OCKHAM Logo

Ockham Alerting Service



Home

The Ockham Initiative is proud to acknowledge support and funding from the following institutions


Emory University
University of Notre Dame
Oregon State University
Virginia Tech

Ockham Alerting Service search results

Your search (title="risk factors") matched 258 record(s). You can now save this link as an RSS feed, or you can email these search results.

  1. The association between secondhand smoke and the risk of developing acute coronary syndromes, among non-smokers, under the presence of several cardiovascular risk factors: The CARDIO2000 case-control study
    • date - 2002
    • creator - Papaioannou Ioanna
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/2/9
    • description - <p>Abstract</p> <p>Background</p> <p>The purpose of this study was to investigate the association between secondhand smoke and the risk of developing a first event of acute coronary syndromes (ACS), i.e. acute myocardial infarction or unstable angina, among non-smokers, in relation to the presence of several other cardiovascular risk factors.</p> <p>Methods</p> <p>Eight hundred and forty-eight patients with first event of ACS and 1078 cardiovascular disease-free matched controls completed a detailed questionnaire regarding their exposure to secondhand smoke, among other investigated parameters.</p> <p>Results</p> <p>Two hundred and ninety&#8211;seven (35%) of the patients and 259 (24%) of the controls were defined as secondhand smokers. After controlling for several potential confounders, the results showed that non-smokers occasionally (< 3 time per week) exposed to cigarette smoke were associated with 26% higher risk of ACS (OR = 1.26, P-value < 0.01) compared to non-smokers not exposed to smoke, while regular exposure is associated with 99% higher risk of developing ACS (OR = 1.99, P-value < 0.001). Moreover, the previous risk increases progressively from 15% to 256% if one or more of the classical cardiovascular risk factors (i.e. hypertension, hypercholesterolemia, diabetes mellitus, sedentary life and family history of premature coronary heart disease) are present.</p> <p>Conclusions</p> <p>Consequently, this study supports the hypothesis that even occasional secondhand smoke increases the risk of developing acute coronary syndromes, especially when other risk factors are present. Given the high prevalence of cigarette smoking, the public health consequences of passive smoking with regard to coronary heart disease are important.</p>
  2. A Study of the Absolute Risk and Distribution of Cardiovascular Risk Factors Among Buyers Attending the Market Places of Aubervilliers
    • date - 2002
    • creator - Le Clésiau H
    • provider - NSDL OAI Repository
    • location - http://www.ameli.fr/pdf/2391.pdf
    • description - Aims: To determine the absolute risk and prevalence of cardiovascular risk factors in a population of buyers attending the market places. Method: We conducted a cross-sectional epidemiological study by offering free cardiovascular screening during a two-week period to buyers at the Aubervilliers’ market places who had been previously exposed to a sensitization program organized by the health and social prevention center of the Seine-Saint-Denis local health agency. We evaluated their non-modifiable and modifiable cardiovascular risk factors and performed fasting-blood sugar, total cholesterol, HDL-cholesterol and triglyceride tests. Results: We enrolled 450 individuals in the study (average age: 59 years; 57% female). Their average 10- year risk for a coronary event was 12.6%. 22% of the study population had a 10-year cardiovascular risk greater than 20%, a level for which preventive treatment is recommended. Among them, 2.6 % had a risk in excess of 40%. More than 56 % of the cohort was already receiving treatment for another health problem including hypertension, diabetes mellitus and dyslipidemia. The prevalence of obesity (IMC ≥ 30 kg/m 2 ) was 29.6% (132/446). 33% of the obese individuals were receiving regular medical care while 22% had no regular medical follow up. Conclusion: This type of field screening program can provide a medical evaluation to a population receiving no care or no longer followed by a doctor. Those who have been followed in the past should be encouraged to see their doctor again while those who have never received care should encouraged to consult a physician.
  3. Portfolio Value-at-Risk with Heavy-Tailed Risk Factors
    • date - 2000-07-21
    • creator - Paul Glasserman,Philip Heidelberger,Perwez Shahabuddin
    • provider - NSDL OAI Repository
    • location - http://citeseer.ist.psu.edu/381772.html
    • description - This paper dev elops e#cient methods for computing portfoliov alue-at-risk (VAR) when the underlying risk factors hav e a heav#a tailed distribution. In modeling heav# tails, we focus on multiv ariate t distributions and some extensions thereof. We dev elop two methods for VAR calculation that exploit a quadratic approximation to the portfolio loss, such as the delta-gamma approximation. In the first method, we deriv e the characteristic function of the quadratic approximation and then use numerical transform inv ersion to approximate the portfolio loss distribution. Because the quadratic approximation may not always yield accurate VAR estimates, we alsodev elop a lowv ariance Monte Carlo method. This method uses the quadratic approximation to guide the selection of an e#ectiv e importance sampling distribution that samples risk factors so that large losses occur more often. Variance is further reduced by combining the importance sampling with stratified sampling. Numerical results on ...
  4. Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity
    • date - 2001
    • creator - Blanc Paul
    • provider - NSDL OAI Repository
    • location - http://dx.doi.org/10.1186/rr37
    • description - <p>Abstract</p> <p>Background</p> <p>The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial.</p> <p>Methods</p> <p>In adults with health care access, we prospectively studied 242 with asthma, aged 18&#8211;50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization.</p> <p>Results</p> <p>Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1&#8211;8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9&#8211;1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7&#8211;6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1&#8211;33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0&#8211;9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02&#8211;1.4).</p> <p>Conclusion</p> <p>In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.</p>
  5. Treating cardiovascular risk factors following acute myocardial infarction
    • date - 2005
    • creator - Benoit E
    • provider - NSDL OAI Repository
    • location - http://www.ameli.fr/pdf/2219.pdf
    • description - Aims: To assess the treatment of cardiovascular risk factors six or 12 months following a first episode of acute myocardial infarction. Method: We enrolled 307 patients who were 70 years old or less when the had their first acute myocardial infarction and who had been exonerated from co-payments for their long-term illness between January 1, 2001 and March 31, 2001 or between June 1, 2001 and August 31, 2001 in the Nord/Pas-de-Calais region of France. Data was gathered by the French healthfund’s salaried physician-advisors during the course of a clinical examination. Results: Drug prescriptions were not always optimal. 28 % of the patients with an alteration in left ventricular function were not receiving an angiotensin converting enzyme inhibitor. 26 % of the patients who had an LDL cholesterol level greater than 1.3 g/L were not being treated with a statin. Almost one-half the patients (48 %) did not have wellcontrolled arterial blood pressure. Risk factors were insufficiently corrected. Nearly 80 % of the patients were overweight with a body mass index equal to or greater than 25. One-third of smokers were still smoking. Cardiac rehabilitation, which encourages patients to stop smoking and helps in secondary prevention, was not prescribed in 37.5 % of the cases. Conclusion: We decided to undertake actions aimed at sensitizing practitioners to the accepted practice guidelines in conjunction with other regional health programs targeting both patients and healthcare professionals. A collegial discussion concerning available care, cardiovascular rehabilitation and treatment networks between the healthfund and all the players in healthcare is needed.
  6. Risk factors, biochemical markers, and genetic polymorphisms in early coronary artery disease
  7. Visual Outcomes of Pan-retinal Photocoagulation in Diabetic Retinopathy at One-year Follow-up and Associated Risk Factors
    • date - 2005
    • creator - Rema Mohan
    • provider - NSDL OAI Repository
    • location - http://www.ijo.in/article.asp?issn=0301-4738;year=2005;volume=53;issue=2;spage=93;epage=99;aulast=Rema
    • description - <b>Purpose: </b> To assess the visual outcomes at one-year follow-up after pan-retinal photocoagulation (PRP) in type 2 diabetes mellitus subjects with proliferative diabetic retinopathy (PDR) and associated risk factors. <b> Materials and Methods:</b> A retrospective study, using data from medical records of 5000 Type 2 diabetic patients who underwent a retinal examination between 1995 and 1999 at a diabetic centre. Ocular, clinical and biochemical parameters were assessed at baseline and at one-year follow-up after PRP. Diabetic retinopathy (DR) was documented by colour photography and PRP was performed according to the ETDRS criteria. <b> Results</b> : PRP was done in 413 eyes, of which 261 eyes of 160 subjects were eligible for the study.<b> </b> One hundred and forty eyes (73&#x0025;)<b> </b> of 191 eyes with good visual acuity (6/9) at baseline maintained the same vision at one-year follow-up.<b> </b> Of the 53 eyes with visual acuity of 6/12-6/36 at<b> </b> baseline,<b> </b> 58.5&#x0025; (31 eyes) maintained same vision and 18.9&#x0025; (10 eyes) improved their vision at one-year follow-up. Of the 17 eyes with visual acuity &#x00A3;6/60 at baseline, 12 maintained the same vision and the remaining 5 improved their vision. The causes of visual loss included vitreous haemorrhage in 20 subjects (31.7&#x0025;), progression of cataract in 19 (30&#x0025;), chronic macular oedema in 15 (23.8&#x0025;), pre-retinal haemorrhage in the macula in 6 (9.5&#x0025;) and pre-retinal fibrosis in the macula in 3 (4.7&#x0025;) subjects. On multiple logistic regression analysis, diastolic blood pressure (<i> P</i> =0.03), duration of diabetes (<i> P</i> =0.006), fasting blood glucose (<i> P</i> =0.02) and nephropathy (<i> P</i> =0.01) were associated with decreased vision after PRP. Glycated haemoglobin (HbA1c) (<i> P</i> <0.001), serum creatinine (<i> P</i> =0.03), HDL cholesterol (<i> P</i> =0.05), diabetic neuropathy (<i> P</i> <0.001), hypertension (<i> P</i> =0.01) and diabetic nephropathy (<i> P</i> <0.001) showed a significant association with PDR. <b>Conclusion: </b> Visual acuity at baseline, the duration of diabetes and proteinuria played a significant role in determining the post-PRP visual acuity.
  8. Percutaneous endoscopic gastrostomy: 30-day mortality trends and risk factors
    • date - 2005
    • creator - Janes Simon
    • provider - NSDL OAI Repository
    • location - http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2005;volume=51;issue=1;spage=23;epage=29;aulast=Janes
    • description - BACKGROUND AND AIMS: 30-day Percutaneous endoscopic gastrostomy (PEG) mortality of 8&#x0025; (1992). Recent concerns suggest that mortality may have increased, prompting a comparison of current practice with that reported earlier. MATERIALS AND METHODS: Data regarding PEG insertion with relation to case mix, complications, 30-day mortality and associated risk factors, in 2002, in a British University Hospital was compared with that in 1992. Logistic regression analysis was used to determine factors independently predictive of 30-day mortality. RESULTS: In 2002, 112 patients (70&#x0025; males, mean age 67.5 years; 1992: 63.6 years) underwent PEG. The 30-day mortality increased significantly from 8&#x0025; (1992) to 22&#x0025; (2002), P= 0.03. During this time, PEG insertion rate increased ten-fold, however, procedure-related mortality decreased from 2&#x0025; to nil. In terms of percentage, the indications for PEG in 1992 and 2002 respectively were: cerebrovascular disease (33/25), head and neck tumours (16/24), motor neuron disease (27/11, P= 0.01). The proportion of PEGs for non-evidence-based indications increased from 16&#x0025; in 1992 to 31&#x0025; in 2002, P= 0.048. The number of PEGs placed radiologically increased (0/17, P= 0.02). Radiological patients received less antibiotic prophylaxis (P< 0.001) and had more PEG site infections than standard placement, P= 0.04. Multivariate analysis identified nil by mouth 7 days or 11.4 (CI 3.2-41.7), albumin 30 g/L or 12 (2.2-66.7) and >1 cardiac factor or 5.1 (1.02-25.6) as independent predictors of 30-day mortality. CONCLUSIONS: The ten-fold rise in the PEG insertion rate has been accompanied by a three-fold rise in 30-day mortality. This may reflect a lowered threshold of PEG insertion. The risk factors identified may help decision-making in cases where the risk-benefit relationship is not clear-cut.
  9. Risk factors for reinvasion of human dwellings by sylvatic triatomines in northern Bahia State, Brazil
    • date - 2005
    • creator - Ferreira Agenor José
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2005000300034
    • description - The aim of this study in Curaça, Bahia, Northeast Brazil was to explore possible factors associated with the infestation of human dwellings by Triatoma brasiliensis or Triatoma pseudomaculata, two sylvatic triatomine species. We use multiple logistic regression analysis to show how structural features of the peridomiciliary area combine with the number of animals and sociological factors to allow infestation of some dwellings. It is suggested that T. brasiliensis is associated with human activities, while T. pseudomaculata is associated with vegetation and animals. Peridomiciliary farm animals are a strong risk factor for triatomine infestation.
  10. Assessment of cardiovascular risk factors in a rural community in the Brazilian state of Bahia
    • date - 2003
    • creator - Matos André Costa
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2003&volume=81&issue=3&spage=297
    • description - OBJECTIVE: To assess the frequency of cardiovascular risk factors in the rural community of Cavunge, in the Brazilian state of Bahia. METHODS: A cross-sectional study was carried out with 160 individuals (age > 19 years) randomly drawn from those listed in the population census of the Cavunge Project. The following parameters were studied: arterial hypertension, dyslipidemia, diabetes, obesity, smoking, waist-hip ratio (WHR), physical activity, and overall cardiovascular risk classified according to the Framingham score. The assessing parameters used were those established by the III Brazilian Consensus on Hypertension and the II Brazilian Consensus on Dyslipidemia. RESULTS: Of the randomly drawn individuals, 126 with a mean age of 46.6 + 19.7 years were included in the study, 43.7% of whom were males. The frequency of arterial hypertension was 36.5%; 20.4% of the individuals had cholesterol levels >240 mg/dL; 31.1% of the individuals had LDL-C levels > 130 mg/dL; 4% were diabetic; and 39.7% had a high-risk Framingham score. Abdominal obesity was observed in 41.3% of the population and in 57.7% of the females. High caloric-expenditure (HCE) physical activities were performed by 56.5% of the individuals. The HCE group had a greater frequency of normal triglyceride levels (63% vs 44%; P=0.05), no diabetes, and WHR tending towards normal (46% vs 27%, P=0.08) as compared with those in the low caloric-expenditure group. CONCLUSION: Cardiovascular risk factors, such as hypertension and hypercholesterolemia, are frequently found in rural communities. The greatest frequency of normal triglyceride levels and normal WHR in the HCE group reinforces the association between greater caloric expenditure and a better risk profile.
  11. Prevalence and risk factors of syphilis infection among drug addicts
    • date - 2005
    • creator - Reymann Gerhard
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/5/33
    • description - <p>Abstract</p> <p>Background</p> <p>Recent epidemiological data show an increased trend of official estimates for syphilis infection in the general population. Many of the infected cases remain undetected leaving an underestimation of the true prevalence of syphilis in the general population, but also among subpopulations such as illicit drug users. There is limited epidemiological data published on the proportion and risk factors of syphilis infections associated with illicit drug abuse.</p> <p>Methods</p> <p>Illicit drug addicts (n = 1223) in inpatients units in Germany were screened (2000&#8211;01) for syphilis and interviewed regarding patterns of drug use and sexual behaviour. TPHA-test for initial screening and FTA-ABS-IgM test in TPHA-positive patients were used.</p> <p>Results</p> <p>In total, TPHA-tests were positive in 39 (3.3%) and 7 patients (0.6%) were IgM positive. The prevalence rate for syphilis in males was 1.9% and for women it was 8.5%. Female patients were 4.56 (CI 95% 2.37&#8211;8.78) times more likely to have a positive TPHA test than males. Sexual behaviours such as high number of sexual partners, sex for drugs/money, sex on the first day were associated with syphilis infection only in women. Females with frequent sex for drugs or money had 4.31 (CI 95% 2.32&#8211;8.52) times more likely a reactive TPHA test than remaining patients. Neither the sociodemographic factors nor sexual behaviour were statistically significant associated with syphilis infection among men at all.</p> <p>Conclusion</p> <p>Our data suggest the need for screening for syphilis among these illicit drug users in inpatient settings, in particular among sexual active women. This conclusion is corroborated by the finding of increasing numbers of syphilis infections in the general population. The identification of syphilis cases among drug addicts would give treatment options to these individuals and would help to reduce the spread of infection in this population, but also a spread into heterosexual populations related to prostitution.</p>
  12. The influence of calcium and magnesium in drinking water and diet on cardiovascular risk factors in individuals living in hard and soft water areas with differences in cardiovascular mortality
    • date - 2003
    • creator - Lenner Ragnhild
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2003&volume=3&issue=1&spage=21
    • description - <p>Abstract</p> <p>Background</p> <p>The role of water hardness as a risk factor for cardiovascular disease has been widely investigated and evaluated as regards regional differences in cardiovascular disease. This study was performed to evaluate the relation between calcium and magnesium in drinking water and diet and risk factors for cardiovascular disease in individuals living in hard and soft water areas with considerable differences in cardiovascular mortality.</p> <p>Methods</p> <p>A random sample of 207 individuals living in two municipalities characterised by differences in cardiovascular mortality and water hardness was invited for an examination including a questionnaire about health, social and living conditions and diet. Intake of magnesium and calcium was calculated from the diet questionnaire with special consideration to the use of local water. Household water samples were delivered by each individual and were analysed for magnesium and calcium.</p> <p>Results</p> <p>In the total sample, there were positive correlations between the calcium content in household water and systolic blood pressure (SBP) and negative correlations with s-cholesterol and s-LDL-cholesterol. No correlation was seen with magnesium content in household water to any of the risk factors.</p> <p>Calcium content in diet showed no correlation to cardiovascular risk factors. Magnesium in diet was positively correlated to diastolic blood pressure (DBP). In regression analyses controlled for age and sex 18.5% of the variation in SBP was explained by the variation in BMI, HbA1c and calcium content in water. Some 27.9% of the variation in s-cholesterol could be explained by the variation in s-triglycerides (TG), and calcium content in water.</p> <p>Conclusions</p> <p>This study of individuals living in soft and hard water areas showed significant correlations between the content of calcium in water and major cardiovascular risk factors. This was not found for magnesium in water or calcium or magnesium in diet. Regression analyses indicated that calcium content in water could be a factor in the complexity of relationships and importance of cardiovascular risk factors. From these results it is not possible to conclude any definite causal relation and further research is needed.</p>
  13. Prevalence and risk factors for <it>Plasmodium falciparum </it>malaria in pregnant women of eastern Sudan
    • date - 2005
    • creator - Khamis Amar
    • provider - NSDL OAI Repository
    • location - http://www.malariajournal.com/content/4/1/18
    • description - <p>Abstract</p> <p>Background</p> <p>Pregnant women are more susceptible to malaria, which is associated with serious adverse effects on pregnancy. The presentation of malaria during pregnancy varies according to the level of transmission in the area. Our study aimed to demonstrate the prevalence and risk factors for malaria (age, parity and gestational age) among pregnant women of eastern Sudan, which is characterized by unstable malaria transmission.</p> <p>Methods</p> <p>The prevalence and possible risk factors for <it>Plasmodium falciparum </it>malaria were investigated in 744 pregnant Sudanese women attending the antenatal clinic of New Haifa Teaching Hospital, eastern Sudan, during October 2003-April 2004.</p> <p>Results</p> <p>A total 102 (13.7%) had <it>P. falciparum </it>malaria, 18(17.6%) of these were severe cases (jaundice and severe anaemia). Univariate and multivariate analysis showed that, age and parity were not associated with malaria. Women who attended the antenatal clinic in the third trimester were at highest risk for malaria (OR = 1.58, 95% CI = 1.02&#8211;2.4; P < 0.05).</p> <p>Women with malaria had significantly lower mean haemoglobin (9.4 g/dl, 95% CI 9.1&#8211;9.7 versus 10.7, CI 10.6&#8211;10.8, P < 0.05). A significantly lower haemoglobin was observed in those with severe falciparum malaria compared to non-severe form (8.3 g/dl, 95% CI 7.6&#8211;9.1 versus 9.4, 95% CI 9.1&#8211;9.7, P = < 0.05).</p> <p>Conclusion</p> <p>The results suggest that <it>P. falciparum </it>malaria is common in pregnant women attending antenatal care and that anaemia is an important complication. Preventive measures (chemoprophylaxis and insecticide-treated bednets) may be beneficial in this area for all women irrespective of age or parity.</p>
  14. Family structure and risk factors for schizophrenia: case-sibling study
    • date - 2004
    • creator - Haukka Jari
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-244X/4/41
    • description - <p>Abstract</p> <p>Background</p> <p>Several family structure-related factors, such as birth order, family size, parental age, and age differences to siblings, have been suggested as risk factors for schizophrenia. We examined how family-structure-related variables modified the risk of schizophrenia in Finnish families with at least one child with schizophrenia born from 1950 to 1976.</p> <p>Methods</p> <p>We used case-sibling design, a variant of the matched case-control design in the analysis. Patients hospitalized for schizophrenia between 1969 and 1996 were identified from the Finnish Hospital Discharge Register, and their families from the Population Register Center. Only families with at least two children (7914 sibships and 21059 individuals) were included in the analysis. Conditional logistic regression with sex, birth cohort, maternal schizophrenia status, and several family-related variables as explanatory variables was used in the case-sibling design. The effect of variables with the same value in each sibship was analyzed using ordinary logistic regression.</p> <p>Results</p> <p>Having a sibling who was less than five years older (OR 1.46, 95% CI 1.29&#8211;1.66), or being the firstborn (first born vs. second born 1.62, 1.87&#8211;1.4) predicted an elevated risk, but having siblings who were more than ten years older predicted a lower risk (0.66, 0.56&#8211;0.79).</p> <p>Conclusions</p> <p>Several family-structure-related variables were identified as risk factors for schizophrenia. The underlying causative mechanisms are likely to be variable.</p>
  15. Urbanization and traffic related exposures as risk factors for Schizophrenia
    • date - 2006
    • creator - Pedersen Carsten
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-244X/6/2
    • description - <p>Abstract</p> <p>Background</p> <p>Urban birth or upbringing increase schizophrenia risk. Though unknown, the causes of these urban-rural differences have been hypothesized to include, e.g., infections, diet, toxic exposures, social class, or an artefact due to selective migration.</p> <p>Methods</p> <p>We investigated the hypothesis that traffic related exposures affect schizophrenia risk and that this potential effect is responsible for the urban-rural differences. The geographical distance from place of residence to nearest major road was used as a proxy variable for traffic related exposures. We used a large population-based sample of the Danish population (1.89 million people) including information on all permanent addresses linked with geographical information on all roads and house numbers in Denmark. Schizophrenia in cohort members (10,755 people) was identified by linkage with the Danish Psychiatric Central Register.</p> <p>Results</p> <p>The geographical distance from place of residence to nearest major road had a significant effect. The highest risk was found in children living 500&#8211;1000 metres from nearest major road (RR = 1.30 (95% Confidence Interval: 1.17&#8211;1.44). However, when we accounted for the degree of urbanization, the geographical distance to nearest major road had no significant effect.</p> <p>Conclusion</p> <p>The cause(s) or exposure(s) responsible for the urban-rural differences in schizophrenia risk were closer related to the degree of urbanization than to the geographical distance to nearest major road. Traffic related exposures might thus be less likely explanations for the urban-rural differences in schizophrenia risk.</p>
  16. Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993
    • date - 1998
    • creator - Menezes Ana M. B.
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89101998000300002
    • description - INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.
  17. Pleiotropic effects on cardiovascular risk factors within and between the fourth and sixth decades of life: Implications for genotype × age interactions
    • date - 2003
    • creator - Havill LM
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712156&date=2003&volume=4&issue=Suppl%201&spage=S54
    • description - <p>Abstract</p> <p>We used an approach for detecting genotype × environment interactions to detect and characterize genotype × age interaction in longitudinal measures of three well known cardiovascular risk factors: total plasma cholesterol (TC), systolic blood pressure (SBP), and body weight (Wgt). Our objectives were to determine if the same gene or suite of genes influences quantitative variation in each of these phenotypes in the 4<sup>th </sup>and 6<sup>th </sup>decades of life, to assess the impact of additive gene effects in these two decades, and to evaluate the stability of pleiotropic relationships among these phenotypes. Using the Framingham Heart Study data, we constructed two cross-sectional samples comprising individuals on whom these phenotypes were measured at ages 30-39 years (Original Cohort: exam 1, Offspring Cohort: exam 2) and at ages 50-59 years (Original Cohort: exam 11, Offspring Cohort: exam 5). We also constructed a longitudinal sample from the cross-sectional sample members for whom measures on these traits were available at both ages (i.e., 4<sup>th </sup>and 6<sup>th </sup>decades of life). Patterns of pleiotropy, inferred from genetic correlations between traits, differ between the two age classes. Further, additive genetic variance in SBP during the 4<sup>th </sup>decade of life is attributable to a different gene or suite of genes than during the 6<sup>th</sup>. The magnitude of the effect increases for SBP. Variation in TC and Wgt appear to be influenced by the same gene or genes in both decades. The magnitude of the effect is stable for TC, but increases dramatically with age for Wgt.</p>
  18. Cumulative effect of risk factors on short-term surgical success of mitomycin augmented trabeculectomy.
    • date - 2002
    • creator - Agarwal H
    • provider - NSDL OAI Repository
    • location - http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2002;volume=48;issue=2;spage=92;epage=6;aulast=Agarwal
    • description - CONTEXT: Risk factors for failure of trabeculectomy may have a cumulative effect on the outcome. AIMS: To study the effect of preoperative ocular risk factors on the surgical outcome of trabeculectomy augmented with 2 commonly used doses of Mitomycin C. SETTINGS AND DESIGN: In a prospective cohort study, cases were recruited over an 18 month period. 92 eyes of 83 patients with one to three known risk factors for failure of trabeculectomy underwent Mitomycin-C (MMC) augmented trabeculectomy. METHODS AND MATERIAL: Trabeculectomy was done with a randomly chosen MMC dose of 0.2 mg/ml or 0.4 mg/ml. All cases were followed up for a period of at least 3 months. Surgical success was defined as the lowering of intraocular pressure (IOP) below 21 mmHg during the follow up period. STATISTICAL ANALYSIS USED: Chi square test, paired t test, odds ratio, effect size. RESULTS: Eyes with two or three risk factors (out of aphakic glaucoma, failed trabeculectomy, neovascular glaucoma, post uveitic glaucoma, traumatic glaucoma, adherent leucoma, juvenile glaucoma, prolonged medical therapy, steroid induced glaucoma, post penetrating keratoplasty glaucoma and developmental glaucoma) had a significantly poorer surgical success rate (88&#x0025; and 78&#x0025;) than eyes with one risk factor (100&#x0025;). 0.4 mg/ml MMC used sub-sclerally had a statistically similar effect on lowering the IOP as 0.2 mg/ml in all groups. The rate of complications was significantly higher in the 0.4 mg/ml subgroup. CONCLUSIONS: The presence of more than one preoperative ocular risk factor, affects the surgical success of MMC augmented trabeculectomy in high-risk cases. Because of the significantly higher rate of complications with the higher dose of MMC, this should be used sparingly, only in cases with more than two risk factors.
  19. Psychological and anthropometrical risk factors in the appearance of eating disorders in 11 years old children in the prefecture of Ioannina, Greece
  20. Comparison between 100-g glucose tolerance test and two other screening tests for gestational diabetes: combined fasting glucose with risk factors and 50-g glucose tolerance test
    • date - 2006
    • creator - Ayach Wilson
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000100002
    • description - CONTEXT AND OBJECTIVE: Lack of consensus about which screening tests to use for gestational diabetes mellitus (GDM) and difficulties in performing the gold-standard diagnostic test, the 100-g glucose tolerance test (100-g GTT), justify comparison with alternatives. The aim was to compare this with two other screening tests: combined fasting glucose with risk factors (FG + RF) and 50-g GTT. DESIGN AND SETTING: Prospective longitudinal cohort study in the Hospital School of Universidade Federal de Mato Grosso do Sul. METHODS: The three tests were performed independently on 341 pregnant women. Sensitivity (S), specificity (Sp), positive (PPV) and negative (NPV) predictive values, positive (PLR) and negative (NLR) likelihood ratios, and false-positive (FP) and false-negative (FR) rates obtained with FG + RF and 50-g GTT were compared with values from 100-g GTT. The average one-hour post-intake glucose levels (1hPG) with 50-g and 100-g were compared. Student?s t test was used in the statistical analysis. RESULTS: FG + RF led more pregnant women (53.9%) to diagnostic confirmation than did 50-g GTT (14.4%). The tests were equivalent for S (86.4 and 76.9%), PPV (98.7 and 98.9%), NLR (0.3 and 0.27) and FR (15.4 and 23.1%). Average 1hPG values were similar: 50-g GTT = 106.8 mg/dl and 100-g GTT = 107.5 mg/dl. CONCLUSION: Diagnostic efficiency with simplicity, practicality and low cost make FG + RF more appropriate for screening for GDM. The equivalence of 1hPG allows a new, cheaper and less uncomfortable protocol to be proposed for screening and diagnosing GDM.
  21. Risk factors for fatal candidemia caused by <it>Candida albicans </it>and non-albicans <it>Candida </it>species
    • date - 2005
    • creator - Yu Kwok-Woon
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/5/22
    • description - <p>Abstract</p> <p>Background</p> <p>Invasive fungal infections, such as candidemia, caused by <it>Candida </it>species have been increasing. Candidemia is not only associated with a high mortality (30% to 40%) but also extends the length of hospital stay and increases the costs of medical care. Sepsis caused by <it>Candida </it>species is clinically indistinguishable from bacterial infections. Although, the clinical presentations of the patients with candidemia caused by <it>Candida albicans </it>and non-albicans <it>Candida</it> species (NAC) are indistinguishable, the susceptibilities to antifungal agents of these species are different. In this study, we attempted to identify the risk factors for candidemia caused by <it>C. albicans </it>and NAC in the hope that this may guide initial empiric therapy.</p> <p>Methods</p> <p>A retrospective chart review was conducted during 1996 to 1999 at the Veterans General Hospital-Taipei.</p> <p>Results</p> <p>There were 130 fatal cases of candidemia, including 68 patients with <it>C. albicans </it>and 62 with NAC. Candidemia was the most likely cause of death in 55 of the 130 patients (42.3 %). There was no significant difference in the distribution of <it>Candida </it>species between those died of candidemia and those died of underlying conditions. Patients who had one of the following conditions were more likely to have <it>C. albicans</it>, age &#8807; 65 years, immunosuppression accounted to prior use of steroids, leukocytosis, in the intensive care unit (ICU), and intravascular and urinary catheters. Patients who had undergone cancer chemotherapy often appeared less critically ill and were more likely to have NAC.</p> <p>Conclusion</p> <p>Clinical and epidemiological differences in the risk factors between candidemia caused by <it>C. albicans </it>and NAC may provide helpful clues to initiate empiric therapy for patients infected with <it>C. albicans </it>versus NAC.</p>
  22. HTLV-I/II seroprevalence and risk factors in pregnant women treated at primary health units in the municipality of Botucatu
  23. Parental educational level and cardiovascular disease risk factors in schoolchildren in large urban areas of Turkey: Directions for public health policy
    • date - 2005
    • creator - Hayran Osman
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/5/13
    • description - <p>Abstract</p> <p>Background</p> <p>It is widely accepted that the development of atherosclerosis starts at an early age. However, there are very few studies evaluating the prevalence of the common clinical and behavioral cardiovascular disease (CVD) risk factors among children, especially in developing countries. The aim of the present cross-sectional survey was to evaluate the distribution of blood lipid profile and various behavioral (i.e. dietary habits, physical activity status) factors related to CVD risk and its relationships to paternal (PEL) and maternal educational level (MEL) among primary schoolchildren in Turkey.</p> <p>Methods</p> <p>In three major metropolises in Turkey (Istanbul, Ankara and Izmir), a random sample of 1044 children aged 12 and 13 years old was examined. ANOVA was applied to evaluate the tested hypothesis, after correcting for multiple comparisons (Tukey correction).</p> <p>Results</p> <p>After controlling for energy and fat intake, physical activity status and Body Mass Index (BMI), it was found that mostly PEL had a significant positive effect for most of the subgroups examined (Lower vs. Higher and Medium vs. Higher) on TC and HDL-cholesterol and a negative effect on TC/HDL ratio for both genders. Furthermore, both boys and girls with higher PEL and MEL were found to have higher energy intake derived from fat and protein than their counterparts with Medium and Lower PEL and MEL, while the opposite was observed for the percentage of energy derived from carbohydrates.</p> <p>Conclusions</p> <p>Our study provides indications for a possible association between an adverse lipid profile, certain dietary patterns and Higher PEL and MEL among schoolchildren in Turkey. These findings underline the possible role of social status, indicated by the degree of education of both parents, in developing certain health behaviors and health indices among Turkish children and provide some guidance for Public Health Policy.</p>
  24. Risk factors of neurological lesions in low cervical spine fractures and dislocations
    • date - 2000
    • creator - COELHO DANILO GONÇALVES
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2000000600009
    • description - Eighty-nine patients with lower cervical spine fractures or dislocations were evaluated for risk factors of neurological lesion. The age, sex, level and pattern of fracture and sagittal diameter of the spinal canal were analysed. There were no significant differences on the age, gender, level and Torg's ratio between intact patients and those with nerve root injury, incomplete or complete spinal cord injuries. Bilateral facet dislocations and burst fractures are a significant risk factor of spinal cord injury.
  25. Detection of Altered Risk Factors in Hospitalized Patients with Coronary Artery Disease
    • date - 2002
    • creator - Soares Eliane de Abreu
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2002&volume=79&issue=3&spage=263
    • description - OBJECTIVE: To assess biochemical, anthropometric, and dietary variables considered risk factors for coronary artery disease. METHODS: Using anthropometrics, dietary allowance, and blood biochemistry, we assessed 84 patients [54 males (mean age of 55± 8 years) and 30 females (mean age of 57±7 years)], who had severe ( > or = 70% coronary artery obstruction) and nonsevere forms of coronary artery disease determined by cardiac catheterization. The severe form of the disease prevailed in 70% of the males and 64% of the females, and a high frequency of familial antecedents (92% ' 88%) and history of acute myocardial infarction (80% ' 70%) were observed. Smoking predominated among males (65%) and diabetes mellitus among females (43%). RESULTS: Males and females had body mass index and body fat above the normal values. Females with nonsevere lesions had HDL > 35 mg/dL, and this constituted a discriminating intergroup indicator. Regardless of the severity of the disease, hyperglycemia and hypertriglyceridemia were found among females, and cholesterolemia > 200 mg/dL in both sexes, but only males had LDL fraction > 160 mg/dL and homocysteine > 11.7 mmol/L. The male dietary allowance was inadequate in nutrients for homocysteine metabolism and in nutrients with an antioxidant action, such as the vitamins B6, C, and folate. Individuals of both sexes had a higher lipid and cholesterol intake and an inadequate consumption of fiber. The diet was classified as high-protein, high-fat, and low-carbohydrate. CONCLUSION: The alterations found had no association with the severity of lesions, indicating the need for more effective nutritional intervention.
  26. ACOG issues recommendations on assessment of risk factors for preterm birth. American College of Obstetricians and Gynecologists.
  27. Should risk factors for breast cancer influence evaluation of breast abnormalities?
  28. Risk Factors for tuberculosis among human immunodeficiency virus-infected persons. A case-control study in Belo Horizonte, Minas Gerais, Brazil (1985-1996)
    • date - 2000
    • creator - Toledo Jr. Antonio Carlos de Castro
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762000000400001
    • description - The objective of this study was to identify tuberculosis risk factors and possible surrogate markers among human immunodeficiency virus (HIV)-infected persons. A retrospective case-control study was carried out at the HIV outpatient clinic of the Universidade Federal de Minas Gerais in Belo Horizonte. We reviewed the demographic, social-economical and medical data of 477 HIV-infected individuals evaluated from 1985 to 1996. The variables were submitted to an univariate and stratified analysis. Aids related complex (ARC), past history of pneumonia, past history of hospitalization, CD4 count and no antiretroviral use were identified as possible effect modifiers and confounding variables, and were submitted to logistic regression analysis by the stepwise method. ARC had an odds ratio (OR) of 3.5 (CI 95% - 1.2-10.8) for tuberculosis development. Past history of pneumonia (OR 1.7 - CI 95% 0.6-5.2) and the CD4 count (OR 0.4 - CI 0.2-1.2) had no statistical significance. These results show that ARC is an important clinical surrogate for tuberculosis in HIV-infected patients. Despite the need of confirmation in future studies, these results suggest that the ideal moment for tuberculosis chemoprophylaxis could be previous to the introduction of antiretroviral treatment or even just after the diagnosis of HIV infection.
  29. Genetic risk factors for cerebrovascular disease in children with sickle cell disease: design of a case-control association study and genomewide screen
    • date - 2003
    • creator - Adams Gaye
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2350/4/6
    • description - <p>Abstract</p> <p>Background</p> <p>The phenotypic heterogeneity of sickle cell disease is likely the result of multiple genetic factors and their interaction with the sickle mutation. High transcranial doppler (TCD) velocities define a subgroup of children with sickle cell disease who are at increased risk for developing ischemic stroke. The genetic factors leading to the development of a high TCD velocity (i.e. cerebrovascular disease) and ultimately to stroke are not well characterized.</p> <p>Methods</p> <p>We have designed a case-control association study to elucidate the role of genetic polymorphisms as risk factors for cerebrovascular disease as measured by a high TCD velocity in children with sickle cell disease. The study will consist of two parts: a candidate gene study and a genomewide screen and will be performed in 230 cases and 400 controls. Cases will include 130 patients (TCD &#8805; 200 cm/s) randomized in the Stroke Prevention Trial in Sickle Cell Anemia (STOP) study as well as 100 other patients found to have high TCD in STOP II screening. Four hundred sickle cell disease patients with a normal TCD velocity (TCD < 170 cm/s) will be controls. The candidate gene study will involve the analysis of 28 genetic polymorphisms in 20 candidate genes. The polymorphisms include mutations in coagulation factor genes (Factor V, Prothrombin, Fibrinogen, Factor VII, Factor XIII, PAI-1), platelet activation/function (GpIIb/IIIa, GpIb IX-V, GpIa/IIa), vascular reactivity (ACE), endothelial cell function (MTHFR, thrombomodulin, VCAM-1, E-Selectin, L-Selectin, P-Selectin, ICAM-1), inflammation (TNF&#945;), lipid metabolism (Apo A1, Apo E), and cell adhesion (VCAM-1, E-Selectin, L-Selectin, P-Selectin, ICAM-1). We will perform a genomewide screen of validated single nucleotide polymorphisms (SNPs) in pooled DNA samples from 230 cases and 400 controls to study the possible association of additional polymorphisms with the high-risk phenotype. High-throughput SNP genotyping will be performed through MALDI-TOF technology using Sequenom's MassARRAY&#8482; system.</p> <p>Discussion</p> <p>It is expected that this study will yield important information on genetic risk factors for the cerebrovascular disease phenotype in sickle cell disease by clarifying the role of candidate genes in the development of high TCD. The genomewide screen for a large number of SNPs may uncover the association of novel polymorphisms with cerebrovascular disease and stroke in sickle cel
  30. Hepatitis C prevalence and risk factors in hemodialysis patients in Central Brazil: a survey by polymerase chain reaction and serological methods
    • date - 2001
    • creator - Lopes Carmen L
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762001000600003
    • description - An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.
  31. The Effect of Coronary Risk Factors on Restenosis after Transluminal Coronary Angioplasty and Stenting
    • date - 2002
    • creator - Ersan TATLI
    • provider - NSDL OAI Repository
    • location - http://tipfak.trakya.edu.tr/tutfd/pdf/2002-2/03.%20Cetin%20Gul.pdf
    • description - Objectives: We investigated the relationship between coronary risk factors (age, gender, smoking, diabetes mellitus, hypertension, family history, and hypercholesterolemia) and the development of restenosis after percutaneous transluminal coronary interventions. Patients and Methods: A total of 162 patients underwent successful percutaneous transluminal coronary angioplasty with or without stenting. Follow-up coronary angiograms were performed in 107 patients (15 females, 92 males; mean age 55.5 years, range 39 to 77 years) after a mean of 184 days. Logistic regression was used for the analysis of the associations between the variables and restenosis. Results: Restenosis was detected in 47 patients (39%). Age, gender, smoking, hypertension, hypercholesterolemia, family history, a history of previous myocardial infarction, ejection fraction, and the degree and location of stenosis were not found as significant variables in the development of restenosis. However, restenosis was significantly correlated with diabetes mellitus (-2 log likelihood 28.28, p=0.0002). The rate of restenosis was significantly lower in the stent group (n=56, 52%) (p<0.01). Conclusion: Diabetes mellitus presents as the most significant risk factor in the development of restenosis after coronary angioplasty and stenting.
  32. Interventions to reduce cardiovascular risk factors in children and adolescents.
    • date - 1999
    • creator - Washington RL
    • provider - NSDL OAI Repository
    • location - http://www.aafp.org/afp/990415ap/contents.html
    • description - Certain modifiable risk factors for cardiovascular disease have their beginnings in childhood. Cigarette smoking, hypertension, physical inactivity, obesity, hypercholesterolemia, hyperinsulinemia, homocysteinemia and poor nutrition in childhood and adolescence may all contribute to the development of cardiovascular disease in adulthood. Identifying at-risk children and adolescents is the first step in modifying or preventing these risk factors. Intervention is most effectively accomplished with an integrated family-oriented approach. Involving the entire family in counseling about interventions to reduce the risk factors for coronary artery disease is important. The family should complete a questionnaire about the family's history and risk of cardiovascular disease. The child, along with other family members, should be given advice on dietary changes to reduce fat intake. Incorporating a cardiovascular health schedule into routine office visits is useful for monitoring the risk of cardiovascular disease and for reinforcing the need to maintain healthy habits.
  33. Intraventricular hemorrhage in very low birth weight infants: associated risk factors and outcome in the neonatal period
    • date - 1999
    • creator - Leone Cléa Rodrigues
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00418781&date=1999&volume=54&issue=5&spage=151
    • description - Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0.035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0.02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.
