scholarly journals Prevalence and progression of aortic dilatation in adult patients with Turner syndrome: a cohort study

2020 ◽  
Vol 183 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Bruno Donadille ◽  
Sophie Tuffet ◽  
Clement Cholet ◽  
Mariana Nedelcu ◽  
Nathalie Bourcigaux ◽  
...  
Keyword(s):  
Risk Factors ◽  
Turner Syndrome ◽  
Ascending Aorta ◽  
Adult Patients ◽  
Growth Potential ◽  
Aortic Dilatation ◽  
Root Growth Potential ◽  
Potential Risk Factors ◽  
Mri Protocol

Objective: Turner syndrome (TS) is a rare disorder affecting 1/2500 female newborn. Aortic dilatation (AD) and aortic dissection represent a major concern in TS. The aims of our study were to describe the aortic root growth, potential aortic dilatation (AD) risk factors and cardiovascular outcomes in a cohort of patients with TS. Methods: Among 204 adult patients included, 197 were studied using a standardized 1.5 Tesla MRI protocol. AD was defined as an aortic diameter ≥20 mm/m2 at the Valsalva sinuses and/or at the ascending aorta, when indexed to body surface area. Results: At baseline, AD was present in 81/197 (41.1%) and 32/197 (16.2%) of patients, at the levels of Valsalva and ascending aorta, respectively. The aortic Valsalva diameter was larger in patients treated for thyroiditis (P < 0.001). Potential risk factors of AD were aging (P < 0.001) and the presence of bicuspid aortic valve (BAV) (P = 0.002). The hazard ratio (HR) of AD occurrence in the presence of BAV was 2.2 (95% CI: 1.33–3.71). After a median follow-up period of 5.1 years (n = 143), AD was present in 58/143 (40.6%) and 25/143 (17.5%) of patients at the levels of Valsalva and ascending aorta, respectively. The median aortic growth of the Valsalva sinuses remained stable. At the ascending aorta, it increased by 0.14 ± 0.61 mm/year. Only one aortic-related death was observed. Conclusion: AD is common in adult patients with TS. However, our results are rather reassuring, as the median aortic diameters remained stable after 5.1 years and few aortic events were observed.

scholarly journals Trend and treatment outcomes of latent tuberculosis infection among migrant persons in Japan: retrospective analysis of Japan tuberculosis surveillance data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Kawatsu ◽  
Kazuhiro Uchimura ◽  
Akihiro Ohkado
Keyword(s):  
Risk Factors ◽  
Surveillance System ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Migrant Population ◽  
Foreign Born ◽  
Ltbi Treatment ◽  
Potential Risk Factors ◽  
Lost To Follow Up

Abstract Background Screening for latent tuberculosis infection (LTBI) among migrant population has become a critical issue for many low tuberculosis (TB) burden countries. Evidence regarding effectiveness of LTBI programs are limited, however, partly because of paucity of national data on treatment outcomes for LTBI. In Japan, notification of LTBI is mandatory, and its treatment outcome is reported as part of Japan’s national TB surveillance system. We thus conducted a detailed analysis of LTBI among foreign-born persons, to update the epidemiological trend of newly notified LTBI between 2007 and 2018, and to examine the treatment regimen and outcome of those notified in 2016 and 2017, focusing specifically on the potential risk factors for lost to follow-up. Methods We extracted and analyzed the data of newly notified LTBI patients from the Japan Tuberculosis Surveillance System to examine the overall trend of notification and by age groups and modes of detection between 2007 and 2018, and the cohort data for treatment regimen and outcomes of foreign-born persons notified with LTBI in 2016 and 2017. Trends and proportions were summarized descriptively, and logistic regression analysis was conducted to identify potential risk factors for lost to follow-up. Comparisons were made with the Japan-born patients where appropriate, using chi-squared tests. Results Both the number and proportion of LTBI among foreign-born persons have been constantly increasing, reaching 963 cases in 2018. Cohort analysis of the surveillance data indicated that the proportion of those on shorter regimen was higher among the foreign- than Japan-born patients (5.5% vs. 1.8%, p < 0.001). The proportion of those who have been lost to follow-up and transferred outside of Japan combined was higher among the foreign- than Japan-born patients (12.0% vs, 8.2%, p < 0.001). Risk factors for lost to follow-up were being employed on a temporal basis, and job status unknown (adjusted odds ratios 3.11 and 4.09, 95% confidence intervals 1.34–7.26 and 1.60–10.48, respectively). Conclusions Migrant population face greater risk of interrupting LTBI treatment, and interventions to improve adherence are a critical component of programmatic management of LTBI. Further studies are needed to explore the cultural and socioeconomic situation in which foreign-born persons undergo LTBI treatment in Japan.

scholarly journals Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2575
Author(s):  
Pier Carmine Passarelli ◽  
Stefano Pagnoni ◽  
Giovan Battista Piccirillo ◽  
Viviana Desantis ◽  
Michele Benegiamo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Periodontal Disease ◽  
Smoking Habit ◽  
Extraction Process ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Related Risk ◽  
Potential Risk Factors ◽  
Practice Methods ◽  
Tooth Extractions

Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

Abstract P249: Incident Sleep-Disordered Breathing is Associated with Obesity: Penn State Child Cohort

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Edward O Bixler ◽  
Alexandros N Vgontzas ◽  
Duanping Liao ◽  
Susan Calhoun ◽  
Julio Fernandez-Mendoza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Sleep Disordered Breathing ◽  
Population Sample ◽  
Population Based ◽  
Penn State ◽  
Potential Risk Factors ◽  
State Child ◽  
Disordered Breathing

Objectives: To study the epidemiology of sleep-disordered breathing (SDB) in adolescents, which has received little attention. Methods: The Penn State Child Cohort (PSCC) is a representative general population sample of 700 children aged 5-12 years. Our preliminary results are based on an average 8 year follow up of the initial 300 prospective subjects (~43%) from this ongoing cohort study. A logistic regression was used to assess the association between potential risk factors and incident SDB. Results: The mean age at the 8-year follow up examination was 17.2 ± 0.1 years, with an average BMI percentile of 66.6 ± 1.6 and 56.5% boys. At baseline 1.5% of this subsample had SDB, defined by Apnea Hypopnia Index (AHI > 5 /hour). Surprisingly, there was no persistence of SDB. Eight-year incident SDB was 10.5%. The average AHI in those with incident SDB was 12.7 with a maximum of 92.4. Incident SDB was similar for girls (7.8%) and boys (12.7%). Those with SDB were older than those without (18.7 vs 17.0 years, P<0.001) and girls with SDB were older than boys with SDB (20.0 vs 18.0 years, P=0.002). Those with incident SDB tended to have a greater change in BMI percentile (8.2 vs 1.8, P = 0.143) during the follow up and slightly higher minority representation (25.8% vs 21.9%, P=0.655). A logistic regression model identified three variables that were associated with incident SDB, controlling for baseline AHI: age (OR = 1.5 (1.3, 1.9) P<0.001), male (OR= 2.5 (1.11,10.00) P=0.021), and [[Unable to Display Character: &#8710;]]BMIPCT (OR=1.2(1.02, 1.5) P=0.032). Conclusion: In this population based sample of adolescents, the 8-year incidence of SDB was high (10.5%), whereas childhood SDB did not persist into adolescence. Further, the results indicate that risk factors for incident SDB in adolescents are age, male and the development of obesity.

Evaluation of the Potential Risk Factors for Drug-Induced Anaphylaxis in Adult Patients

2018 ◽  
Vol 178 (2) ◽  
pp. 167-176 ◽  
Author(s):  
Semra Demir ◽  
Fusun Erdenen ◽  
Asli Gelincik ◽  
Derya Unal ◽  
Muge Olgac ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Adult Patients ◽  
Drug Induced ◽  
Potential Risk Factors

scholarly journals Community prevalence of SARS-CoV-2 in England: Results from the ONS Coronavirus Infection Survey Pilot

2020 ◽  
Author(s):  
Koen B Pouwels ◽  
Thomas House ◽  
Julie V Robotham ◽  
Paul Birrell ◽  
Andrew B Gelman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Credible Interval ◽  
Control Measures ◽  
Cross Sectional ◽  
Direct Patient Contact ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Coronavirus Infection ◽  
Over Time

Objective: To estimate the percentage of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) over time in the community in England and to quantify risk factors. Design: Repeated cross-sectional surveys of population-representative households with longitudinal follow-up if consent given. Setting: England. Participants: 34,992 Individuals aged 2 years and over from 16,722 private residential households. Data were collected in a pilot phase of the survey between 26 April and 28 June 2020. Main outcome measures: Percentage of individuals in the community testing positive for SARS-CoV-2 RNA using throat and nose swabs. Individuals were asked about any symptoms and potential risk factors. Results: The percentage of people in private-residential households testing positive for SARS-CoV-2 reduced from 0.32% (95% credible interval (CrI) 0.19% to 0.52%) on 26 April to 0.08% (95% CrI 0.05% to 0.12%) on 28 June, although the prevalence stabilised near the end of the pilot. Factors associated with an increased risk of testing positive included having a job with direct patient contact (relative exposure (RE) 4.06, 95% CrI 2.42 to 6.77)), working outside the home (RE 2.49, 95% CrI 1.39 to 4.45), and having had contact with a hospital (RE 2.20, 95% CrI 1.09 to 4.16 for having been to a hospital individually and RE 1.95, 95% CrI 0.81 to 4.09 for a household member having been to a hospital). In 133 visits where individuals tested positive, 82 (61%, 95% CrI 53% to 69%) reported no symptoms, stably over time. Conclusion: The percentage of SARS-CoV-2 positive individuals declined between 26 April and 28 June 2020. Positive tests commonly occurred without symptoms being reported. Working outside your home was an important risk factor, indicating that continued monitoring for SARS-CoV-2 in the community will be essential for early detection of increases in infections following return to work and other relaxations of control measures.

