the prevention of NAFLD. MethodsA total of 190 patients with NAFLD who visited the First Affiliated Hospital of Soochow University from January 2011 to January 2013 were included in the study. The investigated factors included sex, age, height, weight, dietary habit, smoking and alcohol consumption, educational level, occupation, intensity and duration of physical exercise, bedtime, previous history, and family history. Univariate and multivariate analyses were performed using SPSS 18.0 to determine the risk factors for NAFLD. ResultsThe univariate analysis showed that sex, age, dietary habit, occupation, body mass index (BMI, and educational level were associated with NAFLD (P<0.05. The logistic regression analysis showed that the risk factors for NAFLD were sex (OR=5.692, P=0.029, age (OR=0.423, P=0.041, occupation (OR=0.698, P=0.008, BMI (OR=3.939, P=0.003, educational level (OR=5.463, P=0.030, and dietary habit (OR=9.235, P=0.039. ConclusionNAFLD may be related to many factors, and corresponding preventive measures may reduce the development of NAFLD.

  14. A primer on the use of cluster analysis or factor analysis to assess co-occurrence of risk behaviors.

    Science.gov (United States)

    Hofstetter, Hedwig; Dusseldorp, Elise; van Empelen, Pepijn; Paulussen, Theo W G M

    2014-10-01

    The aim of this paper is to provide a guideline to a universal understanding of the analysis of co-occurrence of risk behaviors. The use of cluster analysis and factor analysis was clarified. A theoretical introduction to cluster analysis and factor analysis and examples from literature were provided. A representative sample (N=4395) of the Dutch population, aged 16-40 and participating from fall 2005 to spring 2006, was used to illustrate the use of both techniques in assessing the co-occurrence of risk behaviors. Whereas cluster analysis techniques serve to focus on particular clusters of individuals showing the same behavioral pattern, factor analysis techniques are used to assess possible groups of interrelated health-risk behaviors that can be explained by an unknown common source. Choice between the techniques partly depends on the research question and the aim of the research, and has different implications for inferences and policy. By integrating theory and results from an illustrative example, a guideline has been provided that contributes towards a systematic approach in the assessment of co-occurrence of risk behaviors. Following this guideline, a better comparison between outcomes from various studies is expected, leading to improved effectiveness of multiple behavior change interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Factor analysis of risk variables associated with iron status in patients with coronary artery disease.

    Science.gov (United States)

    Spasojevic-Kalimanovska, Vesna; Bogavac-Stanojevic, Natasa; Kalimanovska-Ostric, Dimitra; Memon, Lidija; Spasic, Slavica; Kotur-Stevuljevic, Jelena; Jelic-Ivanovic, Zorana

    2014-05-01

    Epidemiological evidence concerning the role of iron, a lipid peroxidation catalyst, in atherosclerosis and coronary artery disease (CAD) is inconsistent. Exploratory factor analysis was used to examine the potential clustering of variables known to be associated with CAD using data from 188 patients with angiographically-approved disease. The resulting factors were then tested for their association with serum ferritin and soluble transferrin receptor (sTfR) as indicators of body iron status. Factor analysis resulted in a reduction of a variable number from the original 15 to 5 composite clusters. These factors were interpreted as (1) "proatherogenic factor" with positive loadings of TC, LDL-C, apoB and TG; (2) "inflammatory factor" with positive loadings of hsCRP, fibrinogen and MDA; (3) "antiatherogenic factor" with positive loadings of HDL-C and apoA-I; (4) "obesity factor" with positive loadings of weight and waist; and (5) "antioxidative status factor" with positive loadings of SOD and age and negative loading of superoxide anion. "Inflammatory", "obesity" and "antiatherogenic" factors predicted high ferritin values and the "proatherogenic factor" predicted high sTfR values. We compared the ability of the "proatherogenic factor" with that of a multivariable logistic model that included the "proatherogenic factor" and sTfR values in predicting significant stenosis in patients. The area under the ROC curve was 0.692 vs. 0.821, respectively. "Inflammatory", "obesity", "antiatherogenic" and "proatherogenic" factors were associated with increased parameters of body iron status. The measurement of sTfR improves the prediction of CAD based on clustered cardiovascular risk factors. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  16. Analysis on Risk and Protective Factors Related to Premature Ovarian Failure

    Directory of Open Access Journals (Sweden)

    Peng-li LI

    2015-09-01

    Full Text Available Objective: To investigate the risk and protective factors related to premature ovarian failure (POF. Methods: A total of 168 patients with POF inFuning County Hospital of TCM were selected as POF group, and another 42 POF-free patients served as control group at the same term. The patients in both groups were inquired in details by investigators in the form of questionnaire, and the relevant risk questionnaires for POF and A-type behavior scale were filled. The risk and protective factors related to POF were analyzed after database was established via input of qualified raw data into 2007 Excel Table.Results: The incidence of POF in patients at the age of 35-40 was dramatically higher than those at the age of 17-24, 25-29 and 30-34, and there existed statistical significance (P<0.01. No significant difference was presented between two groups in terms of age of menarche, menstrual cycle, menstrual period, dysmenorrhea and active smoking (P>0.05, but there was statistical significance by comparison to gravidity, times of artificial abortion, history of mumps, history of ovarian surgery, passive smoking, physical exercise, intake of bean products, sleep quality, A-type character and self-felt much stress (P<0.05. Multi-factor Logistic regression analysis further revealed that artificial abortion, history of mumps, passive smoking, poor sleep quality and A-type character were all independent risk factors for POF (OR=5.555, 3.906, 4.031, 3.723, 5.912, and physical exercise belonged to the protective factor for POF (OR=0.102.Conclusion: Artificial abortion, history of mumps, passive smoking, poor sleep quality and A-type character pertain to risk factors for POF, and physical exercise to the protective factor for POF.

  17. Urinary tract infection in full-term newborn infants: risk factor analysis

    Directory of Open Access Journals (Sweden)

    Falcão Mário Cícero

    2000-01-01

    Full Text Available OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997 including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability, or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9% and Group II, n = 19 (31.1%. The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter were more frequent in Group II (p<0.05. Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

  18. [The risk factors and analysis of complications after regenerative interventions in surgery of oral cavity].

    Science.gov (United States)

    Avetikov, D S; Krynychko, L P; Stavyts'kyĭ, S A; Raskalupa, A A; Boĭko, I V

    2014-11-01

    Most spreaded risk factors in reconstructive and plastic surgery of oral cavity were analyzed. Trustworthy monitoring of rate of the complications occurrence in augmentation of the jaws bones was conducted, depending on the risk factor.

  19. Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis.

    Science.gov (United States)

    Trieu, Nelson; Eslick, Guy D

    2014-10-20

    Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia. A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model. In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18). Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Complications in tissue expansion: an updated retrospective analysis of risk factors.

    Science.gov (United States)

    Wang, J; Huang, X; Liu, K; Gu, B; Li, Q

    2014-04-01

    The technique of tissue expansion has been widely applied in plastic surgery since the 1980 s. Implantation in the lower limb region, external port placement, and young patient age were known as risk factors for complications. Over the years, surgical experience has increased along with improved patient management and expander manufacturing. The aim of this study was to identify possible changes in risk factors regarding complications in tissue expansion. A retrospective, single-institution large sample observational study over a 5-year period (2006-2010) was performed involving 481 tissue expanders in 344 patients. Patients underwent surgical treatment for resurfacing scar tissue in the scalp, face, neck, nose, and limbs, but not breast. In addition, the results are discussed based on a comprehensive review of the literature published between 1995 and 2009. Statistical analysis showed significant correlations between cheek and hematoma (P=0.0133), scalp and dehiscence (P=0.0139), number of expanders per region and leakage (P=0.0379), number of expanders per region and overall complications (P=0.0252). Factors such as gender, age, tobacco use, and repeated expander implantation had no significant influence on the incidence of complications. The lower extremity region and young patient age ceased to show a statistical correlation with complications. The number of expanders per region was identified as a risk factor that has been disregarded so far. Evidence suggests a recent change in risk factors for tissue expansion-related complications. Consideration of updated risk factors may help to further improve outcomes in tissue expansion. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Risk Factors for Cement Leakage After Vertebroplasty or Kyphoplasty: A Meta-Analysis of Published Evidence.

    Science.gov (United States)

    Zhan, Yi; Jiang, Jianzhong; Liao, Haifen; Tan, Haitao; Yang, Keqin

    2017-05-01

    Cement leakage is the most common complication of vertebroplasty and kyphoplasty. So far, the reported risk factors remain conflicting because of limited data and lack of uniform measurement and evaluation. Here, we performed a systematic review and meta-analysis of potential risk factors for cement leakage after vertebroplasty or kyphoplasty. Relevant literature was retrieved using PubMed, EMBASE, Cochrane Controlled Trial Register, and MEDLINE with no language restriction, supplemented by a hand search of the reference lists of selected articles. A fixed-effects model was used if homogeneity existed among included studies; otherwise, a random-effects model was used. The results were presented with weighted mean difference for continuous outcomes and odds ratio (OR) for dichotomous outcomes with a 95% confidence interval (CI). Twenty-two studies consisting of 2872 patients with 4187 vertebrae were included in the meta-analysis. The incidences of cement leakage for percutaneous vertebroplasty and percutaneous balloon kyphoplasty were 54.7% and 18.4%, respectively. The significant risk factors for new vertebral compression fractures were intravertebral cleft (OR, 1.40; 95% CI, 1.09-1.78; P kyphoplasty. Rigorous patient selection and individual therapeutic strategy irrespective of age, sex and fracture type, operation level, and surgical approach may reduce the occurrence of cement leakage. Given the inherent limitation of the meta-analysis, more large sample-sized randomized controlled trials are needed to further validate the present findings. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Financial Risk Factor Analysis for Facility Gas Leakages of H2 and NG

    Directory of Open Access Journals (Sweden)

    In-Bok Lee

    2016-09-01

    Full Text Available Fuel cells may be the key to a more environmentally-friendly future because they emit low carbon dioxide per unit of energy supplied. However, little work has investigated the potential financial risks pertaining to fuel cell systems. Often used in the analysis of the safety of systems involving flammable or hazardous materials, risk factor analysis has recently been used to analyze the potential financial losses that may occur from industrial hazards. Therefore, this work undertakes a financial risk factor analysis to determine the costs of leakages of hydrogen and natural gas, which are used in fuel cell systems. Total leakage was calculated from an analysis of several leakage rates and modes. The impact of applying appropriate detection and prevention systems was also investigated. The findings were then used to analyze the consequences for various sections of the system and to calculate the overall cost based on facility outage or damage, and the cost of taking safety precautions. This provides a basis for comparison among proposed potential reactionary measures.

  3. Risk factors for dental caries in childhood: a five-year survival analysis.

    Science.gov (United States)

    Lee, Hyo-Jin; Kim, Jin-Bom; Jin, Bo-Hyoung; Paik, Dai-Il; Bae, Kwang-Hak

    2015-04-01

    The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Aneurysm diameter as a risk factor for pretreatment rebleeding: a meta-analysis.

    Science.gov (United States)

    Boogaarts, Hieronymus D; van Lieshout, Jasper H; van Amerongen, Martinus J; de Vries, Joost; Verbeek, André L M; Grotenhuis, J André; Westert, Gert P; Bartels, Ronald H M A

    2015-04-01

    Aneurysmal rerupture prior to treatment is a major cause of death and morbidity in aneurysmal subarachnoid hemorrhage. Recognizing risk factors for aneurysmal rebleeding is particularly relevant and might help to identify the aneurysms that benefit from acute treatment. It is uncertain if the size of the aneurysm is related to rebleeding. This meta-analysis was performed to evaluate whether an association could be determined between aneurysm diameter and the rebleeding rate before treatment. Potentially confounding factors such age, aneurysm location, and the presence of hypertension were also evaluated. The authors systematically searched the PubMed, Embase, and Cochrane databases up to April 3, 2013, for studies of patients with aneurysmal subarachnoid hemorrhage that reported the association between aneurysm diameter and pretreatment aneurysmal rebleeding. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria were used to evaluate study quality. Seven studies, representing 2121 patients, were included in the quantitative analysis. The quality of the studies was low in 2 and very low in 5. Almost all of the studies used 10 mm as the cutoff point for size among other classes, and only one used 7 mm. An analysis was performed with this best unifiable cutoff point. Overall rebleeding occurred in 360 (17.0%) of 2121 patients (incidence range, from study to study, 8.7%-28.4%). The rate of rebleeding in small and large aneurysms was 14.0% and 23.6%, respectively. The meta-analysis of the 7 studies revealed that larger size aneurysms were at a higher risk for rebleeding (OR 2.56 [95% CI 1.62-4.06]; p = 0.00; I (2) = 60%). The sensitivity analysis did not alter the results. Five of the 7 studies reported data regarding age; 4 studies provided age-adjusted results and identified a persistent relationship between lesion size and the risk of rebleeding. The presence of hypertension was reported in two studies and was more prevalent in

  5. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

    NARCIS (Netherlands)

    Lim, S.S.; Vos, T.; Flaxman, A.D.; Danaei, G.; Shibuya, K.; Adair-Rohani, H.; Amann, M.; Anderson, H.R.; Andrews, K.G.; Aryee, M.; Atkinson, C.; Bacchus, L.J.; Bahalim, A.N.; Balakrishnan, K.; Balmes, J.; Barker-Collo, S.; Baxter, A.; Bell, M.L.; Blore, J.D.; Blyth, F.; Bonner, C.; Borges, G.; Bourne, R.; Boussinesq, M.; Brauer, M.|info:eu-repo/dai/nl/31149157X; Brooks, P.; Bruce, N.G.; Brunekreef, B.|info:eu-repo/dai/nl/067548180; Bryan-Hancock, C.; Bucello, C.; Buchbinder, R.; Bull, F.; Burnett, R.T.; Byers, T.E.; Calabria, B.; Carapetis, J.; Carnahan, E.; Chafe, Z.; Charlson, F.; Chen, H.; Chen, J.S.; Cheng, A.T.; Child, J.C.; Cohen, A.; Colson, K.E.; Cowie, B.C.; Darby, S.; Darling, S.; Davis, A.; Degenhardt, L.; Dentener, F.; Des Jarlais, D.C.; Devries, K.; Dherani, M.; Ding, E.L.; Dorsey, E.R.; Driscoll, T.; Edmond, K.; Ali, S.E.; Engell, R.E.; Erwin, P.J.; Fahimi, S.; Falder, G.; Farzadfar, F.; Ferrari, A.; Finucane, M.M.; Flaxman, S.; Fowkes, F.G.R.; Freedman, G.; Freeman, M.K.; Gakidou, E.; Ghosh, S.; Giovannucci, E.; Gmel, G.; Graham, K.; Grainger, R.; Grant, B.; Gunnell, D.; Gutierrez, H.R.; Hall, W.; Hoek, H.W.; Hogan, A.; Hosgood, H.D.; Hoy, D.; Hu, H.; Hubbell, B.J.; Hutchings, S.J.; Ibeanusi, S.E.; Jacklyn, G.L.; Jasrasaria, R.; Jonas, J.B.; Kan, H.; Kanis, J.A.; Kassebaum, N.; Kawakami, N.; Khang, Y-H.; Khatibzadeh, S.; Khoo, J-P.; de Kok, C.; Laden, F.; Lalloo, R.; Lan, Q.; Lathlean, T.; Leasher, J.L.; Leigh, J.; Li, Y.; Lin, J.K.; Lipshultz, S.E.; London, S.; Lozano, R.; Lu, Y.; Mak, J.; Malekzadeh, R.; Mallinger, L.; Marcenes, W.; March, L.; Marks, R.; Martin, R.; McGale, P.; McGrath, J.; Mehta, S.; Mensah, G.A.; Merriman, T.R.; Micha, R.; Michaud, C.; Mishra, V.; Hanafiah, K.M.; Mokdad, A.A.; Morawska, L.; Mozaffarian, D.; Murphy, T.; Naghavi, M.; Neal, B.; Nelson, P.K.; Nolla, J.M.; Norman, R.; Olives, C.; Omer, S. B; Orchard, J.; Osborne, R.; Ostro, B.; Page, A.; Pandey, K.D.; Parry, C.D.H.; Passmore, E.; Patra, J.; Pearce, N.; Pelizzari, P.M.; Petzold, M.; Phillips, M.R.; Pope, D.; Pope, C.A.; Powles, J.; Rao, M.; Razavi, H.; Rehfuess, E.A.; Rehm, J.T.; Ritz, B.; Rivara, F.P.; Roberts, T.; Robinson, C.; Rodriguez-Portales, J.A.; Romieu, I.; Room, R.; Rosenfeld, L.C.; Roy, A.; Rushton, L.; Salomon, J.A.; Sampson, U.; Sanchez-Riera, L.; Sanman, E.; Sapkota, A.; Seedat, S.; Shi, P.; Shield, K.; Shivakoti, R.; Singh, G.M.; Sleet, D.A.; Smith, E.; Smith, K.R.; Stapelberg, N.J.C.; Steenland, K.; Stöckl, H.; Stovner, L.J.; Straif, K.; Straney, L.; Thurston, G.D.; Tran, J.H.; van Dingenen, R.; van Donkelaar, A.; Veerman, J.L.; Vijayakumar, L.; Weintraub, R.; Weissman, M.M.; White, R.A.; Whiteford, H.; Wiersma, S.T.; Wilkinson, J.D.; Williams, H.C.; Williams, W.; Wilson, N.; Woolf, A.D.; Yip, P.; Zielinski, J.M.; Lopez, A.D.; Murray, C.J.L.; Ezzati, M.

    2012-01-01

    BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk

  6. [Clinical analysis of nosocomial infection and risk factors of extremely premature infants].

    Science.gov (United States)

    Jiang, Na; Wang, Ying; Wang, Qi; Li, Haijing; Mai, Jingyun; Lin, Zhenlang

    2014-02-01

    To investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control. There were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed. During the study, nosocomial infection occurred in 78 extremely premature infants 129 times. The nosocomial infection rate was 66.10%. The rate of ventilator-associated pneumonia (VAP) was 1.43% (35/2 452). The catheter related blood stream infection (CRBSI) rate was 0.35% (16/4 613). There were 74 (57.36%) cases of pneumonia, which was the most common nosocomial infection of extremely premature infants. There were 35 cases of VAP, which accounted for 47.30% of pneumonia. The next was sepsis, 48 cases. Seventy-four (74/90, 82.22%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion, followed by Gram-positive (12 strains), fungus (4 strains); Klebsiella pneumonia is the most common pathogens of nosocomial infection in extremely premature infants. The isolation rates of Klebsiella pneumonia with positive extended-spectrum beta-lactamases (ESBL) were 90.91% (20/22) , universally resistant to cephalosporins. Single-factor analysis showed that the body weight, mechanical ventilation, umbilical vein catheterization, central venous catheter, parenteral nutrition and hospitalization time were risk factors for nosocomial infections in extremely preterm infants. Logistic regression analysis showed that length of hospitalization (OR = 1.024, P = 0.043) and central venous catheterization (OR = 6.170, P = 0.041) were independent risk factors of nosocomial infection. Extremely preterm infants were at higher risk of nosocomial infection. It is important to identify the high risk factors for nosocomial

  7. Risk factor analysis of diarrhoeal diseases in the Aral Sea area (Khorezm, Uzbekistan).

    Science.gov (United States)

    Herbst, Susanne; Fayzieva, Dilorom; Kistemann, Thomas

    2008-10-01

    In the Aral Sea basin, human activities have resulted in the severe degradation of water and soil, which is considered to cause serious human health problems. This study investigated the risk factors: water, sanitation and related hygiene issues for diarrhoeal disease in Khorezm province, Uzbekistan. The risk factors were studied using a combination of quantitative and qualitative methods including water quality monitoring, standardised questionnaires and spot checks. Multiple linear regression analysis revealed that visible contamination of drinking water during storage and the absence of anal cleansing materials were significantly associated with the number of diarrhoeal episodes per household. Overall, the findings of the study show that the domestic domain plays a major role with regard to faecal-oral disease transmission in Khorezm, Uzbekistan. Unhealthy excreta disposal habits and unsafe drinking water storage practices have to be urgently tackled in order to break the faecal-oral transmission route.

  8. Risk factors for dislocation after revision total hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Guo, Lele; Yang, Yanjiang; An, Biao; Yang, Yantao; Shi, Linyuan; Han, Xiangzhen; Gao, Shijun

    2017-02-01

    No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of dislocation after revision total hip arthroplasty(THA). The present study aimed to quantitatively and comprehensively conclude the risk factors of dislocation after revision total hip arthroplasty. A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to October 2016). All studies assessing the risk factors of dislocation after revision THA without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. Data were pooled and a meta-analysis completed. A total of 8 studies were selected, which altogether included 4656 revision THAs. 421 of them were cases of dislocation occurred after surgery, suggesting the accumulated incidence of 9.04%. Results of meta-analyses showed that age at surgery (standardized mean difference -0.222; 95% CI -0.413-0.031), small-diameter femoral heads (≤28 mm) (OR 1.451; 95%CI 1.056-1.994), history of instability (OR 2.739; 95%CI 1.888-3.974), number of prior revisions ≥ 3 (OR, 2.226; 95% CI, 1.569-3.16) and number of prior revisions ≥ 2 (OR 1.949; 95% CI 1.349-2.817), acetabular components with elevated rim liner were less likely to develop dislocation after revision THA (OR 0.611; 95% CI 0.415-0.898). Related prophylaxis strategies should be implemented in patients involved with above-mentioned risk factors to prevent dislocation after revision THA. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  9. A Human Factor Analysis to Mitigate Fall Risk Factors in an Aerospace Environment

    Science.gov (United States)

    Ware, Joylene H.

    2010-01-01

    This slide presentation reviews the study done to quanitfy the risks from falls from three locations (i.e., Shuttle Landing Facility Launch Complex Payloads and Vehicle Assembly Building) at the Kennedy Space Center. The Analytical Hierarchy Process (AHP) is reviewed and the mathematical model developed is detailed.

  10. Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis.

    Science.gov (United States)

    Seoane-Pillado, María Teresa; Pita-Fernández, Salvador; Valdés-Cañedo, Francisco; Seijo-Bestilleiro, Rocio; Pértega-Díaz, Sonia; Fernández-Rivera, Constantino; Alonso-Hernández, Ángel; González-Martín, Cristina; Balboa-Barreiro, Vanesa

    2017-03-07

    The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events. Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390-459, except: 427.5, 435, 446, 459.0). The mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes. This study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and

  11. Risk Factors for Acquired Rifamycin and Isoniazid Resistance: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Neesha Rockwood

    Full Text Available Studies looking at acquired drug resistance (ADR are diverse with respect to geographical distribution, HIV co-infection rates, retreatment status and programmatic factors such as regimens administered and directly observed therapy. Our objective was to examine and consolidate evidence from clinical studies of the multifactorial aetiology of acquired rifamycin and/or isoniazid resistance within the scope of a single systematic review. This is important to inform policy and identify key areas for further studies.Case-control and cohort studies and randomised controlled trials that reported ADR as an outcome during antitubercular treatment regimens including a rifamycin and examined the association of at least 1 risk factor were included. Post hoc, we carried out random effects Mantel-Haenszel weighted meta-analyses of the impact of 2 key risk factors 1 HIV and 2 baseline drug resistance on the binary outcome of ADR. Heterogeneity was assessed used I2 statistic. As a secondary outcome, we calculated median cumulative incidence of ADR, weighted by the sample size of the studies.Meta-analysis of 15 studies showed increased risk of ADR with baseline mono- or polyresistance (RR 4.85 95% CI 3.26 to 7.23, heterogeneity I2 58%, 95% CI 26 to 76%. Meta-analysis of 8 studies showed that HIV co-infection was associated with increased risk of ADR (RR 3.02, 95% CI 1.28 to 7.11; there was considerable heterogeneity amongst these studies (I2 81%, 95% CI 64 to 90%. Non-adherence, extrapulmonary/disseminated disease and advanced immunosuppression in HIV co-infection were other risk factors noted. The weighted median cumulative incidence of acquired multi drug resistance calculated in 24 studies (assuming whole cohort as denominator, regardless of follow up DST was 0.1% (5th to 95th percentile 0.07 to 3.2%.Baseline drug resistance and HIV co-infection were significant risk factors for ADR. There was a trend of positive association with non-adherence which is likely

  12. Risk Factors for Acquired Rifamycin and Isoniazid Resistance: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Rockwood, Neesha; Abdullahi, Leila H; Wilkinson, Robert J; Meintjes, Graeme

    2015-01-01

    Studies looking at acquired drug resistance (ADR) are diverse with respect to geographical distribution, HIV co-infection rates, retreatment status and programmatic factors such as regimens administered and directly observed therapy. Our objective was to examine and consolidate evidence from clinical studies of the multifactorial aetiology of acquired rifamycin and/or isoniazid resistance within the scope of a single systematic review. This is important to inform policy and identify key areas for further studies. Case-control and cohort studies and randomised controlled trials that reported ADR as an outcome during antitubercular treatment regimens including a rifamycin and examined the association of at least 1 risk factor were included. Post hoc, we carried out random effects Mantel-Haenszel weighted meta-analyses of the impact of 2 key risk factors 1) HIV and 2) baseline drug resistance on the binary outcome of ADR. Heterogeneity was assessed used I2 statistic. As a secondary outcome, we calculated median cumulative incidence of ADR, weighted by the sample size of the studies. Meta-analysis of 15 studies showed increased risk of ADR with baseline mono- or polyresistance (RR 4.85 95% CI 3.26 to 7.23, heterogeneity I2 58%, 95% CI 26 to 76%). Meta-analysis of 8 studies showed that HIV co-infection was associated with increased risk of ADR (RR 3.02, 95% CI 1.28 to 7.11); there was considerable heterogeneity amongst these studies (I2 81%, 95% CI 64 to 90%). Non-adherence, extrapulmonary/disseminated disease and advanced immunosuppression in HIV co-infection were other risk factors noted. The weighted median cumulative incidence of acquired multi drug resistance calculated in 24 studies (assuming whole cohort as denominator, regardless of follow up DST) was 0.1% (5th to 95th percentile 0.07 to 3.2%). Baseline drug resistance and HIV co-infection were significant risk factors for ADR. There was a trend of positive association with non-adherence which is likely to

  13. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    Science.gov (United States)

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  14. Risks factoring business: accounting measurement

    Directory of Open Access Journals (Sweden)

    Z.V. Gutsaylyuk

    2015-06-01

    Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.

  15. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol

    Directory of Open Access Journals (Sweden)

    Gagliardi Stefano

    2005-05-01

    Full Text Available Abstract Background Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances. Despite landmark studies dating back to the 1940s, the pathogenesis of Delirium remains poorly understood. Early investigators noted that Delirium was characterized by global cortical dysfunction that was associated predominantly with specific electroencephalographic changes. It's important to understand the risk factors and incidence of Delirium. Some of the risk factors are already identified in literature and can be summarized in the word "VINDICATE" which stands for: Vascular, Infections, Nutrition, Drugs, Injury, Cardiac, Autoimmune, Tumors, Endocrine. Aims of this study are: to re-evaluate the above mentioned clinical risk factors, adding some others selected from literature, and to test, as risk factors, a pattern of some genes associated to cognitive dysfunction and inflammation possibly related to postoperative Delirium. Design All patients admitted to our Emergency Unit who are meet our inclusion/exclusion criteria will be recruited. The arising of postoperative Delirium will select incidentally two groups (Delirium/non Delirium and the forward analysis of correlate risk factors will be performed. As in a typical observational case/control study we will consider all the exposure factors to which our population are submitted towards the outcome (presence of Delirium. Our exposures are the following: ASA, Pain (SVS; VAS, Blood gas analysis (pH; Hb; pO2; pCO2, Residence pharmacological therapy (BDZ; hypnotics; narcotic drugs; alcohol; nitrous derivates, Body temperature, Arterial pressure, Heart frequency, Breath frequency, Na, K, Creatinin, Glicemia, Albumin, Hct, White blood cells, Glasgow Coma

  16. Alcohol Use as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis

    Directory of Open Access Journals (Sweden)

    Namkee G. Choi, PhD

    2015-12-01

    Full Text Available Introduction: Late middle-aged and older adults’ share of emergency department (ED visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. Methods: Data came from the 2013 National Health Interview Survey’s Sample Adult file (n=15,713. Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/ moderate drinkers, and current heavy drinkers, chronic health and mental health status, and past-year ED visits as indicators. Results: LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/ mental health problems; Class 2 (21%; low-risk group consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. Conclusion: Alcohol nonuse/use (and quantity of use and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex

  17. Analysis of relevant risk factors for intrauterine death of fetuses in the third trimester of pregnancy.

    Science.gov (United States)

    Qiong, Yang; Yichong, Yuan

    2016-11-01

    Our study aimed to explore the relevant risk factors for intrauterine death of fetuses in the third trimester of pregnancy via a retrospective analysis. Then, 98 pregnant women with intrauterine death of fetuses in the third trimester of pregnancy were enrolled, who had undergone the induced labor of dead fetuses in our hospital from January, 2013 to January, 2015. By taking their disease conditions into considerations, methods of induced labor as softening of cervix with dinoprostone suppositories and amniotic infusion of ethacridine or oxytocin were performed, and the timely cesarean section for termination of pregnancy was performed. After the treatment, a detailed medical history was recorded, including their family history, past history and conditions of this pregnancy. Besides, autopsy of dead fetuses and pathological examinations were performed as well as chromosome examinations of the placenta, the umbilical cord and the fetal membrane in an attempt to identify the relevant factors for causes of death, so as to do a good job in the post-natal consultation. The induced labor procedures were successfully performed on all pregnant women, and the investigation of causes of intrauterine death showed that placental factors were responsible for the largest proportion of all causes of intrauterine death in single (28 patients), which was 31.82%, including 13 patients with placenta praevia and 13 with placental abruption. The secondary factors were umbilical cord factors, accounting for 30.68%. Among the factors of pregnant women, gestational hypertension occurred in 7 patients, accounting for 58.33% of factors of pregnant women. While among the causes of intrauterine death in twins, umbilical cord factors were found to be the main causes of death, accounting for 30.00%, followed by placental factors and factors of pregnant women, which accounted for 20.00%, respectively. Placenta factors, umbilical cord factors and factors of pregnant women were the main causes of

  18. Human and management factors in probabilistic risk analysis: the SAM approach and observations from recent applications

    Energy Technology Data Exchange (ETDEWEB)

    Elisabeth Pate-Cornell, M.; Murphy, Dean M

    1996-08-01

    Most severe industrial accidents have been shown to involve one or more human errors and these are generally rooted in management problems. The objective of this paper is to draw some conclusions from the experience that we have acquired from three different studies of this phenomenon: (1) the Piper Alpha accident including problems of operations management and fire risks on-board offshore platforms, (2) the management of the heat shield of the NASA space shuttle orbiter, and (3) the roots of patient risks in anaesthesia. This paper describes and illustrates the SAM approach (System-Action-Management) that was developed and used in these studies to link the probabilities of system failures to human and management factors. This SAM model includes: first, a probabilistic risk analysis of the physical system, second, an analysis of the decisions and actions that affect the probabilities of its basic events, and third, a study of the management factors that influence those decisions and actions. In the three initial studies, the analytical links (conditional probabilities) among these three submodels were coarsely quantified based on statistical data whenever available, or most often, on expert opinions. This paper describes some observations that were made across these three studies, for example, the importance of the informal reward system, the difficulties in the communication of uncertainties, the problems of managing resource constraints, and the safety implications of the short cuts that they often imply.

  19. [Analysis of selected risk factors for cardiovascular diseases in patients scheduled for Coronary Artery Bypass Graft].

    Science.gov (United States)

    Szylińska, Aleksandra; Mikońajczyk, Anna; Pytńak, Mateusz; Mosiejczuk, Hanna; Listewnik, Mariusz; Ptak, Magdalena; Rotter, Iwona

    2015-01-01

    Cardiovascular diseases are classified as diseases of civilization, and constitute a major social problem because they are the main cause of death. For this reason, according to the WHO, more than 17.3 million people die every year in developed countries. In the European Union the number of deaths is over 2 million, and represents 42% of total mortality. The aim of the study was analysis of selected risk factors for cardiovascular disease in patients scheduled for surgical revascularization, and an outline of their social profile. The study was conducted among patients scheduled for surgery in Cardiac Surgery Department SPSK no. 2 in Szczecin. Ninety patients were studied. The research was carried out using proprietary diagnostic surveys and data obtained from medical records. The selected modifiable risk factors for diseases of the cardiovascular system were evaluated. In the study group 15 patients (17%) were current smokers. Most patients (38, 42%) had not smoked for more than 2 years. 33 patients (37%) suffered from diabetes. More than half (47, 52%) of the respondents did not follow a balanced diet. Most of the patients were obese (37, 41%), including 18 diabetics and 19 non-diabetics. 58 patients (64%) suffered from hypertension. Diabetes, obesity, and smoking were confirmed as risk factors for coronary heart disease. The educational activity of family doctors should be mainly focused on the prevention of diabetes, stopping smoking, and lifestyle changes in order to prevent diseases of the cardiovascular system, especially among the elderly.

  20. [Analysis of carotid atherosclerosis and related risk factors in a university physical examination population in Beijing].

    Science.gov (United States)

    Meng, X F; Liu, G M; Wang, X L; Xu, Q

    2017-09-05

    Objective: To explore the incidence of carotid atherosclerosis in staffs of Tsinghua university according to the different age groups, the possible risk factors and conduct a follow-up survey. Methods: Detailed information about physical examination and carotid ultrasound from 832 staffs of Tsinghua University between 2014 to 2016 were reviewed to observe the occurrence and development of atherosclerosis according to different age groups; the correlation between conventional risk factors and carotid arteriosclerosis was studied by multivariate Logistic regression analysis.The process of different degrees of arteriosclerosis in the population was observed one year later. Results: In the past three years, there were 2 024 cases of carotid examination. Among them, there were 832 staffs who had been followed up for more than 6 months. There were 517 cases of carotid atherosclerosis, with 289 males (55.9%) and 228 females (44.1%), and the incidence of atherosclerosis in male was higher than that in female ( P 0.05). Conclusions: This research suggests that the incidence of atherosclerosis in male is higher than that in female, and hypertension, diabetes and hyperlipidemia are important influencing factors of arteriosclerosis for staffs of Tsinghua University. Early screening, identification of high-risk patients and comprehensive treatment should be done to delay the process of atherosclerosis.In addition, long-term follow-up is necessary in the context of no significant changes within the short-term.

  1. Clinical analysis of risk factors contributing to recurrence of pterygium after excision and graft surgery

    Directory of Open Access Journals (Sweden)

    Sang Won Ha

    2015-06-01

    Full Text Available AIM:To find the risk factors related to the reproliferation of the pterygial tissue after excision and graft surgery.METHODS:Charts of 130 eyes of 130 patients who had pterygial excision from March 2006 to April 2011 were reviewed. Preoperative pterygium morphology, surgical methods, and adjunctive treatments were statistically analyzed for their relationship with recurrence.RESULTS: During the follow-up period, recurrence was observed in 20 eyes (15.4%. None of the preoperative morphologic features were affected the rate of the recurrence. However, an age < 40y [P =0.085, odds ratio (OR 3.609, 95% confidence interval (CI 0.838-15.540] and amniotic membrane graft instead of conjunctival autograft (P =0.002, OR 9.093, 95% CI 2.316-35.698 were statistically significant risk factors for recurrence. Multivariate analysis revealed that intraoperative mitomycin C (MMC (P=0.072, OR 0.298, 95% CI 0.080-1.115 decreased the rate of recurrence.CONCLUSION:Younger age is a risk factor for reproliferation of pterygial tissue after excision and amniotic membrane transplantation (AMT are less effective in preventing recurrence of pterygium after excision based on the comparison between conjunctival autograft and AMT. Intraoperative MMC application and conjunctival autograft reduce recurrence.

  2. Identification of bacteriology and risk factor analysis of asymptomatic bacterial colonization in pacemaker replacement patients.

    Science.gov (United States)

    Chu, Xian-Ming; Yu, Hua; Sun, Xue-Xia; An, Yi; Li, Bing; Li, Xue-Bin

    2015-01-01

    Recent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures. The present study explores the incidence of bacterial colonization of generator pockets in pacemaker replacement patients without signs of infection, and to analyze risk factors for asymptomatic bacterial colonization. From June 2011 to December 2013, 118 patients underwent pacemaker replacement or upgrade. Identification of bacteria was carried out by bacterial culture and 16S rRNA sequencing. Clinical risk characteristics were analyzed. The total bacterial positive rate was 37.3% (44 cases), and the coagulase-negative Staphylococcus aureus detection rate was the highest. Twenty two (18.6%) patients had positive bacterial culture results, of which 50% had coagulase-negative staphylococcus. The bacterial DNA detection rate was 36.4 % (43 cases). Positive bacterial DNA results from pocket tissues and the surface of the devices were 22.0% and 29.7%, respectively. During follow-up (median, 27.0 months), three patients (6.8%, 3/44) became symptomatic with the same genus of microorganism, S. aureus (n=2) and S. epidermidis (n=1). Multivariable logistic regression analysis showed that history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency were independent risk factors for asymptomatic bacterial colonization. There was a high incidence of asymptomatic bacterial colonization in pacemaker patients with independent risk factors. Bacterial culture combined genetic testing could improve the detection rate.

  3. Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis

    Science.gov (United States)

    Objective: To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. Methods: The conditional inference tree analysis, a data mining approach, was used to con...

  4. Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis.

    Science.gov (United States)

    Cheng, Ho Ming; Koutsidis, Georgios; Lodge, John K; Ashor, Ammar; Siervo, Mario; Lara, José

    2017-02-01

    Epidemiological evidence suggests an association between consumption of tomato products or lycopene and lower risk for cardiovascular diseases (CVD). Our aim was to evaluate the state of the evidence from intervention trials on the effect of consuming tomato products and lycopene on markers of cardiovascular (CV) function. We undertook a systematic review and meta-analysis on the effect of supplementing tomato and lycopene on CV risk factors. Three databases including Medline, Web of science, and Scopus were searched from inception to August 2016. Inclusion criteria were: intervention trials reporting effects of tomato products and lycopene supplementation on CV risk factors among adult subjects >18 years of age. The outcomes of interest included blood lipids (total-, HDL-, LDL-cholesterol, triglycerides, oxidised-LDL), endothelial function (flow-mediated dilation (FMD), pulse wave velocity (PWV)) and blood pressure (BP) inflammatory factors (CRP, IL-6) and adhesion molecules (ICAM-1). Random-effects models were used to determine the pooled effect sizes. Out of 1189 publications identified, 21 fulfilled inclusion criteria and were meta-analysed. Overall, interventions supplementing tomato were associated with significant reductions in LDL-cholesterol (-0.22 mmol/L; p = 0.006), IL-6 (standardised mean difference -0.25; p = 0.03), and improvements in FMD (2.53%; p = 0.01); while lycopene supplementation reduced systolic-BP (-5.66 mmHg; p = 0.002). No other outcome was significantly affected by these interventions. The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising individualised nutritional strategies involving tomatoes to tackle CVD. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Isolated increase in serum alkaline phosphatase after liver transplantation: risk factors and outcomes analysis.

    Science.gov (United States)

    Ho, Cheng-Maw; Ho, Ming-Chih; Shau, Wen-Yi; Hu, Rey-Heng; Lai, Hong-Shiee; Wu, Yao-Ming; Lee, Po-Huang

    2013-01-01

    Isolated increase in serum alkaline phosphatase (IISAlp) is frequently observed in liver transplant recipients visiting outpatient clinics. However, whether the increase is associated with risk factors or poor survival is unknown. We retrospectively reviewed the medical records of liver transplant recipients who were followed up during 1999-2009 and had IISAlp 1 month after liver transplantation, which was sustained for at least 6 months. Clinical parameters, survival, and risk factors were analyzed and compared between recipients who survived longer than 6 months after transplantation. Among 307 liver transplant recipients, 44 had IISAlp. Compared with the control group, the patients with IISAlp were more frequently of the pediatric population, recipients of female donor or living-related partial liver grafts, and found to have biliary-related pretransplant disorders, lower body weight, and shorter warm ischemic time (P liver transplantation was 6.3 ± 0.8 months. The mean follow-up duration was 5.5 ± 0.2 years. Stepwise multivariate analysis showed that being a pediatric or living-related liver transplant recipient was an independent risk factor for IISAlp, with adjusted hazard ratios (95% confidence interval) of 5.41 (2.59-11.28) and 3.0 (0.98-9.27), respectively. Therefore, being a pediatric or living-related liver transplant recipient was an independent risk factor for IISAlp. However, IISAlp was not associated with poor survival after liver transplantation. Hence, patients who have undergone liver transplantation do not require frequent routine examination of serum alkaline phosphatase levels. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Seroprevalence of Bartonella in Eastern China and analysis of risk factors

    Directory of Open Access Journals (Sweden)

    Lu Liang

    2010-05-01

    Full Text Available Abstract Background Bartonella infections are emerging in the Zhejiang Province of China. However, there has been no effort to date to explore the epidemiology of these infections in this region, nor to identify risk factors associated with exposure to Bartonella. The aim of this study was to investigate the seroprevalence of Bartonella in both patients bitten by dogs and blood donors (for control in Eastern China, and to identify risk factors associated with exposure to Bartonella. As no previous data for this region have been published, this study will provide baseline data useful for Bartonella infection surveillance, control, and prevention. Methods Blood samples were collected from industrial rabies clinic attendees and blood donors living in eight areas of the Zhejiang Province of China, between December 2005 and November 2006. An indirect immunofluorescent antibody test was used to determine the presence of Bartonella in these samples. Risk factors associated with Bartonella exposure were explored using Chi-square tests and logistic regression analysis of epidemiological data relating to the study's participants. Results Bartonella antibodies were detected in 19.60% (109/556 of blood samples. Seroprevalence varied among the eight areas surveys, ranging from over 32% in Hangzhou to only 2% in Jiangshan (X2 = 28.22, P Bartonella antibodies in people who had been bitten by dogs than in blood donors (X2 = 13.86, P Bartonella was similar among males (18.61%, n = 317 and females (20.92%, n = 239. Conclusions Bartonella antibodies were encountered in people living across Zhejiang Province and the seropositivity rate among those exposed to dog bites was significantly higher than that among blood donors, indicating that dog bites may be a risk factor for Bartonella infection.

  7. An Analysis of the Policy Environment Surrounding Noncommunicable Diseases Risk Factor Surveillance in Kenya

    Directory of Open Access Journals (Sweden)

    Rosemary Mamka Anyona

    2014-12-01

    Full Text Available Kenya is a developing country in sub-Saharan Africa, facing a triple disease burden, with an increase in non-communicable diseases (NCDs; uncontained infectious diseases; coupled with significant morbidity and mortality from environmental causes such as droughts and flooding. The limelight has been on infectious diseases, leaving few resources for NCDs. As NCDs start to gain attention, it is becoming apparent that essential information on their epidemiology and risk factor trends—key in evidence-based decision-making—is lacking. As a consequence, policies have long relied on information derived from unreliable data sources such as vital registries and facility-level data, and unrepresentative data from small-scale clinical and academic research. This study analyzed the health policy aspects of NCD risk factor surveillance in Kenya, describing barriers to the successful design and implementation of an NCD risk factor surveillance system, and suggests a strategy best suited for the Kenyan situation. A review of policy documents and publications was augmented by a field-study consisting of interviews of key informants identified as stakeholders. Findings were analyzed using the Walt and Gilson policy analysis triangle. Findings attest that no population baseline NCD burden or risk factor data was available, with a failed WHO STEPs survey in 2005, to be undertaken in 2013. Despite the continued mention of NCD surveillance and the highlighting of its importance in various policy documents, a related strategy is yet to be established. Hurdles ranged from a lack of political attention for NCDs and competing public interests, to the lack of an evidence-based decision making culture and the impact of aid dependency of health programs. Progress in recognition of NCDs was noted and the international community and civil society's contribution to these achievements documented. While a positive outlook on the future of NCD surveillance were encountered

  8. Analysis of correlative risk factors for C5 palsy after anterior cervical decompression and fusion.

    Science.gov (United States)

    Wang, Haiying; Zhang, Xu; Lv, Bing; Ding, Wenyuan; Shen, Yong; Yang, Dalong; Bai, Zhilong

    2015-01-01

    It has been reported that C5 palsy is a potential complication of both anterior and posterior cervical spine surgery, although several mechanisms of C5 palsy following posterior cervical surgery have been proposed, few reports about correlative risk factors have been elaborated on C5 palsy after anterior cervical decompression and fusion (ACDF). The purpose of this study was to investigate the correlative risk factors of C5 palsy after anterior cervical decompression and fusion. This is a retrospective study. A total of 161 patients (108 males and 53 females) who underwent ACDF between 2007 and 2012 were included in this study. C5 palsy is characterized by deltoid and/or biceps brachii weakness. The patients were divided into two groups: one that had experienced C5 palsy (group A) and the other one had not (group B). In both groups, the age, gender, duration of disease, diagnosis, No. of surgical levels, cervical curvature correction, occupying rate of spinal canal at C4/5, diameter of the C4/5 foramen, intervertebral height variation, decompression width and preoperative high-signal intensity zone (HIZ) of spinal cord in T2-weighted MRI at C4/5 were measured and evaluated. The risk factors of C5 palsy were detected with logistic regression analysis. There were no significant differences in age, gender, duration of disease, diagnosis, No. of surgical levels, rate of spinal canal at C4/5 and HIZ of spinal cord in T2-weighted MRI at C4/5. Cervical curvature correction, diameter of the C4/5 foramen, intervertebral height variation and decompression width had significant differences between the two groups (PC5 palsy. For patients with ACDF, greater cervical curvature correction, narrow diameter of the C4/5 foramen, improper intervertebral height variation and larger decompression width were the correlative risk factors for C5 palsy after ACDF.

  9. Incidence of organizing pneumonia after whole-breast radiotherapy for breast cancer, and risk factor analysis.

    Science.gov (United States)

    Sato, Hisashi; Ebi, Junko; Tamaki, Tomoaki; Yukawa, Ami; Nakajima, Masaru; Ohtake, Tohru; Suzuki, Yoshiyuki

    2018-02-03

    Radiation-induced organizing pneumonia (OP) reportedly occurs in ~2% of patients who receive whole-breast radiotherapy (WBRT). Though there are several reported risk factors, they remain unclear and controversial. We analyzed the incidence of and risk factors for OP after WBRT at our institution. We analyzed 665 breast cancer patients (with WBRT of 679 breasts) who underwent WBRT from October 2007 to September 2012 at our institution and were followed up for more than 1 year after completion of WBRT. Factors included in the analysis were age, the side affected, central lung distance (CLD), radiation dose, concurrent endocrine therapy, and chemotherapy. The median age was 56 years (range, 23-89 years). The sides affected were left, right and bilateral in 342, 309 and 14 patients, respectively. The median CLD was 1.1 cm (range, 0-3.0 cm). Concurrent endocrine therapy was performed in 236 patients, and chemotherapy was given in 215 patients; of these, 4 received concurrent chemotherapy. OP developed in nine patients (1.4%). The median time taken to develop OP after the completion of WBRT was 4 months (range, 2-12 months). All nine patients were treated with steroids, and symptoms promptly improved, except in two patients who relapsed. Statistical analysis revealed that only CLD (≥1.5 cm) was significantly associated with the development of OP (P = 0.004). In conclusion, the incidence of OP after WBRT was 1.4%, and CLD was a significant risk factor. In these patients, OP was controlled with steroid administration. © The Author(s) 2018. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  10. [Pathological gambling: risk factors].

    Science.gov (United States)

    Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L

    2011-09-01

    In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be

  11. Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials.

    Science.gov (United States)

    Kwak, Jin Sook; Kim, Ji Yeon; Paek, Ju Eun; Lee, You Jin; Kim, Haeng-Ran; Park, Dong-Sik; Kwon, Oran

    2014-12-01

    Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.

  12. A meta-analysis of risk factors for depression in adults and children after natural disasters.

    Science.gov (United States)

    Tang, Bihan; Liu, Xu; Liu, Yuan; Xue, Chen; Zhang, Lulu

    2014-06-19

    A number of studies have shown a range of negative psychological symptoms (e.g. depression) after exposure to natural disasters. The aim of this study was to determine risk factors for depression in both children and adults who have survived natural disasters. Four electronic databases (PubMed, Embase, Web of Science, and PsychInfo) were used to search for observational studies (case-control, cross-sectional, and cohort studies) about depression following natural disasters. The literature search, study selection, and data extraction were conducted independently by two authors. Thirty-one articles were included in the study, of which twenty included adult participants and eleven included child participants. Summary estimates were obtained using random-effects models. Subgroup analysis, sensitivity analysis, and publication bias tests were performed on the data. The prevalence of depression after natural disasters ranged from 5.8% to 54.0% in adults and from 7.5% to 44.8% in children. We found a number of risk factors for depression after exposure to natural disasters. For adults, the significant predictors were being female ;not married;holding religious beliefs; having poor education; prior trauma; experiencing fear, injury, or bereavement during the disaster; or losing employment or property, suffering house damage as a result of the disaster. For children, the significant predictors were prior trauma; being trapped during the disaster; experiencing injury, fear, or bereavement during the disaster; witnessing injury/death during the disaster; or having poor social support. The current analysis provides evidence of risk factors for depression in survivors of natural disasters. Further research is necessary to design interventions to improve the mental health of survivors of natural disasters.

  13. Risk Factors for Low Birthweight in Zimbabwean Women: A Secondary Data Analysis.

    Directory of Open Access Journals (Sweden)

    Shingairai A Feresu

    Full Text Available Low birth weight (LBW remains the main cause of mortality and morbidity in infants, and a problem in the care of pregnant women world-wide particularly in developing countries. The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, Zimbabwe.A secondary data analysis from data obtained through a questionnaire and delivery records was conducted. Linear regression models with a complimentary log-log link function were used to estimate the relative risks for all LBW, term LBW and preterm LBW.The frequency of LBW was 16.7%. Lack of prenatal care (adjusted relative risk [ARR] 1.69, 95% CI 1.44, 1.98, mother's mid-arm circumference below 28.5 cm, (ARR 1.35, 95% CI 1.19, 1.54 and rural residence (ARR 1.22, 95% CI 1.04, 1.40 increased the risk of LBW. Eclampsia, anemia, and ante-partum hemorrhage, were associated with LBW (ARR 2.64, 95% CI 1.30, 5.35; ARR = 2.63, 95% CI 1.16, 5.97; and ARR = 2.39, 95% CI 1.55, 3.68, respectively. Malaria increased the risk of LBW (ARR = 1.89, 95% CI 1.21, 2.96. Prenatal care, infant sex, anemia, antepartum hemorrhage, premature rapture of membranes and preterm labor were associated with the three LBW categories. History of abortion or stillbirth, history of LBW, malaria, eclampsia, and placenta Previa, were associated with all LBW and preterm LBW, while pregnancy induced hypertension, and number of children alive were associated with all LBW and term LBW.LBW frequency remains high and is associated with nutritive, reproductive, medical and obstetrical factors. Preterm LBW and term LBW have similar and also different risk factors. Understanding the role of different risk factors in these different LBW categories is important if the goal is to reduce LBW frequency, and its complications, in Zimbabwe.

  14. Risk factors for the perpetration of child sexual abuse: a review and meta-analysis.

    Science.gov (United States)

    Whitaker, Daniel J; Le, Brenda; Karl Hanson, R; Baker, Charlene K; McMahon, Pam M; Ryan, Gail; Klein, Alisa; Rice, Deborah Donovan

    2008-05-01

    Since the late 1980s, there has been a strong theoretical focus on psychological and social influences of perpetration of child sexual abuse. This paper presents the results of a review and meta-analysis of studies examining risk factors for perpetration of child sexual abuse published since 1990. Eighty-nine studies published between 1990 and April of 2003 were reviewed. Risk factors were classified into one of the following six broad categories: family factors, externalizing behaviors, internalizing behaviors, social deficits, sexual problems, and attitudes/beliefs. Sex offenders against children (SOC) were compared to three comparison groups identified within the 89 studies: sex offenders who perpetrated against adults (SOA), non-sex offenders, and non-offenders with no history of criminal or sexual behavior problems. Results for the six major categories showed that SOC were not different from SOA (all d between -.02 and .14) other than showing lower externalizing behaviors (d=-.25). Sex offenders against children were somewhat different from non-sex offenders, especially with regard to sexual problems and attitudes (d=.83 and .51). Sex offenders against children showed substantial differences from non-offenders with medium sized effects in all six major categories (d's range from .39 to .58). Child sex offenders are different from non-sex offenders and non-offenders but not from sex offenders against adults. This study suggests that the presence of general risk factors may lead to a variety of negative behavioral outcomes, including the perpetration of child sexual offending. Family factors were strongly related to the perpetration of child sex offending (vs. non-sexual offending or non-offending) and may be valuable intervention points for interrupting the development of child sex offending, as well as other negative behaviors. Other potential points for intervention may focus on the development of appropriate social and emotional skills that contribute to

  15. Cluster analysis reveals risk factors for repeated suicide attempts in a multi-ethnic Asian population.

    Science.gov (United States)

    Choo, Carol; Diederich, Joachim; Song, Insu; Ho, Roger

    2014-04-01

    This study explores underlying patterns in suicide risk factors using data mining techniques. Medical records of suicide attempters who were admitted to a teaching hospital in January 2004 - December 2006 were studied. Cluster analysis revealed hidden patterns for repeated and single attempters (n=418). Repeated attempters had a more complex clinical picture. Symptoms of psychotic illness, borderline personality disorder, and psychosomatic complaints of insomnia and headaches, reports of adverse life events such as unemployment, divorce and quarrels, experience of negative feelings, and usage of alcohol were associated with risk of repeated overdoses with benzodiazepines and paracetamol. The findings have implications for suicide assessments and interventions. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Groundwater source contamination mechanisms: Physicochemical profile clustering, risk factor analysis and multivariate modelling

    Science.gov (United States)

    Hynds, Paul; Misstear, Bruce D.; Gill, Laurence W.; Murphy, Heather M.