  34. Incidence, risk factors and mortality of nosocomial pneumonia in Intensive Care Units: A prospective study
    • date - 2004
    • creator - Doganay Mehmet
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14760711&date=2004&volume=3&issue=1&spage=17
    • description - <p>Abstract</p> <p>To determine the frequency, risk factors and mortality of nosocomial pneumonia a prospective study was conducted in the intensive care units. In the study period, 2402 patients were included. The nosocomial pneumonia was defined according to the Centers for Disease Control Criteria. Overall, 163 (6.8%) of the patients developed nosocomial pneumonia and 75.5% (n = 123) of all patients with nosocomial pneumonia were ventilator-associated pneumonia. 163 patients who were admitted to the intensive care unit during the same period but had no bacteriologic or histologic evidence of pneumonia were used as a control group. The APACHE II score, coma, hypoalbuminemia, mechanical ventilation, tracheotomy, presence of nasogastric tube were found as independent risk factors. Crude and attributable mortality were 65% and 52.6%, respectively. The mortality rate was five times greater in the cases (OR: 5.2; CI 95%: 3.2&#8211;8.3). The mean length of stay in the intensive care unit and hospital in the cases were longer than controls (p < 0.0001). Patients requiring mechanical ventilation have a high frequency of nosocomial pneumonia.</p>
  35. Attenuating cardiovascular risk factors in patients with type 2 diabetes.
    • date - 2000
    • creator - Garber AJ
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0002838X&date=2000&volume=62&issue=12&spage=2633
    • description - Patients with type 2 diabetes (formerly known as non-insulin-resistant diabetes) have a significantly increased risk of developing cardiovascular disease. Once clinical cardiovascular disease develops, these patients have a poorer prognosis than normoglycemic patients. By inducing endothelial changes, hyperglycemia contributes directly to atherosclerosis. Type 2 diabetes is also associated with atherogenic dyslipidemias. This form of diabetes, or the precursor state of insulin resistance, commonly occurs as a metabolic syndrome (formerly known as syndrome X) consisting of hypertension, atherogenic dyslipidemia and a procoagulant state, in addition to the disorder of glucose metabolism. All cardiovascular risk factors except smoking are more prevalent in patients with type 2 diabetes. In addition to exercise, weight control, aspirin therapy and blood pressure control, therapy to modify lipid profiles is usually necessary. The choice of agent or combination of statin, bile acid sequestrant, fibric acid derivative and nicotinic acid depends on the lipid profile and characteristics of the individual patient.
  36. Water-contact patterns and risk factors for Schistosoma mansoni infection in a rural village of Northeast Brazil
    • date - 1997
    • creator - SILVA Antônio Augusto Moura da
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00364665&date=1997&volume=39&issue=2&spage=91
    • description - Schistosomiasis mansoni in the Serrano village, municipality of Cururupu, state of Maranhão, Brazil, is a widely spread disease. The PECE (Program for the Control of Schistosomiasis), undertaken since 1979 has reduced the prevalence of S. mansoni infection and the hepatosplenic form of the disease. Nevertheless piped water is available in 84% of the households, prevalence remains above 20%. In order to identify other risk factors responsible for the persistence of high prevalence levels, a cross-sectional survey was carried out in a systematic sample of 294 people of varying ages. Socioeconomic, environmental and demographic variables, and water contact patterns were investigated. Fecal samples were collected and analyzed by the Kato-Katz technique. Prevalence of S. mansoni infection was 24.1%, higher among males (35.5%) and between 10-19 years of age (36.6%). The risk factors identified in the univariable analysis were water contacts for vegetable extraction (Risk Ratio - RR = 2.92), crossing streams (RR = 2.55), bathing (RR = 2.35), fishing (RR = 2.19), hunting (RR = 2.17), cattle breeding (RR = 2.04), manioc culture (RR = 1.90) and leisure (RR = 1.56). After controlling for confounding variables by proportional hazards model the risks remained higher for males, vegetable extraction, bathing in rivers and water contact in rivers or in periodically inundated parts of riverine woodland (swamplands)
  37. Risk factors for coronary artery disease and the use of neural networks to predict the presence or absence of high blood pressure
    • date - 2003
    • creator - Falk Catherine
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712156&date=2003&volume=4&issue=Suppl%201&spage=S67
    • description - <p>Abstract</p> <p>Background</p> <p>The Framingham Heart Study was initiated in 1948 as a long-term longitudinal study to identify risk factors associated with cardiovascular disease (CVD). Over the years the scope of the study has expanded to include offspring and other family members of the original cohort, marker data useful for gene mapping and information on other diseases. As a result, it is a rich resource for many areas of research going beyond the original goals. As part of the Genetic Analysis Workshop 13, we used data from the study to evaluate the ability of neural networks to use CVD risk factors as training data for predictions of normal and high blood pressure.</p> <p>Results</p> <p>Applying two different strategies to the coding of CVD risk data as risk factors (one longitudinal and one independent of time), we found that neural networks could not be trained to clearly separate individuals into normal and high blood pressure groups. When training was successful, validation was not, suggesting over-fitting of the model. When the number of parameters was reduced, training was not as good. An analysis of the input data showed that the neural networks were, in fact, finding consistent patterns, but that these patterns were not correlated with the presence or absence of high blood pressure.</p> <p>Conclusion</p> <p>Neural network analysis, applied to risk factors for CVD in the Framingham data, did not lead to a clear classification of individuals into groups with normal and high blood pressure. Thus, although high blood pressure may itself be a risk factor for CVD, it does not appear to be clearly predictable using observations from a set of other CVD risk factors.</p>
  38. High prevalence of hepatitis C infection in a Brazilian prison: identification of risk factors for infection
    • date - 2001
    • creator - Varella Drauzio
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702001000300002
    • description - Hepatitis C virus (HCV) causes infectious hepatitis worldwide. It is transmitted mainly by blood products and sharing of intravenous paraphernalia during illicit drug use. High prevalence rates have been described among specific groups considered to be at higher risk for HCV infection, including prison inmates. The objectives of this study were: to determine the HCV seroprevalence among inmates of Casa de Detenção de São Paulo; to identify risk factors for HCV infection; and to compare the seroprevalence of HCV to other blood borne or sexually transmitted diseases. From December, 1993, to January, 1994, a total of 779 inmates were interviewed to collect information on sociodemographic status, sexual behavior, and past experience with illicit drugs. Blood samples were obtained from 756 inmates for serological tests. 310 (41%) blood samples were positive for anti-HCV, 425 (56.2%) were negative, and 21 (2.8%) showed indeterminate results. In this population, we found a seroprevalence of 13.7% for HIV, 3.3% for syphilis (VDRL), and 68.1% for hepatitis B virus previous infection. Four variables were each identified as associated with a positive anti-HCV serologic test: a positive VDRL (OR = 2.63 IC 95% 1.08 to 6.36); a time of current imprisonment longer than 130 months (OR = 2.44 IC 95% 1.04 to 5.71); previous incarceration at Casa de Detenção de São Paulo (OR = 1.73 IC 95% 1.19 to 2.52) and; illicit drug use before admission to the Casa de Detenção de São Paulo (OR = 1.64 IC 95% 1.15 to 2.33). The seroprevalence of HCV antibodies among the study population was high (41%), indeed, one of the highest clusters of HCV infection recorded until now. Four variables were each shown to be associated with HCV infection. The simultaneous presence of these 4 variables is associated with an 82% probability of being anti-HCV positive. Although risk factor analysis indicates most HCV infections occur prior to inprisonment, initiation of control measures to prevent continued transmission after incarceration should be done.
  39. Risk Factors for CD4 Lymphopenia in Patients Treated With a Tenofovir/Didanosine High Dose-containing Highly Active Antiretroviral Therapy Regimen
  40. Caries prevalence and risk factors among children aged 0 to 36 months
    • date - 2002
    • creator - Soviero Vera Mendes
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1517-74912002000300004
    • description - The aim of this study was to assess the prevalence of caries and risk factors in outpatients of the Pediatric Ambulatory of the Pedro Ernesto University Hospital aging up to 36 months. After signing informed consent forms, the parents answered a structured questionnaire in order to evaluate risk factors for dental caries, including socioeconomic status, oral hygiene and dietary habits. A single investigator carried out the dental examination which assessed the presence of caries, biofilm and gingival bleeding. The data were analyzed by means of the Epi Info program, utilizing the chi-squared test. The children?s mean age was 22.9 months. The prevalence of caries, including white spot lesions, was 41.6%, and the mean def-s was 1.7 (± 2.5). The most affected teeth were the maxillary incisors, and the most common lesion was the white spot. No significant associations were found between the prevalence of caries and socioeconomic status, frequency of oral hygiene, nocturnal bottle- and breast-feeding or cariogenic food and beverage intake during the day. However, the association between caries and oral hygiene quality (dental biofilm) was statistically significant (p < 0.001). The results suggest that the presence of a thick biofilm was the most important factor for the occurrence of early childhood caries in the evaluated sample.
  41. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants
    • date - 2006
    • creator - Altugan F.S.
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000400015
    • description - Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05), primiparity (P < 0.005), less than four stools (P < 0.001), pink diaper (P < 0.001), delay at initiation of first breast giving (P < 0.01), birth by cesarean section (P < 0.05), extra heater usage (P < 0.005), extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001), mean weight loss in neonates with pink diaper (P < 0.05), mean uric acid concentration in neonates with pink diaper (P < 0.0001), fever in hypernatremic neonates (P < 0.02), and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02) were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.
  42. Delirium in elderly individuals with hip fracture: causes, incidence, prevalence, and risk factors
    • date - 2006
    • creator - Garcez-Leme Luiz Eugênio
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322006000100007
    • description - OBJECTIVES: To determine the incidence, prevalence, risk factors, and causes of delirium in elderly individuals with hip fractures, as well as the impact of delrium on mortality and length of hospital stay. PATIENTS: One hundred and three patients aged 65 and older with hip fractures were included consecutively between January 2001 and June 2002. METHOD: Delirium was diagnosed using the Confusion Assessment Method, applied within the first 24 hours after admission, and then daily. All patients underwent a global geriatric evaluation including clinical history, physical examination, laboratory tests, surgical risk evaluation, and functional and mental evaluations. Patients with delirium (cases) were compared with patients without delirium (controls). RESULTS: Thirty (29.1%) patients in this sample met the criteria for delirium, with a prevalence of 16.5% (17/103) and an incidence of 12.6% (13/103). Cognitive and functional deficits had a significant association with delirium, although only cognitive deficit was revealed to be an independent risk factor after analysis with the logistic regression model. The most frequent causes of delirium were drugs and infections. The hospital stay was significantly longer for patients with delirium compared with patients in the control group (26.27 versus 14.38 days, respectively). Mortality showed a tendency to higher levels in patients with delirium during their hospital stay, although with no statistical significance. CONCLUSIONS: Delirium is a frequent complication among hospitalized elderly individuals with hip fractures. It is associated with cognitive and functional deficits, and it is associated with increases the length of hospital stay and mortality.
  43. Risk factors and outcome in 100 patients with aneurysmal subarachnoid hemorrhage
    • date - 2001
    • creator - Borges Guilherme
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2001000500004
    • description - OBJECTIVE: Clinical and surgical outcome of patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm were assessed in comparison to pre-operative data and risk factors such as previous medical history, clinical presenting condition, CT findings and site of bleeding. METHODS: We evaluated 100 consecutive patients with aneurysmal SAH. Gender, color, history of hypertension, smoking habit, site and size of aneurysm, admittance and before surgery Hunt Hess scale, need for cerebro-spinal fluid shunt, presence of complications during the surgical procedure, Glasgow Outcome Scale, presence of vasospasm and of rebleeding were assessed and these data matched to outcome. For statistical analysis, we applied the chi-squared test or Fisher's test using the pondered kappa coeficient. Kruskal-Wallis test was used for comparison of continue variables. Tendency of proportion was analyzed through Cochran-Armitage test. Significance level adopted was 5%. RESULTS: Patients studied were mainly white, female, without previous history of hypertension and non-smokers. Upon hospital admittance, grade 2 of Hunt-Hess scale was most frequently observed (34%), while grade 3 of Fisher scale was the most prevalent. Single aneurysms were most frequent at anterior circulation, between 12 and 24 mm. The most frequent Glasgow Outcome Scale observed was 5 (60%). Hunt Hess upon the moment of surgery and presence of complications during surgical procedure showed positive correlation with clinical outcome (p=0.00002 and p=0.001, respectively). Other variables were not significantly correlated to prognosis. Tendency of proportion was observed between Hunt-Hess scale and Fisher scale. CONCLUSION: Among variables such as epidemiological data, previous medical history and presenting conditions of patients with ruptured aneurysms, the Hunt-Hess scale upon the moment of surgery and the presence of surgical adversities are statistically related to degree of disability.
  44. Preventable risk factors for noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach
    • date - 2006
    • creator - Weinehall Lars
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00429686&date=2006&volume=84&issue=4&spage=305
    • description - OBJECTIVE: To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. METHODS: Using the protocol of the WHO STEPwise approach to Surveillance (STEPS), risk factors for noncommunicable diseases were determined for 1502 men and 1461 women aged 15-74 years at the Purworejo Demographic Surveillance Site in 2001. FINDINGS: Smoking prevalence was high among men (913/1539; weighted percentage = 53.9.%) in both rural and urban populations; it was almost non-existent among women. A higher proportion of the urban population and the richest quintile of the rural population had high blood pressure and were classified as being overweight or obese when compared with the poorest quintile of the rural population. Those classified as being in the richest quintile who lived in the rural area were 1.5 times more likely to have raised blood pressure and 8 times more likely to be overweight than those classified as being in the poorest quintile and living in the rural area. Clustering of risk factors was higher among those classified as being in the richest quintile of those living in the rural area compared with those classified as being in the poorest quintile; and the risks of clustering were just 20-30% lower compared with the urban population. CONCLUSION: Both the rural and urban populations in Purworejo face an unequally distributed burden of risk factors for noncommunicable diseases. The burden among the most well-off group in the rural area has already reached a level similar to that found in the urban area. The implementation of the WHO STEPS approach was feasible, and it provides a comprehensive picture of the burden of risk factors, allowing appropriate health interventions to be implemented to address health inequities.
  45. Epidemiology of cardiovascular risk factors in Greece: aims, design and baseline characteristics of the ATTICA study
    • date - 2003
    • creator - Pitsavos Christos
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/3/32
    • description - <p>Abstract</p> <p>Background</p> <p>In an attempt to evaluate the levels of several cardiovascular risk factors in Greece we conducted a population-based health and nutrition survey, the "ATTICA study". In this work we present the design and the methodology of the study, as well as the status of various baseline characteristics of the participants.</p> <p>Methods</p> <p>From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 adult women, stratified by age &#8211; gender (census 2000), from the greater area of Athens. More than 300 demographic, lifestyle, behavioral, dietary, clinical and biochemical variables have been recorded.</p> <p>Results</p> <p>Regarding the frequency of the classical cardiovascular risk factors we observed that 51% of men and 39% of women reported smokers (p < 0.05), 37% of men and 25% of women were defined as hypertensives (p < 0.05), 46% of men and 40% of women had total serum cholesterol levels above 200 mg/dl (p < 0.05) and 8% of men and 6% of women had history of diabetes mellitus. Moreover, 20% of men and 15% of women were obese (p < 0.05), while men were more physically active as compared to women (42% vs. 39%, p < 0.05). 19% of men and 38% of women had mild to severe depressive symptoms (p < 0.01). Finally, 72 men (5%) and 45 (3%) women reported history of coronary heart disease at entry evaluation.</p> <p>Conclusions</p> <p>The prevalence of the common cardiovascular risk factors in our population seems high. As a consequence a considerable proportion of Greek adults are at "high-risk" for future cardiovascular events.</p>
  46. Colon cancer controls versus population controls in case-control studies of occupational risk factors
    • date - 2004
    • creator - Kaerlev Linda
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2407/4/15
    • description - <p>Abstract</p> <p>Background</p> <p>Since updated population registers do not exist in many countries it is often difficult to sample valid population controls from the study base to a case-control study. Use of patient controls is an alternative option if the exposure experience under study for these patients are interchangeable with the experience for population controls. Patient controls may even be preferable from population controls under certain conditions. In this study we examine if colon cancer patients can serve as surrogates for proper population controls in case-control studies of occupational risk factors.</p> <p>Methods</p> <p>The study was conducted from 1995 to 1997. Incident colon cancer controls (N = 428) aged 35&#8211;69 years with a histological verified diagnosis and population controls (N = 583) were selected. Altogether 254 (59%) of the colon cancer controls and 320 (55%) of the population controls were interviewed about occupational, medical and life style conditions.</p> <p>Results</p> <p>No statistical significant difference for educational level, medical history or smoking status was seen between the two control groups. There was evidence of a higher alcohol intake, less frequent work as a farmer and less exposure to pesticides among colon cancer controls.</p> <p>Conclusions</p> <p>Use of colon cancer controls may provide valid exposure estimates in studies of many occupational risk factors for cancer, but not for studies on exposure related to farming.</p>
  47. Postoperative wound infection in patients undergoing coronary artery bypass graft surgery: A prospective study with evaluation of risk factors
    • date - 2003
    • creator - Mehta A
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=02550857&date=2003&volume=21&issue=4&spage=246
    • description - PURPOSE: Wound infection is an important cause of morbidity and occasional mortality after coronary artery bypass graft surgery (CABG). The aim of this study was to report postoperative wound infection in CABG surgery patients. METHODS: Consecutive patients undergoing CABG surgery between January 1998 and October 1999 have been studied. The exclusion criteria included, age less than 30 years, penicillin / cephalosporin allergy and associated other cardiac pathologies. The parameters studied were age, sex, obesity, hypertension, diabetes, myocardial infarction, chronic renal failure, previous surgeries, alcohol consumption, smoking, length of pre and postoperative hospital stay, antibiotic prophylaxis, MRSA screening, and duration of surgery. Wounds were classified as per modified CDC&#x2032;s NNIS criteria. Suspected sites of infection were cultured and antibiotic susceptibility of cultured organisms was tested. Postoperative follow up was for two months. RESULTS: Six hundred and fifteen patients were studied. Of these 116 (18.86&#x0025;) developed SSI, involving sternum 75&#x0025;, leg 21.3&#x0025;, and forearm sites 3.44&#x0025;. Organisms isolated at sternum site were MSSE, MRSA<i>,</i> and<i> </i>MRSE<i>, </i>at<i> </i>leg site <i>E. coli</i> and <I>MSSE,</I> and at forearm site <I>MSSE</I> and <I>MSSA</I>. Sternal site, obesity, diabetes mellitus and female sex were associated with significantly higher infection rates (p= 0.001). No antibiotic protocol proved more effective. SSI increased the postoperative hospital stay and the total treatment cost. CONCLUSIONS: Post CABG surgery SSI rate is high. Sternum and leg are the common infection sites. Obesity, uncontrolled diabetes mellitus and female sex are associated with higher infection rates. "Higher" antibiotics do not lower postoperative infection rates.
  48. Risk factors for alcoholic liver disease in China.
    • date - 2004
    • creator - Lu XL
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2004&volume=10&issue=16&spage=2423
    • description - <br>AIM: To examine the association of daily alcohol intake, types of alcoholic beverage consumed, drinking patterns and obesity with alcoholic liver disease in China. <br>METHODS: By random cluster sampling and a 3-year follow-up study, 1 270 alcohol drinkers were recruited from different occupations in the urban and suburban areas of Xi'an City. They were examined by specialists and inquired for information on: Medical history and family medical history, alcohol intake, types of alcoholic beverage consumed, drinking patterns by detailed dietary questionnaires. Routine blood tests and ultrasonography were done. <br>RESULTS: Multivariate analysis showed that: (1) The risk threshold for developing alcoholic liver disease was ingestion of more than 20 g alcohol per day, keeping on drinking for over 5 years in men. The highest OR was at the daily alcohol consumption >=160 g, the occurrence rate of ALD amounted to 18.7% (P<0.01). No ALD occurred when ingestion of alcohol was less than 20 g per day. (2) 87.9% of all drank only at mealtimes. The cumulative risk of developing ALD was significantly higher in those individuals who regularly drank alcohol without food than in those who drank only at mealtimes, especially for those who regularly drank hard liquors only and multiple drinks (P<0.05). (3) The alcohol consumption in those with BMI >=25 was lower than in those with BMI<25, but the risk increased to 11.5%, significantly higher than that of general population, 6.5% (P<0.01). (4) Abstinence and weight reduction could benefit the liver function recovery. <br>CONCLUSION: In the Chinese population the ethanol risk threshold for developing ALD is 20 g per day, and this risk increases with increased daily intake. Drinking 20 g of ethanol per day and for less than 5 years are safe from ALD. Drinking alcohol outside mealtimes and drinking hard liquors only and multiple different alcohol beverages both increase the risk of developing ALD. Obesity also increases the risk. Abstinence and weight reduction will directly affect the prognosis of ALD. Doctor's strong advice might influence the prognosis indirectly.
  49. Risk factors associated to fetal death
    • date - 1998
    • creator - Aquino Márcia Maria Auxiliadora de
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31801998000600005
    • description - OBJECTIVE: The purpose of this study was to investigate risk factors associated to fetal death in a Brazilian population. DESIGN: A case control study. SETTING: The Hospital Maternidade Leonor Mendes de Barros in São Paulo. PARTICIPANTS:122 pregnant women with diagnosis of fetal death and gestation age of 20 or more weeks and 244 controls of pregnant women who delivered liveborns. VARIABLES STUDIED: The fetal death (dependent variable), independent variable (the social demographic factors, clinical and obstetrical history, prenatal care indicators and pathological conditions). RESULTS: The risk factors associated to fetal death were abruptio placentae, syphilis, few prenatal care visits, one or more previous stillbirths, hospitalization during pregnancy, diabetes, age above or equal to 25 years, hypertension during pregnancy, anemia and age below 20 years. CONCLUSIONS: Results of the current study might be useful to orientate a primary prevention health program, specially those concerning antenatal care.
  50. Determination of risk factors & evaluation of the outcome of patients with spina bifida aperta
  51. Incidence and risk factors of venous thromboembolism (VTD) in patients with amyloidosis
    • date - 2005
    • creator - Hussein Mohamad
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14777800&date=2005&volume=2&issue=1&spage=17
    • description - <p>Abstract</p> <p>Background</p> <p>Coagulation problems in amyloidosis are historically associated with bleeding tendencies (mostly Factor X abnormalities). Increased clotting was observed in isolated cases diagnosed with low-grade disseminated intravascular coagulation (DIC). Problem of venous thromboembolic disaease (VTD) in amyloidosis was not systematically investigated.</p> <p>Methods</p> <p>We evaluated frequency of VTD and risk factors for VTD in 56 consecutive amyloidosis patients with a documented disease evaluated and followed up at our Center from 1991&#8211;2001. Data was collected in 5 categories: (a) demographics, (b) disease and treatment, (c) thrombosis case information, (d) major risk factors for thrombosis and (e) baseline laboratory data. Univariable correlates of VTD were assessed using Kaplan-Meier analysis and Cox proportional hazards analysis.</p> <p>Results</p> <p>Mean age of the patients was 67 (years range 21 &#8211; 83). Male/female percentage ratio was 70/30. 29 % of the patients had high creatinine level (> 1.4 mg/dl). Personal or family history of VTD was recorded in 2 and 0 % of patients, respectively. Known hypercoagulable state was present in 1 patient (2%). 8 % of patients were smokers. Of 56 patients, 6 developed VTD (11%). Median time from diagnosis of amyloidosis to VTD was 12.5 month (range 1&#8211;107). Treatment was given within a median of 1 month (range 0&#8211;4) from the development of thrombosis. Only sites of VTD were lower extremities. No cases were associated with I.V. line. 1 case (17 %) was identified postoperatively. We identified several univariable correlates of VTD in amyloid patients, including greater age at diagnosis (HR-2.99, P = .041), personal history of DVT (HR-47.7, P = .006) and immobility (HR-11.78, P = .006). Presence of circulating serum M-protein had protective role in our analysis (HR-.08, P = .031). There was no correlation with the type of treatment patients were receiving.</p> <p>Conclusion</p> <p>Risk for thromboembolic diseases in patients with amyloidosis is similar to one previously described for multiple myeloma. Additional studies with higher number of thromboembolic events could help to further elucidate risk factors for VTD in this population of patients.</p>
  52. Costs and risk factors for ventilator-associated pneumonia in a Turkish University Hospital's Intensive Care Unit: A case-control study
    • date - 2004
    • creator - Atalay Habip
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2466/4/3
    • description - <p>Abstract</p> <p>Background</p> <p>Ventilator-associated pneumonia (VAP) which is an important part of all nosocomial infections in intensive care unit (ICU) is a serious illness with substantial morbidity and mortality, and increases costs of hospital care. We aimed to evaluate costs and risk factors for VAP in adult ICU.</p> <p>Methods</p> <p>This is a-three year retrospective case-control study. The data were collected between 01 January 2000 and 31 December 2002. During the study period, 132 patients were diagnosed as nosocomial pneumonia of 731 adult medical-surgical ICU patients. Of these only 37 VAP patients were assessed, and multiple nosocomially infected patients were excluded from the study. Sixty non-infected ICU patients were chosen as control patients.</p> <p>Results</p> <p>Median length of stay in ICU in patients with VAP and without were 8.0 (IQR: 6.5) and 2.5 (IQR: 2.0) days respectively (P < 0.0001). Respiratory failure (OR, 11.8; 95%, CI, 2.2&#8211;62.5; P < 0.004), coma in admission (Glasgow coma scale < 9) (OR, 17.2; 95% CI, 2.7&#8211;107.7; P < 0.002), depressed consciousness (OR, 8.8; 95% CI, 2.9&#8211;62.5; P < 0.02), enteral feeding (OR, 5.3; 95% CI, 1.0&#8211;27.3; P = 0.044) and length of stay (OR, 1.3; 95% CI, 1.0&#8211;1.7; P < 0.04) were found as important risk factors. Most commonly isolated microorganism was methicillin resistant Staphylococcus aureus (30.4%). Mortality rates were higher in patients with VAP (70.3%) than the control patients (35.5%) (P < 0.003). Mean cost of patients with and without VAP were 2832.2+/-1329.0 and 868.5+/-428.0 US Dollars respectively (P < 0.0001).</p> <p>Conclusion</p> <p>Respiratory failure, coma, depressed consciousness, enteral feeding and length of stay are independent risk factors for developing VAP. The cost of VAP is approximately five-fold higher than non-infected patients.</p>
  53. Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy
    • date - 2006
    • creator - Riesen Walter
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2006&volume=6&issue=1&spage=9
    • description - <p>Abstract</p> <p>Background</p> <p>We assessed the prevalence of risk factors for cardiovascular disease (CVD) in a middle-income country in rapid epidemiological transition and estimated direct costs for treating all individuals at increased cardiovascular risk, i.e. following the so-called "high risk strategy".</p> <p>Methods</p> <p>Survey of risk factors using an age- and sex-stratified random sample of the population of Seychelles aged 25&#8211;64 in 2004. Assessment of CVD risk and treatment modalities were in line with international guidelines. Costs are expressed as US$ per capita per year.</p> <p>Results</p> <p>1255 persons took part in the survey (participation rate of 80.2%). Prevalence of main risk factors was: 39.6% for high blood pressure (&#8805;140/90 mmHg or treatment) of which 59% were under treatment; 24.2% for high cholesterol (&#8805;6.2 mmol/l); 20.8% for low HDL-cholesterol (<1.0 mmol/l); 9.3% for diabetes (fasting glucose &#8805;7.0 mmol/l); 17.5% for smoking; 25.1% for obesity (body mass index &#8805;30 kg/m<sup>2</sup>) and 22.1% for the metabolic syndrome. Overall, 43% had HBP, high cholesterol or diabetes and substantially increased CVD risk. The cost for medications needed to treat all high-risk individuals amounted to US $45.6, i.e. $11.2 for high blood pressure, $3.8 for diabetes, and $30.6 for dyslipidemia (using generic drugs except for hypercholesterolemia). Cost for minimal follow-up medical care and laboratory tests amounted to $22.6.</p> <p>Conclusion</p> <p>High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries. Our findings emphasize the need for affordable cost-effective treatment strategies and the critical importance of population strategies aimed at reducing risk factors in the entire population.</p>
  54. The relationship between risk factors for falling and the quality of life in older adults
    • date - 2005
    • creator - Ozcan Ayse
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/5/90
    • description - <p>Abstract</p> <p>Background</p> <p>Falls are one of the major health problems that effect the quality of life among older adults. The aim of this study was to explore the relationship between quality of life (Short Form-12) and the risk factors of falls (balance, functional mobility, proprioception, muscle strength, flexibility and fear of falling) in older adults.</p> <p>Methods</p> <p>One hundred sixteen people aged 65 or older and living in the T.C. Emekli Sandigi Narlidere nursing home participated in the study. Balance (Berg Balance test), functional mobility (Timed Up and Go), proprioception (joint position sense), muscle strength (back/leg dynamometer), flexibility (sit and reach) and fear of falling (Visual Analogue Scale) were assessed as risk factors for falls. The quality of life was measured by Short Form-12 (SF-12).</p> <p>Results</p> <p>A strong positive correlation was observed between Physical Health Component Summary of SF-12, General Health Perception and balance, muscle strength. Proprioception and flexibility did not correlated with SF-12 (p > 0.05). There was negative correlation between Physical Health Component Summary of SF-12, General Health Perception and fear of falling, functional mobility (p < 0.05).</p> <p>Conclusion</p> <p>We concluded that the risk factors for falls (balance, functional mobility, muscle strength, fear of falling) in older adults are associated with quality of life while flexibility and proprioception are not.</p>
  55. Novel cardiovascular risk factors: do they add value to your practice?
  56. MOLECULAR EPIDEMIOLOGY OF HYPOSPADIAS; REVIEW OF GENETIC AND ENVIRONMENTAL RISK FACTORS. (R828599)
    • date - 2005-02-25T05:10:35Z
    • creator - M Carr
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=117644
    • description - The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency. The information contained in this record was developed via an EPA Grant or Fellowship.
  57. Management of risk factors in relatives of patients with SAH.
  58. Risk factors for delirium in acutely admitted elderly patients: a prospective cohort study
    • date - 2005
    • creator - van Munster Barbara
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2318/5/6
    • description - <p>Abstract</p> <p>Background</p> <p>Delirium is a neuropsychiatric syndrome frequently observed in elderly hospitalised patients and can be found in any medical condition. Due to the severe consequences, early recognition of delirium is important in order to start treatment in time. Despite the high incidence rate, the occurrence of delirium is not always identified as such. Knowledge of potential risk factors is important. The aim of the current study is to determine factors associated with the occurrence of a prevalent delirium among elderly patients acutely admitted to an internal medicine ward.</p> <p>Methods</p> <p>All consecutive patients of 65 years and over acutely admitted to the Department of Internal Medicine of the Academic Medical Centre, Amsterdam, a university hospital, were asked to participate. The presence of delirium was determined within 48 hrs after admission by an experienced geriatrician.</p> <p>Results</p> <p>In total, 126 patients were included, 29% had a prevalent delirium after acute admission. Compared to patients without delirium, patients with delirium were older, more often were cognitively and physically impaired, more often were admitted due to water and electrolyte disturbances, and were less often admitted due to malignancy or gastrointestinal bleeding. Independent risk factors for having a prevalent delirium after acute admission were premorbid cognitive impairment, functional impairment, an elevated urea nitrogen level, and the number of leucocytes.</p> <p>Conclusions</p> <p>In this study, the most important independent risk factors for a prevalent delirium after acute admission were cognitive and physical impairment, and a high serum urea nitrogen concentration. These observations might contribute to an earlier identification and treatment of delirium in acutely admitted elderly patients.</p>
  59. Antibodies to the atherosclerotic plaque components beta2-glycoprotein I and heat-shock proteins as risk factors for acute cerebral ischemia
    • date - 2003
    • creator - Staub Henrique Luiz
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2003000500010
    • description - One third of cases of cerebral ischemia have no clear etiology. A humoral response to the atherosclerotic plaques components beta2-glycoprotein l (beta2-gpl) and heat-shock proteins (Hsp) might be involved in the pathogenesis of stroke. This case-control study includes a complete profile of anti-beta2-gpl antibodies and testing of IgG antibodies to the 60/65 kilodaltons (kDa) Hsp in stroke patients. Ninety-three patients with acute ischemic stroke and 93 controls were evaluated for age, sex, race, hypertension, smoking, previous cardiopathy, diabetes mellitus, hypercholesterolemia and previous history of cerebral ischemia. lgG/lgM/lgA anticardiolipin (aCL) and anti-beta2-gpl antibodies, as well as lgG antibodies to human 60 kDa Hsp and to Mycobacterium bovis 65 kDa Hsp, were detected by immunoassay. Adjusted odds ratios (OR) were calculated by logistic regression. The adjusted OR for IgA anti-beta2-gpl antibodies was 4.6 (90%Cl 1.5 to 14.3; p = 0.025). The non-adjusted OR for IgG antibodies to Hsp 60 was 26.1. The adjusted OR for IgG antibodies to Hsp 65 was 3.2 (90%Cl 1.2 to 8.3; p = 0.044). The adjusted OR for lgG to any Hsp (60 or 65) was 4.8 (90%Cl 1.9 to 12.1; p = 0.006). This study demonstrates that elevated IgA anti-beta2-gpl and lgG anti-Hsp 60/65 antibodies are associated with increased risk of ischemic stroke. The association occurred independently of other risk factors. This humoral response might link autoimmunity, thrombophilia and atherosclerosis in stroke patients.
  60. Risk factors for high anti-HHV-8 antibody titers (&#8805;1:51,200) in black, HIV-1 negative South African cancer patients: a case control study
    • date - 2003
    • creator - Wojcicki Janet
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/3/21
    • description - <p>Abstract</p> <p>Background</p> <p>Infection with human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV), is the necessary causal agent in the development of Kaposi's sarcoma (KS). Infection with HIV-1, male gender and older age all increase risk for KS. However, the geographic distribution of HHV-8 and KS both prior to the HIV/AIDS epidemic and with HIV/AIDS suggest the presence of an additional co-factor in the development of KS.</p> <p>Methods</p> <p>Between January 1994 and October 1997, we interviewed 2576 black in-patients with cancer in Johannesburg and Soweto, South Africa. Blood was tested for antibodies against HIV-1 and HHV-8 and the study was restricted to 2191 HIV-1 negative patients. Antibodies against the latent nuclear antigen of HHV-8 encoded by orf73 were detected with an indirect immunofluorescence assay. We examined the relationship between high anti-HHV-8 antibody titers (&#8805;1:51,200) and sociodemographic and behavioral factors using unconditional logistic regression models. Variables that were significant at p = 0.10 were included in multivariate analysis.</p> <p>Results</p> <p>Of the 2191 HIV-1 negative patients who did not have Kaposi's sarcoma, 854 (39.0%) were positive for antibodies against HHV-8 according to the immunofluorescent assay. Among those seropositive for HHV-8, 530 (62.1%) had low titers (1:200), 227 (26.6%) had medium titers (1:51,200) and 97 (11.4%) had highest titers (1:204,800). Among the 2191 HIV-1 negative patients, the prevalence of high anti-HHV-8 antibody titers (&#8805;1:51,200) was independently associated with increasing age (ptrend = 0.04), having a marital status of separated or divorced (p = 0.003), using wood, coal or charcoal as fuel for cooking 20 years ago instead of electricity (p = 0.02) and consuming traditional maize beer more than one time a week (p = 0.02; p-trend for increasing consumption = 0.05) although this may be due to chance given the large number of predictors considered in this analysis.</p> <p>Conclusions</p> <p>Among HIV-negative subjects, patients with high anti-HHV-8 antibody titers are characterized by older age. Other associations that may be factors in the development of high anti-HHV-8 titers include exposure to poverty or a low socioeconomic status environment and consumption of traditional maize beer. The relationship between these variables and high anti-HHV-8 titers requires further, prospective study.</p>
  61. Tracking and prevalence of cardiovascular disease risk factors across socio-economic classes: A longitudinal substudy of the European Youth Heart Study
    • date - 2006
    • creator - Wedderkopp Niels
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2006&volume=6&issue=1&spage=20
    • description - <p>Abstract</p> <p>Background</p> <p>The highest prevalence of several cardiovascular disease risk factors including obesity, smoking and low physical activity level is observed in adults of low socioeconomic status. This study investigates whether tracking of body mass index and physical fitness from childhood to adolescence differs between groups of socioeconomic status. Furthermore the study investigates whether social class differences in the prevalence of overweight and low physical fitness exist or develop within the age range from childhood to adolescence.</p> <p>Methods</p> <p>In all, 384 school children were followed for a period of six years (from third to ninth grade). Physical fitness was determined by a progressive maximal cycle ergometer test and the classification of overweight was based on body mass index cut-points proposed by the International Obesity Task Force. Socioeconomic status was defined according to <it>The International Standard Classification of Occupation </it>scheme.</p> <p>Results</p> <p>Moderate and moderately high tracking was observed for physical fitness and body mass index, respectively. No significant difference in tracking was observed between groups of socioeconomic status. A significant social gradient was observed in both the prevalence of overweight and low physical fitness in the 14&#8211;16-year-old adolescents, whereas at the age of 8&#8211;10 years, only the prevalence of low physical fitness showed a significant inverse relation to socioeconomic status. The odds of both developing and maintaining risk during the measurement period were estimated as bigger in the group of low socioeconomic status than in the group of high socioeconomic status, although differences were significant only with respect to the odds of developing overweight.</p> <p>Conclusion</p> <p>The results indicate that the fundamental possibilities of predicting overweight and low physical fitness at an early point in time are the same for different groups of socio-economic status. Furthermore, the observed development of social inequalities in the absolute prevalence of overweight and low physical fitness underline the need for broad preventive efforts targeting children of low socioeconomic status in early childhood.</p>
  62. Rural Community Knowledge of Stroke Warning Signs and Risk Factors
    • date - 2005
    • creator - Todd S. Harwell, MPH
    • provider - NSDL OAI Repository
    • location - http://www.cdc.gov/pcd/issues/2005/apr/04_0095.htm
    • description - Introduction Rapid identification and treatment of ischemic stroke can lead to improved patient outcomes. Public education campaigns in selected communities have helped to increase knowledge about stroke, but most data represent large metropolitan centers working with academic institutions. Much less is known about knowledge of stroke among residents in rural communities. Methods In 2004, 800 adults aged 45 years and older from two Montana counties participated in a telephone survey using unaided questions to assess awareness of stroke warning signs and risk factors. The survey also asked respondents if they had a history of atrial fibrillation, diabetes, high blood pressure, high cholesterol, smoking, heart disease, or stroke. Results More than 70% of survey participants were able to correctly report two or more warning signs for stroke: numbness on any side of the face/body (45%) and speech difficulties (38%) were reported most frequently. More than 45% were able to correctly report two or more stroke risk factors: smoking (50%) and high blood pressure (44%) were reported most frequently. Respondents aged 45 to 64 years (odds ratio [OR] 2.44; 95% confidence interval [CI], 1.78–3.46), women (OR 2.02; 95% CI, 1.46–2.80), those with 12 or more years of education (OR 1.96; 95% CI, 1.08–3.56), and those with high cholesterol (OR 1.68; 95% CI, 1.17–2.42) were more likely to correctly identify two or more warning signs compared with respondents without these characteristics. Women (OR 1.48; 95% CI, 1.07–2.05) and respondents aged 45 to 64 years (OR 1.35; 95% CI, 1.01–1.81) were also more likely to correctly identify two or more stroke risk factors compared with men and older respondents. Conclusion Residents of two rural counties were generally aware of stroke warning signs, but their knowledge of stroke risk factors was limited.
  63. Congenital and acquired thrombotic risk factors in lymphoma patients bearing upper extremities deep venous thrombosis: a preliminary report
    • date - 2004
    • creator - Di Micco Pierpaolo
    • provider - NSDL OAI Repository
    • location - http://www.translational-medicine.com/content/2/1/7
    • description - <p>Abstract</p> <p>Background</p> <p>Congenital thrombotic risk factors, oncological diseases and its therapies have been related to an increased occurrence of upper extremities deep venous thrombosis (UEDVT).</p> <p>Patients and methods</p> <p>We studied seven patients bearing lymphoma (one Hodgkin's and six non-Hodgkin's) who developed UEDVT, one at diagnosis and six during chemotherapy (two of these six cases had implantation of a central venous catheter and four received Growth Colony Stimulating Factors in addition to chemotherapy). Patients were screened for: factor V G1691A (Leiden), prothrombin G20210A, methylene tetrahydrofolate reductase (MTHFR) C677T mutations and antithrombin III, proteins C and S plasma activity.</p> <p>Results</p> <p>All patients were wild-type homozygotes for G20210A. One was heterozygote for factor V G1691A, the other 6 were wild-type homozygotes. Three of the 7 patients were homozygotes and 2 heterozygotes for the MTHFR mutation; the remaining 2 were wild-type homozygotes. Clotting inhibitor levels were normal in all patients.</p> <p>Conclusions</p> <p>UEDVT in patients bearing haematological malignancies can occur irrespective of congenital thrombophilic alterations. However, in a subgroup of patients UEDVT could also depend on congenital thrombophilic alterations. A screening for inherited thrombophilia can identify high risk patients that could be specifically treated to prevent thrombotic complications.</p>
  64. Pathogenic Eating Behaviors and Psychological Risk Factors of Weight Preoccupied College Students
    • date - 2002-12-12
    • creator - McIvor, Debra Lynn
    • provider - NSDL OAI Repository
    • location - http://scholar.lib.vt.edu/theses/available/etd-12042002-074156/
    • description - <html> <head> <title>Debra McIvor's Abstract</title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> </head> <body bgcolor="#FFFFFF"> This study investigated the connection between Body Dissatisfaction and Drive for Thinness to several psychological correlates- Ineffectiveness, Interpersonal Distrust, Perfectionism, Interoceptive Awareness, and Maturity Fears. Regression analyses indicated that these five correlates together accounted for 23% of the variance in a measure of Body Dissatisfaction. Body Dissatisfaction and the five correlates together accounted for 52% of the variance in a measure of Drive for Thinness. Results of the path analysis confirmed that Ineffectiveness, Interoceptive Awareness and Maturity Fears were the strongest predictors of Body Dissatisfaction. In turn, Body Dissatisfaction, Ineffectiveness and Interoceptive Awareness were the strongest predictors of Drive for Thinness. Gender differences and prevalence rates of eating disordered behavior were reviewed. Consistent with other research, this study confirmed high levels of bingeing and purging behavior (44%) among college men and women. </body> </html>
  65. Seroprevalence of hepatitis C and associated risk factors among an urban population in Haiti
    • date - 2004
    • creator - Hepburn Matthew
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-230X/4/31
    • description - <p>Abstract</p> <p>Background</p> <p>The seroprevalence of hepatitis C varies substantially between countries and geographic regions. A better understanding of the seroprevalence of this disease, and the risk factors associated with seropositive status, supply data for the development of screening programs and provide insight into the transmission of the disease. The purpose of this investigation was to determine the seroprevalence of hepatitis C and associated risk factors in an urban population in Haiti.</p> <p>Methods</p> <p>A prospective survey for hepatitis C antibodies was conducted among an urban outpatient population in Cap-Haïtien, Haiti, with a sample size of 500 subjects. An anonymous 12 question survey, with inquiries related to demographic characteristics and risk factors for HCV acquisition, was concomitantly administered with testing. These demographic and behavioral risk factors were correlated with HCV antibody status using univariate and multivariate tests.</p> <p>Results</p> <p>The prevalence of positive HCV antibody was 22/500 (4.4%). Subjects that were anti-HCV positive had an average of 7 ± 8.6 lifetime sexual partners, compared to average of 2.5 ± 3.5 lifetime sexual partners among HCV-negative subjects (p = 0.02). In a multiple logistic regression model, intravenous drug use (OR 3.7, 1.52&#8211;9.03 95% CI) and number of sexual partners (OR 1.1, 1.04&#8211;1.20 95% CI) were independently associated with a positive HCV antibody result.</p> <p>Conclusions</p> <p>A substantial number of subjects with HCV antibodies were detected in this population in Haiti. Further investigation into the correlation between the number of sexual partners and testing positive for hepatitis C antibodies is indicated.</p>
  66. Conversion from laparoscopic to open cholecystectomy: Multivariate analysis of preoperative risk factors
    • date - 2005
    • creator - Tayeb M
    • provider - NSDL OAI Repository
    • location - http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2005;volume=51;issue=1;spage=17;epage=20;aulast=Tayeb
    • description - BACKGROUND: Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. However, there is a need to devise a risk-scoring system based on the identified risk factors to (a) predict the risk of conversion preoperatively for selected patients, (b) prepare the patient psychologically, (c) arrange operating schedules accordingly, and (d) minimize the procedure-related cost and help overcome financial constraints, which is a significant problem in developing countries. AIM: This study was aimed to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy in our setting. SETTINGS AND DESIGNS: A case control study of patients who underwent laparoscopic surgery from January 1997 to December 2001 was conducted at the Aga Khan University Hospital, Karachi, Pakistan. MATERIALS AND METHODS: All those patients who were converted to open surgery (n = 73) were enrolled as cases. Two controls who had successful laparoscopic surgery (n = 146) were matched with each case for operating surgeon and closest date of surgery. STATISTICAL ANALYSIS USED: Descriptive statistics were computed and, univariate and multivariate analysis was done through multiple logistic regression. RESULTS: The final multivariate model identified two risk factors for conversion: ultrasonographic signs of inflammation (adjusted odds ratio [aOR] = 8.5; 95&#x0025; confidence interval [CI]: 3.3, 21.9) and age > 60 years (aOR = 8.1; 95&#x0025; CI: 2.9, 22.2) after adjusting for physical signs, alkaline phosphatase and BMI levels. CONCLUSION: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors is important for understanding the characteristics of patients at a higher risk of conversion.
  67. Hereditary risk factors for the development of gastric cancer in younger patients
    • date - 2004
    • creator - Joshaghani Yasamin
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1471230X&date=2004&volume=4&issue=1&spage=28
    • description - <p>Abstract</p> <p>Background</p> <p>It is believed that the development of gastric cancer (GC) before the age of 50 has a hereditary basis. Blood group A and history of gastric cancer in first-degree relatives have been shown to be risk factors for GC.</p> <p>Methods</p> <p>In this case-control study, we enrolled patients with GC who were diagnosed before the age of 50. Patients who were diagnosed as having GC were selected. A total of 534 cases were found; of these, 44 diagnosed before the age of 50 were included in the case group. For the control group, 22 males and 22 females were randomly selected from the remaining subjects, who had diagnoses of GC after the age of 50. All the surviving patients and family members of the dead patients were interviewed about the history of cancer in the family and the age at which other family members developed cancer. The blood group of each subject was also obtained.</p> <p>Results</p> <p>forty-four cases under 50 years old (mean age: 36.2 years) and forty-four controls (mean age: 67.1 years) were enrolled in the study. At the time of the study, 59.1% of the study group and 50% of the control group were alive (P value = NS). In the study group, 68.1%, 13.6%, 13.6% and 4.5% had blood groups O, A, B and AB, respectively. In the control group the corresponding figures were 27.7%, 63.6%, 6.8% and 4.5%. First or second-degree relatives with cancer, including gastric (the most frequent), breast, lung, gynecological and hematological malignancies, were noted in 54.5% of the cases and 11.4% of the controls (p < 0.01). Family histories of cancer were accepted as valid provided that they were based on valid medical documents.</p> <p>Conclusions</p> <p>It seems that the development of GC before the age of 50 is likely to be accompanied by familial susceptibility. Interestingly, our study showed a significant correlation between blood group O and the development of gastric cancer under the age of 50.</p>
  68. Alcohol consumption, physical activity, and chronic disease risk factors: a population-based cross-sectional survey
    • date - 2006
    • creator - Mukamal Kenneth
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/6/118
    • description - <p>Abstract</p> <p>Background</p> <p>Whether the association of alcohol consumption and cardiovascular disease is the product of confounding and the degree to which this concern applies to other behaviors are unclear.</p> <p>Methods</p> <p>Using the 2003 Behavioral Risk Factor Surveillance System, a population-based telephone survey of adults in the US, we compared chronic disease risk factors between 123,359 abstainers and 126,674 moderate drinkers, defined as intake of &#8804; 2 drinks per day among men and &#8804; 1 drink per day among women, using age- and sex- and multivariable-adjusted models. We also compared sedentary and active individuals, defined as moderate physical activity &#8805; 30 minutes per day for &#8805; 5 days per week, or vigorous activity for &#8805; 20 minutes per day on &#8805; 3 days.</p> <p>Results</p> <p>Chronic disease risk factors and features of unhealthy lifestyle were generally more prevalent among abstainers than drinkers in age- and sex-adjusted analyses, but these differences were generally attenuated or eliminated by additional adjustment for race and education. For low fruit and vegetable intake, divorced marital status, and absence of a personal physician, adjustment for race and education reversed initially positive age- and sex-adjusted associations with abstention. Comparison of sedentary and active individuals produced similar findings, with generally lower levels of risk factors among more physical active individuals.</p> <p>Conclusion</p> <p>The differences between abstainers and drinkers are attenuated after adjustment for limited sociodemographic features, and sedentary and active individuals share a similar pattern. Although observational studies of both factors may be susceptible to uncontrolled confounding, our results provide no evidence that moderate drinking is unique in this regard. Ultimately, randomized trials of all such lifestyle factors will be needed to answer these questions definitively.</p>
  69. A cohort study of possible risk factors for over-reporting of antihypertensive adherence
    • date - 2001
    • creator - Choo Peter
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2261/1/6
    • description - <p>Abstract</p> <p>Background</p> <p>The identification of poor medicinal adherence is difficult because direct observation of medication use is usually impractical. Up to 50% of individuals on chronic therapies may not be taking their medication as prescribed. This study is one of the first to explore possible risk factors for over-reporting of antihypertensive adherence using electronic medication monitoring.</p> <p>Methods</p> <p>The adherence of 286 individuals on single-drug antihypertensive therapy in a large managed care organization was electronically monitored for approximately three months. Questionnaires on socioeconomic background, adherence to therapy, health beliefs, and social support before and after adherence monitoring were completed. Over-reporting of antihypertensive adherence was assessed by comparing the self-reported frequency of noncompliance with that determined from electronic dosing records. Risk factors for over-reporting were identified by contingency table analysis and step-wise logistic regression.</p> <p>Results</p> <p>Although only 21% of participants acknowledged missing doses on one or more days per week, electronic monitoring documented nonadherence at this or a higher level in 42% of participants. The following variables were associated with over-reporting: >1 versus 1 daily dose (OR = 2.58; 95% CI = 1.50&#8211;4.41; <it>p</it> = .0006), lower perceived health risk from nonadherence (OR = 1.35; 95% CI = 1.10&#8211;1.64; <it>p</it> = .0035), and annual household income of <$15,000 versus >$30,000 (OR = 2.64; 95% CI = 1.13&#8211;6.18; <it>p</it> = .025).</p> <p>Conclusions</p> <p>Over-reporting of adherence may be affected by factors related to dosing frequency, health beliefs and socioeconomic status. This topic deserves further investigation in other patient populations to elucidate possible underlying behavioral explanations.</p>
  70. Fibronectin in the ascitic fluid of cirrhotic patients: correlation with biochemical risk factors for the development of spontaneous bacterial peritonitis
    • date - 1997
    • creator - Mesquita R.C.A.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0100879X&date=1997&volume=30&issue=7&spage=843
    • description - Cirrhotic patients (23 with alcoholic cirrhosis, 5 with posthepatitic cirrhosis and 2 with cryptogenic cirrhosis) with ascites and portal hypertension were studied and divided into two groups corresponding to high or low risk to develop spontaneous bacterial peritonitis (SBP) related to the concentration of total protein in the ascitic fluid (A-TP): group I (high risk): A-TP<FONT FACE="Symbol">£</font>1.5 g/dl and group II (low risk): A-TP>1.5 g/dl. Fibronectin (FN), C3 and C4 concentrations were measured by radial immunodiffusion while total protein was measured by the biuret method. The mean values (group I vs group II) of C3 (12.59 ± 4.72 vs 24.53 ± 15.58 mg/dl), C4 (4.26 ± 3.87 vs 7.26 ± 4.14 mg/dl) and FN (50.47 ± 12.49 vs 75.89 ± 24.70 mg/dl) in the ascitic fluid were significantly lower (P<0.05) in the group considered to be at high risk for SBP. No significant difference was observed in the plasma/ascites fibronectin ratio (3.91 ± 1.21 vs 3.80 ± 1.26) or gradient (131.46 ± 64.01 vs 196.96 ± 57.38) between groups. Fibronectin in ascites was significantly correlated to C3 (r = 0.76), C4 (r = 0.58), total protein (r = 0.73) and plasma FN (r = 0.58) (P<0.05). The data suggest that the FN concentration in ascites is related to the opsonic capacity of this fluid, and that its concentration in the ascitic fluid may be a biochemical risk factor indicator for the development of spontaneous bacterial peritonitis
  71. Distribution of risk factors in parents and siblings of patients with early coronary artery disease
  72. NEW APPROACH TO ESTIMATION OF RELATIVE RISKS DUE TO TWO OR MORE RISK FACTORS UNDER MULTIPLE MATCHING IN CASE-CONTROL STUDIES
    • date - 2004-04-16T20:54:55Z
    • creator - A. Ejigou
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=35751
    • description - The analysis of case-control data using logistic regression involves making some critical model assumptions. n the analysis of matched data for which the values of the matching variables are unavailable, use of logistic regression presupposes that odds ratios are homogeneous over the levels of the matching variables; this is done since logistic regression cannot, at present, provide a way of testing for the homogeneity of odds ratios. n this model, it is possible, as in logistic regression, to estimate odds ratios, check the multiplicativity of effects, or test for the significance of association. n addition, and unlike logistic regression, this model enables one to test for the homogeneity of the odds ratios over the levels of the matching variables even, when explicit information is not available on the matching variables.
  73. Reproductive tract infections: prevalence and risk factors in rural Bangladesh
    • date - 2002
    • creator - Hawkes Sarah
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000300003
    • description - OBJECTIVE: To determine the prevalence of and risk factors for reproductive tract infections among men and women in a rural community in Bangladesh. METHODS: In the Matlab area a systematic sample of married non-pregnant women aged 15-50 years was drawn from a comprehensive household registration system for married women. A systematic sample of married and unmarried men in the same age group was drawn from a census-derived demographic surveillance list. Private interviews were conducted with 804 women in a clinic, and cervical, vaginal, urinary and serological samples were collected. Urine and blood specimens were obtained from 969 men who were interviewed at home. FINDINGS: The prevalence of bacterial and viral reproductive tract infections was low to moderate. For example, fewer than 1% of the women had a cervical infection. No cases of human immunodeficiency virus (HIV) infection were found. However, among men there was a high level of reported risk behaviour and a low level of protection against infection. CONCLUSION: A low prevalence of reproductive tract infections, coupled with a high level of reported risk behaviour, indicated a need for primary programmes that would prevent an increase in the incidence of reproductive tract infections, sexually transmitted infections and HIV infection.
  74. Which Risk Factors Matter to Whom?
  75. RESPIRATORY SYMPTOMS AND RISK FACTORS IN AN ARIZONA POPULATION SAMPLE OF ANGLO AND MEXICAN-AMERICAN WHITES
    • date - 2003-10-01T21:36:25Z
    • creator - M. Lebowitz
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=44428
    • description - Prevalence rates of respiratory symptoms and diseases in a large group of Anglos and Mexican-Americans were analyzed. ach subject completed a questionnaire. mong current smokers, chronic productive cough and dyspnea were significantly higher in both ethnic groups; wheezy symptoms were higher in Anglos. here were no significant differences in the symptom prevalence rates between the two groups, after stratifying y current cigarette consumption and CRT. he spirometric values were not significantly different. n both ethnic groups, the prevalence rates of wheeze, SOBWHZ and asthma were significantly higher In those who had CRT. mong Anglos, less educated smokers had significantly higher prevalence rates of SOBWHZ and dyspnea; nonsmokers with less education had higher prevalence rates of cough, chronic cough and dyspnea. ur results confirm the importance of CRT and lower educational level as risk factors for respiratory symptoms. thnicity is not associated with symptomatology or lung function impairment. CRT=childhood respiratory trouble; SOBWHZ=attacks of shortness of breath with wheeze; AOD=airways obstructive diseases; NIH=National Institutes of Health; FVC=forced vital capacity; ATS=American Thoracic Society; FEV=forced respiratory volume in 1 s; ANOVA=analysis of variance; FEF25-75%=mean forced expiratory flow during the middle half of the FVC; SES=socioeconomic status; Vmax5O%=instantaneous forced expiratory flow when the lung is at 50% of its forces viral capacity.
  76. LACK OF EFFECT OF DRINKING WATER BARIUM ON CARDIOVASCULAR RISK FACTORS
    • date - 2003-10-01T21:36:40Z
    • creator - B.L. Stadler
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=45617
    • description - Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels of barium in drinking water. he purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for cardiovascular disease. leven healthy men completed a 10-week dose-response protocol in which diet was controlled (600 mg cholesterol; 40% fat, 40% carbohydrate, 20% protein; sodium and potassium controlled at the subject's pre-protocol estimated intake). ther aspects of the subjects' lifestyles known to affect cardiac risk factors were controlled, and the barium content (as barium chloride) of the drinking water (1.5 L/day) was varied from 0 (first 2 weeks), to 5 ppm (next 4 weeks), to 10 ppm (last 4 weeks). ultiple blood and urine samples, morning and evening blood pressure measurements, and 48-hr electrocardiographic monitoring. rend was seen toward increased total serum calcium levels with exposure to barium, which was of borderline statistical significance and of doubtful clinical significance. n summary, drinking water barium at levels of 5 and 10 ppm did not appear to affect any of the known modifiable cardiovascular risk factors,
  77. EPIDEMIOLOGIC STUDIES OF CORONARY HEART DISEASE AND STROKE IN JAPANESE MEN LIVING IN JAPAN, HAWAII AND CALIFORNIA. CORONARY HEART DISEASE RISK FACTORS IN JAPAN AND HAWAII
    • date - 2004-04-16T20:59:51Z
    • creator - Thomas L. Robertson
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=47869
    • description - Various risk factors were evaluated to explain a significantly greater incidence of coronary heart disease in men of Japanese ancestry resident in Hawaii compared with men resident in Japan. The independent predictors of incidence of coronary heart disease in both Japan and Hawaii were systolic blood pressure, serum cholesterol, relative weight and age. These factors appeared to influence incidence similarly in both areas because in each case the correlation coefficients for Japan and Hawaii did not differ significantly. The hypothesis that the greater incidence in Hawaii could be attributed to differences in levels of these risk factors was tested with the Walker-Duncan method. The four variable multiple logistic function describing the probability of coronary heart disease in Japan was applied to the cohort characteristics observed in Hawaii. The estimated incidence thus obtained was not significantly different from that actually observed in the men resident in Hawaii. Therefore the increased coronary risk profile in Hawaii compared with Japan can account for the greater incidence of coronary heart disease in the former. Current cigarette smoking was significantly related to the risk of coronary heart disease in Hawaii but not in Japan.
  78. MATERNAL OCCUPATIONAL CHEMICAL EXPOSURES AND BIOTRANSFORMATION GENOTYPES AS RISK FACTORS FOR SELECTED CONGENITAL ANOMALIES. (R828292)
    • date - 2004-06-22T06:09:37Z
    • creator - G Shaw
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=71737
    • description - The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency. The information contained in this record was developed via an EPA Grant or Fellowship.
  79. ENVIRONMENTAL RISK FACTORS FOR ASTHMA
    • date - 2005-09-12T18:17:03Z
    • creator -
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=72466
    • description - The incidence of asthma has doubled in the last 20 years with the largest increase among children below the age of 15 years (CDC, 1998). This increase cannot be explained by changes in diagnostic categorization or by alterations in the gene pool, and suggests a strong association between environmental influences and the incidence of disease. About 75% of asthma is associated with allergy, and it appears that early in life, the immune system can be programmed to promote asthmatic responses to certain antigens. While some allergens have been studied extensively (e.g., dust mite and cockroach), almost none of the mold allergens have been characterized, despite their widespread distribution and potential importance in the induction and exacerbation of asthma. Epidemiologic and clinical studies have also demonstrated that asthmatic responses can be exacerbated by ambient combustion-related products and by domestic and occupational exposures to airborne chemicals (air toxics). Clinical and epidemiologic studies have also shown that children with asthma are especially sensitive to the respiratory effects of ambient combustion-related pollutants such as sulfur dioxide and ozone. This project will study environmental influences that act directly as allergens to induce asthma or as agents that enhance the induction or exacerbate the disease via non-specific stimulation of immune or inflammatory responses. We will use a mouse model to study the role of fungal antigens as initiators of allergic asthma, and we will develop laboratory-based assays that can predict the ability of various pollutants to enhance the induction or exacerbate the severity of allergic asthma in a dose-dependent manner.
  80. MOLECULAR EPIDEMIOLOGY OF HYPOSPADIAS: REVIEW OF GENETIC AND ENVIRONMENTAL RISK FACTORS. (R828599)
    • date - 2005-02-14T18:07:59Z
    • creator - M Carr
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=76065
    • description - The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency. The information contained in this record was developed via an EPA Grant or Fellowship.
  81. RISK FACTORS FOR ENDEMIC GASTROINTESTINAL ILLNESS AMONG A WASHINGTON COHORT
    • date - 2005-06-06T17:33:31Z
    • creator - R Calderon
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=80136
    • description - RISK FACTORS FOR ENDEMIC GASTROINTESTINAL ILLNESS AMONG A WASHINGTON COHORT<br><br>*Christina A. Peterson 1,2,3 and Rebecca L. Calderon 2<br><br>1 Department of Epidemiology <br>School of Public Health (SPH) <br>University of North Carolina at Chapel Hill (UNC-CH), 27516<br>2 National Health and Environmental Effects Laboratory<br>US Environmental Protection Agency<br>Research Triangle Park, NC 27711<br>3 Department of Environmental Sciences and Engineering, SPH, UNC-CH, 27516<br><br>Risk factors for infectious gastrointestinal (GI) disease have been identified through outbreak investigations. The objective of our analysis was to investigate the role of known risk factors for endemic GI illness to identify possible prevention strategies. Outbreaks are by definition times of unusual disease occurrence, so lessons learned from outbreaks may be applicable to endemic disease prevention. We compared participants' exposure to various GI illness risk factors at the time they were ill to their exposure experience when they were well during a longitudinal study of GI illness and calculated odds ratios for each of the risk factors under study. Contact with someone with a GI illness within the previous seven days was the strongest predictor of illness within our study population. There were different distributions of exposures among participants when stratified by age and sex. Among children, drinking untreated water carried the highest association with illness. Children should be taught to avoid consuming water while swimming or drinking from untreated sources. Personal hygiene education could also reduce some of the burden of endemic GI illness. This work was supported in part by the NHEERL-DESE Cooperative Training in Environmental Sciences Research Agreement, EPA (CT 826513). (This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.)<br>
  82. ENVIRONMENTAL RISK FACTORS FOR PRESENCE OF CRYPTOSPORIDIUM PARVUM ANTIBODIES IN HUMAN SERUM
    • date - 2005-06-06T17:45:47Z
    • creator - E Hilborn
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=82615
    • description - There is no abstract available for this product. If further information is requested, please refer to the bibliographic citation and contact the person listed under Contact field.
  83. RISK FACTORS FOR NEURAL TUBE DEFECTS: ASSOCIATIONS BETWEEN UNCOUPLING PROTEIN 2 POLYMORPHISMS AND SPINA BIFIDA. (R828292)
    • date - 2004-06-22T06:09:57Z
    • creator - E Lammer
    • provider - NSDL OAI Repository
    • location - http://oaspub.epa.gov/eims/eimsapi.dispdetail?deid=84189
    • description - The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency. The information contained in this record was developed via an EPA Grant or Fellowship.
  84. The interface of obesity and depression: risk factors for the metabolic
  85. Overexpression of P53 and its risk factors in esophageal cancer in urban areas of Xi'an.
    • date - 1998
    • creator - Qiao GB
    • provider - NSDL OAI Repository
    • location - http://www.wjgnet.com/1007-9327/4/57.asp
    • description - <br>AIM:To investigate the risk factors of esophageal cancer (EC) in urban areas of Xi'an and to determine the association between overexpression of P53 and these risk factors.<br>METHODS: All cases (89) and controls (97) were permanent residents in urban areas of Xi'an, all cases of primary EC had been histologically confirmed, controls were inpatients with non-cancer and nonsmoking-related disease. Cancer tissues and tissues adjacent to the cancer of 65 cases and 24 available normal esophageal tissues of controls were detected for P53 overexpression by the immunohistochemical method.<br>RESULTS: The smoking and familial history of cancer were significantly associated with EC in Xi'an inhabitants. The laboratory assay indicated that P53 positive stain in EC was 50.0%(34/65)and 6.1%(4/65) in tissues adjacent to the cancer, but no positive stain was found in normal esophageal tissues of controls. The results showed that P53 overexpression in EC was closely related to smoking and cases with familial history of cancer.<br>CONCLUSION: Smoking and familial cancer history were important risk factors for EC,and the alteration of P53 gene may be due to smoking and inheritance factors.
  86. A matched case-control study of risk factors for neonatal tetanus in Karachi, Pakistan
    • date - 2004
    • creator - Raza Syed
    • provider - NSDL OAI Repository
    • location - http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2004;volume=50;issue=4;spage=247;epage=251;aulast=Raza
    • description - Background: Previous studies have identified various risk factors for neonatal tetanus (NNT) in rural areas of Pakistan. The present matched case control study was conducted to further evaluate these risk factors in an urban setting. Aim: The study was carried out to identify risk factors for NNT in Karachi. Materials and Methods: Patients of NNT (n = 125) diagnosed from January 1998 to February 2001 were recruited through a surveillance system of Expanded Programme on Immunization (EPI). Two neighbourhood controls (n = 250) were matched for each case for gender and date of birth of the case. Statistical Analysis: Conditional logistic regression was performed to assess the independent effect of factors associated with NNT. Results: The final multivariable model identified subsequent application of substances on the umbilical cord (adjusted matched odds ratio [adj. mOR] = 5.1 [2.7-9.7]), home delivery (adj. mOR = 1.8; 95&#x0025; CI: 1.1- 3.1) and illiterate mother (adj. mOR = 1.6; 95&#x0025; CI: 1.0- 2.0) as risk factors for NNT after adjusting for other variables in the model. Population attributable risk per cent (PAR &#x0025;) for subsequent cord application was 69&#x0025; and PAR &#x0025; for home delivery was 31&#x0025;. Conclusion: Health planners, while formulating control strategies through immunization programmes should also take into account the impact of post-delivery practices, such as &#x0027;subsequent cord application&#x0027; along with pre-delivery practices. Health awareness regarding appropriate post-delivery practices should be promoted and counselling of pregnant women for giving preference to health care setting for delivery is also crucial.
  87. Physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease
    • date - 2001
    • creator - Guedes Dartagnan Pinto
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001000900005
    • description - OBJECTIVE: To analyze associations between levels of physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease. METHODS: Sixty-two individuals aged between 20 and 45 years were evaluated. Levels of physical activity were established by estimates of energy demand corresponding to everyday activity; indices for cardiorespiratory fitness were obtained from estimates of maximal oxygen consumption; information about dietary content was obtained from dietary records kept on seven consecutive days. To indicate risk factors that cause a predisposition towards cardiovascular disease, use was made of body mass indexes, waist-hip circumference relationships, levels of arterial pressure and of plasma lipid-lipoprotein concentration. To establish associations between the variables studied, multiple regression analysis was used. RESULTS: Physical activity levels and cardiorespiratory fitness levels were inversely correlated with the amount and distribution of body fat and arterial pressure. Taken together, the two variables were responsible for between 16% and 19% of the variation in arterial pressure. Total and saturated fat ingestion was associated with higher serum lipid levels. Both dietary components were responsible for between 49% and 61% of the variation in LDL-cholesterol. CONCLUSION: High ingestion of food rich in total and saturated fat and decreased levels of physical activity and of cardiorespiratory fitness are associated with an increased risk of cardiovascular disease, which supports previous data.
  88. Fatores de risco em carcinomas de células transicionais da bexiga: risk factors
  89. Risk factors for bacterial catheter colonization in regional anaesthesia
    • date - 2005
    • creator - Niestolik Roswitha
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712253&date=2005&volume=5&issue=1&spage=1
    • description - <p>Abstract</p> <p>Background</p> <p>Although several potential risk factors have been discussed, risk factors associated with bacterial colonization or even infection of catheters used for regional anaesthesia are not very well investigated.</p> <p>Methods</p> <p>In this prospective observational trial, 198 catheters at several anatomical sites where placed using a standardized technique. The site of insertion was then monitored daily for signs of infection (secretion at the insertion site, redness, swelling, or local pain). The catheters were removed when clinically indicated (no or moderate postoperative pain) or when signs of potential infection occurred. After sterile removal they were prospectively analyzed for colonization, defined as > 15 colony forming units.</p> <p>Results</p> <p>33 (16.7%) of all catheters were colonized, and 18 (9.1%) of these with additional signs of local inflammation. Two of these patients required antibiotic treatment due to superficial infections. Stepwise logistic regression analysis was used to identify factors associated with catheter colonization. Out of 26 potential factors, three came out as statistically significant. Catheter placement in the groin (odds-ratio and 95%-confidence interval: 3.4; 1.5&#8211;7.8), and repeated changing of the catheter dressing (odds-ratio: 2.1; 1.4&#8211;3.3 per removal) increased the risk for colonization, whereas systemic antibiotics administered postoperatively decreased it (odds ratio: 0.41; 0.12&#8211;1.0).</p> <p>Conclusion</p> <p>Colonization of peripheral and epidural nerve catheter can only in part be predicted at the time of catheter insertion since two out of three relevant variables that significantly influence the risk can only be recorded postoperatively. Catheter localisation in the groin, removal of the dressing and omission of postoperative antibiotics were associated with, but were not necessarily causal for bacterial colonization. These factors might help to identify patients who are at increased risk for catheter colonization.</p>
  90. Risk factors for alloimmunization by patients with sickle cell disease
    • date - 2005
    • creator - Murao M.
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2005000500004
    • description - Blood transfusion in patients with sickle cell disease (SCD) is limited by the development of alloantibodies to erythrocytes. In the present study, the frequency and risk factors for alloimmunization were determined. Transfusion records and medical charts of 828 SCD patients who had been transfused and followed at the Belo Horizonte Blood Center, Belo Horizonte, MG, Brazil, were retrospectively reviewed. Alloimmunization frequency was 9.9% (95% CI: 7.9 to 11.9%) and 125 alloantibodies were detected, 79% of which belonged to the Rhesus and Kell systems. Female patients developed alloimmunization more frequently (P = 0.03). The median age of the alloimmunized group was 23.3 years, compared to 14.6 years for the non-alloimmunized group (P < 0.0001). Multivariate analyses were applied to the data for 608 hemoglobin (Hb) SS or SC patients whose number of transfusions was recorded accurately. Number of transfusions (P = 0.00006), older age (P = 0.056) and Hb SC (P = 0.02) showed independent statistical associations with alloimmunization. Hb SC patients older than 14 years faced a 2.8-fold higher (95% CI: 1.3 to 6.0) risk of alloimmunization than Hb SS patients. Female Hb SC patients had the highest risk of developing alloantibodies. In patients younger than 14 years, only the number of transfusions was significant. We conclude that an increased risk of alloimmunization was associated with older patients with Hb SC, specially females, even after adjustments were made for the number of transfusions received, the most significant variable.
  91. Retinopathy of prematurity - Risk factors
    • date - 2004
    • creator - Gupta Piyush
    • provider - NSDL OAI Repository
    • location - http://www.ijppediatricsindia.org/article.asp?issn=0019-5456;year=2004;volume=71;issue=10;spage=887;epage=892;aulast=Gupta
    • description - OBJECTIVE: Improved survival of low birth weight, premature babies have increased the incidence of retinopathy of prematurity. This hospital-based, prospective, study was undertaken to determine its incidence and risk factors in our neonatal unit. METHODS: Neonates with gestational age 35 weeks and/or birth weight 1500 gm born over a one-year period were examined by indirect ophthalmoscopy between 2 to 4 weeks after birth, and followed up till retinal vascularisation was complete. Maternal and neonatal risk factors were noted and data analyzed by statistical package SPSS-10.0. RESULTS: Sixty babies were thus examined. The incidence of retinopathy was 21.7&#x0025; in the cohort, 33.3&#x0025; in babies 32 weeks gestation and 36.4&#x0025; in babies weighing 1250 gm. Oxygen (p=0.01), sepsis (p=0.04) and apnoea (p=0.02) were independent risk factors. Retinopathy was significantly more severe in babies with hyaline membrane disease (p=0.02) and lower birth weight (p=0.02). Severe disease was never seen before 6.5 weeks of age. CONCLUSION: Indirect ophthalmoscopy should be performed at 4 weeks of post natal age in all preterm babies with birth weight 1500 gm, and intensified in the presence of risk factors like oxygen administration, apnoea and septicemia.
  92. A case-control study on alcohol and psychiatric disorders as risk factors for drug abuse pattern
    • date - 2002
    • creator - Lopes Claudia S.
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X2002000600010
    • description - We evaluated alcohol and psychiatric disorders as risk factors for the pattern of drug abuse/dependence in a matched case-control study (370 adults). Cases (drug abusers) and controls were selected in the community using the snowball technique and matched by sex, age, and friendship. Information was gathered using the "Composite International Diagnostic Interview" (CIDI). Three patterns of drug abuse/dependence were evaluated: any drug abuse/dependence, only cannabis, and cocaine and other drugs. Logistic conditional regression showed that alcohol dependence was strongly associated with pattern of drug abuse/dependence. Thus, compared to the "no drug abuse group", the odds ratio for association with diagnosis of abuse/dependence on cocaine and other drugs was 10.2 (95% CI: 4.9-21.2), whereas for abuse/dependence on cannabis only, the odds ratio was 1.0. For affective disorders, the odds ratio was 2.0 (95% CI: 1.10-3.64) for the group that received a diagnosis of abuse/dependence on cocaine and other drugs, whereas no association was found for those with abuse/dependence on cannabis only. In conclusion, there is not a homogeneous group of "drug users", and the role of risk factors depends on the drug use pattern.
  93. Risk factors associated with mental illness in Oyo State, Nigeria: A Community based study
    • date - 2005
    • creator - Amoran OE
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1744859X&date=2005&volume=4&issue=1&spage=19
    • description - <p>Abstract</p> <p>Background</p> <p>The main objective of this study was to determine the prevalence and factors associated with mental illness in Oyo State at community level using the general health questionnaire as a screening tool.</p> <p>Method</p> <p>This cross-sectional, community- based survey was carried out among adults in three randomly selected LGAs using multi-stage sampling technique.</p> <p>Results</p> <p>A total of 1105 respondents were assessed in all. The overall prevalence of psychiatric morbidity in Oyo state Nigeria was found to be 21.9%, (18.4% in the urban areas and 28.4% in the rural areas, p = 0.005). Young age &#8804; 19 yrs (X<sup>2 </sup>= 20.41, p = 0.00013), Unemployment (X<sup>2 </sup>= 11.86 p = 0.0005), living condition below average (X<sup>2 </sup>= 12.21, p = 0.00047), physical health (X<sup>2 </sup>= 6.07, p = 0.014), and large family size (X<sup>2 </sup>= 14.09 p = 0.00017) were associated with increase risk for psychiatric morbidity.</p> <p>Following logistic regression analysis, Unemployment (C.I = 1.18&#8211;3.70, OR -2.1) and living conditions perceived to be above average (C.I = 1.99&#8211;5.50, OR-3.3) were significant predictors of mental illness while family size less than 6 (C.I = 0.86&#8211;0.97, OR-0.91) was protective.</p> <p>Conclusion</p> <p>The teenagers and the rural populations are in greater need of mental health promotional services. Family planning should be made freely available in order to reduce the family size and hence incidence of mental illness in the African population.</p>
  94. Risk Factors for Invasive Epithelial Ovarian Cancer by Histologic Subtype
    • date - 2004
    • creator - Natarajan N
    • provider - NSDL OAI Repository
    • location - http://www.ojhas.org/issue11/2004-3-2.htm
    • description - It is unclear whether the different histologic subtypes of epithelial ovarian carcinoma have different risk factors. We investigated the relationships between selected epidemiologic variables (i.e., parity, family history of ovarian cancer, oral contraceptive use, a history of tubal ligation and noncontraceptive estrogen use) and the major histologic subtypes of epithelial ovarian cancer in a hospital-based case-control study of adult women at Roswell Park Cancer Institute in Buffalo, NY, USA. Multivariate unconditional logistic regression models were used for statistical analysis. We observed a pattern of increased risk associated with family history and a pattern of risk reduction associated with parity, noncontraceptive estrogen use and tubal ligation across all histologic subtype groups. However, we did not observe a consistent pattern of risk associated with oral contraceptive use. These results provide some additional support for the hypothesis that the effects of various ovarian cancer risk factors may differ according to the histologic subtype.
  95. Intelligent data analysis to interpret major risk factors for diabetic patients with and without ischemic stroke in a small population
    • date - 2003
    • creator - Gürgen Nurgül
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1475925X&date=2003&volume=2&issue=1&spage=5
    • description - <p>Abstract</p> <p>This study proposes an intelligent data analysis approach to investigate and interpret the distinctive factors of diabetes mellitus patients with and without ischemic (non-embolic type) stroke in a small population. The database consists of a total of 16 features collected from 44 diabetic patients. Features include age, gender, duration of diabetes, cholesterol, high density lipoprotein, triglyceride levels, neuropathy, nephropathy, retinopathy, peripheral vascular disease, myocardial infarction rate, glucose level, medication and blood pressure. Metric and non-metric features are distinguished. First, the mean and covariance of the data are estimated and the correlated components are observed. Second, major components are extracted by principal component analysis. Finally, as common examples of local and global classification approach, a k-nearest neighbor and a high-degree polynomial classifier such as multilayer perceptron are employed for classification with all the components and major components case. Macrovascular changes emerged as the principal distinctive factors of ischemic-stroke in diabetes mellitus. Microvascular changes were generally ineffective discriminators. Recommendations were made according to the rules of evidence-based medicine. Briefly, this case study, based on a small population, supports theories of stroke in diabetes mellitus patients and also concludes that the use of intelligent data analysis improves personalized preventive intervention.</p>
  96. Risk factors for protein-energy malnutrition in pre-school shantytown children in São Paulo, Brazil
    • date - 1998
    • creator - Ferrari Alexandre Archanjo
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=15163180&date=1998&volume=116&issue=2&spage=1654
    • description - OBJECTIVE: To investigate the health and nutritional conditions of people living in a shantytown in the city of São Paulo in order to identify risk factors for infant malnutrition. DESIGN: A retrospective cohort study. PARTICIPANTSs: Children living in a shantytown was conducted among children less than 72 months of age. METHODS: Home visits were made and information was collected regarding the risk factors for malnutrition. RESULTS: The prevalence of chronic malnutrition was 41.6% according to Gomez, 36.6% according to Waterlow, and 17.6% according to WHO. Risk factors for malnutrition, according to the weight-for-age index, included birthweight, presence of upper respiratory tract infections, number of pregnancies, number of births, maternal body mass index, birthplace of father, and home building material; according to the weight-for-height index, they included birthweight and maternal age at the time of birth; and according to the height-for-age index, they included the number of pre-natal medical visits, birthweight, maternal height, maternal body mass index, father's employment being unregistered, and maternal birthplace. An instrument for identifying children at risk of malnutrition was devised from these major risk factors for future malnutrition, which may then be applied to newly-born children.
  97. Colorectal cancer: risk factors and recommendations for early detection.
    • date - 1999
    • creator - Read TE
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0002838X&date=1999&volume=59&issue=11&spage=3083
    • description - Spurred by mounting evidence that the detection and treatment of early-stage colorectal cancers and adenomatous polyps can reduce mortality, Medicare and some other payors recently authorized reimbursement for colorectal cancer screening in persons at average risk for this malignancy. A collaborative group of experts convened by the U.S. Agency for Health Care Policy and Research has recommended screening for average-risk persons over the age of 50 years using one of the following techniques: fecal occult blood testing each year, flexible sigmoidoscopy every five years, fecal occult blood testing every year combined with flexible sigmoidoscopy every five years, double-contrast barium enema every five to 10 years or colonoscopy every 10 years. Screening of persons with risk factors should begin at an earlier age, depending on the family history of colorectal cancer or polyps. These recommendations augment the colorectal cancer screening guidelines of the American Academy of Family physicians. Recent advances in genetic research have made it possible to identify persons at high risk for colorectal cancer because of an inherited predisposition to develop this malignancy. These patients require aggressive screening, usually by lower endoscopy performed at an early age. In some patients, genetic testing can guide screening and may be cost-effective.
  98. Risk factors for atherosclerosis in an elderly out patient population in the City of São Paulo
    • date - 2000
    • creator - Curiati José Antonio Esper
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2000000300001
    • description - OBJECTIVE: To analyze in out clinic elderly patients of both sexes for the prevalence of risk factors for atherosclerosis and study their association with the complications of atherosclerosis. METHODS: Five hundred and sixteen outpatients, 152 men and 364 women, 60 years or older, were studied. The prevalences of hypertension, dyslipidemia, diabetes mellitus, cigarette smoking and obesity were determined in both sexes and compared using the chi-square test. The association between these factors and the presence of atherosclerotic complications was analyzed by logistic regression. RESULTS: The comparative analysis of the factors in both sexes showed that hypertension, total cholesterol > or = 240mg/dL, LDL-cholesterol > or = 160mg/dL, and body mass index >27.5 were more frequent among women, but HDL-cholesterol <35mg/dL and cigarette smoking were more frequent among men, and no difference occurred between sexes in relation to the frequency of triglycerides > or = 250mg/dL and diabetes mellitus. After adjustment of the variables in the regression model, we observed that in the total of elderly patients, risk factors for complications of atherosclerosis were: triglycerides > or = 250mg/dL, hypertension, and male sex. Among men, the risk factors were: LDL-cholesterol > or = 160mg/dL, diabetes mellitus, HDL-cholesterol <35mg/dL and hypertension. Among women, the risk factors were: tryglicerides > or = 250mg/dL and hypertension. CONCLUSION: The results showed that, in the elderly, the risk factors for atherosclerosis persist, but with different behaviors between men and women. The study suggests that the relative importance of the risk factors can change with the aging process.
  99. Evaluation of the Risk Factors For the Development of Posttraumatic Stress Symptoms in the Survivors of the 1999 Earthquake in Marmara: a Cross-Sectional Field Survey.
    • date - 2004
    • creator - Ilhan Yargic
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=13008773&date=2004&volume=42&issue=1&spage=3
    • description - Objective: This study evaluates posttraumatic stress (PTS) symptom severity and associated risk factors among survivors of the 1999 Marmara Earthquake in Turkey. Method: People [n»144, men 60%, mean age: 33 years (17-65)], living in prefabricated houses in Kocaeli region were assessed using PDE-Q, DIS-Q and IES-R. Sociodemog-raphic variables related with pretraumatic individual characteristics were collected. The participants completed Disaster Severity Questionnaire consisting of questions on subjective emotional feelings, objective experiences and postdisaster adversities during the earthquake. IES-R was the outcome variable in stepwise linear regression model. Pre-tra-uma variables, trauma related variables and scale scores were studied in three different msdels. Then significant variables were included into the final model. Results: It was defined that, age (B=0.216, p=0.049), female gender (B-6.974, p=0.011), intense fear during the earthquake (B=7.886, p=0.008j, and scores of PDE-Q p=0.0Q1) and DES-Q (B*0.106, p=0.001) and increase in smoking (B=6.735, p=0.009), correlated with IES-R score. Multiple R of this final mode) was 6.746, Discussion and Conclusion: Major predictors of IES score were age, female gender, intense fear experience during the earthquake and scores of PDE-Q and DIS-G.