    2014-04-01

    An integrated domestic well sampling and "susceptibility assessment" programme was undertaken in the Republic of Ireland from April 2008 to November 2010. Overall, 211 domestic wells were sampled, assessed and collated with local climate data. Based upon groundwater physicochemical profile, three clusters have been identified and characterised by source type (borehole or hand-dug well) and local geological setting. Statistical analysis indicates that cluster membership is significantly associated with the prevalence of bacteria (p = 0.001), with mean Escherichia coli presence within clusters ranging from 15.4% (Cluster-1) to 47.6% (Cluster-3). Bivariate risk factor analysis shows that on-site septic tank presence was the only risk factor significantly associated (p agriculture adjacency was significantly associated with both borehole-related clusters. Well design criteria were associated with hand-dug wells and boreholes in areas characterised by high permeability subsoils, while local geological setting was significant for hand-dug wells and boreholes in areas dominated by low/moderate permeability subsoils. Multivariate susceptibility models were developed for all clusters, with predictive accuracies of 84% (Cluster-1) to 91% (Cluster-2) achieved. Septic tank setback was a common variable within all multivariate models, while agricultural sources were also significant, albeit to a lesser degree. Furthermore, well liner clearance was a significant factor in all models, indicating that direct surface ingress is a significant well contamination mechanism. Identification and elucidation of cluster-specific contamination mechanisms may be used to develop improved overall risk management and wellhead protection strategies, while also informing future remediation and maintenance efforts.

  17. Organic Solvents as Risk Factor for Autoimmune Diseases: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Barragán-Martínez, Carolina; Speck-Hernández, Cesar A.; Montoya-Ortiz, Gladis; Mantilla, Rubén D.; Anaya, Juan-Manuel; Rojas-Villarraga, Adriana

    2012-01-01

    Background Genetic and epigenetic factors interacting with the environment over time are the main causes of complex diseases such as autoimmune diseases (ADs). Among the environmental factors are organic solvents (OSs), which are chemical compounds used routinely in commercial industries. Since controversy exists over whether ADs are caused by OSs, a systematic review and meta-analysis were performed to assess the association between OSs and ADs. Methods and Findings The systematic search was done in the PubMed, SCOPUS, SciELO and LILACS databases up to February 2012. Any type of study that used accepted classification criteria for ADs and had information about exposure to OSs was selected. Out of a total of 103 articles retrieved, 33 were finally included in the meta-analysis. The final odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by the random effect model. A sensitivity analysis confirmed results were not sensitive to restrictions on the data included. Publication bias was trivial. Exposure to OSs was associated to systemic sclerosis, primary systemic vasculitis and multiple sclerosis individually and also to all the ADs evaluated and taken together as a single trait (OR: 1.54; 95% CI: 1.25–1.92; p-valueautoimmunity or carrying genetic factors) should avoid any exposure to OSs in order to avoid increasing their risk of ADs. PMID:23284705

  18. Association between Factor V Gene Polymorphism and Risk of Ischemic Stroke: An Updated Meta-Analysis.

    Science.gov (United States)

    Alhazzani, Adel Ali; Kumar, Amit; Selim, Magdy

    2018-02-22

    Ischemic stroke is a complex, multifactorial, and polygenic disease. Reports on relationship between Factor V G1691A single nucleotide gene polymorphism and ischemic stroke have revealed inconsistent results. We conducted an updated meta-analysis to determine the role of Factor V single nucleotide gene polymorphism in ischemic stroke. We searched the literature using academic electronic databases that is, PubMed, Trip Data Base, EBSCO, and Google Scholar, last search up to September 2017. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from fixed or random effects models whichever applicable using software STATA version 13 (StataCorp LP, College Station, TX). Forty case-control studies met the inclusion criteria, which included 6860 cases and 18,025 controls. Altogether, 19 studies in young adults (age  40). Four studies did not report the mean age at recruitment. Significant association between Factor V G1691A gene polymorphism and risk of ischemic stroke were observed under dominant model (OR 1.40; 95% CI: 1.22 to 1.62, P value V gene polymorphism and risk of ischemic stroke in cases with onset at young age (OR 1.84; 95% CI: 1.47 to 2.30), but was not statistical significant in cases at old age (>40 years). Factor V G1691A single nucleotide gene polymorphism was associated with risk of ischemic stroke mainly in young adults. Further research with adequately powered prospective studies in homogenous subjects are required to determine the nature of association in young stroke. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Risk factor analysis following maxillary sinus augmentation: a retrospective multicenter study.

    Science.gov (United States)

    Testori, Tiziano; Weinstein, Roberto L; Taschieri, Silvio; Del Fabbro, Massimo

    2012-01-01

    Implant-supported rehabilitation of the atrophic posterior maxilla often necessitates maxillary sinus surgery to augment existing bone volumes. Recent systematic reviews have reported implant survival rates above 90% following sinus elevation. However, statistical assessment of the effect of anatomic factors, implant design and surface, individual risk factors, and complications related to sinus floor elevation procedures on implant survival through analyzing patient data has not yet been performed. The aim of this study is to identify risk factors that might affect implant survival following sinus elevation. Three centers were involved in this retrospective multicenter study; 106 patients were treated with 144 sinus elevation procedures and received 328 implants. The mean follow-up was 48.4 months, and the longest follow-up period was 72 months. The analysis considered patient age, gender, health status, and smoking habit; implant size, shape, and surface; residual ridge height; timing of implant placement with respect to grafting; graft material; and the occurrence of surgical complications. For quantitative variables, the Pearson correlation was used. The chi-square test and Fisher exact test (for samples smaller than five units) were used for qualitative variables. The cumulative implant survival rate was 93.0% up to 5 years. Complications occurred in 41 patients. Intraoperative sinus membrane perforation occurred in 40 sinuses (28%) and was not a significant risk factor for implant survival. Six patients experienced postoperative infection leading to graft failure, and two patients had considerable intraoperative bleeding. Smoking more than 15 cigarettes/day and a residual ridge height < 4 mm were significantly associated with reduced implant survival. Smoking habits and residual ridge height should be evaluated carefully prior to sinus elevation procedures.

  20. Analysis of risk factors associated with unplanned reoperations following pediatric plastic surgery.

    Science.gov (United States)

    Jubbal, Kevin T; Zavlin, Dmitry; Buchanan, Edward P; Hollier, Larry H

    2017-10-01

    Unplanned reoperation (UR) is an outcome measure with multiple advantages that can be used as a standardized tool to assess an institution's quality and safety of medical care. This study aimed to identify parameters associated with an increased likelihood of UR following plastic surgery in patients less than 18 years of age by using a large validated national multicenter database. We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database between 2012 and 2014 to identify pediatric patients undergoing primary plastic surgery procedures. Two cohorts were compared: patients who experienced UR and those who did not. Multiple logistic regression analysis was utilized to identify independent risk factors associated with UR. A total of 18,106 patients were identified in this analysis, with an overall UR rate of 0.8% (n = 137) within 30 days after surgery. Patients were on average 5.59 ± 5.27 years of age with 9522 boys (52.6%) and 8584 girls (47.4%). The procedures most commonly associated with UR were excision of skin and subcutaneous tissue for hidradenitis (UR = 10.3%), forehead, and/or supraorbital rim reconstruction with grafts (allograft or prosthetic material, UR = 6.1%), use of multiplane external fixators (UR = 5.6%), mastectomy for gynecomastia (UR = 4.4%), and forehead and/or supraorbital rim reconstruction with autograft (3.3%). The average number of relative value units per case was 10.01 ± 7.91. Independent risk factors for UR include inpatient procedure (p plastic surgery. These results may aid in the informed consent process, improve patient risk assessment, counseling, and surgical planning. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Analysis of Risk and Protective Factors for Recidivism in Spanish Youth Offenders.

    Science.gov (United States)

    Cuervo, Keren; Villanueva, Lidón

    2015-10-01

    Although a large body of research has studied the factors associated to general recidivism, predictive validity of these factors has received less attention. Andrews and Bonta's General Personality and Social-Psychological Model attempts to provide an in-depth explanation of risk and protective factors in relation to youth recidivism. The Youth Level of Service/Case Management Inventory was administered to 210 adolescents aged between 14 and 18 with a criminal record to analyse risk and protective factors in relation to youth recidivism. Their possible differential contribution over a 2-year follow-up period was also examined. Risk factors showed good levels of recidivism prediction. The factors that emerged as the most discriminative were education/employment, leisure/recreation, and personality. Protective factors differentiated between recidivists and non-recidivists in all factors. Hence, results showed that not only individual but also social factors would be crucial in predicting recidivism. © The Author(s) 2014.

  2. Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis.

    Science.gov (United States)

    Grammatikopoulou, M G; Chourdakis, M; Gkiouras, K; Roumeli, P; Poulimeneas, D; Apostolidou, E; Chountalas, I; Tirodimos, I; Filippou, O; Papadakou-Lagogianni, S; Dardavessis, T

    2018-01-08

    The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls. A total of 361 children (2-14 years old), outpatients of an Athenian hospital, participated in this case-control study by forming two groups: the obese (n = 203) and the normoweight controls (n = 158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors' analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models. The majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all P  2 times/week was associated with reduced obesity odds in the GA analysis (OR = 0.57, 95% CI = 0.33-0.98, P linear = 0.047), it lost its significance in the multivariate analysis (P linear = 0.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status. Few outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities

  3. Dietary patterns and risk of laryngeal cancer: an exploratory factor analysis in Uruguayan men.

    Science.gov (United States)

    De Stefani, Eduardo; Boffetta, Paolo; Ronco, Alvaro L; Deneo-Pellegrini, Hugo; Acosta, Giselle; Mendilaharsu, María

    2007-09-01

    Laryngeal carcinoma is a common malignancy among Uruguayan men. A number of case-control and prospective studies have studied the role of diet in this malignancy. To our knowledge, this is the first study that has explored broad dietary patterns by factor (principal components) analysis. The results of this study retained 6 dietary patterns. Pattern 5 (drinker) was directly associated with risk of laryngeal carcinoma (OR 3.8, 95% CI 1.9-7.5), whereas the Pattern 2 (healthy) was protective (OR 0.6, 95% CI 0.3-1.2). Finally, the Pattern 6 (western) displayed a significant increase in risk of 3.2 (95% CI 1.6-6.2). Most dietary patterns were associated with supraglottic cancer, supporting a possible etiological difference between supraglottic and glottic carcinomas. This study also suggests that the analysis of dietary patterns might be a useful approach for investigating nutritional factors implicated in laryngeal carcinogenesis. (c) 2007 Wiley-Liss, Inc.

  4. Analysis of Risk Factors for Pneumonia in 482 Patients Undergoing Oral Cancer Surgery With Tracheotomy.

    Science.gov (United States)

    Li, Li; Yuan, Weijun; Zhang, Shilei; Wang, Kewei; Ruan, Hong

    2016-02-01

    Elective tracheostomy is a common procedure used in patients with oral cancer. However, secondary tracheotomy-associated pneumonia (TAP) is an important complication after surgery. This study investigated the risk factors related to postoperative TAP complications in patients with oral cancer. A retrospective study was performed from January 2012 to October 2013. Data on patients who had oral cancer and underwent neck dissection or reconstructive surgery with tracheotomy were collected from the Hospital Information System. The predictive variables were age, gender, alcohol history, smoking history, basic disease (including diabetes, hypertension, and cardiovascular disease), tumor location, and duration of tracheotomy, which were extracted from electronic medical records. The outcome variable was TAP. Descriptive single factors and bivariate statistics were computed and the P value was set at .05. Four hundred eighty-two patients who received tracheotomy after oral cancer surgery were included in this study and 95 (19.7%) developed TAP. Univariate analysis showed that male gender (odds ratio [OR] = 1.853; 95% confidence interval [CI], 1.083-3.17; P = .024 to tracheotomy (OR = 1.673; 95% CI, 1.343-2.083; P tracheotomy (OR = 1.694; P = .0001). The present findings indicate that male gender and tracheotomy duration are important risk factors for TAP in patients undergoing major oral cancer surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Factors influencing adolescent girls' sexual behavior: a secondary analysis of the 2011 youth risk behavior survey.

    Science.gov (United States)

    Anatale, Katharine; Kelly, Sarah

    2015-03-01

    Adolescence is a tumultuous and challenging time period in life. Sexual risk behavior among adolescents is a widespread topic of interest in the current literature. Two common factors that influence increased sexual risk behavior are symptoms of depression and negative body image. The purpose of this study was to investigate the effect of body image and symptoms of depression upon sexual risk-taking in an adolescent female population. A secondary data analysis of the 2011 Youth Risk Behavior Survey (YRBS) was used to explore girls' sexual activity, body image, and mental health. There were 7,708 high-school girls who participated in this study. Three questions were used to represent the constructs under investigation. There were significant correlations between sexual activity, body image, and symptoms of depression; only symptoms of depression were significant predictors of both sexual activity and condom usage. Body image was a predictor of sexual activity, but not condom use. Our findings support previous studies that suggested that people with depressive symptoms were more likely to engage in risky sexual behaviors. Our study also supports the idea that a negative body image decreases sexual activity; however, other researchers have reported that negative body image leads to an increase in sexual activity.

  6. An Analysis of the Factors Leading to Rising Credit Risk in the Zimbabwe Banking Sector

    Directory of Open Access Journals (Sweden)

    Maxwell Sandada

    2016-02-01

    Full Text Available The study sought to analyse the factors that lead to rising credit risk in the Zimbabwean banking sector. The objective was to ascertain the impact of macroeconomic, industry and bank specific factors on rising credit risk in in Zimbabwe. The study aimed at contributing to credit risk management literature by providing evidence Sub Saharan context. Being anchored on the positivist quantitative research approach, a survey was carried out gather the data that were analysed using descriptive, correlation and regression analyses. The results revealed that the most significant factors leading to credit risk in the Zimbabwean banking sector were macroeconomic and bank specific factors. The industry factors did not show a significant influence on the rising credit risk. The research findings of this study will a valuable addition to the existing knowledge and provide a platform for further research on how the credit risk problems can be dealt with. While credit risk is known as one of the risks inherent to any banking institutions, the alarming levels of credit risk in the Zimbabwe banking sector has motivated this current study to critically analyse the factors that have led to the high credit risk levels.

  7. Risk Factor Analysis for Late-onset Neonatal Hyperbilirubinemia in Taiwanese Infants

    Directory of Open Access Journals (Sweden)

    Mi-Shu Huang

    2009-12-01

    Conclusion: Thirty-nine (21.7% infants develop late hyperbilirubinemia at the age of one week. Exclusive breast-feeding and less body weight loss were significant risk factors. Follow-up visits are recommended for all infants, especially for those who have these risk factors.

  8. [Analysis of risk factors for anastomotic infectious complications following bowel resection for Crohn disease].

    Science.gov (United States)

    Wang, Wang-yue; Chen, Cheng-long; Chen, Guang-lan; Wu, Cheng-jun; Li, Hong-guang; Luan, Shuang-mei; Zhu, Ya-bi

    2013-04-01

    To investigate the risk factors for anastomotic infectious complications after bowel resection in patients with Crohn disease. Clinical data of 124 patients with Crohn disease undergoing bowel resection between January 1990 and October 2012 were analyzed retrospectively. The risk factors were identified by χ(2) test and Logistic regression. Fourteen patients (12.3%, 14/114) developed anastomotic infectious complications in the postoperative period, including anastomotic leak (n=7), intra-abdominal abscess (n=6), and enterocutaneous fistula (n=1). Crohn disease activity index (CDAI)>150 (OR=2.185, 95%CI:1.098-6.256, P=0.040), steroid usage (OR=2.674, 95%CI:1.118-8.786, P=0.027), and the presence of preoperative abscess/fistula (OR=3.447, 95%CI:1.254-10.462, P=0.014) were identified as independent risk factors of anastomotic infectious complications. In the absence of these 3 risk factors, the rate of anastomotic infectious complication was 5.7% (3/53), which increased to 11.4% (4/35) when one risk factor was present, 21.1% (4/19) when two risk factors were present, and 42.9% (3/7) when all the 3 risk factors were present. CDAI>150, steroid usage and preoperative abscess/fistula are associated with higher rates of anastomotic infectious complications following bowel resection for Crohn disease. A prudent management should be carried out if risk factors can not be eliminated preoperatively.

  9. Exploratory spatial data analysis for the identification of risk factors to birth defects

    Directory of Open Access Journals (Sweden)

    Song Xinming

    2004-06-01

    Full Text Available Abstract Background Birth defects, which are the major cause of infant mortality and a leading cause of disability, refer to "Any anomaly, functional or structural, that presents in infancy or later in life and is caused by events preceding birth, whether inherited, or acquired (ICBDMS". However, the risk factors associated with heredity and/or environment are very difficult to filter out accurately. This study selected an area with the highest ratio of neural-tube birth defect (NTBD occurrences worldwide to identify the scale of environmental risk factors for birth defects using exploratory spatial data analysis methods. Methods By birth defect registers based on hospital records and investigation in villages, the number of birth defects cases within a four-year period was acquired and classified by organ system. The neural-tube birth defect ratio was calculated according to the number of births planned for each village in the study area, as the family planning policy is strictly adhered to in China. The Bayesian modeling method was used to estimate the ratio in order to remove the dependence of variance caused by different populations in each village. A recently developed statistical spatial method for detecting hotspots, Getis's 7, was used to detect the high-risk regions for neural-tube birth defects in the study area. Results After the Bayesian modeling method was used to calculate the ratio of neural-tube birth defects occurrences, Getis's statistics method was used in different distance scales. Two typical clustering phenomena were present in the study area. One was related to socioeconomic activities, and the other was related to soil type distributions. Conclusion The fact that there were two typical hotspot clustering phenomena provides evidence that the risk for neural-tube birth defect exists on two different scales (a socioeconomic scale at 6.84 km and a soil type scale at 22.8 km for the area studied. Although our study has limited

  10. Risk factors of severe hand, foot and mouth disease: a meta-analysis.

    Science.gov (United States)

    Fang, Yirong; Wang, Shuiping; Zhang, Lijie; Guo, Zhinan; Huang, Zhaohui; Tu, Chunyu; Zhu, Bao-Ping

    2014-07-01

    In recent years, outbreaks of hand, foot and mouth disease (HFMD) have increased, and more and more severe cases have appeared. We conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD. PubMed, Elsevier Science Direct, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 11.0. We conducted a meta-analysis of 19 separate studies. Duration of fever ≥ 3 days (odds ratio (OR) 10.09, 95% confidence interval (CI) 6.22-16.35), body temperature ≥ 37.5°C (OR 4.91, 95% CI 1.26-19.18), lethargy (OR 7.75, 95% CI 3.78-15.89), hyperglycemia (OR 2.77, 95% CI 2.06-3.71), vomiting (OR 8.83, 95% CI 1.05-74.57), increased neutrophil count (weighted mean difference (WMD) 0.61, 95% CI 0.52-0.70), enterovirus 71 (EV71) infection (OR 5.13, 95% CI 3.11- 8.46), young age (WMD - 0.44, 95% CI - 0.69 to -0.19), and home care (OR 1.65, 95% CI 1.26-2.17) were significantly related to the risk of severe HFMD. We also found that a confirmed diagnosis at first visit to hospital significantly decreased the risk of severe HFMD (OR 0.30, 95% CI 0.09-0.99). We did not find an association between oral rash (OR 1.07, 95% CI 0.82-1.39), increased leukocyte count (WMD 0.51, 95% CI - 0.05-1.06), male sex (OR 1.06, 95% CI 0.91-1.24), or living in a rural area (OR 1.39, 95% CI 0.95-2.02) and the risk of severe HFMD. Duration of fever ≥ 3 days, body temperature ≥ 37.5°C, lethargy, hyperglycemia, vomiting, increased neutrophil count, EV71 infection, and young age are risk factors for severe HFMD. A confirmed diagnosis at first visit to hospital can significantly decrease the risk of severe HFMD.

  11. Tumor necrosis factor alpha rs1800629 polymorphism and risk of cervical lesions: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Min Li

    Full Text Available BACKGROUND: Tumor necrosis factor- alpha (TNF-α is an inflammatory cytokine which may play important role on the immune response may control the progression of cervical lesions. There is a possible association between TNF-α rs1800629 G/A polymorphism and cervical lesions, but previous studies report conflicting results. We performed a meta-analysis to comprehensively assess the association between TNF-α rs1800629 polymorphism and cervical lesions risk. METHODS: Literature searches of Pubmed, Embase, Web of Science, and Wanfang databases were performed for all publications on the association between TNF-α rs1800629 polymorphism and cervical lesions through December 15, 2012. The pooled odds ratios (ORs with their 95% confidence interval (95%CIs were calculated to assess the strength of the association. RESULTS: Twenty individual case-control studies from 19 publications with a total of 4,146 cases and 4,731 controls were finally included into the meta-analysis. Overall, TNF-α rs1800629 polymorphism was significantly associated with increased risk of cervical lesions under two main genetic comparison models (For A versus G: OR 1.22, 95%CI 1.04-1.44, P = 0.017; for AA versus GG: OR 1.32, 95%CI 1.02-1.71, P = 0.034. Subgroup analysis by ethnicity further showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical lesions in Caucasians but not in Asians. Subgroup analysis by the types of cervical lesions showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical cancer (For A versus G: OR 1.24, 95%CI 1.05-1.47, P = 0.011; for AA versus GG: OR 1.31, 95%CI 1.01-1.70, P = 0.043; for AA/GA versus GG: OR 1.25, 95%CI 1.01-1.54, P = 0.039. CONCLUSION: The meta-analysis suggests that TNF-α rs1800629 polymorphism is associated with increased risk of cervical lesions, especially in Caucasians.

  12. Diabetes as a risk factor for carpal tunnel syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Pourmemari, M H; Shiri, R

    2016-01-01

    To assess whether diabetes increases the risk of carpal tunnel syndrome and to estimate the magnitude of the association with Type 1 and Type 2 diabetes. We conducted a systematic search of PubMed, Embase, Web of Science, Scopus, Google Scholar and ResearchGate for articles published between 1950 and January 2015. A total of 36 studies (eight cross-sectional, 21 case-control and seven cohort studies) qualified for meta-analysis. We used a random-effects meta-analysis and assessed heterogeneity and publication bias. The pooled odds ratio of 25 studies (including a total of 92 564 individuals) that reported unadjusted estimates for the association between diabetes and carpal tunnel syndrome or carpal tunnel release was 1.97 (95% CI 1.56-2.49). The pooled odds ratio of 18 case-control or cohort studies consisting of >37 million individuals that reported estimates after controlling for potential confounders was 1.69 (95% CI 1.45-1.96). The association did not differ for Type 1 and Type 2 diabetes. Furthermore, there was no publication bias. This meta-analysis suggests that both Type 1 and Type 2 diabetes are risk factors for carpal tunnel syndrome. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  13. An Path Analysis on the Risk Factors of Cardiovascular Disease in Makassar City Indonesia

    OpenAIRE

    Amiruddin, Ridwan; Muh. Taufiq, La Ode

    2016-01-01

    ABSTRACT The aims of the research were to analyze to what extent the relationship between risk factor and the occurrence of cardiovascular diseases and to analyze to what extent direct and indirect relationship (with the involvement of intermediary factor) between risk factor and occurrence of cardiovascular diseases. The Research used case control method to 91 cardiovascular disease patients and 91 respondents who did not suffer from cardiovascular diseases in the outpatient rooms of Dr. ...

  14. Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

    Science.gov (United States)

    Conraths, Franz J; Probst, Carolina; Possenti, Alessia; Boufana, Belgees; Saulle, Rosella; La Torre, Giuseppe; Busani, Luca; Casulli, Adriano

    2017-07-01

    Human alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs) associated with AE in humans. Six bibliographic databases were searched, generating a total of 1,009 publications. Following the removal of duplicate records and the exclusion of papers that failed to meet the criteria of a previously agreed a priori protocol, 23 publications were retained; however, 6 of these did not contain data in a format that allowed their inclusion in the meta-analysis. The remaining 17 publications (6 case-control and 11 cross-sectional studies) were meta-analysed to investigate associations between AE and PRFs. Pooled odds ratios (OR) were used as a measure of effect and separately analysed for case-control and cross-sectional studies. In the case-control studies, the following PRFs for human AE showed higher odds of outcome: "dog ownership", "cat ownership", "have a kitchen garden", "occupation: farmer", "haymaking in meadows not adjacent to water", "went to forests for vocational reasons", "chewed grass" and "hunting / handling foxes". In the cross-sectional studies, the following PRFs showed higher odds of outcome: "dog ownership", "play with dogs", "gender: female", "age over 20 years", "ethnic group: Tibetan", "low income", "source of drinking water other than well or tap", "occupation: herding" and "low education". Our meta-analysis confirmed that the chance of AE transmission through ingestion of food and water contaminated with E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do not significantly increase the risk of infection. This systematic review analysed international peer-reviewed articles that have over the years

  15. Potential risk factors associated with human alveolar echinococcosis: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Franz J Conraths

    2017-07-01

    Full Text Available Human alveolar echinococcosis (AE is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. AE is commonly associated with a long incubation period that may last for more than ten years. The objective of this systematic literature review was to identify and summarize the current knowledge on statistically relevant potential risk factors (PRFs associated with AE in humans.Six bibliographic databases were searched, generating a total of 1,009 publications. Following the removal of duplicate records and the exclusion of papers that failed to meet the criteria of a previously agreed a priori protocol, 23 publications were retained; however, 6 of these did not contain data in a format that allowed their inclusion in the meta-analysis. The remaining 17 publications (6 case-control and 11 cross-sectional studies were meta-analysed to investigate associations between AE and PRFs. Pooled odds ratios (OR were used as a measure of effect and separately analysed for case-control and cross-sectional studies. In the case-control studies, the following PRFs for human AE showed higher odds of outcome: "dog ownership", "cat ownership", "have a kitchen garden", "occupation: farmer", "haymaking in meadows not adjacent to water", "went to forests for vocational reasons", "chewed grass" and "hunting / handling foxes". In the cross-sectional studies, the following PRFs showed higher odds of outcome: "dog ownership", "play with dogs", "gender: female", "age over 20 years", "ethnic group: Tibetan", "low income", "source of drinking water other than well or tap", "occupation: herding" and "low education". Our meta-analysis confirmed that the chance of AE transmission through ingestion of food and water contaminated with E. multilocularis eggs exists, but showed also that food- and water-borne PRFs do not significantly increase the risk of infection.This systematic review analysed international peer-reviewed articles that have over the

  16. Multifactorial analysis of risk factors for reduced bone mineral density among postmenopausal women

    Science.gov (United States)

    Opala, Tomasz; Kleka, Paweł; Chuchracki, Marek

    2012-01-01

    Introduction The study aimed to determine the risk factors for reduced bone mineral density (BMD) among postmenopausal women. Material and methods Two hundred and fifty-three postmenopausal women were included to the study. The study group consisted of 85 women with osteoporosis (mean age: 59.9 years) and 168 with osteopenia (mean age: 57.8 years). Patients were assigned to groups according to their BMD measured in the lumbar spine, hip and femoral neck by dual X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorption by measuring serum C-terminal type I α-collagen chain telopeptide. Results Multiple regression analysis for lumbar spine showed association of age (p = 0.001), parental history of fracture (p = 0.05), use of hormone replacement therapy (p = 0.034), bisphosphonates therapy (p femoral neck and hip total showed association of age (p = 0.001), parental history of fracture (p = 0.049), use of bisphosphonates (p femoral neck and hip total. Conclusions The present study demonstrated correlations between the variables and BMD, which are known and widely described in the literature. Osteoporosis and osteopenia in Polish subjects appear to be associated with several known risk factors that are well described in the literature. PMID:22662008

  17. ANALYSIS OF RISK FACTORS ATTENISTIC DERMATITIS ATTENDANCE ON THE CENTER IN PUSKESMAS PAUH PADANG

    Directory of Open Access Journals (Sweden)

    Dian Sari

    2017-10-01

    Full Text Available This study discusses the analysis of risk factors of atopic dermatitis occurrence in infants due to the high incidence rate of atopic dermatitis in infants. The purpose of this study was to determine what factors are at risk of incidence of atopic dermatitis in infants. This type of research is quantitative with case control study. The study was conducted from February to July 2017 with samples for 75 cases and control of 75 people (1: 1 so that the overall sample was 150 people. This research was conducted through interview using questionnaire. Result on Chi-Square was obtained p = 0.000 (p <0.05, where there was significant relationship between genetic, allergen, environment and hygiene with occurrence of atopic dermatitis in infants. Health workers can provide counseling to underfive mothers in Puskesmas Padang Puskesmas work area to be able to pay attention to food given to toddlers and to suppress incidence of atopic dermatitis in under fives. Health workers can increase the knowledge, awareness and willingness of the community about PHBS so as to reduce the incidence rate of atopic dermatitis. Maternal care in paying attention to the food in toddlers can reduce the incidence rate of atopic dermatitis in infants.

  18. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Amna Umer

    2017-08-01

    Full Text Available Abstract Background Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods Studies were included if they met the following criteria: (1 longitudinal and cohort studies (including case-cohort, (2 childhood exposure and adult outcomes collected on the same individual over time, (3 childhood obesity, as defined by the original study authors, (4 English-language articles, (5 studies published up to June, 2015, (6 one or more of the following CVD risk factors [systolic blood pressure (SBP, diastolic blood pressure (DBP, total cholesterol (TC, high-density lipoprotein cholesterol (HDL, low-density lipoprotein cholesterol (LDL, non-high-density lipoprotein cholesterol (non-HDL, and triglycerides (TG], (7 outcome(s not self-reported, and (8 exposure measurements (child’s adiposity assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and

  19. Climate change - An uncertainty factor in risk analysis of contaminated land.

    Science.gov (United States)

    Augustsson, Anna; Filipsson, Monika; Oberg, Tomas; Bergbäck, Bo

    2011-10-15

    Metals frequently occur at contaminated sites, where their potential toxicity and persistence require risk assessments that consider possible long-term changes. Changes in climate are likely to affect the speciation, mobility, and risks associated with metals. This paper provides an example of how the climate effect can be inserted in a commonly used exposure model, and how the exposure then changes compared to present conditions. The comparison was made for cadmium (Cd) exposure to 4-year-old children at a highly contaminated iron and steel works site in southeastern Sweden. Both deterministic and probabilistic approaches (through probability bounds analysis, PBA) were used in the exposure assessment. Potential climate-sensitive variables were determined by a literature review. Although only six of the total 39 model variables were assumed to be sensitive to a change in climate (groundwater infiltration, hydraulic conductivity, soil moisture, soil:water distribution, and two bioconcentration factors), the total exposure was clearly affected. For example, by altering the climate-sensitive variables in the order of 15% to 20%, the deterministic estimate of exposure increased by 27%. Similarly, the PBA estimate of the reasonable maximum exposure (RME, defined as the upper bound of the 95th percentile) increased by almost 20%. This means that sites where the exposure in present conditions is determined to be slightly below guideline values may in the future exceed these guidelines, and risk management decisions could thus be affected. The PBA, however, showed that there is also a possibility of lower exposure levels, which means that the changes assumed for the climate-sensitive variables increase the total uncertainty in the probabilistic calculations. This highlights the importance of considering climate as a factor in the characterization of input data to exposure assessments at contaminated sites. The variable with the strongest influence on the result was the

  20. Analysis of risk factors for schizophrenia with two different case definitions

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Larsen, Janne T; Mors, Ole

    2015-01-01

    contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher...... risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include......Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range...

  1. Analysis of risk factors for sagittal translation after pedicle subtraction osteotomy in ankylosing spondylitis patients.

    Science.gov (United States)

    Park, Jin-Sung; Kim, Jaedong; Joo, Il-Han; Sim, Kyu-Dong; Park, Ye-Soo

    2018-01-02

    Sagittal translation, a potential complication of pedicle subtraction osteotomy (PSO), can results in neurologic damage. However, few studies have been conducted on sagittal translation and its risk factors after PSO in patients with ankylosing spondylitis (AS). To report cases of sagittal translation that developed after PSO in patients with AS with kyphotic deformity and to analyze risk factors for sagittal translation. A retrospective case-control study PATIENT SAMPLE: This study included 53 patients (58 cases) with AS who underwent PSO to correct their kyphotic deformity. The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was measured before the surgery. Radiologic pelvic and sagittal parameters were also measured before and after surgery. Developments of sagittal translation were confirmed with intraoperative radiograph. The subjects were grouped according to the presence (ST group) and absence (non-ST group) of sagittal translation. The demographic and radiologic parameters were compared between two groups. Through multivariate logistic regression analysis, the correlations between sagittal translation and relevant parameters were analyzed for risk factor evaluation. Sagittal translation developed in 16 patients (30.2%) [16 cases (27.6%)]. The mean lumbar lordosis angle and sagittal vertical axis of both ST group and non-ST group were successfully corrected. In a comparison of two groups, the ST group (58.2 ± 13.3) showed a significantly higher mSASSS than the non-ST group (33.9 ± 11.9) (p<0.001). The ST group (50.4°± 7.8°, 16.9° ± 6.8°) also showed a significantly higher preoperative pelvic incidence and sacral slope than the non-ST group (45.3° ± 7.2°, 11.0°± 7.7°) (p=0.026, p=0.011). No significant differences were observed between the two groups for the rest of radiologic parameters. In multivariate analysis, only mSASSS was positively correlated with sagittal translation (odds ratio 1.16, p=0.001). The incidence of sagittal

  2. Risk and Protective Factors of Internet Addiction: A Meta-Analysis of Empirical Studies in Korea

    Science.gov (United States)

    Koo, Hoon Jung

    2014-01-01

    Purpose A meta-analysis of empirical studies performed in Korea was conducted to systematically investigate the associations between the indices of Internet addiction (IA) and psychosocial variables. Materials and Methods Systematic literature searches were carried out using the Korean Studies Information Service System, Research Information Sharing Service, Science Direct, Google Scholar, and references in review articles. The key words were Internet addiction, (Internet) game addiction, and pathological, problematic, and excessive Internet use. Only original research papers using Korean samples published from 1999 to 2012 and officially reviewed by peers were included for analysis. Ninety-five studies meeting the inclusion criteria were identified. Results The magnitude of the overall effect size of the intrapersonal variables associated with internet addiction was significantly higher than that of interpersonal variables. Specifically, IA demonstrated a medium to strong association with "escape from self" and "self-identity" as self-related variables. "Attention problem", "self-control", and "emotional regulation" as control and regulation-relation variables; "addiction and absorption traits" as temperament variables; "anger" and "aggression" as emotion and mood and variables; "negative stress coping" as coping variables were also associated with comparably larger effect sizes. Contrary to our expectation, the magnitude of the correlations between relational ability and quality, parental relationships and family functionality, and IA were found to be small. The strength of the association between IA and the risk and protective factors was found to be higher in younger age groups. Conclusion The findings highlight a need for closer examination of psychosocial factors, especially intrapersonal variables when assessing high-risk individuals and designing intervention strategies for both general IA and Internet game addiction. PMID:25323910

  3. Risk and protective factors of internet addiction: a meta-analysis of empirical studies in Korea.

    Science.gov (United States)

    Koo, Hoon Jung; Kwon, Jung-Hye

    2014-11-01

    A meta-analysis of empirical studies performed in Korea was conducted to systematically investigate the associations between the indices of Internet addiction (IA) and psychosocial variables. Systematic literature searches were carried out using the Korean Studies Information Service System, Research Information Sharing Service, Science Direct, Google Scholar, and references in review articles. The key words were Internet addiction, (Internet) game addiction, and pathological, problematic, and excessive Internet use. Only original research papers using Korean samples published from 1999 to 2012 and officially reviewed by peers were included for analysis. Ninety-five studies meeting the inclusion criteria were identified. The magnitude of the overall effect size of the intrapersonal variables associated with internet addiction was significantly higher than that of interpersonal variables. Specifically, IA demonstrated a medium to strong association with "escape from self" and "self-identity" as self-related variables. "Attention problem", "self-control", and "emotional regulation" as control and regulation-relation variables; "addiction and absorption traits" as temperament variables; "anger" and "aggression" as emotion and mood and variables; "negative stress coping" as coping variables were also associated with comparably larger effect sizes. Contrary to our expectation, the magnitude of the correlations between relational ability and quality, parental relationships and family functionality, and IA were found to be small. The strength of the association between IA and the risk and protective factors was found to be higher in younger age groups. The findings highlight a need for closer examination of psychosocial factors, especially intrapersonal variables when assessing high-risk individuals and designing intervention strategies for both general IA and Internet game addiction.

  4. Analysis of various risk factors affecting potentially malignant disorders and oral cancer patients of Central India

    Directory of Open Access Journals (Sweden)

    Vidya Kadashetti

    2015-01-01

    Conclusions: Chewing tobacco/betel quid is a strong risk factor in the development of PMD and oral cancer. Also age, gender, SES, education, and occupation influence the development of PMD and oral cancer.

  5. Analysis of the prevalence and associated risk factors of tinnitus in adults.

    Directory of Open Access Journals (Sweden)

    Hyung-Jong Kim

    Full Text Available Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus.We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling.The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h, those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss.Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.

  6. Analysis of the Prevalence and Associated Risk Factors of Tinnitus in Adults

    Science.gov (United States)

    Kim, Hyung-Jong; Lee, Hyo-Jeong; An, Soo-Youn; Sim, Songyong; Park, Bumjung; Kim, Si Whan; Lee, Joong Seob; Hong, Sung Kwang; Choi, Hyo Geun

    2015-01-01

    Background Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus. Methods We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling. Results The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss. Conclusions Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history. PMID:26020239

  7. Analysis of Risk Factors for Patient Readmission 30 Days Following Discharge From General Surgery.

    Science.gov (United States)

    McIntyre, Lisa K; Arbabi, Saman; Robinson, Ellen F; Maier, Ronald V

    2016-09-01

    Previous studies investigating patients at risk for hospital readmissions focus on medical services and have found chronic conditions as contributors. Little is known, however, of the characteristics of patients readmitted from surgical services. Surgical patients readmitted within 30 days following discharge were analyzed to identify opportunities for intervention in a cohort that may differ from the medical population. Medical record review of patients readmitted to any service within 30 days of discharge from the general surgery service to characterize index and readmission data between July 1, 2014, and June 30, 2015, at a Level I trauma center and safety-net hospital. Reasons for readmission identified by manual medical record review and risk factors identified via statistical analysis of all discharges during this period. One hundred seventy-three patients were identified as being unplanned readmissions within 30 days among 2100 discharges (8.2%). Of these 173 patients, 91 were men. Common reasons for readmission included 29 patients with injection drug use who were readmitted with soft tissue infections at new sites (16.8% of readmissions), 25 with disposition support issues (14.5%), 23 with infections not detectable during index admission (13.3%), and 16 with sequelae of their injury or condition (9.2%). Sixteen patients were identified as having a likely preventable complication of care (9.2%), and 2 were readmitted owing to deterioration of medical conditions (1.2%). On univariate and multivariate analyses, female sex (men to women risk of readmission odds ratio [OR], 0.5; 95% CI, 0.37-0.71; P < .001), presence of diabetes (OR, 1.7; 95% CI, 1.1-2.6; P = .009), sepsis on admission (OR, 1.7; 95% CI, 1.05-2.6; P = .03), or intensive care unit stay during index admission (OR, 1.7; 95% CI, 1.2-2.4; P = .002), as well as discharge to respite care (OR, 2.3; 95% CI, 1.2-4.5; P = .01) and payer status (Medicaid/Medicare compared with commercial OR, 2.0; 95

  8. Obesity as a risk factor for sciatica: a meta-analysis.

    Science.gov (United States)

    Shiri, Rahman; Lallukka, Tea; Karppinen, Jaro; Viikari-Juntura, Eira

    2014-04-15

    The aim of this study was to assess the associations of overweight and obesity with lumbar radicular pain and sciatica using a meta-analysis. We searched the PubMed, Embase, Scopus, and Web of Science databases from 1966 to July 2013. We performed a random-effects meta-analysis and assessed publication bias. We included 26 (8 cross-sectional, 7 case-control, and 11 cohort) studies. Both overweight (pooled odds ratio (OR) = 1.23, 95% confidence interval (CI): 1.14, 1.33; n = 19,165) and obesity (OR = 1.40, 95% CI: 1.27, 1.55; n = 19,165) were associated with lumbar radicular pain. The pooled odds ratio for physician-diagnosed sciatica was 1.12 (95% CI: 1.04, 1.20; n = 109,724) for overweight and 1.31 (95% CI: 1.07, 1.62; n = 115,661) for obesity. Overweight (OR = 1.16, 95% CI: 1.09, 1.24; n = 358,328) and obesity (OR = 1.38, 95% CI: 1.23, 1.54; n = 358,328) were associated with increased risk of hospitalization for sciatica, and overweight/obesity was associated with increased risk of surgery for lumbar disc herniation (OR = 1.89, 95% CI: 1.25, 2.86; n = 73,982). Associations were similar for men and women and were independent of the design and quality of included studies. There was no evidence of publication bias. Our findings consistently showed that both overweight and obesity are risk factors for lumbar radicular pain and sciatica in men and women, with a dose-response relationship.

  9. Investigating injury severity risk factors in automobile crashes with predictive analytics and sensitivity analysis methods

    OpenAIRE

    Delen, Dursun; Tomak, Leman; Topuz, Kazim; Eryarsoy, Enes

    2017-01-01

    Investigation of the risk factors that contribute to the injury severity in motor vehicle crashes has proved to be a thought-provoking and challenging problem. The results of such investigation can help better understand and potentially mitigate the severe injury risks involved in automobile crashes and thereby advance the well-being of people involved in these traffic accidents. Many factors were found to have an impact on the severity of injury sustained by occupants in the event of an auto...

  10. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis.

    Science.gov (United States)

    Umer, Amna; Kelley, George A; Cottrell, Lesley E; Giacobbi, Peter; Innes, Kim E; Lilly, Christa L

    2017-08-29

    Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child's adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher's r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr

  11. Risk factors for postpartum depression among Chinese women: path model analysis.

    Science.gov (United States)

    Liu, Shiping; Yan, Yan; Gao, Xiao; Xiang, Shiting; Sha, Tingting; Zeng, Guangyu; He, Qiong

    2017-05-02

    Postpartum depression causes harm to both mothers and infants. The purpose of this study was to find out several potential risk factors, and to identify the intrinsic interrelationships between factors and postpartum depression by constructing a path model. The results of this study may help to control the increasing incidence of maternal postpartum depression. The study was based on a sample of mothers from a cross-sectional study which was set up at 4 weeks after a mother had childbirth and was conducted in three streets at Kaifu District of Changsha in Hunan province from January to December 2015. Questionnaires were distributed to subjects who responded to questions concerning factors related to pregnancy, delivery and infants within 4 weeks after childbirth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure postpartum depression. Chi-square test was used to detect significant differences between non-postpartum depression group and postpartum depression group. A path model was constructed to explore the interrelationships between variables, and to verify the relationships between variables and postpartum depression. The proportion of maternal postpartum depression was 6.7%. Univariate analysis showed that there were significant differences between non-postpartum depression group and postpartum depression group (all P-values <0.05) on the part of maternal age, parity, frequent exposure to mobile phone during pregnancy, gestational hypertensive disorders, fetus number, premature delivery, birth weight, initiation of breastfeeding, mode of feeding, infant illness within 4 weeks after delivery and infant weight at 4 weeks. Path analysis results showed that the final model could be fitted well with sample data (P = 0.687, CMIN/DF = 0.824, NFI = 0.992, RFI = 0.982, IFI = 1.002, TLI =1.004, CFI = 1.000 and RMSEA < 0.001). Frequent exposure to mobile phone during pregnancy, maternal age and gestational hypertensive

  12. Application of Canonical Correlation Analysis for Detecting Risk Factors Leading to Recurrence of Breast Cancer.

    Science.gov (United States)

    Sadoughi, Farahnaz; Lotfnezhad Afshar, Hadi; Olfatbakhsh, Asiie; Mehrdad, Neda

    2016-03-01

    Advances in treatment options of breast cancer and development of cancer research centers have necessitated the collection of many variables about breast cancer patients. Detection of important variables as predictors and outcomes among them, without applying an appropriate statistical method is a very challenging task. Because of recurrent nature of breast cancer occurring in different time intervals, there are usually more than one variable in the outcome set. For the prevention of this problem that causes multicollinearity, a statistical method named canonical correlation analysis (CCA) is a good solution. The purpose of this study was to analyze the data related to breast cancer recurrence of Iranian females using the CCA method to determine important risk factors. In this cross-sectional study, data of 584 female patients (mean age of 45.9 years) referred to Breast Cancer Research Center (Tehran, Iran) were analyzed anonymously. SPSS and NORM softwares (2.03) were used for data transformation, running and interpretation of CCA and replacing missing values, respectively. Data were obtained from Breast Cancer Research Center, Tehran, Iran. Analysis showed seven important predictors resulting in breast cancer recurrence in different time periods. Family history and loco-regional recurrence more than 5 years after diagnosis were the most important variables among predictors and outcomes sets, respectively. Canonical correlation analysis can be used as a useful tool for management and preparing of medical data for discovering of knowledge hidden in them.

  13. [A multifactor epidemiological analysis of risk factors for pancreatic cancer in women].

    Science.gov (United States)

    Azeem, K; Horáková, D; Tomášková, H; Ševčíková, J; Vlčková, J; Pastucha, D; Procházka, V; Shonová, O; Martínek, A; Janout, V; Žídková, V; Kollárová, H

    2015-03-01

    A multifactor analysis of risk factors for pancreas cancer in women. A case-control study was conducted in three centres in the Czech Republic (Olomouc, Ostrava, and České Budějovice) in 2006-2009. In total, 226 women (129 pancreas cancer cases, 97 controls) were included in the study. Statistical analysis was performed, the crude odds ratio (OR) was calculated, and logistic regression analysis was used at a 5% level of statistical significance. A statistically significant inverse association was found between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69). Pregnancy and number of pregnancies or gynecological surgical procedures did not show any association with pancreatic cancer. No significant difference in the first menstrual period was found between pancreatic cancer patients and controls. The study results showed inverse association between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69), controlled alcohol consumption (OR 0.26; 95% CI: 0.12-0.55), and anti-inflamatory drug use (OR 0.10; 95% CI: 0.02-0.41).

  14. A Feature Analysis of Risk Factors for Stroke in the Middle-Aged Adults

    OpenAIRE

    Haewon Byeon; Hyeung Woo Koh

    2015-01-01

    In order to maintain health during middle age and achieve successful aging, it is important to elucidate and prevent risk factors of middle-age stroke. This study investigated high risk groups of stroke in middle age population of Korea and provides basic material for establishment of stroke prevention policy by analyzing sudden perception of speech/language problems and clusters of multiple risk factors. This study analyzed 2,751 persons (1,191 males and 1,560 females) aged 40–59 who partici...

  15. γ-Glutamyltransferase and Breast Cancer Risk Beyond Alcohol Consumption and Other Life Style Factors - A Pooled Cohort Analysis.

    Science.gov (United States)

    Preyer, Oliver; Johansen, Dorthe; Holly, Jessica; Stocks, Tanja; Pompella, Alfonso; Nagel, Gabriele; Concin, Hans; Ulmer, Hanno; Concin, Nicole

    2016-01-01

    Elevated γ-Glutamyltransferase serum levels are associated with increased risk of overall cancer incidence and several site-specific malignancies. In the present prospective study we report on the associations of serum γ-Glutamyltransferase with the risk of breast cancer in a pooled population-based cohort considering established life style risk factors. Two cohorts were included in the present study, i.e. the Vorarlberg (n = 97,268) and the Malmoe cohort (n = 9,790). Cox proportional hazards regression models were fitted to estimate HRs for risk of breast cancer. In multivariate analysis adjusted for age, body mass index and smoking status, women with γ-Glutamyltransferase levels in the top quartile were at significantly higher risk for breast cancer compared to women in the lowest quartile (HR 1.21, 95% CI 1.09 to 1.35; p = 0.005). In the subgroup analysis of the Malmoe cohort, γ-Glutamyltransferase remained an independent risk factor for breast cancer when additionally considering alcohol intake. A statistically significant increase in risk was seen in women with γ-Glutamyltransferase-levels in the top versus lowest quartile in a multivariate model adjusted for age, body mass index, smoking status, physical activity, parity, oral contraceptive-use and alcohol consumption (HR 1.37, 95% CI 1.11-1.69, p = 0.006). Our findings identified γ-Glutamyltransferase as an independent risk factor for breast cancer beyond the consumption of alcohol and other life style risk factors.

  16. Protective/Risk Factors for Problem Drug Use: A Longitudinal Analysis.

    Science.gov (United States)

    Felix-Ortiz, Maria; Newcomb, Michael D.

    With few exceptions, virtually all research on the etiology of adolescent substance abuse has focused entirely on identifying risk factors while ignoring protective factors that insulate teenagers from drug involvement. This perspective fails to consider that protective forces may operate in both direct and interactive ways. This longitudinal…

  17. Environmental and Risk Factors of Leptospirosis: A Spatial Analysis in Semarang City

    Science.gov (United States)

    Nur Fajriyah, Silviana; Udiyono, Ari; Saraswati, Lintang Dian

    2017-02-01

    Leptospirosis is zoonotic potentially epidemic with clinical manifestations from mild to severe and can cause death. The incidence of leptospirosis in Indonesia tends to increase by the year. The case fatality rate in Semarang was greater than the national’s (9.38%). The purpose of this study was to describe the environmental risk factors of leptospirosis in Semarang spatially. The study design was descriptive observational with cross sectional approach. The population and samples in this study were confirmed leptospirosis in Semarang from January 2014 until May 2015, 88 respondents in 61 villages of 15 sub-districts in Semarang. The variables were environmental conditions, the presence of rats, wastewater disposal, waste disposal facilities, the presence of pets, the presence of rivers, flood’s profile, tidal inundation profile, vegetation, contact with rats, and Protected Personal Equipment/PPE utilization. Based on the spatial analysis, variables that found in the big half area of Semarang are environmental conditions, the presence of rats, wastewater disposal, waste disposal facilities, contact with rats, and PPE utilization. The presence of pets at risk, the presence of rivers, flood’s profile, inundation profile, and vegetation were found only in small half of Semarang area. People are expected to maintain their personal and environmental hygiene to prevent the transmission.

  18. [Analysis of risk factors for bone metastasis after radical resection of colorectal cancer within 5 years].