  100. Risk factors for treatment delay in pulmonary tuberculosis in Recife, Brazil
    • date - 2005
    • creator - dos Santos Martinho
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/5/25
    • description - <p>Abstract</p> <p>Background</p> <p>Tuberculosis is still a great challenge to public health in Brazil and worldwide. Early detection followed by effective therapy is extremely important in controlling the disease. Recent studies have investigated reasons for delays in treatment, but there is no agreed definition of what constitutes an "acceptable" delay. This study investigates factors associated with total delay in treatment of tuberculosis.</p> <p>Methods</p> <p>A cohort of adult cases of pulmonary tuberculosis diagnosed over a two-year period was studied. Patients were interviewed on entry, reporting the duration of symptoms before the start of treatment, and sputum and blood samples were collected. It was decided that sixty days was an acceptable total delay. Associations were investigated using univariable and multivariable analysis and the population attributable fraction was estimated.</p> <p>Results</p> <p>Of 1105 patients, 62% had a delay of longer than 60 days. Age, sex, alcoholism and difficulty of access were not associated with delays, but associations were found in the case of unemployment, having given up smoking, having lost weight and being treated in two of the six health districts. The proportion attributable to: not being an ex-smoker was 31%; unemployment, 18%; weight loss, 12%, and going to the two worst health districts, 25%.</p> <p>Conclusion</p> <p>In this urban area, delays seem to be related to unemployment and general attitudes towards health. Although they reflect the way health services are organized, delays are not associated with access to care.</p>
  101. Pancreatic Pseudocysts Following Acute Pancreatitis: Risk Factors Influencing Therapeutic Outcomes
    • date - 2004
    • creator - Soliani P
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&eissn=15908577&date=2004&volume=5&issue=5&spage=338
    • description - CONTEXT: The natural history of pancreatic pseudocysts has become well known in recent years, but the choice of a proper treatment still remains controversial. OBJECTIVE: This study aims at establishing whether predictive factors influencing therapeutic outcomes exist. SETTING: Patients with pancreatic pseudocysts following an episode of acute pancreatitis treated from January 1980 to December 2001 at the Department of General Surgery and Organ Transplantation of the University of Parma, Italy. PATIENTS: Seventy-four patients were studied: 12 had a spontaneous resolution, 37 patients were treated surgically, 15 were treated endoscopically and in 10, percutaneous drainage was used. MAIN OUTCOME MEASURES: Epidemiological, clinical and pathological characteristics of patients with pancreatic pseudocysts were related to morbidity, recurrence rates and hospital stay. RESULTS: At univariate logistic regression, our data reveal a significant increase in morbidity related to age (P=0.013), etiology (alcoholic vs. biliary, P=0.024), Ranson score of previous pancreatitis (P=0.006), nutritional assessment (P=0.001), residual necrosis (P<0.001) and modality of treatment (P=0.009), whereas none of these parameters has been shown to be significantly correlated to recurrence. At multivariate logistic regression, only residual necrosis was significantly related to morbidity. CONCLUSIONS: Some factors, such as epidemiological (age, etiology), clinical (severity of previous pancreatitis, malnourishment), pathological (residual necrosis), and therapeutical factors (emergency/urgency treatment) are predictive of worse outcomes for invasive treatment of pseudocysts. In particular residual necrosis appeared to be the most important factor influencing invasive treatment outcomes, confirming that this pathological aspect deserves particular attention from surgeons. No risk factors predicting pancreatic pseudocyst recurrence emerged.
  102. ORIGINAL PAPER <br>An analysis of coronarography results and selected cardiac risk factors in patients with acute coronary syndrome according to the level of cardiac troponin T
    • date - 2006
    • creator - Agnieszka DÄ™bska
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=17341922&date=2006&volume=2&issue=1&spage=20
    • description - Introduction: There are many classical cardiac risk factors leading to acute coronary syndromes (ACS): arterial hypertension (HA), diabetes mellitus (DM), lipid disorders, family history (FH), smoking (Sm), obesity. The one of risk stratification is an evaluation of biochemical cardiac markers demonstrating myocardial injury. Material and methods: The studied group included 124 patients (27% females, mean age 60.5±11.1 years) hospitalized with symptoms of ACS. In all patients the level of cardiac troponin T (cTnT) was measured in admission. In the case of a negative result a measurement was repeated after 6-12 hours. According to results the patients were stratified into: group 1 – with negative (<0.1 µg/L) and group 2 – with positive (³0.1 µg/L) cTnT concentrations. In these groups results of coronarography and selected classical cardiac risk factors were analyzed. Results: The performance of: HA, Sm, FH, obesity and lipid profile was similar. The percentage of critical single and multivessel coronary stenoses did not differentiate both groups. In patients with a positive cTnT in comparison to the cTnT negative group diabetes, and the critical stenoses of the circumflex coronary artery (p<0.05) occurred more often. In diabetics with the positive cTnT compared to non-diabetics of group 2 frequently the elevated concentration of triglycerides (p<0.01) and the overweight in comparison to diabetics of the 1 group (p<0.05) were documented. Conclusions: In patients with acute coronary syndrome and a positive cTnT diabetes occurs more often compared to the cTnT negative patients. Diabetics belong to the group of high risk, so they require a detailed diagnosis and treatment.
  103. Risk factors of breast cancer in Mexican women
    • date - 2000
    • creator - Calderón-Garcidueñas Ana Laura
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342000000100006
    • description - OBJECTIVE: To investigate the association between family history (FH) of neoplasia, gyneco-obstetric factors and breast cancer (BC) in a case--control study. In cases, to analyze those variables in relation with early onset of BC, the manner of detection (self-examination, prompted by pain, or casual), the size of tumor, and the elapsed time to seek medical attention. MATERIAL AND METHODS: Data from 151 prevalent BC cases and 235 age-matched controls were analyzed by multiple logistic regression, to assess the influence of BC risk factors. RESULTS: Ten per cent of patients and 1% of controls had first-degree relatives (FDR) with BC. Family history of FDR with BC (OR, 11.2; 95% CI 2.42-51.92) or with gastric or pancreatic cancer (OR, 17.7; 95% CI 2.2-142.6) was associated with BC risk. Breastfeeding at or under 25 years of age was protective against BC (OR, 0.40; 95% CI 0.24-0.66). The manner of tumor detection did not influence its size at the time of diagnosis. CONCLUSIONS: Our study confirms that FH of BC and/or of gastric or pancreatic carcinoma are risk factors for BC, while lactation at 25 years of age or earlier is protective.
  104. Maternal and congenital syphilis in Bolivia, 1996: prevalence and risk factors
    • date - 2001
    • creator - Fears Martha
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00429686&date=2001&volume=79&issue=1&spage=33
    • description - OBJECTIVES: The present study was carried out in seven maternity hospitals to determine the prevalence of maternal syphilis at the time of delivery and the associated risk factors, to conduct a pilot project of rapid syphilis testing in hospital laboratories, to assure the quality of syphilis testing, and to determine the rate of congenital syphilis in infants born to women with syphilis at the time of delivery - all of which would provide baseline data for a national prevention programme in Bolivia. METHODS: All women delivering either live-born or stillborn infants in the seven participating hospitals in and around La Paz, El Alto, and Cochabamba between June and November 1996 were eligible for enrolment in the study. FINDINGS: A total of 61 out of 1428 mothers (4.3%) of live-born infants and 11 out of 43 mothers (26%) of stillborn infants were found to have syphilis at delivery. Multivariate analysis showed that women with live-born infants who had less than secondary-level education, who did not watch television during the week before delivery (this was used as an indicator of socioeconomic status), who had a previous history of syphilis, or who had more than one partner during the pregnancy were at increased risk of syphilis. While 76% of the study population had received prenatal care, only 17% had syphilis testing carried out during the pregnancy; 91% of serum samples that were reactive to rapid plasma reagin (RPR) tests were also reactive to fluorescent treponemal antibody-absorption (FTA-ABS) testing. There was 96% agreement between the results from local hospital laboratories and national reference laboratories in their testing of RPR reactivity of serum samples. Congenital syphilis infection was confirmed by laboratory tests in 15% of 66 infants born to women with positive RPR and FTA-ABS testing. CONCLUSION: These results indicate that a congenital syphilis prevention programme in Bolivia could substantially reduce adverse infant outcomes due to this disease.
  105. Stroke in Trinidad and Tobago: burden of illness and risk factors
    • date - 1998
    • creator - Mahabir Deepak
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10204989&date=1998&volume=4&issue=4&spage=
    • description - This study describes the burden of stroke on hospital services in a Caribbean community. The settings are the two main acute general hospitals in Trinidad observed over a 12-month period. All subjects were admitted with a clinical diagnosis of acute stroke. The measures were hospital admission rates, length of hospital stay, case-fatality rates, disability at discharge, and risk factors for stroke. There were 1 105 hospital admissions with a diagnosis of stroke. The median length of stay was 4 days, with an interquartile range of 2 to 9, and stroke accounted for approximately 9 478 bed days per annum. The hospital admission fatality rate was 29%. Among surviving patients, 437 (56%) were severely disabled at discharge. Age-standardized admission rates for first strokes in persons aged 35_64 years were 114 (95%CI: 83 to 145) per 100 000 in Afro-Trinidadian men and 144 (109 to 179) in Indo-Trinidadian men. The equivalent rates for women were 115 (84 to 146) and 152 (118 to 186). Among patients with first strokes, 348/531 (66%) reported physician-diagnosed hypertension, but only 226 (65%) of these reported being on antihypertensives at admission. Stroke in Trinidad and Tobago is associated with a high case-fatality rate and severe disability in survivors. Modifiable risk factors were reported in a majority of stroke cases, and there is a need to develop effective preventive strategies.
  106. Risk factors for cataract: A case control study
    • date - 1998
    • creator - Zodpey Sanjay
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=03014738&date=1998&volume=46&issue=4&spage=221
    • description - The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES), illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI), use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.
  107. Asthma in Adults. Clinical Features, Risk Factors and Patient Follow Up in the Region Centre of France
    • date - 2002
    • creator - Balland S
    • provider - NSDL OAI Repository
    • location - http://www.ameli.fr/pdf/2396.pdf
    • description - Aims: To describe the clinical features and evaluate the medical management and follow up of asthmatic patients from the viewpoint of the 1995 National Agency for the Development of Medical Evaluation guidelines. Method: We used national health fund’s computerized pharmacy coding system to identify a cohort of 731 patients aged between 16 and 55 years who were taking rapid-acting, beta-2-mimetic inhalers. After a detailed history and physical examination by one of national health fund’s medical advisors ( médecins-conseils ), we selected the 691 asthmatic patients in this group for enrollment in the study. Results: 52 % of the patients were male, 19 % were obese (body-mass index > 30), 35 % were smokers and 14 % worked in a professional environment presenting risk-factors for asthma although only 1 % were receiving statutory benefits related to recognized occupational asthma. At the time the study was performed (in other words, while they were receiving treatment), 49 % of the patients were classified as stage I, 25 % as stage II, 17 % as stage III and 9 % as stage IV. 80 % of the patients studied were followed by a general practitioner and 53 % stated that they had never consulted a pulmonary specialist. 30 % had never had pulmonary function tests. Conclusions: Patient follow up needs to be improved. This requires increased referral to specialists in order to obtain a base-line evaluation, including pulmonary function tests and direct skin tests for allergy associated with better patient education.
  108. Risk Factors Having Impact On The Prevalence Of Addiction Of Cigarrette, Alcohol And Substance In The Apprentices In The Mersin Vocational Training And Apprenticeship Center
    • date - 2005
    • creator - A.O. Kurt
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=13008773&date=2005&volume=43&issue=1&spage=33
    • description - Objective: Studies concerning the addiction of cigarette, alcohol and other substances have been conducted mainly on normal opulations, such as school age and childhood. Although the working children and adolescents constitute an important risk group in terms of the addiction to these substances, the number of the studies conducted on them is insufficient. For this reason, this study aimed at investigating the risk factors having impact on the prevalence of addiction of cigarette, alcohol and substances in the apprentices in the Mersin Vocational Training and Apprenticeship Center. Method: This study which was conducted in Mersin Vocational Training and Apprenticeship Center as a cross-sectional study. All of 1450 students in the center were included in the study. A questionnaire form filled by the parents and Children Beck Depression Scale was used. Binary Logistic Regression Analysis was used for the purpose of determining definitive statistics and risk factors in summarizing the data. Findings: 1152 apprentices including 960 (83.3%) boys attended the study and their mean age was 17.3±1.3. It was found that prevalence of trying cigarette, alcohol and illegal substances at least for once was respectively 45.7%, 39.1%, 4.2%. Some of the primary risk factors detected are as follows: i) for experience with cigarette: to use alcohol, to be a male, to come from a family where parents quarrel, to attempt to conduct suicide, ii) for experience with alcohol: to be a male, to be aged over 18, to try smoking, to have a mother or father with alcohol addiction, to come from a family where there is quarrel and Exchange of bad words and to be made fun in the workplace, iii) for the experience with illegal substances: to attempt suicide, to carry symptoms of depression, to try alcohol and to have a father with cigarette addiction. Discussion: It can be seen that there is close relationship between experience of smoking, alcohol and illegal substance by apprentices and their environment of their house and workplace. It is necessary that the master in the workplace, the family and the child should be evaluated as a whole in the trainings to be provided for the purpose pf protecting children from these substances. Conclusion: Working environment of the children should be improved and units of consultancy and guidance should be established.
  109. A longitudinal analysis of the risk factors for diabetes and coronary heart disease in the Framingham Offspring Study
    • date - 2003
    • creator - Bhargava Alok
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14787954&date=2003&volume=1&issue=1&spage=3
    • description - <p>Abstract</p> <p>Background</p> <p>The recent trends in sedentary life-styles and weight gain are likely to contribute to chronic conditions such as hypertension, diabetes, and cardiovascular diseases. The temporal sequence and pathways underlying these conditions can be modeled using the knowledge from the biomedical and social sciences.</p> <p>Methods</p> <p>The Framingham Offspring Study in the U.S. collected information on 5124 subjects at baseline, and 8, 12, 16, and 20 years after the baseline. Dynamic random effects models were estimated for the subjects' weight, LDL and HDL cholesterol, and blood pressure using 4 time observations. Logistic and probit models were estimated for the probability of diabetes and coronary heart disease (CHD) events.</p> <p>Results</p> <p>The subjects' age, physical activity, alcohol consumption, and cigarettes smoked were important predictors of the risk factors. Moreover, weight and height were found to differentially affect the probabilities of diabetes and CHD events; body weight was positively associated with the risk of diabetes while taller individuals had lower risk of CHD events.</p> <p>Conclusion</p> <p>The results showed the importance of joint modeling of body weight, LDL and HDL cholesterol, and blood pressure that are risk factors for diabetes and CHD events. Lower body weight and LDL concentrations and higher HDL levels achieved via physical exercise are likely to reduce diabetes and CHD events.</p>
  110. Neurodevelopmental risk factors in schizophrenia
    • date - 2001
    • creator - Teruchkin B.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0100879X&date=2001&volume=34&issue=2&spage=155
    • description - The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
  111. Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study
    • date - 2000
    • creator - MIRANDA-FILHO Demócrito B.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00364665&date=2000&volume=42&issue=6&spage=333
    • description - A case-control study was conducted to identify risk factors for death from tetanus in the State of Pernambuco, Brazil. Information was obtained from medical records of 152 cases and 152 controls, admitted to the tetanus unit in the State University Hospital, in Recife, from 1990 to 1995. Variables were grouped in three different sets. Crude and adjusted odds ratios, p-values and 95% confidence intervals were estimated. Variables selected in the multivariate analysis in each set were controlled for the effect of those selected in the others. All factors related to the disease progression - incubation period, time elapsed between the occurrence of the first tetanus symptom and admission, and period of onset - showed a statistically significant association with death from tetanus. Similarly, signs and/or symptoms occurring on admission or in the following 24 hours (second set): reflex spasms, neck stiffness, respiratory signs/symptoms and respiratory failure requiring artificial ventilation (third set) were associated with death from tetanus even when adjusted for the effect of the others.
  112. Risk factors for antibiotic resistance in <it>Campylobacter </it>spp. isolated from raw poultry meat in Switzerland
    • date - 2003
    • creator - Ledergerber Ursula
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/3/39
    • description - <p>Abstract</p> <p>Background</p> <p>The world-wide increase of foodborne infections with antibiotic resistant pathogens is of growing concern and is designated by the World Health Organization as an emerging public health problem. Thermophilic <it>Campylobacter </it>have been recognised as a major cause of foodborne bacterial gastrointestinal human infections in Switzerland and in many other countries throughout the world. Poultry meat is the most common source for foodborne cases caused by <it>Campylobacter</it>. Because all classes of antibiotics recommended for treatment of human campylobacteriosis are also used in veterinary medicine, in view of food safety, the resistance status of <it>Campylobacter </it>isolated from poultry meat is of special interest.</p> <p>Methods</p> <p>Raw poultry meat samples were collected throughout Switzerland and Liechtenstein at retail level and examined for <it>Campylobacter </it>spp. One strain from each <it>Campylobacter</it>-positive sample was selected for susceptibility testing with the disc diffusion and the E-test method. Risk factors associated with resistance to the tested antibiotics were analysed by multiple logistic regression.</p> <p>Results</p> <p>In total, 91 <it>Campylobacter </it>spp. strains were isolated from 415 raw poultry meat samples. Fifty-one strains (59%) were sensitive to all tested antibiotics. Nineteen strains (22%) were resistant to a single, nine strains to two antibiotics, and eight strains showed at least three antibiotic resistances. Resistance was observed most frequently to ciprofloxacin (28.7%), tetracycline (12.6%), sulphonamide (11.8%), and ampicillin (10.3%). One multiple resistant strain exhibited resistance to five antibiotics including ciprofloxacin, tetracycline, and erythromycin. These are the most important antibiotics for treatment of human campylobacteriosis. A significant risk factor associated with multiple resistance in <it>Campylobacter </it>was foreign meat production compared to Swiss meat production (odds ratio = 5.7).</p> <p>Conclusion</p> <p>Compared to the situation in other countries, the data of this study show a favourable resistance situation for <it>Campylobacter </it>strains isolated from raw poultry meat produced in Switzerland. Nevertheless, the prevalence of 19% ciprofloxacin resistant strains is of concern and has to be monitored. "Foreign production vs. Swiss production" was a significant risk factor for multiple resistance in the logistic regression m
  113. Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors
    • date - 2002
    • creator - Manfroi Waldomiro Carlos
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2002000400006
    • description - OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04) and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03). The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.
  114. Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study
    • date - 2002
    • creator - Brandão Ajacio
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-230X/2/18
    • description - <p>Abstract</p> <p>Background</p> <p>In Brazil, it is estimated that between 2.5 and 4.9% of the general population present anti-hepatitis C virus (HCV) antibodies, which corresponds to as many as 3.9 to 7.6 million chronic carriers. Chronic liver disease is associated with HCV infection in 20% to 58% of the Brazilian patients. The objective of this case-control study was to investigate the risk factors for presence of anti-HCV antibody in blood donors in southern Brazil.</p> <p>Methods</p> <p>One hundred and seventy eight blood donors with two positive ELISA results for anti-HCV were cases, and 356 controls tested negative. A standardized questionnaire was used to collect data concerning demographic and socioeconomic aspects, history of previous hepatitis infection, social and sexual behaviors, and number of donations. Variables were grouped into sets of hierarchical categories. Cases and controls were compared using logistic regression, odds ratios, and 95% confidence intervals. The statistical significance of the associations was assessed through likelihood ratio tests based on a P value < 0.05.</p> <p>Results</p> <p>The prevalence of anti-HCV among blood donors was 1.1%. Most of the donors were white and males. In the multivariate analysis, independent predictors of anti-HCV positivity were: intravenous drug use, blood transfusion >10 years earlier, having had two to four sexually transmitted diseases, incarceration, tattooing, sex with a hepatitis B or C virus carrier or with intravenous drug users.</p> <p>Conclusion</p> <p>Intravenous drug use, blood transfusion, and tattooing were the main risk factors for anti-HCV positivity among blood donors from southern Brazil, but sexual HCV transmission should also be considered.</p>
  115. The Bambuí Health and Aging study (BHAS): prevalence of risk factors and use of preventive health care services
    • date - 2001
    • creator - Barreto Sandhi M.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10204989&date=2001&volume=9&issue=4&spage=219
    • description - Objective. To describe, for the first time in Brazil, the prevalence of risk factors and the use of preventive health care services among adults 60 years and older. Methods. This population-based study was conducted during 1996-1997 in the state of Minas Gerais, in the town of Bambuí, which is located in the municipality of the same name. In 1996 the town had 14 950 inhabitants. For the study, all the town's residents aged > or = 60 years were selected, along with a comparison sample of persons aged 18-59 years. Data were gathered using interviews and physical examinations. Results. Of the 1 742 inhabitants of the town of Bambuí aged > or = 60 years, 1 606 (92.2%) participated in the interview and 1 495 (85.8%) were examined (blood pressure, anthropometric measurements, and blood tests). Among the 1 020 younger adults selected for the survey, 909 of them (89.1%) participated in the interview, and 820 of them (80.4%) underwent the physical examination. The prevalence of the following risk factors was higher among older adults than among younger adults: physical inactivity (47.7% vs. 28.0%); blood pressure 140-159 mmHg (systolic) or 90-99 mmHg (diastolic) (25.8% vs. 8.7%); blood pressure > or = 160 mmHg (systolic) or > or = 100 mmHg (diastolic) (19.1% vs. 4.1%); total cholesterol > or = 240 mg/dL (40.6% vs. 9.8%); and blood glucose > or = 126 mg/dL (12.4% vs. 2.2%). The daily consumption of fruits and vegetables was similar among the older adults and the younger ones (51.9% and 51.7%), as was also body mass index > or = 25 kg/m² (51.6% and 56.2%). Smoking was lower among the older adults (18.7%) than among the younger ones (31.1%). The proportion of participants whose blood pressure had been checked in the preceding year was high (86.8% among the older adults and 61.2% among the younger ones), suggesting that the high prevalence of uncontrolled hypertension was not due to limited access to health care. Conclusions. For a long time it was believed that the kinds of risk factors that we found in the urban section of the municipality of Bambuí were public health problems only in large Brazilian cities. Around 72% of the municipalities in Brazil have<= 20 000 inhabitants, and these smaller municipalities contain some 19% of the country's entire population. The high prevalence of various risk factors among the older and younger adults in Bambuí indicates a great need for health promotion and disease prevention actions. More research is needed to find out whether
  116. Study on the risk factors of lymphatic metastasis and the indications of less in vasive operations in early gastric cancer.
  117. Clinical practice guidelines for chronic kidney disease in adults: Part I. Definition, disease stages, evaluation, treatment, and risk factors.
  118. Exploratory spatial data analysis for the identification of risk factors to birth defects
    • date - 2004
    • creator - Song Xinming
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2004&volume=4&issue=1&spage=23
    • description - <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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 <graphic file="/1471_2458_4_23_i1.gif"/gtltabbrgrpgtltabbr_bid/index.html"B7">7</abbr></abbrgrp>, was used to detect the high-risk regions for neural-tube birth defects in the study area.</p> <p>Results</p> <p>After the Bayesian modeling method was used to calculate the ratio of neural-tube birth defects occurrences, Getis's <graphic file="/1471_2458_4_23_i1.gif"/> 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.</p> <p>Conclusion</p> <p>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 spatial exploratory data for the analysis of the neural-tube birth defect occurrence ratio and for finding clues to risk factors, this result provides effective clues for further physical, chemical and even more molecular laboratory testing according to these two spatial scales.</p>
  119. Hospital-associated funguria: analysis of risk factors, clinical presentation and outcome
    • date - 2001
    • creator - Mayer Júnior José Ronaldo
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14138670&date=2001&volume=5&issue=6&spage=313
    • description - Fungal urinary tract infections are an increasing problem in hospitalized patients. Funguria may be a result of contamination of the urine specimen, colonization of the urinary tract, or may be indicative of true invasive infection. In this study, we report the risk factors, clinical features, treatments and outcome in a group of 68 hospitalized patients (adults and children) with fungal isolates recovered from 103 urinary samples. Underlying medical conditions were present in most patients. In the pediatric group, urinary tract abnormalities (86%) and prematurity (19%) accounted for the majority of the cases. Diabetes mellitus (28%), nephrolithiasis, and benign prostatic hyperplasia were the most common diseases in adults. Indwelling urethral catheters were noted in 38% of the pediatric patients and in 43% of adults during hospitalization. Candida albicans strains were responsible for 97% and 75% of positive cultures in children and adults, respectively. Symptoms such as fever, dysuria, frequency and flank pain were generally absent in both groups. Fluconazole was the most frequent antifungal utilized (61%) in children and ketoconazole in the adult group (42%). Removing the urinary catheter was attempted in 6 pediatric patients (29%) and in only 8 adults (17%). One patient (4%) in the pediatric group died compared to 10 in the adult group (21%, p=0.04). Successful diagnosis and treatment of funguria depends on a clear understanding of the risk factors and awareness of fungal epidemiology.
  120. Central venous catheter related infections: Risk factors and the effect of glycopeptide antibiotics
    • date - 2003
    • creator - Ay Pinar
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14760711&date=2003&volume=2&issue=1&spage=3
    • description - <p>Abstract</p> <p>Backround</p> <p>We undertook a prospective study of all new central venous catheters inserted into patients in the intensive care units, in order to identify the risk factors and to determine the effect of glycopeptide antibiotics on catheter &#8211; related infections.</p> <p>Methods</p> <p>During the study period 300 patients with central venous catheters were prospectively studied. The catheters used were nontunneled, noncuffed, triple lumen and made of polyurethane material. Catheters were cultured by semiquantitative method and blood cultures done when indicated. Data were obtained on patient age, gender, unit, primary diagnosis on admission, catheter insertion site, duration of catheterization, whether it was the first or a subsequent catheter and glycopeptide antibiotic usage.</p> <p>Results</p> <p>Ninety-one (30.3%) of the catheters were colonized and infection was found with 50 (16.7%) catheters. Infection was diagnosed with higher rate in catheters inserted via jugular vein in comparison with subclavian vein (95% CI: 1.32&#8211;4.81, p = 0.005). The incidence of infection was higher in catheters which were kept in place for more than seven days (95% CI 1.05&#8211;3.87, p = 0.03). The incidence of infection was lower in patients who were using glycopeptide antibiotic during catheterization (95% CI: 1.49&#8211;5.51, p = 0.005). The rate of infection with Gram positive cocci was significantly lower in glycopeptide antibiotic using patients (p = 0.01). The most commonly isolated organism was <it>Staphylococcus aureus </it>(n = 52, 37.1%).</p> <p>Conclusion</p> <p>Duration of catheterization and catheter insertion site were independent risk factors for catheter related infection. Use of glycopeptide antibiotic during catheterization seems to have protective effect against catheter related infection.</p>
  121. Risk factors to hospital mortality in valvar reoperations
    • date - 2002
    • creator - Oliveira Sérgio Almeida de
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=01027638&date=2002&volume=17&issue=4&spage=345
    • description - OBJECTIVE: Analyze the risk factors for hospital mortality in valvar reoperations. METHOD: A prospective analysis was performed of 194 patients that underwent valvar reoperations between July 1995 and June 1999. The following variables were analyzed: gender, age, functional class, number and type of previous operations, cardiac rhythm, urgency at operation, creatinine level, left ventricular ejection fraction, left ventricular systolic and diastolic diameters, right ventricular systolic pressure, prothrombin activity, activated partial thromboplastin time relation, platelet count, cardiopulmonary bypass time, aortic cross-clamp time, number and position of valves, type of procedure, associated procedures and intraoperative bleeding volume. Univariate and multivariate statistical analyses were performed to determine the risk factors for hospital mortality. RESULTS: The overall hospital mortality was 8.8% (17 patients). Univariate analysis showed that the following variables were associated with higher mortality rates: advanced New York Heart Association functional class, decreased left ventricular ejection fraction, decreased prothrombin activity, increased creatinine level, longer aortic cross-clamping time, prolonged cardiopulmonary bypass time, concomitant associated procedures, and higher intraoperative bleeding volume. Logistic multivariate analysis identified advanced New York Heart Association functional class, creatinine level higher than 1.5 mg/dl, and cardiopulmonary bypass time longer than 120 minutes as independent predictors of hospital mortality. CONCLUSIONS: The variables functional class IV, creatinine level > 1.5 mg/dl and cardiopulmonary bypass time > 120 min were independent predictors of hospital mortality in valvar reoperations.
  122. Sick leave among home-care personnel: a longitudinal study of risk factors
    • date - 2004
    • creator - Holmström Eva
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712474&date=2004&volume=5&issue=1&spage=38
    • description - <p>Abstract</p> <p>Background</p> <p>Sick leave due to neck, shoulder and back disorders (NSBD) is higher among health-care workers, especially nursing aides/assistant nurses, compared with employees in other occupations. More information is needed about predictors of sick leave among health care workers. The aim of the study was to assess whether self-reported factors related to health, work and leisure time could predict: 1) future certified sick leave due to any cause, in nursing aides/assistant nurses (<it>Study group I</it>) and 2) future self-reported sick leave due to NSBD in nursing aides/assistant nurses (<it>Study group II</it>).</p> <p>Methods</p> <p><it>Study group </it>I, comprised 443 female nursing aides/assistant nurses, not on sick leave at baseline when a questionnaire was completed. Data on certified sick leave were collected after 18 months. <it>Study group II </it>comprised 274 of the women, who at baseline reported no sick leave during the preceding year due to NSBD and who participated at the 18 month follow-up. Data on sick leave due to NSBD were collected from the questionnaire at 18 months. The associations between future sick leave and factors related to health, work and leisure time were tested by logistic regression analyses.</p> <p>Results</p> <p>Health-related factors such as previous low back disorders (OR: 1.89; 95% CI 1.20&#8211;2.97) and previous sick leave (OR 6.40; 95%CI 3.97&#8211;10.31), were associated with a higher risk of future sick leave due to any cause. Factors related to health, work and leisure time, i.e. previous low back disorders (OR: 4.45; 95% CI 1.27&#8211;15.77) previous sick leave, not due to NSBD (OR 3.30; 95%CI 1.33&#8211;8.17), high strain work (OR 2.34; 95%CI 1.05&#8211;5.23) and high perceived physical exertion in domestic work (OR 2.56; 95%CI 1.12&#8211;5.86) were associated with a higher risk of future sick leave due to NSBD. In the final analyses, previous low back disorders and previous sick leave remained significant in both study groups.</p> <p>Conclusion</p> <p>The results suggest a focus on previous low back disorders and previous sick leave for the design of early prevention programmes aiming at reducing future sick leave due to any cause, as well as due to NSBD, among nursing aides/assistant nurses. A multifactorial approach may be of importance in the early prevention of sick leave due to NSBD.</p>
  123. A survey on risk factors associated with cervical cancer.
    • date - 2003
    • creator - Pandey A
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00195359&date=2003&volume=40&issue=1&spage=15
    • description - Carcinoma of the cervix is one of the leading malignancies in the developing countries including India. In view of this health care program might have to be redefined. Most of the data are available from the developed countries, which rely mainly on cytology screening on regular basis. This however may not be feasible in developing countries because of various constraints. Thus alternative approaches are needed based on risk reduction modalities. This article while dealing with the control approaches based on secondary prevention, reviews several risk factors associated with cervical cancer. The various articles were approached through Medline search including cross-references. The important life styles associated with cervical cancer and which are amenable to primary prevention strategies through health education, behavioral interventions, legislative approaches and modifying the health care seeking behavior were identified through the review process. These factors mainly pertain to early sexual debut, multiple sexual partners, menstrual hygiene and unprotected sex. Role of male partners has also been delineated in the process of cervical carcinogenesis. These factors are essentially conducive to the transmission of an etiological agent; the high-risk types human papillomaviruses, the more proximal cause in the web of causation. Barrier method of contraception and prophylactic vaccine in future could help to check the transmission of the virus. Role of smoking and oral contraceptives has also been discussed. Till the facilities for mass scale screening are developed in developing countries the primary prevention approaches could certainly help to check the incidence of the disease.
  124. Candida esophagitis: risk factors in non-HIV population in Pakistan.
    • date - 2003
    • creator - Yakoob J
    • provider - NSDL OAI Repository
    • location - http://www.wjgnet.com/1007-9327/9/2328.asp
    • description - <br>AIM: Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital. <br>METHODS: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied. <br>RESULTS: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% patients. <br>CONCLUSION: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.
  125. Retinopathy of prematurity and risk factors: a prospective cohort study
    • date - 2005
    • creator - Karmaus Wilfried
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2431/5/18
    • description - <p>Abstract</p> <p>Background</p> <p>Increased survival of extremely low birth infants due to advances in antenatal and neonatal care has resulted in a population of infants at high risk of developing retinopathy of prematurity (ROP). Therapeutic interventions include the use of antenatal and postnatal steroids however, their effects on the severity of ROP is in dispute. In addition, it has not been investigated whether severe ROP is due to therapeutic interventions or due to the severity of illness. The aim of the present study was to assess the association between the incidence of severe retinopathy of prematurity (greater than stage 2 &#8211; International classification of ROP) and mechanical ventilation, oxygen therapy, gestational age, antenatal and postnatal steroids in extremely low birth weight infants.</p> <p>Methods</p> <p>Neonates admitted to the neonatal intensive care unit in Lansing, Michigan, during 1993&#8211;2000 were followed to determine factors influencing the development of severe retinopathy of prematurity. Ophthalmologic examinations were started at 6 weeks and followed until resolution. We used logistic regression to estimate the relative risk (odds ratio) associated with risk factors of ROP.</p> <p>Results</p> <p>Of the neonates with &#8804; 1500 g birth weight, admitted to the neonatal intensive care unit, 85% (616/725) survived. Severe retinopathy of prematurity was detected in 7.8% of 576 neonates who had eye examinations. Neonates of lower gestational age (&#8804; 25 weeks and 26&#8211;28 weeks) had an increased odds ratio of 8.49 and 3.19 for the development of severe retinopathy of prematurity, respectively, compared to those 29 weeks and older. Late postnatal steroid treatment starting after 3 weeks of life showed 2.9-fold increased odds ratio, in particular administration for two weeks and more (OR: 4.09, 95% CI: 1.52&#8211;11.03). With increasing antenatal steroids courses the risk of severe retinopathy of prematurity decreased, however, it was not significant. Lower gestational age, dependence on ventilation, and use of postnatal steroids were intertwined. Simultaneous presence of these factors seems to indicate severe disease status.</p> <p>Conclusion</p> <p>Prolonged and late postnatal steroids treatment in very low birth weight infants may pose an increased risk for the development of severe retinopathy of prematurity; however, use of postnatal steroids may also be a marker for severity of illness. Further studies nee
  126. Risk factors for acute myocardial infarction during the postoperative period of myocardial revascularization
    • date - 2003
    • creator - Piegas Leopoldo S.
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2003000300008
    • description - OBJECTIVE: To identify risk factors for acute myocardial infarction during the postoperative period after myocardial revascularization. METHODS: This was a case-control study paired for sex, age, number, type of graft used, coronary endarterectomy, type of myocardial protection, and use of extracorporeal circulation. We assessed 178 patients (89 patients in each group) undergoing myocardial revascularization, and the following variables were considered: dyslipidemia, systemic hypertension, smoking, diabetes mellitus, previous myocardial revascularization surgery, previous coronary angioplasty, and acute myocardial infarction. RESULTS: Baseline clinical characteristics did not differ in the groups, except for previous myocardial revascularization surgery, prevalent in the case group (34 patients vs. 12 patients; p = 0.0002). This was the only independent predictor of risk for acute myocardial infarction in the postoperative period, based on a multivariate logistic regression analysis (p=0.0001). Mortality and the time of hospital stay of the case group were significantly higher (19.1% vs. 1.1%; p<0.001 and 15.7 days vs. 10.6 days; p<0.05 respectively) than those of the control. CONCLUSION: Only previous myocardial revascularization was an independent predictor of acute myocardial infarction in the postoperative period, based on multivariate logistic regression analysis.
  127. Analysis of the Association Between Apolipoprotein E Polymorphism and Cardiovascular Risk Factors in an Elderly Population with Longevity
    • date - 2002
    • creator - Moriguchi Yukio
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2002&volume=78&issue=6&spage=571
    • description - OBJECTIVE: To establish the allelic and genotypic frequencies related to apolipoprotein E (ApoE) polymorphism and association of the genotypes with risk factors and cardiovascular morbidity in an elderly population with longevity. METHODS: We analyzed 70 elderly patients aged 80 years or more who were part of the Projeto Veranópolis. We used the gene amplification technique through the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and cleavage with the restriction enzyme Hha I to identify the ApoE genotypes. The most frequent genotypes were compared considering biological variables and cardiovascular risks and morbidity. RESULTS: The frequencies of the E2, E3, and E4 alleles were 0.05, 0.84, and 0.11, respectively, and of the genotypes were as follows: E3E3 (0.70), E3E4 (0.22), E2E3 (0.06), and E2E2 (0.02). Individuals with the E3E4 had a mean age greater than those with the E3E3. No association was observed between the genotypes and the variables analyzed, except for obesity, which was associated with the E3E3 genotype. Individuals with the E3E4 genotype had high levels of LDL-cholesterol and fibrinogen as compared with those with the E3E3 genotype. CONCLUSION: The results suggest that the E4E4 genotype may be associated with early mortality. A balance between the protective or neutral factors and the cardiovascular risk factors may occur among the individuals with different genotypes, attenuating the negative effects of the E4 allele.
  128. Risk factors in hospital deaths in severely malnourished children in Kampala, Uganda
    • date - 2006
    • creator - Bachou Hanifa
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712431&date=2006&volume=6&issue=1&spage=7
    • description - <p>Abstract</p> <p>Background</p> <p>Although the risk factors for increased fatality among severely malnourished children have been reported, recent information from Africa, during a period of HIV pandemic and constrained health services, remains sketchy. The aim of this study has been to establish the risk factors for excess deaths among hospitalized severely malnourished children of below five years of age.</p> <p>Method</p> <p>In 2003, two hundred and twenty consecutively admitted, severely malnourished children were followed in the paediatric wards of Mulago, Uganda's national referral and teaching hospital. The children's baseline health conditions were established by physical examination, along with haematological, biochemical, microbiological and immunological indices.</p> <p>Results</p> <p>Of the 220 children, 52 (24%) died, with over 70% of the deaths occurring in the first week of admission. There was no significant difference by sex or age group. The presence of oedema increased the adjusted odds-ratio, but did not reach significance (OR = 2.0; 95% CI = 0.8 &#8211; 4.7), similarly for a positive HIV status (OR = 2.6, 95% CI = 0.8 &#8211; 8.6). Twenty four out of 52 children who received blood transfusion died (OR = 5.0, 95% CI = 2 &#8211; 12); while, 26 out of 62 children who received intravenous infusion died (OR = 4.8, 95% CI = 2 &#8211; 12). The outcome of children who received blood or intravenous fluids was less favourable than of children who did not receive them. Adjustment for severity of disease did not change this.</p> <p>Conclusion</p> <p>The main risk factors for excess hospital deaths among severely malnourished children in Mulago hospital include blood transfusion and intravenous infusion. An intervention to reduce deaths needs to focus on guideline compliance with respect to blood transfusions/infusions.</p>
  129. Risk factors for multi-resistant acquired tuberculosis
  130. Risk factors for glucose intolerance in active acromegaly
    • date - 2001
    • creator - Kreze A.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0100879X&date=2001&volume=34&issue=11&spage=1429
    • description - In the present retrospective study we determined the frequency of glucose intolerance in active untreated acromegaly, and searched for risk factors possibly supporting the emergence of the diabetic condition. Among 43 patients, 8 (19%; 95% CI: 8-33%) had diabetes mellitus and 2 (5%; 1-16%) impaired glucose tolerance. No impaired fasting glycemia was demonstrable. The frequency of diabetes was on average 4.5 times higher than in the general Slovak population. Ten factors suspected to support progression to glucose intolerance were studied by comparing the frequency of glucose intolerance between patients with present and absent risk factors. A family history of diabetes and arterial hypertension proved to have a significant promoting effect (P<0.05, chi-square test). A significant association with female gender was demonstrated only after pooling our data with literature data. Concomitant prolactin hypersecretion had a nonsignificant promoting effect. In conclusion, the association of active untreated acromegaly with each of the three categories of glucose intolerance (including impaired fasting glycemia, not yet studied in this connection) was defined as a confidence interval, thus permitting a sound comparison with the findings of future studies. Besides a family history of diabetes, female gender and arterial hypertension were defined as additional, not yet described risk factors.