    Science.gov (United States)

    Li, Ang; Tan, Zhen; Fu, Chuangang; Wang, Hao; Yuan, Jie

    2017-01-25

    To investigate the risk factors of metachronous bone metastasis after radical resection of colorectal cancer within 5 years. Clinical data of 1 749 patients with colorectal cancer, of whom 50(2.8%) patients developed metastasis to bone after operation, in the Department of Colorectal Surgery, Changhai Hospital of The Second Military Medical University from January 2001 to December 2010 were analyzed retrospectively. Univariate and multivariate analysis were performed to find the risk factors of metachronous bone metastasis from colorectal cancer using Chi square test and Logistic regression, respectively. Of 50 colorectal cancer cases with bone metastasis, 29 were male and 21 were female. The age was ≥ 60 years old in 28 cases. Tumors of 36 cases were located in the rectum and of 14 cases located in the colon. Pathology examination showed 43 cases were adenocarcinomas, 7 cases were mucinous adenocarcinoma. Forty-two cases had T3-4 stage lesions, 30 cases had lymph node metastasis, 14 cases had pulmonary metastasis, and 5 cases had liver metastasis. Univariate Chi square test indicated that factors associated with the metachronous bone metastasis of colorectal cancer within 5 years were tumor site (χ2=4.932, P=0.026), preoperative carbohydrate antigen 199 (CA199) level (χ2=4.266, P=0.039), lymph node metastasis (χ2=13.054, P=0.000) and pulmonary metastasis(χ2=35.524, P=0.000). The incidence of bone metastasis in patients with rectal cancer (3.6%, 36/991) was higher compared to those with colon cancer (1.8%, 14/758). The incidence of bone metastasis in patients with higher(> 37 kU/L) preoperative serum CA199 level (4.9%, 12/245) was higher compared to those with lower serum CA199 level (2.5%, 38/1504). The incidence of bone metastasis in patients with lymph node metastasis(4.8%,30/627) and pulmonary metastasis (11.6%, 14/121) was significantly higher compared to those without lymph node metastasis (1.8%, 20/1122) and pulmonary metastasis(2.2%, 36

  19. Brain Tumor Risk Factors

    Science.gov (United States)

    ... Professional Meetings Order Materials Clinical Trials Support Group Leader Training Adolescent and Young Adult Guidelines For brain ... nitrites), cigarette smoking, cell phone use, and residential power line exposure, for example—are true risk factors ...

  20. Risk Factor Analysis Between Newly Screened and Established Hepatitis C in GI and Hepatology Clinics.

    Science.gov (United States)

    Hossain, Newaz; Puchakayala, Bharat; Kanwar, Pushpjeet; Verma, Siddharth; Abraham, George; Ivanov, Zhanna; Niaz, Muhammad Obaid; Mohanty, Smruti R

    2017-11-01

    Several studies show inconsistencies in the rate of hepatitis C virus (HCV) detection among baby boomers (born 1945-1965). We conducted a cross-sectional HCV screening followed by a case-controlled comparison of the newly screened population with established HCV subjects. Enrollment was offered to subjects aged 40-75 at our gastroenterology and hepatology clinics. Demographic data and potential risk factors were obtained, and HCV antibody test was offered to those who had never been screened and compared with a group with established HCV. Logistic regression analysis and Fisher's exact test were performed. Six hundred and seventy-five patients were offered participation, of whom 128 declined while 50 consented to participate but did not perform the HCV antibody test. Of 497 enrolled subjects, 252 patients had HCV, while 245 subjects (188 patients among "baby boomer") underwent screening for HCV. There were more females (62.4 vs. 41.7%) and immigrants (34.7 vs. 22.2%) among the newly screened group. Among the screened population, five patients had HCV antibody (2.04%), and two of them had positive viral load (0.82%) of whom only one fell in the baby boomer category (0.53%). Compared to HCV group, screened group had significantly lower-risk factors, such as IV drug use (1.22 vs. 43.3%), intranasal cocaine use (14.3 vs. 49.6%), and blood transfusion (18.8 vs. 32.5%). We found a slightly lower but similar prevalence of HCV antibody when screening based on birth cohort as compared to larger baby boomer studies. Future studies evaluating addition of other screening strategies or possibly universal screening may be needed.

  1. Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

    Science.gov (United States)

    Yoo, Ri Na; Kye, Bong-Hyeon; Kim, Gun; Kim, Hyung Jin; Cho, Hyeon-Min

    2017-10-01

    Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

  2. [Analysis on risk factors of endotracheal cuff under inflation in mechanically ventilated patients].

    Science.gov (United States)

    Fu, You; Xi, Xiuming

    2014-12-01

    To investigate the prevalent condition of endotracheal cuff pressure and risk factors for under inflation. A prospective cohort study was conducted. Patients admitted to the Department of Critical Care Medicine of Fuxing Hospital Affiliated to Capital Medical University, who were intubated with a high-volume low-pressure endotracheal tube, and had undergone mechanical ventilation for at least 48 hours, were enrolled. The endotracheal cuff pressure was determined every 8 hours by a manual manometer connected to the distal edge of the valve cuff at 07 : 00, 15 : 00, and 23 : 00. Measurement of the endotracheal cuff pressure was continued until the extubation of endotracheal or tracheostomy tube, or death of the patient. According to the incidence of under inflation of endotracheal cuff, patients were divided into the incidence of under inflation lower than 25% group (lower low cuff pressure group) and higher than 25% group (higher low cuff pressure group). The possible influencing factors were evaluated in the two groups, including body mass index (BMI), size of endotracheal tube, duration of intubation, use of sedative or analgesic, number of leaving from intensive care unit (ICU), the number of turning over the patients, and aspiration of sputum. Logistic regression analysis was used to determine risk factors for under-inflation of the endotracheal cuff. During the study period, 53 patients were enrolled. There were 812 measurements, and 46.3% of them was abnormal, and 204 times (25.1%) of under inflation of endotracheal cuff were found. There were 24 patients (45.3%) in whom the incidence of under inflation rate was higher than 25%. The average of under inflation was 7 (4, 10) times. Compared with the group with lower rate of low cuff pressure, a longer time for intubation was found in group with higher rate of low cuff pressure [hours: 162 (113, 225) vs. 118 (97, 168), Z=-2.034, P=0.042]. There were no differences between the two groups in other factors

  3. Population-Level Prediction of Type 2 Diabetes From Claims Data and Analysis of Risk Factors.

    Science.gov (United States)

    Razavian, Narges; Blecker, Saul; Schmidt, Ann Marie; Smith-McLallen, Aaron; Nigam, Somesh; Sontag, David

    2015-12-01

    We present a new approach to population health, in which data-driven predictive models are learned for outcomes such as type 2 diabetes. Our approach enables risk assessment from readily available electronic claims data on large populations, without additional screening cost. Proposed model uncovers early and late-stage risk factors. Using administrative claims, pharmacy records, healthcare utilization, and laboratory results of 4.1 million individuals between 2005 and 2009, an initial set of 42,000 variables were derived that together describe the full health status and history of every individual. Machine learning was then used to methodically enhance predictive variable set and fit models predicting onset of type 2 diabetes in 2009-2011, 2010-2012, and 2011-2013. We compared the enhanced model with a parsimonious model consisting of known diabetes risk factors in a real-world environment, where missing values are common and prevalent. Furthermore, we analyzed novel and known risk factors emerging from the model at different age groups at different stages before the onset. Parsimonious model using 21 classic diabetes risk factors resulted in area under ROC curve (AUC) of 0.75 for diabetes prediction within a 2-year window following the baseline. The enhanced model increased the AUC to 0.80, with about 900 variables selected as predictive (p predicting diabetes onset 1-3 years and 2-4 years after baseline. The enhanced model improved positive predictive value by at least 50% and identified novel surrogate risk factors for type 2 diabetes, such as chronic liver disease (odds ratio [OR] 3.71), high alanine aminotransferase (OR 2.26), esophageal reflux (OR 1.85), and history of acute bronchitis (OR 1.45). Liver risk factors emerge later in the process of diabetes development compared with obesity-related factors such as hypertension and high hemoglobin A1c. In conclusion, population-level risk prediction for type 2 diabetes using readily available administrative

  4. [Risk factors analysis of low back pain among workers in a foundry factory of the automobile company].

    Science.gov (United States)

    Sun, Jing-zhi; Ling, Rui-jie; Wang, Zheng-lun; Song, Ting-bo; Chen, Biao; Wu, Lei; Wu, Jia-bing; Yang, Qiu-ling; He, Li-hua; Wang, Sheng; Yang, Lei

    2011-02-01

    To study the main risk factors of low back pain of workers ina foundry factory of the automobile company using cross sectional epidemiological investigation, and to provide scientific base for preventing the disorder. The low back pain and work loads of 1340 workers in a foundry factory of the automobile company were investigated using questionnaire, and logistic regression analysis was used to analyze the risk factors. The one-year morbidity of low back pain in workers was 58.9% the morbidities of low back pain in workers engaged in foundry, transportation and modeling were 64.6%, 64.6% and 62.5%, respectively. The lifting with squat postures, bending trunk heavily, bending trunk with twisting and moving the heavy objects were found to be the most dominant risk factors for low-back pain, the OR values were 2.085, 1.961, 1.967 and 1.956, respectively. The distributions of risk factors were different among the different jobs. The logistic regression analysis showed that moving the heavy objects, lifting with squat postures, bending trunk heavily, bending trunk with twisting existed simultaneously, also the work years and gender were the risk factors. The manual moving heavy objects, awkward working posture or both were the most important risk factors for low-back pain. The intervene ergonomic study should be performed in future to reduce the morbidity of low-back pain.

  5. Is age a risk factor for hypothyroidism in pregnancy? An analysis of 5223 pregnant women.

    Science.gov (United States)

    Potlukova, Eliska; Potluka, Oto; Jiskra, Jan; Limanova, Zdenka; Telicka, Zdenek; Bartakova, Jana; Springer, Drahomira

    2012-06-01

    The guidelines of American Thyroid Association from 2011 include age over 30 as one of the risk factors for hypothyroidism in pregnancy. Our objective was to verify whether age increases the risk of autoimmune thyroid disease in pregnancy. We performed a cross-sectional study in 2006-2008 with laboratory assessment in a single center using primary care gynecological ambulances in cooperation with a referral center. The study included 5223 consecutive pregnant women in gestational wk 9-12. We assessed the occurrence of pathological serum concentrations of TSH and/or antibodies against thyroperoxidase (TPOAb) with regard to age. Reference interval for TSH was 0.06-3.67 mU/liter; the upper cutoff value for TPOAb was 143 kU/liter. Overall, 857 women (16.4%) were positively screened. Of these, 294 (5.63%) had TSH elevation, 146 (2.79%) had TSH suppression, 561 (10.74%) were TPOAb positive, and 417 (7.98%) were euthyroid and TPOAb positive. The average age of women was 31.1 yr. The prevalence of hypothyroidism was 5.5 and 5.8% in women aged 30 or older and those under 30 yr, respectively (P value nonsignificant). Using a logistic regression model, we didn't find any significant association between age and serum TSH suppression, TSH elevation, or TPOAb positivity (P = 0.553, P = 0.680, and P = 0.056, respectively) or between age and TSH elevation with TPOAb positivity (P = 0.967). In a subgroup analysis of risk factors for hypothyroidism in 132 hypothyroid women, addition of age 30 or older increased the proportion of women identified in a case-finding screening strategy from 55.3 to 85.6%. Prevalence of autoimmune thyroid disease does not increase with age in pregnant women; however, addition of age 30 or over to the case-finding screening strategy may substantially improve its efficiency due to a larger number of women screened.

  6. Factor V G1691A is associated with an increased risk of retinal vein occlusion: a meta-analysis.

    Science.gov (United States)

    Zou, Yuanyuan; Zhang, Xi; Zhang, Jingyi; Ji, Xiangning; Liu, Yuqing

    2017-09-26

    We performed a meta-analysis to investigate the association between the Factor V G1691A polymorphism and the risk of retinal vein occlusion (RVO). This analysis included 37 studies involving 2,510 cases and 3,466 controls. Factor V G1691A was associated with an increased risk of RVO in the allele, heterozygote, dominant, and carrier models (PA 1), but not the homozygote or recessive models (PA > 0.05). Similar results were observed in a meta-analysis of central retinal vein occlusion (CRVO) and when comparing Caucasian subgroups to population-based controls. These data demonstrate that the G/A genotype of Factor V G1691A is associated with an increased risk of RVO/CRVO in a Caucasian population.

  7. Systematic Risk Factors for Australian Stock Market Returns: a Cointegration Analysis

    Directory of Open Access Journals (Sweden)

    Mazharul H. Kazi

    2008-12-01

    Full Text Available This paper identifies the systematic risk factors for the Australian stock market by applyingthe cointegration technique of Johansen. In conformity with the finance literature andinvestors’ common intuition, relevant a priori variables are chosen to proxy for Australiansystematic risk factors. The results show that only a few systematic risk factors are dominantfor Australian stock market price movements in the long-run while short-run dynamics are inplace. It is observed that the linear combination of all a priori variables is cointegratedalthough not all variables are significantly influential. The findings show that bank interestrate, corporate profitability, dividend yield, industrial production and, to a lesser extent, globalmarket movements are significantly influencing the Australian stock market returns in thelong-run; while in the short-run it is being adjusted each quarter by its own performance,interest rate and global stock market movements of previous quarter.

  8. Association between Workplace Risk Factor Exposure and Sleep Disturbance: Analysis of the 2nd Korean Working Conditions Survey.

    Science.gov (United States)

    Heo, Yong-Seok; Chang, Sei-Jin; Park, Shin-Goo; Leem, Jong-Han; Jeon, Sung-Hwan; Lee, Bum-Joon; Rhee, Kyung-Yong; Kim, Hwan-Cheol

    2013-12-27

    Sleep is essential for human beings to live and work properly. This study was conducted to investigate the relationship between occupational exposures to workplace risk factors and sleep disturbance in Korean workers. The data were drawn from the second Korean Working Conditions Survey (KWCS); a total of 7,112 paid workers were analyzed. The independent variables were occupational exposures such as physical, chemical, biological, and psychosocial risk factor in the workplace, and psychosocial risk factor was divided into five categories (job demand, job control, social support, job insecurity, lack of reward). We estimated the relationship between various occupational exposures and sleep disturbance using multivariate logistic regression analysis. The results showed that people who exposed to physical, chemical, biological, and psychosocial (high job demand, inadequate social support, lack of reward) risk factors were more likely to increase the risk of sleep disturbance. Furthermore, after adjusting for general and occupational characteristics, we found significant positive associations between exposures to physical (odds ratios [OR] 1.47, 95% confidence interval [CI] 1.05-2.07) and psychosocial (high job demand (OR 2.93, 95% CI 2.16-3.98), inadequate social support (OR 1.57, 95% CI 1.14-2.15), lack of reward (OR 1.45, 95% CI 1.08-1.96)) risk factors and sleep disturbance. These results suggest that occupational exposures to physical and psychosocial workplace risk factors are significantly related to sleep disturbance.

  9. Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

    Directory of Open Access Journals (Sweden)

    Mahmut Kuntay kuntay Kokanali

    2015-03-01

    Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000: 63-71

  10. Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Jaana I Halonen

    Full Text Available The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates.The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity, and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression.After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI: 1.03-1.24 and 1.75 (95% CI, 1.54-1.98. Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors.Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.

  11. The Risk Factors of Child Lead Poisoning in China: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    You Li

    2016-03-01

    Full Text Available Background: To investigate the risk factors of child lead poisoning in China. Methods: A document retrieval was performed using MeSH (Medical subject heading terms and key words. The Newcastle-Ottawa Scale (NOS was used to assess the quality of the studies, and the pooled odd ratios with a 95% confidence interval were used to identify the risk factors. We employed Review Manager 5.2 and Stata 10.0 to analyze the data. Heterogeneity was assessed by both the Chi-square and I2 tests, and publication bias was evaluated using a funnel plot and Egger’s test. Results: Thirty-four articles reporting 13,587 lead-poisoned children met the inclusion criteria. Unhealthy lifestyle and behaviors, environmental pollution around the home and potential for parents’ occupational exposure to lead were risk factors of child lead poisoning in the pooled analyses. Our assessments yielded no severe publication biases. Conclusions: Seventeen risk factors are associated with child lead poisoning, which can be used to identify high-risk children. Health education and promotion campaigns should be designed in order to minimize or prevent child lead poisoning in China.

  12. Multifactorial Analysis of Cardiovascular Risk Factors in a Group of Patients with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Maxim George Razvan

    2014-12-01

    Full Text Available Background and Aims: Acute myocardial infarction is one of the main causes of mortality worldwide, atherosclerosis being the most common mechanism of coronary artery obstruction. Many cardiovascular (CV risk factors are associated with these pathogenic processes. The aim of our study was to investigate a group of patients with ST-segment elevation acute myocardial infarction in terms of the prevalence of cardiovascular risk factors. Materials and Methods: We investigated 97 patients with acute myocardial infarction (AMI and 30 persons without AMI (control group for CV risk parameters (metabolic syndrome, diabetes, sedentary, dyslipidemia, glycosylated hemoglobin- HbA1c, and the risk of developing AMI. Results: We found statistically significant differences (p<0.05 for the patients with metabolic syndrome, diabetes, sedentary lifestyle, high level of total cholesterol, LDLc, HbA1c, low level of HDLc for the risk to develop AMI. Conclusion: This study emphasizes the need to implement measures of primary and secondary prevention, and carry out a strict control of cardiovascular risk factors as well as implicitly improve the therapeutic conduct.

  13. Risk Factors for Tuberculosis

    Directory of Open Access Journals (Sweden)

    Padmanesan Narasimhan

    2013-01-01

    Full Text Available The risk of progression from exposure to the tuberculosis bacilli to the development of active disease is a two-stage process governed by both exogenous and endogenous risk factors. Exogenous factors play a key role in accentuating the progression from exposure to infection among which the bacillary load in the sputum and the proximity of an individual to an infectious TB case are key factors. Similarly endogenous factors lead in progression from infection to active TB disease. Along with well-established risk factors (such as human immunodeficiency virus (HIV, malnutrition, and young age, emerging variables such as diabetes, indoor air pollution, alcohol, use of immunosuppressive drugs, and tobacco smoke play a significant role at both the individual and population level. Socioeconomic and behavioral factors are also shown to increase the susceptibility to infection. Specific groups such as health care workers and indigenous population are also at an increased risk of TB infection and disease. This paper summarizes these factors along with health system issues such as the effects of delay in diagnosis of TB in the transmission of the bacilli.

  14. Effect of factor XIII-A Val34Leu polymorphism on myocardial infarction risk: a meta-analysis.

    Science.gov (United States)

    Chen, Fei; Qiao, Qi; Xu, Peng; Fan, Bing; Chen, Zaoping

    2014-11-01

    The association between factor XIII-A (FXIII-A) Val34Leu polymorphism and myocardial infarction (MI) risk remained controversial. We performed a meta-analysis. Online databases were searched. Twenty-eight studies were included. The FXIII-A Val34Leu polymorphism was significantly associated with MI risk (odds ratio (OR) = 0.83, 95% confidence interval [CI] 0.76-0.91; P analysis by age group, significant associations were observed in early-onset patients and in late-onset patients. In the subgroup analysis by gender, there was a significant association in women but not in men. In the subgroup analysis stratified by smoking status, MI risk was decreased in both smokers and nonsmokers. This study suggested that FXIIIA Val34Leu polymorphism was a protective factor for MI in caucasians. © The Author(s) 2013.

  15. Risk factors identified for certain lymphoma subtypes

    Science.gov (United States)

    In a large international collaborative analysis of risk factors for non-Hodgkin lymphoma (NHL), scientists were able to quantify risk associated with medical history, lifestyle factors, family history of blood or lymph-borne cancers, and occupation for 11

  16. [Clinical value and multiple risk factors analysis of sputum culture for fungus in neonates].

    Science.gov (United States)

    Hu, Ya; Yu, Jia-lin; Li, Lu-quan

    2007-06-01

    In recent years, the incidence of fungal infection in neonates has been risen year by year, but there are no widely accepted criteria to identify the clinical significance of the culture results of secretion from lower respiratory tract at present. The aim of the present study was to understand the clinical value and risk factors of fungal infections as suggested by sputum culture in neonates, which may help clinicians to diagnose and treat the neonates with fungal infection of respiratory tract. One hundred and forty nine neonates with positive sputum culture results and suffered from pneumonia hospitalized from October, 2002 to May, 2005 in Children's Hospital of Chongqing Medical University were analyzed. The cases were divided into three groups according to the results of sputum culture. Forty cases who were only fungus positive were enrolled into the fungal group, 30 cases who were positive for both fungus and bacteria were classified into the mixed group, and the remaining 79 cases who were positive for bacteria only were recruited into bacterial group. Several clinical characteristics of neonates from the three groups were compared retrospectively. t test, chi-square test and Logistic regression analysis were used for statistical analyses. Seventy of the 149 patients (47.0%) had fungal infections. Candida was the main genus cultured from sputum. Rate of resistance to fluconazole was 25.7% (9/35). Candida albicans was the most common strain, which was found in 56.9% of cases whose sputum culture was positive for fungi. In fungal group (n = 40), mixed group (n = 30) and bacterial group (n = 79), white blood cell count were (10.3 +/- 3.5) x 10(9)/L (11.7 +/- 5.2) x 10(9)/L and (14.4 +/- 10.5) x 10(9)/L, respectively, F = 3.78, P = 0.03, with neutrophil count (5.1 +/- 3.3) x 10(9)/L, (7.4 +/- 4.7) x 10(9)/L and (9.0 +/- 7.4) x 10(9)/L, respectively, F = 5.50, P = 0.01. Ratios of risk factors were as follows:for preterm infant, 32.5% (13/40), 20% (6/30) and 12

  17. Multilevel analysis of workplace and individual risk factors for long-term sickness absence

    DEFF Research Database (Denmark)

    Labriola, Merete; Christensen, Karl B; Lund, Thomas

    2006-01-01

    OBJECTIVE: The objective of this study was to examine if psychosocial and physical work-environment factors predict long-term sickness absence (>8 weeks) at both the individual and the workplace level. MATERIAL AND METHODS: Data were collected in a prospective study in 52 Danish workplaces....... Psychosocial factors were aggregated as workplace means. We used multilevel logistic regression models with psychosocial factors as predictors of long-term sickness absence over 5 years based on data from a national absence register. RESULTS: Long-term sickness absence was predicted by physical work......-environment factors at the individual level and psychosocial work environment factors at the workplace level. Interaction between the individual physical and workplace-level psychosocial risk factors was found. CONCLUSION: Workplace-based absence reduction interventions can be enhanced by concurrently addressing...

  18. A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses.

    Science.gov (United States)

    Smith, Derek R; Mihashi, Mutsuko; Adachi, Yasuko; Koga, Hatsuyo; Ishitake, Tatsuya

    2006-01-01

    Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan. We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions. A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07). The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.

  19. Risk factors for unplanned readmissions in older adult trauma patients in Washington State: a competing risk analysis.

    Science.gov (United States)

    Fawcett, Vanessa J; Flynn-O'Brien, Katherine T; Shorter, Zeynep; Davidson, Giana H; Bulger, Eileen; Rivara, Frederick P; Arbabi, Saman

    2015-03-01

    Hospital readmission is a significant contributor to increasing health care use related to caring for older trauma patients. This study was undertaken with the following aims: determine the proportion of older adult trauma patients who experience unplanned readmission, as well as risk factors for these readmissions and identify the most common readmission diagnoses among these patients. We conducted a retrospective cohort study of trauma patients age 55 years and older who survived their hospitalization at a statewide trauma center between 2009 and 2010. Linking 3 statewide databases, nonelective readmission rates were calculated for 30 days, 6 months, and 1 year after index discharge. Competing risk regression was used to determine risk factors for readmission and account for the competing risk of dying without first being readmitted. Subhazard ratios (SHR) are reported, indicating the relative risk of readmission by 30 days, 6 months, and 1 year. The cumulative readmission rates for the 14,536 participants were 7.9%, 18.9%, and 25.2% at 30 days, 6 months, and 1 year, respectively. In multivariable models, the strongest risk factors for readmission at 1 year (based on magnitude of SHR) were severe head injury (adjusted SHR = 1.47; 95% CI, 1.24-1.73) and disposition to a skilled nursing facility (SHR = 1.54; 95% CI, 1.39-1.71). The diagnoses most commonly associated with readmission were atrial fibrillation, anemia, and congestive heart failure. In this statewide study, unplanned readmissions after older adult trauma occurred frequently up to 1 year after discharge, particularly for patients who sustained severe head trauma and who could not be discharged home independently. Examining common readmission diagnoses might inform the development of interventions to prevent unplanned readmissions. Copyright © 2015 American College of Surgeons. All rights reserved.

  20. Smoking as a risk factor for diabetic nephropathy: a meta-analysis.

    Science.gov (United States)

    Su, Sensen; Wang, Wanning; Sun, Tao; Ma, Fuzhe; Wang, Yue; Li, Jia; Xu, Zhonggao

    2017-10-01

    Previous studies have investigated the connection between diabetic nephropathy and smoking, and reported widely varying rates. This study aimed to systematically analyze the impact of smoking on diabetic nephropathy. We searched the PubMed and EMBASE electronic databases to identify relevant English-language studies published up to March 2016. Eligible studies were selected using inclusion and exclusion criteria. Data for each study were extracted independently by two authors. The homogeneity of the effect size across the studies was tested. Odds ratio (OR) was calculated by using the random-effect model. Sensitivity analysis was performed to reduce heterogeneity, and publication biases were examined. A total of 21 eligible studies were selected and pooled analyzed. No significant differences in demographic characteristics were found between patients with diabetic nephropathy and those with non-diabetic nephropathy. Significant heterogeneity across studies was found except those of diabetes mellitus controls. The aggregate OR of smoking in the patients with diabetic nephropathy in comparison with those with non-diabetic nephropathy was 1.70 (95% confidence interval 1.48-1.95). No evidence of publication bias was found. Our findings indicate that smoking is a significant risk factor for diabetic nephropathy in diabetic patients.

  1. Metabolomics analysis of exhaled breath condensate for discrimination between lung cancer patients and risk factor individuals.

    Science.gov (United States)

    Peralbo-Molina, A; Calderón-Santiago, M; Priego-Capote, F; Jurado-Gámez, B; Luque de Castro, M D

    2016-02-11

    The search for new clinical tests aimed at diagnosing chronic respiratory diseases is a current research line motivated by the lack of efficient screening tools and the severity of some of these pathologies. Alternative biological samples can open the door to new screening tools. A promising biofluid that is rarely used for diagnostic purposes is exhaled breath condensate (EBC), the composition of which has been inadequately studied. In this research, untargeted analysis of EBC using gas chromatography time-of-flight mass spectrometry has been applied to a cohort of patients with lung cancer (n  =  48), risk factor individuals (active smokers and ex-smokers, n  =  130) and control healthy individuals (non-smokers without respiratory diseases, n  =  61). An identical protocol was applied to the two EBC fractions provided by the sampling device (upper and central airways and distal airway) from each individual, which allowed the compositional differences between the two EBC fractions to be detected. Tentative compounds that contribute to discrimination between the three groups were identified, and a relevant role for lipids such as monoacylglycerols and squalene was found. These results could support the ability of metabolomics to go inside the study of lung cancer.

  2. Demographic risk factors for injury among Hispanic and non-Hispanic white children: an ecologic analysis

    Science.gov (United States)

    Anderson, C.; Agran, P.; Winn, D.; Tran, C.

    1998-01-01

    Objectives—To determine the effects of neighborhood levels of poverty, household crowding, and acculturation on the rate of injury to Hispanic and non-Hispanic white children. Setting—Orange County, California. Methods—An ecologic study design was used with census block groups as the unit of analysis. Measures of neighborhood poverty, household crowding, and acculturation were specific to each ethnic group. Poisson regression was used to calculate mutually adjusted incidence rate ratios (IRRs) corresponding to a 20% difference in census variables. Results—Among non-Hispanic white children, injury rates were more closely associated with neighborhood levels of household crowding (adjusted IRR 2.36, 95% confidence interval (CI) 1.22 to 4.57) than with neighborhood poverty (adjusted IRR 1.06, 95% CI 0.89 to 1.26). For Hispanic children, the strongest risk factors were the proportion of Hispanic adults who spoke only some English (compared with the proportion who spoke little or no English, adjusted IRR 1.26, 95% CI 1.04 to 1.53) and the proportion who were US residents for injury among Hispanic children (adjusted IRR 0.98, 95% CI 0.89 to 1.08), but surprisingly, neighborhood poverty was associated with lower injury rates (adjusted IRR 0.89, 95% CI 0.81 to 0.97). Conclusions—Cultural and geographic transitions, as well as socioeconomic differences, appear to contribute to differences in childhood injury rates between ethnic groups. PMID:9595329

  3. Social and individual risk factors for suicide ideation among Chinese children and adolescents: A multilevel analysis.

    Science.gov (United States)

    Tan, Ling; Xia, Tiansheng; Reece, Christy

    2016-04-18

    The objective of this study was to investigate the prevalence and predictors of suicide ideation among primary, middle and high school students. We used multilevel modelling to investigate suicide ideation among 12,733 Chinese children and adolescents aged 9-18 years from wide range of areas across China. Approximately, 32.09% of children and adolescents reported suicide ideation, with females were more likely to report suicide ideation than males (38.09% vs. 29.95%). Our results showed that the risk factors in primary school students were different from middle and high school student groups, whereas significant risk factors for middle and high school students were similar. The city's standard of living as indicated by the Engel coefficient and the city's divorce rate were positively associated with the prevalence of suicide ideation; in contrast, the school's pupil-to-teacher ratio was negatively correlated with elevated suicide ideation. Significant risk factors for suicide ideation included study anxiety, self-accusation tendency, impulsive tendency, terror tendency and physical symptoms. These results have important implications for the prevention of suicide, suggesting that both contextual (city-level) and compositional (individual-level) factors could be important targets for prevention and intervention for children and adolescents at risk of suicide ideation. © 2016 International Union of Psychological Science.

  4. Aneurysm diameter as a risk factor for pretreatment rebleeding: a meta-analysis

    NARCIS (Netherlands)

    Boogaarts, H.D.; Lieshout, J.H. van; Amerongen, M.J. van; Vries, J. de; Verbeek, A.L.M.; Grotenhuis, J.A.; Westert, G.P.; Bartels, R.H.M.A.

    2015-01-01

    OBJECT: Aneurysmal rerupture prior to treatment is a major cause of death and morbidity in aneurysmal subarachnoid hemorrhage. Recognizing risk factors for aneurysmal rebleeding is particularly relevant and might help to identify the aneurysms that benefit from acute treatment. It is uncertain if

  5. Risk Factors for Premature Births: A Cross-Sectional Analysis of ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the risk factors for preterm births in the Yaounde Gynaeco-Obstetric and Paediatric Hospital in Cameroon, and to describe their outcomes. We conducted a cross-sectional analytical study of hospital records over eight years. The incidence of prematurity was 26.5 % of admissions over ...

  6. Risk factors for infectious complications after open fractures; a systematic review and meta-analysis

    NARCIS (Netherlands)

    K. Kortram (Kirsten); H. Bezstarosti (Hans); W.-J. Metsemakers (Willem-Jan); M.J. Raschke (Michael J.); E.M.M. van Lieshout (Esther); M.H.J. Verhofstad (Michiel)

    2017-01-01

    markdownabstract__Purpose__ The purpose of this study was to identify risk factors for the development of infection after open fracture fixation. __Methods__ A comprehensive search in all scientific literature of the last 30 years was performed in order to identify patient-, trauma-,

  7. Analysis of farm specific risk factors for Campylobacter colonization of broilers in six European countries

    DEFF Research Database (Denmark)

    Sommer, Helle Mølgaard; Borck Høg, Birgitte; Larsen, Lars Stehr

    2016-01-01

    This study presents on-farm risk factors for the colonization of broiler flocks with Campylobacter based on comparable data from six European countries: Denmark, the Netherlands, Norway, Poland, Spain, and the UK. The study includes explanatory variables from a large questionnaire concerning...... production, farm management procedures and farm conditions, climate data on mean temperature, sunshine hours, and precipitation, as well as data on Campylobacter status of broiler flocks. All together the study comprises data from more than 6000 flocks. The data were analysed using a generalized linear model....... These were generally related to inadequate biosecurity. Identified risk factors were: broiler houses older than 15 years, absence of anterooms and barriers in each house, shared tools between houses, long downtime, and drinker systems with bells or cups. Also, the risk of broiler flocks becoming colonized...

  8. Risk factors for post-stroke seizures: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Chao; Wang, Xiu; Wang, Yao; Zhang, Jian-guo; Hu, Wenhan; Ge, Ming; Zhang, Kai; Shao, Xiaoqiu

    2014-12-01

    To perform a systematic review and meta-analysis to identify risk factors associated with early seizure (ES) or late seizure (LS) onset in adults following stroke. Electronic databases (MEDLINE and EMBASE), archives of stroke or epilepsy patients, and bibliographies of relevant articles, which were written in English. We included studies published since 1990 that reported the stroke and seizure outcomes of adult patients during follow-up. We independently performed title, abstract and full-text screening and resolved disagreements through discussion. Two authors performed the data extraction. We recorded all possible risk factors predictive of seizure onset. We used odds ratios (ORs) or the mean difference (MD) to compare the pooled rates of seizure onset between the exposed group and the non-exposed group. All meta-analyses were performed with Review Manager Software. Intracerebral hemorrhage (OR=1.88, 95% CI=1.43-2.47), cerebral infarction with hemorrhagic transformation (OR=3.28, 95% CI=2.09-5.16), stroke severity (OR=3.10, 95% CI=2.00-4.81, p<0.01, I(2)=0%; MD=3.98, 95% CI=1.06-6.90, p<0.01), and alcoholism (OR=1.70, 95% CI=1.23-2.34, p<0.01) were associated with a significantly greater probability of ES occurrence. There were significant effects of cortical involvement (OR=2.50, 95% CI=1.93-3.23) and stroke severity (MD=5.72, 95% CI=4.23-7.22, p<0.01, I(2)=0) on LS onset. However, there was no significant difference in the probability of single LS episode between patients with intracerebral hemorrhage and infarction stroke (OR=1.20, 95% CI=0.92-1.55). Evidence suggests that cortical involvement, stroke subtypes and stroke severity are significant predictors of seizure onset following stroke. However, we did not find a significant difference in the rate of onset of single LS episodes between patients with intracerebral hemorrhage and cerebral infarction. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Risk Factors Predicting Infectious Lactational Mastitis: Decision Tree Approach versus Logistic Regression Analysis.

    Science.gov (United States)

    Fernández, Leónides; Mediano, Pilar; García, Ricardo; Rodríguez, Juan M; Marín, María

    2016-09-01

    Objectives Lactational mastitis frequently leads to a premature abandonment of breastfeeding; its development has been associated with several risk factors. This study aims to use a decision tree (DT) approach to establish the main risk factors involved in mastitis and to compare its performance for predicting this condition with a stepwise logistic regression (LR) model. Methods Data from 368 cases (breastfeeding women with mastitis) and 148 controls were collected by a questionnaire about risk factors related to medical history of mother and infant, pregnancy, delivery, postpartum, and breastfeeding practices. The performance of the DT and LR analyses was compared using the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity and accuracy of both models were calculated. Results Cracked nipples, antibiotics and antifungal drugs during breastfeeding, infant age, breast pumps, familial history of mastitis and throat infection were significant risk factors associated with mastitis in both analyses. Bottle-feeding and milk supply were related to mastitis for certain subgroups in the DT model. The areas under the ROC curves were similar for LR and DT models (0.870 and 0.835, respectively). The LR model had better classification accuracy and sensitivity than the DT model, but the last one presented better specificity at the optimal threshold of each curve. Conclusions The DT and LR models constitute useful and complementary analytical tools to assess the risk of lactational infectious mastitis. The DT approach identifies high-risk subpopulations that need specific mastitis prevention programs and, therefore, it could be used to make the most of public health resources.

  10. Physical activity and cardiovascular risk factors in children: meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Cesa, Claudia Ciceri; Sbruzzi, Graciele; Ribeiro, Rodrigo Antonini; Barbiero, Sandra Mari; de Oliveira Petkowicz, Rosemary; Eibel, Bruna; Machado, Natássia Bigolin; Marques, Renata das Virgens; Tortato, Gabriela; dos Santos, Tiago Jerônimo; Leiria, Carina; Schaan, Beatriz D'Agord; Pellanda, Lucia Campos

    2014-12-01

    To assess the effects of physical activity interventions in preventing cardiovascular risk factors in childhood through a systematic review and meta-analysis of randomized clinical trials (RCTs). A search of online databases (PubMed, EMBASE and Cochrane CENTRAL) was conducted from inception until June 2013. RCTs enrolling children 6-12years old conducted physical activity interventions longer than 6months, assessing their effect on body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC) and triglycerides (TG) were included. Data analysis was performed using a random-effects model. Of 23.091 articles retrieved, 11 RCTs (10.748 subjects) were included. Physical activity interventions were not associated with reductions of BMI [-0.03kg/m(2) (95%CI -0.16, 0.13) I(2) 0%]. However, there was an association between the interventions and reduction of SBP [-1.25mmHg (95%CI -2.47, -0.02) I(2) 0%], DBP [-1.34mmHg (95%CI -2.57, -0.11) I(2) 43%] and TG [-0.09mmol/L (95%CI -0.14, -0.04) I(2) 0%], and increase of TC [0.14mmol/L (95%CI 0.01, 0.27) I(2) 0%]. As physical activity intervention programs lasting longer than 6months are associated with reductions in blood pressure levels and triglycerides, they should be considered to be included in prevention programs for cardiovascular diseases in schoolchildren. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Risk Factor Analysis for C5 Palsy after Double-Door Laminoplasty for Cervical Spondylotic Myelopathy.

    Science.gov (United States)

    Baba, Satoshi; Ikuta, Ko; Ikeuchi, Hiroko; Shiraki, Makoto; Komiya, Norihiro; Kitamura, Takahiro; Senba, Hideyuki; Shidahara, Satoshi

    2016-04-01

    A retrospective comparative study. To clarify the risk factors related to the development of postoperative C5 palsy through radiological studies after cervical double-door laminoplasty (DDL). Although postoperative C5 palsy is generally considered to be the result of damage to the nerve root or segmental spinal cord, the associated pathology remains controversial. A consecutive case series of 47 patients with cervical spondylotic myelopathy treated by DDL at our institution between April 2008 and April 2015 were reviewed. Postoperative C5 palsy occurred in 5 of 47 cases after DDL. We investigated 9 radiologic factors that have been reported to be risk factors for C5 palsy in various studies, and statistically examined these between the two groups of palsy and the non-palsy patients. We found a significant difference between patients with and without postoperative C5 palsy with regards to the posterior shift of spinal cord at C4/5 (p=0.008). The logistic regression analyses revealed posterior shift of the spinal cord at C4/5 (odds ratio, 12.066; p=0.029; 95% confidence interval, 1.295-112.378). For the other radiologic factors, there were no statistically significant differences between the two groups. In the present study, we showed a significant difference in the posterior shift of the spinal cord at C4/5 between the palsy and the non-palsy groups, indicating that the "tethering phenomenon" was likely a greater risk factor for postoperative C5 palsy.

  12. Factors of risk and protection/resilience in adolescent scholar bullying. Longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Hernández de Frutos, Teodoro

    2014-12-01

    Full Text Available Theories of risk, protection and resilience have gained widespread acceptance in recent years, as the university community, to a large extent, consider that they offer a satisfactory explanation as to why some adolescents fail to survive in a hostile environment while others cope adequately, almost as if they were immunized against the difficulties they encounter in the course of their lives. Applying these theories to adolescent harassment could explain why certain youth fall victim to it and others do not, despite sharing the same life variables: age, sex, school structure, family structure, residential area, mass media and so on. This longitudinal analysis examines the risks and resilience associated with the social environment, using Bronfenbrenner’s version, taking into account that resilience is not necessarily due to individual personality conditioning or other significant factors, as some theories hold. Rather, it argues that environmental factors may also be responsible for increasing or reducing its effects. Given that some experts use this concept in a manner that leads to confusion, understanding adolescent bullying to be aggressive behavior on an individual level, it is necessary to highlight that it is understood here to be a multidimensional concept. It is a single variable which includes individual aggression, collective aggression, individual and collective victimization. This will avoid the misunderstanding arising from a holistic and undifferentiated use of the term. It also takes into account that the aggressor as well as the victim is also exposed, although to a lesser degree, to risks, protection and resilience.Las teorías del riesgo, protección/resiliencia han surgido con fuerza en los últimos años porque explican satisfactoriamente, en opinión de una por parte significativa de la comunidad universitaria, porque algunos adolescentes se hunden en un medio ambiente hostil, mientras que otros sobreviven sin que parezca

  13. Social and behavioral determinants of perceived insufficient sleep: analysis of the behavioral risk factor surveillance system

    Directory of Open Access Journals (Sweden)

    Michael A Grandner

    2015-06-01

    Full Text Available Background: Insufficient sleep is associated with cardiometabolic disease and poor health. However, few studies have assessed its determinants in a nationally-representative sample. Methods: Data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS was used (N=323,047 adults. Insufficient sleep was assessed as insufficient rest/sleep over 30 days. This was evaluated relative to sociodemographics (age, sex, race/ethnicity, marital status, region, socioeconomics (education, income, employment, insurance, health behaviors (diet, exercise, smoking, alcohol, and health/functioning (emotional support, BMI, mental/physical health. Results: Overall, insufficient sleep was associated with being female, White or Black/African-American, unemployed, without health insurance, and not married; decreased age, income, education, physical activity; worse diet and overall health; and increased household size, alcohol, and smoking. Conclusion: These factors should be considered risk factors for insufficient sleep.

  14. Multimorbidity: Epidemiology and Risk Factors in the Golestan Cohort Study, Iran: A Cross-Sectional Analysis.

    Science.gov (United States)

    Ahmadi, Batoul; Alimohammadian, Masoomeh; Yaseri, Mehdi; Majidi, Azam; Boreiri, Majid; Islami, Farhad; Poustchi, Hossein; Derakhshan, Mohammad H; Feizesani, Akabar; Pourshams, Akram; Abnet, Christian C; Brennan, Paul; Dawsey, Sanford M; Kamangar, Farin; Boffetta, Paolo; Sadjadi, Alireza; Malekzadeh, Reza

    2016-02-01

    Advances in medicine and health policy have resulted in growing of older population, with a concurrent rise in multimorbidity, particularly in Iran, as a country transitioning to a western lifestyle, and in which the percent of the population over the age of 60 years is increasing. This study aims to assess multimorbidity and the associated risk factors in Iran. We used data from 50,045 participants (age 40-75 y) in the Golestan Cohort Study, including data on demographics, lifestyle habits, socioeconomic status, and anthropometric indices. Multimorbidity was defined as the presence of 2 or more out of 8 self-reported chronic conditions, including cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, gastroesophageal reflux disease, tuberculosis, and cancer. Multivariate logistic regression models were used to examine the associations between multiple different factors and the risk factors. Multimorbidity prevalence was 19.4%, with the most common chronic diseases being gastroesophageal reflux disease (76.7%), cardiovascular diseases (72.7%), diabetes (25.3%), and chronic obstructive pulmonary disease (21.9%). The odds of multimorbidity was 2.56-fold higher at the age of >60 years compared with that at <50 years (P < 0.001), and 2.11-fold higher in women than in men (P < 0.001). Other factors associated with higher risk of multimorbidity included non-Turkmen ethnicity, low education, unemployment, low socioeconomic status, physical inactivity, overweight, obesity, former smoking, opium and alcohol use, and poor oral health. Apart from advanced age and female sex, the most important potentially modifiable lifestyle factors, including excess body weight and opium use, and opium user, are associated with multimorbidity. Policies aiming at controlling multimorbidity will require a multidimensional approach to reduce modifiable risk factors in the younger population in developing countries alongside

  15. Parental risk factors and anorectal malformations: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Zwink Nadine

    2011-05-01

    Full Text Available Abstract Background Anorectal malformations (ARM are rare forms of congenital uro-rectal anomalies with largely unknown causes. Besides genetic factors, prenatal exposures of the parents to nicotine, alcohol, caffeine, illicit drugs, occupational hazards, overweight/obesity and diabetes mellitus are suspected as environmental risk factors. Methods Relevant studies published until August 2010 were identified through systematic search in PubMed, EMBASE, ISI Web of Knowledge and the Cochrane Library databases. Furthermore, related and cross-referencing publications were reviewed. Pooled odds ratios (95% confidence intervals were determined to quantify associations of maternal and paternal smoking, maternal alcohol consumption, underweight (body mass index [BMI] Results 22 studies that reported on the association between prenatal environmental risk factors and infants born with ARM were included in this review. These were conducted in the United States of America (n = 12, Spain (n = 2, Sweden (n = 2, the Netherlands (n = 2, Japan (n = 1, France (n = 1, Germany (n = 1 and Hungary (n = 1. However, only few of these studies reported on the same risk factors. Studies were heterogeneous with respect to case numbers, control types and adjustment for covariates. Consistently increased risks were observed for paternal smoking and maternal overweight, obesity and diabetes, but not for maternal smoking and alcohol consumption. In meta-analyses, pooled odds ratios (95% confidence intervals for paternal smoking, maternal overweight, obesity, pre-gestational and gestational diabetes were 1.53 (1.04-2.26, 1.25 (1.07-1.47, 1.64 (1.35-2.00, 4.51 (2.55-7.97 and 1.81 (1.23-2.65, respectively. Conclusion Evidence on risk factors for ARM from epidemiological studies is still very limited. Nevertheless, the few available studies indicate paternal smoking and maternal overweight, obesity and diabetes to be associated with increased risks. Further, ideally large

  16. Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial 1

    Science.gov (United States)

    Johann, Derdried Athanasio; Danski, Mitzy Tannia Reichembach; Vayego, Stela Adami; Barbosa, Dulce Aparecida; Lind, Jolline

    2016-01-01

    ABSTRACT Objective: analyze the risk factors linked to complications in peripheral intravenous catheters. Method: secondary data analysis of a randomized controlled trial with 169 medical and surgical patients placed in two groups, one with integrated safety catheter (n=90) and other using simple needle catheter (n=79), with three months follow-up time. Results: the risk factors that raised the odds of developing complications were: hospitalization between 10-19 days (p=0.0483) and 20-29 days (p=0,0098), antimicrobial use (p=0.0288) and use of fluid solutions (p=0.0362). The 20 Gauge lowered the risks of complications (p=0.0153). Multiple analysis showed reduction of risk for the 20 Gauge (p=0.0350); heightened risk for solutions and fluids (p=0.0351) and use of corticosteroids (p=0.0214). Conclusion: risk factors linked to complications in peripheral intravenous catheters were: hospitalization periods between 10-29 days, antimicrobial infusion, solutions and fluids and corticosteroids. Regarding complications, 20 Gauge is a protecting factor compared with 22. Brazilian Clinical Trials Registry: RBR-46ZQR8. PMID:27901218

  17. Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.

    Directory of Open Access Journals (Sweden)

    Rachel L Pullan

    Full Text Available Individuals living in areas endemic for helminths are commonly infected with multiple species. Despite increasing emphasis given to the potential health impacts of polyparasitism, few studies have investigated the relative importance of household and environmental factors on the risk of helminth co-infection. Here, we present an investigation of exposure-related risk factors as sources of heterogeneity in the distribution of co-infection with Necator americanus and Schistosoma mansoni in a region of southeastern Brazil.Cross-sectional parasitological and socio-economic data from a community-based household survey were combined with remotely sensed environmental data using a geographical information system. Geo-statistical methods were used to explore patterns of mono- and co-infection with N. americanus and S. mansoni in the region. Bayesian hierarchical models were then developed to identify risk factors for mono- and co-infection in relation to community-based survey data to assess their roles in explaining observed heterogeneity in mono and co-infection with these two helminth species.The majority of individuals had N. americanus (71.1% and/or S. mansoni (50.3% infection; 41.0% of individuals were co-infected with both helminths. Prevalence of co-infection with these two species varied substantially across the study area, and there was strong evidence of household clustering. Hierarchical multinomial models demonstrated that relative socio-economic status, household crowding, living in the eastern watershed and high Normalized Difference Vegetation Index (NDVI were significantly associated with N. americanus and S. mansoni co-infection. These risk factors could, however, only account for an estimated 32% of variability between households.Our results demonstrate that variability in risk of N. americanus and S. mansoni co-infection between households cannot be entirely explained by exposure-related risk factors, emphasizing the possible role of

  18. Analysis of risk factors and morphological ultrasound image for gallbladder polyp in adults living in Busan and Gyeongnam provinces

    Energy Technology Data Exchange (ETDEWEB)

    An, Hyeon [Dept. of Radiology, Inje University Busan Paik Hospital, Busan (Korea, Republic of); Hwang, Chul Hwan [Dept. of Radiation Oncology, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Chang Soo; Ko, Sung Jin [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2016-09-15

    This study were to evaluate risk factors of GB polpy in Busan and Gyeongnam area. This study was performed with patients by abdominal ultrasonography among the patients who came to the P hospital from January to May 2016. Among them, risk factors were analyzed on 399 people at the same time when abdominal ultrasonography and hematological test. The statistical analysis of risk factors related to the GB ployp was performed by independent t-test and chi-square test. In consider of difference verification result for calculations odds ratio about independent variables, multiple logistic regression analysis to conduct verify adequacy by calculating forecasting model from variable. As a result, GB polyp risk factors have relevance to male, HBsAg positive, triglyceride. GB polyp risk factors confirmed to male, HBsAg positive, triglyceride were calculated forecasting model and forecasting probability value. Forecasting probability sensitivity 61.0%, specificity 76.8%, ROC area under curve 0.735 showed, it confirmed validity of forecasting model. When analyzing the GB polyps morphologically, among the GB polyp types observed from abdominal ultrasonography, the hyperechoic and homogeneous pattern with neck was the largest as shown from 27.5% and two GB polyps were shown most from 38%, sizes were shown most by maximum diameter, 5 to 10mm from 53%. As a disease accompany with GB polyp showed mild fatty liver(23%), diffuse hepatopathy(21%)

  19. RISK FACTOR ASSESSMENT AND CLINICOPATHOLOGICAL ANALYSIS OF BREAST DISEASES IN A TERTIARY CENTER- A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Abhishek Jina

    2017-08-01

    Full Text Available BACKGROUND Breast is modified sebaceous gland. It is an organ of female beauty and pride. From puberty to death, the breast is subjected to constant physical and physiological alterations that are related to menses, pregnancy and menopause. The breast problem could be as simple as breast abscess to as ominous as cancer. Both benign and malignant diseases occur in men and women of all ages but benign lesion tend to occur more commonly at younger age than cancer. Benign breast diseases (BBD are common with estimate of over half of the female population at some times in life seeking medical advice for breast problem. This prospective study was done on patients attending OPD for breast complaints in 1 year period, to do the risk factors assessment & clinical analysis of patients presented with breast complaints. MATERIALS AND METHODS Total 200 patients who have attended OPD with breast related complaints and given consent for study, were studied in a period of 1 year duration from at Nehru Hospital, B.R.D Medical College, Gorakhpur. RESULTS Benign breast diseases are more common in the population than malignant one, Fibroadenoma, Breast abscesses and Fibrocystic disease and ANDI are the most common cause of mass seen in middle ages. Malignant lesion of the breast is major concern and the second most commonly diagnosed cancer in our region as seen in study. Incidence is high in western industrialized countries and relatively low in developing countries in Asia and other parts of the world, predisposing factors for BBD are age, sex, race, inverted nipple, retracted nipple, cracked nipple, improper feeding due to lack of knowledge about breast-feeding and endogenous hormonal factors. CONCLUSION BBD is the most frequent type of lesion found in the present study in surgery OPD in BRD medical college, Gorakhpur. Among BBD, fibroadenoma was the commonest, followed by breast abscess, ANDI and gynecomastia. In this study, breast abscess was second most

  20. Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis.

    Science.gov (United States)

    Nelson, Heidi D; Zakher, Bernadette; Cantor, Amy; Fu, Rongwei; Griffin, Jessica; O'Meara, Ellen S; Buist, Diana S M; Kerlikowske, Karla; van Ravesteyn, Nicolien T; Trentham-Dietz, Amy; Mandelblatt, Jeanne S; Miglioretti, Diana L

    2012-05-01

    Identifying risk factors for breast cancer specific to women in their 40s could inform screening decisions. To determine what factors increase risk for breast cancer in women aged 40 to 49 years and the magnitude of risk for each factor. MEDLINE (January 1996 to the second week of November 2011), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (fourth quarter of 2011), Scopus, reference lists of published studies, and the Breast Cancer Surveillance Consortium. English-language studies and systematic reviews of risk factors for breast cancer in women aged 40 to 49 years. Additional inclusion criteria were applied for each risk factor. Data on participants, study design, analysis, follow-up, and outcomes were abstracted. Study quality was rated by using established criteria, and only studies rated as good or fair were included. Results were summarized by using meta-analysis when sufficient studies were available or from the best evidence based on study quality, size, and applicability when meta-analysis was not possible. Data from the Breast Cancer Surveillance Consortium were analyzed with proportional hazards models by using partly conditional Cox regression. Reference groups for comparisons were set at U.S. population means. Sixty-six studies provided data for estimates. Extremely dense breasts on mammography or first-degree relatives with breast cancer were associated with at least a 2-fold increase in risk for breast cancer. Prior breast biopsy, second-degree relatives with breast cancer, or heterogeneously dense breasts were associated with a 1.5- to 2.0-fold increased risk; current use of oral contraceptives, nulliparity, and age 30 years or older at first birth were associated with a 1.0- to 1.5-fold increased risk. Studies varied by measures, reference groups, and adjustment for confounders, which could bias combined estimates. Effects of multiple risk factors were not considered. Extremely dense breasts and first

  1. The effects of common risk factors on stock returns: A detrended cross-correlation analysis

    Science.gov (United States)

    Ruan, Qingsong; Yang, Bingchan

    2017-10-01

    In this paper, we investigate the cross-correlations between Fama and French three factors and the return of American industries on the basis of cross-correlation statistic test and multifractal detrended cross-correlation analysis (MF-DCCA). Qualitatively, we find that the return series of Fama and French three factors and American industries were overall significantly cross-correlated based on the analysis of a statistic. Quantitatively, we find that the cross-correlations between three factors and the return of American industries were strongly multifractal, and applying MF-DCCA we also investigate the cross-correlation of industry returns and residuals. We find that there exists multifractality of industry returns and residuals. The result of correlation coefficients we can verify that there exist other factors which influence the industry returns except Fama three factors.

  2. The Analysis of Research on Psychosocial Risk Factors in Lithuanian Companies

    Directory of Open Access Journals (Sweden)

    Laura Urnikytė

    2011-04-01

    Full Text Available Psychosocial risk factors are quite hard to identify and analyze, as such work needs special knowledge and practice. Difficulties may appear as many concepts of psychosocial risk factors are hardly defined exactly and depend on a subjective perception of employee’s workplace environment. Different questionnaires, e.g. a questionnaire assessing stress at work, are created to identify psychosocial risk factors. The main purpose of each questionnaire is slightly different but simultaneously remains the same, i.e. to define stress level at work environment. Although, this kind of research has been conducted in other countries for quite a long time, however, in Lithuania, similar practice faces only first steps. The paper proposes an overview of research conducted in 19 companies in Lithuania. 245 respondents were involved in completing 4 questionnaires. The survey has revealed that the most contributory factor of stress appearance is the age and experience of workers. Female rather than male respondents feel stressed; the surveyed participants having higher education feel more affected by stress than those having other than higher education. Moreover, different questionnaires have revealed the existence of much the same problems.Article in Lithuanian

  3. Interaction between genetic and environmental risk factors for Alzheimer's disease: a re-analysis of case-control studies

    NARCIS (Netherlands)

    C.M. van Duijn (Cornelia); D.G. Clayton (David); V. Chandra; L. Fratiglioni (Laura); A.B. Graves; A. Heyman; A.F. Jorm; E. Kokmen (Emre); K. Kondo; J.A. Mortimer; W.A. Rocca; S.L. Shalat; H. Soininen; A. Hofman (Albert)

    1994-01-01

    textabstractTo study the interaction among genetic and environmental risk factors, a reanalysis of case-control studies of Alzheimer's disease (AD) was conducted based on the original data of all studies carried out to January 1, 1990. Seven studies were included in the present analysis, comprising

  4. Effect of Vascular Risk Factors and Diseases on Mortality in Individuals with Dementia : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Van De Vorst, Irene E.; Koek, Huiberdina L.|info:eu-repo/dai/nl/257372962; De Vries, Rehana; Bots, Michiel L.|info:eu-repo/dai/nl/110610032; Reitsma, Johannes B.; Vaartjes, Ilonca|info:eu-repo/dai/nl/304812102

    2016-01-01

    Objectives To assess the effect of cardiovascular diseases and risk factors on mortality in individuals with dementia. Design Systematic review and meta-analysis. English- and Dutch-language studies in PubMed, EMBASE, and PsycINFO databases were searched in April 2014 with hand-searching of in-text

  5. Risk factors for cage retropulsion after posterior lumbar interbody fusion: analysis of 1070 cases.

    Science.gov (United States)

    Kimura, Hiroaki; Shikata, Jitsuhiko; Odate, Seiichi; Soeda, Tsunemitsu; Yamamura, Satoru

    2012-06-01

    Single-center retrospective study. We examined the risk factors for cage retropulsion after posterior lumbar interbody fusion (PLIF) performed for patients with degenerative lumbar spinal diseases. Although PLIF is a widely accepted procedure, problems remain regarding perioperative and postoperative complications. There are few reported studies identifying specific risk factors for cage retropulsion, one of the implant-related complications after PLIF, although several case reports have been published. Between April 2006 and July 2010, 1070 patients with various degenerative lumbar spinal diseases underwent single- or multilevel PLIF combined with posterolateral fusion, using posterior pedicle screw fixation and box-type cages. Their medical records and preoperative radiographs were reviewed and the factors influencing the incidence of cage retropulsion were analyzed. There were 9 cases of cage retropulsion (7 men and 2 women; mean age, 68.2 yr), and it developed within 2 months after surgery in all cases. Five patients had low back pain or leg pain, 3 of whom required revision surgery. The mean fusion level was 3.9 (range, 2-5); in 6 of the 9 patients, the cage had migrated at L5/S, 2 at L4/5, and 1 at L3/4. All of the cages were inserted at the end disc level of multilevel fusion procedures. The disc heights and ranges of motion were significantly greater in patients with cage retropulsion, and patients with a pear-shaped disc space also showed a higher rate of cage retropulsion. These results indicate that PLIF at L5/S, a wide disc space with instability, multilevel fusion surgery, and a pear-shaped disc space on lateral radiographs are risk factors for cage retropulsion. The identification of these risk factors should allow us to avoid this complication, and the use of expandable cages is an effective option for such cases.

  6. Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: A systematic review and meta-analysis.

    Science.gov (United States)

    Norrish, Gabrielle; Cantarutti, Nicoletta; Pissaridou, Eleni; Ridout, Deborah A; Limongelli, Giuseppe; Elliott, Perry M; Kaski, Juan Pablo

    2017-07-01

    Aims To perform a systematic literature review and meta-analysis of clinical risk factors for sudden cardiac death (SCD) in childhood hypertrophic cardiomyopathy. Methods Medline and PubMed databases were searched for original articles published in English from 1963 through to December 2015 that included patients under 18 years of age with a primary or secondary end-point of either SCD or SCD-equivalent events (aborted cardiac arrest or appropriate implantable cardioverter-defibrillator discharge) or cardiovascular death (CVD). Results Twenty-five studies (3394 patients) met the inclusion criteria. We identified four conventional major risk factors that were evaluated in at least four studies and that we found to be statistically associated with an increased risk of death in at least two studies: previous adverse cardiac event (pooled hazard ratio [HR] 5.4, 95% confidence interval [CI] 3.67-7.95, p cardiomyopathy means that the evidence base for individual risk factors is not robust. We have identified four clinical parameters that are likely to be associated with increased risk of SCD, SCD-equivalent events or CVD. Multi-centre prospective studies are needed in order to further determine the relevance of these factors in predicting SCD in childhood hypertrophic cardiomyopathy and to identify novel risk markers. Condensed abstract A systematic review and meta-analysis of clinical risk factors predicting sudden cardiac death in childhood hypertrophic cardiomyopathy was performed, identifying four 'major' factors: previous adverse cardiac event; non-sustained ventricular tachycardia; syncope; and extreme left ventricular hypertrophy. Well-designed multi-centre studies are required in the future in order to confirm these findings.

  7. γ-Glutamyltransferase and Breast Cancer Risk Beyond Alcohol Consumption and Other Life Style Factors - A Pooled Cohort Analysis.

    Directory of Open Access Journals (Sweden)

    Oliver Preyer

    Full Text Available Elevated γ-Glutamyltransferase serum levels are associated with increased risk of overall cancer incidence and several site-specific malignancies. In the present prospective study we report on the associations of serum γ-Glutamyltransferase with the risk of breast cancer in a pooled population-based cohort considering established life style risk factors.Two cohorts were included in the present study, i.e. the Vorarlberg (n = 97,268 and the Malmoe cohort (n = 9,790. Cox proportional hazards regression models were fitted to estimate HRs for risk of breast cancer.In multivariate analysis adjusted for age, body mass index and smoking status, women with γ-Glutamyltransferase levels in the top quartile were at significantly higher risk for breast cancer compared to women in the lowest quartile (HR 1.21, 95% CI 1.09 to 1.35; p = 0.005. In the subgroup analysis of the Malmoe cohort, γ-Glutamyltransferase remained an independent risk factor for breast cancer when additionally considering alcohol intake. A statistically significant increase in risk was seen in women with γ-Glutamyltransferase-levels in the top versus lowest quartile in a multivariate model adjusted for age, body mass index, smoking status, physical activity, parity, oral contraceptive-use and alcohol consumption (HR 1.37, 95% CI 1.11-1.69, p = 0.006.Our findings identified γ-Glutamyltransferase as an independent risk factor for breast cancer beyond the consumption of alcohol and other life style risk factors.

  8. Risk Factors for Breast Cancer for Women Age 40 to 49: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Nelson, Heidi D.; Zakher, Bernadette; Cantor, Amy; Fu, Rongwei; Griffin, Jessica; O’Meara, Ellen S.; Buist, Diana S.M.; Kerlikowske, Karla; van Ravesteyn, Nicolien T.; Trentham-Dietz, Amy; Mandelblatt, Jeanne; Miglioretti, Diana

    2012-01-01

    Background Identifying risk factors for breast cancer specific to women in their forties could inform screening decisions. Purpose To determine what factors increase risk for breast cancer in women age 40–49 years and the magnitudes of risk for each factor. Data Sources MEDLINE (January 1996 to November 2011), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (fourth Quarter 2011), Scopus, and reference lists for published studies; and data from the Breast Cancer Surveillance Consortium (BCSC). Study Selection English-language studies and systematic reviews of risk factors for breast cancer in women age 40–49 years. Additional inclusion criteria were applied for each risk factor. Data Extraction Data on participants, study design, analysis, follow-up, and outcomes were abstracted. Study quality was rated using established criteria and only studies rated good or fair were included. Results were summarized using meta-analysis when sufficient studies were available, or from the best evidence based on study quality, size, and applicability when meta-analysis was not possible. BCSC data were analyzed with proportional hazards models using partly conditional Cox regression. Reference groups for comparisons were set at U.S. population means. Data Synthesis 65 studies provided data for estimates. Extremely dense breasts on mammography or first-degree relatives with breast cancer were associated with ≥2-fold increase in breast cancer. Prior breast biopsy, second degree relatives with breast cancer, or heterogeneously dense breasts were associated with 1.5–2.0 increased risk; current oral contraceptive use, nulliparity, and age ≥30 at first birth were associated with 1.0–1.5 increased risk. Limitations Studies varied by measures, reference groups, and adjustment for confounders; effects of multiple risk factors were not considered. Conclusions Extremely dense breasts and first degree relatives with breast cancer were each

  9. Sociodemographic characteristics and risk factor analysis of Demodex infestation (Acari: Demodicidae)*

    Science.gov (United States)

    Zhao, Ya-e; Guo, Na; Xun, Meng; Xu, Ji-ru; Wang, Mei; Wang, Duo-lao

    2011-01-01

    To identify sociodemographic characteristics and risk factor of Demodex infestation, 756 students aged 13–22 years in Xi’an, China were sampled for the school-based cross-sectional study. Demodex was examined using the cellophane tape method (CTP). The results showed that the total detection rate of Demodex was 67.6%. Logistic regression analysis revealed that five variables (gender, residence, sharing sanitary ware, frequency of face-wash per day, and use of facial cleanser) were found to be uncorrelated with Demodex infestation, whereas three variables (age, skin type, and skin disease) were found to be independent correlates. Students aged over 18 years had 22.1 times higher odds of Demodex infestation compared to those under 16 years and students aged 16–18 years also had 2.1 times higher odds compared to those aged 13–15 years. Odds of having a Demodex infestation for oily or mixed skin were 2.1 times those for dry or neutral skin. Students with a facial skin disease had 3.0 times higher odds of being infested with Demodex compared to those without. The inception rate of students with facial dermatoses increased in parallel with increasing mite count. The inception rates were 21.3%, 40.7%, 59.2%, and 67.7% in the negative, mild, moderate, and severe infestation groups, respectively (χ 2=60.6, PDemodex prevalence increases with age, and Demodex presents in nearly all adult human. Sebaceous hyperplasia with oily or mixed skin seems to favour Demodex proliferation. Demodex infestation could be associated with acne vulgaris. The CTP is a good sampling method for studies of Demodex prevalence. PMID:22135149

  10. Sociodemographic characteristics and risk factor analysis of Demodex infestation (Acari: Demodicidae).

    Science.gov (United States)

    Zhao, Ya-e; Guo, Na; Xun, Meng; Xu, Ji-ru; Wang, Mei; Wang, Duo-lao

    2011-12-01

    To identify sociodemographic characteristics and risk factor of Demodex infestation, 756 students aged 13-22 years in Xi'an, China were sampled for the school-based cross-sectional study. Demodex was examined using the cellophane tape method (CTP). The results showed that the total detection rate of Demodex was 67.6%. Logistic regression analysis revealed that five variables (gender, residence, sharing sanitary ware, frequency of face-wash per day, and use of facial cleanser) were found to be uncorrelated with Demodex infestation, whereas three variables (age, skin type, and skin disease) were found to be independent correlates. Students aged over 18 years had 22.1 times higher odds of Demodex infestation compared to those under 16 years and students aged 16-18 years also had 2.1 times higher odds compared to those aged 13-15 years. Odds of having a Demodex infestation for oily or mixed skin were 2.1 times those for dry or neutral skin. Students with a facial skin disease had 3.0 times higher odds of being infested with Demodex compared to those without. The inception rate of students with facial dermatoses increased in parallel with increasing mite count. The inception rates were 21.3%, 40.7%, 59.2%, and 67.7% in the negative, mild, moderate, and severe infestation groups, respectively (χ(2)=60.6, PDemodex prevalence increases with age, and Demodex presents in nearly all adult human. Sebaceous hyperplasia with oily or mixed skin seems to favour Demodex proliferation. Demodex infestation could be associated with acne vulgaris. The CTP is a good sampling method for studies of Demodex prevalence.

  11. Analysis of Risk Factors for Abnormal Pulmonary Function in Pediatric Cancer Survivors.

    Science.gov (United States)

    Record, Elizabeth; Williamson, Rebecca; Wasilewski-Masker, Karen; Mertens, Ann C; Meacham, Lillian R; Popler, Jonathan

    2016-07-01

    Childhood cancer survivors are at increased risk for pulmonary-related morbidity and mortality. The Children's Oncology Group Long-Term Follow-Up (COG-LTFU) guidelines recommend pulmonary function testing after treatment with bleomycin, busulfan, carmustine, lomustine, thoracic radiation, bone marrow transplant, or pulmonary surgery. The aim of this analysis was to determine the prevalence of pulmonary function abnormalities in a pediatric survivor cohort. Patients ≥5 years old seen in our survivor clinic with at least one exposure outlined by COG-LFTU Guidelines were included. Original pulmonary function test (PFT) results were obtained and blindly reinterpreted by a single reviewer. Demographic, diagnosis, treatment factors, and clinical and/or patient-reported symptoms of cough, wheeze, and/or dyspnea were abstracted from their medical record. Overall, 143 (63.3%) survivors had PFT results available; 55.2% were male, 49.7% were white, and the mean age was 14.1 ± 4.8 years. Abnormal PFTs were found in 65.0% (n = 93) with 21.0% having multiple abnormalities. Specifically, 41.3% had hyperinflation, 25.9% had obstructive, and 13.3% had restrictive disease. Patients diagnosed at pulmonary abnormality (P = 0.04); a majority of those diagnosed pulmonary surgery or thoracic radiation. Regardless of the presence of a PFT abnormality, more than 80% of survivors were asymptomatic (82.9% vs.81.5%; P-value = 0.54). Almost two-thirds of survivors screened per the COG-LTFU Guidelines had an abnormal PFT but a majority reported no clinical symptoms. Hyperinflation was the most prevalent abnormality. © 2016 Wiley Periodicals, Inc.

  12. Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

    Directory of Open Access Journals (Sweden)

    Kuljić Blagoje

    2004-01-01

    Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

  13. Chi-squared Automatic Interaction Detection Decision Tree Analysis of Risk Factors for Infant Anemia in Beijing, China.

    Science.gov (United States)

    Ye, Fang; Chen, Zhi-Hua; Chen, Jie; Liu, Fang; Zhang, Yong; Fan, Qin-Ying; Wang, Lin

    2016-05-20

    In the past decades, studies on infant anemia have mainly focused on rural areas of China. With the increasing heterogeneity of population in recent years, available information on infant anemia is inconclusive in large cities of China, especially with comparison between native residents and floating population. This population-based cross-sectional study was implemented to determine the anemic status of infants as well as the risk factors in a representative downtown area of Beijing. As useful methods to build a predictive model, Chi-squared automatic interaction detection (CHAID) decision tree analysis and logistic regression analysis were introduced to explore risk factors of infant anemia. A total of 1091 infants aged 6-12 months together with their parents/caregivers living at Heping Avenue Subdistrict of Beijing were surveyed from January 1, 2013 to December 31, 2014. The prevalence of anemia was 12.60% with a range of 3.47%-40.00% in different subgroup characteristics. The CHAID decision tree model has demonstrated multilevel interaction among risk factors through stepwise pathways to detect anemia. Besides the three predictors identified by logistic regression model including maternal anemia during pregnancy, exclusive breastfeeding in the first 6 months, and floating population, CHAID decision tree analysis also identified the fourth risk factor, the maternal educational level, with higher overall classification accuracy and larger area below the receiver operating characteristic curve. The infant anemic status in metropolis is complex and should be carefully considered by the basic health care practitioners. CHAID decision tree analysis has demonstrated a better performance in hierarchical analysis of population with great heterogeneity. Risk factors identified by this study might be meaningful in the early detection and prompt treatment of infant anemia in large cities.

  14. Environmental Risk Factors influencing Bicycle Theft: A Spatial Analysis in London, UK.

    Directory of Open Access Journals (Sweden)

    Lucy Waruguru Mburu

    Full Text Available Urban authorities are continuously drawing up policies to promote cycling among commuters. However, these initiatives are counterproductive for the targeted objectives because they increase opportunities for bicycle theft. This paper explores Inner London as a case study to address place-specific risk factors for bicycle theft at the street-segment level while controlling for seasonal variation. The presence of certain public amenities (e.g., bicycle stands, railway stations, pawnshops was evaluated against locations of bicycle theft between 2013 and 2016 and risk effects were estimated using negative binomial regression models. Results showed that a greater level of risk stemmed from land-use facilities than from area-based socioeconomic status. The presence of facilities such as train stations, vacant houses, pawnbrokers and payday lenders increased bicycle theft, but no evidence was found that linked police stations with crime levels. The findings have significant implications for urban crime prevention with respect to non-residential land use.

  15. Risk Factors for Injuries During Military Static-Line Airborne Operations: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Knapik, Joseph; Steelman, Ryan

    2016-01-01

    Objective: To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations. Data Sources: We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal. Study Selection: The search identified 17 684 potential studies. Studies were included if they were written in English, involved military static-line parachute operations, recorded injuries directly from events on the landing zone or from safety or medical records, and provided data for quantitative assessment of injury risk factors. A total of 23 studies met the review criteria, and 15 were included in the meta-analysis. Data Extraction: The summary statistic obtained for each risk factor was the risk ratio, which was the ratio of the injury risk in 1 group to that of another (baseline) group. Where data were sufficient, meta-analyses were performed and heterogeneity and publication bias were assessed. Data Synthesis: Risk factors for static-line parachuting injuries included night jumps, jumps with extra equipment, higher wind speeds, higher air temperatures, jumps from fixed-wing aircraft rather than balloons or helicopters, jumps onto certain types of terrain, being a female paratrooper, greater body weight, not using the parachute ankle brace, smaller parachute canopies, simultaneous exits from both sides of an aircraft, higher heat index, winds from the rear of the aircraft on exit entanglements, less experience with a particular parachute system, being an enlisted soldier rather than an officer, and jumps involving a greater number of paratroopers. Conclusions: We analyzed and summarized factors that increased the injury risk for soldiers during military static-line parachute operations. Understanding and considering these factors in risk evaluations may reduce the

  16. Analysis of potential oral cleft risk factors in the Kosovo population.

    Science.gov (United States)

    Salihu, Sami; Krasniqi, Blerim; Sejfija, Osman; Heta, Nijazi; Salihaj, Nderim; Geci, Agreta; Sejdini, Milaim; Arifi, Hysni; Isufi, Ramazan; Ueeck, Brett A

    2014-01-01

    The aim of this study was to analyze the association of potential risk factors such as positive family cleft history, smoking, use of drugs during pregnancy, and parental age with oral clefts in offspring within the Kosovo population. We conducted a population-based case-control study of live births in Kosovo from 1996 to 2005. Using a logistic regression model, 244 oral cleft cases were compared with 488 controls. We have excluded all syndromic clefts. Heredity increases the risk of clefts in newborns [odds ratio (OR) = 8.25, 95% confidence interval (CI) 3.12-23.52]. Clefts were also associated with smoking (OR = 1.87, 95% CI 0.75-4.08), use of drugs during pregnancy (OR = 2.25, 95% CI 0.82-5.12), increasing maternal age (OR = 1.83, 95% CI 1.42-2.49), and increasing paternal age (OR = 1.3, 95% CI 1.2- 1.4). We found heredity to be the most important factor for cleft occurrence in Kosovar newborns. Another significant potential risk factor for occurrence of clefts is the parental age. We found the use of drugs and smoking during pregnancy to be less significant.

  17. Contextual socioeconomic determinants of cardiovascular risk factors in rural south-west China: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Geater Alan

    2007-05-01

    Full Text Available Abstract Background We examined independent influences of contextual variables on cardiovascular risk factors in Shilin county, Yunnan province, South-west China. Methods Three villages were selected from each of the ten townships based on probability proportional to size. In each selected village, 200 individuals aged ≥ 45 years were chosen based on simple random sampling method. From 6006 individuals, information on demographic characteristics, smoking and drinking status was obtained by interview. Blood pressure, height, weight, and waist and hip girth were measured. Fasting blood sugar was measured in a 10-percent subsample. Contextual data were from official reports. Multi-level regression modelling with adjustment for individual and contextual variables was used. Results Contextual variables associated with CVD risk factors included: remoteness of village with higher blood pressure and fasting blood sugar, high proportion of Yi minority with drinking, high literacy rate with a lower rate of smoking and a lower mean waist-hip ratio, and high average income with lower systolic blood pressure and body mass index (BMI but higher FBS. Conclusion While contextual SES is associated with a few CVD risk factors, villages with high level of income are worse off in fasting blood sugar. Strategies of economic development should be reviewed to avoid adverse effects on health.

  18. [Analysis of some of the possible neonatal risk factors of development of retinopathy of prematurity].

    Science.gov (United States)

    Niwald, Anna; Piotrowski, Andrzej; Grałek, Mirosława

    2008-01-01

    The aim of the study was to evaluate some of the possible risk factors for retinopathy of prematurity (ROP) treated with laser photocoagulation or cryocoagulation. The study comprised 71 preterm infants with ROP needing treatment and 118 prematures without ROP or with ROP requiring no treatment, as a control group. All infants were born with gestational age convulsiones (OR = 2.15), mechanical ventilation for more than 20 days (OR = 5.86) and > 30 days (OR = 7.47), CPAP for more than 5 days (OR = 4.15) and > 10 days (OR = 2.84), total parenteral nutrition for more than 10 days (OR = 7.84) and > 20 days (OR = 9.02) and elevated peak of alanine aminotransferase (AIAT) levels (OR = 3.17) were significant risk factors for ROP requiring treatment. The opthalmic examination for retinopathy of prematurity requiring laser photocoagulation or cryocoagulation should be obligatory for prematures born < or = 32 weeks of gestational age, with birth weight < or = 1500 g. The frequency of the consecutive ophthalmic examinations depends on the severity of prematurity and on the presence and intensification of the risk factors for ROP.

  19. Maternal and perinatal risk factors for SIDS: a novel analysis utilizing pregnancy outcome data.

    Science.gov (United States)

    Highet, Amanda R; Goldwater, Paul N

    2013-03-01

    A number of maternal and perinatal factors to increase an infant's risk of sudden infant death syndrome (SIDS) have been found in past investigations. We analysed data for potential SIDS risk factors including the presence of complications or conditions considered as detrimental to the infant's or mother's health. The data for 118 SIDS cases and 227 matched controls were obtained from a state pregnancy outcome unit. SIDS was found to be significantly more common in cases where the infant's mother was not in a relationship (i.e. divorced, separated or never married) (p = 0.005), if the infant was not the first born (p = 0.0001) and when the mother resided in a socioeconomically disadvantaged area (p = 0.03). Overall, this SIDS cohort appears to display classical SIDS associations, and our findings are consistent with those from other regions. This novel epidemiological tool opens the way for a national Australia-wide study using pregnancy outcome data collected by the individual states and could be helpful in assessing maternal and fetal risk factors for other paediatric medical conditions.

  20. Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis.

    Science.gov (United States)

    Pyo, Jeung Hui; Ha, Sang Yun; Hong, Sung Noh; Chang, Dong Kyung; Son, Hee Jung; Kim, Kyoung-Mee; Kim, Hyeseung; Kim, Kyunga; Kim, Jee Eun; Choi, Yoon-Ho; Kim, Young-Ho

    2017-10-31

    Little is known about the risk factors associated with serrated polyps, because the early studies, which occurred before the new World Health Organization classification was introduced, included mixtures of serrated polyps. This study aimed to evaluate the risk factors associated with the presence of sessile serrated adenomas (SSAs) and traditional serrated adenomas (TSAs) using big data analytics. Using a case-control design, we evaluated the risk factors associated with the presence of SSAs and TSAs. Subjects who underwent colonoscopies from 2002 to 2012 as part of the comprehensive health screening programs undertaken at the Samsung Medical Center, South Korea, participated in this study. Of the 48,677 individuals who underwent colonoscopies, 183 (0.4%) had SSAs and 212 (0.4%) had TSAs. The multivariate analysis determined that being aged ≥50 years (odds ratio [OR] 1.91, 95% confidential interval [CI] 1.27-2.90, P=0.002) and a history of CRC among first-degree relatives (OR 3.14, 95% CI 1.57-6.27, P=0.001) were significant risk factors associated with the presence of SSAs, and that being aged ≥50 years (OR 2.61, 95% CI 1.79-3.80, P<0.001), obesity (OR 1.63, 95% CI 1.12-2.36, P=0.010), and a higher triglyceride level (OR 1.63, 95% CI 1.12-2.36, P=0.010) were independent risk factors associated with the presence of TSAs. We used big data analytics to determine the risk factors associated with the presence of specific polyp subgroups, and individuals who have these risk factors should be carefully scrutinized for the presence of SSAs or TSAs during screening colonoscopies. This article is protected by copyright. All rights reserved.

  1. Extracting a stroke phenotype risk factor from Veteran Health Administration clinical reports: an information content analysis.

    Science.gov (United States)

    Mowery, Danielle L; Chapman, Brian E; Conway, Mike; South, Brett R; Madden, Erin; Keyhani, Salomeh; Chapman, Wendy W

    2016-01-01

    In the United States, 795,000 people suffer strokes each year; 10-15 % of these strokes can be attributed to stenosis caused by plaque in the carotid artery, a major stroke phenotype risk factor. Studies comparing treatments for the management of asymptomatic carotid stenosis are challenging for at least two reasons: 1) administrative billing codes (i.e., Current Procedural Terminology (CPT) codes) that identify carotid images do not denote which neurovascular arteries are affected and 2) the majority of the image reports are negative for carotid stenosis. Studies that rely on manual chart abstraction can be labor-intensive, expensive, and time-consuming. Natural Language Processing (NLP) can expedite the process of manual chart abstraction by automatically filtering reports with no/insignificant carotid stenosis findings and flagging reports with significant carotid stenosis findings; thus, potentially reducing effort, costs, and time. In this pilot study, we conducted an information content analysis of carotid stenosis mentions in terms of their report location (Sections), report formats (structures) and linguistic descriptions (expressions) from Veteran Health Administration free-text reports. We assessed an NLP algorithm, pyConText's, ability to discern reports with significant carotid stenosis findings from reports with no/insignificant carotid stenosis findings given these three document composition factors for two report types: radiology (RAD) and text integration utility (TIU) notes. We observed that most carotid mentions are recorded in prose using categorical expressions, within the Findings and Impression sections for RAD reports and within neither of these designated sections for TIU notes. For RAD reports, pyConText performed with high sensitivity (88 %), specificity (84 %), and negative predictive value (95 %) and reasonable positive predictive value (70 %). For TIU notes, pyConText performed with high specificity (87 %) and negative predictive

  2. Configurations of Common Childhood Psychosocial Risk Factors

    Science.gov (United States)

    Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

    2009-01-01

    Background: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class…

  3. [Laryngeal cancer risk factors].

    Science.gov (United States)

    Jurkiewicz, Dariusz; Dzaman, Karolina; Rapiejko, Piotr

    2006-07-01

    Laryngeal cancer is the most common of head and neck cancers. Neoplasm used to develop basing on DNA mutation which leads to uncontrolled growth and cells' division. It is due to spontaneous mutations or influence of chemical, biological and physical factors. Laryngeal cancer generation is conditioned by many synergic factors. Some of them certainly participate in cancer genesis and this thesis is accepted by medical environment and other of them have been discussed giving different information. Definition of the risk factors role in laryngeal cancer etiology is very difficult especially regarding their contemporary occurrence in one person. Most common risk factors are environmental factors, gastroesophageal reflux, viral infections, diet, radiation, individual predisposition. Some of them, such as cigarette smoking and abuse alcohol are significantly oftener confirmed in patients with neoplasm diagnosis and others' role in developing of illness has been still researched. Thus the purpose of the study was to present so far achievements in laryngeal cancer etiology and to emphasize controversies relating to some factors' role in cancer genesis.

  4. Seroprevalence of Herpes Simplex Virus Type 1 and 2 in Taiwan and Risk Factor Analysis, 2007.

    Directory of Open Access Journals (Sweden)

    Jen-Hsiang Shen

    Full Text Available Herpes simplex virus type 1 (HSV-1 and 2 (HSV-2 are common human pathogens and might cause severe illness. Following primary infection, the viruses establish lifelong latent infection and are transmitted by close contact, both sexual and nonsexual. However, the information about the seroprevalence of HSV-1 and HSV-2 across all age groups is limited.Residual sera collected during the nationwide serosurvey in 2007 in Taiwan were selected for the study. The enzyme-linked immunosorbent assay was used to detect anti-HSV-1 and anti-HSV-2 type-specific glycoprotein IgG. Demographics and personal health data were used for risk analysis.A total of 1411 and 1072 serum samples were included for anti-HSV-1 and anti-HSV-2 seroprevalence analysis, respectively. The weighted overall seroprevalence was 63.2% for HSV-1, and 7.7% for HSV-2, respectively. The HSV-1 seropositive rate was 19.2% for those less than 5 years old, increased to 46.4% for those aged 5-13 years, 60.9% for those aged 14-29 years, and reached as much as 95.0% for those aged over 30 years. In contrast, the HSV-2 seropositve rate was 1.6% for those less than 30 years old, rose to 10.1% for those age 30-39 years, and was up to 31.2% for those aged over 60 years. A significantly higher HSV-2 seropositive rate was noted in females than males aged over 40 years (26.3% v.s. 16.8%, and the overall HSV-2 seropositive rate was almost twice higher in females than males. Smoking history, drinking habit, and educational level were associated with the HSV-1 seropositivity. Female gender and rural residence were independent factors for the HSV-2 seropositivity.An obvious increase of primary HSV-1 infection occurred in late adolescents and young adults, joined by the rise of HSV-2 infection in middle-aged adults, especially females. The acquistion and transmission of HSV warrant further studies in the susceptible population.

  5. Risk factors for postoperative delirium in patients undergoing major head and neck cancer surgery: a meta-analysis.

    Science.gov (United States)

    Zhu, Yun; Wang, Gangpu; Liu, Shengwen; Zhou, Shanghui; Lian, Ying; Zhang, Chenping; Yang, Wenjun

    2017-06-01

    Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. They provided a total of 1940 patients (286 with delirium and 1654 without), and predominantly included patients undergoing head and neck cancer surgery. The incidence of postoperative delirium ranged from 11.50% to 36.11%. Ten statistically significant risk factors were identified in pooled analysis. Old age, age >70 years, male sex, duration of surgery, history of hypertension, blood transfusions, tracheotomy, American Society of Anesthesiologists physical status grade at least III, flap reconstruction and neck dissection were more likely to sustain delirium after head and neck cancer surgery. Delirium is common in patients undergoing major head neck cancer surgery. Several risk factors were consistently associated with postoperative delirium. These factors help to highlight patients at risk of developing delirium and are suitable for preventive action.

  6. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Silverwood, V; Blagojevic-Bucknall, M; Jinks, C; Jordan, J L; Protheroe, J; Jordan, K P

    2015-04-01

    Osteoarthritis (OA) is a leading cause of pain and disability and leads to a reduced quality of life. The aim was to determine the current evidence on risk factors for onset of knee pain/OA in those aged 50 and over. A systematic review and meta-analysis was conducted of cohort studies for risk factors for the onset of knee pain. Two authors screened abstracts and papers and completed data extraction. Where possible, pooled odds ratios (OR) were calculated via random effects meta-analysis and population attributable fractions (PAFs) derived. 6554 papers were identified and after screening 46 studies were included. The main factors associated with onset of knee pain were being overweight (pooled OR 1.98, 95% confidence intervals (CI) 1.57-2.20), obesity (pooled OR 2.66 95% CI 2.15-3.28), female gender (pooled OR 1.68, 95% CI 1.37-2.07), previous knee injury (pooled OR 2.83, 95% CI 1.91-4.19). Hand OA (pooled OR 1.30, 95% CI 0.90-1.87) was found to be non-significant. Smoking was found not to be a statistically significant risk or protective factor (pooled OR 0.92, 95% CI 0.83-1.01). PAFs indicated that in patients with new onset of knee pain 5.1% of cases were due to previous knee injury and 24.6% related to being overweight or obese. Clinicians can use the identified risk factors to identify and manage patients at risk of developing or increasing knee pain. Obesity in particular needs to be a major target for prevention of development of knee pain. More research is needed into a number of potential risk factors. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis.

    Science.gov (United States)

    Newman, Phil; Witchalls, Jeremy; Waddington, Gordon; Adams, Roger

    2013-11-13

    Medial tibial stress syndrome (MTSS) affects 5%-35% of runners. Research over the last 40 years investigating a range of interventions has not established any clearly effective management for MTSS that is better than prolonged rest. At the present time, understanding of the risk factors and potential causative factors for MTSS is inconclusive. The purpose of this review is to evaluate studies that have investigated various risk factors and their association with the development of MTSS in runners. Medical research databases were searched for relevant literature, using the terms "MTSS AND prevention OR risk OR prediction OR incidence". A systematic review of the literature identified ten papers suitable for inclusion in a meta-analysis. Measures with sufficient data for meta-analysis included dichotomous and continuous variables of body mass index (BMI), ankle dorsiflexion range of motion, navicular drop, orthotic use, foot type, previous history of MTSS, female gender, hip range of motion, and years of running experience. The following factors were found to have a statistically significant association with MTSS: increased hip external rotation in males (standard mean difference [SMD] 0.67, 95% confidence interval [CI] 0.29-1.04, Prisk ratio [RR] 2.31, 95% CI 1.56-3.43, P10 mm (RR 1.99, 95% CI 1.00-3.96, P=0.05). Female gender, previous history of MTSS, fewer years of running experience, orthotic use, increased body mass index, increased navicular drop, and increased external rotation hip range of motion in males are all significantly associated with an increased risk of developing MTSS. Future studies should analyze males and females separately because risk factors vary by gender. A continuum model of the development of MTSS that links the identified risk factors and known processes is proposed. These data can inform both screening and countermeasures for the prevention of MTSS in runners.

  8. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Mohd Hanafiah, Khayriyyah; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid; AlMazroa, Mohammad A; Memish, Ziad A

    2012-12-15

    Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved

  9. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

    Science.gov (United States)

    Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Hanafiah, Khayriyyah Mohd; Mokdad, Ali A; Morawska, Lidia; Mozaff arian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope III, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid

    2014-01-01

    Summary Background Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. Methods We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. Findings In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2–7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5–7·0]), and alcohol use (5·5% [5·0–5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8–9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6–8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4–6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2–10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect

  10. Risk factors for childhood obesity at age 5: Analysis of the Millennium Cohort Study

    Directory of Open Access Journals (Sweden)

    Lyons Ronan A

    2009-12-01

    Full Text Available Abstract Background Weight at age 5 is a predictor for future health of the individual. This study examines risk factors for childhood obesity with a focus on ethnicity. Methods Data from the Millennium Cohort study were used. 17,561 singleton children of White/European (n = 15,062, Asian (n = 1,845 or African (n = 654 background were selected. Logistic regression and likelihood ratio tests were used to examine factors associated with obesity at age 5. All participants were interviewed in their own homes. The main exposures examined included; Birth weight, sedentary lifestyle, family health behaviours, ethnicity, education and income. Results Children with a sedentary lifestyle, large at birth, with high risk family health behaviours (overweight mothers, smoking near the child, missing breakfast and from a family with low income or low educational attainment, were more likely to be obese regardless of ethnicity. Feeding solid food before 3 months was associated with obesity in higher income White/European families. Even when controlling for socioeconomic status, ethnic background is an important independent risk factor for childhood obesity [Odds ratio of obesity; was 1.7 (95%CI: 1.2-2.3 for Asian and 2.7 (95%CI: 1.9-3.9 for African children, compared to White/European]. The final adjusted model suggests that increasing income does not have a great impact on lowering obesity levels, but that higher academic qualifications are associated with lower obesity levels [Odds of obesity: 0.63 (95%CI: 0.52-0.77 if primary carer leaves school after age 16 compared at age 16]. Conclusions Education of the primary carer is an important modifiable factor which can be targeted to address rising obesity levels in children. Interventions should be family centred supporting and showing people how they can implement lifestyle changes in their family.

  11. Risk Factors for Dementia

    Directory of Open Access Journals (Sweden)

    Jen-Hau Chen

    2009-10-01

    Full Text Available Dementia is a complex human disease. The incidence of dementia among the elderly population is rising rapidly worldwide. In the United States, Alzheimer's disease (AD is the leading type of dementia and was the fifth and eighth leading cause of death in women and men aged ≥ 65 years, respectively, in 2003. In Taiwan and many other counties, dementia is a hidden health issue because of its underestimation in the elderly population. In Western countries, the prevalence of AD increases from 1–3% among people aged 60–64 years to 35% among those aged > 85 years. In Taiwan, the prevalence of dementia for people aged ≥ 65 years was 2–4% by 2000. Therefore, it is important to identify protective and risk factors for dementia to prevent this disease at an early stage. Several factors are related to dementia, e.g. age, ethnicity, sex, genetic factors, physical activity, smoking, drug use, education level, alcohol consumption, body mass index, comorbidity, and environmental factors. In this review, we focus on studies that have evaluated the association between these factors and the risk of dementia, especially AD and vascular dementia. We also suggest future research directions for researchers in dementia-related fields.

  12. Breast cancer risk factors

    Directory of Open Access Journals (Sweden)

    Marzena Kamińska

    2015-09-01

    Full Text Available Breast cancer is the most frequently diagnosed neoplastic disease in women around menopause often leading to a significant reduction of these women’s ability to function normally in everyday life. The increased breast cancer incidence observed in epidemiological studies in a group of women actively participating in social and professional life implicates the necessity of conducting multidirectional studies in order to identify risk factors associated with the occurrence of this type of neoplasm. Taking the possibility of influencing the neoplastic transformation process in individuals as a criterion, all the risk factors initiating the process can be divided into two groups. The first group would include inherent factors such as age, sex, race, genetic makeup promoting familial occurrence of the neoplastic disease or the occurrence of benign proliferative lesions of the mammary gland. They all constitute independent parameters and do not undergo simple modification in the course of an individual’s life. The second group would include extrinsic factors conditioned by lifestyle, diet or long-term medical intervention such as using oral hormonal contraceptives or hormonal replacement therapy and their influence on the neoplastic process may be modified to a certain degree. Identification of modifiable factors may contribute to development of prevention strategies decreasing breast cancer incidence.

  13. Genetic analysis of thermolabile methylenetetrahydrofolate reductase as a risk factor for myocardial infarction.

    Science.gov (United States)

    Adams, M; Smith, P D; Martin, D; Thompson, J R; Lodwick, D; Samani, N J

    1996-06-01

    Hyperhomocyst(e)inemia is associated with an increased risk of coronary artery disease and myocardial infarction. Both genetic and environmental factors influence the plasma level of homocysteine. One of the metabolic pathways for homocysteine involves the enzyme methylenetetrahydrofolate reductase (MTHFR), which regulates the conversion of homocysteine to methionine. A thermolabile variant of MTHFR is associated with reduced enzyme activity and increased plasma homocysteine levels. Recently, the cause of this variant of MTFHR has been identified as a single base change altering an alanine to a valine residue in the protein. Using a PCR-based assay to distinguish the normal and thermolabile variants of MTHFR in this study, we investigated whether the thermolabile variant is a genetic risk factor for myocardial infarction. In a study of 532 subjects (310 myocardial infarction patients and 222 population-based controls), we found no difference in either MTHFR genotype distribution (p = 0.57) or allele frequencies (p = 0.68) between cases and controls. The allele frequencies of the thermolabile variant were 0.34 and 0.35 in cases and controls, respectively. The age- and sex-stratified odds ratio for risk of myocardial infarction associated with homozygosity for the thermolabile variant was 0.85 (95% CI 0.50-1.50, p = 0.57) and that with carriage of the thermolabile allele was 1.06 (95% CI 0.73-1.52, p = 0.76). The odds ratios remained non-significant when restricted to young subjects (< 60 years) or males, and were not influenced by several other risk factors for myocardial infarction considered either singly or in combination. Interestingly, in both cases and controls, there was a trend toward a higher prevalence of hypertension in subjects carrying the normal allele, although as this is a post-hoc finding it needs to be interpreted with caution. The thermolabile variant of MTHFR is not a major risk factor for myocardial infarction and is unlikely to explain a

  14. Corneal Melt after Boston Keratoprosthesis: Clinical Presentation, Management, Outcomes and Risk Factor Analysis.

    Science.gov (United States)

    Bouhout, Soumaya; Robert, Marie-Claude; Deli, Sousans; Harissi-Dagher, Mona

    2017-01-12

    To determine the presentation, risk factors, and outcomes of keratolysis after Boston type I keratoprosthesis (B-KPro). Retrospective chart review. A total of 16 (14%) of the 110 eyes (96 patients) which underwent B-KPro implantation developed keratolysis at an average 20 ± 11 months. Retroprosthetic membrane (RPM), infectious keratitis, and corneal dellen were identified in 31%, 25%, and 13% of corneal melts, respectively. Five eyes had keratolysis without a readily identifiable cause. RPM (odds-ratio, OR = 4.4, p = 0.02) and infectious keratitis (OR = 17.6, p<0.0005) were confirmed as significant risk factors. Retinal detachment (p = 0.001) and choroidal detachment (p = 0.003) were more common in eyes with keratolysis. Management included B-KPro removal or exchange (n = 7), amniotic membrane transplantation (n = 1), tectonic corneal transplantation (n = 2), medical treatment (n = 4), and observation (n = 2). The risk of keratolysis following B-Kpro increases with the development of RPM and infectious keratitis. Patients with keratolysis had higher complication rates and should receive rigorous monitoring.

  15. The interplay between cognitive risk and resilience factors in remitted depression: A network analysis.

    Science.gov (United States)

    Hoorelbeke, Kristof; Marchetti, Igor; De Schryver, Maarten; Koster, Ernst H W

    2016-05-01

    Individuals in remission from depression are at increased risk for developing future depressive episodes. Several cognitive risk- and resilience factors have been suggested to account for this vulnerability. In the current study we explored how risk- and protective factors such as cognitive control, adaptive and maladaptive emotion regulation, residual symptomatology, and resilience relate to one another in a remitted depressed (RMD) sample. We examined the relationships between these constructs in a cross-sectional dataset of 69 RMD patients using network analyses in order to obtain a comprehensive, data-driven view on the interplay between these constructs. We subsequently present an association network, a concentration network, and a relative importance network. In all three networks resilience formed the central hub, connecting perceived cognitive control (i.e., working memory complaints), emotion regulation, and residual symptomatology. The contribution of the behavioral measure for cognitive control in the network was negligible. Moreover, the directed relative importance network indicates bidirectional influences between these constructs, with all indicators of centrality suggesting a key role of resilience in remission from depression. The presented findings are cross-sectional and networks are limited to a fixed set of key constructs in the literature pertaining cognitive vulnerability for depression. These findings indicate the importance of resilience to successfully cope with stressors following remission from depression. Further in-depth studies will be essential to identify the specific underlying resilience mechanisms that may be key to successful remission from depression. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Risk Factors in Derivatives Markets

    Directory of Open Access Journals (Sweden)

    Raimonda Martinkutė-Kaulienė

    2015-02-01

    Full Text Available The objective of the article is to analyse and present the classification of risks actual to derivative securities. The analysis is based on classical and modern literature findings and analysis of newest statistical data. The analysis led to the conclusion, that the main risks typical for derivatives contracts and their traders are market risk, liquidity risk, credit and counterparty risk, legal risk and transactions risk. Pricing risk and systemic risk is also quite important. The analysis showed that market risk is the most important kind of risk that in many situations influences the level of remaining risks.

  17. Meta-Analysis of Anxiety as a Risk Factor for Cardiovascular Disease.

    Science.gov (United States)

    Emdin, Connor A; Odutayo, Ayodele; Wong, Christopher X; Tran, Jenny; Hsiao, Allan J; Hunn, Benjamin H M

    2016-08-15

    Whether anxiety is a risk factor for a range of cardiovascular diseases is unclear. We aimed to determine the association between anxiety and a range of cardiovascular diseases. MEDLINE and EMBASE were searched for cohort studies that included participants with and without anxiety, including subjects with anxiety, worry, posttraumatic stress disorder, phobic anxiety, and panic disorder. We examined the association of anxiety with cardiovascular mortality, major cardiovascular events (defined as the composite of cardiovascular death, stroke, coronary heart disease, and heart failure), stroke, coronary heart disease, heart failure, and atrial fibrillation. We identified 46 cohort studies containing 2,017,276 participants and 222,253 subjects with anxiety. Anxiety was associated with a significantly elevated risk of cardiovascular mortality (relative risk [RR] 1.41, CI 1.13 to 1.76), coronary heart disease (RR 1.41, CI 1.23 to 1.61), stroke (RR 1.71, CI 1.18 to 2.50), and heart failure (RR 1.35, CI 1.11 to 1.64). Anxiety was not significantly associated with major cardiovascular events or atrial fibrillation although CIs were wide. Phobic anxiety was associated with a higher risk of coronary heart disease than other anxiety disorders, and posttraumatic stress disorder was associated with a higher risk of stroke. Results were broadly consistent in sensitivity analyses. Anxiety disorders are associated with an elevated risk of a range of different cardiovascular events, including stroke, coronary heart disease, heart failure, and cardiovascular death. Whether these associations are causal is unclear. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes.

    Science.gov (United States)

    Hamdan, Alhafidz; Barnes, Jonathan; Mitchell, Patrick

    2014-12-01

    The pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH) is unclear. Sex may play a role in the outcome of patients with aSAH. The authors retrospectively identified 617 patients with aSAH (April 2005 to February 2010) and analyzed sex differences in risk factors (age, hypertension, smoking, alcohol consumption, and family history), admission-related factors (World Federation of Neurosurgical Societies grade and admission delay), aneurysm characteristics (site, side, location, and multiplicity), and outcomes (treatment modalities [coiling/clipping/both/conservative], complications [vasospasm and hydrocephalus], length of stay, and modified Rankin Scale score at 3 months). The female patients with aSAH were older than the male patients (mean age 56.6 vs 51.9 years, respectively, p differences were noted. There were no sex differences in risk factors, admission-related factors, or outcome measures. For both sexes, outcomes varied according to aneurysm location, with odds ratios for a poor outcome of 1.62 (95% CI 0.91-2.86, p = 0.1) for middle cerebral artery, 2.41 (95% CI 1.29-4.51, p = 0.01) for ICA, and 2.41 (95% CI 1.29-4.51, p = 0.006) for posterior circulation aneurysms compared with those for anterior cerebral artery aneurysms. The odds ratio for poor outcome (modified Rankin Scale score of 4-6) in women compared with men after adjusting for significant prognostic factors was 0.71 (95% CI 0.45-1.11, p > 0.05). The overall outcomes after aSAH between women and men are similar.

  19. Information theoretical analysis of aging as a risk factor for heart disease.

    Science.gov (United States)

    Blokh, David; Stambler, Ilia

    2015-06-01

    We estimate the weight of various risk factors in heart disease, and the particular weight of age as a risk factor, individually and combined with other factors. To establish the weights we use the information theoretical measure of normalized mutual information that permits determining both individual and combined correlation of diagnostic parameters with the disease status. The present information theoretical methodology takes into account the non-linear correlations between the diagnostic parameters, as well as their non-linear changes with age. Thus it may be better suited to analyze complex biological aging systems than statistical measures that only estimate linear relations. We show that individual parameters, including age, often show little correlation with heart disease. Yet in combination, the correlation improves dramatically. For diagnostic parameters specific for heart disease the increase in the correlative capacity thanks to the combination of diagnostic parameters, is less pronounced than for the less specific parameters. Age shows the highest influence on the presence of disease among the non-specific parameters and the combination of age with other diagnostic parameters substantially improves the correlation with the disease status. Hence age is considered as a primary "metamarker" of aging-related heart disease, whose addition can improve diagnostic capabilities. In the future, this methodology may contribute to the development of a system of biomarkers for the assessment of biological/physiological age, its influence on disease status, and its modifications by therapeutic interventions.

  20. Cardiovascular Risk Factor Analysis in Patients with a Recent Clinical Fracture at the Fracture Liaison Service

    Directory of Open Access Journals (Sweden)

    Caroline E. Wyers

    2014-01-01

    Full Text Available Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD and venous thromboembolic events (VTE. The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT, and diabetes mellitus type 2 (DM2 in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS. Out of 3057 patients aged 50–90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs. Based on medical history, 29.9% had a history of CVD (13.7%, VTE (1.7%, HT (14.9%, and DM2 (7.1% or a combination. Their prevalence increased with age (21% in patients aged 50–59 years to 48% in patients aged >80 years and was higher in men than in women (36% versus 27%, but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.

  1. Spatial analysis of the distribution, risk factors and access to medical resources of patients with hepatitis B in Shenzhen, China.

    Science.gov (United States)

    Xi, Yuliang; Ren, Fu; Liang, Shi; Zhang, Jinghua; Lin, De-Nan

    2014-11-07

    Considering the high morbidity of hepatitis B in China, many epidemiological studies based on classic medical statistical analysis have been started but lack spatial information. However, spatial information such as the spatial distribution, autocorrelation and risk factors of the disease is of great help in studying patients with hepatitis B. This study examined 2851 cases of hepatitis B that were hospitalized in Shenzhen in 2010 and studied the spatial distribution, risk factors and spatial access to health services using spatial interpolation, Pearson correlation analysis and the improved two-step floating catchment area method. The results showed that the spatial distribution of hepatitis B, along with risk factors as well as spatial access to the regional medical resources, was uneven and mainly concentrated in the south and southwest of Shenzhen in 2010. In addition, the distribution characteristics of hepatitis B revealed a positive correlation between four types of service establishments and risk factors for the disease. The Pearson correlation coefficients are 0.566, 0.515, 0.626, 0.538 corresponding to bath centres, beauty salons, massage parlours and pedicure parlours (p < 0.05). Additionally, the allocation of medical resources for hepatitis B is adequate, as most patients could be treated at nearby hospitals.

  2. Spatial Analysis of the Distribution, Risk Factors and Access to Medical Resources of Patients with Hepatitis B in Shenzhen, China

    Directory of Open Access Journals (Sweden)

    Yuliang Xi

    2014-11-01

    Full Text Available Considering the high morbidity of hepatitis B in China, many epidemiological studies based on classic medical statistical analysis have been started but lack spatial information. However, spatial information such as the spatial distribution, autocorrelation and risk factors of the disease is of great help in studying patients with hepatitis B. This study examined 2851 cases of hepatitis B that were hospitalized in Shenzhen in 2010 and studied the spatial distribution, risk factors and spatial access to health services using spatial interpolation, Pearson correlation analysis and the improved two-step floating catchment area method. The results showed that the spatial distribution of hepatitis B, along with risk factors as well as spatial access to the regional medical resources, was uneven and mainly concentrated in the south and southwest of Shenzhen in 2010. In addition, the distribution characteristics of hepatitis B revealed a positive correlation between four types of service establishments and risk factors for the disease. The Pearson correlation coefficients are 0.566, 0.515, 0.626, 0.538 corresponding to bath centres, beauty salons, massage parlours and pedicure parlours (p < 0.05. Additionally, the allocation of medical resources for hepatitis B is adequate, as most patients could be treated at nearby hospitals.