  131. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol
    • date - 2005
    • creator - Gagliardi Stefano
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712482&date=2005&volume=5&issue=1&spage=12
    • description - <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Design</p> <p>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 Scale (GCS), Cognitive state (SPMSQ), Functional state (ADL and IADL), Psychological Distress (HADS), Cumulative Illness Rating Scale (CIRS), Hypotension (classified in: light; moderate and severe and duration), Blood loss (classified in: < 2 lt and > 2 lt), Blood transfusions (< 2 lt and > 2 lt), Quantity of red cells and plasma transfusions, Visual VAS / SVS (timing: I-II-III post-operative day), Red cells and Plasma transfusions, Blood count evaluation and Saturation (O<sub>2</
  132. Risk factors for acquisition of hepatitis C virus infection: a case series and potential implications for disease surveillance
    • date - 2001
    • creator - Yee Leland
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712334&date=2001&volume=1&issue=1&spage=8
    • description - <p>Abstract</p> <p>Background</p> <p>Transmission of hepatitis C vims (HCV) is strongly associated with use of contaminated blood products and injection drugs. Other "non-parental" modes of transmission including sexual activity have been increasingly recognized. We examined risk factors for acquiring HCV in patients who were referred to two tertiary care centers and enrolled in an antiviral therapy protocol.</p> <p>Methods</p> <p>Interviews of 148 patients were conducted apart from their physician evaluation using a structured questionnaire covering demographics and risk factors for HCV acquisition.</p> <p>Results</p> <p>Risk factors (blood products, injection/intranasal drugs, razor blades/ toothbrushes, body/ear piercing, occupational exposure, sexual activity) were identified in 141 (95.3%) of participants; 23 (15.5%) had one (most frequently blood or drug exposure), 41 (27.7%) had two, and 84 (53.4%) had more than two risk factors. No patient reported sexual activity as a sole risk factor. Body piercing accounted for a high number of exposures in women. Men were more likely to have exposure to street drugs but less exposure to blood products than women. Blood product exposure was less common in younger than older HCV patients.</p> <p>Conclusion</p> <p>One and often multiple risk factors could be identified in nearly all HCV-infected patients seen in a referral practice. None named sexual transmission as the sole risk factor. The development of a more complete profile of factors contributing to transmission of HCV infection may assist in clinical and preventive efforts. The recognition of the potential presence of multiple risk factors may have important implications in the approach to HCV surveillance, and particularly the use of hierarchical algorithms in the study of risk factors.</p>
  133. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country
    • date - 2004
    • creator - Wietlisbach V
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2004&volume=4&issue=1&spage=9
    • description - <p>Abstract</p> <p>Background</p> <p>The prevalence of hyperuricemia has rarely been investigated in developing countries. The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiovascular risk factors in a developing country with high average blood pressures (the Seychelles, Indian Ocean, population mainly of African origin).</p> <p>Methods</p> <p>This cross-sectional health examination survey was based on a population random sample from the Seychelles. It included 1011 subjects aged 25 to 64 years. Blood pressure (BP), body mass index (BMI), waist circumference, waist-to-hip ratio, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Data were analyzed using scatterplot smoothing techniques and gender-specific linear regression models.</p> <p>Results</p> <p>The prevalence of a serum uric acid level >420 &#956;mol/L in men was 35.2% and the prevalence of a serum uric acid level >360 &#956;mol/L was 8.7% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.73 in men and r = 0.59 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI, blood pressure, alcohol and the use of antihypertensive therapy. In a regression model, triglycerides, age, BMI, antihypertensive therapy and alcohol consumption accounted for about 50% (R2) of the serum uric acid variations in men as well as in women.</p> <p>Conclusions</p> <p>This study shows that the prevalence of hyperuricemia can be high in a developing country such as the Seychelles. Besides alcohol consumption and the use of antihypertensive therapy, mainly diuretics, serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Considering the growing incidence of obesity and metabolic syndrome worldwide and the potential link between hyperuricemia and cardiovascular complications, more emphasis should be put on the evolving prevalence of hyperuricemia in developing countries.</p>
  134. Incidence and risk factors for liver enzyme elevation during highly active antiretroviral therapy in HIV-HCV co-infected patients: results from the Italian EPOKA-MASTER Cohort
    • date - 2005
    • creator - Casari Salvatore
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712334&date=2005&volume=5&issue=1&spage=58
    • description - <p>Abstract</p> <p>Background</p> <p>The risk of hepatotoxicity associated with different highly active antiretroviral therapy (HAART) regimens (containing multiple-protease inhibitors, single-protease inhibitors or non nucleoside reverse transcriptase inhibitors) in HIV-HCV co-infected patients has not been fully assessed.</p> <p>Methods</p> <p>Retrospective analysis of a prospective cohort of 1,038 HIV-HCV co-infected patients who commenced a new HAART in the Italian MASTER database. Patients were stratified into naïve and experienced to antiretroviral therapy before starting the study regimens. Time to grade &#8805;III hepatotoxicity (as by ACTG classification) was the primary outcome. Secondary outcome was time to grade IV hepatotoxicity.</p> <p>Results</p> <p>Incidence of grade &#8805;III hepatotoxicity was 17.71 per 100 patient-years (p-yr) of follow up in naïve patient group and 8.22 per 100 p-yrs in experienced group (grade IV: 4.13 per 100 p-yrs and 1.08 per 100 p-yrs, respectively). In the latter group, the only independent factors associated with shorter time to the event at proportional hazards regression model were: previous liver transaminase elevations to grade &#8805;III, higher baseline alanine amino-transferase values, and use of a non nucleoside reverse transcriptase inhibitor based regimen. In the naive group, baseline aspartate transaminase level was associated with the primary outcome.</p> <p>Conclusion</p> <p>Use of a single or multiple protease inhibitor based regimen was not associated with risk of hepatotoxicity in either naïve or experienced patient groups to a statistically significant extent. A cautious approach with strict monitoring should be applied in HIV-HCV co-infected experienced patients with previous liver transaminase elevations, higher baseline alanine amino-transferase values and who receive regimens containing non nucleoside reverse transcriptase inhibitors.</p>
  135. Risk factors for acquired multidrug-resistant tuberculosis
    • date - 2003
    • creator - Rodrigues Jorge Luís Nobre
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-35862003000200008
    • description - Multidrug-resistant tuberculosis (MDR-TB) is a severe and feared problem, that is difficult to control and has shown a tendency to increase worldwide. OBJECTIVE: To analyze the risk factors for acquired MDR-TB. CASUISTIC AND METHODS: A retrospective population-based case-control study was conducted. A bacillus was considered multidrug-resistant whenever it was resistant at least to rifampin (RFP) + isoniazid (INH), and a case was considered as sensitive tuberculosis (TB) if it had undergone the first treatment during a similar period as the first treatment of an MDR-TB case, but was cured at the time of the interview. Case selection was made based on the list of Sensitivity Tests (ST) performed at the Central Public Health Laboratory of the State of Ceará, from 1990 through 1999. The Proportion Method was used to investigate resistance to the six antituberculosis drugs (isoniazid, rifampin, pyrazinamide, ethambutol, ethionamide, streptomycin) used as the standard treatment in Brazil. Controls were selected from the registry of the TB Control Program. Univariate and multivariate analysis were performed, with p < 0.05 considered significant. RESULTS: Out of the 1,500 STs performed during the studied period, 266 strains were multidrug-resistant; 153 patients were identified, 19 of which were excluded. The Group of Cases comprised 134 patients, and the Group of Controls comprised 185. Multivariate analysis helped to detect the following risk factors: lack of home sewer system, alcoholism + smoking, number of previous treatments, irregular treatment, and lung cavities. CONCLUSION: These five factors are important for the development of acquired MDR-TB, and an attempt to neutralize them might contribute to control TB.
  136. Poverty levels and children's health status: study of risk factors in an urban population of low socioeconomic level
    • date - 1996
    • creator - Pires Milton
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00348910&date=1996&volume=30&issue=6&spage=506
    • description - To test the hypothesis that the low socioeconomic population living is shanty towns in Porto Alegre presents different levels of poverty which are reflected on its health status, a cross-sectional study was designed involving 477 families living in Vila Grande Cruzeiro, Porto Alegre, Brazil. The poverty level of the families was measured by using an instrument specifically designed for poor urban populations. Children from families living in extreme poverty (poorest quartile) were found to have higher infant mortality rate, lower birth weights, more hospitalizations, and higher malnutrition rates, in addition to belonging to more numerous families. Thus, the shanty town population of Porto Alegre is not homogeneous, and priority should be given to the more vulnerable subgroups.
  137. The socioeconomic gradient and chronic illness and associated risk factors in Australia
    • date - 2004
    • creator - Tennant Sarah
    • provider - NSDL OAI Repository
    • location - http://www.anzhealthpolicy.com/content/1/1/8
    • description - <p>Abstract</p> <p>Objective</p> <p>To examine the prevalence of major chronic diseases and their risk factors in different socioeconomic groups in the Australian population, in order to highlight the need for public policy initiatives to reduce socioeconomic inequalities in health.</p> <p>Methods</p> <p>Data were provided by the Australian Bureau of Statistics (ABS) from the 2001 National Health Survey (NHS) for selected chronic diseases and associated risk factors. Conditions selected were those, which form the National Health Priority Area (NHPA) conditions (other than injury, which has not been included in this paper, with its focus on chronic disease); plus other 'serious' chronic conditions, in line with the classification developed by Mathers; and for which sufficient cases were available for analysis by socioeconomic status. Indirectly age-standardised prevalence rates were calculated by broad age group for Australia and for five groups of socioeconomic status; rate ratios were calculated to show variations in prevalence between these groups.</p> <p>Results</p> <p>Significant socioeconomic inequalities were evident for many of the major chronic diseases; the largest was for diabetes mellitus (at ages 25 to 64 years); and for many diseases, there was also a strong, continuous socioeconomic gradient in the rates.</p> <p>Circulatory system diseases (in particular, hypertensive disease) and digestive system diseases also exhibited a strong differential in the 25 to 64 year age group.</p> <p>In the 65 years and over age group, the strongest inequalities were evident for mental and behavioural problems, diabetes (with a continuous socioeconomic gradient in rates) and respiratory system diseases.</p> <p>A number of risk factors for chronic diseases, namely self-reported smoking, alcohol misuse, physical inactivity and excess weight showed a striking association with socioeconomic status, in particular for people who were smokers and those who did not exercise.</p> <p>Conclusion</p> <p>This analysis shows that the prevalence of chronic disease varies across the socioeconomic gradient for a number of specific diseases, as well as for important disease risk factors. Therefore, any policy interventions to address the impact of chronic disease, at a population level, need to take into account these socioeconomic inequalities.</p>
  138. Cardiovascular disease risk factors among children of different socioeconomic status in Istanbul, Turkey: Directions for public health and nutrition policy
    • date - 2004
    • creator - Hayran Osman
    • provider - NSDL OAI Repository
    • location - http://www.lipidworld.com/content/3/1/11
    • description - <p>Abstract</p> <p>Objectives</p> <p>The aim of the current study was to examine the influence of socioeconomic status (SES) on physiological (lipid profile, obesity indices) and behavioral (dietary habits, physical activity) cardiovascular disease (CVD) risk factors among primary schoolchildren in Istanbul.</p> <p>Design</p> <p>Cross sectional study.</p> <p>Setting</p> <p>One private school and two public schools from different SES districts in Istanbul.</p> <p>Participants</p> <p>510 randomly selected children aged 12 and 13 years old (257 boys, 253 girls).</p> <p>Results</p> <p>The prevalence of overweight (15.2%) and the energy intake (p < 0.001 and p < 0.05 for boys and girls respectively) were found to be higher for the middle/ high SES group for both genders. Regarding biochemical indices, middle/ high SES children had higher values of High Density Lipoprotein-cholesterol (HDL-C) (p < 0.001 and p < 0.05 for boys and girls respectively) and lower values of TC/HDL-C ratio and LDL-C/HDL-C ratio (p < 0.05 and p < 0.001 for boys and girls respectively). This could be attributed to the higher physical activity levels observed for middle/ high SES children (p < 0.001).</p> <p>Conclusion</p> <p>The findings of the current study revealed a coexistence of both overweight and higher energy intake in middle/ high SES children, as well as a coexistence of underweight and lower physical activity levels in low SES children. These observations should guide the public health policy in developing appropriate intervention strategies to efficiently tackle these health and social issues early in life.</p>
  139. Prognostic relevance of risk factors for obstetrical brachial plexopathy
    • date - 2006
    • creator - Heise Carlos O.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0004282X&date=2006&volume=64&issue=1&spage=30
    • description - We did a case-control study to verify if the birthweight, forceps delivery or perinatal asphyxia have any significant effect on the prognosis of obstetrical brachial plexopathy. Group A was composed of 25 infants who completely recovered at the age of 6 months. Group B was composed of 21 infants who were still not able to remove a blindfold from the face with the affected limb in the sitting position at the age of 12 months. There was no statistical difference of the median birthweight or median first minute Apgar score between the groups. There was also no relation between birthweight higher than 4000g, first minute Apgar score lower than 6 or forceps delivery with a poor prognosis.
  140. Who died as a result of the tsunami? &#8211; Risk factors of mortality among internally displaced persons in Sri Lanka: a retrospective cohort analysis
    • date - 2006
    • creator - Moji Kazuhiko
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2006&volume=6&issue=1&spage=73
    • description - <p>Abstract</p> <p>Background</p> <p>Describing adverse health effects and identifying vulnerable populations during and after a disaster are important aspects of any disaster relief operation. This study aimed to describe the mortality and related risk factors which affected the displaced population over a period of two and a half months after the 2004 Indian Ocean tsunami in an eastern coastal district of Sri Lanka.</p> <p>Methods</p> <p>A cross-sectional household survey was conducted in 13 evacuation camps for internally displaced persons (IDP). Information on all pre-tsunami family members was collected from householders, and all deaths which occurred during the recall period (77 to 80 days starting from the day of the tsunami) were recorded. The distribution of mortality and associated risk factors were analysed. Logistic regression modelling using the generalized estimating equations method was applied in multivariate analysis.</p> <p>Results</p> <p>Overall mortality rate out of 3,533 individuals from 859 households was 12.9% (446 deaths and 11 missing persons). The majority of the deaths occurred during and immediately after the disaster. A higher mortality was observed among females (17.5% vs. 8.2% for males, <it>p </it>< 0.001), children and the elderly (31.8%, 23.7% and 15.3% for children aged less than 5 years, children aged 5 to 9 years and adults over 50 years, respectively, compared with 7.4% for adults aged 20 to 29 years, <it>p </it>< 0.001). Other risk factors, such as being indoors at the time of the tsunami (13.8% vs. 5.9% outdoors, <it>p </it>< 0.001), the house destruction level (4.6%, 5.5% and 14.2% in increasing order of destruction, <it>p </it>< 0.001) and fishing as an occupation (15.4% vs. 11.2% for other occupations, <it>p </it>< 0.001) were also significantly associated with increased mortality. These correlations remained significant after adjusting for the confounding effects by multivariate analysis.</p> <p>Conclusion</p> <p>A significantly high mortality was observed in women and children among the displaced population in the eastern coastal district of Sri Lanka who were examined by us. Reconstruction activities should take into consideration these changes in population structure.</p>
  141. Labour complications remain the most important risk factors for perinatal mortality in rural Kenya
    • date - 2003
    • creator - Muhoro Anne
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862003000800005
    • description - OBJECTIVES: To identify and quantify risk factors for perinatal mortality in a Kenyan district hospital and to assess the proportion of perinatal deaths attributable to labour complications, maternal undernutrition, malaria, anaemia and human immunodeficiency virus (HIV). METHODS: A cross-sectional study of 910 births was conducted between January 1996 and July 1997 and risk factors for perinatal mortality were analysed. FINDINGS: The perinatal mortality rate was 118 per 1000 births. Complications of labour such as haemorrhage, premature rupture of membranes/premature labour, and obstructed labour/ malpresentation increased the risk of death between 8- and 62-fold, and 53% of all perinatal deaths were attributable to labour complications. Placental malaria and maternal HIV, on the other hand, were not associated with perinatal mortality. CONCLUSIONS: Greater attention needs to be given to the quality of obstetric care provided in the rural district-hospital setting.
  142. Levels of cardiovascular disease risk factors in Singapore following a national intervention programme
    • date - 2001
    • creator - Chew Suok Kai
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862001001000003
    • description - OBJECTIVE: To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. METHODS: The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18--69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. FINDINGS: The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. CONCLUSION: The intervention had mixed results after six years. Successful strategies have been continued and strengthened.
  143. Public awareness of risk factors for cancer among the Japanese general population: A population-based survey
    • date - 2006
    • creator - Sasazuki Shizuka
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/6/2
    • description - <p>Abstract</p> <p>Background</p> <p>The present study aimed to provide information on awareness of the attributable fraction of cancer causes among the Japanese general population.</p> <p>Methods</p> <p>A nationwide representative sample of 2,000 Japanese aged 20 or older was asked about their perception and level of concern about various environmental and genetic risk factors in relation to cancer prevention, as a part of an Omnibus Survey. Interviews were conducted with 1,355 subjects (609 men and 746 women).</p> <p>Results</p> <p>Among 12 risk factor candidates, the attributable fraction of cancer-causing viral and bacterial infection was considered highest (51%), followed by that of tobacco smoking (43%), stress (39%), and endocrine-disrupting chemicals (37%). On the other hand, the attributable fractions of cancer by charred fish and meat (21%) and alcohol drinking (22%) were considered low compared with other risk factor candidates. For most risk factors, attributable fraction responses were higher in women than in men. As a whole, the subjects tended to respond with higher values than those estimated by epidemiologic evidence in the West. The attributable fraction of cancer speculated to be genetically determined was 32%, while 36% of cancer was considered preventable by improving lifestyle.</p> <p>Conclusion</p> <p>Our results suggest that awareness of the attributable fraction of cancer causes in the Japanese general population tends to be dominated by cancer-causing infection, occupational exposure, air pollution and food additives rather than major lifestyle factors such as diet.</p>
  144. Seroprevalence and risk factors for <it>toxoplasma </it>infection among pregnant women in Aydin province, Turkey
    • date - 2005
    • creator - Turkmen Munevver
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2005&volume=5&issue=1&spage=66
    • description - <p>Abstract</p> <p>Background</p> <p>The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey.</p> <p>Method</p> <p>The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used.</p> <p>Results</p> <p>The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected.</p> <p>Conclusion</p> <p>One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings.</p>
  145. Risk factors for esophageal cancer in Coimbatore, southern India : a hospital-based case-control study.
    • date - 2004
    • creator - Chitra S
    • provider - NSDL OAI Repository
    • location - http://www.indianjgastro.com/article.asp?issn=0254-8860;year=2004;volume=23;issue=1;spage=19;epage=21;aulast=Chitra
    • description - BACKGROUND: Cancer of the esophagus is common in India. The risk factors predisposing to cancer in southern Indian patients are not known. AIM: To determine the role of smoking, alcohol and their combination, and diet factors in the etiology of cancer of the esophagus. METHODS: Risk factors like alcohol consumption, smoking, tobacco chewing, and pre-illness diet details in 90 patients with cancer of the esophagus were compared with those in age- and sex-matched control subjects. RESULTS: The risk for esophageal cancer was 3.5 times higher with alcohol consumption, 2.5 times higher for tobacco users, and 2.8 times higher each for betel nut chewers and smokers. The calculated odds ratio for the social habits and diet factors was significant amongst cases of cancer esophagus. CONCLUSION: Alcoholism, smoking, and chewing of tobacco are factors predisposing to esophageal cancer in southern India.
  146. Multilocus and interaction-based genome scan for alcoholism risk factors in Caucasian Americans: the COGA study
    • date - 2005
    • creator - Langefeld Carl
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712156&date=2005&volume=6&issue=Suppl%201&spage=S37
    • description - <p>Abstract</p> <p>In this paper, we applied the nonparametric linkage regression approach to the Caucasian genome scan data from the Collaborative Study on the Genetics of Alcoholism to search for regions of the genome that exhibit evidence for linkage to putative alcoholism-predisposing genes. The multipoint single-locus model identified four regions of the genome with LOD scores greater than one. These regions were on 7p near D7S1790 (LOD = 1.31), two regions on 7q near D7S1870 (LOD = 1.15) and D7S1799 (LOD = 1.13) and 21q near D21S1440 and D21S1446 (LOD = 1.78). Jointly modeling these loci provided stronger evidence for linkage in each of these regions (LOD = 1.58 on 7q11, LOD = 1.61 on 11q23, and LOD = 1.95 on 21q22). The evidence for linkage tended to increase among pedigrees with earlier mean age of onset at 8q23 (<it>p </it>= 0.0016), 14q21 (<it>p </it>= 0.0079), and 18p12 (<it>p </it>= 0.0021) and with later mean age of onset at 4q35 (<it>p </it>= 0.0067) and 9p22 (<it>p </it>= 0.0008).</p>
  147. Measles vaccine effectiveness and risk factors for measles in Dhaka, Bangladesh
    • date - 2002
    • creator - Mahalanabis Dilip
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00429686&date=2002&volume=80&issue=10&spage=776
    • description - OBJECTIVE: To evaluate vaccine effectiveness and to assess risk factors for measles in Dhaka, Bangladesh. METHOD: A case-control study, involving 198 cases with 783 age-matched neighbourhood controls and 120 measles cases with 365 age-matched hospital controls, was conducted in 1995-96 in three large hospitals in Dhaka. FINDINGS: Measles vaccine effectiveness was estimated at 80% (95% confidence interval (CI) = 60-90%) using neighbourhood controls; very similar results were obtained using hospital controls. Visits to a health facility 7-21 days before onset of any symptoms were associated with increased risk of measles compared with neighbourhood (adjusted odds ratio (OR) = 7.0, 95% CI = 4.2-11.6) or hospital (adjusted OR = 1.7, 95% CI = 1.01-2.8) controls. Cases were more likely than controls to come from a household where more than one child lived (adjusted OR = 1.6, 95% CI = 1.1-2.5 versus neighbourhood controls; adjusted OR = 1.8, 95% CI = 1.02-3.0 versus hospital controls). CONCLUSIONS: To improve measles control in urban Dhaka missed immunization opportunities must be reduced in all health care facilities by following WHO guidelines. For measles elimination, more than one dose of vaccine would be required.
  148. Stomach cancer incidence in Brazil: an ecologic study with selected risk factors
    • date - 1997
    • creator - Koifman Sergio
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X1997000500009
    • description - Contrary to many industrialized countries in which a sharp decline in stomach cancer incidence has been observed, Brazil still shows intermediate to high incidence rates. An ecologic analysis was performed to explore variables possibly associated with the development of stomach cancer. Cluster analysis, principal component analysis, and factor analysis were carried out with population data, including the following: stomach cancer incidence rates in the early 1990s obtained from population-based cancer registries in Porto Alegre, Campinas, Fortaleza, Belém, and Goiânia; and data from a Brazilian national survey on family expenditures (several diet consumption items and availability of home refrigerators) carried out in 1974-75. The results suggested that past availability of a home refrigerator, i.e. food preservation, may have played an important role in currently observed differences in stomach cancer incidence among the various populations studied in Brazil. Differences in living standards among populations in these cities also appear to have played an important role in the observed incidence differences.
  149. High frequency of colonization and absence of identifiable risk factors for methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units in Brazil
    • date - 2001
    • creator - Mimica Igor M.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14138670&date=2001&volume=5&issue=1&spage=1
    • description - Colonization of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) is of increasing concern. To evaluate this problem in Intensive Care Units (ICUs) in Brazil, we studied 100 patients admitted to two ICUs from April to June, 1997. Of the 100 patients, 70 were male, 53 were age 60 years or older, 55 were previously hospitalized, 78 were transferred to the ICU from other hospital units, 49 had received antibiotic therapy, and 66 had undergone recent surgery. Nasal and axillary swab cultures were obtained on admission and every 48 hours thereafter until discharge. MRSA were identified by plating any cultured S. aureus on Mueller-Hinton agar containing 6mug/ml of oxacillin. At the time of admission, 46 (46%) of the patients were colonized with MRSA. No associated risk factors for acquiring MRSA (age, previous hospitalization, prior surgery) could be identified. Of the 54 patients negative for MRSA on admission, 28 (52%) became colonized while in the ICU. Sixteen (22%) of the 74 colonized patients (colonized either on admission or during ICU stay) had associated respiratory or urinary tract infections due to MRSA, and 9 (56%) died. No correlation with special risk factors (invasive procedures, antibiotic use, age, chronic disease) was identified. MRSA occurred frequently, but there was minimal evidence of associated risk factors. Thus, control of MRSA cannot be accomplished by targeting special factors alone, but requires attention to preventing microbial spread in all areas. Of special concern is the high frequency of acquiring the organism in the ICU (52%). Education concerning the importance of hand washing, environmental surface cleaning, and barrier protection from infected patients is needed.
  150. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study
    • date - 2006
    • creator - Chaturvedi Nish
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712261&date=2006&volume=6&issue=1&spage=18
    • description - <p>Abstract</p> <p>Background</p> <p>Knowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan.</p> <p>Methods</p> <p>A hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients admitted with their first AMI were eligible to participate. Standard questionnaire was used to interview 720 subjects. Knowledge of four modifiable risk factors of heart disease: fatty food consumption, smoking, obesity and exercise were assessed. The participants knowing three out of four risk factors were regarded as having a good level of knowledge. A multiple logistic regression model was constructed to identify the determinants of good level of knowledge.</p> <p>Results</p> <p>The mean age (SD) was 54 (11.66) years. A mere 42% of our study population had a good level of knowledge. In multiple logistic regression analysis, independent predictors of "good" level of knowledge were (odds ratio [95% confidence interval]) more than ten years of schooling were 2.5 [1.30, 4.80] (verses no schooling at all) and nuclear family system (verses extended family system) 2.54 [1.65, 3.89]. In addition, Sindhi ethnicity OR [3.03], higher level of exercise OR [2.76] and non user of tobacco OR [2.53] were also predictors of good level of knowledge.</p> <p>Conclusion</p> <p>Our findings highlight the lack of good level of knowledge of modifiable risk factors for heart disease among subjects admitted with AMI in Pakistan. There is urgent need for aggressive and targeted educational strategies in the Pakistani population.</p>
  151. Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil
    • date - 1998
    • creator - Franquini Júnior João
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86821998000100009
    • description - An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil - during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.
  152. Myocardial revascularization with coronary endarterectomy. Stratification of risk factors for early mortality
    • date - 2000
    • creator - Lisboa Luiz Augusto Ferreira
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2000001000002
    • description - OBJECTIVE: To determine the risk factors for mortality related to myocardial revascularization when performed in association with coronary endarterectomy. METHODS: We assessed retrospectively 353 patients who underwent 373 coronary endarterectomies between January '89 and November '98, representing 3.73% of the myocardial revascularizations in this period of time. The arteries involved were as follows: right coronary artery in 218 patients (58.45%); left anterior descending in 102 patients (27.35%); circumflex artery in 39 patients (10.46%); and diagonal artery in 14 patients (3.74%). We used 320 (85.79%) venous grafts and 53 (14.21%) arterial grafts. RESULTS: In-hospital mortality among our patients was 9.3% as compared with 5.7% in patients with myocardial revascularizations without endarterectomy (p=0.003). Cause of death was related to acute myocardial infarction in 18 (54.55%) patients. The most significant risk factors for mortality identified were as follows: diabetes mellitus (p=0.001; odds ratio =7.168), left main disease (<0.001; 9.283), female sex (0.01; 3.111), acute myocardial infarction (0.02; 3.546), ejection fraction <35% (<0.001; 5.89), and previous myocardial revascularization (<0.001; 4.295). CONCLUSION: Coronary endarterectomy is related to higher mortality, and the risk factors involved are important elements of a poor outcome.
  153. Correlation of breast cancer risk factors with HER-2/neu protein overexpression according to menopausal and estrogen receptor status
    • date - 2005
    • creator - Tsiftsis Dimitris
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1472-6874/5/1
    • description - <p>Abstract</p> <p>Background</p> <p>Several researchers have claimed that classification of tumours on the basis of HER-2/<it>neu </it>overexpression or amplification may define a subset of breast cancer in which the net effect of a risk factor could be rather more obvious and its impact on breast cancer development more clear. We decided to investigate, in a group of patients from a geographical area with a low incidence of breast cancer, whether HER-2/<it>neu </it>positive tumours are correlated with established or suspected risk factors for breast cancer and thus to identify distinct subgroups of high risk women.</p> <p>Methods</p> <p>This study analysed data from patients who attended the Breast Unit at the University Hospital of Heraklion, Crete, Greece between 1996 and 2002. 384 women with primary invasive breast cancer were compared with 566 screened women who were referred to the Unit and had not developed breast neoplasm by the time the data were analysed. Risk factor data were obtained from each subject by personal interviews using a structured questionnaire. The detection and scoring of the HER-2/<it>neu </it>protein, estrogen and progesterone receptor expression were performed using immunochemistry. Odds ratios and 95% confidence intervals were determined by chi-square test and logistic regression analysis. Case-case odds ratios were calculated in order to measure the risk heterogeneity between HER-2/<it>neu</it>+ and HER-2/<it>neu</it>-tumours. Separate analyses were performed for premenopausal and postmenopausal women and according to estrogen receptor status.</p> <p>Results</p> <p>In multivariate analysis without HER-2/<it>neu </it>stratification, an increased breast cancer risk was associated with only <it>four </it>of the factors examined: use of oral contraceptives (OR = 4.40, 95%C.I: 1.46&#8211;13.28), use of HRT (OR = 7.34, 95%C.I: 2.03&#8211;26.53), an age at first full pregnancy more than 23 years (OR = 1.91, 95%C.I: 1.29&#8211;2.83) and body mass index more than 29 kg/m<sup>2 </sup>(OR = 3.13, 95%C.I: 2.02&#8211;4.84). Additionally, a history of abortion or miscarriage (OR = 0.56, 95%C.I: 0.38&#8211;0.82) was correlated with a decreased risk of breast cancer. In the case to case comparison only BMI >29 kg/m<sup>2 </sup>revealed a relative connection that was stronger with positive than with negative HER-2/<it>neu </it>tumours (ratio of OR's = 2.23, 95%C.I: 1.20&#8211;4.15, p = 0.011). This may indicate evidence of heterogeneity of a
  154. Prevalence and risk factors for vaginal <it>Candida</it> colonization in women with type 1 and type 2 diabetes
    • date - 2002
    • creator - de Leon Ella
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/2/1
    • description - <p>Abstract</p> <p>Background</p> <p>Diabetes mellitus increases the rate of vaginal colonization and infection with <it>Candida</it> species</p> <p>Methods</p> <p>We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal <it>Candida</it> colonization, diabetes type and duration, and HbA<sub>1c</sub> level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for <it>Candida</it> culture. <it>Candida</it> colonization was similar by age and race.</p> <p>Results</p> <p>Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any <it>Candida</it> species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even after adjusting for abnormal HbA<sub>1c</sub>, which had an independent effect (OR = 1.4; 95% CI: 1.04, 1.76; p = 0.02). Recent antibiotic use (OR = 4.5; 95% CI: 1.18, 16.79; p = 0.03), lifetime history of chlamydia (OR = 5.8; 95% CI: 1.09, 30.54; p = 0.04), and performing oral sex during the past 2 weeks (OR = 4.9; 95% CI:0.84, 28.27; p = 0.08) were also associated with <it>Candida</it> carriage after adjusting for diabetic type and abnormal HbA<sub>1c</sub>. <it>C. albicans</it> was isolated from the majority of colonized type 1 participants (56%), while <it>C. glabrata</it> was the most common isolate among colonized type 2 participants (54%).</p> <p>Conclusions</p> <p>Improving glucose control and possibly modifying sexual behavior may reduce risk of <it>Candida</it> colonization, and potentially symptomatic infection, among women with diabetes.</p>
  155. Risk factors influencing recurrence following resection of pancreatic head cancer.
    • date - 2004
    • creator - Wang GF
    • provider - NSDL OAI Repository
    • location - http://www.wjgnet.com/1007-9327/10/906.asp
    • description - <br>AIM: Whether operative procedure is a risk factor influencing recurrence following resection of carcinoma in the head of pancreas or not remains controversies. In this text we compared the recurrence rate of two operative procedure: the Whipple procedure and extended radical operation, and inquired into the factors influencing recurrence after radical resection. <br>METHODS: From January 1995 to December 1998, 35 cases of carcinoma of pancreas underwent the Whipple operadure, 21 patients received the Extended radical operation. All patients were followed up for more than 3 years. Prognostic factors included operative procedure, size of tumor, lymph node, interstitial invasion. <br>RESULTS: Deaths duo to recurrence within 3 years after operation were studied. The death rate was 51.4% in the Whipple procedure and 42.9% in the Extended radical operative procedure. There was a significant difference between the two groups. Recurrence occurred in 75% patients with tumor large than 4 cm, in 87.5% patients with lymph node involvement, and in 50% patients with the presence of interstitial invasion. <br>CONCLUSION: Tumor exceeding 4 cm, lymph node involvement, and presence of interstitial invasion are high risk factors of recurrence after Whipple's procedure and extended radical operation.
  156. Risk factors for ovarian failure in patients with systemic lupus erythematosus
    • date - 2001
    • creator - Menezes A.P.T.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0100879X&date=2001&volume=34&issue=12&spage=1561
    • description - The aim of the present study was to identify the risk factors for ovarian failure in patients with systemic lupus erythematosus. Seventy-one women aged 17 to 45 years with systemic lupus erythematosus were studied. Patients were interviewed and their medical records reviewed. Demographic characteristics, clinical and serologic profiles, and menstrual and obstetric histories were recorded. Disease activity was measured by the systemic lupus erythematosus disease activity index. Serum FSH, LH, estradiol, progesterone, TSH, prolactin, and antimicrosomal and antithyroglobulin antibodies were measured. Patients who developed ovarian failure were compared to those who did not. Ovarian failure occurred in 11 patients (15.5%) and nine had premature menopause (11.3%). Cyclophosphamide administration and older patient age were found to be associated with ovarian failure. The cumulative cyclophosphamide dose was significantly higher in patients with ovarian failure than in those without this condition (18.9 vs 9.1 g; P = 0.04). The relative risk for ovarian failure in patients with cumulative cyclophosphamide dose higher than 10 g was 3.2. TSH levels were high in 100% of patients with ovarian failure who had received pulse cyclophosphamide. Ovarian failure, and premature menopause in particular, is common in patients with systemic lupus erythematosus, with the most important risk factors being cyclophosphamide dose and age. Thyroid problems may be another risk factor for ovarian failure in patients with lupus.
  157. Risk factors for the gastric cardia cancer: a case-control study in Fujian Province.
    • date - 2003
    • creator - Cai L
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2003&volume=9&issue=2&spage=214
    • description - <br>AIM: The incidence of gastric cardia cancer has greatly increased in the past 2-3 decades, however, the risk factors for the disease are still not clearly understood. The investigations among Chinese population on the risk factors of gastric cardia cancer were also scarcely reported. We therefore conducted a case-control study in Fujian province, China, to investigate the potential risk and protective factors of this disease. <br>METHODS: 191 cardia and 190 non-cardia gastric cancer cases, and a total of 222 control cases were included in this study. Standard questionnaires were used in collecting epidemiological factors and the data were then analyzed by the unconditional logistic regression model. <br>RESULTS: As the factors such as age, gender, smoking, alcohol consumption, and family history of gastric cancer were controlled, a multivariable analysis was conducted, which revealed that there was a significant correlation between the dietary habits such as irregular meal, over and fast eating, and the gastric cardia cancer with the odds ratios (ORs) of 4.2 (95 % confidence interval: 2.3-7.7), 4.7 (2.1-10.8), and 2.7 (1.3-5.3) respectively. Other correlations were also observed between the gastric cardia cancer and the consumption of salty fish or pickled vegetable, smoking, and the family cancer history with the ORs of 5.5 (1.4-19.5), 1.8 (1.0-3.0), 2.1 (1.3-3.5), and 3.8 (2.3-6.2) respectively. In contrast, the negative correlations were found existing between the intake of fresh vegetables and fruits, the use of refrigerator, and the gastric cardia cancer, with the ORs of 0.4 (0.2-0.9), 0.2 (0.1-0.5), and 0.2 (0.1-0.4), respectively. However, dietary habits were associated less with non-cardia gastric cancer compared with its cardia counterpart. <br>CONCLUSION: Dietary habits might be one of the risk factors for the cardia carcinogenesis among Chinese population.
  158. Nematode Infections Are Risk Factors for Staphylococcal Infection in Children
    • date - 2002
    • creator - Pereira Fausto EL
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00740276&date=2002&volume=97&issue=3&spage=395
    • description - Nematode infection may be a risk factor for pyogenic liver abscess in children and we hypothesized that the immunomodulation induced by those parasites would be a risk factor for any staphylococcal infection in children. The present study was designed to compare, within the same hospital, the frequency of intestinal nematodes and Toxocara infection in children with and without staphylococcal infections. From October 1997 to February 1998, 80 children with staphylococcal infection and 110 children with other diseases were submitted to fecal examination, serology for Toxocara sp., evaluation of plasma immunoglobulin levels, and eosinophil counts. Mean age, gender distribution, birthplace, and socioeconomic conditions did not differ significantly between the two groups. Frequency of intestinal nematodes and positive serology for Toxocara, were remarkably higher in children with staphylococcal infections than in the non-staphylococcal group. There was a significant correlation between intestinal nematodes or Toxocara infection and staphylococcal infection in children, reinforced by higher eosinophil counts and higher IgE levels in these children than in the control group. One possible explanation for this association would be the enhancement of bacterial infection by the immunomodulation induced by helminth infections, due to strong activation of the Th2 subset of lymphocytes by antigens from larvae and adult worms.
  159. Clinical features and risk factors of patients with fatty liver in Guangzhou area.
    • date - 2004
    • creator - Zhong YQ
    • provider - NSDL OAI Repository
    • location - http://www.wjgnet.com/1007-9327/10/899.asp
    • description - <br>AIM: There is still no accepted conclusion regarding the clinical features and related risk factors of patients with fatty liver. The large-scale clinical studies have not carried out yet in Guangzhou area. The aim of the present study was to investigate the clinical features and related risk factors of patients with fatty liver in Guangzhou area. <br>METHODS: A total of 413 cases with fatty liver were enrolled in the study from January 1998 to May 2002. Retrospective case-control study was used to evaluate the clinical features and related risk factors of fatty liver with logistic regression. <br>RESULTS: Obesity (OR: 21.204), alcohol abuse (OR: 18.601), type 2 diabetes mellitus (OR: 4.461), serum triglyceride (TG) (OR: 3.916), serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.840) and fasting plasma glucose (FPG) (OR: 1.535) were positively correlated to the formation of the fatty liver. The levels of serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) increased mildly in the patients with fatty liver and were often less than 2-fold of the normal limit. The higher abnormalities of aspartate aminotransferase (AST) levels (42.9%) with AST/ALT more than 2(17.9%) were found in patients with alcoholic fatty liver (AFL) than those with nonalcoholic fatty liver (NAFL) (16.9% and 5.0% respectively). The elevation of serum TG, cholesterol (CHOL), LDL-C was more common in patients with NAFL than with AFL. <br>CONCLUSION: Obesity, alcohol abuse, type 2 diabetes mellitus and hyperlipidemia may be independent risk factors of fatty liver. The mildly abnormal hepatic functions can be found in patients with fatty liver. More obvious damages of liver function with AST/ALT usually more than 2 were noted in patients with AFL.
  160. The contribution of leading diseases and risk factors to excess losses of healthy life in eastern Europe: burden of disease study
    • date - 2005
    • creator - Ezzati Majid
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2005&volume=5&issue=1&spage=116
    • description - <p>Abstract</p> <p>Background</p> <p>The East/West gradient in health across Europe has been described often, but not using metrics as comprehensive and comparable as those of the Global Burden of Disease 2000 and Comparative Risk Assessment studies.</p> <p>Methods</p> <p>Comparisons are made across 3 epidemiological subregions of the WHO region for Europe &#8211; A (very low child and adult mortality), B (low child and low adult mortality) and C (low child and high adult mortality) &#8211; with populations in 2000 of 412, 218 and 243 millions respectively, and using the following measures: 1. Probabilities of death by sex and causal group across 7 age intervals; 2. Loss of healthy life (DALYs) to diseases and injuries per thousand population; 3. Loss of healthy life (DALYs) attributable to selected risk factors across 3 age ranges.</p> <p>Results</p> <p>Absolute differences in mortality are most marked in males and in younger adults, and for deaths from vascular diseases and from injuries. Dominant contributions to east-west differences come from the nutritional/physiological group of risk factors (blood pressure, cholesterol concentration, body mass index, low fruit and vegetable consumption and inactivity) contributing to vascular disease and from the legal drugs &#8211; tobacco and alcohol.</p> <p>Conclusion</p> <p>The main requirements for reducing excess health losses in the east of Europe are: 1) favorable shifts in all amenable vascular risk factors (irrespective of their current levels) by population-wide and personal measures; 2) intensified tobacco control; 3) reduced alcohol consumption and injury control strategies (for example, for road traffic injuries). Cost effective strategies are broadly known but local institutional support for them needs strengthening.</p>
  161. Action Schools! BC: A Socioecological Approach to Modifying Chronic Disease Risk Factors in Elementary School Children
    • date - 2006
    • creator - Heather A. McKay, PhD
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=15451151&date=2006&volume=3&issue=2&spage=
    • description - Background Childhood physical inactivity and obesity are serious public health threats. Socioecological approaches to addressing these threats have been proposed. The school is a critical environment for promoting children’s health and provides the opportunity to explore the impact of a socioecological approach. Context Thirty percent of children in British Columbia, Canada, are overweight or obese, and 50% of youths are not physically active enough to yield health benefits. Methods Action Schools! BC, a socioecological model, was developed to create 1) an elementary school environment where students are provided with more opportunities to make healthy choices and 2) a supportive community and provincial environment to facilitate change at the school and individual levels. Consequences The environment in British Columbia for school- and provincial-level action on health behaviors improved. Focus group and project tracking results indicated that the Action Schools! BC model enhanced the conceptual use of knowledge and was an influencing factor. Political will and public interest were also cited as influential factors. Interpretation The Action Schools! BC model required substantial and demanding changes in the approach of the researchers, policy makers, and support team toward health promotion. Despite challenges, Action Schools! BC provides a good example of how to enhance knowledge exchange and multilevel intersectoral action in chronic disease prevention.
  162. Genetic Analysis Workshop 13: Analysis of Longitudinal Family Data for Complex Diseases and Related Risk Factors
  163. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil
    • date - 2000
    • creator - Bettiol Heloisa
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89102000000600006
    • description - OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.
  164. Risk factors for preterm births in São Luís, Maranhão, Brazil
    • date - 2004
    • creator - Silva Antônio Augusto Moura da
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0102311X&date=2004&volume=20&issue=1&spage=57
    • description - Preterm birth continues to be one of the main causes of neonatal morbidity and mortality. The objective of the present study was to identify risk factors for preterm birth in São Luís, Maranhão, Brazil. The sample consisted of hospital births at 10 public and private hospitals from March 1, 1997 to February 28, 1998. A total of 2,443 live births were randomly selected, excluding multiple deliveries and stillbirths. Preterm birth rate in São Luís was 12.7%. Risk factors for preterm delivery were maternal age below 18 years, family income equal to or less than one minimum wage/ month, primiparity, vaginal delivery at a public hospital, single mothers (or living without a partner), and absence of prenatal care. The following factors remained associated with preterm birth after multivariate analysis to control for confounding: maternal age below 18 years (OR = 1.9), primiparity (OR = 1.5), and failure to appear for scheduled prenatal care visits (OR = 1.5).
  165. Risk factors for traumatic and non-traumatic lower limb pain among preadolescents: a population-based study of Finnish schoolchildren
    • date - 2006
    • creator - Mikkelsson Marja
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712474&date=2006&volume=7&issue=1&spage=3
    • description - <p>Abstract</p> <p>Background</p> <p>The child's lower limb is the most commonly reported musculoskeletal location with pain and also the most commonly injured site in sports. Some potential risk factors have been studied, but the results are inconsistent. We hypothesized that distinction of traumatic from non-traumatic pain would provide a clearer picture of these factors. The aim of this study is to assess factors associated with lower extremity pain and its impact on preadolescents in a population-based cohort.</p> <p>Methods</p> <p>A structured pain questionnaire was completed by 1756 schoolchildren of third and fifth grades to assess musculoskeletal pain, psychosomatic symptoms, subjective disabilities, school absence and frequency of exercise. In addition, hypermobility and physical fitness were measured.</p> <p>Results</p> <p>The knee was the most common site of pain followed by the ankle-foot and thigh. Of the children who reported pain in their lower extremity, approximately 70% reported at least one disability and 19 % reported school absence attributed to their pain during the previous three-month period. Children with traumatic pain had a higher subjective disability index than those with non-traumatic pain (P = 0.02). Age less than 11 years, headache, abdominal pain, depressive feelings, day tiredness, and vigorous exercise were more common in children with lower limb pain than those free of it. In the stratified analysis, younger age was related to both traumatic and non-traumatic pain groups. Vigorous exercise was positively associated with traumatic pain, while subjects with non-traumatic pain had more frequent psychosomatic symptoms.</p> <p>Conclusion</p> <p>Risk factors and consequences of traumatic and non-traumatic lower limb pain are not similar. Traumatic lower limb pain is associated with practicing vigorous exercise and high level of physical fitness, while non-traumatic pain is more correlated with psychosomatic symptoms. These differences might be one of the reasons for the discrepancy of previous research conclusions. The two conditions need to be treated as different disorders in future studies.</p>
  166. Corneal allograft rejection: Risk factors, diagnosis, prevention, and treatment
    • date - 1999
    • creator - Dua Harminder
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=03014738&date=1999&volume=47&issue=1&spage=3
    • description - Recent advances in corneal graft technology, including donor tissue retrieval, storage and surgical techniques, have greatly improved the clinical outcome of corneal grafts. Despite these advances, immune mediated corneal graft rejection remains the single most important cause of corneal graft failure. Several host factors have been identified as conferring a "high risk" status to the host. These include: more than two quadrant vascularisation, with associated lymphatics, which augment the afferent and efferent arc of the immune response; herpes simplex keratitis; uveitis; silicone oil keratopathy; previous failed (rejected) grafts; "hot eyes"; young recipient age; and multiple surgical procedures at the time of grafting. Large grafts, by virtue of being closer to the host limbus, with its complement of vessels and antigen-presenting Langerhans cells, also are more susceptible to rejection. The diagnosis of graft rejection is entirely clinical and in its early stages the clinical signs could be subtle. Graft rejection is largely mediated by the major histocompatibility antigens, minor antigens and perhaps blood group ABO antigens and some cornea-specific antigens. Just as rejection is mediated by active immune mediated events, the lack of rejection (tolerance) is also sustained by active immune regulatory mechanisms. The anterior chamber associated immune deviation (ACAID) and probably, conjunctiva associated lymphoid tissue (CALT) induced mucosal tolerance, besides others, play an important role. Although graft rejection can lead to graft failure, most rejections can be readily controlled if appropriate management is commenced at the proper time. Topical steroids are the mainstay of graft rejection management. In the high-risk situations however, systemic steroids, and other immunosuppressive drugs such as cyclosporin and tacrolimus (FK506) are of proven benefit, both for treatment and prevention of rejection.