  3. Prognostic Factors in Non-Small Cell Lung Cancer Less Than 3 Centimeters: Actuarial Analysis, Accumulative Incidence and Risk Groups.

    Science.gov (United States)

    Peñalver Cuesta, Juan C; Jordá Aragón, Carlos; Mancheño Franch, Nuria; Cerón Navarro, José A; de Aguiar Quevedo, Karol; Arrarás Martínez, Miguel; Vera Sempere, Francisco J; Padilla Alarcón, Jose D

    2015-09-01

    In TNM classification, factors determining the tumor (T) component in non-small cell lung cancer have scarcely changed over time and are still based solely on anatomical features. Our objective was to study the influence of these and other morphopathological factors on survival. A total of 263 patients undergoing lung resection due to stage I non-small cell lung cancer ≤3cm in diameter were studied. A survival analysis and competing-risk estimate study was made on the basis of clinical, surgical and pathological variables using actuarial analysis and accumulative incidence methods, respectively. A risk model was then generated from the results. Survival at 5 and 10 years was 79.8 and 74.3%, respectively. The best prognostic factors were presence of symptoms, smoking habit and FEV1>60%, number of resected nodes>7, squamous histology, absence of vascular invasion, absence of visceral pleural invasion and presence of invasion more proximal than the lobar bronchus. All these were statistically significant according to the actuarial method. The factor "age60%. Pleural invasion and vascular invasion determine survival or risk of death due to non-small cell lung cancer ≤3cm and can be used for generating a predictive risk model. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  4. Frequency and risk factors for thrombosis in idiopathic myelofibrosis: analysis in a series of 155 patients from a single institution.

    Science.gov (United States)

    Cervantes, F; Alvarez-Larrán, A; Arellano-Rodrigo, E; Granell, M; Domingo, A; Montserrat, E

    2006-01-01

    Thrombosis is a frequent complication of polycythemia vera and essential thrombocythemia, but its incidence and predisposing factors in idiopathic myelofibrosis (IM) are unknown. In 18 (11.6%) of 155 patients diagnosed with IM in a single institution, 31 thrombotic events (19 arterial, 12 venous) were registered after a mean follow-up of 4.2 (s.d.: 4.5) years. In six patients, the thrombosis was simultaneous to or appeared a few months before IM diagnosis and 14 had one or more thrombotic episodes. When compared with the general population, a significant increase was observed in the incidence of venous thrombosis (odds ratio 17.5, 95% confidence interval: 10.3-31.4). At multivariate analysis, the initial variables associated with an increased risk of thrombosis were thrombocytosis (platelets >450 x 10(9)/l, P=0.001), presence of one cardiovascular risk factor (arterial hypertension, smoking, hypercholesterolemia, or diabetes, P=0.003), cellular phase of myelofibrosis (P=0.005), and Hb >11 g/dl (P=0.02). Considering post-diagnosis events, the 5-year thrombosis-free survival probability was 90.4% in the series, 80.6% for patients with platelets >450 x 10(9)/l, 82.6% for patients with one cardiovascular risk factor, and 85.1% for those in cellular phase. These results indicate an increased thrombotic risk for IM patients with hyperproliferative features and/or coexistent cardiovascular risk factors.

  5. Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.

    Directory of Open Access Journals (Sweden)

    Jochen Schneider

    Full Text Available Bacterial colonization of biliary stents is one of the driving forces behind sludge formation which may result in stent occlusion. Major focus of the study was to analyze the spectrum and number of microorganisms in relation to the indwelling time of stents and the risk factors for sludge formation. 343 stents were sonicated to optimize the bacterial release from the biofilm and identified by matrix-associated laser desorption/ionization-time of flight mass spectrometer (MALDI-TOF. 2283 bacteria were analyzed in total. The most prevalent microorganisms were Enterococcus species (spp. (504;22%, followed by Klebsiella spp. (218;10% and Candida spp. (188;8%. Colonization of the stents mainly began with aerobic gram-positive bacteria (43/49;88% and Candida spp. (25/49;51%, whereas stents with an indwelling time>60 days(d showed an almost equal colonization rate by aerobic gram-negative (176/184;96% and aerobic gram-positive bacteria (183/184;99% and a high proportion of anaerobes (127/184;69%. Compared to stents without sludge, more Clostridium spp. [(P = 0.02; Odds Ratio (OR: 2.4; 95% confidence interval (95%CI: (1.1-4.9] and Staphylococcus spp. [(P = 0.03; OR (95%CI: 4.3 (1.1-16.5] were cultured from stents with sludge. Multivariate analysis revealed a significant relationship between the number of microorganisms [P<0.01; OR (95%CI: 1.3(1.1-1.5], the indwelling time [P<0.01; 1-15 d vs. 20-59 d: OR (95%CI: 5.6(1.4-22, 1-15 d vs. 60-3087 d: OR (95% CI: 9.5(2.5-35.7], the presence of sideholes [P<0.01; OR (95%CI: 3.5(1.6-7.9] and the occurrence of sludge. Stent occlusion was found in 70/343(20% stents. In 35% of cases, stent occlusion resulted in a cholangitis or cholestasis. In conclusion, microbial colonization of the stents changed with the indwelling time. Sludge was associated with an altered spectrum and an increasing number of microorganisms, a long indwelling time and the presence of sideholes. Interestingly, stent occlusion did not

  6. Risk Factors Associated with Irreversible Airway Obstruction in Asthma: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Lanlan Zhang

    2016-01-01

    Full Text Available Irreversible airway obstruction (IAO is a subtype of asthma and relates to poorer prognosis in some asthma patients. However, the prevalence and risk factors for IAO are unknown. A systematic review regarding controlled clinical studies (cohort, case-control studies on IAO asthma in adult and/or children affected by asthma/early wheeze was performed. Eighteen papers were identified in this study. It was reported that the incidence of IAO at random effects or fixed effects in severe asthma and nonsevere asthma was 0.54 (95% CI: 0.45–0.62 and 0.16 (95% CI: 0.12–0.20, respectively. In IAO asthma, the pooled odds ratio (OR related to smoking exposure was 2.22 (95% CI: 1.82–2.73, the OR for male, smoking, and fractional exhaled nitric oxide (FENO was 2.22 (95% CI: 1.82–2.7, 1.79 (95% CI: 1.46–2.19, and 2.16 (95% CI: 1.05–4.43, respectively, suggesting these factors increase the risk of IAO. However, a decreased OR in IAO asthma was observed due to rhinitis (OR = 0.31, 95% CI: 0.24–0.40, atopy (OR = 0.584, 95% CI: 0.466–0.732, and atopic dermatitis (OR = 0.60, 95% CI: 0.42–0.85, indicating these factors are associated with reduced risk of IAO. IAO in asthma is associated with gender, smoking, FENO, rhinitis, atopy, and atopic dermatitis.

  7. [Analysis of main risk factors causing foodborne diseases in food catering business].

    Science.gov (United States)

    Fan, Yong-xiang; Liu, Xiu-mei; Bao, Yi-dan

    2011-06-01

    To study main risk factors that cause foodborne diseases in food catering business. Data from references and investigations conducted in food catering units were used to establish models which based on @Risk 4.5 with Monte Carlo method referring to food handling practice model (FHPM) to make risk assessment on factors of food contamination in food catering units. The Beta-Poisson models on dose-response relationship to Salmonella (developed by WHO/FAO and United States Department of Agriculture) and Vibrio parahaemolyticus (developed by US FDA) were used in this article to analyze the dose-response relationship of pathogens. The average probability of food poisoning by consuming Salmonella contaminated cooked meat under refrigeration was 1.96 × 10(-4) which was 1/2800 of the food under non-refrigeration (the average probability of food poisoning was 0.35 at room temperature 25°C). The average probability by consuming 6 hours stored meat under room temperature was 0.11 which was 16 times of 2 hours storage (6.79 × 10(-3)). The average probability by consuming contaminated meat without fully cooking was 1.71 × 10(-4) which was 100 times of consuming fully cooked meat (1.88 × 10(-6)). The probability growth of food poisoning by consuming Vibrio parahaemolyticus contaminated fresh seafood was proportional with contamination level and prevalence. The primary contamination level, storage temperature and time, cooking process and cross contamination are important factors of catering food safety.

  8. Seroprevalence of HBV, HCV & HIV co-infection and risk factors analysis in Tripoli-Libya.

    Directory of Open Access Journals (Sweden)

    Mohamed A Daw

    Full Text Available BACKGROUND: In 1998 Libya experienced a major outbreak of multiple blood borne viral hepatitis and HIV infections. Since then, no studies have been done on the epidemic features and risk factors of HBV, HCV, HIV and co-infection among the general population. METHODS: A prospective study was carried out using a multi-centre clustering method to collect samples from the general population. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. This information was correlated with the risk factors involved in the transmission of HBV, HCV and HIV. Blood samples were collected and the sera were tested for HBsAg, anti-HCV and anti-HIV using enzyme immunoassay. RESULTS: A total of 9,170 participants from the nine districts of Tripoli were enrolled. The average prevalence of HBsAg was 3.7%, anti-HCV 0.9%, anti-HIV 0.15% and co-infection 0.02%. The prevalence varied from one district to another. HBV was more prevalent among those aged over 50 years and was associated with family history. Anti-HCV and anti-HIV were more prevalent among those aged 20-40 years. Intravenous drug use and blood transfusion were the main risk factors for HCV and HIV infection. CONCLUSION: HBV, HCV, HIV and co-infection are relatively common in Libya. High prevalence was associated with geographic, ethnic and socioeconomic variability within the community. HCV and HIV infections among the younger age groups are becoming an alarming issue. Regulations and health care education need to be implemented and longer term follow-up should be planned.

  9. Analysis of risk factors and clinical manifestations associated with Clostridium difficile disease in Serbian hospitalized patients

    Directory of Open Access Journals (Sweden)

    Stojanović Predrag

    Full Text Available Abstract Clostridium difficile is the leading cause of infectious diarrhoea in hospitalized patients. The aim of this study was to determine the risk factors important for the development of hospital-acquired Clostridium difficile-associated disease and clinical manifestations of Clostridium difficile-associated disease. The clinical trial group included 37 hospitalized patients who were selected according to the inclusion criteria. A control group of 74 hospitalized patients was individually matched with cases based on hospital, age (within 4 years, sex and month of admission.Clostridium difficile-associated disease most commonly manifested as diarrhoea (56.76% and colitis (32%, while in 8.11% of patients, it was diagnosed as pseudomembranous colitis, and in one patient, it was diagnosed as fulminant colitis. Statistically significant associations (p < 0.05 were found with the presence of chronic renal failure, chronic obstructive pulmonary disease, cerebrovascular accident (stroke and haemodialysis. In this study, it was confirmed that all the groups of antibiotics, except for tetracycline and trimethoprim-sulfamethoxazole, were statistically significant risk factors for Clostridium difficile-associated disease (p < 0.05. However, it was difficult to determine the individual role of antibiotics in the development of Clostridium difficile-associated disease. Univariate logistic regression also found that applying antibiotic therapy, the duration of antibiotic therapy, administration of two or more antibiotics to treat infections, administering laxatives and the total number of days spent in the hospital significantly affected the onset of Clostridium difficile-associated disease (p < 0.05, and associations were confirmed using the multivariate model for the application of antibiotic therapy (p = 0.001, duration of antibiotic treatment (p = 0.01, use of laxatives (p = 0.01 and total number of days spent in the hospital (p = 0.001. In this study

  10. Seroprevalence of HBV, HCV & HIV co-infection and risk factors analysis in Tripoli-Libya.

    Science.gov (United States)

    Daw, Mohamed A; Shabash, Amira; El-Bouzedi, Abdallah; Dau, Aghnya A

    2014-01-01

    In 1998 Libya experienced a major outbreak of multiple blood borne viral hepatitis and HIV infections. Since then, no studies have been done on the epidemic features and risk factors of HBV, HCV, HIV and co-infection among the general population. A prospective study was carried out using a multi-centre clustering method to collect samples from the general population. The participants were interviewed, and relevant information was collected, including socio-demographic, ethnic, and geographic variables. This information was correlated with the risk factors involved in the transmission of HBV, HCV and HIV. Blood samples were collected and the sera were tested for HBsAg, anti-HCV and anti-HIV using enzyme immunoassay. A total of 9,170 participants from the nine districts of Tripoli were enrolled. The average prevalence of HBsAg was 3.7%, anti-HCV 0.9%, anti-HIV 0.15% and co-infection 0.02%. The prevalence varied from one district to another. HBV was more prevalent among those aged over 50 years and was associated with family history. Anti-HCV and anti-HIV were more prevalent among those aged 20-40 years. Intravenous drug use and blood transfusion were the main risk factors for HCV and HIV infection. HBV, HCV, HIV and co-infection are relatively common in Libya. High prevalence was associated with geographic, ethnic and socioeconomic variability within the community. HCV and HIV infections among the younger age groups are becoming an alarming issue. Regulations and health care education need to be implemented and longer term follow-up should be planned.

  11. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark

    DEFF Research Database (Denmark)

    Schreiber Pedersen, Louise; Lose, Gunnar; Høybye, Mette Terp

    2017-01-01

    the prevalence of UI and associated risk factors in Germany and Denmark by using the same methodology, definition and population MATERIAL AND METHODS: Postal survey conducted in two regions Germany and Denmark, including 8000 women aged 18+ years. UI was defined as any complaint of involuntary loss of urine......INTRODUCTION: Urinary incontinence (UI) is a prevalent condition that interferes with women's health-related quality of life. Prevalence rates from earlier studies are wide-ranging, due to heterogeneity in methodology, definition of UI and the populations included. We aimed to determine...

  12. Risk factor analysis for involvement of resection margins in gastric and esophagogastric junction cancer: an Italian multicenter study.

    Science.gov (United States)

    Bissolati, Massimiliano; Desio, Matteo; Rosa, Fausto; Rausei, Stefano; Marrelli, Daniele; Baiocchi, Gian Luca; De Manzoni, Giovanni; Chiari, Damiano; Guarneri, Giovanni; Pacelli, Fabio; De Franco, Lorenzo; Molfino, Sarah; Cipollari, Chiara; Orsenigo, Elena

    2017-01-01

    Resection margin (RM) involvement is associated with negative prognosis after gastrectomy. Intraoperative frozen section (IFS) analysis allows radical resection to be achieved in a single operation but is time-consuming and resource-consuming. The aim of this study was to assess risk factors associated with RM involvement to identify patients who would benefit from IFS analysis. We retrospectively analyzed patients who underwent gastrectomy with curative intent for gastric or esophagogastric junction (EGJ) cancer from 2000 to 2014 in six Italian hospitals. RM status was assessed by IFS analysis and/or definitive histopathology examination. A set of 21 potential risk factors were compared in a multivariate analysis between patients with positive RMs on IFS analysis or definitive histopathology examination and a control cohort of similar patients with negative RMs, with the samples stratified into three subgroups (T1, T2-T4 Lauren intestinal pattern, T2-T4 Lauren diffuse/mixed pattern). One hundred forty-five patients had positive RMs. Survival was significantly worse in positive RM patients than in negative RM patients (89.5 months vs 28.9 months). Multivariate analysis showed that in T1 cancers a margin distance of less than 2 cm is a risk factor for RM involvement (odds ratio 15.7), in T2-T4 intestinal pattern cancers, serosa invasion (odds ratio 6.0), EGJ location (odds ratio 4.1), and a margin distance of less than 3 cm (odds ratio 4.0) are independent risk factors, and in T2-T4 diffuse/mixed pattern cancers, lymphatic infiltration (odds ratio 4.2), tumor diameter greater than 4 cm (odds ratio 3.5), EGJ location (odds ratio 2.8), and serosa invasion (odds ratio 2.2) are independent risk factors. Survival after gastrectomy is negatively affected by positive RMs. IFS analysis should be routinely used in patients with a high risk of positive RMs, especially in diffuse pattern cancers.

  13. Post-hepatectomy Refractory Ascites in Cirrhotic Patients with Hepatocellular Carcinoma: Risk Factor Analysis to Overcome this Problematic Complication.

    Science.gov (United States)

    Itoh, Shinji; Uchiyama, Hideaki; Ikeda, Yasuharu; Morita, Kazutoyo; Harada, Noboru; Sugimachi, Keishi; Kawanaka, Hirofumi; Korenaga, Daisuke; Yoshizumi, Tomoharu; Takenaka, Kenji; Maehara, Yoshihiko

    2017-03-01

    Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy. The data of 73 cirrhotic patients with HCC who underwent limited or small hepatectomy were analyzed. Limited or small hepatectomy was defined as hepatectomy equal to or of less than subsegmentectomy. We compared the clinicopathological factors between patients with and without postoperative refractory ascites. Fourteen cirrhotic patients suffered postoperative refractory ascites. Total cholesterol, duration of operation, duration of Pringle maneuver, resection of segment VII, intraoperative blood loss, and intraoperative blood transfusion were found to be significant risk factors for postoperative refractory ascites in univariate analyses. Multivariate analysis revealed that resection of segment VII was an independent risk factor. Resection of segment VII necessitates extensive dissection of the right triangular or coronary ligaments, which could explain that it was an independent risk factor for post-hepatectomy refractory ascites. Surgeons should avoid extensive dissection of these ligaments in order to avoid this detrimental complication. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  14. A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population.

    Science.gov (United States)

    Li, Ye; Fang, Xiang; Zhao, Wei-Gang; Chen, Yan; Hu, Shi-Lian

    2017-09-22

    BACKGROUND This study analyzed the risk factors of cognitive impairment (CI) in elderly patients with chronic diseases. MATERIAL AND METHODS In total of 385 elderly patients with chronic diseases were selected and assigned into CI and normal groups. The activities of daily living (ADL), global deterioration scale (GDS), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), patient-generated subjective global assessment (PG-SGA), and mini nutritional assessment (MNA) were performed to analyze the differences between the 2 groups. Logistic regression analysis was conducted for risk factors of CI in elderly patients with chronic diseases. RESULTS There were differences in age, education level, type 2 diabetes mellitus, multifocal cerebral infarction, hearing, and eyesight between CI and normal groups. Patients in the CI group showed more CD4+ cells, more admission times, and higher GDS scores than the normal group. Also, MMSE and MoCA scores revealed differences in total score, directive force, attention and calculating ability, language, delayed memory, reading comprehension, writing, and visual-spatial ability between the 2 groups. The number of B and CD8+ cells, ADL, and MNA scores were protective factors, while cerebral infarction history, number of CD4+ cells, admission times, GDS score, and age were risk factors of CI in elderly patients with chronic diseases. CONCLUSIONS Our study provides evidence that cerebral infarction history, number of CD4+ cells, admission times, GDS score, and age are risk factors of CI in elderly patients with chronic diseases.

  15. Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah, Iran: A Latent Class Analysis.

    Science.gov (United States)

    Sharifi, Hamid; Mirzazadeh, Ali; Noroozi, Alireza; Marshall, Brandon D L; Farhoudian, Ali; Higgs, Peter; Vameghi, Meroe; Mohhamadi Shahboulaghi, Farahnaz; Qorbani, Mostafa; Massah, Omid; Armoon, Bahram; Noroozi, Mehdi

    2017-01-01

    The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk profiles and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44-8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2-0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.

  16. Medial Tibial Stress Syndrome in Active Individuals: A Systematic Review and Meta-analysis of Risk Factors.

    Science.gov (United States)

    Reinking, Mark F; Austin, Tricia M; Richter, Randy R; Krieger, Mary M

    Medial tibial stress syndrome (MTSS) is a common condition in active individuals and presents as diffuse pain along the posteromedial border of the tibia. To use cross-sectional, case-control, and cohort studies to identify significant MTSS risk factors. Bibliographic databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE, EBM Reviews, PEDRo), grey literature, electronic search of full text of journals, manual review of reference lists, and automatically executed PubMed MTSS searches were utilized. All searches were conducted between 2011 and 2015. Inclusion criteria were determined a priori and included original research with participants' pain diffuse, located in the posterior medial tibial region, and activity related. Systematic review with meta-analysis. Level 4. Titles and abstracts were reviewed to eliminate citations that did not meet the criteria for inclusion. Study characteristics identified a priori were extracted for data analysis. Statistical heterogeneity was examined using the I2 index and Cochran Q test, and a random-effects model was used to calculate the meta-analysis when 2 or more studies examined a risk factor. Two authors independently assessed study quality. Eighty-three articles met the inclusion criteria, and 22 articles included risk factor data. Of the 27 risk factors that were in 2 or more studies, 5 risk factors showed a significant pooled effect and low statistical heterogeneity, including female sex (odds ratio [OR], 2.35; CI, 1.58-3.50), increased weight (standardized mean difference [SMD], 0.24; CI, 0.03-0.45), higher navicular drop (SMD, 0.44; CI, 0.21-0.67), previous running injury (OR, 2.18; CI, 1.00-4.72), and greater hip external rotation with the hip in flexion (SMD, 0.44; CI, 0.23-0.65). The remaining risk factors had a nonsignificant pooled effect or significant pooled effect with high statistical heterogeneity. Female sex, increased weight, higher navicular drop, previous running injury, and greater hip external rotation

  17. Analysis of Predictive Values Based on Individual Risk Factors in Multi-Modality Trials

    Directory of Open Access Journals (Sweden)

    Katharina Lange

    2013-03-01

    Full Text Available The accuracy of diagnostic tests with binary end-points is most frequently measured by sensitivity and specificity. However, from the clinical perspective, the main purpose of a diagnostic agent is to assess the probability of a patient actually being diseased and hence predictive values are more suitable here. As predictive values depend on the pre-test probability of disease, we provide a method to take risk factors influencing the patient’s prior probability of disease into account, when calculating predictive values. Furthermore, approaches to assess confidence intervals and a methodology to compare predictive values by statistical tests are presented. Hereby the methods can be used to analyze predictive values of factorial diagnostic trials, such as multi-modality, multi-reader-trials. We further performed a simulation study assessing length and coverage probability for different types of confidence intervals, and we present the R-Package facROC that can be used to analyze predictive values in factorial diagnostic trials in particular. The methods are applied to a study evaluating CT-angiography as a noninvasive alternative to coronary angiography for diagnosing coronary artery disease. Hereby the patients’ symptoms are considered as risk factors influencing the respective predictive values.

  18. A retrospective analysis of the risk factors for allergic reactions induced by the administration of oxaliplatin.

    Science.gov (United States)

    Yamauchi, H; Goto, T; Takayoshi, K; Sagara, K; Uoi, M; Kawanabe, C; Matsunaga, M; Miyoshi, T; Uchino, K; Misumi, N; Nishino, T

    2015-01-01

    This study retrospectively investigated the clinical features and risk factors of allergic reactions induced by oxaliplatin administration. This study investigated the incidence of allergic reactions and analysed the background and laboratory data in patients with colorectal cancer treated with oxaliplatin-based chemotherapy at Kyushu Medical Center between April 2012 and September 2012. A total of 62 patients were included in this study. The number of patients in the allergic and non-allergic groups was 7 and 55 respectively. The incidence of allergic reactions was 11.3%. We compared the patients' characteristics and laboratory data between the two groups and found that the average dose of dexamethasone in the allergic group was significantly lower than that observed in the non-allergic group (P = 0.0111). Furthermore, the incidence of allergic reactions in the group that received prophylaxis of less than 12 mg of dexamethasone was significantly higher than that observed in the group that received more than 12 mg of dexamethasone (P = 0.0103). In conclusion, a lower dexamethasone dose is a possible risk factor for allergic reactions induced by the administration of oxaliplatin; however, given the retrospective design used in this study, further validation of this finding is warranted. © 2013 John Wiley & Sons Ltd.

  19. Impact of Interstitial Pneumonia on the Survival and Risk Factors Analysis of Patients with Hematological Malignancy

    Directory of Open Access Journals (Sweden)

    Wei-Liang Chen

    2013-01-01

    Full Text Available Background. The emergence of interstitial pneumonia (IP in patients with hematological malignancy (HM is becoming a challenging scenario in current practice. However, detailed characterization and investigation of outcomes and risk factors on survival have not been addressed. Methods. We conducted a retrospective study of 42,584 cancer patients covering the period between 1996 and 2008 using the institutional cancer registry system. Among 816 HM patients, 61 patients with IP were recognized. The clinical features, laboratory results, and histological types were studied to determine the impact of IP on survival and identify the profile of prognostic factors. Results. HM patients with IP showed a significant worse survival than those without IP in the 5-year overall survival (P=0.027. The overall survival showed no significant difference between infectious pneumonia and noninfectious interstitial pneumonia (IIP versus nIIP (P=0.323. In a multivariate Cox regression model, leukocyte and platelet count were associated with increased risk of death. Conclusions. The occurrence of IP in HM patients is associated with increased mortality. Of interest, nIIP is a prognostic indicator in patients with lymphoma but not in patients with leukemia. However, aggressive management of IP in patients with HM is strongly advised, and further prospective survey is warranted.

  20. Analysis on the risk factors of second fracture in osteoporosis-related fractures.

    Science.gov (United States)

    Ruan, Wen-Dong; Wang, Pei; Ma, Xin-Long; Ge, Rui-Ping; Zhou, Xian-Hu

    2011-04-01

    To explore the clinical characteristics and risk factors of refracture in patients suffering from osteoporosis-related fractures as well as effective interventions. From January 2006 to January 2008, both out-patients and in-patients in our hospital who were over 50 years old and suffered from osteoporosis-related fractures were selected for this research. They were divided into fracture group and refracture group. The refracture rate was followed up for 2 years, during which 11 patients developed refracture, thus were included in the refracture group. Therefore, 273 patients, 225 first-fracture cases, aged (67.7+/-8.5) years, and 48 refracture cases, aged (72.7+/-9.5) years, were included in this study. General data including age and sex, fracture types, femoral neck bone mineral density (BMD) T-scores tested by dual-energy X-rays absorptiometry (DEXA), Charlson index, time-frame between two fractures as well as mobility skill assessment were collected and analyzed by single-factor and multivariate statistical methods. Females accounted for 70.2% of the fracture group and 77.1% of the refracture group. The most common refracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the follow-up. The second fracture happened 3.7 years after the first one on average. The refracture rate was 2.12% within one year, and 4.66% within two years. Risk factors for a second fracture in osteoporotic fracture patients included age (larger than 75 years, HR equal to 1.23, 95%CI 1.18-1.29; larger than 85 years, HR equal to 1.68, 95% CI 1.60-1.76), female sex (HR equal to 1.36, 95%CI 1.32-1.40), prior vertebral fractures (HR equal to 1.62, 95%CI 1.01-2.07), prior hip fractures (HR equal to 1.27, 95%CI 0.89-2.42), BMD T-score less than -3.5 (HR equal to 1.38, 95%CI 1.17-1.72) and weakened motor skills (HR equal to 1.27, 95%CI 1.09-1.40). The risks of second fracture among patients with initial brittle fracture are substantial. There

  1. Suicide risk and psychopathology in immigrants: a multi-group confirmatory factor analysis.

    Science.gov (United States)

    Iliceto, Paolo; Pompili, Maurizio; Candilera, Gabriella; Borges, Guilherme; Lamis, Dorian A; Serafini, Gianluca; Girardi, Paolo

    2013-07-01

    Immigrants may experience several negative consequences as a result of their migration including discrimination, unsatisfactory economic conditions, and rejection from the host countries, which may contribute to psychiatric illness and vulnerability to suicidal behaviors. The purpose of the current study was to determine whether or not the theorized components of measured dimensions of suicide risk and psychopathology vary across samples of Italians and immigrants. We investigated 237 Italians and 234 immigrants, who were administered self-report questionnaires to assess temperament (TEMPS-A), hopelessness (BHS), personality (EPQ-R), and self-other perception (9AP). Multi-group confirmatory factor analyses were conducted, which yielded a final model with an excellent fit to the data (χ (53) (2)  = 57.56; CFI = 0.994; RMSEA = 0.014). This final model fits significantly better than the previously tested models and indicated that the same pattern of relationships was found between suicide risk and psychopathology across both groups. Although immigrants represent a unique population and may experience specific stressors contributing to psychopathology and suicide risk, our findings suggest that the samples of Italians and immigrants may be more similar on the study variables under investigation than previously thought. Implications are offered for the improved identification and treatment of immigrants and resident citizens in Europe in general and in Italy in particular.

  2. Analysis of risk factors for rebleeding after splenectomy and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis

    Directory of Open Access Journals (Sweden)

    ZHANG Lei

    2015-03-01

    Full Text Available ObjectiveTo investigate the possible risk factors for rebleeding after splenectomy and pericardial devascularization in the treatment of portal hypertension due to liver cirrhosis, and to provide a certain basis for reducing the incidence of digestive tract re-hemorrhage for these patients. MethodsA retrospective analysis was performed on 238 cirrhotic patients with portal hypertension who underwent splenectomy and pericardial devascularization in the First Hospital of Lanzhou University from December 2003 to December 2013. These patients were divided into postoperative rebleeding group (n=32 and non-bleeding group (n=206. Univariate analysis (t test or chi-square test and multivariate logistic regression analysis were performed to investigate the risk factors for rebleeding after splenectomy and pericardial devascularization. ResultsOf the 32 patients with postoperative rebleeding, 17 had esophagogastric variceal bleeding, 11 had bleeding due to portal hypertensive gastropathy, and 4 had stress ulcer bleeding. The univariate analysis showed that there were significant differences between the two groups in the following factors: Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, pathological changes of the gastric mucosa, platelet count, prothrombin time (PT, activated partial thromboplastin time (APTT, and presence of diabetes (all P<0.05. The multivariate logistic regression analysis suggested that the significant independent influential factors for postoperative rebleeding were presence of diabetes, Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, diffuse lesion of the gastric mucosa, PT, and APTT. ConclusionFor cirrhotic patients with portal hypertension, the appropriate methods for managing these risk factors are of great clinical significance for preventing rebleeding after splenectomy and pericardial devascularization.

  3. Analysis of ulnar variance as a risk factor for developing scaphoid nonunion.

    Science.gov (United States)

    Lirola-Palmero, S; Salvà-Coll, G; Terrades-Cladera, F J

    2015-01-01

    Ulnar variance may be a risk factor of developing scaphoid non-union. A review was made of the posteroanterior wrist radiographs of 95 patients who were diagnosed of scaphoid fracture. All fractures with displacement less than 1mm treated conservatively were included. The ulnar variance was measured in all patients. Ulnar variance was measured in standard posteroanterior wrist radiographs of 95 patients. Eighteen patients (19%) developed scaphoid nonunion, with a mean value of ulnar variance of -1.34 (-/+ 0.85) mm (CI -2.25 - 0.41). Seventy seven patients (81%) healed correctly, and the mean value of ulnar variance was -0.04 (-/+ 1.85) mm (CI -0.46 - 0.38). A significant difference was observed in the distribution of ulnar variance (p<.05). These results remained significant after adjusting for age, with an OR of 0.69 (CI 0.49 to 0.95). The patients were categorized into two groups: ulnar variance less than -1mm, and ulnar variance greater than -1mm. It appears that patients with ulnar variance less than -1mm had an OR 4.58 (CI 1.51 to 13.89) with p<.007. Desai et al. concluded that radiological features of acute scaphoid fractures cannot be used to predict the likelihood of fracture union. For this reason, the existence of other risk factors was analysed. According to the results of the present study, it can be concluded that patients with scaphoid fracture and ulnar variance less than -1mm have a greater risk of developing scaphoid nonunion, OR 4.58 (CI 1.51 to 13.89) with p<.007. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Hypertension and diabetes as risk factors for dementia: A secondary post-hoc analysis from north-west India.

    Science.gov (United States)

    Raina, Sunil Kumar; Chander, Vishav; Raina, Sujeet; Kumar, Dinesh; Grover, Ashoo; Bhardwaj, Ashok

    2015-01-01

    A relation between midlife risk factors (hypertension and diabetes) and dementia has been studied in past and an association has been documented, in spite of some studies pointing to the contrary. The study was based on post-hoc analysis of data obtained from a study conducted on an elderly population (60 years and above) from selected geographical areas (migrant, urban, rural and tribal) of the Himachal Pradesh state in North-West India. Analysis of variance revealed an effect of risk factors on cognitive scores; however, post hoc Tukey's honest significant difference (HSD) test revealed that only hypertensives' demonstrated higher chances of scoring lower on cognitive measures. The possibility that hypertension and diabetes affect dementia needs further evaluation, more so in Indian context.

  5. [Systemic candidiasis in medical intensive care unit: analysis of risk factors and the contribution of colonization index].

    Science.gov (United States)

    Massou, S; Ahid, S; Azendour, H; Bensghir, M; Mounir, K; Iken, M; Lmimouni, B E; Balkhi, H; Drissi Kamili, N; Haimeur, C

    2013-06-01

    Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care. Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CIcandidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively. CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis.

    Science.gov (United States)

    Neal, Bradley S; Griffiths, Ian B; Dowling, Geoffrey J; Murley, George S; Munteanu, Shannon E; Franettovich Smith, Melinda M; Collins, Natalie J; Barton, Christian J

    2014-01-01

    Static measures of foot posture are regularly used as part of a clinical examination to determine the need for foot level interventions. This is based on the premise that pronated and supinated foot postures may be risk factors for or associated with lower limb injury. This systematic review and meta-analysis investigates foot posture (measured statically) as a potential risk factor for lower limb overuse injuries. A systematic search was performed using Medline, CINAHL, Embase, SportDiscus in April 2014, to identify prospective cohort studies that investigated foot posture and function as a risk factor for lower limb overuse injury. Eligible studies were classified based on the method of foot assessment: (i) static foot posture assessment; and/or (ii) dynamic foot function assessment. This review presents studies evaluating static foot posture. The methodological quality of included studies was evaluated by two independent reviewers, using an adapted version of the Epidemiological Appraisal Instrument (EAI). Where possible, effects were expressed as standardised mean differences (SMD) for continuous scaled data, and risk ratios (RR) for nominal scaled data. Meta-analysis was performed where injuries and outcomes were considered homogenous. Twenty-one studies were included (total n = 6,228; EAI 0.8 to 1.7 out of 2.0). There was strong evidence that a pronated foot posture was a risk factor for medial tibial stress syndrome (MTSS) development and very limited evidence that a pronated foot posture was a risk factor for patellofemoral pain development, although associated effect sizes were small (0.28 to 0.33). No relationship was identified between a pronated foot posture and any other evaluated pathology (i.e. foot/ankle injury, bone stress reactions and non-specific lower limb overuse injury). This systematic review identified strong and very limited evidence of small effect that a pronated foot posture is a risk factor for MTSS and patellofemoral pain respectively

  7. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Newman P

    2013-11-01

    Full Text Available Phil Newman, Jeremy Witchalls, Gordon Waddington, Roger Adams Faculty of Health, Physiotherapy, University of Canberra, Bruce, ACT, Australia Background: Medial tibial stress syndrome (MTSS affects 5%–35% of runners. Research over the last 40 years investigating a range of interventions has not established any clearly effective management for MTSS that is better than prolonged rest. At the present time, understanding of the risk factors and potential causative factors for MTSS is inconclusive. The purpose of this review is to evaluate studies that have investigated various risk factors and their association with the development of MTSS in runners. Methods: Medical research databases were searched for relevant literature, using the terms “MTSS AND prevention OR risk OR prediction OR incidence”. Results: A systematic review of the literature identified ten papers suitable for inclusion in a meta-analysis. Measures with sufficient data for meta-analysis included dichotomous and continuous variables of body mass index (BMI, ankle dorsiflexion range of motion, navicular drop, orthotic use, foot type, previous history of MTSS, female gender, hip range of motion, and years of running experience. The following factors were found to have a statistically significant association with MTSS: increased hip external rotation in males (standard mean difference [SMD] 0.67, 95% confidence interval [CI] 0.29–1.04, P10 mm (RR 1.99, 95% CI 1.00–3.96, P=0.05. Conclusion: Female gender, previous history of MTSS, fewer years of running experience, orthotic use, increased body mass index, increased navicular drop, and increased external rotation hip range of motion in males are all significantly associated with an increased risk of developing MTSS. Future studies should analyze males and females separately because risk factors vary by gender. A continuum model of the development of MTSS that links the identified risk factors and known processes is proposed

  8. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Flenady, Vicki; Koopmans, Laura; Middleton, Philippa; Frøen, J Frederik; Smith, Gordon C; Gibbons, Kristen; Coory, Michael; Gordon, Adrienne; Ellwood, David; McIntyre, Harold David; Fretts, Ruth; Ezzati, Majid

    2011-04-16

    Stillbirth rates in high-income countries have shown little or no improvement over the past two decades. Prevention strategies that target risk factors could be important in rate reduction. This systematic review and meta-analysis was done to identify priority areas for stillbirth prevention relevant to those countries. Population-based studies addressing risk factors for stillbirth were identified through database searches. The factors most frequently reported were identified and selected according to whether they could potentially be reduced through lifestyle or medical intervention. The numbers attributable to modifiable risk factors were calculated from data relating to the five high-income countries with the highest numbers of stillbirths and where all the data required for analysis were available. Odds ratios were calculated for selected risk factors, from which population-attributable risk (PAR) values were calculated. Of 6963 studies initially identified, 96 population-based studies were included. Maternal overweight and obesity (body-mass index >25 kg/m(2)) was the highest ranking modifiable risk factor, with PARs of 8-18% across the five countries and contributing to around 8000 stillbirths (≥22 weeks' gestation) annually across all high-income countries. Advanced maternal age (>35 years) and maternal smoking yielded PARs of 7-11% and 4-7%, respectively, and each year contribute to more than 4200 and 2800 stillbirths, respectively, across all high-income countries. In disadvantaged populations maternal smoking could contribute to 20% of stillbirths. Primiparity contributes to around 15% of stillbirths. Of the pregnancy disorders, small size for gestational age and abruption are the highest PARs (23% and 15%, respectively), which highlights the notable role of placental pathology in stillbirth. Pre-existing diabetes and hypertension remain important contributors to stillbirth in such countries. The raising of awareness and implementation of effective

  9. Risk Factors for Open Malleolar Fractures: An Analysis of the National Trauma Data Bank (2007 to 2011).

    Science.gov (United States)

    Shibuya, Naohiro; Liu, George T; Davis, Matthew L; Grossman, Jordan P; Jupiter, Daniel C

    2016-01-01

    A limited number of studies have described the epidemiology of open fractures, and the epidemiology of open ankle fractures is not an exception. Therefore, the risk factors associated with open ankle fractures have not been extensively evaluated. The frequencies and proportions of open ankle fractures among all the recorded malleolar fractures in the US National Trauma Data Bank data set from January 2007 to December 2011 were analyzed. Clinically relevant variables captured in the data set were also used to evaluate the risk factors associated with open ankle fractures, adjusting for other covariates. The entire cohort was further subdivided into "lower" and "higher" energy trauma groups and the same analysis performed for each group separately. We found that a body mass index of >40 kg/m(2) and farm location were risk factors for open ankle fractures and impaired sensorium was protective against open ankle fractures. In the "lower energy" group, male gender, alcohol use, peripheral vascular disease, other injuries, and injury occurring at a farm location were risk factors for open fractures. In the "higher energy" group, female gender, work-related injury, and injury at a farm or industry location demonstrated statistically significantly associations with open fractures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Depression as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies.

    Science.gov (United States)

    Gao, Yuan; Huang, Changquan; Zhao, Kexiang; Ma, Louyan; Qiu, Xuan; Zhang, Lei; Xiu, Yun; Chen, Lin; Lu, Wei; Huang, Chunxia; Tang, Yong; Xiao, Qian

    2013-05-01

    This study examined whether depression was a risk factor for onset of dementia including Alzheimer's disease (AD), vascular dementia (VD) and any dementia, and mild cognitive impairment (MCI) by using a quantitative meta-analysis of longitudinal studies. EMBASE and MEDLINE were searched for articles published up to February 2011. All studies that examined the relationship between depression and the onset of dementia or MCI were included. Pooled relative risk was calculated using fixed-effects models. Twelve studies met our inclusion criteria for this meta-analysis. All subjects were without dementia or MCI at baseline. Four, two, five, and four studies compared the incidence of AD, VD, any dementia, and MCI between subjects with or without depression, respectively. After pooling all the studies, subjects with depression had higher incidence of AD (relative risk (RR):1.66, 95% confidence interval (CI): 1.29-2.14), VD (RR: 1.89, 95% CI: 1.19-3.01), any dementia (RR: 1.55, 95% CI: 1.31-2.83), and MCI (RR: 1.97, 95% CI: 1.53-2.54) than those without depression. The quantitative meta-analysis showed that depression was a major risk factor for incidence of dementia (including AD, VD, and any dementia) and MCI. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Impact Factors and Risk Analysis of Tropical Cyclones on a Highway Network.

    Science.gov (United States)

    Yang, Saini; Hu, Fuyu; Jaeger, Carlo

    2016-02-01

    Coastal areas typically have high social and economic development and are likely to suffer huge losses due to tropical cyclones. These cyclones have a great impact on the transportation network, but there have been a limited number of studies about tropical-cyclone-induced transportation network functional damages, especially in Asia. This study develops an innovative measurement and analytical tool for highway network functional damage and risk in the context of a tropical cyclone, with which we explored the critical spatial characteristics of tropical cyclones with regard to functional damage to a highway network by developing linear regression models to quantify their relationship. Furthermore, we assessed the network's functional risk and calculated the return periods under different damage levels. In our analyses, we consider the real-world highway network of Hainan province, China. Our results illustrate that the most important spatial characteristics were location (in particular, the midlands), travel distance, landfalling status, and origin coordinates. However, the trajectory direction did not obviously affect the results. Our analyses indicate that the highway network of Hainan province may suffer from a 90% functional damage scenario every 4.28 years. These results have critical policy implications for the transport sector in reference to emergency planning and disaster reduction. © 2015 Society for Risk Analysis.

  12. Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

    Science.gov (United States)

    Possenti, Alessia; Manzano-Román, Raúl; Sánchez-Ovejero, Carlos; Boufana, Belgees; La Torre, Giuseppe; Siles-Lucas, Mar; Casulli, Adriano

    2016-01-01

    Background Scientific literature on cystic echinococcosis (CE) reporting data on risk factors is limited and to the best of our knowledge, no global evaluation of human CE risk factors has to date been performed. This systematic review (SR) summarizes available data on statistically relevant potential risk factors (PRFs) associated with human CE. Methodology/Principal Findings Database searches identified 1,367 papers, of which thirty-seven were eligible for inclusion. Of these, eight and twenty-nine were case-control and cross-sectional studies, respectively. Among the eligible papers, twenty-one were included in the meta-analyses. Pooled odds ratio (OR) were used as a measure of effect and separately analysed for the two study designs. PRFs derived from case-control studies that were significantly associated with higher odds of outcome were “dog free to roam” (OR 5.23; 95% CI 2.45–11.14), “feeding dogs with viscera” (OR 4.69; 95% CI 3.02–7.29), “slaughter at home” (OR 4.67; 95% CI 2.02–10.78) or at “slaughterhouses” (OR 2.7; 95% CI 1.15–6.3), “dog ownership” (OR 3.54; 95% CI 1.27–9.85), “living in rural areas” (OR 1.83; 95% CI 1.16–2.9) and “low income” (OR 1.68; 95% CI 1.02–2.76). Statistically significant PRFs from cross-sectional studies with higher odds of outcome were “age >16 years” (OR 6.08; 95% CI 4.05–9.13), “living in rural areas” (OR 2.26; 95% CI 1.41–3.61), “being female” (OR 1.38; 95% CI 1.06–1.8) and “dog ownership” (OR 1.37; 95% CI 1.01–1.86). Conclusions/Significance Living in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasitic infection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas. PMID:27820824

  13. Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis.

    Science.gov (United States)

    Lee, Sungjoon; Kim, Chi Heon; Chung, Chun Kee; Park, Sung Bae; Yang, Seung Heon; Kim, Soo Hyun; Kang, Soohee; Lee, Ju Hee; Choi, Yunhee

    2017-04-01

    Postoperative urinary retention (POUR) may not be considered a major complication after surgery for degenerative lumbar spinal stenosis. However, improper management of transient POUR leads to bladder overdistension and permanent bladder detrusor damage. Systematic monitoring of POUR may be recommended in vulnerable patients. The aim of the present study was to determine the incidence of and risk factors for POUR. This is a retrospective nested case-control study. A total of 284 consecutive patients (M : F=125:159; mean age, 63.3 years) who underwent spine surgery for degenerative lumbar spinal stenosis were reviewed. A multivariable logistic model was utilized to identify risk factors. A systematic postoperative voiding care protocol was applied for all patients to monitor them for the development of POUR. An indwelling urethral catheter was inserted intraoperatively and removed in the postanesthesia care unit. The patients were encouraged to void within 6 hours postoperatively and every 4-6 hours thereafter. After each voiding, the postvoid residual urine (PVR) was measured by an ultrasound bladder scan. POUR was defined as the inability to void or having a PVR≥100 mL for more than 2 days after surgery. The incidence of POUR was 27.1% (77/284). Older age (odds ratio, 1.062; 95% confidence interval, 1.029-1.095) and a long duration of surgery (odds ratio, 1.003; 95% confidence interval, 1.001-1.005) were significant risk factors. A formula for determining the probability of POUR was developed, and a probability of ≥0.26 was regarded as the cut-off value (sensitivity of 0.75 and specificity of 0.57; C-statics, 0.684). POUR was a common morbidity after surgery for degenerative lumbar spinal stenosis. We recommend adopting a systematic postoperative voiding care protocol to prevent bladder overdistension and detrusor damage, especially for elderly patients and those who have undergone longer surgeries. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Geographic distribution of HCV genotypes in Libya and analysis of risk factors involved in their transmission.

    Science.gov (United States)

    Daw, Mohamed A; El-Bouzedi, Abdallah; Dau, Aghnaya A

    2015-08-21

    Hepatitis C virus (HCV) genotypes have been shown to be differently distributed between distinct geographical areas. Libya is a large country has the longest coast in the Mediterranean basin. Information regarding hepatitis C genotypes and subtypes circulating in Libya are not well known. The objectives of this study were to determine the frequency of various HCV genotypes cross Libya and the demographic and attributable risk factors associated with HCV transmission among Libyan population. A cross-sectional study was carried out on patients with recently confirmed HCV infection. A total of 3,227 serum samples enrolled at 19 collection center cross Libya. 1,756 belonged to Tripoli region, 452 to West region 355 to North region, 181 South regions and 483 East region. The samples were tested by type specific genotyping assay and correlated with demographic and potential risk factors within the studied populations. A total of 20 discrete genotypes and subtypes were identified among the Libyan population ranging from 11.5 to 0.3% cross the country. Genotype 1 was the most frequent among all regions (19.7-40.5%), reaching the highest value in Tripoli region, followed by genotype 4 which was more prevalent in the South (49.3%) and West (40.0%) regions. Genotype 3, was higher in Tripoli (21.3%) and East (15.9%) regions while genotype 2, common in North (23.6%) and South (22.5%) regions. However, we found evidence that there is a changing relative prevalence of HCV genotypes in relation to age, gender and the mode of transmission which is reflected in the predominance of certain genotypes among Libyan population. Different HCV genotypes were isolated form Libyan population including newly emerged ones. The prevalence of the genotypes varied by geographic region and influenced by demographic and risk factors. Knowing the frequency and distribution of the genotypes would provide key information on understanding the spread of HCV in Libya and this could be greatly reflected

  15. Risk Acceptance in the Furniture Sector: Analysis of Acceptance Level and Relevant Influence Factors

    OpenAIRE

    Rodrigues, Matilde A.; P. M. Arezes; Leão, C.P.

    2015-01-01

    Risk acceptance has been broadly discussed in relation to hazardous risk activities and/or technologies. A better understanding of risk acceptance in occupational settings is also important; however, studies on this topic are scarce. It seems important to understand the level of risk that stakeholders consider sufficiently low, how stakeholders form their opinion about risk, and why they adopt a certain attitude toward risk. Accordingly, the aim of this study is to examine risk acceptance in ...

  16. Information security risk analysis

    CERN Document Server

    Peltier, Thomas R

    2001-01-01

    Effective Risk AnalysisQualitative Risk AnalysisValue AnalysisOther Qualitative MethodsFacilitated Risk Analysis Process (FRAP)Other Uses of Qualitative Risk AnalysisCase StudyAppendix A: QuestionnaireAppendix B: Facilitated Risk Analysis Process FormsAppendix C: Business Impact Analysis FormsAppendix D: Sample of ReportAppendix E: Threat DefinitionsAppendix F: Other Risk Analysis OpinionsIndex

  17. Geographic analysis of individual and environmental risk factors for hypospadias births.

    Science.gov (United States)

    Winston, Jennifer J; Meyer, Robert E; Emch, Michael E

    2014-11-01

    Hypospadias is a relatively common birth defect affecting the male urinary tract. We explored the etiology of hypospadias by examining its spatial distribution in North Carolina and the spatial clustering of residuals from individual and environmental risk factors. We used data collected by the North Carolina Birth Defects Monitoring Program from 2003 to 2005 to estimate local Moran's I statistics to identify geographic clustering of overall and severe hypospadias, using 995 overall cases and 16,013 controls. We conducted logistic regression and local Moran's I statistics on standardized residuals to consider the contribution of individual variables (maternal age, maternal race/ethnicity, maternal education, smoking, parity, and diabetes) and environmental variables (block group land cover) to this clustering. Local Moran's I statistics indicated significant clustering of overall and severe hypospadias in eastern central North Carolina. Spatial clustering of hypospadias persisted when controlling for individual factors, but diminished somewhat when controlling for environmental factors. In adjusted models, maternal residence in a block group with more than 5% crop cover was associated with overall hypospadias (odds ratio = 1.22; 95% confidence interval = 1.04-1.43); that is living in a block group with greater than 5% crop cover was associated with a 22% increase in the odds of having a baby with hypospadias. Land cover was not associated with severe hypospadias. This study illustrates the potential contribution of mapping in generating hypotheses about disease etiology. Results suggest that environmental factors including proximity to agriculture may play some role in the spatial distribution of hypospadias. Birth Defects Research (Part A) 100:887-894, 2014. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  18. A geographic analysis of individual and environmental risk factors for hypospadias births

    Science.gov (United States)

    Winston, Jennifer J; Meyer, Robert E; Emch, Michael E

    2014-01-01

    Background Hypospadias is a relatively common birth defect affecting the male urinary tract. We explored the etiology of hypospadias by examining its spatial distribution in North Carolina and the spatial clustering of residuals from individual and environmental risk factors. Methods We used data collected by the North Carolina Birth Defects Monitoring Program from 2003-2005 to estimate local Moran's I statistics to identify geographic clustering of overall and severe hypospadias, using 995 overall cases and 16,013 controls. We conducted logistic regression and local Moran's I statistics on standardized residuals to consider the contribution of individual variables (maternal age, maternal race/ethnicity, maternal education, smoking, parity, and diabetes) and environmental variables (block group land cover) to this clustering. Results Local Moran's I statistics indicated significant clustering of overall and severe hypospadias in eastern central North Carolina. Spatial clustering of hypospadias persisted when controlling for individual factors, but diminished somewhat when controlling for environmental factors. In adjusted models, maternal residence in a block group with more than 5% crop cover was associated with overall hypospadias (OR = 1.22; 95% CI = 1.04 – 1.43); that is living in a block group with greater than 5% crop cover was associated with a 22% increase in the odds of having a baby with hypospadias. Land cover was not associated with severe hypospadias. Conclusions This study illustrates the potential contribution of mapping in generating hypotheses about disease etiology. Results suggest that environmental factors including proximity to agriculture may play some role in the spatial distribution of hypospadias. PMID:25196538

  19. An analysis of the factors for microbial contamination risk for pork at slaughterhouses in Korea using the LOGIT model.

    Science.gov (United States)

    Kim, Yun-Ji; Song, Yanghoon

    2009-01-01

    To assess the effect of slaughtering practices on the probability of microbial contamination at slaughterhouses in Korea, 840 samples from 8 slaughterhouses were collected and 50 factors observed for 2 yr. Target microorganisms were Salmonella spp. and Listeria monocytogenes and 20 contaminated samples were found. Twenty-one out of 50 factors were identified as possible sources of microbial contamination. To narrow down the more critical factors and quantify the effects, simple regression analysis for 21 factors was executed and 6 factors were found to be significant. The LOGIT model was used to measure the effects of the six variables on the chance of microbial risk. Data showed the effect of size of lairage area was negligible. However, increased duration in lairage, size of hair removing pot, and usage of rubber gloves all decreased the contamination risk. Lastly, it was found that increases in duration time from kill to intestine extraction and duration time from intestine extraction to precooling raised the risk of contamination.

  20. Effect of Vascular Risk Factors and Diseases on Mortality in Individuals with Dementia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    van de Vorst, Irene E; Koek, Huiberdina L; de Vries, Rehana; Bots, Michiel L; Reitsma, Johannes B; Vaartjes, Ilonca

    2016-01-01

    To assess the effect of cardiovascular diseases and risk factors on mortality in individuals with dementia. Systematic review and meta-analysis. English- and Dutch-language studies in PubMed, EMBASE, and PsycINFO databases were searched in April 2014 with hand-searching of in-text citations and no publication limitations. Inclusion criteria were original studies reporting on cardiovascular risk factors or diseases and their relationship with survival in individuals with dementia. The Quality In Prognosis Studies tool was used to appraise all included articles. Population-, hospital-, and nursing home-based. Community-dwelling, hospitalized individuals and nursing home residents with dementia. A random-effects meta-analysis was performed to investigate the effect of several cardiovascular diseases and risk factors on overall mortality. Twelve studies with 235,865 participants were included. In pooled analyses, male sex (hazard ratio (HR)=1.67, 95% confidence interval (CI)=1.56-1.78), diabetes mellitus (DM) (HR=1.49, 95% CI=1.33-1.68), smoking (ever vs never) (HR=1.37, 95% CI=1.17-1.61), coronary heart disease (CHD) (HR=1.21, 95% CI=1.02-1.44) and congestive heart failure (CHF) (HR=1.37, 95% CI=1.18-1.59) were associated with mortality. Stroke, high blood pressure, being overweight, and hypercholesterolemia were not statistically significantly related to mortality. Individuals with dementia and DM, smoking, CHD, and CHF have a greater risk of death than individuals with dementia without these risk factors or diseases. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  1. Risk Analysis

    Science.gov (United States)

    Morring, Frank, Jr.

    2004-01-01

    A National Academies panel says the Hubble Space Telescope is too valuable ;or gamblingon a long-shot robotic mission to extend its service life, and urges Directly contradicting Administrator Sean O'Keefe, who killed a planned fifth shuttle servicing mission to the telescope on grounds it was too dangerous for a human crew in the post-Challenger environment, the expert committee found that upgrades to shuttle safety actually should make it less hazardous to fly to the telescope than it was before Columbia was lost. Risks of a telescope-servicing mission are only marginally greater than the planned missions to the International Space Station (ISS) O'Keefe has authorized, the panel found. After comparing those risks to the dangers inherent in trying to develop a complex space robot in the 39 months remaining in the Hubble s estimated service life, the panel opted for the human mission to save one of the major achievements of the American space program, in the words of Louis J. Lanzerotti, its chairman.

  2. Analysis of risk factors for cluster behavior of dental implant failures.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    2017-08-01

    Some studies indicated that implant failures are commonly concentrated in few patients. To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained. © 2017 Wiley Periodicals, Inc.

  3. Air pollution and anemia as risk factors for pneumonia in ecuadorian children: a retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    Harris Aaron M

    2011-11-01

    Full Text Available Abstract Background Ambient air pollution and malnutrition, particularly anemia, are risk factors for pneumonia, a leading cause of death in children under five. We simultaneously assessed these risk factors in Quito, Ecuador. Methods In 2005, we studied two socioeconomically similar neighborhoods in Quito: Lucha de los Pobres (LP and Jaime Roldos (JR. LP had relatively high levels of air pollution (annual median PM2.5 = 20.4 μg/m3; NO2 = 29.5 μg/m3 compared to JR (annual median PM2.5 = 15.3 μg/m3; NO2 = 16.6 μg/m3. We enrolled 408 children from LP (more polluted and 413 children from JR (less polluted. All subjects were aged 18-42 months. We obtained medical histories of prior physician visits and hospitalizations during the previous year, anthropometric nutrition data, hemoglobin levels, and hemoglobin oxygen saturation via oximetry. Results In anemic children, higher pollution exposure was significantly associated with pneumonia hospitalization (OR = 6.82, 95%CI = 1.45-32.00; P = 0.015. In non-anemic children, no difference in hospitalizations by pollution exposure status was detected (OR = 1.04, NS. Children exposed to higher levels of air pollution had more pneumonia hospitalizations (OR = 3.68, 1.09-12.44; P = 0.036, total respiratory illness (OR = 2.93, 95% CI 1.92-4.47; P Conclusions Ambient air pollution is associated with rates of hospitalization for pneumonia and with physician's consultations for acute respiratory infections. Anemia may interact with air pollution to increase pneumonia hospitalizations. If confirmed in larger studies, improving nutrition-related anemia, as well as decreasing the levels of air pollution in Quito, may reduce pneumonia incidence.

  4. A meta-analysis of avascular necrosis in systemic lupus erythematosus: prevalence and risk factors.

    Science.gov (United States)

    Nevskaya, Tatiana; Gamble, Maeve P; Pope, Janet E

    2017-01-01

    To determine the prevalence of and risk factors for avascular necrosis (AVN) in systemic lupus erythematosus (SLE). MEDLINE, CINAHL, Web of Science, EMBASE and Cochrane Library were searched from inception to July, 2015 and a random effects model was used to combine frequencies; study quality was assessed using STROBE. 2,041 citations identified 62 articles. Many results had high heterogeneity. The prevalence of symptomatic AVN was 9% (range 0.8%-33%) in SLE and 29% for asymptomatic AVN; femoral head was the most common location (8.0%). High-dose corticosteroids (CS) any CS use, maximum and cumulative dose, pulse therapy, and CS side-effects (hypertension, Cushings, but not diabetes mellitus or hyperlipidaemia) were associated with AVN, as was active SLE (cutaneous vasculitis, renal and neuropsychiatric manifestations, serositis, cytopenias) and Sjögren's, Raynaud's phenomenon, arthritis, cyclophosphamide (but not azathioprine mycophenolate mofetil, or methotrexate) and more damage (excluding musculoskeletal system). Antimalarial drugs were not protective. Rashes and oral ulcers were not associated with AVN. Mean daily dose of CS and duration of CS use had no impact on AVN occurence. Autoantibodies and other immunological markers did not predispose to AVN, except IgM anticardiolipin antibodies which doubled the risk. African Americans experienced more AVN (OR 1.8, p=0.04). AVN may occur in 1/3 of patients with SLE and 9% with symptoms. Features of active organ SLE (CNS, renal, cutaneous vasculitis, serositis, cytopenias) are associated with AVN as are CS, especially early in disease and at high doses. Those with early CS side-effects seem to have the highest risk of AVN.

  5. New Levels of Vertebral Compression Fractures after Percutaneous Kyphoplasty: Retrospective Analysis of Styles and Risk Factors.

    Science.gov (United States)

    Ning, Lei; Wan, Shuanglin; Liu, Chao; Huang, Zhaobo; Cai, Hongxin; Fan, Shunwu

    2015-11-01

    The causes of subsequent vertebral fractures after kyphoplasty are debated. It is reported that most new vertebral fractures after kyphoplasty develop in adjacent vertebrae. We explored whether kyphoplasty increases the incidence of adjacent vertebral fractures and identified risk factors for new vertebral compression fractures (VCFs) after kyphoplasty. Retrospective study. Inpatient population of a single center. We studied 356 patients treated with kyphoplasty from January 2008 to March 2012. Among those patients, there were 35 new VCFs after kyphoplasty. Subsequently, these patients were divided into 2 groups: an "adjacent fracture" group and a "nonadjacent fracture" group. In addition, all patients treated with kyphoplasty were further assigned to either a "new fracture" group or a "no fracture" group. The occurrence of new VCFs in the "nonadjacent fracture" group was significantly higher than that in the "adjacent fracture" group. The average bone mineral density (BMD) of the spine was -3.95 in the "new fracture" group and -2.86 in the "no fracture" group. The risk of new vertebral fracture increased as the bone mineral density decreased (P kyphoplasty occurred most often in nonadjacent vertebrae. VCFs after kyphoplasty were common in patients with low bone mineral density and in women, suggesting that osteoporosis is an underlying mechanism. INSTITUTIONAL REVIEW: This study was approved by the institutional review board.

  6. Analysis of the risk factors relating to cows' resistance to Rhipicephalus microplus ticks during the peripartum.

    Science.gov (United States)

    da Silva, Jenevaldo Barbosa; Rangel, Charles Passos; de Azevedo Baêta, Bruna; da Fonseca, Adivaldo Henrique

    2014-08-01

    This study aimed to evaluate season, breed, number of lactations and milk production as risk factors relating to Rhipicephalus microplus infestation in dairy cows during the peripartum. Eighty-four animals were randomly selected through proportional stratified sampling. All engorged and partially engorged female R. microplus specimens measuring 4.5-8.0 mm were counted during the 5 weeks before calving, calving week and 5 weeks after calving. The peripartum had a significant effect [calving (p tick count was higher during the rainy season than during the dry season, there was no significant difference (p = 0.055; PR = 0.63). The average R. microplus count was significantly higher (p < 0.05; PR = 2.10) in Bos taurus animals, followed by F1 (p < 0.05; PR = 1.64) and Girolando (p < 0.05; PR = 1.39). The average R. microplus count was significantly higher (p < 0.05; PR = 0.97) in first-lactation animals, followed by those at the second, third and, fourth or subsequent lactation. Milk production showed a negative correlation with R. microplus count, such that high-production animals were significantly (p = 0.003; PR = 2.04) more vulnerable to infestation than were low-production animals. First-lactation and high-production B. taurus animals had greatest vulnerability to R. microplus infestation over the peripartum period, and constituted the at-risk group in the dairy herd.

  7. A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors.

    Science.gov (United States)

    Li, Huixia; Luo, Miyang; Luo, Jiayou; Zheng, Jianfei; Zeng, Rong; Du, Qiyun; Fang, Junqun; Ouyang, Na

    2016-11-23

    A risk prediction model of non-syndromic cleft lip with or without cleft palate (NSCL/P) was established by a discriminant analysis to predict the individual risk of NSCL/P in pregnant women. A hospital-based case-control study was conducted with 113 cases of NSCL/P and 226 controls without NSCL/P. The cases and the controls were obtained from 52 birth defects' surveillance hospitals in Hunan Province, China. A questionnaire was administered in person to collect the variables relevant to NSCL/P by face to face interviews. Logistic regression models were used to analyze the influencing factors of NSCL/P, and a stepwise Fisher discriminant analysis was subsequently used to construct the prediction model. In the univariate analysis, 13 influencing factors were related to NSCL/P, of which the following 8 influencing factors as predictors determined the discriminant prediction model: family income, maternal occupational hazards exposure, premarital medical examination, housing renovation, milk/soymilk intake in the first trimester of pregnancy, paternal occupational hazards exposure, paternal strong tea drinking, and family history of NSCL/P. The model had statistical significance (lambda = 0.772, chi-square = 86.044, df = 8, P < 0.001). Self-verification showed that 83.8 % of the participants were correctly predicted to be NSCL/P cases or controls with a sensitivity of 74.3 % and a specificity of 88.5 %. The area under the receiver operating characteristic curve (AUC) was 0.846. The prediction model that was established using the risk factors of NSCL/P can be useful for predicting the risk of NSCL/P. Further research is needed to improve the model, and confirm the validity and reliability of the model.

  8. A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Yang Su-Pen

    2013-01-01

    Full Text Available Abstract Background The incidence of fungal healthcare-associated infection (HAI has increased in a major teaching hospital in the northern part of Taiwan over the past decade, especially in the intensive care units (ICUs. The purpose of this study was to determine the factors that were responsible for the outbreak and trend in the ICU. Methods Surveillance fungal cultures were obtained from “sterile” objects, antiseptic solutions, environment of infected patients and hands of medical personnel. Risk factors for comparison included age, gender, admission service, and total length of stay in the ICU, Acute Physiology and Chronic Health Evaluation (APACHE II scores at admission to the ICU, main diagnosis on ICU admission, use of invasive devices, receipt of hemodialysis, total parenteral nutrition (TPN use, history of antibiotic therapy before HAI or during ICU stay in no HAI group, and ICU discharge status (ie, dead or alive. Univariable analysis followed by multiple logistic regression analysis was performed to identify the independent risk factors for ICU fungal HAIs and ICU mortality. Results There was a significant trend in ICU fungal HAIs from 1998 to 2009 (P Candida albicans (27.3%, Candida tropicalis (6.6%, Candida glabrata (6.6%, Candida parapsilosis (1.9%, Candida species (0.8%, and other fungi (1.9%. Candida albicans accounted for 63% of all Candida species. Yeasts were found in the environment of more heavily infected patients. The independent risk factors (P P  Conclusions There was a secular trend of an increasing number of fungal HAIs in our ICU over the past decade. Patients with ICU fungal HAIs had a significantly higher mortality rate than did patients without ICU HAIs. Total parenteral nutrition was a significant risk factor for all types of ICU fungal HAIs, and its use should be monitored closely.

  9. Classical sheep scrapie in Great Britain: spatial analysis and identification of environmental and farm-related risk factors

    Directory of Open Access Journals (Sweden)

    Del Río Vilas Victor J

    2009-09-01

    Full Text Available Abstract Background Previous studies suggest that the spatial distribution of classical sheep scrapie in Great Britain is uneven and that certain flock characteristics may be associated with occurrence of the disease. However, the existence of areas of high and low disease-risk may also result from differences in the spatial distribution of environmental characteristics. In this study we explored the spatial pattern of classical scrapie in Great Britain between 2002 and 2005 and investigated the association between disease occurrence and various environmental and farm-related risk factors. Results Exploratory spatial analysis: South Wales was found to have a higher density of scrapie-positive farms than the rest of Great Britain. In addition, a small cluster of high-risk farms was identified in the center of this region in which clustering of scrapie-positive farms occurred up to a distance of approximately 40 km. Spatial modelling: A mixed-effects regression model identified flock-size and soil drainage to be significantly associated with the occurrence of scrapie in England and Wales (area under the curve (AUC 0.71 ± 0.01, 95% CI 0.68 - 0.74. The predictive risk map based on the estimated association between these factors and disease occurrence showed most of Wales to be at risk of being confirmed positive for scrapie with areas of highest risk in central and south Wales. In England, areas with the highest risk occurred mainly in the north and the midlands. Conclusion The observed distribution of scrapie in Great Britain exhibited a definite spatial pattern with south Wales identified as an area of high occurrence. In addition both flock (flock size and environmental variables (soil drainage were found to be significantly associated with the occurrence of the disease. However, the model's AUC indicated unexplained variation remaining in the model and the source of this variation may lie in farm-level characteristics rather than spatially

  10. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Klem, Fabiane; Wadhwa, Akhilesh; Prokop, Larry J; Sundt, Wendy J; Farrugia, Gianrico; Camilleri, Michael; Singh, Siddharth; Grover, Madhusudan

    2017-04-01

    Foodborne illness affects 15% of the US population each year, and is a risk factor for irritable bowel syndrome (IBS). We evaluated risk of, risk factors for, and outcomes of IBS after infectious enteritis. We performed a systematic review of electronic databases from 1994 through August 31, 2015 to identify cohort studies of the prevalence of IBS 3 months or more after infectious enteritis. We used random-effects meta-analysis to calculate the summary point prevalence of IBS after infectious enteritis, as well as relative risk (compared with individuals without infectious enteritis) and host- and enteritis-related risk factors. We identified 45 studies, comprising 21,421 individuals with enteritis, followed for 3 months to 10 years for development of IBS. The pooled prevalence of IBS at 12 months after infectious enteritis was 10.1% (95% confidence interval [CI], 7.2-14.1) and at more than 12 months after infectious enteritis was 14.5% (95% CI, 7.7-25.5). Risk of IBS was 4.2-fold higher in patients who had infectious enteritis in the past 12 months than in those who had not (95% CI, 3.1-5.7); risk of IBS was 2.3-fold higher in individuals who had infectious enteritis more than 12 months ago than in individuals who had not (95% CI, 1.8-3.0). Of patients with enteritis caused by protozoa or parasites, 41.9% developed IBS, and of patients with enteritis caused by bacterial infection, 13.8% developed IBS. Risk of IBS was significantly increased in women (odds ratio [OR], 2.2; 95% CI, 1.6-3.1) and individuals with antibiotic exposure (OR, 1.7; 95% CI, 1.2-2.4), anxiety (OR, 2; 95% CI, 1.3-2.9), depression (OR, 1.5; 95% CI, 1.2-1.9), somatization (OR, 4.1; 95% CI, 2.7-6.0), neuroticism (OR, 3.3; 95% CI, 1.6-6.5), and clinical indicators of enteritis severity. There was a considerable level of heterogeneity among studies. In a systematic review and meta-analysis, we found >10% of patients with infectious enteritis develop IBS later; risk of IBS was 4-fold higher than in

  11. Assessment of Various Risk Factors for Success of Delayed and Immediate Loaded Dental Implants: A Retrospective Analysis.

    Science.gov (United States)

    Prasant, M C; Thukral, Rishi; Kumar, Sachin; Sadrani, Sannishth M; Baxi, Harsh; Shah, Aditi

    2016-10-01

    Ever since its introduction in 1977, a minimum of few months of period is required for osseointegration to take place after dental implant surgery. With the passage of time and advancements in the fields of dental implant, this healing period is getting smaller and smaller. Immediate loading of dental implants is becoming a very popular procedure in the recent time. Hence, we retrospectively analyzed the various risk factors for the failure of delayed and immediate loaded dental implants. In the present study, retrospective analysis of all the patients was done who underwent dental implant surgeries either by immediate loading procedure or by delayed loading procedures. All the patients were divided broadly into two groups with one group containing patients in which delayed loaded dental implants were placed while other consisted of patients in whom immediate loaded dental implants were placed. All the patients in whom follow-up records were missing and who had past medical history of any systemic diseases were excluded from the present study. Evaluation of associated possible risk factors was done by classifying the predictable factors as primary and secondary factors. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Kaplan-Meier survival analyses and chi-square test were used for assessment of level of significance. In delayed and immediate group of dental implants, mean age of the patients was 54.2 and 54.8 years respectively. Statistically significant results were obtained while comparing the clinical parameters of the dental implants in both the groups while demographic parameters showed nonsignificant correlation. Significant higher risk of dental implant failure is associated with immediate loaded dental implants. Tobacco smoking, shorter implant size, and other risk factors play a significant role in predicting the success and failure of dental implants. Delayed loaded dental implant placement should be preferred

  12. Hypernatremia is a significant risk factor for acute kidney injury after subarachnoid hemorrhage: a retrospective analysis.

    Science.gov (United States)

    Kumar, Avinash B; Shi, Yaping; Shotwell, Matthew S; Richards, Justin; Ehrenfeld, Jesse M

    2015-04-01

    Hypertonic saline therapy is often used in critically ill subarachnoid hemorrhage (SAH) patients for indications ranging from control of intracranial hypertension to managing symptomatic hyponatremia. The risk factors for developing acute kidney injury (AKI) in this patient population are not well defined. To study the role of serum sodium in developing AKI (based on the AKIN definition) in the SAH population admitted to a large academic neurocritical care unit. This is an IRB-approved, retrospective cohort study of patients admitted to a tertiary neuro intensive care unit. We included adult (age ≥ 18 years) SAH patients admitted to the neuro intensive care unit for at least 72 h. Development of AKI after admission to the ICU was defined using the AKIN serum creatinine criteria between 72 h and 14 days following admission. A Cox proportional hazards survival model with multiple time varying covariates was developed to evaluate the effect of maximum sodium exposure on the risk of AKI. Sodium exposure was captured as the running maximum of daily maximum serum sodium concentration (mEq/L). Sodium exposure was used as a surrogate for hypertonic saline therapy. The final cohort of patients included 736 patients admitted to the neuro intensive care unit between 2006 and 2012. The number of patients who developed AKI was 64 (9 %). These patients had an increased length of stay (15.6 ± 9.4 vs. 12.5 ± 8.7 days). The odds of death were more than two fold greater among patients who developed AKI (odds ratio 2.33 95 % CI 1.27, 4.3). Sodium exposure was significantly associated with the hazard of developing AKI, adjusting for age, sex, preexisting renal disease, diabetes mellitus, radiocontrast exposure, number of days on mechanical ventilation, and admission Glasgow Coma Scale score. For each 1 mEq/L increase in the running maximum daily serum sodium, the hazard of developing AKI was increased by 5.4 % (95 % CI 1.4, 9.7). The maximum daily sodium is a significant risk

  13. Salivary Gland Cancer: Risk Factors

    Science.gov (United States)

    ... Cancer > Salivary Gland Cancer: Risk Factors Request Permissions Salivary Gland Cancer: Risk Factors Approved by the Cancer.Net ... f t k e P Types of Cancer Salivary Gland Cancer Guide Cancer.Net Guide Salivary Gland Cancer ...

  14. Risk factors for tuberculosis in foreign-born people (FBP in Italy: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Loredana Ingrosso

    Full Text Available In Italy, TB notifications in foreign-born people (FBP are steadily increasing. To investigate this issue we did a meta-analysis on risk factors for FBP people. A systematic search was performed in PubMed and EMBASE from Jan-1980 to Jan-2013. We analysed HIV status, previous TB-treatment, intravenous drug use and alcohol abuse, and multidrug resistant TB. Odd ratio was used as a measure of effect. One and two-stages approaches were used. In the main analysis we used a 2-stages approach to include studies with only aggregate estimates. Among 1996 references, 18 fulfilled inclusion criteria. In TB-affected FBP people positive HIV-status was about 3 times higher than among Italians, after 1996 when combined antiretroviral therapy for HIV was introduced (OR: 2.91; 95%CI: 1.37; 6.17. No association was found between FBP and intravenous drug users in adults; after 1-stage meta-analysis foreign born people from highly endemic countries had a 4 times higher risk to be multidrug resistant TB than Italian people. Finally, TB-affected FBP were less likely than Italians to be alcoholics (OR: 0.10 95%CI: 0.01; 0.84 or of having received previous TB-treatment (OR: 0.55; 95%CI: 0.43; 0.71. An association of multidrug resistant TB with immigrant status as well as an association of Tuberculosis with HIV-positive status in foreign-born people are major findings of this analysis. Drugs and alcohol abuse do not appear to be risk factors for TB in FBP, however they cannot be discharged since may depend on cultural traditions and their role may change in the future along with the migratory waves. An effective control of TB risk factors among migrants is crucial to obtain the goal of TB eradication.

  15. Arthritis as a risk factor for carpal tunnel syndrome: a meta-analysis.

    Science.gov (United States)

    Shiri, R

    2016-10-01

    The effects of inflammatory and degenerative arthritis on carpal tunnel syndrome (CTS) are not well known. This systematic review and meta-analysis aimed to assess whether rheumatoid arthritis (RA) and osteoarthritis (OA) increase the risk of CTS. Literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar, and ResearchGate until January 2015. Twenty-three (five cohort, 10 case control, and eight cross sectional) studies qualified for the meta-analyses. A random-effects meta-analysis was used and heterogeneity and publication bias were assessed. Both RA and OA were associated with CTS. Pooled unadjusted odds ratios (ORs) were 1.91 [95% confidence interval (CI) 1.33-2.75, I(2) = 55.2%, nine studies, n = 10 688] for arthritis (either inflammatory or degenerative), 2.91 (95% CI 2.33-3.62, I(2) = 22.3%, 11 studies, n = 74 730) for RA, and 2.13 (95% CI 1.65-2.76, I(2) = 39.2%, five studies, n = 20 574) for OA of any joint. Pooled confounder-adjusted ORs were 1.96 (95% CI 1.21-3.18, I(2) = 73.1%, six studies, n = 11 542) for arthritis, 1.96 (95% CI 1.57-2.44, I(2) = 32.2%, eight studies, n = 72 212) for RA, and 1.87 (95% CI 1.64-2.13, I(2) = 0%, two studies, n = 19 480) for OA. There was no evidence of publication bias, and excluding cross-sectional studies or studies appraised as having a high risk of selection bias did not change the magnitude of the associations. The findings of this systematic review and meta-analysis suggest that both RA and OA increase the risk of CTS. Further prospective studies on the effect of wrist OA on CTS are needed.

  16. [Cardiovascular risk factors in women].

    Science.gov (United States)

    Cengel, Atiye

    2010-03-01

    It is estimated that at least 80% of patients with cardiovascular disease (CVD) have conventional risk factors and optimization of these risk factors can reduce morbidity and mortality due to this disease considerably. Contemporary women have increased burden of some of these risk factors such as obesity, metabolic syndrome and smoking. Turkish women have a worse CV risk profile than Turkish men in some aspects. Risk stratification systems such as Framingham have a tendency of underestimating the risk in women. Coronary artery disease remains in vessel wall for a longer period of time in women; therefore obstructive disease appear later in their lifespan necessitating risk stratification systems for estimating their lifetime risk.

  17. Risk factor analysis and spatiotemporal CART model of cryptosporidiosis in Queensland, Australia

    Directory of Open Access Journals (Sweden)

    Mengersen Kerrie

    2010-10-01

    Full Text Available Abstract Background It remains unclear whether it is possible to develop a spatiotemporal epidemic prediction model for cryptosporidiosis disease. This paper examined the impact of social economic and weather factors on cryptosporidiosis and explored the possibility of developing such a model using social economic and weather data in Queensland, Australia. Methods Data on weather variables, notified cryptosporidiosis cases and social economic factors in Queensland were supplied by the Australian Bureau of Meteorology, Queensland Department of Health, and Australian Bureau of Statistics, respectively. Three-stage spatiotemporal classification and regression tree (CART models were developed to examine the association between social economic and weather factors and monthly incidence of cryptosporidiosis in Queensland, Australia. The spatiotemporal CART model was used for predicting the outbreak of cryptosporidiosis in Queensland, Australia. Results The results of the classification tree model (with incidence rates defined as binary presence/absence showed that there was an 87% chance of an occurrence of cryptosporidiosis in a local government area (LGA if the socio-economic index for the area (SEIFA exceeded 1021, while the results of regression tree model (based on non-zero incidence rates show when SEIFA was between 892 and 945, and temperature exceeded 32°C, the relative risk (RR of cryptosporidiosis was 3.9 (mean morbidity: 390.6/100,000, standard deviation (SD: 310.5, compared to monthly average incidence of cryptosporidiosis. When SEIFA was less than 892 the RR of cryptosporidiosis was 4.3 (mean morbidity: 426.8/100,000, SD: 319.2. A prediction map for the cryptosporidiosis outbreak was made according to the outputs of spatiotemporal CART models. Conclusions The results of this study suggest that spatiotemporal CART models based on social economic and weather variables can be used for predicting the outbreak of cryptosporidiosis in

  18. An analysis of cervical non-infectious inflammatory myelitis risk factors.

    Science.gov (United States)

    Zhou, Heng; Zhang, Xinghu; Bian, Liheng; Wang, Liqun; Wang, Yongjun; Zhao, Xingquan

    2014-02-01

    Non-infectious inflammatory myelitis or non-infectious myelitis (NIM) is an inflammatory condition that occurs following an immune response in the central nervous system (CNS). In cases of spinal disc degeneration, multiple factors converge to cause pathologic changes in disc structure. To date, no studies have examined the potential relationship between disc degeneration and NIM. To investigate the relationship between cervical NIM and cervical disc degeneration. Magnetic resonance imaging (MRI) was used to examine 85 patients with cervical NIM. Peripheral levels of the pro-inflammatory cytokines, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were also measured. Non-infectious myelitis occurrence rates and TNF-alpha and IL-6 levels were compared between patients with cervical disc degeneration and a control group. The relationship between cervical NIM and cervical disc degeneration was analyzed with logistic regression and a receiver operating characteristic (ROC) curve. Magnetic resonance imaging showed that 78.8% of patients with myelitis exhibited disc degeneration compared to only 18.9% of the control group. Moreover, IL-6 and TNF-alpha levels in patients with NIM were significantly higher than those in the control group; levels of these inflammatory cytokines were even higher in NIM patients with cervical disc degeneration than in those without. Our results suggest that patients with cervical NIM have a higher incidence of cervical disc degeneration, indicating that cervical disc degeneration is likely a possible risk factor in cervical NIM progression. Future quantitative studies are required to confirm this observation.

  19. Factor analysis and psychometric properties of the Mother-Adolescent Sexual Communication (MASC) instrument for sexual risk behavior.

    Science.gov (United States)

    Cox, Mary Foster; Fasolino, Tracy K; Tavakoli, Abbas S

    2008-01-01

    Sexual risk behavior is a public health problem among adolescents living at or below poverty level. Approximately 1 million pregnancies and 3 million cases of sexually transmitted infections (STIs) are reported yearly. Parenting plays a significant role in adolescent behavior, with mother-adolescent sexual communication correlated with absent or delayed sexual behavior. This study developed an instrument examining constructs of mother-adolescent communication, the Mother-Adolescent Sexual Communication (MASC) instrument. A convenience sample of 99 mothers of middle school children completed the self-administered questionnaires. The original 34-item MASC was reduced to 18 items. Exploratory factor analysis was conducted on the 18-item scale, which resulted in four factors explaining 84.63% of the total variance. Internal consistency analysis produced Cronbach alpha coefficients of .87, .90, .82, and .71 for the four factors, respectively. Convergent validity via hypothesis testing was supported by significant correlations with several subscales of the Parent-Child Relationship Questionnaire (PCRQ) with MASC factors, that is, content and style factors with warmth, personal relationships and disciplinary warmth subscales of the PCRQ, the context factor with personal relationships, and the timing factor with warmth. In light of these findings, the psychometric characteristics and multidimensional perspective of the MASC instrument show evidence of usefulness for measuring and advancing knowledge of mother and adolescent sexual communication techniques.

  20. Risk factor analysis and molecular epidemiology of respiratory adenovirus infections among children in northern Taiwan, 2009-2013.

    Science.gov (United States)

    Cheng, Jia Lu; Peng, Chun-Chih; Chiu, Nan-Chang; Weng, Li-Chuan; Chiu, Yu-Ying; Chang, Lung; Huang, Daniel Tsung-Ning; Huang, Fu-Yuan; Liu, Chang-Pan; Chi, Hsin

    2017-08-01

    Respiratory infections caused by human adenoviruses (HAdV) are worldwide, and have significantly increased recently in Taiwan. This study aimed to clarify the molecular epidemiology and risk factors of HAdV severe infections and pneumonia among Taiwanese children. Patients with HAdV infections and hospitalized in a medical center between 2009 and 2013 were divided into severe or nonsevere HAdV infections based on whether or not they received intensive care. HAdV pneumonia was identified for comparison. The HAdV genotype was determined by sequencing the partial hexon and fiber genes. The nucleotide sequences were compared by phylogenetic analysis. The 176 patients (97 boys, 79 girls) had a median age of 3.7 years. The HAdV infections circulated year-round. HAdV B3 (54.5%) was the most common genotype, followed by HAdV C2 (21%), HAdV E4 (8%), and HAdV B7 (6.8%). Thirty-two patients needed intensive care. In multivariate analysis, the risk factors for severe HAdV infections were underlying neurologic diseases [odds ratio (OR): 164.9; p acute respiratory distress syndrome. HAdV infections circulate all year-round. HAdV B7 is strongly related to severe infections and pneumonia. Underlying neurologic diseases and prematurity are risk factors for severe HAdV infections. Copyright © 2015. Published by Elsevier B.V.

  1. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents.

    Science.gov (United States)

    Trickey, David; Siddaway, Andy P; Meiser-Stedman, Richard; Serpell, Lucy; Field, Andy P

    2012-03-01

    Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  3. Obesity As a Risk Factor for Anthracyclines and Trastuzumab Cardiotoxicity in Breast Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Guenancia, Charles; Lefebvre, Annick; Cardinale, Daniela; Yu, Anthony F; Ladoire, Sylvain; Ghiringhelli, François; Zeller, Marianne; Rochette, Luc; Cottin, Yves; Vergely, Catherine

    2016-09-10

    Patients with metabolic syndrome have a greater risk of cardiovascular disease, although their susceptibility to chemotherapy-induced cardiac disease is not well documented. The aim of this meta-analysis was to assess associations between obesity or being overweight and cardiotoxicity from anthracyclines and sequential anthracyclines and trastuzumab in patients with breast cancer. We performed a random-effects analysis and a network meta-analysis and assessed publication bias. We included 15 studies and 8,745 patients with breast cancers who were treated with anthracyclines and sequential anthracyclines and trastuzumab. Combination of obesity and being overweight was significantly associated with a greater risk of developing cardiotoxicity after anthracyclines and a sequential anthracyclines and trastuzumab regimen in patients with breast cancer. Pooled odds ratio for cardiotoxicity was 1.38 (95% CI, 1.06 to 1.80; I(2) = 43%; N = 8,745) for overweight or obesity (body mass index > 25 kg/m(2)), 1.47 (95% CI, 0.95 to 2.28; I(2) = 47%; n = 2,615) for obesity, and 1.15 (95% CI, 0.83 to 1.58; I(2) = 27%; n = 2,708) for overweight. Associations were independent of study design, year of publication, drug regimen (anthracyclines alone v sequential anthracyclines and trastuzumab), or definitions of cardiotoxicity and of overweight or obesity. There was no evidence of publication bias; however, we could not separate the contributions of obesity-related cardiovascular risk factors, such as diabetes and hypertension, from that of obesity itself in this largely unadjusted analysis. Our findings in a largely unadjusted analysis suggest that overweight and obesity are risk factors for cardiotoxicity from anthracyclines and sequential anthracyclines and trastuzumab. © 2016 by American Society of Clinical Oncology.

  4. The tumor necrosis factor-α-238 polymorphism and digestive system cancer risk: a meta-analysis.

    Science.gov (United States)

    Hui, Ming; Yan, Xiaojuan; Jiang, Ying

    2016-08-01

    Many studies have reported the association between tumor necrosis factor-α (TNF-α)-238 polymorphism and digestive system cancer susceptibility, but the results were inconclusive. We performed a meta-analysis to derive a more precise estimation of the relationship between TNF-α-238 G/A polymorphism and digestive system cancer risk. Pooled analysis for the TNF-α-238 G/A polymorphism contained 26 studies with a total of 4849 cases and 8567 controls. The meta-analysis observed a significant association between TNF-α-238 G/A polymorphism and digestive system cancer risk in the overall population (GA vs GG: OR 1.19, 95 % CI 1.00-1.40, P heterpgeneity = 0.016; A vs G: OR 1.19, 95 % CI 1.03-1.39, P heterpgeneity = 0.015; dominant model: OR 1.20, 95 % CI 1.02-1.41, P heterpgeneity = 0.012). In the analysis of the ethnic subgroups, however, similar results were observed only in the Asian population, but not in the Caucasian population. Therefore, this meta-analysis suggests that TNF-α-238 G/A polymorphism is associated with a significantly increased risk of digestive system cancer. Further large and well-designed studies are needed to confirm these findings.

  5. Center-Specific Factors Associated with Peritonitis Risk-A Multi-Center Registry Analysis.

    Science.gov (United States)

    Nadeau-Fredette, Annie-Claire; Johnson, David W; Hawley, Carmel M; Pascoe, Elaine M; Cho, Yeoungjee; Clayton, Philip A; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil; McDonald, Stephen P

    ♦ Previous studies have reported significant variation in peritonitis rates across dialysis centers. Limited evidence is available to explain this variability. The aim of this study was to assess center-level predictors of peritonitis and their relationship with peritonitis rate variations. ♦ All incident peritoneal dialysis (PD) patients treated in Australia between October 2003 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant Registry. The primary outcome was peritonitis rate, evaluated in a mixed effects negative binomial regression model. Peritonitis-free survival was assessed as a secondary outcome in a Cox proportional hazards model. ♦ Overall, 8,711 incident PD patients from 51 dialysis centers were included in the study. Center-level predictors of lower peritonitis rates included smaller center size, high proportion of PD, low peritoneal equilibration test use at PD start, and low proportion of hospitalization for peritonitis. In contrast, a low proportion of automated PD exposure, high icodextrin exposure and low or high use of antifungal prophylaxis at the time of peritonitis were associated with a higher peritonitis rate. Similar results were obtained for peritonitis-free survival. Overall, accounting for center-level characteristics appreciably decreased peritonitis variability among dialysis centers (p = 0.02). ♦ This study identified specific center-level characteristics associated with the variation in peritonitis risk. Whether these factors are directly related to peritonitis risk or surrogate markers for other center characteristics is uncertain and should be validated in further studies. Copyright © 2016 International Society for Peritoneal Dialysis.

  6. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Yanjiang; Zhao, Xin; Dong, Tianhua; Yang, Zongyou; Zhang, Qi; Zhang, Yingze

    2017-04-01

    No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of delirium after hip surgery. The present study aimed to quantitatively and comprehensively conclude the risk factors of delirium after hip surgery in elderly patients. A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to August 2015). All studies assessing the risk factors of delirium after hip surgery in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. Data were pooled and a meta-analysis was completed. A total of 24 studies were selected, which altogether included 5364 patients with hip fracture. One thousand and ninety of them were cases of delirium occurred after surgery, suggesting the accumulated incidence of 24.0 %. Results of meta-analyses showed that elderly patients with preoperative cognitive impairment [odds ratio (OR) 3.21, 95 % confidence interval (CI) 2.26-4.56), advanced age (standardized mean difference 0.50, 95 % CI 0.33-0.67), living in an institution (OR 2.94; 95 % CI 1.65-5.23), heart failure (OR 2.46; 95 % CI 1.72-3.53), total hip arthroplasty (OR 2.21; 95 % CI 1.16-4.22), multiple comorbidities (OR 1.37; 95 % CI 1.12-1.68) and morphine usage (OR 3.01; 95 % CI 1.30-6.94) were more likely to sustain delirium after hip surgery. Females were less likely to develop delirium after hip surgery (OR 0.83; 95 % CI 0.70-0.98). Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent delirium after hip surgery.

  7. Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies.

    Science.gov (United States)

    Cairns, Kathryn Elizabeth; Yap, Marie Bee Hui; Pilkington, Pamela Doreen; Jorm, Anthony Francis

    2014-12-01

    Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. To fill this gap, a review was carried out to identify risk and protective factors for depression during adolescence that are modifiable by the young person. Employing the PRISMA method, we conducted a systematic review and meta-analysis of longitudinal studies to identify risk and protective factors during the adolescent period (aged 12-18 years) that are potentially modifiable by the young person without professional intervention or assistance. Stouffer׳s method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations. We identified 113 publications which met the inclusion criteria. Putative risk factors implicated in the development of depression for which there is a sound evidence base, and which are potentially modifiable during adolescence without professional intervention, are: substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; negative coping strategies; and weight. Modifiable protective factors with a sound evidence base are healthy diet and sleep. Limitations include not systematically reviewing moderators and mediators, the lack of generalisability across cultures or to younger children or young adults, and the inability to conduct a meta-analysis on all included studies. Findings from this review suggest that future health education campaigns or self-help prevention interventions targeting adolescent depression should aim to reduce substance use (alcohol, tobacco, cannabis, other illicit drugs, and polydrug use); dieting; and negative coping strategies; and promote healthy weight; diet; and sleep patterns. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. [Severe complications of orotracheal intubation in the Intensive Care Unit: An observational study and analysis of risk factors].

    Science.gov (United States)

    Badia, M; Montserrat, N; Serviá, L; Baeza, I; Bello, G; Vilanova, J; Rodríguez-Ruiz, S; Trujillano, J

    2015-01-01

    A study is made to determine the characteristics of endotracheal intubation (ETI) procedures performed in an Intensive Care Unit, and to describe the associated severe complications and related risk factors. A prospective cohort study involving a 2-year period was carried out. The combined clinical/surgical Intensive Care Unit in a secondary university hospital. All ETIs carried out by intensivists were included. None. We analyzed the data associated with the patient, the procedure and the postoperative complications after intubation. The study of risk factors was performed using multiple logistic regression analysis. Seventy-six percent of the ETIs were performed immediately. Most of them were carried out by Intensive Care Units residents (60%). A total of 34% of the procedures had severe complications, including respiratory (16%) or hemodynamic (5%) disorders, or both (10%). Three patients died (1%), and 2% of the subjects experienced cardiac arrest. Logistic regression analysis identified the following independent risk factors for complications: age (OR 1.1; 95% CI: 1.1-1.2), systolic blood pressure≤90mmHg (OR 3.0; 95% CI: 1.4-6.4) and SpO2≤90% (OR 4.4; 95% CI: 2.3-8.1) prior to intubation, the presence of secretions (OR 2.2; 95% CI: 1.1-4.6), and the need for more than one ETI attempt (OR 3.5; 95% CI: 1.4-8.7). ETI in Intensive Care Unit patients is associated with respiratory and hemodynamic complications. The independent risk factors associated with the development of complications were advanced age, hypotension and previous hypoxemia, the presence of secretions, and the need for more than one ETI attempt. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  9. Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Aye Thida

    Full Text Available BACKGROUND: The outcomes from an antiretroviral treatment (ART program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. METHODS: A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up; a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. RESULT: The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84% patients were retained in ART program: 750 (7% were lost to follow-up and 909 (9% died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. CONCLUSION: High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings.

  10. [Analysis of the effect of risk factors at gestational diabetes mellitus].

    Science.gov (United States)

    Shuang, Wang; Huixia, Yang

    2014-05-01

    To assesment the effect of risk factors at gestational diabetes mellitus (GDM). We collected 427 pregnant women who had done 75 g oral glucose tolerance test (OGTT) between September 1(st), 2012 and April 19(th), 2013 in Peking University First Hospital, including 74 pregnant women diagnosed as GDM (GDM group) and 353 pregnant women undiagnosed (non-GDM group). Then we conducted a multiple logistic regression to analyze the clinical datas collected from two groups, which included age, pre-pregnancy body weight and body mass index (BMI), body weight during 11-12 weeks pregnancy, body weight during 23-24 weeks pregnancy; and fasting plasma glucose (FPG), triglyceride (TG) , total cholesterol (TCH) , high density lipoprotein (HDL) , low density lipoprotein (LDL), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR) during early pregnancy; and family history of diabetes mellitus. (1) There were significant difference in age, pre-pregnancy BMI, and FPG, TG, FINS, HOMA-IR during early pregnancy, and family history of diabetes mellitus between two groups (P diabetes mellitus (OR:3.15, 95%CI:1.66-5.99), TG during early pregnancy (OR:2.13, 95%CI:1.17-3.87),BMI before pregnancy (OR:1.36, 95%CI:1.08-1.70), age ≥ 35 years (OR:1.15, 95%CI:1.05-1.26), early pregnancy weight gain (OR:1.20, 95%CI:1.06-1.35), mid pregnancy weight gain (OR:1.28, 95%CI:1.12-1.47), FINS during early pregnancy (OR:1.09, 95%CI:1.01-1.17). FPG, TG and FINS during early pregnancy, BMI before pregnancy, early and mid pregnancy weight gain, family history of diabetes mellitus and age ≥ 35 years are the indepadent risk factors for GDM. We should pay more attention to FPG and TG during early pregnancy, and put weight management into practise since early pregnancy and try to control pregnancy weight gain within reasonable limits.

  11. Cancers in the TREAT Asia HIV Observational Database (TAHOD: a retrospective analysis of risk factors

    Directory of Open Access Journals (Sweden)

    Petoumenos Kathy

    2010-12-01

    Full Text Available Abstract Background This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer. Methods TREAT Asia HIV Observational Database (TAHOD sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs, and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR and unrelated (NADC-IUR. Results A total of 617 patients were included in this study: 215 cancer cases and 402 controls from 13 sites. The majority of cancer cases were male (71%. The mean age (SD for cases was 39 (10.6, 46 (11.5 and 44 (13.7 for ADCs, NADC-IURs and NADCs-IR, respectively. The majority (66% of cancers were ADCs (16% Kaposi sarcoma, 40% non-Hodgkin's lymphoma, and 9% cervical cancer. The most common NADCs were lung (6%, breast (5% and hepatocellular carcinoma and Hodgkin's lymphoma (2% each. There were also three (1.4% cases of leiomyosarcoma reported in this study. In multivariate analyses, individuals with CD4 counts above 200 cells/mm3 were approximately 80% less likely to be diagnosed with an ADC (p Conclusions The spectrum of cancer diagnoses in the Asia region currently does not appear dissimilar to that observed in non-Asian HIV populations. One interesting finding was the cases of leiomyosarcoma, a smooth-muscle tumour, usually seen in children and young adults with AIDS, yet overall quite rare. Further detailed studies are required to better describe the range of cancers in this region, and to help guide the development of screening programmes.

  12. Air pollution and anemia as risk factors for pneumonia in Ecuadorian children: a retrospective cohort analysis.

    Science.gov (United States)

    Harris, Aaron M; Sempértegui, Fernando; Estrella, Bertha; Narváez, Ximena; Egas, Juan; Woodin, Mark; Durant, John L; Naumova, Elena N; Griffiths, Jeffrey K

    2011-11-03

    Ambient air pollution and malnutrition, particularly anemia, are risk factors for pneumonia, a leading cause of death in children under five. We simultaneously assessed these risk factors in Quito, Ecuador. In 2005, we studied two socioeconomically similar neighborhoods in Quito: Lucha de los Pobres (LP) and Jaime Roldos (JR). LP had relatively high levels of air pollution (annual median PM2.5 = 20.4 μg/m3; NO2 = 29.5 μg/m3) compared to JR (annual median PM2.5 = 15.3 μg/m3; NO2 = 16.6 μg/m3). We enrolled 408 children from LP (more polluted) and 413 children from JR (less polluted). All subjects were aged 18-42 months. We obtained medical histories of prior physician visits and hospitalizations during the previous year, anthropometric nutrition data, hemoglobin levels, and hemoglobin oxygen saturation via oximetry. In anemic children, higher pollution exposure was significantly associated with pneumonia hospitalization (OR = 6.82, 95%CI = 1.45-32.00; P = 0.015). In non-anemic children, no difference in hospitalizations by pollution exposure status was detected (OR = 1.04, NS). Children exposed to higher levels of air pollution had more pneumonia hospitalizations (OR = 3.68, 1.09-12.44; P = 0.036), total respiratory illness (OR = 2.93, 95% CI 1.92-4.47; P < 0.001), stunting (OR = 1.88, 1.36-2.60; P < 0.001) and anemia (OR = 1.45, 1.09-1.93; P = 0.013) compared to children exposed to lower levels of air pollution. Also, children exposed to higher levels of air pollution had significantly lower oxygen saturation (92.2% ± 2.6% vs. 95.8% ± 2.2%; P < 0.0001), consistent with air pollution related dyshemoglobinemia. Ambient air pollution is associated with rates of hospitalization for pneumonia and with physician's consultations for acute respiratory infections. Anemia may interact with air pollution to increase pneumonia hospitalizations. If confirmed in larger studies, improving nutrition-related anemia, as well as decreasing the levels of air pollution in Quito

  13. Work Disability among Employees with Diabetes: Latent Class Analysis of Risk Factors in Three Prospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Marianna Virtanen

    Full Text Available Studies of work disability in diabetes have examined diabetes as a homogeneous disease. We sought to identify subgroups among persons with diabetes based on potential risk factors for work disability.Participants were 2,445 employees with diabetes from three prospective cohorts (the Finnish Public Sector study, the GAZEL study, and the Whitehall II study. Work disability was ascertained via linkage to registers of sickness absence and disability pensions during a follow-up of 4 years. Study-specific latent class analysis was used to identify subgroups according to prevalent comorbid disease and health-risk behaviours. Study-specific associations with work disability at follow-up were pooled using fixed-effects meta-analysis.Separate latent class analyses for men and women in each cohort supported a two-class solution with one subgroup (total n = 1,086; 44.4% having high prevalence of chronic somatic diseases, psychological symptoms, obesity, physical inactivity and abstinence from alcohol and the other subgroup (total n = 1,359; 55.6% low prevalence of these factors. In the adjusted meta-analyses, participants in the 'high-risk' group had more work disability days (pooled rate ratio = 1.66, 95% CI 1.38-1.99 and more work disability episodes (pooled rate ratio = 1.33, 95% CI 1.21-1.46. These associations were similar in men and women, younger and older participants, and across occupational groups.Diabetes is not a homogeneous disease in terms of work disability risk. Approximately half of people with diabetes are assigned to a subgroup characterised by clustering of comorbid health conditions, obesity, physical inactivity, abstinence of alcohol, and associated high risk of work disability; the other half to a subgroup characterised by a more favourable risk profile.

  14. Tumor necrosis factor-308 polymorphism with the risk and prognosis of non-Hodgkin lymphomas: a meta-analysis study

    Directory of Open Access Journals (Sweden)

    Gao S

    2016-03-01

    Full Text Available Sicheng Gao,1,* Guoqing Zhu,2,* Yan Lin,1 Xingliang Fan,1 Pingan Qian,1 Junfeng Zhu,3 Yongchun Yu1 1Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 2Department of Clinical Laboratory Medicine, Shanghai Tenth People’s Hospital, Tongji University, 3Department of Hepatology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Tumor necrosis factor-308 (TNF-308 was implied to be associated with the development of non-Hodgkin lymphoma (NHL. The aim of this meta-analysis study was to investigate the association of TNF-308A polymorphism with the susceptibility to, and prognosis of, NHL. Methods: PubMed, Web of Science, Elsevier, HighWire, Scopus, and Google Scholar were searched up to May 2015. The association of TNF-308 polymorphism with the risk of NHL and prognosis was assessed by odds ratio and hazard ratio, respectively. Results: Overall, TNF-308G>A polymorphism increased the risk of NHL, B-cell lymphomas (BCL, and T-cell lymphomas and decreased the risk of follicular lymphomas. In stratified analysis, increased risk of BCL and diffuse large B-cell lymphomas (DLBCL were observed in Caucasians and population-based studies, whereas decreased risk of NHL, BCL, and DLBCL were detected in Asians and hospital-based studies. Furthermore, pooled results of 1,192 patients with NHL from five studies suggested that TNF-308A was correlated with shorter progression-free survival and overall survival in patients with NHL, BCL, and DLBCL. Conclusion: Current evidence indicated that TNF-308A polymorphism was significantly associated with the risk and prognosis of NHL. Future studies should further confirm these associations in other NHL subtypes and ethnicities. Keywords: tumor necrosis factor, polymorphism, rs1800629

  15. A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.

    Directory of Open Access Journals (Sweden)

    Chen Xue

    Full Text Available Post-traumatic stress disorder (PTSD, a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO were used to search for observational studies (cross-sectional, retrospective, and cohort studies about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility

  16. A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans

    Science.gov (United States)

    Liu, Yuan; Kang, Peng; Wang, Meng; Zhang, Lulu

    2015-01-01

    Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD. PMID

  17. A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans.

    Science.gov (United States)

    Xue, Chen; Ge, Yang; Tang, Bihan; Liu, Yuan; Kang, Peng; Wang, Meng; Zhang, Lulu

    2015-01-01

    Post-traumatic stress disorder (PTSD), a complex and chronic disorder caused by exposure to a traumatic event, is a common psychological result of current military operations. It causes substantial distress and interferes with personal and social functioning. Consequently, identifying the risk factors that make military personnel and veterans more likely to experience PTSD is of academic, clinical, and social importance. Four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) were used to search for observational studies (cross-sectional, retrospective, and cohort studies) about PTSD after deployment to combat areas. The literature search, study selection, and data extraction were conducted by two of the authors independently. Thirty-two articles were included in this study. Summary estimates were obtained using random-effects models. Subgroup analyses, sensitivity analyses, and publication bias tests were performed. The prevalence of combat-related PTSD ranged from 1.09% to 34.84%. A total of 18 significant predictors of PTSD among military personnel and veterans were found. Risk factors stemming from before the trauma include female gender, ethnic minority status, low education, non-officer ranks, army service, combat specialization, high numbers of deployments, longer cumulative length of deployments, more adverse life events, prior trauma exposure, and prior psychological problems. Various aspects of the trauma period also constituted risk factors. These include increased combat exposure, discharging a weapon, witnessing someone being wounded or killed, severe trauma, and deployment-related stressors. Lastly, lack of post-deployment support during the post-trauma period also increased the risk of PTSD. The current analysis provides evidence of risk factors for combat-related PTSD in military personnel and veterans. More research is needed to determine how these variables interact and how to best protect against susceptibility to PTSD.