  167. Geographical clustering of prostate cancer grade and stage at diagnosis, before and after adjustment for risk factors
    • date - 2005
    • creator - Curriero Frank
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1476072X&date=2005&volume=4&issue=1&spage=1
    • description - <p>Abstract</p> <p>Background</p> <p>Spatial variation in patterns of disease outcomes is often explored with techniques such as cluster detection analysis. In other types of investigations, geographically varying individual or community level characteristics are often used as independent predictors in statistical models which also attempt to explain variation in disease outcomes. However, there is a lack of research which combines geographically referenced exploratory analysis with multilevel models. We used a spatial scan statistic approach, in combination with predicted block group-level disease patterns from multilevel models, to examine geographic variation in prostate cancer grade and stage at diagnosis.</p> <p>Results</p> <p>We examined data from 20928 Maryland men with incident prostate cancer reported to the Maryland Cancer Registry during 1992&#8211;1997. Initial cluster detection analyses, prior to adjustment, indicated that there were four statistically significant clusters of high and low rates of each outcome (later stage at diagnosis and higher histologic grade of tumor) for prostate cancer cases in Maryland during 1992&#8211;1997. After adjustment for individual case attributes, including age, race, year of diagnosis, patterns of clusters changed for both outcomes. Additional adjustment for Census block group and county-level socioeconomic measures changed the cluster patterns further.</p> <p>Conclusions</p> <p>These findings provide evidence that, in locations where adjustment changed patterns of clusters, the adjustment factors may be contributing causes of the original clusters. In addition, clusters identified after adjusting for individual and area-level predictors indicate area of unexplained variation, and merit further small-area investigations.</p>
  168. Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection
    • date - 2003
    • creator - Gontijo Filho Paulo Pinto
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000200008
    • description - Bacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC) in the subclavian vein. Seven or more days catheterization (p=0.001) and >3 invasive devices (p=0.01) were infection risk factors associated with catheterization of the jugular vein. More than half of the patients presented high colony counts at the insertion site (>200 CFU/20 cm²) and 27% of the catheter tips were contaminated. The risk factors associated with contaminated catheter tips were >14 days hospital stay (p=0.02), >7 days catheterization (p=0.01) and antibiotic therapy (p=0.04). Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common microorganisms at the insertion site (78%) and in the catheter tip (94%). Five patients presented sepsis (4.1%), four caused by Staphylococci and one by GNB. Twelve patients had the same microorganisms at the insertion site and catheter tip. We found a high prevalence of ORSA (62.5%) and ORCoNS (57.1%) in catheter tips. The high counts of staphylococci, including ORSA and ORCoNS, at the insertion site, and the significant association of this colonization with catheter tip contamination, indicate that the skin is an important reservoir of microorganisms associated with catheter-related bloodstream infection (CR-BSI). Health professionals should be aware of this potential source of infection at the CVC insertion site.
  169. Paediatric open globe injuries. Visual outcome and risk factors for endophthalmitis
    • date - 2004
    • creator - Narang Subina
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=03014738&date=2004&volume=52&issue=1&spage=29
    • description - <b>Purpose:</b> To study the incidence of open globe injuries and the outcome in children, and to study the risk factors for post-traumatic endophthalmitis. <u> </u><b> Methods:</b> Paediatric patient population. Retrospective analysis of 72 consecutive cases of open globe injury over 3 years (January 1998 to December 2000). <b> Results:</b> The cause of trauma was sports related (n = 18), home-made bow and arrow (n = 16), household kitchen injuries (n = 10), cracker injuries (n = 7) and other miscellaneous outdoor activities (n = 16). In 5 children the cause could not be ascertained. Visual acuity of <u> ></u> 3/60 in the injured eye at the last follow-up examination was recorded in 37 of 70 patients (52.86&#x0025;) whose visual acuity could be tested. The final visual acuity was significantly poorer in eyes where primary repair was delayed beyond 24 hours of injury (P< 0.05). Post- traumatic endophthalmitis developed in 39 of 72 (54.16&#x0025;) eyes. Bow and arrow and household injuries (P < 0.5) and eyes in which primary repair was delayed beyond 24 hours of injury (P< 0.01) had a higher risk of endophthalmitis in univariate analysis. In multivariate analysis delayed repair was the only significant risk factor for the occurrence of endophthalmitis (P=0.014). <b> Conclusion:</b> Delayed repair, bow and arrow injuries and household injuries were associated with significantly higher risk of endophthalmitis. The incidence of endophthalmitis can be reduced by early referral of trauma cases and parental supervision.
  170. Risk factors for dental caries in Turkish preschool children
    • date - 2005
    • creator - Can G
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=09704388&date=2005&volume=23&issue=3&spage=115
    • description - The aim of this study was to evaluate risk factors of dental caries in preschool children in Istanbul. Five nursery schools in Istanbul were included and results of 598 students&#x2032; were collected. Subjects were orally examined. Socio-demographic data were obtained from the records and from parents. Oral examination data were recorded on examination forms in accordance with the WHO criteria. Bivariate analyses were conducted using chi-square test Multivariate analyses were then performed to estimate the simultaneous impact of the independent variables on dft. Logistic regression analysis was performed in stages. In the study, while although the percentage of children had 60&#x0025; caries and 0 results at the age of 3, this percentage drops to 15.3&#x0025; at the age 6. 36&#x0025;Thirty-six percent of the students have insufficient oral hygiene. Statistically meaningful difference was ascertained in chi-square analysis related to age, mother&#x2032;s education level, and father&#x2032;s occupation. When the variables with statistically meaningful difference are estimated with logistic regression analysis, the age and father&#x2032;s father&#x2032;s occupation turned out to be the risk indicators that affect dft level.
  171. Risk factors for acute chemical releases with public health consequences: Hazardous Substances Emergency Events Surveillance in the U.S., 1996&#8211;2001
    • date - 2004
    • creator - Wattigney Wendy
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1476069X&date=2004&volume=3&issue=1&spage=10
    • description - <p>Abstract</p> <p>Background</p> <p>Releases of hazardous materials can cause substantial morbidity and mortality. To reduce and prevent the public health consequences (victims or evacuations) from uncontrolled or illegally released hazardous substances, a more comprehensive analysis is needed to determine risk factors for hazardous materials incidents.</p> <p>Methods</p> <p>Hazardous Substances Emergency Events Surveillance (HSEES) data from 1996 through 2001 were analyzed using bivariate and multiple logistic regression. Fixed-facility and transportation-related events were analyzed separately.</p> <p>Results</p> <p>For fixed-facility events, 2,327 (8%) resulted in at least one victim and 2,844 (10%) involved ordered evacuations. For transportation-related events, 759 (8%) resulted in at least one victim, and 405 (4%) caused evacuation orders. Fire and/or explosion were the strongest risk factors for events involving either victims or evacuations. Stratified analysis of fixed-facility events involving victims showed a strong association for acid releases in the agriculture, forestry, and fisheries industry. Chlorine releases in fixed-facility events resulted in victims and evacuations in more industry categories than any other substance.</p> <p>Conclusions</p> <p>Outreach efforts should focus on preventing and preparing for fires and explosions, acid releases in the agricultural industry, and chlorine releases in fixed facilities.</p>
  172. Terminology in “Rural Community Knowledge of Stroke Warning Signs and Risk Factors�
    • date - 2005
    • creator - Michael W. Day, RN, MSN, CCRN
    • provider - NSDL OAI Repository
    • location - http://www.cdc.gov/pcd/issues/2005/jul/05_0040.htm
    • description - While I appreciate the effort of Blades et al in conducting the valuable research for “Rural Community Knowledge of Stroke Warning Signs and Risk Factorsâ€� (1), I believe that respondents to the survey do not necessarily represent rural communities.
  173. Psychosocial risk factors for obesity among women in a family planning clinic
    • date - 2004
    • creator - Rohland Barbara
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712296&date=2004&volume=5&issue=1&spage=20
    • description - <p>Abstract</p> <p>Background</p> <p>The epidemiology of obesity in primary care populations has not been thoroughly explored. This study contributes to filling this gap by investigating the relationship between obesity and different sources of personal stress, mental health, exercise, and demographic characteristics.</p> <p>Methods</p> <p>A cross-sectional survey using a convenience sample. Five hundred women who attended family planning clinics were surveyed and 274 provided completed answers to all of the questions analyzed in this study. Exercise, self-rated mental health, stress, social support, and demographic variables were included in the survey. Multiple logistic regression analysis was performed.</p> <p>Results</p> <p>After adjusting for mental health, exercise, and demographic characteristics of subjects, analysis of the data indicated that that being having a large family and receiving no support from parents were related to obesity in this relatively young low-income primary care sample, but self-reported stress and most types of social support were not significant.</p> <p>Conclusion</p> <p>Obesity control programs in primary care centers directed at low-income women should target women who have large families and who are not receiving support from their parents.</p>
  174. Risk factors of development of gut-derived bacterial translocation in thermally injured rats.
    • date - 2004
    • creator - Sheng ZY
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2004&volume=10&issue=11&spage=1619
    • description - <br>AIM: Studies have demonstrated that gut-derived bacterial translocation (BT) might play a role in the occurrence of sepsis and multiple organ dysfunction syndrome (MODS). Yet, no convincing overall analysis of risk factors for BT has been reported. The purpose of this study was to evaluate the related factors for the development of BT in burned rats. <br>METHODS: Wistar rats were subjected to 30% third-degree burns. Then samples were taken on postburn d 1, 3, and 5. Incidence of BT and counts of mucosal bifidobacteria, fungi and E. coli, mucus sIgA, degree of injury to ileal mucosa, and plasma interleukin-6 were observed. Univariate analysis and multivariate logistic regression analysis were performed. <br>RESULTS: The overall BT rate was 53.9% (69 in 128). The result of univariate analysis showed that the levels of plasma endotoxin and interleukin-6, the counts of mucosal fungi and E. coli, and the scores of ileum lesion were markedly increased in animals with BT compared with those without (P=0.000-0.005), while the levels of mucus sIgA and the counts of mucosal bifidobacteria were significantly reduced in animals with translocation compared with those without (P=0.000). There was a significant positive correlation between mucus sIgA and the counts of mucosal bifidobacteria (r=0.74, P=0.001). Moreover, there were strong negative correlations between scores of ileum-lesion and counts of bifidobacteria (r=-0.67, P=0.001). Multivariate logistic regression revealed that ileum lesion score (odds ratio [OR] 45.52, 95% confidence interval [CI] 5.25-394.80), and counts of mucosal bifidobacteria (OR 0.039, 95% CI 0.0032-0.48) were independent predictors of BT secondary to severe burns. <br>CONCLUSION: Ileal lesion score and counts of mucosal bifidobacteria can be chosen as independent prognosis factors of the development of BT. Specific interventions targeting these high-risk factors might be implemented to attenuate BT, including strategies for repair of damaged intestinal mucosae and restoration of the balance of gastrointestinal flora.
  175. Hemiparetic cerebral palsy: etiological risk factors and neuroimaging
    • date - 2001
    • creator - Moura-Ribeiro Maria Valeriana Leme de
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2001000100007
    • description - The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP), was to verify the etiological risk period for this disease. Etiological risk factors (ERF) were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the prenatal and perinatal period was 41% and no ERF was 18% of the cases. The computerized tomographic scan (CT) and MRI were performed on all the patients, who were then classified according to their etiopathogenic data: CT1= normal (18%); CT 2= unilateral ventricular enlargement (25%); CT 3= cortical/ subcortical cavities (28%); CT4= hemispheric atrophy and other findings (14%); CT 5= malformations (15%). CT 5 was associated with physical malformations beyond the central nervous system and with prenatal ERF's , while CT 2 was associated with the perinatal ERF's, mainly in premature births. Magnetic resonance imaging was performed on 57 patients and demonstrated a good degree of concordance with the CT. Etiology remained undefined in only 37% of the cases after neuroimaging was related to ERF. A high perinatal RF frequency (59%) was observed and emphasized the need for special care during this period.
  176. Smoking cessation and cardiovascular disease risk factors: results from the Third National Health and Nutrition Examination Survey.
    • date - 2005
    • creator - Erlinger Thomas P
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=15491277&date=2005&volume=2&issue=6&spage=e160
    • description - BACKGROUND: Cigarette smoking is a major risk factor for the development and progression of cardiovascular disease. While smoking is associated with increased levels of inflammatory markers and accelerated atherosclerosis, few studies have examined the impact of smoking cessation on levels of inflammatory markers. The degree and rate at which inflammation subsides after smoking cessation are uncertain. It also remains unclear as to whether traditional risk factors can adequately explain the observed decline in cardiovascular risk following smoking cessation. METHODS AND FINDINGS: Using data from 15,489 individuals who participated in the Third National Health and Nutrition Examination Survey (NHANES III), we analyzed the association between smoking and smoking cessation on levels of inflammatory markers and traditional cardiovascular risk factors. In particular, we examined changes in C-reactive protein, white blood cell count, albumin, and fibrinogen. Inflammatory markers demonstrated a dose-dependent and temporal relationship to smoking and smoking cessation. Both inflammatory and traditional risk factors improved with decreased intensity of smoking. With increased time since smoking cessation, inflammatory markers resolved more slowly than traditional cardiovascular risk factors. <br>CONCLUSION: Inflammatory markers may be more accurate indicators of atherosclerotic disease. Inflammatory markers returned to baseline levels 5 y after smoking cessation, consistent with the time frame associated with cardiovascular risk reduction observed in both the MONICA and Northwick Park Heart studies. Our results suggest that the inflammatory component of cardiovascular disease resulting from smoking is reversible with reduced tobacco exposure and smoking cessation.
  177. Evaluation of easily measured risk factors in the prediction of osteoporotic fractures
    • date - 2005
    • creator - Bensen W
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2474/6/47
    • description - <p>Abstract</p> <p>Background</p> <p>Fracture represents the single most important clinical event in patients with osteoporosis, yet remains under-predicted. As few premonitory symptoms for fracture exist, it is of critical importance that physicians effectively and efficiently identify individuals at increased fracture risk.</p> <p>Methods</p> <p>Of 3426 postmenopausal women in CANDOO, 40, 158, 99, and 64 women developed a new hip, vertebral, wrist or rib fracture, respectively. Seven easily measured risk factors predictive of fracture in research trials were examined in clinical practice including: age (<b><65</b>, 65&#8211;69, 70&#8211;74, 75&#8211;79, 80+ years), rising from a chair with arms (yes, <b>no</b>), weight (< 57, <b>&#8805; 57</b>kg), maternal history of hip facture (yes, <b>no</b>), prior fracture after age 50 (yes, <b>no</b>), hip T-score (<b>>-1</b>, -1 to >-2.5, &#8804;-2.5), and current smoking status (yes, <b>no</b>). Multivariable logistic regression analysis was conducted.</p> <p>Results</p> <p>The inability to rise from a chair without the use of arms (3.58; 95% CI: 1.17, 10.93) was the most significant risk factor for new hip fracture. Notable risk factors for predicting new vertebral fractures were: low body weight (1.57; 95% CI: 1.04, 2.37), current smoking (1.95; 95% CI: 1.20, 3.18) and age between 75&#8211;79 years (1.96; 95% CI: 1.10, 3.51). New wrist fractures were significantly identified by low body weight (1.71, 95% CI: 1.01, 2.90) and prior fracture after 50 years (1.96; 95% CI: 1.19, 3.22). Predictors of new rib fractures include a maternal history of a hip facture (2.89; 95% CI: 1.04, 8.08) and a prior fracture after 50 years (2.16; 95% CI: 1.20, 3.87).</p> <p>Conclusion</p> <p>This study has shown that there exists a variety of predictors of future fracture, besides BMD, that can be easily assessed by a physician. The significance of each variable depends on the site of incident fracture. Of greatest interest is that an inability to rise from a chair is perhaps the most readily identifiable significant risk factor for hip fracture and can be easily incorporated into routine clinical practice.</p>
  178. Prevalence, and associated risk factors, of self-reported diabetes mellitus in a sample of adult urban population in Greece: MEDICAL Exit Poll Research in Salamis (MEDICAL EXPRESS 2002)
    • date - 2004
    • creator - Pappas Stavros
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2004&volume=4&issue=1&spage=2
    • description - <p>Abstract</p> <p>Background</p> <p>The continuous monitoring and future prediction of the growing epidemic of diabetes mellitus worldwide presuppose consistent information about the extent of the problem. The aim of this study was to determine the prevalence of diagnosed diabetes and to identify associated risk factors in a sample of adult urban Greek population.</p> <p>Methods</p> <p>A cross-sectional population-based survey was conducted in municipality of Salamis, Greece, during an election day (2002). The study sample consisted of 2805 participants, aged 20&#8211;94 years. Data were collected using a standardized short questionnaire that was completed by a face-to-face interview. Multiple regression analyses were performed to evaluate the association of diabetes with potential risk factors.</p> <p>Results</p> <p>The overall prevalence of diagnosed diabetes was 8.7% (95% CI 7.7&#8211;9.8%). After age adjustment for the current adult population (2001 census) of Greece, the projection prevalence was calculated to 8.2%. Multivariate logistic regression analysis identified as independent risk factors: increasing age (odds ratio, OR = 1.07, 95% CI 1.06&#8211;1.08), male sex (OR = 1.43, 95% CI 1.04&#8211;1.95), overweight and obesity (OR = 1.97, 95% CI 1.29&#8211;3.01 and OR = 3.76, 95% CI 2.41&#8211;5.86, respectively), family history of diabetes (OR = 6.91, 95% CI 5.11&#8211;9.34), hypertension (OR = 2.19, 95% CI 1.60&#8211;2.99) and, among women, lower educational level (OR = 2.62, 95% CI 1.22&#8211;5.63). The prevalence of overweight and obesity, based on self-reported BMI, were 44.2% and 18.4%, respectively. Moreover, the odds for diabetes in obese subjects with family history were 25-fold higher than those with normal weight and without family history of diabetes, while the odds in overweight subjects with family history of diabetes were 15-fold higher.</p> <p>Conclusions</p> <p>Our findings indicated that the prevalence of diabetes is high in Greek population. It is suggested that the main modifiable contributing factor is obesity, whose effect is extremely increased upon positive heredity presence.</p>
  179. Canine visceral leishmaniasis in Barra de Guaratiba, Rio de Janeiro, Brazil: assessment of risk factors
    • date - 2003
    • creator - Silva Alba Valéria M. da
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652003000200005
    • description - Barra de Guaratiba is a coastal area of the city of Rio de Janeiro where American visceral leishmaniasis (AVL) is endemic. Although control measures including killing of dogs and use of insecticides have been applied at this locality, the canine seroprevalence remains at 25% and during 1995 and 1997 eight autochthonous human cases were notified. In order to evaluate factors related to the increase of the risk for Leishmania (Leishmania) chagasi infection in dogs we have screened 365 dogs by anti-Leishmania immunofluorescent antibody test (IFAT) and captured sandflies in the domestic and peridomestic environment. Some variables related to the infection were assessed by uni- and multivariate analysis. The distance of the residence from the forest border, its altitude and the presence of the opossum Didelphis marsupialis in the backyard, were found predictor factors for L. (L.) chagasi infection in dogs in Barra de Guaratiba. The presence of Lutzomyia longipalpis in the peridomestic environment indicates the possibility of appearence of new human cases. Our data also suggest the presence of a sylvatic enzootic cycle at this locality.
  180. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital
    • date - 2005
    • creator - Razavi Seyd
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712482&date=2005&volume=5&issue=1&spage=2
    • description - <p>Abstract</p> <p>Background</p> <p>Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran.</p> <p>Methods</p> <p>Patients (n = 802) who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups.</p> <p>Results</p> <p>Of the 802 patients, 139 suffered from SSI (17.4%). In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation) hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001.</p> <p>Conclusion</p> <p>In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature), this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and approximating the timing of shaving to the operation and substituting cefazolin for cefaluthin when prophylactic antibiotic is to be administered, the SSI may be reduced to a more acceptable level.</p>
  181. Potential risk factors for diabetic neuropathy: a case control study
    • date - 2005
    • creator - Bandarian Fatemeh
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712377&date=2005&volume=5&issue=1&spage=24
    • description - <p>Abstract</p> <p>Background</p> <p>Diabetes mellitus type II afflicts at least 2 million people in Iran. Neuropathy is one of the most common complications of diabetes and lowers the patient's quality of life. Since neuropathy often leads to ulceration and amputation, we have tried to elucidate the factors that can affect its progression.</p> <p>Methods</p> <p>In this case-control study, 110 diabetic patients were selected from the Shariati Hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to differentiate cases from controls. The diagnosis of neuropathy was confirmed by nerve conduction studies (nerve conduction velocity and electromyography). The multiple factors compared between the two groups included consumption of angiotensin converting enzyme inhibitors (ACEI), blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.</p> <p>Results</p> <p>Statistically significant relationships were found between neuropathy and age, gender, quality of diabetes control and duration of disease (P values in the order: 0.04, 0.04, < 0.001 and 0.005). No correlation was found with any atherosclerosis risk factor (high BP, hyperlipidemia, cigarette smoking).</p> <p>Conclusion</p> <p>In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control reduces the incidence of neuropathy, slows its progression and improves the diabetic patient's quality of life. More attention must be paid to elderly male diabetic patients with poor diabetes control with regard to regular foot examinations and more practical education.</p>
  182. Recommendations from the Canadian Diabetes Association. 2003 guidelines for prevention and management of diabetes and related cardiovascular risk factors.
  183. Risk Factors for Human T Cell Lymphotropic Virus Type I among Injecting Drug Users in Northeast Brazil: Possibly Greater Efficiency of Male to Female Transmission
    • date - 1999
    • creator - Galvão-Castro Bernardo
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00740276&date=1999&volume=94&issue=1&spage=
    • description - It was observed in the city of Salvador, State of Bahia, the highest seroprevalence of human T cell lymphotropic virus type 1 (HTLV-I) infection in Brazil as demonstrated by national wide blood bank surveys. In this paper, we report results of an investigation of drug use and sexual behavior associated with HTLV-I infection among male and female injecting drug users (IDUs) in Salvador. A cross sectional study was conducted in the Historical District of Salvador from 1994-1996 (Projeto Brasil-Salvador) and 216 asymptomatic IDUs were selected using the snowball contact technique. Blood samples were collected for serological assays. Sera were screened for human immunodeficiency virus (HIV-1/2) and HTLV-I/II antibodies by ELISA and confirmed by Western blot. The overall prevalence of HTLV-I/II was 35.2% (76/216). The seroprevalence of HTLV-I, HTLV-II and HIV-1 was for males 22%, 11.3% and 44.1% and for females 46.2%, 10.3% and 74.4% respectively. HTLV-I was identified in 72.4% of HTLV positive IDUs. Variables which were significantly associated with HTLV-I infection among males included needle sharing practices, duration of injecting drug use, HIV-1 seropositivity and syphilis. Among women, duration of injecting drug use and syphilis were strongly associated with HTLV-I infection. Multivariate analysis did not change the direction of these associations. Sexual intercourse might play a more important role in HTLV-I infection among women than in men.
  184. Risk factors for basal cell carcinoma: a case-control study
    • date - 1995
    • creator - Maia Marcus
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89101995000100006
    • description - A controlled trial was performed with the purpose of investigating which factors could be considered of significant risk for the development of basal cell carcinoma. A total of 259 cases of basal cell carcinoma diagnosed from July 1991 to July 1992 were compared with 518 controls matched for age and sex. All subjects in both groups were white. Protocol data were submitted to statistical analysis by the chi-square test and by multiple conditional logistic regression analysis and the following conclusions were reached: 1) light skin color (types I and II of the Fitzpatrick classification), odds ratio of 2.8; outdoor work under constant sunlight, odds ratio of 5.0; the presence of actinic lesions due to exposure to the sun, odds ratio of 4.9, are risk factors perse. 2) Type III skin in the Fitzpatrick classification only represents a risk factor when the patient reports a history of intense sunburns, but not in the absence of such a history. 3) Sunburns per se do not represent a risk factor althorig the point made in item 2 of these conclusions is valid. 4) Other suspected risk factors whose significance was not confirmed by multiple conditioned logistic regression analysis were: residence in rural areas, light eyes and blond hair color, extent of the awareness of the "sun x skin cancer" relationship, familial occurrence of skin cancer, excessive exposure to the sun, and freckles appearing in childhood.
  185. Nested case-control study on the risk factors of colorectal cancer.
    • date - 2003
    • creator - Ma XY
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2003&volume=9&issue=1&spage=99
    • description - <br>AIM: To investigate the risk factors of colon cancer and rectal cancer. <br>METHODS: A nested case-control study was conducted in a cohort of 64 693 subjects who participated in a colorectal cancer screening program from 1989 to 1998 in Jiashan county, Zhejiang, China. 196 cases of colorectal cancer were detected from 1990 to 1998 as the case group and 980 non-colorectal cancer subjects, matched with factors of age, gender, resident location, were randomly selected from the 64 693 cohort as controls. By using univariate analysis and multivariate conditional logistic regression analysis, the odds ratio (OR) and its 95 % confidence interval (95 %CI) were calculated between colorectal cancer and personal habits, dietary factors, as well as intestinal related symptoms. <br>RESULTS: The multivariate analysis results showed that after matched with age, sex and resident location, mucous blood stool history and mixed sources of drinking water were closely associated with colon cancer and rectal cancer, OR values for the mucous blood stool history were 3.508 (95 %CI: 1.370-8.985) and 2.139 (95 %CI: 1.040-4.402) respectively; for the mixed drinking water sources, 2.387 (95 %CI: 1.243-4.587) and 1.951 (95 %CI: 1.086-3.506) respectively. All reached the significant level with a P-value less than 0.05. <br>CONCLUSION: The study suggested that mucous blood stool history and mixed sources of drinking water were the risk factors of colon cancer and rectal cancer. There was no any significant association between dietary habits and the incidence of colorectal cancer.
  186. Hepatitis B virus infection in Haemodialysis Centres from Santa Catarina State, Southern Brazil. Predictive risk factors for infection and molecular epidemiology
    • date - 2004
    • creator - Bassit Leda
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2004&volume=4&issue=1&spage=13
    • description - <p>Abstract</p> <p>Background</p> <p>Patients under haemodialysis are considered at high risk to acquire hepatitis B virus (HBV) infection. Since few data are reported from Brazil, our aim was to assess the frequency and risk factors for HBV infection in haemodialysis patients from 22 Dialysis Centres from Santa Catarina State, south of Brazil.</p> <p>Methods</p> <p>This study includes 813 patients, 149 haemodialysis workers and 772 healthy controls matched by sex and age. Serum samples were assayed for HBV markers and viraemia was detected by nested PCR. HBV was genotyped by partial S gene sequencing. Univariate and multivariate statistical analyses with stepwise logistic regression analysis were carried out to analyse the relationship between HBV infection and the characteristics of patients and their Dialysis Units.</p> <p>Results</p> <p>Frequency of HBV infection was 10.0%, 2.7% and 2.7% among patients, haemodialysis workers and controls, respectively. Amidst patients, the most frequent HBV genotypes were A (30.6%), D (57.1%) and F (12.2%). Univariate analysis showed association between HBV infection and total time in haemodialysis, type of dialysis equipment, hygiene and sterilization of equipment, number of times reusing the dialysis lines and filters, number of patients per care-worker and current HCV infection. The logistic regression model showed that total time in haemodialysis, number of times of reusing the dialysis lines and filters, and number of patients per worker were significantly related to HBV infection.</p> <p>Conclusions</p> <p>Frequency of HBV infection among haemodialysis patients at Santa Catarina state is very high. The most frequent HBV genotypes were A, D and F. The risk for a patient to become HBV positive increase 1.47 times each month of haemodialysis; 1.96 times if the dialysis unit reuses the lines and filters &#8805; 10 times compared with haemodialysis units which reuse < 10 times; 3.42 times if the number of patients per worker is more than five. Sequence similarity among the HBV S gene from isolates of different patients pointed out to nosocomial transmission.</p>
  187. Hypertension and clustering of cardiovascular risk factors in a community in Southeast Brazil: the Bambuí Health and Ageing Study
    • date - 2001
    • creator - Lima-Costa Maria Fernanda Furtado
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001001200008
    • description - OBJECTIVE - A population-based prospective study was analysed to: a) determine the prevalence of hypertension; b) investigate the clustering of other cardiovascular risk factors and c) verify whether older differed from younger adults in the pattern of clustering. METHODS - The data comprised a representative sample of the population of Bambuí, Brazil. Multiple logistic regression was used to investigate the independent association between hypertension and selected factors. RESULTS - A total of 820 younger adults (82.5%) and 1494 older adults (85.9%) participated in this study. The overall prevalence of hypertension was 24.8% (SE=1.4 %), being higher in women (26.9±1.5%) than in men (22.0± 1.7%) (p=0.033). Hypertension was positively and significantly associated with physical inactivity, overweight, hypercholesterolemia hyperglycemia and hypertriglyceridemia. The coexistence of hypertension with 4 or more of these risk factors occurred 6 times more than expected by chance, after adjusting for age and sex (OR=6.3; 95%CI: 3.4-11.9). The pattern of risk factor clustering in hypertensive individuals differed with age. CONCLUSION - Our results reinforce the need to increase detection and treatment of hypertension and to approach patients' global risk profiles.
  188. Age and gender as risk factors for the transmission of HIV in a sample of drug users of Porto Alegre, Brazil
    • date - 2002
    • creator - De Boni Raquel
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=15164446&date=2002&volume=24&issue=3&spage=137
    • description - Objective: To verify the association between age and gender regarding HIV seropositivity in drug users who seek public health centers in Porto Alegre, Brazil. Methods: The authors designed a cross-sectional study with a convenience sampling of 695 men and women aged above 15, who reported recent drug use and risk behaviors to HIV exposure. We used a standard questionnaire (CRA, Brazilian version of the RAB, Risk Assessment Battery) to assess risk behaviors and we collected blood for HIV testing. Results: Most individuals were males (75,8%), with a mean age of 29.4 years, less than seven years of schooling (42,4%), and family income equal or superior to four minimum wages (46%). There was no significant association between gender and seropositivity. Multivariate analyses showed that individuals aged above 30 had a three-fold increased odds of being seropositive over subjects aged 20 or less. Intravenous drug users who had been using drugs since 1980 had five-fold odds of seropositivity and those who had been using them in the month prior to the interview had four-fold odds. Discussion: Subjects aged more than 30 showed higher odds of seropositivity than the younger group. This is possibly due to a higher use of intravenous cocaine and to having more risk behaviors along their lifetime. There was no difference in seropositivity between genders, what differs from current data of other studies, if we take into consideration that rates of populational seropositivity among women have increased, mostly among drug users, who are, therefore, at 'double risk'. The development of further studies is mandatory in order to assess gender and age as risk factors for seropositivity, whether to confirm or to deny these findings, and to plan specific strategies for high-risk groups.
  189. Prevalence of Trypanosoma cruzi and Leishmania chagasi infection and risk factors in a Colombian indigenous population
    • date - 1999
    • creator - SANTACRUZ Maria Mercedes
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00364665&date=1999&volume=41&issue=4&spage=229
    • description - This study was carried out in order to obtain base-line data concerning the epidemiology of American Visceral Leishmaniasis and Chagas? Disease in an indigenous population with whom the government is starting a dwelling improvement programme. Information was collected from 242 dwellings (1,440 people), by means of house to house interviews about socio-economic and environmental factors associated with Leishmania chagasi and Trypanosoma cruzi transmission risk. A leishmanin skin test was applied to 385 people and 454 blood samples were collected on filter paper in order to detect L. chagasi antibodies by ELISA and IFAT and T. cruzi antibodies by ELISA. T. cruzi seroprevalence was 8.7% by ELISA, L. chagasi was 4.6% and 5.1% by IFAT and ELISA, respectively. ELISA sensitivity and specificity for L. chagasi antibodies were 57% and 97.5% respectively, as compared to the IFAT. Leishmanin skin test positivity was 19%. L. chagasi infection prevalence, being defined as a positive result in the three-immunodiagnostic tests, was 17.1%. Additionally, 2.7% of the population studied was positive to both L. chagasi and T. cruzi, showing a possible cross-reaction. L. chagasi and T. cruzi seropositivity increased with age, while no association with gender was observed. Age (p<0.007), number of inhabitants (p<0.05), floor material (p<0.03) and recognition of vector (p<0.01) were associated with T. cruzi infection, whilst age ( p<0.007) and dwelling improvement (p<0.02) were associated with L. chagasi infection. It is necessary to evaluate the long-term impact of the dwelling improvement programme on these parasitic infections in this community.
  190. Seroprevalence and risk factors associated with Helicobacter pylori infection in blood donors in Salvador, Northeast-Brazil
    • date - 2003
    • creator - Lyra Luiz G.
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000500009
    • description - Helicobacter pylori plays an important role in the etiology of peptic ulcer disease. Its prevalence appears to be higher in developing countries. We evaluated the seroprevalence of H. pylori and risk factors associated with infection in voluntary blood donors who attended the main blood center of the city of Salvador, Brazil. The subjects responded to an epidemiological questionnaire, with information about sex, age, race, lifestyle, social-economic level indicators, and residence and hygiene conditions. Anti-H. pylori antibody was determined by ELISA (Cobas Core, Roche). Three hundred and seven subjects were included in the study. Anti-H. pylori antibody results were indeterminate in 33 individuals (10.8%), who were excluded from analysis. Among the remaining 274 subjects, 187 (68.2%) were anti-H. pylori positive. Based on multivariate logistic regression analysis three variables were found to be significantly associated with a higher prevalence of H. pylori infection: absence of plumbing in the residence during childhood, a history of rainwater invading the dwelling during childhood, and low ingestion of milk.
  191. Risk factors for adverse perinatal outcomes in imprisoned pregnant women: a systematic review
    • date - 2005
    • creator - Plugge Emma
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2005&volume=5&issue=1&spage=111
    • description - <p>Abstract</p> <p>Background</p> <p>Imprisoned pregnant women constitute an important obstetric group about whom relatively little is known. This systematic review was conducted to identify the risk factors associated with adverse pregnancy outcome present in this group of women.</p> <p>Methods</p> <p>The review was conducted according to a prespecified protocol. Studies of any design were included if they described information on any of the pre-specified risk factors. We calculated the results as summary percentages or odds ratios where data was available on both cases and population controls.</p> <p>Results</p> <p>The search strategy identified 27 relevant papers of which 13 met the inclusion criteria, involving 1504 imprisoned pregnant women and 4571 population control women. Imprisoned women are more likely to be single, from an ethnic minority, and not to have completed high school. They are more likely to have a medical problem which could affect the pregnancy outcome and yet less likely to receive adequate antenatal care. They are also more likely to smoke, drink alcohol to excess and take illegal drugs.</p> <p>Conclusion</p> <p>Imprisoned women are clearly a high risk obstetric group. These findings have important implications for the provision of care to this important group of women.</p>
  192. HIV infection and risk factors among Bangkok prisoners, Thailand: a prospective cohort study
    • date - 2003
    • creator - Vongsheree Suthon
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/3/25
    • description - <p>Abstract</p> <p>Background</p> <p>Incarceration has been associated with HIV infection among injection drug users. However, data on HIV risk factors of the inmates during incarceration are rarely reported from Thailand.</p> <p>Methods</p> <p>A prospective cohort of 689 male inmates in a Bangkok central prison was studied during 2001&#8211;2002. Follow up visits were conducted for 5 months, with testing for HIV and other infections and interviewing of demographics and risk behaviors.</p> <p>Results</p> <p>Among 689 male inmates, half (50.9 %) were drug injectors. About 49% of the injectors had injection during incarceration. Most (94.9%) of the injectors had shared injection paraphernalia with others. Successful follow up rate was 98.7% after 2,581 person-months observation. HIV incidence was 4.18 per 100 person &#8211; years among all inmates, and 11.10 per 100 person &#8211; years among the injection inmates. Multivariate analysis identified variables associated with HIV prevalence: history of injection [OR = 2.30, 95%CI: 1.91&#8211;2.77], positive urine opiate test [OR = 5.04, 95%CI: 2.63&#8211;9.67], history of attendance to drug withdrawal clinics [OR = 2.00, 95%CI: 1.19&#8211;3.35] and presence of tattoos on the body [OR = 1.23, 95%CI: 1.01&#8211;1.52].</p> <p>Conclusions</p> <p>The main HIV risk factors of Bangkok inmates were those related to drug injection. Harm reduction measures and HIV intervention strategies should be implemented to prevent more spread of HIV among the inmates and into the community.</p>
  193. Frequency, clinical features and risk factors of lacunar infarction (data from a stroke registry in South India).
    • date - 2000
    • creator - Murthy J
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00283886&date=2000&volume=48&issue=2&spage=116
    • description - Analysis of 893 patients of ischaemic stroke in the stroke registry of Nizam&#x2032;s institute of Medical Sciences, Hyderabad is presented. 16&#x0025; of them had lacunar infarction. The mean age at presentation was 56.9 years and male to female ratio was 3.5:1. The common risk factors included hypertension(62&#x0025;),diabetes(38&#x0025;) and smoking(28&#x0025;). Six percent had an underlying cardiac source of embolism and none had significant (>50&#x0025;) extracranial carotid atherosclerosis. In 22&#x0025; of patients, no obvious risk factors could be identified. The frequency of risk factors was similar in patients with lacunar and non- lacunar infarctions. However, patients with lacunar infarction had higher frequency of diabetes and absence of significant (>50&#x0025;) extracranial carotid artery disease. Pure motor hemiparesis was the presenting syndrome in 45&#x0025; patients. Ataxic hemiparesis and sensorimotor stroke accounted for 18&#x0025; each and dysarthria-clumsy hand syndrome for 14&#x0025;. This study suggests that the frequency, risk factors and clinical profile of lacunar infarction in our stroke registry is similar to most of the western stroke registries.
  194. Risk factors related to the severity of diabetic retinopathy
    • date - 2003
    • creator - Freitas André Moraes
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00042749&date=2003&volume=66&issue=6&spage=739
    • description - PURPOSE: To determine the relationship between the severity or stage of diabetic retinopathy and associated risk factors in a southern Brazilian population. METHODS: Transversal study of diabetic patients without previous ophthalmologic treatment, seen at a University eye clinic. These patients underwent fundus photography, complete blood work-up, systemic blood pressure measurement, urine analysis, and were questioned about risk factors previously determined by the authors. The presence or absence of risk factors was compared to the severity of diabetic retinopathy. RESULTS: Eighty-one patients were selected, 28 male, 53 female, 55 Caucasians, 26 African descendants, 28 had insulin-dependent diabetes mellitus, 53 had non-insulin-dependent diabetes mellitus. Factors related to more severe diabetic retinopathy include: insulin-dependent diabetes mellitus (a<0.01), nephropathy (a<0.05), proteinuria (a<0.05), duration of the disease (p<0.001), elevated fasting plasma glucose (p=0.11), glycosylated hemoglobin (HbA (1c)) (p=0.001), total serum cholesterol (p=0.019), lower hematocrit (p=0.004) and hemoglobin (p=0.001). CONCLUSIONS: The severity of diabetic retinopathy appears to be associated with risk factors such as duration of disease, type of diabetes, poor metabolic control, hemoglobin levels, total cholesterol and proteinuria. Factors apparently not related to severity of diabetic retinopathy include gender, age, systemic hypertension and hypomagnesemia.
  195. Risk factors of thyroid abnormalities in bipolar patients receiving lithium: a case control study
    • date - 2003
    • creator - Ahmadi-Abhari Seyed-Ali
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1471244X&date=2003&volume=3&issue=1&spage=4
    • description - <p>Abstract</p> <p>Background</p> <p>Lithium-induced thyroid abnormalities have been documented in many studies. They may occur despite normal plasma lithium levels. The objectives of this study were: 1) to determine possible relationship between lithium ratio, defined as erythrocyte lithium concentrations divided by plasma lithium concentrations, and thyroid abnormalities in bipolar patients receiving lithium and 2) to find other possible risk factors for developing thyroid abnormalities in the subjects.</p> <p>Methods</p> <p>Sixty-eight bipolar patients receiving lithium therapy were enrolled in a cross-sectional evaluation of thyroid function test and thyroid size. Patients were divided into two groups based on their thyroid function tests and thyroid sizes. Erythrocyte and plasma lithium concentrations were determined by atomic absorption spectrometry for each patient. Lithium ratio was then calculated.</p> <p>Results</p> <p>No significant differences were found between age, positive family history of affective disorder, plasma lithium concentration, erythrocyte lithium concentration, and lithium ratio comparing the two groups. Thyroid abnormalities was significantly higher in women than in men (p < 0.05).</p> <p>Conclusions</p> <p>Lithium ratio does not appear to have a predictive role for thyroidal side effects of lithium therapy. Female gender was the main risk factor. We suggest more frequent thyroid evaluation of bipolar women who are treated with lithium.</p>
  196. Risk factors associated with injection initiation among drug users in Northern Thailand
    • date - 2006
    • creator - Jittiwutikarn Jaroon
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14777517&date=2006&volume=3&issue=1&spage=10
    • description - <p>Abstract</p> <p>Background</p> <p>Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand.</p> <p>Methods</p> <p>A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection.</p> <p>Results</p> <p>After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation.</p> <p>Conclusion</p> <p>Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.</p>
  197. Social risk factors for sexually transmitted diseases
    • date - 2002
    • creator - Shendre Mohan
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=03786323&date=2002&volume=68&issue=1&spage=25
    • description - The present case control study included 322 cases of sexually transmitted diseases and equal number of age group matched and sex pair matched controls from the Skin and Venereal Disease out patient department of Indira Gandhi Medical College, Nagpur. Of the six study factors viz. type of family, educational status, religion, socioeconomic status, marital status and social disharmony, except for religion and socioeconomic status other four factors were found to be significantly associated with sexually transmitted diseases&#x2032;
  198. Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka.