  18. Risk factors for loneliness in patients with cancer: a systematic literature review and meta-analysis.

    Science.gov (United States)

    Deckx, Laura; van den Akker, Marjan; Buntinx, Frank

    2014-10-01

    To systematically review the literature on the severity and risk factors for loneliness in adult cancer patients. We systematically reviewed quantitative studies addressing loneliness in cancer patients. Exclusion criteria were absence of a validated loneliness questionnaire, and studies that focused on loneliness determined by specific circumstances, and not cancer in general (e.g. appearance concerns, cultural and language barriers, requiring palliative care). We searched PsycINFO, CINAHL, Embase, Cochrane Library, and Pubmed in compliance with the predefined in- and exclusion criteria. The search, quality appraisal, and data extraction were performed by two independent reviewers. Weighted mean scores were calculated by using random effects adjusted inverse variance weighting. We included 15 studies. In 13 studies the UCLA loneliness scale was used (range 20-80; higher scores indicate higher loneliness). The weighted mean loneliness score was 38.26 (95% CI: 35.51-41.00), which corresponds to moderate loneliness. Time since diagnosis was positively associated with degree of loneliness. Other cancer-related factors, such as cancer site, treatment type, or stage of disease were not associated with loneliness. The non-cancer related determinants of loneliness in cancer patients that emerged from our review were being unmarried (people who have never been married, are widowed or divorced), and lack of psychological or social support. Our findings suggest that the level of loneliness rises with increasing time after cancer diagnosis. Furthermore, social functioning emerged as a consistent theme, for which it was shown that lack of social support was associated with increasing levels of loneliness. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Surgical wound infection in urology. Analysis of risk factors and associated microorganisms.

    Science.gov (United States)

    Alonso-Isa, M; Medina-Polo, J; Lara-Isla, A; Pérez-Cadavid, S; Arrébola-Pajares, A; Sopeña-Sutil, R; Benítez-Sala, R; Justo-Quintas, J; Gil-Moradillo, J; Passas-Martínez, J B; Tejido-Sánchez, A

    2017-03-01

    Open surgery continues to have a fundamental role in urology, and one of its main complications is surgical wound infection. Our objective was to analyse surgical wound infection in patients who underwent surgery in our Department of Urology and to assess the risk factors, microorganisms and resistances by type of surgery. This was a prospective observational study that included 940 patients: 370 abdominal/open lumbar surgeries and 570 genitoperineal surgeries. We analysed age, sex, comorbidities, stay and type of surgery, as well as the causal microorganisms and antibiotic resistances. For genitoperineal surgery, we found 15 cases (2.6%) of surgical wound infection associated with previous urinary catheterisation. Most of the isolated microorganisms corresponded to enterobacteriaceae, highlighting the resistance to beta-lactam. In abdominal/lumbar surgery, we found 41 cases (11.1%) of surgical wound infection. The incidence rate was 3.3% in prostate surgery; 9.8% in renal surgery; and 45.0% in cystectomy. Heart disease was associated with a higher incidence rate of surgical wound infection. The most common microorganisms were Enterococcus spp. (27.1%), E.coli (22.9%) and Staphylococcus aureus (14.6%). Enterococcus and beta-lactamase-producing E.coli are resistant to ampicillin in 37.5% and 41.7% of cases, respectively. We found a low incidence rate of surgical wound infection in genitoperineal surgery, compared with renal surgery and cystectomy. The presence of heart disease and carrying a previous urinary catheter are factors associated with surgical wound infection. Enterococcus and E.coli are the most common pathogens, with high rates of resistance. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis.

    Science.gov (United States)

    Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Maïga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J D; Hounton, Sennen

    2015-01-01

    Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia. Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15-49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey) and modern contraceptive use among currently married women in all administrative regions over the time period 2000-2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third) after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62%) fall in one of the risk categories (excluding first births), with wide regional variation from 55% in

  1. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); M’Kacher, Radhia [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Lessard, Nathalie [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Koscielny, Serge [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Elfassy, Eric; Raoux, François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France); Carde, Patrice [Department of Hematology, Institut Gustave Roussy, Villejuif (France); Santos, Marcos Dos [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Margainaud, Jean-Pierre [Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif (France); Sabatier, Laure [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Ghalibafian, Mithra [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Paul, Jean-François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France)

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  2. Recipient-related clinical risk factors for primary graft dysfunction after lung transplantation: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yao Liu

    Full Text Available BACKGROUND: Primary graft dysfunction (PGD is the main cause of early morbidity and mortality after lung transplantation. Previous studies have yielded conflicting results for PGD risk factors. Herein, we carried out a systematic review and meta-analysis of published literature to identify recipient-related clinical risk factors associated with PGD development. METHOD: A systematic search of electronic databases (PubMed, Embase, Web of Science, Cochrane CENTRAL, and Scopus for studies published from 1970 to 2013 was performed. Cohort, case-control, or cross-sectional studies that examined recipient-related risk factors of PGD were included. The odds ratios (ORs or mean differences (MDs were calculated using random-effects models. RESULT: Thirteen studies involving 10042 recipients met final inclusion criteria. From the pooled analyses, female gender (OR 1.38, 95% CI 1.09 to 1.75, African American (OR 1.82, 95%CI 1.36 to 2.45, idiopathic pulmonary fibrosis (IPF (OR 1.78, 95% CI 1.49 to 2.13, sarcoidosis (OR 4.25, 95% CI 1.09 to 16.52, primary pulmonary hypertension (PPH (OR 3.73, 95%CI 2.16 to 6.46, elevated BMI (BMI≥25 kg/m2 (OR 1.83, 95% CI 1.26 to 2.64, and use of cardiopulmonary bypass (CPB (OR 2.29, 95%CI 1.43 to 3.65 were significantly associated with increased risk of PGD. Age, cystic fibrosis, secondary pulmonary hypertension (SPH, intra-operative inhaled nitric oxide (NO, or lung transplant type (single or bilateral were not significantly associated with PGD development (all P>0.05. Moreover, a nearly 4 fold increased risk of short-term mortality was observed in patients with PGD (OR 3.95, 95% CI 2.80 to 5.57. CONCLUSIONS: Our analysis identified several recipient related risk factors for development of PGD. The identification of higher-risk recipients and further research into the underlying mechanisms may lead to selective therapies aimed at reducing this reperfusion injury.

  3. Perinatal risk factors for strabismus

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry

    2010-01-01

    Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....

  4. Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients.

    Science.gov (United States)

    Tarr, T; Lakos, G; Bhattoa, H P; Shoenfeld, Y; Szegedi, G; Kiss, E

    2007-01-01

    The objective of this study was to characterize risk factors for thrombotic events in lupus patients. A total of 272 lupus patients were followed up for five years during which the presence of aPL antibodies [anticardiolipin (aCL), anti-beta2-glycoprotein I (abeta2GPI) and lupus anticoagulant (LAC)] were determined, and all thrombotic incidents and antithrombotic therapy-related data were collected. At baseline, three groups were constituted, an aPL- group with 107 aPL negative patients, an aPL+ group with 81 aPL positive patients without clinical thrombosis and a secondary antiphospholipid syndrome (APS) group with 84 aPL+ patients who met the Sapporo criteria. LAC was more common in the APS than the aPL+ group (32.1% versus 9.9%, P anticoagulant therapy, thrombotic events reoccurred in 8.3% of the APS group. These findings indicate that LAC, constant and cumulative presence of aPL and previous thrombosis are positive predictors for the development of thrombotic complication in lupus patients.

  5. Seroprevalence and risk factor analysis for exposure to equine encephalosis virus in Israel, Palestine and Jordan.

    Science.gov (United States)

    Tirosh-Levy, Sharon; Gelman, Boris; Zivotofsky, Doni; Quraan, Lara; Khinich, Evgeny; Nasereddin, Abdelmajeed; Abdeen, Ziad; Steinman, Amir

    2017-05-01

    Equine encephalosis virus (EEV) is an orbivirus transmitted by Culicoides species. Most infected horses show mild clinical signs and mortality is usually very low. EEV is closely related and similarly transmitted to other, more pathogenic and economically important, orbiviruses such as African horse sickness virus (AHSV), bluetongue virus (BTV) and epizootic haemorrhagic disease viruses (EHDV), and may serve as an indicator for possible transmission of the latter. Israel has been reported to be endemic for EEV since 2001. This study was initiated to re-evaluate the current seroprevalence and risk factors for EEV exposure in Israel, and to assess, for the first time, the seroprevalence of EEV in Palestine and Jordan. Three hundred and sixteen serum samples were collected from apparently healthy horses at 21 farms in Israel, 66 horses at nine farms in Palestine and 100 horses at three farms in Jordan. The presence of EEV antibodies was detected by a serum neutralization assay. Seroprevalence of EEV was 58.2% (184/316 horses) in Israel, 48.5% (32/66 horses) in Palestine and 2% (2/100 horses) in Jordan. Seroprevalence in Jordan was significantly lower than in Israel and Palestine (P Palestine and horses in Jordan were also exposed to this virus emphasizing the potential of pathogens to invade new ecological niches.

  6. Bladder Carcinoma Data with Clinical Risk Factors and Molecular Markers: A Cluster Analysis

    Directory of Open Access Journals (Sweden)

    Enrique Redondo-Gonzalez

    2015-01-01

    Full Text Available Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments of nonmuscle invasive bladder carcinoma (NMIBC. A population of 45 patients with a new diagnosis of NMIBC was selected. Patients with benign prostatic hyperplasia (BPH, muscle invasive bladder carcinoma (MIBC, carcinoma in situ (CIS, and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventional transurethral resection (TURBT and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR. A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior.

  7. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark.

    Science.gov (United States)

    Schreiber Pedersen, Louise; Lose, Gunnar; Høybye, Mette Terp; Elsner, Susanne; Waldmann, Annika; Rudnicki, Martin

    2017-08-01

    Urinary incontinence (UI) is a prevalent condition that interferes with women's health-related quality of life. Prevalence rates from earlier studies are wide-ranging, due to heterogeneity in methodology, definition of UI and the populations included. We aimed to determine the prevalence of UI and associated risk factors in Germany and Denmark using the same methodology, definition and population. A postal survey was conducted in two regions in Germany and Denmark, including 8000 women aged 18+ years. UI was defined as any complaint of involuntary loss of urine. The questionnaire contained socio-demographic questions and the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF). The response rate in Germany and Denmark was 46.2 and 66.6% (p Denmark, respectively. The subgroup of women with body mass index (BMI) ≥35 had the highest prevalence of UI (67.3%). The subgroup of women with BMI Denmark were similar, despite significantly different response rates. This difference may reflect various attitudes towards answering a questionnaire, but the response rate on questions concerning UI seemed consistent. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis.

    Directory of Open Access Journals (Sweden)

    Tauqeer Hussain Mallhi

    Full Text Available Dengue induced acute kidney injury (AKI imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients.A total 667 dengue patients (2008-2013 were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods.There were 95 patients (14.2% who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P3days was also observed among AKI patients (OR = 1.3, P = 0.044 [corrected].Additionally, 48.4% AKI patients had renal insufficiencies at discharge that were signicantly associated with severe dengue, secondary infection and diabetes mellitus. Overall mortality was 1.2% and all fatal cases had AKI.The incidence of AKI is high at 14.2% among dengue patients, and those with AKI portended significant morbidity, mortality, longer hospital stay and poor renal outcomes. Our findings suggest that AKI in dengue is likely to increase healthcare burden that underscores the need of clinicians' alertness to this highly morbid and potentially fatal complication for optimal prevention and management.

  9. Incidence and mechanism of central pontine myelinolysis based on analysis of MRI images and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, Masato [Akita Univ. (Japan). School of Medicine

    2000-02-01

    In this study, the incidence of central pontine myelinolysis (CPM)-like lesions on MRI images was studied in 1917 subjects, 1,500 of which were psychiatric patients and 417 were patients attending a brain health examination. The CPM-like lesions were first classified into four groups based on the characteristics of their MRI images: group 1 showed symmetrical lesions on both T1 low and T2 high images and were considered to be typical CPM; group 2 showed symmetrical high intensity lesions only on T2 images; group 3 had asymmetrical lesions only on T2 images; and group 4 had asymmetrical lesions on both T1 low and T2 high images. Furthermore, the relationships of each group with particular risk factors, such as alcoholism, hypertension, hyperlipidemia were statistically analysed. The cause of CPM-like features in the MRI images were discussed. Among our subjects, the incidence of CPM-like lesions was 3.8%, and that of group 1 was 1.2%. Significant correlations between group 1 and alcoholism, and group 3 and 4 with brain ischemic lesions were observed. A previous hypothesis that group 2 may be a premature state of CPM is not supported by our results. (author)

  10. Risk factors of placental abruption

    Directory of Open Access Journals (Sweden)

    Hooria Seyedhosseini Ghaheh

    2013-01-01

    Full Text Available Background: Placental abruption is one of the most common causes of bleeding during pregnancy. Multiple factors are known to be associated with increase of risk of placental abruption such as alcohol, cocaine use and cigarette smoking. The objective of this study was to identify risk factors for placental abruption in an Iranian women population. Materials and Methods: In a retrospective case - control study birth records included 78 cases with placental abruption and 780 randomly selected controls were investigated. Statistical analysis for comparing the studied risk factors between groups was performed using Pearson ′ s Chi-square test along with presenting relevant odds ratio (OR. Results: From 7301 deliveries included in the study, 78 (1% was complicated placental abruption. Women aged 35 or more likely for experiencing (OR = 3.650, 95% confidence interval [CL] = 1.57-6.83 and those who had a previous cesarean section (OR = 2.65, 95% CL = 3.91- 33.41 were in higher risk for placental abruption ([50 cases] 64% vs. [28 cases] 36% P < 0.01. Conclusion: The results indicate that among the placental abruption is one of the most common causes of bleeding during the pregnancy and one of the major obstetrical emergency.

  11. Analysis of risk factors in the development of bronchopleural fistula after major anatomic lung resection: experience of a single centre.

    Science.gov (United States)

    Nachira, Dania; Chiappetta, Marco; Fuso, Leonello; Varone, Francesco; Leli, Ilaria; Congedo, Maria T; Margaritora, Stefano; Granone, Pierluigi

    2017-02-01

    The bronchopleural fistula (BPF) is a rare but potentially fatal complication of major thoracic surgery. The purpose of this work is to investigate the risk factors associated with the development of fistulas after lobectomy and pneumonectomy. We retrospectively reviewed the records of 835 patients who underwent major anatomic lung resection at our centre from January 2003 to December 2013. Of these, 49 underwent pneumonectomy (P group) and 786 lobectomy (L group). A total of 18 patients (2.6%) developed a BPF in the postoperative period, of which there were 11 in the L group (1.3%) and seven in the P group (14.28%). The 30-day mortality was 0.05% (one patient after right pneumonectomy). In the L group, three patients developed a fistula after a left lobectomy and eight after a right one, of which four developed after bilobectomy. Univariate analysis showed that induction therapy, lower lobectomy, manual suture of the bronchus, 'not covered' bronchial stump, empyema, postoperative anaemia and pulmonary infections and mechanical ventilation >24 h are associated with the development of fistulas after lobectomy. Multivariate analysis confirmed that induction therapy, manual closure of the bronchus, postoperative pulmonary infections and anaemia are the main risk factors involved in our series. In the P group, four patients developed a fistula after a right pneumonectomy and three after a left one. Postoperative empyema and pulmonary infections, mechanical ventilation >24 h and female gender emerged as the main risk factors on univariate analysis, while on multivariate analysis, only the female gender presented a trend towards significance. Postoperative pulmonary infections, empyema and mechanical ventilation >24 h are strongly associated with the development of BPFs after both pneumonectomy and lobectomy in our series. © 2017 Royal Australasian College of Surgeons.

  12. Dietary patterns and risk of cancers of the upper aerodigestive tract: a factor analysis in Uruguay.

    Science.gov (United States)

    De Stefani, Eduardo; Boffetta, Paolo; Correa, Pelayo; Deneo-Pellegrini, Hugo; Ronco, Alvaro L; Acosta, Gisele; Mendilaharsu, María

    2013-01-01

    In the time period 1996-2004, we conducted a case-control study in Montevideo, Uruguay with the objective of exploring the role of foods and alcoholic beverages in the etiology of cancers of the upper aerodigestive tract (UADT). In brief, 563 male cases and 1099 male controls were frequency matched on age and residence using random sampling. All the participants were drawn from the 4 major public hospitals in Montevideo. We used exploratory factor analysis among controls. Through Scree plot test, the model retained 4 factors, which were labeled as prudent, starchy plants, Western, and drinker. These dietary patterns explained 34.8% of the total variance. Whereas the prudent pattern was inversely associated with UADT cancer [odds ratios (OR) for the upper tertile vs. the lowest one 0.52, 95% confidence intervals 0.32-0.76, P value for trend = 0.0005), the remaining patterns were significantly and positively associated with UADT cancers. We conclude that these patterns were similar among the oral and laryngeal cancers, both in the direction of the ORs and in the magnitude of the associations, suggesting that these cancer sites share the effect of dietary patterns in the etiology of cancer of the upper aerodigestive tract.

  13. Influence of risk factors and past events on flood resilience in coastal megacities: Comparative analysis of NYC and Shanghai.

    Science.gov (United States)

    Xian, Siyuan; Yin, Jie; Lin, Ning; Oppenheimer, Michael

    2018-01-01

    Coastal flood protection measures have been widely implemented to improve flood resilience. However, protection levels vary among coastal megacities globally. This study compares the distinct flood protection standards for two coastal megacities, New York City and Shanghai, and investigates potential influences such as risk factors and past flood events. Extreme value analysis reveals that, compared to NYC, Shanghai faces a significantly higher flood hazard. Flood inundation analysis indicates that Shanghai has a higher exposure to extreme flooding. Meanwhile, Shanghai's urban development, population, and economy have increased much faster than NYC's over the last three decades. These risk factors provide part of the explanation for the implementation of a relatively high level of protection (e.g. reinforced concrete sea-wall designed for a 200-year flood return level) in Shanghai and low protection (e.g. vertical brick and stone walls and sand dunes) in NYC. However, individual extreme flood events (typhoons in 1962, 1974, and 1981) seem to have had a greater impact on flood protection decision-making in Shanghai, while NYC responded significantly less to past events (with the exception of Hurricane Sandy). Climate change, sea level rise, and ongoing coastal development are rapidly changing the hazard and risk calculus for both cities and both would benefit from a more systematic and dynamic approach to coastal protection. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Neurological complications after liver transplantation as a consequence of immunosuppression: univariate and multivariate analysis of risk factors.

    Science.gov (United States)

    Rompianesi, Gianluca; Montalti, Roberto; Cautero, Nicola; De Ruvo, Nicola; Stafford, Anthony; Bronzoni, Carolina; Ballarin, Roberto; De Pietri, Lesley; Di Benedetto, Fabrizio; Gerunda, Giorgio E

    2015-07-01

    Neurological complications (NCs) can frequently and significantly affect morbidity and mortality of liver transplant (LT) recipients. We analysed incidence, risk factors, outcome and impact of the immunosuppressive therapy on NC development after LT. We analysed 478 LT in 440 patients, and 93 (19.5%) were followed by NCs. The average LOS was longer in patients experiencing NCs. The 1-, 3- and 5-year graft survival and patient survival were similar in patients with or without a NC. Multivariate analysis showed the following as independent risk factors for NC: a MELD score ≥20 (OR = 1.934, CI = 1.186-3.153) and an immunosuppressive regimen based on calcineurin inhibitors (CNIs) (OR = 1.669, CI = 1.009-2.760). Among patients receiving an everolimus-based immunosuppression, the 7.1% developed NCs, vs. the 16.9% in those receiving a CNI (P = 0.039). There was a 1-, 3- and 5-year NC-free survival of 81.7%, 81.1% and 77.7% in patients receiving a CNI-based regimen and 95.1%, 93.6% and 92.7% in those not receiving a CNI-based regimen (P < 0.001). In patients undergoing a LT and presenting with nonmodifiable risk factors for developing NCs, an immunosuppressive regimen based on CNIs is likely to result in a higher rate of NCs compared to mTOR inhibitors. © 2015 Steunstichting ESOT.

  15. Combined statistical analysis of vasodilation and flow curves in brachial ultrasonography: technique and its connection to cardiovascular risk factors

    Science.gov (United States)

    Boisrobert, Loic; Laclaustra, Martin; Bossa, Matias; Frangi, Andres G.; Frangi, Alejandro F.

    2005-04-01

    Clinical studies report that impaired endothelial function is associated with Cardio-Vascular Diseases (CVD) and their risk factors. One commonly used mean for assessing endothelial function is Flow-Mediated Dilation (FMD). Classically, FMD is quantified using local indexes e.g. maximum peak dilation. Although such parameters have been successfully linked to CVD risk factors and other clinical variables, this description does not consider all the information contained in the complete vasodilation curve. Moreover, the relation between flow impulse and the vessel vasodilation response to this stimulus, although not clearly known, seems to be important and is not taken into account in the majority of studies. In this paper we propose a novel global parameterization for the vasodilation and the flow curves of a FMD test. This parameterization uses Principal Component Analysis (PCA) to describe independently and jointly the variability of flow and FMD curves. These curves are obtained using computerized techniques (based on edge detection and image registration, respectively) to analyze the ultrasound image sequences. The global description obtained through PCA yields a detailed characterization of the morphology of such curves allowing the extraction of intuitive quantitative information of the vasodilation process and its interplay with flow changes. This parameterization is consistent with traditional measurements and, in a database of 177 subjects, seems to correlate more strongly (and with more clinical parameters) than classical measures to CVD risk factors and clinical parameters such as LDL- and HDL-Cholesterol.

  16. Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yuanfeng Gong

    2017-04-01

    Full Text Available Objective: To investigate the association between serum concentration of insulin-like growth factor (IGF and the risk of pancreatic cancer (PaC. Methods: We identified eligible studies in Medline and EMBASE databases (no reference trials from 2014 to 2016 in addition to the reference lists of original studies and review articles on this topic. A summary of relative risks with 95% confidence intervals (CI was calculated using a random-effects model. The heterogeneity between studies was assessed using Cochran Q and I2 statistics. Results: Ten studies (seven nested case-control studies and three retrospective case-control studies were selected as they met our inclusion criteria in this meta-analysis. All these studies were published between 1997 and 2013. The current data suggested that serum concentrations of IGF-I, IGF-II and insulin-like growth factor binding protein-3 (IGFBP-3in addition to the IGF-I/IGFBP-3 ratio were not associated with an increased risk of PaC (Summary relative risks (SRRs = 0.92, 95% CI: 0.67–1.16 for IGF-I; SRRs = 0.84, 95% CI: 0.54–1.15 for IGF-II; SRRs = 0.93, 95% CI: 0.69–1.17 for IGFBP-3; SRRs = 0.97, 95% CI: 0.71–1.23 for IGF-I/IGFBP-3 ratio. There was no publication bias in the present meta-analysis. Conclusion: Serum concentrations of IGF-I, IGF-II, IGFBP-1 and IGFBP-3 as well as the IGF-I/IGFBP-3 ratio were not associated with increased risk of PaC.

  17. Serum Insulin-Like Growth Factor Axis and the Risk of Pancreatic Cancer: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Gong, Yuanfeng; Zhang, Bingyi; Liao, Yadi; Tang, Yunqiang; Mai, Cong; Chen, Tiejun; Tang, Hui

    2017-04-18

    To investigate the association between serum concentration of insulin-like growth factor (IGF) and the risk of pancreatic cancer (PaC). We identified eligible studies in Medline and EMBASE databases (no reference trials from 2014 to 2016) in addition to the reference lists of original studies and review articles on this topic. A summary of relative risks with 95% confidence intervals (CI) was calculated using a random-effects model. The heterogeneity between studies was assessed using Cochran Q and I² statistics. Ten studies (seven nested case-control studies and three retrospective case-control studies) were selected as they met our inclusion criteria in this meta-analysis. All these studies were published between 1997 and 2013. The current data suggested that serum concentrations of IGF-I, IGF-II and insulin-like growth factor binding protein-3 (IGFBP-3)in addition to the IGF-I/IGFBP-3 ratio were not associated with an increased risk of PaC (Summary relative risks (SRRs) = 0.92, 95% CI: 0.67-1.16 for IGF-I; SRRs = 0.84, 95% CI: 0.54-1.15 for IGF-II; SRRs = 0.93, 95% CI: 0.69-1.17 for IGFBP-3; SRRs = 0.97, 95% CI: 0.71-1.23 for IGF-I/IGFBP-3 ratio). There was no publication bias in the present meta-analysis. Serum concentrations of IGF-I, IGF-II, IGFBP-1 and IGFBP-3 as well as the IGF-I/IGFBP-3 ratio were not associated with increased risk of PaC.

  18. Analysis of risk factors for occlusions of a synthetic femoropopliteal bypass graft

    Directory of Open Access Journals (Sweden)

    Mirković Nikola

    2015-01-01

    Full Text Available Background/Aim. Femoropopliteal bypass is a revascularization technique of lower extremities with excellent outcome. The great saphenous vein is the best graft material, but if it is not adequate or has been removed, synthetic grafts are an useful alternative. Graft occlusion is the most significant complication with the most serious consequences. The aim of this study was to analyse predictive factors for the synthetic femoropopliteal bypass occlusions. Methods. This retrospective case-control study included all patients who underwent synthetic femoropopliteal bypass due to peripheral arterial occlusive disease at the Vascular Surgery Center, Clinical Center of Kragujevac, Serbia, from 2007 to 2013. The cases group were the patients with femoropopliteal graft occlusion (n = 44, with the control group consisted of the patients without such an outcome (n = 88. Results. Significant effects to occlusion were: concomitant cardiovascular disease (adjustedOR 27.05; 95% CI 4.74; 154.35, a type of femoropopliteal bypass (adjustedOR 16.50; 95% CI 4.05; 67.24, previous vascular intervention (adjustedOR 4.67; 95% CI 1.20; 18.14, clinical stage of the disease (adjustedOR 3.73; 95% CI 1.94; 7.18, administration of postoperative oral anticoagulant therapy (adjustedOR 0.05; 95% CI 0.01; 0.23 and the use of angiotensin converting enzyme inhibitors (adjustedOR 0.14; 95% CI 0.03; 0.70. A significant synergism was shown for the following combinations of the observed risk factors: type of femoropopliteal bypass and cardiovascular disease, type of femoropopliteal bypass and previous vascular intervention, previous vascular intervention and cardiovascular disease, previous vascular intervention and beta blockers, cardiovascular disease and diabetes, type of femoropopliteal bypass and antiaggregant therapy, clinical stage of disease and cardiovascular disease, previous vascular intervention and antiaggregant therapy. Conclusion. Concomitant cardiovascular disease

  19. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA.

    Directory of Open Access Journals (Sweden)

    Virginia R Roth

    Full Text Available The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission.The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted.The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76.This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions.

  20. Analysis of Blood Glucose Distribution Characteristics and Its Risk Factors among a Health Examination Population in Wuhu (China)

    Science.gov (United States)

    Song, Jiangen; Zha, Xiaojuan; Li, Haibo; Guo, Rui; Zhu, Yu; Wen, Yufeng

    2016-01-01

    Background: Diabetes mellitus (DM) and Impaired Fasting Glucose (IFG) represent serious threats to human health, and as a result, this study was aimed at understanding the blood glucose distribution characteristics and the risk factors among a large health examination population in China. Methods: An investigation with physical and biochemical examinations and questionnaires was conducted in the physical examination center from 2011 to 2014 and as a result 175,122 physical examination attendees were enrolled in this study. Multivariate logistic regression was used to explore the factors influencing blood sugar levels. Results: The rates of IFG and DM were 6.0% and 3.8%. Prevalence were 7.6%/5.1% in males and 5.1%/2.8% in females for IFG and DM, respectively. The prevalence of IFG and DM were thus higher in males than in females. In the normal group, except high density lipoprotein (HDL) that was significantly higher than in the IFG and DM group, the other indexes (age, body mass index (BMI), glucose (Glu), total cholesterol (TC) and total glycerides (TG) were lower than those in the IFG and DM group. The proportion of IFG and DM also increased with the increases in proportion of abnormal blood pressure, smoking and alcohol consumption. Multivariate logistic regression analysis showed that increasing age, high BMI, high TC, high TG and low HDL increased the risk of diabetes, while in males, in addition to the above factors, the smoking and drinking factors also increased the risk of diabetes. After the age of 65, the blood glucose level reached a peak in males, while in females, the increasing trends was on the rise. The inflexion age of the fast rise was younger in males than in females. Conclusion: The study population showed a high prevalence of DM and IFG among the adults. Regular physical examination for the early detection of diabetes is recommended in the high-risk population. PMID:27043603

  1. Analysis of Blood Glucose Distribution Characteristics and Its Risk Factors among a Health Examination Population in Wuhu (China).

    Science.gov (United States)

    Song, Jiangen; Zha, Xiaojuan; Li, Haibo; Guo, Rui; Zhu, Yu; Wen, Yufeng

    2016-03-31

    Diabetes mellitus (DM) and Impaired Fasting Glucose (IFG) represent serious threats to human health, and as a result, this study was aimed at understanding the blood glucose distribution characteristics and the risk factors among a large health examination population in China. An investigation with physical and biochemical examinations and questionnaires was conducted in the physical examination center from 2011 to 2014 and as a result 175,122 physical examination attendees were enrolled in this study. Multivariate logistic regression was used to explore the factors influencing blood sugar levels. The rates of IFG and DM were 6.0% and 3.8%. Prevalence were 7.6%/5.1% in males and 5.1%/2.8% in females for IFG and DM, respectively. The prevalence of IFG and DM were thus higher in males than in females. In the normal group, except high density lipoprotein (HDL) that was significantly higher than in the IFG and DM group, the other indexes (age, body mass index (BMI), glucose (Glu), total cholesterol (TC) and total glycerides (TG) were lower than those in the IFG and DM group. The proportion of IFG and DM also increased with the increases in proportion of abnormal blood pressure, smoking and alcohol consumption. Multivariate logistic regression analysis showed that increasing age, high BMI, high TC, high TG and low HDL increased the risk of diabetes, while in males, in addition to the above factors, the smoking and drinking factors also increased the risk of diabetes. After the age of 65, the blood glucose level reached a peak in males, while in females, the increasing trends was on the rise. The inflexion age of the fast rise was younger in males than in females. The study population showed a high prevalence of DM and IFG among the adults. Regular physical examination for the early detection of diabetes is recommended in the high-risk population.

  2. Multivariate analysis of perioperative risk factors associated with postoperative pulmonary complications in elder patients undergoing upper abdominal surgery

    Directory of Open Access Journals (Sweden)

    Wen-bing LI

    2011-06-01

    Full Text Available Objective To explore the correlation between the perioperative risk factors and postoperative pulmonary complications(POPC in elder patients undergoing upper abdominal surgery.Methods A retrospective survey of 169 elder patients(age over 60 years,received elective upper abdominal surgery under general anesthesia from Jan.1,2006 to Jan.1,2010 was conducted.The perioperative factors influencing respiratory function were evaluated,including clinical manifestations,chest X-ray,pulmonary function,arterial blood gas analysis,duration of anesthesia,incision type,duration of nasogastric tube and ambulation time.Meanwhile,the relationship between POPC and the factors mentioned above was analyzed.Results POPC were seen to occur in 77 of the 169 patients(45.6%,and the most common complication was pneumonia(20 cases,followed by atelectasis(18 cases,tracheobronchitis or acute exacerbations of chronic bronchitis(17 cases,bronchospasm(15 cases,acute respiratory failure(5 cases and pulmonary embolism(2 cases.Multivariate logistic analysis showed that the postoperative nasogastric intubation,preoperative respiratory symptoms,decreased forced expiratory volume in 1st second/forced vital capacity(FEV1/FVC and longer duration of anesthesia were the valuable risk factors for prediction of POPC.Conclusions It is recommend that a detailed preoperative pulmonary examination and pulmonary function test in elder patients who are going to have upper abdominal surgery should be done to identify the risk for POPC.Preoperative intervention therapy may be helpful to improve pulmonary function,decrease the incidence of POPC and lower mortality of the patients.

  3. Analysis of safety, risk factors and pretreatment methods during rush hymenoptera venom immunotherapy.

    Science.gov (United States)

    Gorska, Lucyna; Chelminska, Marta; Kuziemski, Krzysztof; Skrzypski, Marcin; Niedoszytko, Marek; Damps-Konstanska, Iwona; Szymanowska, Amelia; Siemińska, Alicja; Wajda, Beata; Drozdowska, Adrianna; Jutel, Marek; Jassem, Ewa

    2008-01-01

    The safety profile of venom immunotherapy is a relevant issue. We evaluated the frequency of severe adverse events (SAE), associated risk factors, retrospective comparison of pretreatment protocols including solely H1 receptor blockers and a combination of H1 and H2 receptor blockers during rush Hymenoptera venom immunotherapy. The study group comprised 118 patients. The treatment was initiated according to a 5-day rush protocol with the use of standardized venom allergens of either wasp or honeybee. During the rush induction, side effects occurred in 18 patients (15.2%), whereas SAE were present in 7 patients (5.9%). Twelve out of 18 (66.6%) developed anaphylactic reactions on the fourth day of the rush protocol, with the majority of cases at a dose of 40 or 60 microg of the venom extract (p = 0.001). The frequency of SAE was also significantly higher on the fourth day than thereafter (p = 0.0001) as well as in patients allergic to bee venom (p = 0.049). All systemic side effects were more frequent in women (p = 0.0065). However, this relation was not true when SAE were consider (p = 0.11). A higher percentage of SAE was observed in the subjects pretreated with both H1 and H2 receptor antagonists than in those pretreated with H1 blocker only (8.8 vs. 4.1%); however, the difference was not significant. Considerable severity of allergic adverse events requires particular attention to patients allergic to bee venom and during rush phase, especially when rapidly increasing doses are administered. Pretreatment with H2 blockers is debatable and warrants further investigation. Copyright (c) 2008 S. Karger AG, Basel.

  4. Job demands and job strain as risk factors for employee wellbeing in elderly care: an instrumental-variables analysis.

    Science.gov (United States)

    Elovainio, Marko; Heponiemi, Tarja; Kuusio, Hannamaria; Jokela, Markus; Aalto, Anna-Mari; Pekkarinen, Laura; Noro, Anja; Finne-Soveri, Harriet; Kivimäki, Mika; Sinervo, Timo

    2015-02-01

    The association between psychosocial work environment and employee wellbeing has repeatedly been shown. However, as environmental evaluations have typically been self-reported, the observed associations may be attributable to reporting bias. Applying instrumental-variable regression, we used staffing level (the ratio of staff to residents) as an unconfounded instrument for self-reported job demands and job strain to predict various indicators of wellbeing (perceived stress, psychological distress and sleeping problems) among 1525 registered nurses, practical nurses and nursing assistants working in elderly care wards. In ordinary regression, higher self-reported job demands and job strain were associated with increased risk of perceived stress, psychological distress and sleeping problems. The effect estimates for the associations of these psychosocial factors with perceived stress and psychological distress were greater, but less precisely estimated, in an instrumental-variables analysis which took into account only the variation in self-reported job demands and job strain that was explained by staffing level. No association between psychosocial factors and sleeping problems was observed with the instrumental-variable analysis. These results support a causal interpretation of high self-reported job demands and job strain being risk factors for employee wellbeing. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  5. Analysis of risk factors associated with 30-day readmissions following pediatric plastic surgery: a review of 5376 procedures.

    Science.gov (United States)

    Tahiri, Youssef; Fischer, John P; Wink, Jason D; Paine, Kaitlyn M; Paliga, J Thomas; Bartlett, Scott P; Taylor, Jesse A

    2015-02-01

    Unplanned surgical readmissions represent a benchmark outcome and pose a considerable cost burden for health care systems. The authors evaluated risk factors associated with readmission following pediatric plastic surgery using a prospective, validated, national database. Patients younger than 18 years who underwent primary pediatric plastic surgery procedures were identified from the 2013 pediatric American College of Surgeons National Surgical Quality Improvement Program database.Two cohorts were compared: patients who experienced readmission and those who did not. Patient characteristics, comorbidities, intraoperative details,and 30-day postoperative outcomes, including complications and readmissions,were analyzed. Multivariate logistic regression analysis was used to identify factors associated with readmission. A total of 5376 patients were included, for an overall 2.40 percent readmission rate. The study cohort was, on average, 5.47 ± 5.21 years old,51.60 percent (n = 2774) were male, and 65.92 percent of cases (n = 3544)were outpatient procedures. The average number of relative value units per case was 10.15 ± 8.01. Patients with medical comorbidities (p < 0.001) and those with a preoperatively contaminated or infected wound were at higher risk for readmission (p < 0.001). Patients with higher American Society of Anesthesiologists scores (p < 0.001), longer operative times (p < 0.001), and longer hospitalizations (p < 0.0171) were also independently at greater risk for readmission. The most significant independent predictors of readmission were postoperative surgical and medical complications (OR, 6.94 and 11.92,respectively; p < 0.001). These results help target patients at greater risk for readmission and afford an opportunity to provide evidence-based interventions to mitigate risk and minimize cost burden for health care systems. (Plast. Reconstr. Surg.135: 521, 2015.) Risk, III.

  6. Characteristics and risk factors of rheumatoid arthritis in the United States: an NHANES analysis

    Directory of Open Access Journals (Sweden)

    Bei Xu

    2017-11-01

    Full Text Available Background We examined the United States National Health and Nutrition Examination Survey (NHANES database to determine factors associated with rheumatoid arthritis (RA in adults 20 to 55 years of age. Methods NHANES data collected between 2007 and 2014, excluding the 2011–2012 period, were used. Subjects were divided into those with and without RA. Demographic, clinical, and lifestyle factors were compared between the groups. Results After applying inclusion/exclusion criteria, 8,789 persons were included in the study (8,483 without RA, 306 with RA. Multivariable analysis indicated that advanced age (odds ratio [OR] = 1.09, 95% CI [1.07–1.11], P < 0.001, regular smoking (OR = 2.19, 95% CI [1.49–3.21], P < 0.001, diabetes (OR = 2.00, 95% CI [1.35–2.95], P = 0.001, obesity (reference, normal or underweight; OR = 3.31, 95% CI [2.05–5.36], P < 0.001, and osteoporosis (OR = 3.68, 95% CI [1.64–8.22], P = 0.002 were positively associated with RA. Covered by health insurance (OR = 1.81, 95% CI [1.12–2.93], P = 0.016 and living in poverty (OR = 2.96, 95% CI [1.88–4.65], P < 0.001 were also associated with having RA. Mexican American, Hispanic white or other Hispanic ethnicity (reference, non-Hispanic white; OR = 0.54, 95% CI [0.31–0.96], P = 0.036, appropriate sleep duration (about 6–11 h, OR = 0.46, 95% CI [0.32–0.65], P < 0.001, and insufficient vitamin A intake (reference, recommended; OR = 0.70, 95% CI [0.50–0.98], P = 0.036 were negatively associated with RA. Discussion Some factors associated with RA are potentially modifiable.

  7. Risk factors survey and preventive measures analysis of grenade throwing fractures during the military training in recruits

    Directory of Open Access Journals (Sweden)

    Kai WANG

    2017-04-01

    Full Text Available Objective  To analyze risk factors for grenade throwing fractures and put forward corresponding preventive measures for the fractures during the military training in recruits, so as to reduce the happen in the military training. Methods  The research is case-control study. The trial group and the control group (39 patients each were followed up and investigated. The investigation indicators included height, body mass index (BMI, whether drinking carbonated beverage frequently, literacy, osteoporosis, throwing training score, throwing posture, warm-up sufficiently, region, whether attend often physical exercise before recruitment, exercise strength, and weather factor. Results  There were significant differences in the warm-up sufficiency, attending physical exercise before recruitment, exercise intensity, throwing posture, weather factor between trial group and the control group in recruits. The logistic regression analysis showed that the lack of physical exercise before recruitment, strong exercise intensity, nonstandard throwing posture were the risk factors in grenade throwing fractures in recruits. Conclusion  Sufficient warm-up, avoiding exhausted exercise and assault exercise, strict training in accordance with the standard throwing posture, regular participation in physical exercise before recruitment and training in warm season are effective methods for preventing grenade throwing fractures in recruits. DOI: 10.11855/j.issn.0577-7402.2017.02.15

  8. Generalised linear mixed models analysis of risk factors for contamination of Danish broiler flocks with Salmonella typhimurium

    DEFF Research Database (Denmark)

    Chriél, Mariann; Stryhn, H.; Dauphin, G.

    1999-01-01

    We present a retrospective observational study of risk factors associated with the occurrence of Salmonella typhimurium (ST) in Danish broiler flocks. The study is based on recordings from 1994 in the ante-mortem database maintained by the Danish Poultry Council. The epidemiological units...... and software for the analysis of a moderately-sized data set of veterinary origin. We compare the results from five analyses of the generalised linear mixed model (GLMM) type. The first observation is that the results agree reasonably well and lead to similar conclusions. A closer look reveals certain patterns...

  9. Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and Germany

    Directory of Open Access Journals (Sweden)

    Erbel Raimund

    2007-09-01

    Full Text Available Abstract Background Previous studies have shown that deprived neighbourhoods have higher cardiovascular mortality and morbidity rates. Inequalities in the distribution of behaviour related risk factors are one possible explanation for this trend. In our study, we examined the association between cardiovascular risk factors and neighbourhood characteristics. To assess the consistency of associations the design is cross-national with data from nine industrial towns from the Czech Republic and Germany. Methods We combined datasets from two population based studies, one in Germany ('Heinz Nixdorf Recall (HNR Study', and one in the Czech Republic ('Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE Study'. Participation rates were 56% in the HNR and 55% in the HAPIEE study. The subsample for this particular analysis consists of 11,554 men and women from nine German and Czech towns. Census based information on social characteristics of 326 neighbourhoods were collected from local administrative authorities. We used unemployment rate and overcrowding as area-level markers of socioeconomic status (SES. The cardiovascular risk factors obesity, hypertension, smoking and physical inactivity were used as response variables. Regression models were complemented by individual-level social status (education and relevant covariates. Results Smoking, obesity and low physical activity were more common in deprived neighbourhoods in Germany, even when personal characteristics including individual education were controlled for. For hypertension associations were weak. In the Czech Republic associations were observed for smoking and physical inactivity, but not for obesity and hypertension when individual-level covariates were adjusted for. The strongest association was found for smoking in both countries: in the fully adjusted model the odds ratio for 'high unemployment rate' was 1.30 [95% CI 1.02–1.66] in the Czech Republic and 1.60 [95% CI 1.29

  10. Macrophage migration inhibitory factor -173G/C gene polymorphism increases the risk of renal disease: a meta-analysis.

    Science.gov (United States)

    Tong, Xiang; He, Jie; Liu, Sitong; Peng, Shifeng; Yan, Zhipeng; Zhang, Yonggang; Fan, Hong

    2015-02-01

    Macrophage migration inhibitory factor (MIF) -173G/C (rs755622) gene polymorphism has been associated with renal disease risk. However, lots of studies have reported inconclusive results. Therefore, we performed a meta-analysis to investigate the relationship between MIF -173G/C gene polymorphism and renal disease susceptibility. We conducted a search in PubMed, Embase (OvidSP), Wanfang databases and China National Knowledge Internet (CNKI) up to 20 June 2014. Odds ratio (OR) and 95% confidence interval (95% CI) were used to test the association. Statistical analyses were performed with STATA version 11.0 software. In total, 2755 participants from eight case-control studies were included in this meta-analysis. The pooled results indicated the significant association between MIF -173G/C polymorphism and renal disease risk (CC + CG vs GG, OR = 1.77, P renal disease risk in Asians and Caucasians were observed. Additionally, we found that the heterozygote (CG) may strongly increase renal disease risk in children, while the homozygote (CC) may increase the renal disease susceptibility more significantly in adults. Surprisingly, the results found a significant association between MIF -173G/C polymorphism and glucocorticoid resistance in child patients with idiopathic nephrotic syndrome (INS) (C vs G, OR: 3.83, P renal disease, especially in children. Furthermore, the meta-analysis also indicated that this gene polymorphism may increase risk of glucocorticoid resistance in child patients with INS. © 2014 Asian Pacific Society of Nephrology.

  11. Risk Factors and Outcome Analysis in Children with Carbon Monoxide Poisoning.

    Science.gov (United States)

    Chang, Yu-Ching; Lee, Hao-Yuan; Huang, Jing-Long; Chiu, Cheng-Hsun; Chen, Chyi-Liang; Wu, Chang-Teng

    2017-04-01

    Carbon monoxide (CO) poisoning is one of the common causes of poisoning in patients and can result in significant morbidity and mortality. However, few studies have focused on the pediatric group. We retrospectively reviewed children (age poisoning from nonfire accidents at a tertiary medical center in Taiwan from 2002 to 2010. We analyzed the patients' characteristics, management, and outcome; compared the data of patients who received hyperbaric oxygen (HBO) to those who received normobaric oxygen (NBO) therapy; and identified the ri0sk factors for patients who developed delayed neurological sequelae (DNS) or permanent neurological sequelae (PNS). A total of 81 children were enrolled. The annual case number increased from five cases in 2002 to 20 in 2010, particularly during the cold months (December to February). The most common source of exposure was an indoor heating system (54.3%). The most common presenting symptoms were vomiting (32.1%) and consciousness changes (30.9%). HBO treatment tended to be administered to patients with a higher initial COHb (%) (p incidence of inducing DNS or PNS after multivariate analysis. For those with treatment in the intensive care unit because of prolonged loss of consciousness and rescue by a ventilator, special attention should be given and follow-up should be performed to determine whether DNS or PNS occurs, particularly epilepsy and cognitive deficits. Copyright © 2016. Published by Elsevier B.V.

  12. Delphi-based study and analysis of key risk factors for invasive fungal infection in haematological patients.

    Science.gov (United States)

    Vázquez, L; Salavert, M; Gayoso, J; Lizasoaín, M; Ruiz Camps, I; Di Benedetto, N

    2017-04-01

    Mortality caused by invasive fungal infections due to filamentous fungi (IFI-FF) is high. Predisposing factors to IFI-FF are multiple and should be stratified. The objective of this study was to identify key risk factors for IFI-FF in onco-haematological patients in different clinical settings. Prospective national Delphi study. Risk factors for IFI-FF in patients with onco-haematological diseases were identified by a systematic review of the literature. An anonymous survey was sent by e-mail to a panel of experts. A key risk factor was defined when at least 70% of the surveyed participants assigned a "maximal" or "high" risk. In allogenic stem cell transplantation, 18 of the 42 risk factors analyzed were classified as key risk factors, including neutropenia, previous IFI-FF, grade III/IV acute or extensive chronic graft-versus-host disease (GVHD), umbilical cord blood transplantation, HLA mismatching transplantation, graft failure, absence of HEPA filters, absence of laminar air flow, diagnosis of acute myeloid leukaemia, haploidentical transplantation, anti-TNF-α drugs, alemtuzumab, anti-thymocyte globulin, immunosuppressive prophylaxis for GVHD, lymphocytopenia, cytomegalovirus infection, and proximity to construction areas. In acute leukaemia/myelodysplastic syndrome (AL/MDS), 7 of 25 risk factors were defined as key risk factors, including neutropenia, consolidation therapy without response, induction therapy, antifungal prophylaxis with azoles, proximity to construction areas, and absence of HEPA filters. In lymphoma/multiple myeloma (MM), the five key risk factors among 21 analyzed were use of steroids, neutropenia, progressive disease, anti-CD52 therapies, and proximity to construction areas. The Delphi method was useful for the classification and stratification of risk factors for IFI-FF in patients with onco-haematological diseases. Identifying key risk factors will contribute to a better management of IFI-FF in this group of patients at high or changing

  13. Risk Factors for Central and Branch Retinal Vein Occlusion: A Meta-Analysis of Published Clinical Data

    Directory of Open Access Journals (Sweden)

    Petr Kolar

    2014-01-01

    Full Text Available Retinal vein occlusion (RVO is a major cause of vision loss. Of the two main types of RVO, branch retinal vein occlusion (BRVO is 4 to 6 times more prevalent than central retinal vein occlusion (CRVO. A basic risk factor for RVO is advancing age. Further risk factors include systemic conditions like hypertension, arteriosclerosis, diabetes mellitus, hyperlipidemia, vascular cerebral stroke, blood hyperviscosity, and thrombophilia. A strong risk factor for RVO is the metabolic syndrome (hypertension, diabetes mellitus, and hyperlipidemia. Individuals with end-organ damage caused by diabetes mellitus and hypertension have greatly increased risk for RVO. Socioeconomic status seems to be a risk factor too. American blacks are more often diagnosed with RVO than non-Hispanic whites. Females are, according to some studies, at lower risk than men. The role of thrombophilic risk factors in RVO is still controversial. Congenital thrombophilic diseases like factor V Leiden mutation, hyperhomocysteinemia and anticardiolipin antibodies increase the risk of RVO. Cigarette smoking also increases the risk of RVO as do systemic inflammatory conditions like vasculitis and Behcet disease. Ophthalmic risk factors for RVO are ocular hypertension and glaucoma, higher ocular perfusion pressure, and changes in the retinal arteries.

  14. Risk factors associated with default from multi- and extensively drug-resistant tuberculosis treatment, Uzbekistan: a retrospective cohort analysis.

    Science.gov (United States)

    Lalor, Maeve K; Greig, Jane; Allamuratova, Sholpan; Althomsons, Sandy; Tigay, Zinaida; Khaemraev, Atadjan; Braker, Kai; Telnov, Oleksander; du Cros, Philipp

    2013-01-01

    The Médecins Sans Frontières project of Uzbekistan has provided multidrug-resistant tuberculosis treatment in the Karakalpakstan region since 2003. Rates of default from treatment have been high, despite psychosocial support, increasing particularly since programme scale-up in 2007. We aimed to determine factors associated with default in multi- and extensively drug-resistant tuberculosis patients who started treatment between 2003 and 2008 and thus had finished approximately 2 years of treatment by the end of 2010. A retrospective cohort analysis of multi- and extensively drug-resistant tuberculosis patients enrolled in treatment between 2003 and 2008 compared baseline demographic characteristics and possible risk factors for default. Default was defined as missing ≥60 consecutive days of treatment (all drugs). Data were routinely collected during treatment and entered in a database. Potential risk factors for default were assessed in univariate analysis using chi-square test and in multivariate analysis with logistic regression. 20% (142/710) of patients defaulted after a median of 6 months treatment (IQR 2.6-9.9). Factors associated with default included severity of resistance patterns (pre-extensively drug-resistant/extensively drug-resistant tuberculosis adjusted odds ratio 0.52, 95%CI: 0.31-0.86), previous default (2.38, 1.09-5.24) and age >45 years (1.77, 1.10-2.87). The default rate was 14% (42/294) for patients enrolled 2003-2006 and 24% (100/416) for 2007-2008 enrolments (p = 0.001). Default from treatment was high and increased with programme scale-up. It is essential to ensure scale-up of treatment is accompanied with scale-up of staff and patient support. A successful first course of tuberculosis treatment is important; patients who had previously defaulted were at increased risk of default and death. The protective effect of severe resistance profiles suggests that understanding disease severity or fear may motivate against default. Targeted

  15. [Objective assessment of risk factors of work-stress: first experience of application of the method OSFA(Objective Stress Factors Analysis)].

    Science.gov (United States)

    Argentero, P; Candura, S M

    2009-01-01

    The OSFA (Objective Stress Factors Analysis) method is an approach to stress evaluation based on objective risk factors recording, according to the Italian law (legislative decree 81/08) as well as to national and international guidelines. The method evaluates the work conditions recognized as hazardous for the workers' psychophysical health. It comprises two main phases: phase A (company data analysis) and phase B (analysis of work-related stress conditions). Particularly, phase B is centred on the work conditions peculiar to the different organizational units, and it is conducted by means of structured interviews to experienced employees who know the specific company reality. The interviews, based on a 72 items questionnaire, take into consideration four main work aspects: organization, social environment, safety, and management. The final version of the instrument has been tested on 13 medium-small companies of Lumbardy (Italy), operating in various fields, with a number of employees ranging from 5 to 107 (median = 37). These first OSFA method experimentations allowed to verify its adequacy in relation to the exhaustiveness of the examined areas, the intelligibility of the items, and their capacity to discriminate the stress risk factors peculiar to the various productive activities. The preliminary results indicate that the described approach is easy to apply, and favourably accepted by employers and workers for its objectivity. Additionally, the OSFA method allows to plan preventive and ameliorative interventions, according to both the legislative decree 81/08 and the European agreement of October 8, 2004. Finally, the information obtained can represent the basis for a further stress risk evaluation through subjective evaluation methods.

  16. Risk factors for in-stent restenosis of vertebral artery origin after stent implantation: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    Fang-fang HAO

    2018-01-01

    Full Text Available Objective To systematically review the risk factors for in-stent restenosis (ISR of vertebral artery origin after sent implantation to provide theoretical foundation for clinical prevention and treatment. Methods Taking vertebral artery, vertebrobasilar insufficiency, stents, drug-eluting stents, self expandable metallic stents in English and Chinese as key words, retrospective clinical studies about risk factors for ISR of vertebral artery origin were searched by using PubMed, EMBASE/SCOPUS, Cochrane Library, China Biology Medicine (CBM, China National Knowledge Infrastructure (CNKI, Wanfang Data and VIP database from January 1, 1966 to March 30, 2017. Quality assessment and Meta-analysis were made by using Newcastle-Ottawa Scale (NOS and Stata 12.0 software. Results The research enrolled 3468 articles in all, from which 11 studies were chosen after excluding duplicates and those not meeting the inclusion criteria. A total number of 1352 patients were divided into ISR group (N = 440 and non-ISR group (N = 912. The ISR incidence rate of smokers was significantly higher than non-smokers (OR = 2.179, 95%CI: 1.373-3.458; P = 0.001. The differences of bare metal stents (BMS utilization rate (OR = 2.072, 95% CI: 1.560-2.753; P = 0.000 and drug-eluting stents (DES utilization rate (OR = 0.483, 95% CI: 0.363-0.641; P = 0.000 between ISR group and non-ISR group were statistically significant. Conclusions Smoking and using BMS are risk factors for ISR of vertebral artery origin, and using DES is protective factor. Due to limited study quality, more high-quality studies are needed to verify this conclusion. DOI: 10.3969/j.issn.1672-6731.2017.12.004

  17. Obesity as a risk factor for triple-negative breast cancers: a systematic review and meta-analysis.

    Science.gov (United States)

    Pierobon, Mariaelena; Frankenfeld, Cara L

    2013-01-01

    Triple-negative breast cancer (TNBC) is a subtype of breast tumor with unique characteristics in terms of clinical-pathological presentation, prognosis, and response to therapy. Epidemiological investigations focusing on the identification of risk factors involved in the onset and progression of TNBCs have identified unique demographic, anthropometric, and reproductive characteristics involved in the etiopathogenesis of this subtype of breast tumors. This systematic review and meta-analysis evaluates the association between TNBCs and obesity and menopause status. Eligible articles were identified through three databases and secondary reference analysis. The search was conducted from the first record to February 2012. Eleven original articles meeting a priori established inclusion criteria were incorporated in the quantitative analysis. Case-case and case-control comparisons were performed. In addition, a case-case comparison was conducted before and after stratification according to menopausal status. Based on the level of between-study heterogeneity, pooled odds ratio (OR) and 95 % confidence interval were calculated using fixed or random models. The case-case comparison showed a significant association between TNBC and obesity (OR: 1.20; 95 % CI: 1.03-1.40). These results were confirmed by the case-control comparison (OR: 1.24; 95 % CI: 1.06-1.46). Once stratification based on menopausal status was applied to the case-case analysis, significant results were observed only in the pre-menopausal group (OR: 1.43; 95 % CI: 1.23-1.65). According to this analysis, obese women are at a greater risk of presenting with a TNBC than non-obese women, and menopause status may be a mitigating factor. If validated, these findings should be taken into consideration for the development of targeted preventive programs.

  18. [Epidemiological investigation and related risk factors analysis of allergic rhinitis in primary and middle school students in Changsha].

    Science.gov (United States)

    Wang, Min; Tan, Guolin; Zhao, Sijun; Zhang, Xiaowei; Xiao, Zhirong; Li, Yun

    2014-01-01

    To analyze the epidemiological characteristics and related risk factors of allergic rhinitis in primary and middle school students in Changsha so that to provide the scientific basis for the disease control and intervention. From June 2011 to April 2012, we randomly chose primary and middle school students aged from 10 to 17 years old in Changsha as our research objects. Through stratified sampling and cluster sampling, we carried out epidemiological investigation using questionnaire investigation, physical examination and skin prick test. After statistical analysis of the data,we explored the related risk factors. (1) 7,023 copies of questionnaire were sent out and 6,407 copies of valid questionnaire were received in the stratified sampling survey. The prevalence of complaining about having got allergic rhinitis is 44.6% while the real rates is 20.5%; (2) 814 research objects were investigated in cluster sampling survey. The result of the incidence of allergic rhinitis is 26.3%, and the prevalence of allergic rhinitis is 17.2%. Analysis of Visual Analog Scale Questionnaire showed significant influence of allergic rhinitis on students character, memory, sleep quality, etc. The prevalence of allergic rhinitis in primary and middle school students aged at 10-17 years old in Changsha is 17%-20%. The occurrence and development of allergic rhinitis is related to environment, genetic background and living habits. Allergic rhinitis influenced the students' character, memory and sleep quality significantly.

  19. A multinomial logit analysis of risk factors influencing road traffic injury severities in the Erzurum and Kars Provinces of Turkey.

    Science.gov (United States)

    Çelik, Ali Kemal; Oktay, Erkan

    2014-11-01

    A retrospective cross-sectional study is conducted analysing 11,771 traffic accidents reported by the police between January 2008 and December 2013 which are classified into three injury severity categories: fatal, injury, and no injury. Based on this classification, a multinomial logit analysis is performed to determine the risk factors affecting the severity of traffic injuries. The estimation results reveal that the following factors increase the probability of fatal injuries: drivers over the age of 65; primary-educated drivers; single-vehicle accidents; accidents occurring on state routes, highways or provincial roads; and the presence of pedestrian crosswalks. The results also indicate that accidents involving cars or private vehicles or those occurring during the evening peak, under clear weather conditions, on local city streets or in the presence of traffic lights decrease the probability of fatal injuries. This study comprises the most comprehensive database ever created for a Turkish sample. This study is also the first attempt to use an unordered response model to determine risk factors influencing the severity of traffic injuries in Turkey. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. The Risk Factors and Neonatal outcomes of Isolated Single Umbilical Artery in Singleton Pregnancy: A Meta-analysis.

    Science.gov (United States)

    Luo, Xiaohua; Zhai, Shanshan; Shi, Na; Li, Mei; Cui, Shihong; Xu, Yajuan; Ran, Limin; Ren, Lidan; Hong, Teng; Liu, Rui

    2017-08-07

    The current meta-analysis aims to evaluate the risk factors and neonatal outcomes of isolated Single Umbilical Artery (iSUA) in singleton pregnancy. Standard Mean Difference (SMD) or Weighted Mean Difference (WMD) was pooled for the maternal age, gravidity and parity, neonate birth weight and Apgar score one and five minutes after birth. We also pooled the odds ratios (ORs) at 95% confidence intervals (CIs) for maternal smoking status, the rate of neonate delivery before 37 or 34 weeks, Cesarean section (CS), the rate of being admitted to neonatal intensive care unit (NICU) and the serious adverse neonate outcome. Results show that maternal primigravidity [OR: -0.082, CI (-0.152, -0.011), p = 0.023] and female sex of the neonate [OR: 0.805, CI (0.673, 0.963), p = 0.017] were associated with higher risks of iSUA. As compared to normal neonates, the neonates with iSUA had lower birth weight, worse Apgar score, increased risk of delivery before the normal gestational age, increased rate of CS due to fetal distress, increased rate of admission to NICU and prolonged NICU stay. However, no difference in neonatal mortality was observed. Maternal primigravidity and female neonate might associate with increased risk of iSUA. Identification of iSUA is of great importance for prenatal diagnosis and may improve neonatal outcomes.

  1. FOOD RISK ANALYSIS

    Science.gov (United States)

    Food risk analysis is a holistic approach to food safety because it considers all aspects of the problem. Risk assessment modeling is the foundation of food risk analysis. Proper design and simulation of the risk assessment model is important to properly predict and control risk. Because of knowl...

  2. Associations of Breast Cancer Risk Factors With Tumor Subtypes : A Pooled Analysis From the Breast Cancer Association Consortium Studies

    NARCIS (Netherlands)

    Yang, Xiaohong R.; Chang-Claude, Jenny; Goode, Ellen L.; Couch, Fergus J.; Nevanlinna, Heli; Milne, Roger L.; Gaudet, Mia; Schmidt, Marjanka K.; Broeks, Annegien; Cox, Angela; Fasching, Peter A.; Hein, Rebecca; Spurdle, Amanda B.; Blows, Fiona; Driver, Kristy; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Peter; Vrieling, Alina; Heikkinen, Tuomas; Aittomaeki, Kristiina; Heikkilae, Paeivi; Blomqvist, Carl; Lissowska, Jolanta; Peplonska, Beata; Chanock, Stephen; Figueroa, Jonine; Brinton, Louise; Hall, Per; Czene, Kamila; Humphreys, Keith; Darabi, Hatef; Liu, Jianjun; Van 't Veer, Laura J.; Van Leeuwen, Flora E.; Andrulis, Irene L.; Glendon, Gord; Knight, Julia A.; Mulligan, Anna Marie; O'Malley, Frances P.; Weerasooriya, Nayana; John, Esther M.; Beckmann, Matthias W.; Hartmann, Arndt; Weihbrecht, Sebastian B.; Wachter, David L.; Jud, Sebastian M. S.; Loehberg, Christian R.; Baglietto, Laura; English, Dallas R.; Giles, Graham G.; McLean, Catriona A.; Severi, Gianluca; Lambrechts, Diether; Vandorpe, Thijs; Weltens, Caroline; Paridaens, Robert; Smeets, Ann; Neven, Patrick; Wildiers, Hans; Wang, Xianshu; Olson, Janet E.; Cafourek, Victoria; Fredericksen, Zachary; Kosel, Matthew; Vachon, Celine; Cramp, Helen E.; Connley, Daniel; Cross, Simon S.; Balasubramanian, Sabapathy P.; Reed, Malcolm W. R.; Doerk, Thilo; Bremer, Michael; Meyer, Andreas; Karstens, Johann H.; Ay, Aysun; Park-Simon, Tjoung-Won; Hillemanns, Peter; Arias Perez, Jose Ignacio; Menendez Rodriguez, Primitiva; Zamora, Pilar; Bentez, Javier; Ko, Yon-Dschun; Fischer, Hans-Peter; Hamann, Ute; Pesch, Beate; Bruening, Thomas; Justenhoven, Christina; Brauch, Hiltrud; Eccles, Diana M.; Tapper, William J.; Gerty, Sue M.; Sawyer, Elinor J.; Tomlinson, Ian P.; Jones, Angela; Kerin, Michael; Miller, Nicola; McInerney, Niall; Anton-Culver, Hoda; Ziogas, Argyrios; Shen, Chen-Yang; Hsiung, Chia-Ni; Wu, Pei-Ei; Yang, Show-Lin; Yu, Jyh-Cherng; Chen, Shou-Tung; Hsu, Giu-Cheng; Haiman, Christopher A.; Henderson, Brian E.; Le Marchand, Loic; Kolonel, Laurence N.; Lindblom, Annika; Margolin, Sara; Jakubowska, Anna; Lubinski, Jan; Huzarski, Tomasz; Byrski, Tomasz; Gorski, Bohdan; Gronwald, Jacek; Hooning, Maartje J.; Hollestelle, Antoinette; van den Ouweland, Ans M. W.; Jager, Agnes; Kriege, Mieke; Tilanus-Linthorst, Madeleine M. A.; Collee, Margriet; Wang-Gohrke, Shan; Pylkaes, Katri; Jukkola-Vuorinen, Arja; Mononen, Kari; Grip, Mervi; Hirvikoski, Pasi; Winqvist, Robert; Mannermaa, Arto; Kosma, Veli-Matti; Kauppinen, Jaana; Kataja, Vesa; Auvinen, Paeivi; Soini, Ylermi; Sironen, Reijo; Bojesen, Stig E.; Orsted, David Dynnes; Kaur-Knudsen, Diljit; Flyger, Henrik; Nordestgaard, Borge G.; Holland, Helene; Chenevix-Trench, Georgia; Manoukian, Siranoush; Barile, Monica; Radice, Paolo; Hankinson, Susan E.; Hunter, David J.; Tamimi, Rulla; Sangrajrang, Suleeporn; Brennan, Paul; Mckay, James; Odefrey, Fabrice; Gaborieau, Valerie; Devilee, Peter; Huijts, P. E. A.; Tollenaar, R. A. E. M.; Seynaeve, C.; Dite, Gillian S.; Apicella, Carmel; Hopper, John L.; Hammet, Fleur; Tsimiklis, Helen; Smith, Letitia D.; Southey, Melissa C.; Humphreys, Manjeet K.; Easton, Douglas; Pharoah, Paul; Sherman, Mark E.; Garcia-Closas, Montserrat

    Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35 568 invasive breast cancer case patients

  3. Teen Dating Violence Victimization among High School Students: A Multilevel Analysis of School-Level Risk Factors

    Science.gov (United States)

    Parker, Elizabeth M.; Johnson, Sarah Lindstrom; Debnam, Katrina J.; Milam, Adam J.; Bradshaw, Catherine P.

    2017-01-01

    Background: Much etiologic research has focused on individual-level risk factors for teen dating violence (TDV); therefore, less is known about school-level and neighborhood-level risk factors. We examined the association between alcohol outlet density around high schools and TDV victimization and the association between markers of physical…

  4. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies

    DEFF Research Database (Denmark)

    Yang, Xiaohong R; Chang-Claude, Jenny; Goode, Ellen L

    2011-01-01

    Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors.......Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors....

  5. Prevalence of Metabolic Syndrome and Risk Factor Analysis Among Urban Elderly in One Medical Center in Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Meng-Ting Tsou

    2014-09-01

    Conclusion: The majority of the elderly population in Taiwan had at least two risk factors for MetS. Patient education and regular screening are needed for early detection and management of risk factors in order to prevent evolvement to MetS and related chronic diseases.

  6. AN EMPIRICAL ANALYSIS OF THE INFLUENCE OF RISK FACTORS ON THE FREQUENCY AND IMPACT OF SEVERE EVENTS ON THE SUPPLY CHAIN IN THE CZECH REPUBLIC

    Directory of Open Access Journals (Sweden)

    José María Caridad

    2014-12-01

    Full Text Available Purpose: This paper is focused on an analysis and evaluation of severe events according to their frequency of occurrence and their impact on the company's manufacturing and distribution supply chains performance in the Czech Republic. Risk factors are introduced for critical events.Design/methodology: An identification and classification of severe events are realized on the basis of median mapping and mapping of ordinal variability acquired through the questionnaire survey of 82 companies. Analysis of 46 risk factors was sorted into 5 groups. We used asymmetric Somers's d statistics for testing the dependence of frequency and impact of a severe event on selected risk sources. The hierarchical cluster analysis is performed to identify relatively homogeneous groups of critical severe events according to their dependency on risk factors and its strength.Findings: Results showed that ‘a lack of contracts’ is considered to be the most critical severe event. Groups of demand and supply side and an external risk factor group were identified to be the most significant sources of risk factors. The worst cluster encompasses 11% of examined risk factors which should be prevented. We concluded that organizations need to adopt appropriate precautions and risk management methods in logistics.Originality: In this paper, the methodology for severe events evaluation in supply chain is designed. This methodology involves assessing the critical factors which influence the critical events and which should be prevented.

  7. Extracorporeal membrane oxygenation support in refractory cardiogenic shock: treatment strategies and analysis of risk factors.

    Science.gov (United States)

    Loforte, Antonio; Marinelli, Giuseppe; Musumeci, Francesco; Folesani, Gianluca; Pilato, Emanuele; Martin Suarez, Sofia; Montalto, Andrea; Lilla Della Monica, Paola; Grigioni, Francesco; Frascaroli, Guido; Menichetti, Antonio; Di Bartolomeo, Roberto; Arpesella, Giorgio

    2014-07-01

    . No significant differences were seen by comparing the RotaFlow and CentriMag populations in terms of device performance. At follow-up, persistent heart failure with left ventricle ejection fraction (LVEF)≤40% was a risk factor after hospital discharge. Patients with a poor hemodynamic status may benefit from rapid central or peripheral insertion of ECMO. The blood lactate level, CK-MB relative index, and PRBCs transfused should be strictly monitored during ECMO support. In addition, early ventricular assist device placement or urgent listing for heart transplant should be considered in patients with persistent impaired LVEF after ECMO. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  8. The associations between five polymorphisms of vascular endothelial growth factor and renal cell carcinoma risk: an updated meta-analysis.

    Science.gov (United States)

    Wang, Jiao; Shen, ChangXin; Fu, YouRong; Yu, Tian; Song, JingJing

    2017-01-01

    Vascular endothelial growth factor (VEGF) is a key mediator that plays an important role in angiogenesis, tumor growth, and tumor metastasis. The associations between five polymorphisms of VEGF (rs3025039, rs699947, rs10434, rs1570360, and rs2010963) and renal cell carcinoma (RCC) risk have been extensively investigated, but the currently available results are inconsistent and inconclusive. To obtain a more accurate assessment of the associations, we conducted a meta-analysis in this study. Relevant studies were collected systemically from the following three electronic databases: MEDLINE, Web of Science, and CNKI (Chinese National Knowledge Infrastructure). Statistical analyses were performed using Review Manager 5.2 in a fixed- or random-effects model. Pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to establish the strength of associations. A total of eight case-control studies with 1,936 RCC cases and 2,770 controls fulfilling the inclusion criteria were selected for this meta-analysis. The pooled OR indicated that rs699947 polymorphism was significantly associated with RCC risk in all genetic models. A significant association was also found between the rs3025039 polymorphism and RCC risk in a homozygous model (TT vs CC: OR =1.38, 95% CI =1.11-1.72, P=0.004), a dominant model (CT+TT vs CC: OR =1.21, 95% CI =1.05-1.39, P=0.01), and a recessive model (TT vs CC+CT: OR =1.28, 95% CI =1.04-1.57, P=0.02). After a subgroup analysis of ethnicity in the allele contrast model of rs3025039 polymorphism, we found a significant relationship in the allele contrast model (T vs C: OR =1.21, 95% CI =1.05-1.40, P=0.007) in the Asian population. With regard to rs10434 polymorphism, significant association was observed only in a homozygous model (GG vs AA: OR =0.75, 95% CI =0.57-0.98, P=0.03). As to rs1570360 or rs2010963, we did not observe any relationship between the two polymorphisms and RCC risk in our study. Our meta-analysis confirmed the

  9. Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies.

    Science.gov (United States)

    Dowling, N A; Merkouris, S S; Greenwood, C J; Oldenhof, E; Toumbourou, J W; Youssef, G J

    2017-02-01

    This systematic review aimed to identify early risk and protective factors (in childhood, adolescence or young adulthood) longitudinally associated with the subsequent development of gambling problems. A systematic search of peer-reviewed and grey literature from 1990 to 2015 identified 15 studies published in 23 articles. Meta-analyses quantified the effect size of 13 individual risk factors (alcohol use frequency, antisocial behaviours, depression, male gender, cannabis use, illicit drug use, impulsivity, number of gambling activities, problem gambling severity, sensation seeking, tobacco use, violence, undercontrolled temperament), one relationship risk factor (peer antisocial behaviours), one community risk factor (poor academic performance), one individual protective factor (socio-economic status) and two relationship protective factors (parent supervision, social problems). Effect sizes were on average small to medium and sensitivity analyses revealed that the results were generally robust to the quality of methodological approaches of the included articles. These findings highlight the need for global prevention efforts that reduce risk factors and screen young people with high-risk profiles. There is insufficient investigation of protective factors to adequately guide prevention initiatives. Future longitudinal research is required to identify additional risk and protective factors associated with problem gambling, particularly within the relationship, community, and societal levels of the socio-ecological model. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta-analysis.

    Science.gov (United States)

    Smith, April R; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph

    2018-02-14

    This meta-analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research. © 2018 The American Association of Suicidology.

  11. Risk factors for severe neonatal hyperbilirubinemia in low and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Olusanya, Bolajoko O; Osibanjo, Folasade B; Slusher, Tina M

    2015-01-01

    Available evidence suggests that low- and middle-income countries (LMICs) bear the greatest burden of severe neonatal hyperbilirubinemia characterized by disproportionately high rates of morbidity, mortality and neurodevelopmental disorders compared to high-income countries. We set out to identify the risk factors that contribute to the burden of severe hyperbilirubinemia in the most developmentally disadvantaged LMICs to highlight areas for action and further research. We systematically searched PubMed, Scopus, Ovid EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Library Database (WHOLIS), African Index Medicus (AIM), African Journals Online (AJOL), LILACS, and IndMed for reports published between January 1990 and June 2014. We included only studies that controlled for the effects of confounding variables in determining maternal and infant risk factors for severe hyperbilirubinemia. We conducted meta-analysis of the eligible studies and computed the summary risk estimates with random effects models. A total of 13 studies with 1,951 subjects and 32,208 controls from India, Nigeria, Pakistan, Nepal and Egypt were identified and analyzed. The pooled data showed that primiparity (OR, 1.59; 95% CI:1.26-2.00), delivery outside public hospitals (OR, 6.42; 95% CI:1.76-23.36), ABO incompatibility (OR, 4.01; 95% CI:2.44-6.61), Rhesus hemolytic disease (OR, 20.63; 95% CI:3.95-107.65), G6PD deficiency (OR, 8.01; 95% CI:2.09-30.69), UGT1A1 polymorphisms (OR, 4.92; 95% CI:1.30-18.62), low gestational age (OR, 1.71; 95% CI:1.40-2.11), underweight/weight loss (OR, 6.26; 95% CI:1.23-31.86), sepsis (OR, 9.15; 95% CI:2.78-30.10) and high transcutaneous/total serum bilirubin levels (OR, 1.46; 95% CI:1.10-1.92) placed infants at increased risk of severe hyperbilirubinemia or bilirubin induced neurologic dysfunctions. Low social class was not associated with an increased risk of severe hyperbilirubinemia. Infants at risk of severe hyperbilirubinemia in

  12. Risk factors for severe neonatal hyperbilirubinemia in low and middle-income countries: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Bolajoko O Olusanya

    Full Text Available Available evidence suggests that low- and middle-income countries (LMICs bear the greatest burden of severe neonatal hyperbilirubinemia characterized by disproportionately high rates of morbidity, mortality and neurodevelopmental disorders compared to high-income countries. We set out to identify the risk factors that contribute to the burden of severe hyperbilirubinemia in the most developmentally disadvantaged LMICs to highlight areas for action and further research.We systematically searched PubMed, Scopus, Ovid EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL, WHO Library Database (WHOLIS, African Index Medicus (AIM, African Journals Online (AJOL, LILACS, and IndMed for reports published between January 1990 and June 2014. We included only studies that controlled for the effects of confounding variables in determining maternal and infant risk factors for severe hyperbilirubinemia. We conducted meta-analysis of the eligible studies and computed the summary risk estimates with random effects models.A total of 13 studies with 1,951 subjects and 32,208 controls from India, Nigeria, Pakistan, Nepal and Egypt were identified and analyzed. The pooled data showed that primiparity (OR, 1.59; 95% CI:1.26-2.00, delivery outside public hospitals (OR, 6.42; 95% CI:1.76-23.36, ABO incompatibility (OR, 4.01; 95% CI:2.44-6.61, Rhesus hemolytic disease (OR, 20.63; 95% CI:3.95-107.65, G6PD deficiency (OR, 8.01; 95% CI:2.09-30.69, UGT1A1 polymorphisms (OR, 4.92; 95% CI:1.30-18.62, low gestational age (OR, 1.71; 95% CI:1.40-2.11, underweight/weight loss (OR, 6.26; 95% CI:1.23-31.86, sepsis (OR, 9.15; 95% CI:2.78-30.10 and high transcutaneous/total serum bilirubin levels (OR, 1.46; 95% CI:1.10-1.92 placed infants at increased risk of severe hyperbilirubinemia or bilirubin induced neurologic dysfunctions. Low social class was not associated with an increased risk of severe hyperbilirubinemia.Infants at risk of severe hyperbilirubinemia in

  13. Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies.

    Science.gov (United States)

    Aune, D; Navarro Rosenblatt, D A; Chan, D S M; Vingeliene, S; Abar, L; Vieira, A R; Greenwood, D C; Bandera, E V; Norat, T

    2015-08-01

    Greater body mass index (BMI) has been convincingly related to increased endometrial cancer risk, however, whether adiposity earlier in life or abdominal fatness is an independent risk factor and whether weight gain or greater height increases the risk is not clear. As part of the Continuous Update Project of the World Cancer Research Fund International, we conducted a systematic review and meta-analysis of prospective studies of the association between anthropometric measures and endometrial cancer risk and searched PubMed and several other databases up to February 2015. Summary relative risks (RRs) were calculated using a random-effects model. Thirty prospective studies of BMI and endometrial cancer risk with 22 320 cases among 6 445 402 participants were included. The summary RR for a 5-unit increment was 1.54 [95% confidence interval (CI) 1.47-1.61, I(2) = 81%]. Although the test for non-linearity was significant, Pnon-linearity obese BMI ranges, there was evidence of increased risk even within the high normal BMI range. The summary RR was 1.45 (95% CI 1.28-1.64, I(2) = 76%) per 5 BMI units for BMI in young adulthood, 1.18 (95% CI 1.14-1.23, I(2) = 67%) per 5 kg increase of weight, and 1.16 (95% CI 1.12-1.20, I(2) = 51%) per 5 kg of weight gained between young adulthood and study baseline, 1.27 (95% CI 1.17-1.39, I(2) = 71%) per 10 cm increase in waist circumference, 1.21 (95% CI 1.13-1.29, I(2) = 0%) per 0.1-unit increment in waist-to-hip ratio and 1.30 (95% CI 1.19-1.41, I(2) = 0%) per 10-cm increase in hips circumference. The summary RR was 1.15 (95% CI 1.09-1.22, I(2) = 61%) for a 10-cm increase in height. All measures of adiposity were associated with increased risk of endometrial cancer, and in addition increasing height was associated with increased risk. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  14. Ovarian Cancer Risk Factors by Histologic Subtype : An Analysis From the Ovarian Cancer Cohort Consortium

    NARCIS (Netherlands)

    Wentzensen, Nicolas; Poole, Elizabeth M; Trabert, Britton; White, Emily; Arslan, Alan A; Patel, Alpa V; Setiawan, V Wendy; Visvanathan, Kala; Weiderpass, Elisabete; Adami, Hans-Olov; Black, Amanda; Bernstein, Leslie; Brinton, Louise A; Buring, Julie; Butler, Lesley M; Chamosa, Saioa; Clendenen, Tess V; Dossus, Laure; Fortner, Renee; Gapstur, Susan M; Gaudet, Mia M; Gram, Inger T; Hartge, Patricia; Hoffman-Bolton, Judith; Idahl, Annika; Jones, Michael; Kaaks, Rudolf; Kirsh, Victoria; Koh, Woon-Puay; Lacey, James V; Lee, I-Min; Lundin, Eva; Merritt, Melissa A; Onland-Moret, N Charlotte; Peters, Ulrike; Poynter, Jenny N; Rinaldi, Sabina; Robien, Kim; Rohan, Thomas; Sandler, Dale P; Schairer, Catherine; Schouten, Leo J; Sjöholm, Louise K; Sieri, Sabina; Swerdlow, Anthony; Tjonneland, Anna; Travis, Ruth; Trichopoulou, Antonia; van den Brandt, Piet A; Wilkens, Lynne; Wolk, Alicja; Yang, Hannah P; Zeleniuch-Jacquotte, Anne; Tworoger, Shelley S

    PURPOSE: An understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3). PATIENTS

  15. ANALYSIS OF THE MAIN RISK FACTORS FOR WORKERS’ SAFETY IN SOME DAIRIES

    Directory of Open Access Journals (Sweden)

    Pier Riccardo Porceddu

    2007-09-01

    Full Text Available This work has analysed the principal risks for workers, with respect to current legislation, resulting from noise, microclimate and other risks related to the production system and use of machinery, in a number of dairies having similar production systems and capacities. Noise emission values fell within the range for which current directives require the employer to inform his workers on the risks related with noise production. Measurements of the microclimate have identified different situations that depend on the workers’ clothing and activity. In the transformation area workers experience a comfortable environment during the winter which tends to be slightly hot during summer. In the latter case it is necessary to improve the ventilation system of the area since little could be done to improve the clothing. During packaging the lower rates of metabolic energy utilization, result in a slightly cold environment during winter while being still hot in summer. In the former case it is necessary to act on the clothing while in the latter intervention on the ventilation system is required. With respect to the maturing areas heavier clothing is necessary. Other risks related to the machinery used, the workplace and the behaviour of the workers have been identified. In particular, the lack of use of adequate P.P.E.s during different activities has been observed. This makes it necessary for the employer to give the necessary importance to the education and training of the workers.

  16. Empirical Analysis of Farmers' Drought Risk Perception: Objective Factors, Personal Circumstances and Social Influence

    NARCIS (Netherlands)

    van Duinen, Rianne; Filatova, Tatiana; Geurts, Petrus A.T.M.; van der Veen, A.

    2014-01-01

    Drought-induced water shortage and salinization are a global threat to agricultural production. With climate change, drought risk is expected to increase as drought events are assumed to occur more frequently and to become more severe. The agricultural sector's adaptive capacity largely depends on

  17. Routine use of bilateral internal thoracic artery grafting in women: A risk factor analysis for poor outcomes.

    Science.gov (United States)

    Gatti, Giuseppe; Maschietto, Luca; Morosin, Marco; Russo, Marco; Benussi, Bernardo; Forti, Gabriella; Dreas, Lorella; Sinagra, Gianfranco; Pappalardo, Aniello

    Concerns about increased risk of postoperative complications, primarily deep sternal wound infection (DSWI), prevent liberal use of bilateral internal thoracic artery (BITA) grafting in women. Consequently, outcomes after routine BITA grafting remain largely unexplored in female gender. Of 786 consecutive women with multivessel coronary disease who underwent isolated coronary bypass surgery at the authors' institution from 1999 throughout 2014, 477 (60.7%; mean age: 70±7.7years) had skeletonized BITA grafts; their risk profiles, operative data, hospital mortality and postoperative complications were reviewed retrospectively. Risk factor analysis for hospital death, DSWI and poor late outcomes were performed by means of multivariable models. There were 19 (4%) hospital deaths (mean EuroSCORE II: 5.2±6.1%); glomerular filtration rate50ml/min was an independent risk factor (p=0.035). Prolonged invasive ventilation (11.3%), multiple blood transfusion (12.1%) and DSWI (10.7%) were most frequent major postoperative complications. Predictors of DSWI were body mass index >35kg/m(2) (p=0.0094), diabetes (p=0.005), non-elective surgical priority (p=0.0087) and multiple blood transfusions (p=0.016). The mean follow-up was 6.8±4.5years. The non-parametric estimates of the 13-year freedom from cardiac and cerebrovascular deaths, major adverse cardiac and cerebrovascular events, and repeat myocardial revascularization were 76.1 [95% confidence interval (CI): 73.1-79.1], 59.5 (95% CI: 55.9-63.1) and 91.9% (95% CI: 90.1-93.7), respectively. Preoperative congestive heart failure (p=0.04) and left main coronary artery disease (p=0.0095) were predictors of major adverse cardiac and cerebrovascular events. BITA grafting could be performed routinely even in women. The increased rates of early postoperative complications do not prevent excellent late outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Managing Multiple Risk Factors

    National Research Council Canada - National Science Library

    Lollis, Charlie

    1998-01-01

    ...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...

  19. Risk Factors associated with defaulting from visceral leishmaniasis treatment: analysis under routine programme conditions in Bihar, India.

    Science.gov (United States)

    Kansal, S; Chakravarty, J; Kumar, A; Malaviya, P; Boelaert, M; Hasker, E; Ostyn, B; Sundar, S

    2017-08-01

    To assess the rate of default from treatment in the visceral leishmaniasis (VL) elimination programme and to identify risk factors and its underlying causes. Case-control study conducted between December 2009 and June 2012 in three primary health centres (PHCs) of Muzaffarpur district, India. Patients who defaulted from treatment from the PHCs were considered as 'cases' and those who completed their treatment as 'controls'. Two controls were included in the study for each case. Respondents' opinion and satisfaction with the services provided at the PHCs were also elicited. Logistic regression was performed to assess the contribution of sociodemographic variables on patient status, and a discriminant analysis was used (after decomposing the original data) to identify factors that can predict the patient status as defaulter or not, based on factor scores of the components as predictor variables. During the study period, 16.3% (89/544) of patients defaulted; 87 cases and 188 controls were interviewed through a semistructured questionnaire. Women tended to be more at risk for default (OR, 1.6, 95% CI (0.9 -2.9). Treatment received was miltefosine in 55.6% and sodium stibogluconate (SSG) in 44.4%. Most (86%) defaulters completed their treatment at other healthcare facilities; 70% of them preferred non-governmental institutions. Most cited reasons for default were seeking a second opinion for VL treatment and preferring to be treated in specialised VL centres. Discriminant analysis showed only one significant predictor: dissatisfaction with the medical care received in PHCs. Efforts are needed to enhance the quality of VL care at PHC level, which will be beneficial in increasing treatment completion rates. © 2017 John Wiley & Sons Ltd.

  20. Analysis of risk factors linked to social educator profession in different residential settings of Alicante Province

    Directory of Open Access Journals (Sweden)

    Jorge Heliz Llopis

    2015-10-01

    Full Text Available One of the most important professions in the field of intervention with underage at social risk that are cared for in different residential settings is, undoubtedly, that of the social educator. In that sense, although there are many professionals involved with these underage (psychologists, social workers, psychiatrists, teachers, etc., social educators are the ones who, through the carrying out of functions specific to their profession, often work as the "front line" of action, given that they are the ones who are more in touch with the underage and therefore the most likely to be exposed to different variables that could eventually put them in a situation of risk of psycho-social problems related to their work. Hence, the task of identifying the risk variables related to the teaching profession becomes a key objective in order to prevent the occurrence of likely problems that could undermine their psychosocial health. Therefore, through this communication we intend to expose the results that we obtained with a sample of 50 educators who perform their work in different residential-type services in the province of Alicante.

  1. Stroke Risk Factors and Symptoms

    Science.gov (United States)

    ... Version » [ pdf, 433 kb ] Order Materials » Stroke Risk Factors and Symptoms Risk Factors for a Stroke Stroke prevention is ... and can be treated with drugs or surgery. Symptoms of a Stroke If you see or have one or more ...

  2. Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and meta analysis.

    Science.gov (United States)

    Banura, Cecily; Mirembe, Florence M; Orem, Jackson; Mbonye, Anthony K; Kasasa, Simon; Mbidde, Edward K

    2013-07-10

    The quadrivalent HPV vaccine is highly effective in primary prevention of anogenital warts (AGWs). However, there is lack of systematic review in the literature of the epidemiology of AGWs in Sub Saharan Africa (SSA). To review the prevalence, incidence and risk factors for AGWs in SSA prior to the introduction of HPV vaccination programs. PubMed/MEDLINE, Africa Index Medicus and HINARI websites were searched for peer reviewed English language published medical literature on AGWs from January 1, 1984 to June 30, 2012. Relevant additional references cited in published papers were also evaluated for inclusion. For inclusion, the article had to meet the following criteria (1) original studies with estimated prevalence and/or incidence rates among men and/or women (2) detailed description of the study population (3) clinical or self-reported diagnosis of AGWs (4) HPV genotyping of histologically confirmed AGWs. The final analysis included 40 studies. Data across different studies were synthesized using descriptive statistics for various subgroups of females and males by geographical area. A meta - analysis of relative risk was conducted for studies that had data reported by HIV status. The prevalence rates of clinical AGWs among sex workers and women with sexually transmitted diseases (STDs) or at high risk of sexually transmitted infection (STIs) range from 3.3% - 10.7% in East, 2.4% - 14.0% in Central and South, and 3.5% - 10.5% in West African regions. Among pregnant women, the prevalence rates range from 0.4% - 3.0% in East, 0.2% - 7.3% in Central and South and 2.9% in West African regions. Among men, the prevalence rates range from 3.5% - 4.5% in East, 4.8% - 6.0% in Central and South and 4.1% to 7.0% in West African regions. In all regions, the prevalence rates were significantly higher among HIV+ than HIV- women with an overall summary relative risk of 1.62 (95% CI: 143-1.82).The incidence rates range from 1.1 - 2.7 per 100 person-years among women and 1.4 per

  3. Investigation on amblyopia status of young children in Shaanxi, Xi'an and its risk factors analysis

    Directory of Open Access Journals (Sweden)

    Ping Wang

    2017-10-01

    Full Text Available AIM: To analyze the amblyopia morbidity status of young children in Shaanxi city of Xi'an Province, and to explore the related risk factors.METHODS: Totally 10 268 children between 3-6 years old were screened in 8 kindergartens in our city from March 2012 to April 2016 via a simple non-repeated sampling method, and sight, eye position, eye movement examination were mainly implemented; 10g/L atropine mydriatic optometry was taken to detect eye fundus examination, and to eliminate organic lesion. There were 528 amblyopic children were set as the observation group, 500 healthy children who were treated in our hospital at the same time were set as the control group. Single factor analysis and multiple logistic regression analysis were carried out for children with amblyopia. RESULTS: In a survey, the incidence rate of amblyopia among young children in Shaanxi Xi'an was 5.14%. Ametropic amblyopia accounted for the highest proportion(61.4%, and lesion extent was usually mild to moderate, ametropic amblyopia accounted for 24.1%, which was inferior to that was the strabismus accounted as 12.9%, rare were form deprivation amblyopia accounted for 1.7%. General data analysis showed that, there were significant differences between the two groups in maternal gestational age, gestational weeks and times of pregnancy, smoking history of parents, family genetic history of myopia(PPCONCLUSION: There is a certain oneset risk of amblyopia in young children in Shaanxi Xi'an. Attention should be paid to educate eye care knowledge, organize regular visual screening, ensure early detection, early diagnosis, early treatment.

  4. Interaction of Hereditary Thrombophilia and Traditional Cardiovascular Risk Factors on the Risk of Arterial Thromboembolism: Pooled Analysis of Four Family Cohort Studies

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Lijfering, Willem M.; Brouwer, Jan-Leendert P.; ten Berg, Jur; Hamulyák, Karly; Meijer, Karina

    2016-01-01

    Hereditary thrombophilia is associated with a slightly increased risk of arterial thromboembolism (ATE). Whether hereditary thrombophilia interacts with traditional cardiovascular risk factors on the risk of ATE has yet to be established. A total of 1891 individuals belonging to 4 family cohorts

  5. Interaction of Hereditary Thrombophilia and Traditional Cardiovascular Risk Factors on the Risk of Arterial Thromboembolism Pooled Analysis of Four Family Cohort Studies

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Lijfering, Willem M.; Brouwer, Jan-Leendert P.; ten Berg, Jur; Hamulyak, Karly; Meijer, Karina

    Background- Hereditary thrombophilia is associated with a slightly increased risk of arterial thromboembolism (ATE). Whether hereditary thrombophilia interacts with traditional cardiovascular risk factors on the risk of ATE has yet to be established. Methods and Results- A total of 1891 individuals

  6. Prevalence and risk factors of epiretinal membranes: a systematic review and meta-analysis of population-based studies.

    Science.gov (United States)

    Xiao, Wei; Chen, Xiaoyun; Yan, William; Zhu, Zhuoting; He, Mingguang

    2017-09-25

    This study was to aggregate the prevalence and risks of epiretinal membranes (ERMs) and determine the possible causes of the varied estimates. Systematic review and meta-analysis. The search strategy was designed prospectively. We searched PubMed, Embase and Web of Science databases from inception to July 2016. Reference lists of the included literatures were reviewed as well. Surveys published in English language from any population were included if they had a population-based design and reported the prevalence of ERM from retinal photography with or without optical coherence tomography. Eligibility and quality evaluation was conducted independently by two investigators. The literature search generated 2144 records, and 13 population-based studies comprising 49 697 subjects were finally included. The prevalence of ERM and the ORs of potential risk factors (age, sex, myopia, hypertension and so on) were extracted. The pooled age-standardised prevalence estimates of earlier ERM (cellophane macular reflex (CMR)), advanced ERM (preretinal macular fibrosis (PMF)) and any ERM were 6.5% (95% CI 4.2% to 8.9%), 2.6% (95% CI 1.8% to 3.4%) and 9.1% (95% CI 6.0% to 12.2%), respectively. In the subgroup analysis, race and photography modality contributed to the variation in the prevalence estimates of PMF, while the WHO regions and image reading methods were associated with the varied prevalence of CMR and any ERM. Meta-analysis showed that only greater age and female significantly conferred a higher risk of ERMs. Our findings suggest that ERMs are relatively common among aged population. Race, image taking and reading methodology may play important roles in influencing the large variability of ERM prevalence estimates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Depressive symptoms and cognitive decline: A longitudinal analysis of potentially modifiable risk factors in community dwelling older adults.

    Science.gov (United States)

    Gallagher, Damien; Kiss, Alex; Lanctot, Krista; Herrmann, Nathan

    2016-01-15

    Depressive symptoms have been associated with increased risk of cognitive decline in later life. There are no interventions proven to reduce risk of cognitive decline in older adults with depression, and it is unclear how these effects are mediated. We aim to determine what mediates the relationship between depressive symptoms and cognitive decline in later life. Seven thousand six hundred and sixty six community dwelling older adults (age ≥ 50) from the English Longitudinal study of Ageing (ELSA) underwent clinical assessment. Inflammation was assessed with C Reactive Protein and depressive symptoms were assessed with the 8-item version of the Center for Epidemiologic Studies (CESD) scale. Five thousand, five hundred and ninety (73.5%) had a follow-up cognitive assessment after a median of 47 months. Depressive symptoms were independently associated with cognitive decline (B=0.09, pdepressive symptoms. Low physical activity (z=2.16, p=0.03) and inflammation (z=2.3, p=0.02) mediated the relationship between depressive symptoms and cognitive decline while hypertension, diabetes and smoking also contributed. This is an observational study with a limited duration of follow up. Not all variables related to cognitive decline were accounted for in this analysis. The relationship between depressive symptoms and cognitive decline in later life appears to be mediated by low physical activity, increased inflammation and vascular risk factors that may be amenable to modification. Copyright © 2015. Published by Elsevier B.V.

  8. Foundations of Risk Analysis

    CERN Document Server

    Aven, Terje

    2012-01-01

    Foundations of Risk Analysis presents the issues core to risk analysis - understanding what risk means, expressing risk, building risk models, addressing uncertainty, and applying probability models to real problems. The author provides the readers with the knowledge and basic thinking they require to successfully manage risk and uncertainty to support decision making. This updated edition reflects recent developments on risk and uncertainty concepts, representations and treatment. New material in Foundations of Risk Analysis includes:An up to date presentation of how to understand, define and

  9. [Preoperative risk factors analysis of pulmonary hypertension crisis during perioperative period for caesarean section of woman with severe pulmonary hypertension].

    Science.gov (United States)

    Zhang, Chunlei; Liu, Yaguang; Qing, Enming; Ma, Jun

    2017-05-01

    To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not. Through the case management system, age, height, weight, gestational age, pregnancy time, type of PAH, emergency or selective surgery, New York Heart Association (NYHA) cardiac function classification, and preoperative ultrasound left ventricular ejection fraction (LVEF), left ventricular diastolic final diameter (LVEDD), the pulmonary artery systolic pressure (sPAP) estimated by ultrasonic TI method, radial artery systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), pulse oxygen saturation (SpO2) without oxygen, oral sildenafil ingestion, having Swan-Ganz catheter placement or not, and whether used norepinephrine or not, as well as the occurrence of perioperative PHC and clinical outcomes were collected. Possible preoperative risk factors were compared between the two groups by single factor and multiple factors logistic regression analysis. The receiver-operating characteristic curve (ROC) was plotted to assess the diagnostic value of various risk factors. A total of 152 patients were screened. Ten patients got heart surgery under general anesthesia at the same time, and 4 patients experiencing cesarean section with general anesthesia were excluded. 138 patients were enrolled finally, 27 patients underwent perioperative PHC (19.57%), and 17 patients died with a mortality of 62.96%. Compared with non-PHC group, the patients in PHC group were older (years: 25.07±3.55 vs. 27.64±4.82), had a poor cardiac function (NYHA cardiac function

  10. Analysis of risk factors associated with complications of colonic stenting for malignant obstruction

    Science.gov (United States)

    Dindar, Gokhan; Ustundag, Yucel; Karakan, Tarkan

    2014-01-01

    Self expanding metalic stent (SEMS) application can cause serious problems up to one third of the patients and some studies reported negative effect of SEMSs on survival in patients with malignancy. The SEMS type especially the rigid one like Wall-stent rather than more flexible type Ultraflex was also reported to have bad impact on the risk of perforation we believe that stent based management protocol for patients with non-perforating left sided obstructing colorectal cancer is a complex method that needs qualified medical and technical team. PMID:25083098

  11. A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients.

    Science.gov (United States)

    Sakakibara, Brodie M; Kim, Amy J; Eng, Janice J

    2017-02-01

    The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors. We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses. Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 [95 % CI = 0.02 to 0.17], I 2 = 0 %, p = 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95 % CI = 0.04 to 0.25], I 2 = 0 %, p = 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95 % CI = 0.07 to 0.56], I 2 = 0 %, p = 0.01). Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.

  12. Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, Tuo; Liao, Banghua; Luo, Deyi; Shen, Hong; Wang, Kunjie

    2016-02-01

    To explore the risk factors for mesh erosion after female pelvic floor reconstructive surgery based on published literature. A systematic literature search of the PubMed, Embase, Cochrane Library, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI) and Chinese Science and Technology Periodical (VIP) databases was performed to identify studies related to the risk factors for mesh erosion after female pelvic floor reconstruction published before December 2014. Summary unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations between the factors and mesh erosion. In all, 25 studies containing 7,084 patients were included in our systematic review and meta-analysis. Statistically significant differences in mesh erosion after female pelvic floor reconstruction were found in older vs younger patients (OR 0.96, 95% CI 0.94-0.98), more parities vs less parities (OR 1.27, 95% CI 1.07-1.51), the presence of premenopausal/oestrogen replacement therapy (ERT) (OR 1.36, 95% CI 1.03-1.79), diabetes mellitus (OR 1.87, 95% CI 1.35-2.57), smoking (OR 2.35, 95% CI 1.80-3.08), concomitant pelvic organ prolapse (POP) surgery (OR 0.37, 95% CI 0.16-0.84), concomitant hysterectomy (OR 1.46, 95% CI 1.03-2.07), preservation of the uterus at surgery (OR 0.22, 95% CI 0.08-0.63), and surgery performed by senior vs junior surgeons (OR 0.42, 95% CI 0.30-0.58). Our study indicates that younger age, more parities, premenopausal/ERT, diabetes mellitus, smoking, concomitant hysterectomy, and surgery performed by a junior surgeon were significant risk factors for mesh erosion after female pelvic floor reconstructive surgery. Moreover, concomitant POP surgery and preservation of the uterus may be the potential protective factors for mesh erosion. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  13. Risk factor analysis of peri-neonatal mortality in rural Guatemala.

    Science.gov (United States)

    Schieber, B; O'Rourke, K; Rodríguez, C; Bartlett, A

    1994-09-01

    Peri-neonatal mortality is a serious health problem in Guatemala, especially in rural areas where most deliveries occur at home and are overseen by traditional birth attendants (TBAs) who function in the role of midwives. The three aims of the work reported here were to identify important predictors of peri-neonatal mortality within a rural area of Guatemala; to assess the effects of traditional and modern health care providers on such mortality; and to find ways of identifying high-risk women who might benefit from transfer to a hospital or clinic. For these purposes a case-control study was conducted of 120 women in the rural department of Quetzaltenango who had lost their babies from the 20th week of pregnancy through the 28th day of life. These women and 120 controls were interviewed in their homes by trained physicians, using questionnaires in Spanish or the appropriate Indian dialect, and the results were analyzed through a series of statistical tests. It was found that the complications of pregnancy and delivery with the greatest statistical significance were prematurity, malpresentation, and prolonged labor. Population-based attributable risks of these complications demonstrated that they accounted for significant proportions of the observed peri-neonatal mortality. While these conditions cannot be eliminated, within the rural Guatemalan context it appears that early referral of women with these complications to more specialized care settings could result in improved delivery outcomes.

  14. Risk Factors for Acquired Rifamycin and Isoniazid Resistance: A Systematic Review and Meta-Analysis.

    OpenAIRE

    Neesha Rockwood; Abdullahi, Leila H; Wilkinson, Robert J.; Graeme Meintjes

    2015-01-01

    Background Studies looking at acquired drug resistance (ADR) are diverse with respect to geographical distribution, HIV co-infection rates, retreatment status and programmatic factors such as regimens administered and directly observed therapy. Our objective was to examine and consolidate evidence from clinical studies of the multifactorial aetiology of acquired rifamycin and/or isoniazid resistance within the scope of a single systematic review. This is important to inform policy and identif...

  15. Girls and Drugs. A New Analysis: Recent Trends, Risk Factors and Consequences

    Science.gov (United States)

    Office of National Drug Control Policy, 2006

    2006-01-01

    This report provides an analysis of recent findings on drug and alcohol use trends among girls. Data indicate that girls have caught up with boys in illicit drug and alcohol use and have actually surpassed boys in cigarette and prescription drug use. Also, more girls than boys are new users of substances. Marijuana is the illicit drug most widely…

  16. Ergonomic activity analysis of the musicians of the Symphony Orchestra of Paraná state: risk factors and workloads

    Directory of Open Access Journals (Sweden)

    Jaqueline de Lima

    2014-04-01

    Full Text Available This study aimed to investigate the risk factors present in the work activity and their impact on the health of the musicians of the Symphony Orchestra of Parana state. It is a descriptive qualitative research based on the method of Ergonomic Workplace Analysis of Francophone strand, used as a tool by occupational therapists in the health-work interface. The following procedures were performed: bibliographical survey, documental analysis of productivity data, production and quality of the task, systematic observation of the rehearsals of the Symphony Orchestra of Parana, task and workplace analysis with the application of Ergonomic Workplace Analysis (EWA and, confrontation of the data analyzed with an instrumental musician. As a result, the study showed significant deviations with reference to the standards described in Brazilian Norm 17 (Ergonomics, especially regarding individual cognitive and physical demands as well as demands related to work organization, considering each item evaluated by this analytical instrument. The action of occupational therapy was grounded on the insertion in the health and illness process, health promotion, illness prevention, and training of musicians as workers and social actors, envisioning the transformation of work situations.

  17. Analysis of polymorphism in the survivin gene promoter as a potential risk factor for head and neck cancers development

    Directory of Open Access Journals (Sweden)

    Kostić Marija

    2013-01-01

    Full Text Available Introduction. Association studies have shown that gene polymorphisms in various classes of genes can modulate cancer risk. The -31G/C polymorphism in the promoter of survivin gene, affects the expression of the anti-apoptotic protein survivin which in turn may predispose an individual to some types of cancer. Objective. The aim of the study was to determine whether the survivin promoter -31G/C polymorphism could be a susceptibility factor for squamous cell carcinoma (SCC of the oral cavity and basal cell carcinoma (BCC of the skin. Methods. The DNA obtained from 88 patients with SCC, 60 patients with BCC and 111 healthy individuals was subjected to polymerase chain reaction-restriction fragment length polymorphism analysis (PCR- RFLP in order to determine genotype and allele frequencies in patients and control groups. Logistic regression was used for cancer risk assessment. Results. The following distribution of genotypes was obtained: CC genotype 15% in the SCC group, 13% in the BCC group and 12% in controls; CG genotype 41% in SCCs, 35% in BCCs, 48% in controls; GG genotype 44% in SCCs, 52% in BCCs and 40% in controls. Allelic frequencies were as follows: G allele 0.65 in SCCs, 0.69 in BCCs and 0.64 in the control group; C allele 0.35 in SCCs, 0.31 in BCCs and 0.36 in the control group. There was no statistically significant difference in allele or genotype frequencies between the patients and controls (p>0.05. Conclusion. In Serbian population, -31G/C polymorphism in the promoter of the survivin gene cannot be considered as a risk factor for oral squamous cell carcinoma and skin basal cell carcinoma. [Projekat Ministarstva nauke Republike Srbije, br. 175075

  18. Foundations of factor analysis

    CERN Document Server

    Mulaik, Stanley A

    2009-01-01

    Introduction Factor Analysis and Structural Theories Brief History of Factor Analysis as a Linear Model Example of Factor AnalysisMathematical Foundations for Factor Analysis Introduction Scalar AlgebraVectorsMatrix AlgebraDeterminants Treatment of Variables as Vectors Maxima and Minima of FunctionsComposite Variables and Linear Transformations Introduction Composite Variables Unweighted Composite VariablesDifferentially Weighted Composites Matrix EquationsMulti

  19. Analysis of Risks and Factors of Formation of the Structure of Financial Capital of Subject of Entrepreneurship

    Directory of Open Acce