    • date - 2000
    • creator - Mesaros-Kanjski E
    • provider - NSDL OAI Repository
    • location - http://www.lib.okayama-u.ac.jp/www/acta/pdf/54_1_033.pdf
    • description - This research aims to establish the effect of working conditions on the appearance of varicose veins. The epidemiological study was carried out on 1,324 examinees, 530 males and 794 females, employed in 5 highly represented groups of professional activities in Rijeka (catering, trade, light industry, heavy industry and finances). The data were collected by survey and clinical examination. Varicose veins were more prevalent in the trade than in the office workers (odds ratio (OR) = 2.08; 95% confidence interval (CI) = 1.31-3.31), and more prevalent in catering industries than in the office workers (OR = 1.56; 95% CI = 1.001-2.43). chi 2-testing suggested that standing in the workplace (OR = 1.35; 95% CI = 0.95-1.92), weight handling while working (OR = 1.29; 95% CI = 1.01-1.64) and working indoors (OR = 1.61; 95% CI = 1.02-2.53) were risk factors for varicose veins. By multiple logistic regression, the following risk factors were isolated in the total population: female sex (OR = 1.92; 95% CI = 1.37-2.67), workplace (OR = 0.89; 95% CI = 0.78-0.99), age (OR = 1.05; 95% CI = 1.03-1.07), body mass index (OR = 1.04; 95% CI = 1.01-1.07) and family history of the disease (OR = 1.99; 95% CI = 1.55-2.57).
  199. Diabetic nephropathy in type 2 diabetes mellitus: risk factors and prevention
    • date - 2003
    • creator - Murussi Marcia
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302003000300003
    • description - Diabetic nephropathy (DN) is responsible for the increasing number of patients on dialysis in developing countries, and is already the most common cause of renal replacement therapy in the developed ones. In this manuscript, we review the risk factors and point out strategies to prevent this microvascular complication in type 2 diabetic patients (DM2). There are some known genetic and non-genetic risk factors related to the development and progression of DN in DM2 patients. Candidate genes have been analysed, but there are still controversy about the genetic markers of the disease. Recognized non-genetic risk factors are poor glycemic, pressoric and lipidic control. Additionally, it has been suggested that the presence of diabetic retinopathy, autonomic neuropathy, smoking habit, higher protein ingestion, and higher normal levels of albuminuria (even within the normal range) are associated with an increased risk of developing DN. Some strategies have been investigated and proved to prevent or at least to postpone DN, such as to control blood pressure, glycemic levels and dyslipidemia. Furthermore, angiotensin-converting enzyme inhibitors and angiotensin-II blockers have independent effects, not explained by blood pressure control alone. Other therapeutic items are to consume a low protein diet and to quit smoking.
  200. Sexual violence against intimate partners in Cape Town: prevalence and risk factors reported by men
    • date - 2004
    • creator - Abrahams Naeemah
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=00429686&date=2004&volume=82&issue=5&spage=330
    • description - OBJECTIVE: To describe the prevalence of and risk factors for the perpetration of sexual violence by men against female intimate partners. METHODS: A cross-sectional study was conducted on 1368 randomly selected men working in three Cape Town municipalities. The men were interviewed with the aid of a questionnaire on current sexual partners in the preceding 10 years, personal and relationship characteristics and the use of violence against their partners. RESULTS: The perpetration of sexual violence against intimate partners in the past 10 years was reported by 15.3% of the men. After adjustment for sociodemographic circumstances, the factors associated with such violence were involvement in physical conflict outside the home, problematic alcohol use, having more than one current partner and abusing partners verbally. While having frequent conflict with partners was important for the risk of sexual violence, only two types of conflict sources were significantly associated with this risk, namely conflict over sexual refusal and conflict when men perceived their authority to be undermined. CONCLUSION: Sexual violence in intimate relations was common. The risk of being sexually violent was associated with the use of violence to solve problems in other settings, having more than one current partner, alcohol abuse and verbally abusing a partner. It was also associated with particular types of conflict stemming from ideas of male sexual entitlement and dominance. Prevention programmes that focus on gender relations and non-violent conflict resolution for men and youths may be useful in combating such sexual violence.
  201. Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new <it>Haemophilus influenzae </it>type b and hepatitis b virus antigens
    • date - 2006
    • creator - Ndiritu Moses
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2006&volume=6&issue=1&spage=132
    • description - <p>Abstract</p> <p>Background</p> <p>Kenya introduced a pentavalent vaccine including the DTP, <it>Haemophilus influenzae </it>type b and hepatitis b virus antigens in Nov 2001 and strengthened immunization services. We estimated immunization coverage before and after introduction, timeliness of vaccination and risk factors for failure to immunize in Kilifi district, Kenya.</p> <p>Methods</p> <p>In Nov 2002 we performed WHO cluster-sample surveys of >200 children scheduled for vaccination before or after introduction of pentavalent vaccine. In Mar 2004 we conducted a simple random sample (SRS) survey of 204 children aged 9&#8211;23 months. Coverage was estimated by inverse Kaplan-Meier survival analysis of vaccine-card and mothers' recall data and corroborated by reviewing administrative records from national and provincial vaccine stores. The contribution to timely immunization of distance from clinic, seasonal rainfall, mother's age, and family size was estimated by a proportional hazards model.</p> <p>Results</p> <p>Immunization coverage for three DTP and pentavalent doses was 100% before and 91% after pentavalent vaccine introduction, respectively. By SRS survey, coverage was 88% for three pentavalent doses. The median age at first, second and third vaccine dose was 8, 13 and 18 weeks. Vials dispatched to Kilifi District during 2001&#8211;2003 would provide three immunizations for 92% of the birth cohort. Immunization rate ratios were reduced with every kilometre of distance from home to vaccine clinic (HR 0.95, CI 0.91&#8211;1.00), rainy seasons (HR 0.73, 95% CI 0.61&#8211;0.89) and family size, increasing progressively up to 4 children (HR 0.55, 95% CI 0.41&#8211;0.73).</p> <p>Conclusion</p> <p>Vaccine coverage was high before and after introduction of pentavalent vaccine, but most doses were given late. Coverage is limited by seasonal factors and family size.</p>
  202. Dry Eye: Prevalence and Attributable Risk Factors in a Hospital-Based Population
    • date - 2005
    • creator - Sahai Anshu
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=03014738&date=2005&volume=53&issue=2&spage=87
    • description - <b>Purpose: </b> To study the prevalence of dry eye in a hospital-based population and to evaluate the various risk factors attributable to dry eye. <b> Materials and Methods:</b> In this cross-sectional study, 500 patients above 20 years of age were screened randomly for dry eye. A 13-point questionnaire, Lissamine Green test, Tear film break-up time (TBUT), Schirmer&#x2032;s test and presence of strands/filaments were used to diagnose dry eye. The diagnosis was made when at least three of the tests were positive. The role of air pollution, sunlight, excessive winds, smoking, drugs and refractive status as dry eye risk factors was assessed. <b> Results:</b> Ninety-two (18.4&#x0025;) patients had dry eye. Dry eye prevalence was maximum in those above 70 years of age (36.1&#x0025;) followed by the age group 31-40 years (20&#x0025;). It was significantly higher (<i> P</i> = 0.024) in females (22.8&#x0025;) than in males (14.9&#x0025;), more common in rural residents (19.6&#x0025;) than in urban (17.5&#x0025;) and highest among farmers/labourers (25.3&#x0025;). A 2.15 fold increase was found in the odds for dry eye in those exposed to excessive wind, 1.91 fold to sunlight exposure, 1.42 to smoking, 1.38 to air pollution and 2.04 for persons on drugs. Dry eye prevalence was 14&#x0025; in emmetropes, 16.8&#x0025; in myopes and 22.9&#x0025; in hypermetropes. It was 15.6&#x0025; in those with corrected and 25.3&#x0025; in those with uncorrected refractive errors. <b>Conclusion:</b> Dry eye is an under-diagnosed ocular disorder. Reduction in the modifiable risk factors of dry eye is essential to reduce its prevalence
  203. Hepatitis B virus infection in hemodialysis centers from Santa Catarina State, Southern Brazil. Predictive risk factors for infection and molecular epidemiology
  204. Post-ERCP Pancreatitis: Patient and Technique-Related Risk Factors
  205. Can Book-to-Market, Size and Momentum Be Risk Factors That Predict Economic Growth?
    • date - 1999-07-14
    • creator - Jimmy Liew,Maria Vassalou
    • provider - NSDL OAI Repository
    • location - http://citeseer.ist.psu.edu/404504.html
    • description - We examine the extent to which the profitability of the HML, SMB, and WML trading strategies can be linked to future GDP growth. Using a large cross-section of securities from ten developed markets, we find that the HML and SMB portfolios contain significant information about future GDP growth. The predictive ability of these strategies is to a large degree independent of any information contained in the domestic market factor, which is known to be a leading indicator of economic growth. Even in the presence of popular business cycle variables, HML and SMB retain their ability to predict future economic growth in some of the countries examined. Our results support a risk-based explanation for the performance of the HML and SMB trading strategies. Little evidence was found to support such an explanation in the case of the WML trading strategy. JEL CODES: G11, G12, G15. Keywords: book-to-market, size, momentum, trading strategies, GDP growth 3 A growing body of research shows that cer...
  206. Risk Factors for Academic and Behavioral Problems at the Beginning of School
    • date - 2000-09-08
    • creator - Lynne C. Huffman,Sarah L. Mehlinger,Amy S. Kerivan
    • provider - NSDL OAI Repository
    • location - http://citeseer.ist.psu.edu/396532.html
    • description - this report), because researchers and policy-makers operate within different professional contexts, with different demands, vocabulary, communication styles, and measures of success. Researchers establish the basic or clinical science underpinnings as well as assess the needs for new services, the quality and outcomes of existing services, and the reasons implemented interventions succeed or fail. Policy-makers provide new dollars or shift allocations of existing dollars among programs, and influence effectiveness of programs by setting outcome expectations and procedural requirements. The findings of this review suggest that the need for preventive interventions for the families of children at increased risk for educational problems likely will require changes in social and healthcare policy. It appears that services are frequently designed restrictively, attending only to the individual with the problem, while the larger needs of the family systems, offspring, and the functioning of involved adults seems neglected. Cumulative risk data imply that different services may be required to address multiproblem families. Policy-makers need to consider attempting to increase the effectiveness of intervention programs by delivering more extensive, repeated, and/or longer lasting services. Evidence indicates that a number of markers and predictors of school problems, many of which are detectable during early infancy, may be valuable to policy-makers in determining how to maximize the effectiveness of finite resource allocation. Experience with child and family social services suggests that this research is unfamiliar to most policy-makers and to those responsible for program/policy implementation. As a result, their efforts to target problems may be based more on anecdotal info...
  207. Lipid profile of nutrition students and its association with cardiovascular disease risk factors
    • date - 2001
    • creator - Fisberg Regina Mara
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2001&volume=76&issue=2&spage=143
    • description - OBJECTIVE: To describe the lipid profile and to verify its relationship with cardiovascular disease risk factors in students at a public university in São Paulo. METHODS: After obtaining clinical, anthropomorphic, and lipid profile data from 118 students, variables of the lipid profile were related to other risk factors. RESULTS: The mean age of the students was 20.3 years (SD=1.5). The risk of cardiovascular disease was characterized by a positive family history of ischemic heart disease in 38.9%; sedentariness in 35.6%; limiting and increased total and LDL-C cholesterol levels in 17.7% and 10.2%, respectively; decreased HDL-C levels in 11.1%; increased triglyceride levels in 11.1%; body mass index >25 in 8.5%, and smoking in 6.7% of the subjects. Students' diet was found to be inadequate regarding protein, total fat, saturated fat, sodium, and fiber contents. A statistically significant association between cholesterol and contraceptive use, between HDL-C and contraceptive use, age and percent body fat, and triglycerides and percent lean weight was observed. CONCLUSION: A high prevalence of some risk factors of cardiovascular disease as well as the association between these factors with altered lipid profiles was observed in the young population studied.
  208. Liver biopsy:complications and risk factors.
    • date - 1999
    • creator - Piratvisuth T
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=1999&volume=5&issue=4&spage=301
    • description - <br>AIM:To study the complications and the risk factors of percutaneous liver biopsy, and to compare the complication rate between the periods of 1987-1993 and 1994-1996.<br>METHODS:Medical records of all patients undergoing percutaneous liver biopsy between January 1, 1987 to September 31, 1996 in Songklanagarind Hospital were reviewed retrospectively.<br>RESULTS:There were 484 percutaneous liver biopsies performed. The total complication rate was 6.4%, of which 4.5% were due to major bleeding; the death rate was 1.6%. The important risk factors correlated with bleeding complications and deaths were a platelet count of 70X10(9)/L or less, a prolonged prothrombin time of >3seconds over control, or a prolonged activated partial thromboplastin time of > 10 seconds over control. Although physician inexperience was not statistically significantly associated with bleeding complications and deaths, there was a reduction of death rate from 2.2% in 1987-1993 to 0% in 1993-1996. This reduction is thought to result from both increased experience of senior staff and increased supervision of residents.CONCLUSIONS:Screening of platelet count, prothrombin time, and activated partial thromboplastin time should be done and need to be corrected in case of abnormality before liver biopsy. Percutaneous liver biopsy should be performed or supervised by an expert in gastrointestinal diseases, especially in high risk cases.
  209. Overweight and obesity in relation to cardiovascular disease risk factors among medical students in Crete, Greece
    • date - 2003
    • creator - Kafatos Anthony
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2003&volume=3&issue=1&spage=3
    • description - <p>Abstract</p> <p>Background</p> <p>Recent data indicate increasing rates of adult obesity and mortality from cardiovascular disease (CVD) in Greece. No data, however, are available on prevalence of overweight and obesity in relation to CVD risk factors among young adults in Greece.</p> <p>Methods</p> <p>A total of 989 third-year medical students (527 men, 462 women), aged 22 ± 2 years, were recruited from the University of Crete during the period 1989&#8211;2001. Anthropometric measures and blood chemistries were obtained. The relationships between obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHpR], waist-to-height ratio [WHtR]) and CVD risk factor variables (blood pressure, glucose, serum lipoproteins) were investigated.</p> <p>Results</p> <p>Approximately 40% of men and 23% of women had BMI &#8805; 25.0 kg/m<sup>2</sup>. Central obesity was found in 33.4% (average percentage corresponding to WC &#8805; 90 cm, WHpR &#8805; 0.9 and WHtR &#8805; 50.0) of male and 21.7% (using WC &#8805; 80 cm, WHpR &#8805; 0.8, WHtR &#8805; 50.0) of female students. Subjects above the obesity indices cut-offs had significantly higher values of CVD risk factor variables. BMI was the strongest predictor of hypertension. WHtR in men and WC in women were the most important indicators of dyslipidaemia.</p> <p>Conclusion</p> <p>A substantial proportion of Greek medical students were overweight or obese, obesity status being related to the presence of hypertension and dyslipidaemia. Simple anthropometric indices can be used to identify these CVD risk factors. Our results underscore the need to implement health promotion programmes and perform large-scale epidemiological studies within the general Greek young adult population.</p>
  210. Distribution of Serum Total Homocysteine and Its Association with Diabetes and Cardiovascular Risk Factors of the Insulin Resistance Syndrome in Mexican American Men: The Third National Health and Nutrition Examination Survey
    • date - 2003
    • creator - Gillum Richard
    • provider - NSDL OAI Repository
    • location - http://www.nutritionj.com/content/2/1/6
    • description - <p>Abstract</p> <p>Background</p> <p>Few data have been published on the association of variables of the insulin resistance syndrome and serum total homocysteine (tHcy), a putative risk factor for cardiovascular morbidity, in representative samples of total populations or in Hispanic Americans.</p> <p>Methods</p> <p>To describe the distributions of serum tHcy concentration and variables associated with insulin resistance in Mexican American men and to assess their association, data from a cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey were analyzed. Analyses were restricted to Mexican American men aged 40&#8211;74 years with data on glycated hemoglobin (%), body mass index (BMI), body fat distribution, HDL cholesterol, fasting serum insulin, serum triglycerides and serum tHcy concentrations.</p> <p>Results</p> <p>Cumulative distributions of serum tHcy shifted to the right with increasing age. Log serum tHcy was not associated with prevalence of diagnosed diabetes mellitus or glycated hemoglobin percent or other risk factors other than age. Log serum tHcy concentration showed borderline significant (p = 0.049) positive association with fasting serum insulin concentration independent of age and BMI, only in men aged 60&#8211;74.</p> <p>Conclusion</p> <p>No consistent association of tHcy with diabetes prevalence or variables of the insulin resistance syndrome were found in Mexican American men aged 40&#8211;74 years. Further research is needed on the associations of serum tHcy concentration with insulin resistance and other components of the insulin resistance syndrome in persons of varying ethnicity.</p>
  211. Prevalence of Risk Factors for Coronary Artery Disease in the Brazilian State of Rio Grande do Sul
    • date - 2002
    • creator - Gus Iseu
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2002000500005
    • description - OBJECTIVE - To determine the risk factors prevalence for coronary artery disease in the State of Rio Grande do Sul, Brazil and to identify their relation with the age bracket. METHODS - We carried out an observational, cross-sectional study of 1,066 adults older than 20 years in the Brazilian State of Rio Grande do Sul. We investigated the risk factors: familial antecedents, systemic arterial hypertension, high levels of cholesterol and glycemia, overweight/obesity, smoking and sedentary lifestyle. A standardized questionnaire completed at the patients' dwellings by health agents were used; the data were stored in an EPI-INFO software database. The results were expressed with a 95% confidence interval. RESULTS - The sample composition was of 51.8% females. The risk factors prevalences were: 1) sedentary lifestyle 71.3%; 2) familial antecedents: 57.3%; 3) overweight/obesity (body mass index >25): 54.7%; 4) smokers: 33.9%; 5) hypertension: 31.6% (considering >140/90mmHg) and 14.4% (considering >160/95mmHg); 6) high glycemia (>126 mg/dL): 7%; 7) high cholesterol >240 mg/dL): 5.6%. CONCLUSION - The prevalence of the major risk factors for coronary artery disease in the Brazilian state of Rio Grande do Sul could be determined in a study that integrated public and private institutions.
  212. Risk factors for atherosclerosis in students of a private university in São Paulo - Brazil
    • date - 1999
    • creator - Rabelo Lísia Marcílio
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=1999&volume=72&issue=5&spage=575
    • description - OBJECTIVE: To characterize the risk profile for atherosclerosis (AS) in adolescents and young adults of a private university in São Paulo. METHODS: Clinical, nutritional, and laboratory parameters were evaluated in 209 students of both genders aged 17 to 25 years. In addition to determination of the lipid profile, the association of its abnormal values with other risk factors for AS was also investigated. RESULTS: Increased levels of total cholesterol, LDL-C and triglycerides (TG) were observed in 9.1%, 7.6% and 16.3% of the students, respectively, and decreased levels of HDL-C in 8.6% of them. Prevalence of the remaining risk factors analyzed was elevated: sedentary life style (78.9%); high intake of total fat (77.5%); high cholesterol intake (35.9%); smoking, hypertension (15.8%) and obesity (7.2%). There was an association between elevated LDL-C and TG levels and sedentary life style and body mass index. CONCLUSION: The high prevalence of risk factors for AS in young individuals draws attention to the need for adopting preventive plans.
  213. Risk factors for hepatitis B virus infection in Rio de Janeiro, Brazil
    • date - 2002
    • creator - Yoshida Clara
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2002&volume=2&issue=1&spage=26
    • description - <p>Abstract</p> <p>Background</p> <p>Despite international efforts to prevent hepatitis B virus (HBV) infection through global vaccination programs, new cases are still being reported throughout the world.</p> <p>Methods</p> <p>To supply data that might assist in improving preventive measures and national surveillance for HBV infection, a cross-sectional study was conducted among individuals referred to the Brazilian National Reference Center for Viral Hepatitis (Rio de Janeiro) during a two-year period. Reported risk factors among infected subjects ("HBV-positive") were compared to those of subjects never exposed ("HBV-negative") to HBV. Two subgroups were further identified within the HBV-positive group, "acute" infection and "non-acute" infection.</p> <p>Results</p> <p>A total of 1,539 subjects were tested for HBV, of which 616 were HBV-positive (79 acute infection and 537 non-acute infection). HBV-positive subjects were more likely to be of male gender (63% versus 47%); and to report multiple sexual partners (12% versus 6%) and illicit drug use (IDU and/or intranasal cocaine use) (6% versus 3%). Among the HBV-positive subgroups, age differed significantly, with 48% being under 30 years of age in subjects acutely infected compared to 17% in those with non-acute infection.</p> <p>Conclusions</p> <p>The association of multiple sexual partners with past HBV infection and the age distribution of currently infected subjects suggest that sexual transmission played a major role in the transmission of HBV in this study population. Thus, vaccination during adolescence should be considered.</p>
  214. Cardiovascular disease, risk factors and heart rate variability in the elderly general population: Design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) Study
    • date - 2005
    • creator - Schumann Barbara
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2261/5/33
    • description - <p>Abstract</p> <p>Background</p> <p>The increasing burden of cardiovascular diseases (CVD) in the ageing population of industrialized nations requires an intensive search for means of reducing this epidemic. In order to improve prevention, detection, therapy and prognosis of cardiovascular diseases on the population level in Eastern Germany, it is necessary to examine reasons for the East-West gradient of CVD morbidity and mortality, potential causal mechanisms and prognostic factors in the elderly.</p> <p>Psychosocial and nutritional factors have previously been discussed as possible causes for the unexplained part of the East-West gradient. A reduced heart rate variability appears to be associated with cardiovascular disease as well as with psychosocial and other cardiovascular risk factors and decreases with age. Nevertheless, there is a lack of population-based data to examine the role of heart rate variability and its interaction with psychosocial and nutritional factors regarding the effect on cardiovascular disease in the ageing population. There also is a paucity of epidemiological data describing the health situation in Eastern Germany. Therefore, we conduct a population-based study to examine the distribution of CVD, heart rate variability and CVD risk factors and their associations in an elderly East German population. This paper describes the design and objectives of the CARLA Study.</p> <p>Methods/design</p> <p>For this study, a random sample of 45&#8211;80 year-old inhabitants of the city of Halle (Saale) in Eastern Germany was drawn from the population registry. By the end of the baseline examination (2002&#8211;2005), 1750 study participants will have been examined. A multi-step recruitment strategy aims at achieving a 70 % response rate.</p> <p>Detailed information is collected on own and family medical history, socioeconomic, psychosocial, behavioural and biomedical factors. Medical examinations include anthropometric measures, blood pressure of arm and ankle, a 10-second and a 20-minute electrocardiogram, a general physical examination, an echocardiogram, and laboratory analyses of venous blood samples. On 200 participants, a 24-hour electrocardiogram is recorded. A detailed system of quality control ensures high data quality. A follow-up examination is planned.</p> <p>Discussion</p> <p>This study will help to elucidate pathways to CVD involving autonomic dysfunction and lifestyle factors which might be responsible for the CVD epidemic
  215. RISK FACTORS FOR DELIRIUM IN PATIENTS WITH IN CORONARY BYPASS OPERATION
    • date - 2004
    • creator - Suheyla Unal
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=13008773&date=2004&volume=42&issue=4&spage=182
    • description - Purpose: Etiopathogenesis of delirium still remains to be unclear, although some of underlying factors may causes death in most of the patients. We aimed to investigate risk factors for delirium prospectively. Method: We included 50 patients with coronary illnesses who will undergo bypass operation. Patients were interviewed semistructurally, subsequently assessed psychometrically via Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Mini-Menthal- State-Examination (MMSE) and State-Trait Anxiety Inventory (STAI) in preoperation period. Blood for full biochemical, hemogram were taken preoperationally and postoperationally. Findings: 37 male, 50 patients totally were accepted to our study. The mean age of the patients was 59.8±10.6. 12 (24%) of the patients had delirium diagnose. Delirium was improved in the first post operation day in 11 (91.7%) of the 12 delirium patients. There were no statistically significances between two groups among sociodemoghraphic data, HAMD; HAMA; STAI scores; blood parameters. MMSE scores were significantly lower in delirium group than nondelirium group pre and post operationally. There were statistically significances between two groups among cross clamp duration in intraoperation and amount of cardioplegia. Discussion and Conclusion: Our study is investigated the risk factors for delirium in coronary bypass surgery patients. Our study reveals that delirium incidence is %24 in coronary by pass operation, delirium develops especially in the first post operation day; delirium incidence is more frequent in patients with lower MMSE scores preoperationally, in patients to whom longer cross-clamps duration and excess cardioplegia were administered.
  216. Risk factors in coronary atherosclerosis athero-inflammation: the meeting point
  217. Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation
    • date - 2000
    • creator - Bellotti Giovanni
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2000&volume=75&issue=5&spage=421
    • description - OBJECTIVE: To study the influence of immune and nonimmune risk factors on the development of allograft vasculopathy after cardiac transplantation. METHODS: We studied 39 patients with a mean age of 46±12 years. The following variables were analyzed: weight (kg), body mass index (kg/m²), donor's age and sex, rejection episodes in the first and second years after transplantation, systolic and diastolic blood pressures (mmHg), total cholesterol and fractions (mg/dL), triglycerides (mg/dL), diabetes, and cytomegalovirus infection. The presence of allograft vasculopathy was established through coronary angiography. RESULTS: Allograft vasculopathy was observed in 15 (38%) patients. No statistically significant difference was observed between the two groups in regard to hypertension, cytomegalovirus infection, diabetes, donor's sex and age, rejection episodes in the first and second years after transplantation, and cholesterol levels. We observed a tendency toward higher levels of triglycerides in the group with disease. Univariate and multivariate analyses showed statistically significant differences between the two groups when we analyzed the body mass index (24.53±4.3 versus 28.11±4.6; p=0.019). CONCLUSION: Body mass index was an important marker of allograft vasculopathy in the population studied.
  218. Prevalence of dyslipidemia and risk factors in Campos dos Goytacazes, in the Brazilian State of Rio de Janeiro
    • date - 2003
    • creator - Reis Aldo Franklin Ferreira
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2003&volume=81&issue=3&spage=257
    • description - OBJECTIVE: To determine the prevalence of dyslipidemias in adults in the city of Campos dos Goytacazes, in the Brazilian state of Rio de Janeiro, and to identify its relation to risk factors. METHODS: Cross-sectional, population-based, observational study with sampling through conglomerates and stratified according to socioeconomic levels, sex, and age, with 1,039 individuals. Risk factors, familial history, blood pressure, anthropometric measurements, glucose, triglycerides and cholesterol were determined. RESULTS: The following prevalences were observed: of dyslipidemias 24.2%; of hypercholesterolemia, 4.2%; of elevated LDL-C, 3.5%; of low HDL-C, 18.3%; and of hypertriglyceridemia, 17.1%. The following mean levels were observed: cholesterol, 187.6± 33.7 mg/dL; LDL-C, 108.7±26.8 mg/dL; HDL-C, 48.5±7.7 mg/dL; and triglycerides, 150.1±109.8 mg/dL. The following variables showed a positive correlation with dyslipidemia: increased age (P<0.001), male sex (P<0.001), low familial income (P<0.001), familial history (P<0.01), overweight/obesity (P<0.001), waist measure (P<0.001), high blood pressure (P<0.001), and diabetes mellitus (P<0.001). The following variables had no influence on dyslipidemias: ethnicity, educational level, smoking habits, and sedentary lifestyle. CONCLUSION: The frequency of lipid changes in the population studied was high, suggesting that measures for the early diagnosis should be taken, in association with implementation of programs for primary and secondary prevention of atherosclerosis.
  219. Hepatitis C virus seroprevalence and risk factors among patients with HIV infection
    • date - 2001
    • creator - BARONE Antonio Alci
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652001000100003
    • description - The objective of this study was to evaluate the prevalence and risk factors associated with HCV infection in a group of HIV seropositive patients. We analyzed the medical records of 1,457 patients. All patients were tested for HCV infection by third generation ELISA. Whenever possible, a sample of the positive patients was also tested for HCV by PCR. HCV positive patients were analyzed according to their risk factors for both infections. The prevalence of anti-HCV positive patients was 17.7% (258 patients). Eighty-two (82) of these patients were also tested by PCR and 81 were positive for HCV virus (98%). One hundred fifty-one (58.5%) were intravenous drug users (IDU); 42 (16.3%) were sexual partners of HIV patients; 23 (8.9%) were homosexual males; 12 (4.7%) had received blood transfusion; 61 (17.5%) had promiscuous sexual habits; 14 (5.4%) denied any risk factor; 12 (4.7%) were sexual partners of IDU. Two hundred four patients mentioned only one risk factor. Among them, 28 (10.9%) were sexual partners of HIV-positive patients. Although intravenous drug use was the most important risk factor for co-infection, sexual transmission seemed to contribute to the high HCV seroprevalence in this group of patients.
  220. NATURAL DISASTER EXPERIENCES AND POSTTRAUMATIC STRESS DISORDER: RISK FACTORS AND PREVALENCE
    • date - 2002
    • creator - Gamze Akyuz
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=13008773&date=2002&volume=40&issue=1&spage=25
    • description - Objective: Trauma and disasters are the conditions of our daily life that occur out of desires.Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder appearing after a traumaticexperience having disastrous quality, which lasts at least one month, and characterized byfrequent involuntary remembrance of the traumatic condition, escape behaviors from the conditionsreminding the traumatic event and anxiety symptoms. In this article the objective is toreview the risk factors of this disorder and prevalence of PTSD appearing after the traumaticexperiences, which were especially important from the point of the quality of psychiatric servicesafter a natural disaster.Results: Female gender, presence of psychiatric disorder in the family and past history of thepatient in pre-traumatic period, personal hopelessness, absence of social support, past-disastermoving, loss of business and property, low socioeconomic level, presence of history oftrauma in childhood period, severity, duration and frequency of natural disaster have all beeninformed as risk factors for PTSD appearing after natural disasters. Lifetime prevalence ofPTSD is between 1-14%, risk related to the conditions in posttraumatic period is 9.2%, andprevalence in the people under risk is 3-58%. PTSD prevalence has been estimated as 32%in 1974 and 7% in 1990 after the Buffalo Creek torrent disaster; also PTSD prevalence afterAndrews cycle in 1992 has been estimated as 33% just after the disaster and 24% sixmonths after the disaster. In our country PTSD prevalence after the earthquake disasterwhich occurred 1999 August 17th has been found 55.9%, 76.6% in different studies respectivelyand 25-45% among children.Discussion: When the literature concerning the issue was reviewed it as seen that risk factorsfor PTSD developed after natural disasters were identified relatively better but differentresults were obtained about the prevalences. These different results for prevalences might berelated to evaluation methods and sampling groups in surveys.Conclusion: PTSD prevalence and related risk factors are necessary to be known to giveprofessional intervention and services after natural disasters and it can be said that improvementin social and physical supporting system might decrease long term negative results oftrauma.
  221. Toxoplasma gondii infection: relationship between seroprevalence and risk factors among inhabitants in two offshore islands from Taiwan.
    • date - 2001
    • creator - Kao TC
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0386300X&date=2001&volume=55&issue=5&spage=301
    • description - A seroepidemiological study of toxoplasmosis among inhabitants of Penghu Island and Kinmen Island offshore of Taiwan was performed using the latex agglutination test from July 1999 to June 2000. In order to determine risk factors for Toxoplasma gondii (T. gondii) infection, the effects of a history of eating raw/undercooked meats and raising pets were focused on using a self-administrated questionnaire. The seroprevalence (28.2%; 190/673) in Kinmen Island was significantly higher than that (2.71%; 8/293) in Penghu Island (P < 0.001). A significant difference in seroprevalence between both sexes was found in Kinmen Island (P < 0.05), but not in Penghu Island. The results of multiple logistic regression analysis showed that the older the age, the higher the OR in both Islands, yet a significant difference in seroprevalence between children and adults or the elderly was observed in Kinmen Island (P < 0.001). Moreover, those who had histories of raising cats or eating raw/undercooked meats seemed to have greater opportunities to become infected with T. gondii (OR = 2.9, 95% CI = 1.9-4.5, P < 0.001; OR = 1.5, 95% CI = 1.1-2.1, P < 0.05). In Penghu Island, a significant association between seroprevalence and a history of raising cats was also observed (OR = 4.6, 95% CI = 1.1-20.1, P < 0.05). Furthermore, workers, farmers, and fishermen seemed to be more susceptible to T. gondii infection than students in Kinmen Island.
  222. <it>Pseudomonas aeruginosa </it>bloodstream infections: risk factors and treatment outcome related to expression of the PER-1 extended-spectrum beta-lactamase
    • date - 2006
    • creator - Endimiani Andrea
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712334&date=2006&volume=6&issue=1&spage=52
    • description - <p>Abstract</p> <p>Background</p> <p>Bloodstream infection (BSI) due to Pseudomonas aeruginosa (Pa) has relevant clinical impact especially in relation to drug resistance determinants. The PER-1 extended-spectrum beta-lactamase (ESBL) is a common enzyme conferring high-level resistance to anti-pseudomonal cephalosporins. Risk factors and treatment outcome of BSI episodes caused by PER-1-positive Pa (PER-1-Pa) strains were compared to those caused by ESBL-negative Pa isolates (ESBL-N-Pa).</p> <p>Methods</p> <p>Twenty-six BSI cases due to ceftazidime-resistant Pa strains have been investigated. MIC values of anti-pseudomonal drugs were determined by the Etest method (AB Biodisk, Solna, Sweden). The double-disk synergy test was used to detect ESBL production. PCR amplification and DNA sequencing were used to characterize ESBL types. Clinical records of BSI-patients were examined retrospectively. Demographic data, underlying diseases (McCabe-Jackson classification and Charlson weighted index), risk factors, antimicrobial therapy, and treatment outcome were evaluated in cases due to ESBL-positive and cases due to ESBL-N-Pa isolates. Unpaired Student's t-test, Mann-Whitney U-test, Fisher's exact test and the &#967;<sup>2 </sup>test were used for statistical analysis.</p> <p>Results</p> <p>Nine Pa isolates expressed the PER-1 ESBL; the remaining 17 isolates did not produce ESBLs. Severe sepsis (<it>P </it>= 0.03), bladder and intravascular catheters (both <it>P </it>= 0.01), immunosuppressive therapy (<it>P </it>= 0.04), and mechanical ventilation (<it>P </it>= 0.03) were significantly associated with BSI due to PER-1-Pa. Empirical treatment (<it>P </it>= 0.02) and treatment after ID/AST (<it>P </it>< 0.01) were rarely adequate in PER-1-Pa cases. With regard to treatment outcome, 77.8% BSI cases due to PER-1-Pa <it>vs</it>. 28.6% cases due to ESBL-N-Pa isolates failed to respond (<it>P </it>< 0.03). All cases due to PER-1-Pa that were treated with carbapenems (alone or in combination with amikacin) failed to respond. In contrast, 7/8 cases due to ESBL-N-Pa given carbapenems were responders.</p> <p>Conclusion</p> <p>Therapeutic failure and increased hospital costs are associated with BSI episodes caused by PER-1-Pa strains. Thus, recognition and prompt reporting of ESBL-production appears a critical factor for the management of patients with serious <it>P. aeruginosa </it>infections.</p>
  223. Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment [ISRCTN08045231]
    • date - 2006
    • creator - Crank Helen
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712407&date=2006&volume=6&issue=1&spage=35
    • description - <p>Abstract</p> <p>Background</p> <p>Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival.</p> <p>Methods/design</p> <p>Following ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored.</p> <p>Discussion</p> <p>This research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives.</p>
  224. Risk factors and in-hospital outcomes in stroke and myocardial infarction patients
    • date - 2004
    • creator - Ivanusa Mario
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2004&volume=4&issue=1&spage=26
    • description - <p>Abstract</p> <p>Background</p> <p>Acute stroke (AS) and acute myocardial infarction (AMI) share major risk factors such as age, gender, and high blood pressure. The main objective of this study was to compare vascular risk factor profiles with in-hospital outcomes in AS and AMI patients.</p> <p>Methods</p> <p>We evaluated 486 consecutive patients who were admitted to Bjelovar General Hospital with diagnoses of AS (ischaemic stroke or intracerebral haemorrhage; N = 380) or AMI (N = 106) during a one year period. The frequency of risk factors and in-patient mortality rates were assessed in both groups. For statistical analysis we used t-tests and &#967;<sup>2 </sup>tests.</p> <p>Results</p> <p>AS patients were significantly older than AMI patients: the mean age for AS patients was 68.9 ± 9.1 years, and for AMI patients was 62.8 ± 11.7 years (p < 0.001). AMI was significantly more common than AS in patients younger than 65 years; 51% of this group had AMI and 26% had AS (p < 0.001). Hypertension was a more common risk factor in AS patients (69% AS patients vs. 58% AMI patients; p = 0.042). Patients who died did not differ significantly in age between the groups. In-patient mortality rates were significantly higher in AS than AMI cases (31% vs. 12%, p < 0.001 for all patients; 37% vs.5%, p < 0.001 for men). Women hospitalized for AMI were more likely to die in hospital than men (28% vs. 5%; p = 0.002).</p> <p>Conclusions</p> <p>We found that age at the time of presentation was a significant differentiating factor between patients with AS and AMI. The only exceptions were women, whose ages at the onset of AS and AMI were similar. In contrast, patients who died did not differ significantly in age. We observed significantly higher inpatient mortality for men (when adjusted for age) than for women with AS. The five-fold higher in-patient mortality rate in women than in men with AMI is most likely to have resulted from other factors related to treatment.</p>
  225. Prevalence of risk factors for HIV infection among Mexican migrants and immigrants: probability survey in the north border of Mexico
    • date - 2006
    • creator - Izazola-Licea Jose A.
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342006000100003
    • description - OBJECTIVE: To estimate the prevalence of risk factors for HIV infection among Mexican migrants and immigrants (MMIs) in different geographic contexts, including the sending communities in Mexico, the receiving communities in the United States (US), and the Mexican North border region. MATERIAL AND METHODS: We conducted a probability survey among MMIs traveling through key border crossing sites in the Tijuana (Baja California, Mexico)-San Diego (California, US) border region (N=1 429). RESULTS: The survey revealed substantial rates of reported sexually transmitted infections, needle-sharing and sexual risk practices in all migration contexts. CONCLUSIONS: The estimated levels of HIV risk call for further binational research and preventive interventions in all key geographic contexts of the migration experience to identify and tackle the different personal, environmental, and structural determinants of HIV risk in each of these contexts.
  226. Risk factors for early infant mortality in Sarlahi district, Nepal
    • date - 2003
    • creator - Shrestha Sharada Ram
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862003001000006
    • description - OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15 469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR =1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR =1.85, 95% CI 1.24-2.75). A larger maternal mid_upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR =11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy.
  227. Meta analysis of risk factors for colorectal cancer.
    • date - 2003
    • creator - Zhao YW
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2003&volume=9&issue=7&spage=1598
    • description - <br>AIM: To study the risk factors for colorectal cancer in China. <br>METHODS: A meta-analysis of the risk factors of colorectal cancer was conducted for 14 case-control studies, and reviewed 14 reports within 13 years which included 5034 cases and 5205 controls. Dersimonian and Laird random effective models were used to process the results. <br>RESULTS: Meta analysis of the 14 studies demonstrated that proper physical activities and dietary fibers were protective factors (pooled OR<0.8), while fecal mucohemorrhage, chronic diarrhea and polyposis were highly associated with colorectal cancer (all pooled OR>4). The stratified results showed that different OR values of some factors were due to geographic factors or different resources. <br>CONCLUSION: Risks of colorectal cancer are significantly associated with the histories of intestinal diseases or relative symptoms, high lipid diet, emotional trauma and family history of cancers. The suitable physical activities and dietary fibers are protective factors.
  228. Postoperative adjuvant arterial chemoembolization improves survival of hepatocellular carcinoma patients with risk factors for residual tumor: a retrospective control study.
    • date - 2004
    • creator - Lin ZY
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10079327&date=2004&volume=10&issue=19&spage=2791
    • description - <br>AIM: To evaluate the effect of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on the prognosis of hepatocellular carcinoma (HCC) patients with or without risk factors for the residual tumor. <br>METHODS: From January 1995 to December 1998, 549 consecutive HCC patients undergoing surgical resection were included in this research. There were 185 patients who underwent surgical resection with adjuvant TACE and 364 patients who underwent surgical resection only. Tumors with a diameter more than 5 cm, multiple nodules, and vascular invasion were defined as risk factors for residual tumor and used for patient stratification. Kaplan-Meier method was used to analyze survival curve and Cox proportional hazard model was used to evaluate the prognostic significance of adjuvant TACE. <br>RESULTS: In the patients without any risk factors for the residual tumor, the 1-, 3-, 5-year survival rates were 93.48%, 75.85%, 62.39% in the control group and 97.39%, 70.37%, 50.85% in the adjuvant TACE group, respectively. There was no significant difference in the survival between two groups (P = 0.3956). However, in the patients with risk factors for residual tumor, postoperative adjuvant TACE significantly prolonged the patients' survival. There was a statistically significant difference in survival between two groups (P = 0.0216). The 1-, 3-, 5-year survival rates were 69.95%, 49.86%, 37.40% in the control group and 89.67%, 61.28%, 44.36% in the adjuvant TACE group, respectively. Cox proportional hazard model showed that tumor diameter and cirrhosis, but not the adjuvant TACE, were the significantly independent prognostic factors in the patients without risk factors for residual tumor. However, in the patients with risk factors for residual tumor adjuvant TACE, and also tumor diameter, AFP level, vascular invasion, were the significantly independent factors associated with the decreasing risk for patients' death from HCC. <br>CONCLUSION: Postoperative adjuvant TACE can prolong the survival of patients with risk factors for residual tumor, but can not prolong the survival of patients without risk factors for residual tumor.
  229. Plasma lipids and other cardiovascular risk factors in Costa Rican adolescents
    • date - 2000
    • creator - Rifai Nader
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=10204989&date=2000&volume=8&issue=4&spage=234
    • description - This study assessed plasma lipids and other cardiovascular risk factors in adolescents in a developing Latin American country and compared those risk factors to those of adolescents in the United States of America, where the risk of heart disease is high. In a cross-sectional study, data were collected from September 1998 to April 1999 on 161 Costa Rican adolescents between the ages of 12 and 20. A general questionnaire was used to collect demographic, smoking, socioeconomic, and women's health data. Anthropometric measurements, blood pressure, and a fasting blood sample were taken. The Costa Rican males had lower levels of total cholesterol than did the Costa Rican females (mean ± standard error of the mean (SEM), 149 ± 6.5 mg/dL vs. 158 ± 6.3 mg/dL). This was mainly due to lower high-density lipoprotein (HDL) cholesterol in males than in females (mean ± SEM, 38 ± 2.0 mg/dL vs. 44 ± 2.4 mg/dL). As compared to the United States, adolescents in this study had lower levels of total cholesterol, largely due to lower HDL cholesterol. Both genders of Costa Ricans had levels of low-density lipoprotein (LDL) cholesterol that were similar to those of counterpart groups in the United States. Costa Rican male and female adolescents had higher LDL/HDL ratios than did their United States counterparts. Therefore, as compared to the United States, Costa Rican adolescents have an adverse lipid profile as demonstrated by a higher LDL/HDL ratio. Overweight prevalence in Costa Rica was 13%, approaching the 15% overall level of the United States.
  230. An <it>IGF-I promoter </it>polymorphism modifies the relationships between birth weight and risk factors for cardiovascular disease and diabetes at age 36
    • date - 2005
    • creator - Twisk Jos
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14726823&date=2005&volume=5&issue=1&spage=5
    • description - <p>Abstract</p> <p>Objective</p> <p>To investigate whether <it>IGF-I promoter </it>polymorphism was associated with birth weight and risk factors for cardiovascular disease (CVD) and type 2 diabetes (T2DM), and whether the birth weight &#8211; risk factor relationship was the same for each genotype.</p> <p>Design and participants</p> <p>264 subjects (mean age 36 years) had data available on birth weight, IGF-I promoter polymorphism genotype, CVD and T2DM risk factors. Student's t-test and regression analyses were applied to analyse differences in birth weight and differences in the birth weight &#8211; risk factors relationship between the genotypes.</p> <p>Results</p> <p>Male variant carriers (VCs) of the <it>IGF-I promoter </it>polymorphism had a 0.2 kg lower birth weight than men with the wild type allele (p = 0.009). Of the risk factors for CVD and T2DM, solely LDL concentration was associated with the genotype for the polymorphism. Most birth weight &#8211; risk factor relationships were stronger in the VC subjects; among others the birth weight &#8211; systolic blood pressure relationship: 1 kg lower birth weight was related to an 8.0 mmHg higher systolic blood pressure</p> <p>Conclusion</p> <p>The polymorphism in the promoter region of the <it>IGF-I gene </it>is related to birth weight in men only, and to LDL concentration only. Furthermore, the genotype for this polymorphism modified the relationships between birth weight and the risk factors, especially for systolic and diastolic blood pressure.</p>
  231. Exploring cancer register data to find risk factors for recurrence of breast cancer &#8211; application of Canonical Correlation Analysis
    • date - 2005
    • creator - Shahsavar Nosrat
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14726947&date=2005&volume=5&issue=1&spage=29
    • description - <p>Abstract</p> <p>Background</p> <p>A common approach in exploring register data is to find relationships between outcomes and predictors by using multiple regression analysis (MRA). If there is more than one outcome variable, the analysis must then be repeated, and the results combined in some arbitrary fashion. In contrast, Canonical Correlation Analysis (CCA) has the ability to analyze multiple outcomes at the same time.</p> <p>One essential outcome after breast cancer treatment is recurrence of the disease. It is important to understand the relationship between different predictors and recurrence, including the time interval until recurrence. This study describes the application of CCA to find important predictors for two different outcomes for breast cancer patients, loco-regional recurrence and occurrence of distant metastasis and to decrease the number of variables in the sets of predictors and outcomes without decreasing the predictive strength of the model.</p> <p>Methods</p> <p>Data for 637 malignant breast cancer patients admitted in the south-east region of Sweden were analyzed. By using CCA and looking at the structure coefficients (loadings), relationships between tumor specifications and the two outcomes during different time intervals were analyzed and a correlation model was built.</p> <p>Results</p> <p>The analysis successfully detected known predictors for breast cancer recurrence during the first two years and distant metastasis 2&#8211;4 years after diagnosis. Nottingham Histologic Grading (NHG) was the most important predictor, while age of the patient at the time of diagnosis was not an important predictor.</p> <p>Conclusion</p> <p>In cancer registers with high dimensionality, CCA can be used for identifying the importance of risk factors for breast cancer recurrence. This technique can result in a model ready for further processing by data mining methods through reducing the number of variables to important ones.</p>
  232. Family History, Diabetes, and Other Demographic and Risk Factors Among Participants of the National Health and Nutrition Examination Survey 1999–2002
    • date - 2005
    • creator - Michelle L. Cook, MPH
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=15451151&date=2005&volume=2&issue=2&spage=
    • description - Introduction Family history of diabetes has been recognized as an important risk factor of the disease. Family medical history represents valuable genomic information because it characterizes the combined interactions between environmental, behavioral, and genetic factors. This study examined the strength and effect of having a family history of diabetes on the prevalence of self-reported, previously diagnosed diabetes among adult participants of the National Health and Nutrition Examination Survey 1999–2002. Methods The study population included data from 10,283 participants aged 20 years and older. Gender, age, race/ethnicity, poverty income ratio, education level, body mass index, and family history of diabetes were examined in relation to diabetes status. Diabetes prevalence estimates and odds ratios of diabetes were calculated based on family history and other factors. Results The prevalence of diabetes among individuals who have a first-degree relative with diabetes (14.3%) was significantly higher than that of individuals without a family history (3.2%), corresponding to a crude odds ratio of five. Both prevalence and odds ratio estimates significantly increased with the number of relatives affected with diabetes. Family history was also associated with several demographic and risk factors. Conclusion Family history of diabetes was shown to be a significant predictor of diabetes prevalence in the adult U.S. population. We advocate the inclusion of family history assessment in public health prevention and screening programs as an inexpensive and valuable source of genomic information and measure of diabetes risk.
  233. Low back pain risk factors in a large rural Australian Aboriginal community. An opportunity for managing co-morbidities?
    • date - 2005
    • creator - Jamison Jennifer
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=17461340&date=2005&volume=13&issue=1&spage=21
    • description - <p>Abstract</p> <p>Background</p> <p>Low back pain (LBP) is the most prevalent musculo-skeletal condition in rural and remote Australian Aboriginal communities. Smoking, physical inactivity and obesity are also prevalent amongst Indigenous people contributing to lifestyle diseases and concurrently to the high burden of low back pain.</p> <p>Objectives</p> <p>This paper aims to examine the association between LBP and modifiable risk factors in a large rural Indigenous community as a basis for informing a musculo-skeletal and related health promotion program.</p> <p>Methods</p> <p>A community Advisory Group (CAG) comprising Elders, Aboriginal Health Workers, academics, nurses, a general practitioner and chiropractors assisted in the development of measures to assess self-reported musculo-skeletal conditions including LBP risk factors. The Kempsey survey included a community-based survey administered by Aboriginal Health Workers followed by a clinical assessment conducted by chiropractors.</p> <p>Results</p> <p>Age and gender characteristics of this Indigenous sample (n = 189) were comparable to those reported in previous Australian Bureau of Statistics (ABS) studies of the broader Indigenous population. A history of traumatic events was highly prevalent in the community, as were occupational risk factors. Thirty-four percent of participants reported a previous history of LBP. Sporting injuries were associated with multiple musculo-skeletal conditions, including LBP. Those reporting high levels of pain were often overweight or obese and obesity was associated with self-reported low back strain. Common barriers to medical management of LBP included an attitude of being able to cope with pain, poor health, and the lack of affordable and appropriate health care services.</p> <p>Though many of the modifiable risk factors known to be associated with LBP were highly prevalent in this study, none of these were statistically associated with LBP.</p> <p>Conclusion</p> <p>Addressing particular modifiable risk factors associated with LBP such as smoking, physical inactivity and obesity may also present a wider opportunity to prevent and manage the high burden of illness imposed by co-morbidities such as heart disease and type-2 diabetes.</p>
  234. Coronary heart disease clinical manifestation and risk factors in Japanese immigrants and their descendents in the city of São Paulo
    • date - 2003
    • creator - Mansur Antonio de Pádua
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0066782X&date=2003&volume=81&issue=3&spage=234
    • description - OBJECTIVE: To assess whether a difference exists in coronary heart disease clinical manifestations and the prevalence of risk factors between Japanese immigrants and their descendents in the city of São Paulo. METHODS: Retrospective analysis of coronary artery disease clinical manifestations and the prevalence of risk factors, comparing 128 Japanese immigrants (Japanese group) with 304 Japanese descendents (Nisei group). RESULTS: The initial manifestation of the disease was earlier in the Nisei group (mean = 53 years), a difference of 12 years when compared with that in the Japanese group (mean = 65 years) (P<0.001). Myocardial infarction was the first manifestation in both groups (P = 0.83). The following parameters were independently associated with early coronary events: smoking (OR = 2.25; 95% CI = 1.35-3.77; P<0.002); Nisei group (OR = 10.22; 95% CI = 5.64-18.5; P<0.001); and female sex (OR = 5.04; 95% CI = 2.66-9.52; P<0.001). CONCLUSION: The clinical presentation of coronary heart disease in the Japanese and their descendents in the city of São Paulo was similar, but coronary heart disease onset occurred approximately 12 years earlier in the Nisei group than in the Japanese group.
  235. Atrial fibrillation in chronic dialysis patients in the United states: risk factors for hospitalization and mortality
    • date - 2003
    • creator - Agodoa Lawrence
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712369&date=2003&volume=4&issue=1&spage=1
    • description - <p>Abstract</p> <p>Background</p> <p>The incidence and risk factors for hospitalized atrial fibrillation have not been previously assessed in a national population of dialysis patients.</p> <p>Methods</p> <p>We analyzed the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study (DMMS) Wave II in a historical cohort study of hospitalized atrial fibrillation. Data from 3374 patients who started dialysis in 1996 with valid follow-up times were available for analysis, censored at the time of renal transplantation and followed until November 2000. Cox Regression analysis was used to model factors associated with time to first hospitalization for atrial fibrillation (ICD9 code 427.31x) adjusted for comorbidities, demographic factors, baseline laboratory values, blood pressures, dialysis modality, and cardioprotective medications.</p> <p>Results</p> <p>The incidence density of atrial fibrillation was 12.5/1000 person years. Factors associated with atrial fibrillation were older age (> = 71 years vs. <48 years), extremes (both high and low) of pre-dialysis systolic blood pressure, dialysis modality (hemodialysis vs. peritoneal dialysis), and digoxin use. Baseline use of coumadin was associated with reduced mortality in patients later hospitalized for atrial fibrillation.</p> <p>Conclusions</p> <p>Dialysis patients had a high incidence of atrial fibrillation. This risk was largely segregated among those with established risk factors for atrial fibrillation, and hemodialysis patients. Use of coumadin was associated with improved survival among patients later hospitalized for atrial fibrillation.</p>
  236. Risk factors of infant and child mortality in rural Burkina Faso
    • date - 2004
    • creator - Kouyaté Bocar
    • provider - NSDL OAI Repository
    • location - http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000400008
    • description - OBJECTIVE: The aim of the study was to quantify the effect of risk factors for childhood mortality in a typical rural setting in sub- Saharan Africa. METHODS: We performed a survival analysis of births within a population under demographic surveillance from 1992 to 1999 based on data from a demographic surveillance system in 39 villages around Nouna, western Burkina Faso, with a total population of about 30 000. All children born alive in the period 1 January 1993 to 31 December 1999 in the study area (n = 10 122) followed-up until 31 December 1999 were included. All-cause childhood mortality was used as outcome variable. FINDINGS: Within the observation time, 1340 deaths were recorded. In a Cox regression model a simultaneous estimation of hazard rate ratios showed death of the mother and being a twin as the strongest risk factors for mortality. For both, the risk was most pronounced in infancy. Further factors associated with mortality include age of the mother, birth spacing, season of birth, village, ethnic group, and distance to the nearest health centre. Finally, there was an overall decrease in childhood mortality over the years 1993-99. CONCLUSION: The study supports the multi-causation of childhood deaths in rural West Africa during the 1990s and supports the overall trend, as observed in other studies, of decreasing childhood mortality in these populations. The observed correlation between the factors highlights the need for multivariate analysis to disentangle the separate effects. These findings illustrate the need for more comprehensive improvement of prenatal and postnatal care in rural sub-Saharan Africa.
  237. Age, body mass index and wrist index as risk factors for carpal tunnel syndrome and relationship to severity of nerve conduction abnormality
  238. Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil
    • date - 1999
    • creator - Schreier E.
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X1999000900009
    • description - Viral hepatitis constitutes a major health issue, with high prevalence among injecting drug users (IDUs). The present study assessed the prevalence and risk determinants for hepatitis B, C and D viruses (HBV, HCV and HDV) infections among 102 IDUs from Rio de Janeiro, Brazil. Serological markers and HCV-RNA were detected by enzyme immunoassay and nested PCR, respectively. HCV genotyping was determined by restriction fragment length polymorphism analysis (RFLP). HBsAg, anti-HBc and anti-HBs were found in 7.8, 55.8 and 24.7% of IDUs, respectively. In the final logistic regression, HBV infection was independently associated with male homosexual intercourse within the last 5 years (odds ratio (OR) 3.1; 95% confidence interval (CI) 1.1-8.8). No subject presented anti-delta (anti-HD). Anti-HCV was detected in 69.6% of subjects, and was found to be independently associated with needle sharing in the last 6 months (OR 3.4; 95% CI 1.3-9.2) and with longer duration of iv drug use (OR 3.1; 95% CI 1.1-8.7). These data demonstrate that this population is at high risk for both HBV and HCV infection. Among IDUs from Rio de Janeiro, unprotected sexual intercourse seems to be more closely associated with HBV infection, whereas HCV is positively correlated with high risk injecting behavior. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged.
  239. Risk factors for breast cancer: a systematic review of studies with female samples among the general population in Brazil
    • date - 2005
    • creator - Coutinho Evandro da Silva Freire
    • provider - NSDL OAI Repository
    • location - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2005000200002
    • description - A systematic review of studies was conducted to determine the characteristics of epidemiological research on risk factors for breast cancer in female samples from the general population in Brazil. Of the 23 articles identified, only 14 were selected for review. Most of the studies were from Southeast Brazil. Three were cross-sectional, conducted in specific populations, and 11 used case-control designs. The sample sizes varied from 40 to 164,269 women. Twenty-nine risk factors were researched, and among these, 11 were investigated in four or more studies. Nulliparity was the most frequent factor, found in 12 of the studies. Prevalence of the factors varied widely among the samples, and since the samples were heterogeneous and the studies presented several methodological limitations, a summary mean was not calculated.
  240. Sex differences in risk factors for coronary heart disease: a study in a Brazilian population
    • date - 2001
    • creator - Oliveira Helena
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2458/1/3
    • description - <p>Abstract</p> <p>Background</p> <p>In Brazil coronary heart disease (CHD) constitutes the most important cause of death in both sexes in all the regions of the country and interestingly, the difference between the sexes in the CHD mortality rates is one of the smallest in the world because of high rates among women. Since a question has been raised about whether or how the incidence of several CHD risk factors differs between the sexes in Brazil the prevalence of various risk factors for CHD such as high blood cholesterol, diabetes mellitus, hypertension, obesity, sedentary lifestyle and cigarette smoking was compared between the sexes in a Brazilian population; also the relationships between blood cholesterol and the other risk factors were evaluated.</p> <p>Results</p> <p>The population presented high frequencies of all the risk factors evaluated. High blood cholesterol (CHOL) and hypertension were more prevalent among women as compared to men. Hypertension, diabetes and smoking showed equal or higher prevalence in women in pre-menopausal ages as compared to men. Obesity and physical inactivity were equally prevalent in both sexes respectively in the postmenopausal age group and at all ages. CHOL was associated with BMI, sex, age, hypertension and physical inactivity.</p> <p>Conclusions</p> <p>In this population the high prevalence of the CHD risk factors indicated that there is an urgent need for its control; the higher or equal prevalences of several risk factors in women could in part explain the high rates of mortality from CHD in females as compared to males.</p>
  241. Genetics University of Toronto Thrombophilia Study in Women (GUTTSI): genetic and other risk factors for venous thromboembolism in women
    • date - 2001
    • creator - Cole David
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14686708&date=2001&volume=2&issue=3&spage=141
    • description - <p>Abstract</p> <p>Background</p> <p>Women may be at increased risk for venous thromboembolism (VTE) as compared with men. We studied the effects of genetic and biochemical markers of thrombophilia in women, in conjunction with other established risk factors for VTE.</p> <p>Method</p> <p>The present retrospective case-control study was conducted in a thrombosis treatment programme at a large Toronto hospital. The cases were 129 women aged 16-79 years with objectively confirmed VTE. Age-matched control individuals were women who were free of venous thrombosis. Neither cases nor control individuals had known cardiovascular disease. Participants were interviewed regarding personal risk factors for VTE, including smoking, history of malignancy, pregnancy, and oestrogen or oral contraceptive use. Blood specimens were analyzed for common single nucleotide polymorphisms of prothrombin, factor V and methylenetetrahydrofolate reductase (MTHFR; C677T, A1298C and T1317C), and the A66G polymorphism for methionine synthase reductase (MTRR).Fasting plasma homocysteine was also analyzed.</p> <p>Results</p> <p>Women with VTE were significantly more likely than female control individuals to carry the prothrombin polymorphism and the factor V polymorphism, or to have fasting hyperhomocysteinaemia. Homozygosity for the C677T MTHFR gene was not a significant risk factor for VTE, or were the A1298C or T1317C MTHFR homozygous variants. Also, the A66G MTRR homozygous state did not confer an increased risk for VTE.</p> <p>Conclusion</p> <p>Prothrombin and factor V polymorphisms increased the risk for VTE in women, independent from other established risk factors. Although hyperhomocysteinaemia also heightens this risk, common polymorphisms in two genes that are responsible for homocysteine remethylation do not. These findings are consistent with previous studies that included both men and women.</p>
  242. Inadequate Knowledge About Sexually Transmitted Diseases[STDS] And Risky Sexual Behaviour: The Risk Factors for Wild Spread Of STDS Among Youth in Developing Countries
  243. Diagnosis of alcoholism based on neural network analysis of phenotypic risk factors
    • date - 2005
    • creator - Falk Catherine
    • provider - NSDL OAI Repository
    • location - http://dx.doi.org/10.1186/1471-2156-6-S1-S131
    • description - <p>Abstract</p> <p>Background</p> <p>Alcoholism is a serious public health problem. It has both genetic and environmental causes. In an effort to gain understanding of the underlying genetic susceptibility to alcoholism, a long-term study has been undertaken. The Collaborative Study on the Genetics of Alcoholism (COGA) provides a rich source of genetic and phenotypic data. One ongoing problem is the difficulty of reliably diagnosing alcoholism, despite many known risk factors and measurements. We have applied a well known pattern-matching method, neural network analysis, to phenotypic data provided to participants in Genetic Analysis Workshop 14 by COGA. The aim is to train the network to recognize complex phenotypic patterns that are characteristic of those with alcoholism as well as those who are free of symptoms. Our results indicate that this approach may be helpful in the diagnosis of alcoholism.</p> <p>Results</p> <p>Training and testing of input/output pairs of risk factors by means of a "feed-forward back-propagation" neural network resulted in reliability of about 94% in predicting the presence or absence of alcoholism based on 36 input phenotypic risk factors. Pruning the neural network to remove relatively uninformative factors resulted in a reduced network of 14 input factors that was still 95% reliable. Some of the factors selected by the pruning steps have been identified as traits that show either linkage or association to potential candidate regions.</p> <p>Conclusion</p> <p>The complex, multivariate picture formed by known risk factors for alcoholism can be incorporated into a neural network analysis that reliably predicts the presence or absence of alcoholism about 94&#8211;95% of the time. Several characteristics that were identified by a pruned neural network have previously been shown to be important in this disease based on more traditional linkage and association studies. Neural networks therefore provide one less traditional approach to both identifying alcoholic individuals and determining the most informative risk factors.</p>
  244. Risk factors for decreased bone density in premenopausal women
    • date - 1997
    • creator - Gross J.L.
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=0100879X&date=1997&volume=30&issue=9&spage=1061
    • description - Osteoporosis is a major health problem. Little is known about the risk factors in premenopause. Sixty 40-50-year old patients with regular menses were studied cross-sectionally. None of the patients were on drugs known to interfere with bone mass. Patients answered a dietary inquiry and had their bone mineral density (BMD) measured. The Z scores were used for the comparisons. A blood sample was taken for the determination of FSH, SHBG, estradiol, testosterone, calcium and alkaline phosphatase. Calcium and creatinine were measured in 24-h urine. A Z score less than -1 was observed for the lumbar spine of 14 patients (23.3%), and for the femur of 24 patients (40%). Patients with a Z score less than -1 for the lumbar spine were older than patients with a Z score <FONT FACE="Symbol">³</font>-1 (45.7 vs 43.8 years) and presented higher values of alkaline phosphatase (71.1 ± 18.2 vs 57.1 ± 14.3 IU/l). Multiple regression analysis showed that a lower lumbar spine BMD was associated with higher values of alkaline phosphatase, lower calcium ingestion, a smaller body mass index (BMI), less frequent exercising, and older age. The patients with a Z score less than -1 for the femur were shorter than patients with a Z score <FONT FACE="Symbol">³</font>-1 (158.2 vs 161.3 cm). Multiple regression analysis showed that a lower femoral BMD was associated with lower BMI, higher alkaline phosphatase and caffeine intake, and less frequent exercising. A lower than expected BMD was observed in a significant proportion of premenopausal women and was associated with lower calcium intake, relatively lower physical activity and lower BMI. We conclude that the classical risk factors for osteoporosis may be present before ovarian failure, and their effect may be partly independent of estrogen levels.
  245. Public beliefs about causes and risk factors for mental disorders: a comparison of Japan and Australia
    • date - 2005
    • creator - Griffiths Kathleen
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=1471244X&date=2005&volume=5&issue=1&spage=33
    • description - <p>Abstract</p> <p>Background</p> <p>Surveys of the public in a range of Western countries have shown a predominant belief in social stressors as causes of mental disorders. However, there has been little direct cross-cultural comparison. Here we report a comparison of public beliefs about the causes of mental disorders in Japan and Australia.</p> <p>Methods</p> <p>Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs about causes and risk factors in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over.</p> <p>Results</p> <p>In both countries, both social and personal vulnerability causes were commonly endorsed across all vignettes. The major differences in causal beliefs were that Australians were more likely to believe in infection, allergy and genetics, while Japanese were more likely to endorse "nervous person" and "weakness of character". For risk factors, Australians tended to believe that women, the young and the poor were more at risk of depression, but these were not seen as higher risk groups by Japanese.</p> <p>Conclusion</p> <p>In both Japan and Australia, the public has a predominant belief in social causes and risk factors, with personal vulnerability factors also seen as important. However, there are also some major differences between the countries. The belief in weakness of character as a cause, which was stronger in Japan, is of particular concern because it may reduce the likelihood of seeking professional help and support from others.</p>
  246. Genetic Risk Factors in Tumours of the Testis: Lessons From
    • date - 2004-06-18
    • creator - Cornelis B Lambalk,Dorret I Boomsma
    • provider - NSDL OAI Repository
    • location - http://citeseer.ist.psu.edu/639813.html
    • description - vals of 1.1--7.0) than males of monozygotic twins. This was one important finding in a study conducted by Swerdlow et al published in the Lancet of 13December 1997. They identified twins with testicular cancer diagnosed in England and Wales during 1971--1989. In addition to the risk associated with being a dizygotic twin, men with a twin brother with testicular carcinoma have a greatly increased risk of developing testicular cancer themselves -- 75-fold in monozygotic and 38-fold in dizygotic twins. The same study also reports a 35-fold increase in risk of breast cancer in monozygotic twin sisters of young women with breast cancer. Females of dizygotic twins have no increased risk of breast cancer compared to monozygotic twins (Odd Ratio of 1.1 with 95% confidence limits of 0.8--1.4). Young dizygotic sisters (up to 35 years old) of probands with breast cancer had also no increase in risk. In this situation, the risk increased significantly about 5-fold when over 35 years of age. Th
  247. Comparative assessment of spent nuclear fuel transportation routes using risk factors and a geographic information system
    • date - 2005-11-07
    • creator - Toth, D.M.
    • provider - NSDL OAI Repository
    • location - http://www.osti.gov/servlets/purl/671979-0THzxe/webviewable/
    • description - The assessment of potential alternative routes was simplified through the use of six comparative risk factors evaluated using detailed, route-specific data. The route and environmental attributes varied strongly with location and were developed from national, state, and local sources. The six comparative factors were risk measures of incident-free transportation radiation exposure, radiological accident population exposure, nonradiological accidents, contamination of environmental sensitive areas, environmental justice for minority populations, and environmental justice for low-income populations. An assessment of four real North-Central Florida routes provided a sample implementation of the analysis tools and risk factors. The assessment routes, consisting of common beginning and end locations, included an interstate highway, a rural highway, a mostly urban highway, and a combination interstate highway with rural bypass. This route comparative assessment study predicted that the interstate highway, despite a higher population density, greater traffic volume, and greater number of vehicular fatality accidents, would present the lowest cumulative risk. On the contrary, the rural highway route, characterized as having the lowest population density, minimal vehicle traffic volume, and the lowest percentages of minority and low-income populations, displayed the highest cumulative risk measure. Factors contributing to the high risk for the rural highway route included greater route length, higher vehicular fatality accident rates per vehicle mile traveled, and the close proximity to environmentally sensitive areas. This route comparative assessment study predicted that the interstate highway, despite a higher population density, greater traffic volume, and greater number of vehicular fatality accidents, would present the lowest cumulative risk. On the contrary, the rural highway route, characterized as having the lowest population density, minimal vehicle traffic volume, and the lowest percentages of minority and low income populations, displayed the highest cumulative risk measure. Factors contributing to the high risk for the rural highway route included greater route length, higher vehicular fatality accident rates per vehicle mile traveled, and the close proximity to environmentally sensitive areas.
  248. Building-related risk factors and work-related lower respiratory symptoms in 80 office buildings
    • date - 2002-04-22
    • creator - Mendell, M.J.; Naco, G.M.; Wilcox, T.G.; Sieber, W.K.
    • provider - NSDL OAI Repository
    • location - http://www.osti.gov/servlets/purl/792973-afLD57/native/
    • description - We assessed building-related risk factors for lower respiratory symptoms in office workers. The National Institute for Occupational Safety and Health in 1993 collected data during indoor environmental health investigations of workplaces. We used multivariate logistic regression analyses to assess relationships between lower respiratory symptoms in office workers and risk factors plausibly related to microbiologic contamination. Among 2,435 occupants in 80 office buildings, frequent, work-related multiple lower respiratory symptoms were strongly associated, in multivariate models, with two risk factors for microbiologic contamination: poor pan drainage under cooling coils and debris in outside air intake. Associations tended to be stronger among those with a history of physician-diagnosed asthma. These findings suggest that adverse lower respiratory health effects from indoor work environments, although unusual, may occur in relation to poorly designed or maintained ventilation systems, particularly among previously diagnosed asthmatics. These findings require confirmation in more representative buildings.
  249. Breast cancer and personal environmental risk factors in Marin County - Pilot study
    • date - 2003-08-18
    • creator - Erdmann, C.A.; Farren, G.; Baltzell, K.; Chew, T.; Clarkson, C.; Fleshman, R.; Leary, C.; Mizroch, M.; Orenstein, F.; Russell, M.L.; Souders-Mason, V.; Wrensch, M.
    • provider - NSDL OAI Repository
    • location - http://www.osti.gov/servlets/purl/812452-PkODWK/native/
    • description - The purpose of the Personal Environmental Risk Factor Study (PERFS) pilot project was to develop methodologies and a questionnaire for a future population-based case-control study to investigate the role of selected environmental exposures in breast cancer development. Identification of etiologically relevant exposures during a period of potential vulnerability proximate to disease onset offers the possibility of clinical disease prevention even when disease initiation may have already occurred many years earlier. Certain personal environmental agents or combinations of agents may influence disease promotion. Therefore, this pilot study focused on exposures that occurred during the ten-year period prior to diagnosis for cases and the last ten years for controls, rather than more historic exposures. For this pilot study, they used a community-based research approach. In the collaborative efforts, community members participated with academic researchers in all phases of the research, including research question identification, study design, development of research tools, development of the human subjects protocol, and report writing. Community member inclusion was based upon the concept that community participation could improve the relevance of scientific studies and ultimate success of the research by encouraging an ongoing dialogue between community members and academic representatives. Early activities of this project focused on the collection of input from the community regarding the possible role of environmental factors in the incidence of breast cancer in Marin County. The intent was to inform the scientists of community concerns, enhance the research team's understanding of the community being studied, and provide interested community members with a better understanding of the strengths and weaknesses of traditional research methods through active participation in the research process.
  250. Indoor Environmental Risk Factors for Occupant Symptoms in 100U.S. Office Buildings: Summary of Three Analyses from the EPA BASEStudy
    • date - 2006-05-15
    • creator - Mendell, M.J.; Lei-Gomez, Q.; Cozen, M.; Brightman, H.S.; Apte,M.; Erdmann, C.A.; Brunner, G.; Girman, J.R.
    • provider - NSDL OAI Repository
    • location - http://www.osti.gov/servlets/purl/877688-x4IWOF/
    • description - This paper summarizes three analyses of data on building-related environmental factors and occupant symptoms collected from 100 representative large U.S. office buildings. Using multivariate logistic regression models, we found increased occupant symptoms associated with a number of building-related factors, including lower ventilation rates even at the current guideline levels, lack of scheduled cleaning for air-conditioning drain pans and cooling coils, poor condition of cooling coils, poorly maintained humidification systems, and lower outdoor air intake height. Some expected relationships were not found, and several findings were opposite of expected. Although requiring replication, these findings suggest preventive actions to reduce occupant symptoms in office buildings.
  251. RISK FACTORS FOR SEXUAL COERCION IN MALE BATTERERS
    • date - 2002-05-23
    • creator - HAZRA, ROCHNA
    • provider - NSDL OAI Repository
    • location - http://scholar.lib.vt.edu/theses/available/etd-04252002-220557/
    • description - RISK FACTORS FOR SEXUAL COERCION IN MALE BATTERERS by Rochna Hazra Sandra M. Stith, Chairperson Human Development (ABSTRACT) This exploratory study examined risk factors for sexual coercion using data provided by 87 couples that were screened to participate in a couples treatment program for domestic violence. Risk factors examined included: level of alcohol use, anger, beliefs about wife beating, jealousy, dominance, depression, physical and psychological violence. Overall, 46.9% of the women reported that their partners were sexually coercive. Slightly over 46% of the women whose partners were severely violent reported that they also were sexually coercive and slightly less than 46% of the women whose partners engaged in minor aggression reported that their partners were sexually coercive. Almost 23% of the female participants reported that their partners raped them during the past year. Furthermore, results from correlational analyses indicate that level of male physical violence and male beliefs about wife beating are risk factors for sexual coercion within the context of a violent relationship. Level of alcohol use, anger, male depression, jealousy, dominance and psychological violence do not appear to be risk factors. These results have implications for further understanding and treatment of sexually coercive male batterers.
  252. A Validation of Measures Associated with the Risk Factors in Information
    • date - 2002-12-17
    • creator - Bouchaib Bahli,Suzanne Rivard
    • provider - NSDL OAI Repository
    • location - http://citeseer.ist.psu.edu/658020.html
    • description - In recent years, many firms have adopted outsourcing as a means to govern their information technology (IT) operations. While outsourcing is associated with several important benefits, it also entails risk. The main purpose of this study was to validate measures of the risk factors associated with outsourcing IT operations. Insights from transaction costs theory suggest that risk factors are inherent in the transaction itself, the supplier and the client. A survey of 132 senior IT executives was conducted to assess the measures, and reliability and validity assessment was performed using PLS.
  253. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study
    • date - 2006-04-27
    • creator - Rasool, Syed I
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2261/6/18
    • description - Abstract Background Knowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan. Methods A hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients admitted with their first AMI were eligible to participate. Standard questionnaire was used to interview 720 subjects. Knowledge of four modifiable risk factors of heart disease: fatty food consumption, smoking, obesity and exercise were assessed. The participants knowing three out of four risk factors were regarded as having a good level of knowledge. A multiple logistic regression model was constructed to identify the determinants of good level of knowledge. Results The mean age (SD) was 54 (11.66) years. A mere 42% of our study population had a good level of knowledge. In multiple logistic regression analysis, independent predictors of "good" level of knowledge were (odds ratio [95% confidence interval]) more than ten years of schooling were 2.5 [1.30, 4.80] (verses no schooling at all) and nuclear family system (verses extended family system) 2.54 [1.65, 3.89]. In addition, Sindhi ethnicity OR [3.03], higher level of exercise OR [2.76] and non user of tobacco OR [2.53] were also predictors of good level of knowledge. Conclusion Our findings highlight the lack of good level of knowledge of modifiable risk factors for heart disease among subjects admitted with AMI in Pakistan. There is urgent need for aggressive and targeted educational strategies in the Pakistani population.
  254. Pseudomonas aeruginosabloodstream infections: risk factors and treatment outcome related to expression of the PER-1 extended-spectrum beta-lactamase
    • date - 2006-03-16
    • creator - Toniolo, Antonio Q
    • provider - NSDL OAI Repository
    • location - http://www.biomedcentral.com/1471-2334/6/52
    • description - Abstract Background Bloodstream infection (BSI) due to Pseudomonas aeruginosa (Pa) has relevant clinical impact especially in relation to drug resistance determinants. The PER-1 extended-spectrum beta-lactamase (ESBL) is a common enzyme conferring high-level resistance to anti-pseudomonal cephalosporins. Risk factors and treatment outcome of BSI episodes caused by PER-1-positive Pa (PER-1-Pa) strains were compared to those caused by ESBL-negative Pa isolates (ESBL-N-Pa). Methods Twenty-six BSI cases due to ceftazidime-resistant Pa strains have been investigated. MIC values of anti-pseudomonal drugs were determined by the Etest method (AB Biodisk, Solna, Sweden). The double-disk synergy test was used to detect ESBL production. PCR amplification and DNA sequencing were used to characterize ESBL types. Clinical records of BSI-patients were examined retrospectively. Demographic data, underlying diseases (McCabe-Jackson classification and Charlson weighted index), risk factors, antimicrobial therapy, and treatment outcome were evaluated in cases due to ESBL-positive and cases due to ESBL-N-Pa isolates. Unpaired Student's t-test, Mann-Whitney U-test, Fisher's exact test and the χ 2 test were used for statistical analysis. Results Nine Pa isolates expressed the PER-1 ESBL; the remaining 17 isolates did not produce ESBLs. Severe sepsis ( P = 0.03), bladder and intravascular catheters (both P = 0.01), immunosuppressive therapy ( P = 0.04), and mechanical ventilation ( P = 0.03) were significantly associated with BSI due to PER-1-Pa. Empirical treatment ( P = 0.02) and treatment after ID/AST ( P < 0.01) were rarely adequate in PER-1-Pa cases. With regard to treatment outcome, 77.8% BSI cases due to PER-1-Pa vs . 28.6% cases due to ESBL-N-Pa isolates failed to respond ( P < 0.03). All cases due to PER-1-Pa that were treated with carbapenems (alone or in combination with amikacin) failed to respond. In contrast, 7/8 cases due to ESBL-N-Pa given carbapenems were responders. Conclusion Therapeutic failure and increased hospital costs are associated with BSI episodes caused by PER-1-Pa strains. Thus, recognition and prompt reporting of ESBL-production appears a critical factor for the management of patients with serious P. aeruginosa infections.
  255. Effects of Time Pressure and Mental Workload on Physiological Risk Factors for Upper Extremity Musculoskeletal Disorders While Typing
    • date - 2004-07-30
    • creator - Hughes, Laura E.
    • provider - NSDL OAI Repository
    • location - http://scholar.lib.vt.edu/theses/available/etd-07262004-163847/
    • description - Work-related musculoskeletal disorders (WMSDs) are a major source of lost productivity and revenue in the workplace and disability in workers. There is strong evidence for a relationship between physical risk factors, such as repetitive motions and excessive force, and the development of WMSDs; yet there are unexplained discrepancies in determining which workers are more at risk. Researchers hypothesize that non-physical factors in the workplace, or psychosocial factors, may contribute to the development of WMSDs. The following study examined the effects of two psychosocial factors, mental workload and time pressure, on perceived workload and physiological reactions of the lower arm and wrist during typing activity by measuring muscle activation patterns, wrist posture and movement, key strike forces, and subjective assessments of overall workload. The results indicate that increases in time pressure lead to increases in lower arm muscle activation, key strike forces, and wrist deviations. Key strike forces may increase with higher mental workload levels, but other effects of mental workload were not clear. Perceived overall workload (time load, mental effort load, and stress load) increased with mental workload and time pressure, and typing performance decreased. The evidence from this study suggests that these psychosocial factors (mental workload and time pressure) mediate physical risk factors to increase risk for WMSD development in the upper extremities. The results illustrate the need for those designing jobs and work tasks to consider both physical and psychosocial aspects of the working environment to prevent injuries in employees.
  256. Intestinal Parasitic Infection: Prevalence, Risk Factors and Consequences for Child Growth, Iron Status and Development in Rural Ecuador.
    • date - 2001-08-24
    • creator - Sackey, Mamie Eleanor
    • provider - NSDL OAI Repository
    • location - http://scholar.lib.vt.edu/theses/available/etd-08232001-195222/
    • description - Intestinal parasitic infections (IPIs) are considered to be a public health problem of global importance by the World Health Organization. The present epidemiologic survey study investigated the prevalence, risk factors, and consequences of pathogenic IPIs on the growth, nutrition and psychomotor development of 244 Ecuadorian children aged 0.2-14 years. The study was conducted in five rural hamlets located in a tropical rainforest area in northwest Ecuador. The study data were obtained by means of a structured questionnaire, a developmental screening examination, anthropometry, and lab analysis of blood and fecal samples. Data analysis was conducted using appropriate bivariate and multivariate statistical techniques. The study results revealed that 90% of the child subjects were infected with at least one pathogenic IPI species. Fifty-one percent were identified with helminthic infections, 37.6% with protozoal infections, and 21.4% were infected with both. The most common intestinal parasites detected were Ascaris lumbricoides (39.7%), Giardia intestinalis (25.2%), Trichuris trichiura (19.7%), Entamoeba histolytica/dispar (18.5%), Blastocystis hominis (13.3%), and Ancylostoma duodenale (1.7%). The prevalence of growth stunting (40%) and iron-deficiency anemia (26%) also was high. Children infected with Giardia exhibited a risk for stunted growth that was twice that of their non-infected counterparts (51.7% vs. 33.1%; OR=2.16, 95% C.I.= 1.13-4.15; p= 0.01). They also had significantly reduced mean blood hemoglobin levels compared to non-infected children 11.8 + 1.5.g/dL vs. 12.2 + 1.4g/dL; p= 0.023) but the proportion with iron-deficiency anemia was slightly but not significantly increased (29.4% vs. 24.3%). The characteristic most consistently associated with risk for pathogenic protozoal IPIs was a high density of domestic animals living in and around the home. Children who lived in such households had a risk for infection that was 2-5 times greater than others. This suggests that domestic animals were important reservoirs for IPI infection in the child group studied. Contrary to the a priori hypothesis, no gender, ethnic, nor age differences in infection risk were identified except for Trichuris infection, which was reduced in younger children contrary to expectations. Mass or targeted chemotherapy combined with health education and promotion are needed to reduce the cycle of infection and re-infection and the negative impact of these on child growth and
  257. Identification and Quantification of Workstation Set Up on Risk Factors Associated with the Development of Low Back and Neck Discomfort
    • date - 2001-09-17
    • creator - Stanfield, Jennifer Renee
    • provider - NSDL OAI Repository
    • location - http://scholar.lib.vt.edu/theses/available/etd-09112001-235340/
    • description - ii Identification and Quantification of Workstation Set Up on Risk Factors Associated with the Development of Low Back and Neck Discomfort Jennifer R. Stanfield (ABSTRACT) Work related musculoskeletal disorders (WMSD) remain the focus of research efforts as costs associated with these disorders range from 13 to 54 billion dollars annually. WMSDs associated with the back and neck compromise almost 27% of all reported WMSDs. Approximately 1/3 of visual display terminal (VDT) operators report back and neck pain annually (BLS, 1998). Physical risk factors of VDTs associated with low back and neck WMSDs include static work postures and workstation design. The objectives of this study were to assess the effects of monitor height, chair type and their interaction on task performance, back/neck electromyography (EMG), perceived discomfort, and number of posture shifts. Both monitor height and chair type were assessed using two levels (high and low). Participants, four male and four female college age students, performed two data entry tasks using a standard keyboard and monitor and a fully adjustable bi-level table. In addition to the experimenter defined workstation configurations, participants were allowed to adjust their workstation to their preferred settings. Analysis of variance was performed to assess differences in task performance, perceived level of discomfort, number of posture shifts, and EMG data associated with various combinations of monitor height and chair type. Correlation analysis was performed to assess the relationship between participantís perceived discomfort and measured muscle activity to help determine if these two measurements could be used interchangeably to assess workstation design. No effect of workstation configuration (monitor height/chair type) was found for the majority of dependent variables. An exception was that configuration of low monitor, high chair, and their interaction generated significantly more muscle activity for the low back. User preferred settings were not found to differ significantly from those investigated with respect to muscle activity, perceived discomfort, posture shifts, and performance. Additionally, it was found the participants chose to position the iii workstation according to guidelines suggested in the literature for reducing WMSD discomfort. Task effects were found for performance, posture shifts, and perceived level of discomfort. Higher levels of performance and posture shifts for the neck were as
  258. Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees
    • date - 2006
    • creator - Kouvonen Anne
    • provider - NSDL OAI Repository
    • location - http://www.doaj.org/openurl?genre=article&issn=14712458&date=2006&volume=6&issue=1&spage=24
    • description - <p>Abstract</p> <p>Background</p> <p>In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model &#8211; effort, rewards and ERI &#8211; are associated with the co-occurrence of lifestyle risk factors.</p> <p>Methods</p> <p>Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index &#8805;25 kg/m<sup>2</sup>, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models.</p> <p>Results</p> <p>After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously &#8805;3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors.</p> <p>Conclusion</p> <p>This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evi

Author: Eric Lease Morgan <emorgan@nd.edu>
Date created: 2004-08-25
Date updated: 2005-09-06
URL: http://alert.ockham.org