scholarly journals Perioperative changes of response to antiplatelet medication in vascular surgery patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244330
Author(s):  
Thomas Hummel ◽  
Saskia Hannah Meves ◽  
Andreas Breuer-Kaiser ◽  
Jan-Ole Düsterwald ◽  
Dominic Mühlberger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Vascular Surgery ◽  
Reactive Protein ◽  
Antiplatelet Medication ◽  
Impedance Aggregometry ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Artery Disease

Introduction Reduced antiplatelet activity of aspirin (ALR) or clopidogrel (CLR) is associated with an increased risk of thromboembolic events. The reported prevalence data for low-responders vary widely and there have been few investigations in vascular surgery patients even though they are at high risk for thromb-embolic complications. The aim of this prospective observational monocentric study was to elucidate possible changes in ALR or CLR after common vascular procedures. Methods Activity of aspirin and clopidogrel was measured by impedance aggregometry using a multiple electrode aggregometer (Multiplate®). Possible risk factors for ALR or CLR were identified by demographical, clinical data and laboratory parameters. In addition, a follow-up aggregometry was performed after completion of the vascular procedure to identify changes in antiplatelet response. Results A total of 176 patients taking antiplatelet medications aspirin and/or clopidogrel with peripheral artery disease (PAD) and/or carotid stenosis (CS) were included in the study. The prevalence of ALR was 13.1% and the prevalence of CLR was 32% in the aggregometry before vascular treatment. Potential risk factors identified in the aspirin group were concomitant insulin medication (p = 0.0006) and elevated C-reactive protein (CRP) (p = 0.0021). The overall ALR increased significantly postoperatively to 27.5% (p = 0.0006); however, there was no significant change in CLR that was detected. In a subgroup analysis elevation of the platelet count was associated with a post-procedure increase of ALR incidence. Conclusion The incidence of ALR in vascular surgery patients increases after vascular procedures. An elevated platelet count was detected as a risk factor. Further studies are necessary to analyse this potential influence on patency rates of vascular reconstructions.

scholarly journals Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ehsan Alimohammadi ◽  
Seyed Reza Bagheri ◽  
Paniz Ahadi ◽  
Sahar Cheshmehkaboodi ◽  
Homa Hadidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conservative Treatment ◽  
Burst Fracture ◽  
Binary Logistic Regression ◽  
Operative Management ◽  
Binary Logistic Regression Analysis ◽  
Thoracolumbar Burst Fracture ◽  
Potential Risk Factors ◽  
Non Operative Management

Abstract Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for surgery during the follow-up period in these patients. Methods We retrospectively evaluated 67 patients with a traumatic thoracolumbar burst fracture who managed conservatively at our center between May 2014 and May 2019. Suggested variables as potential risk factors for the failure of conservative treatment including age, gender, body mass index (BMI), smoking, diabetes, vertebral body compression rate (VBCR), percentage of anterior height compression (PAHC), Cobb angle, interpedicular distance (IPD), canal compromise, and pain intensity as visual analog scale (VAS) were compared between patients with successful conservative treatment and those with failure of non-operative management. Results There were 41 males (61.2%) and 26 females (38.8%) with the mean follow-up time of 15.52 ± 5.30 months. Overall, 51 patients (76.1%) successfully completed conservative treatment. However, 16 cases (23.9%) failed the non-operative management. According to the binary logistic regression analysis, only age (risk ratio [RR], 2.21; 95% confidence interval [95%], 1.78–2.64; P = 0.019) and IPD (RR 1.97; 95% CI 1.61–2.33; P = 0.005) were the independent risk factors for the failure of the non-operative management. Conclusions Our results showed that older patients and those with greater interpedicular distance are at a higher risk for failure of the conservative treatment. As a result, a closer follow-up should be considered for them.

scholarly journals The Relationship Between Anxiety and Incident Agitation in Alzheimer’s Disease

2020 ◽  
Vol 78 (3) ◽  
pp. 1119-1127
Author(s):  
Kathy Y. Liu ◽  
Harry Costello ◽  
Suzanne Reeves ◽  
Robert Howard ◽  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Regression Models ◽  
Mixed Effects ◽  
Neuropsychiatric Symptom ◽  
Positive Linear Relationship ◽  
Potential Risk Factors ◽  
The Relationship

Background: Agitation in Alzheimer’s disease (AD) has been hypothesized to be an expression of anxiety, but whether anxiety early in the course of dementia could be a risk factor for developing later agitation is unknown. Objective: We used the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database to examine the longitudinal relationship between anxiety and incident agitation in individuals with a diagnosis of AD at baseline or during follow-up. Methods: Longitudinal neuropsychiatric symptom data from AD individuals who were agitation-free at study baseline (N = 272) were analyzed using mixed effects regression models to test the longitudinal relationship between baseline and incident anxiety with incident agitation. Results: Anxiety at baseline was not associated with subsequent agitation, but there was a positive linear relationship between incident anxiety and agitation over the study duration. Baseline apathy and delusions were consistently associated with subsequent agitation and greater disease severity and illness duration also appeared to be risk factors for agitation. Conclusion: Our findings support the concept that anxiety and agitation are likely to be distinct rather than equivalent constructs in mild-moderate AD. Future longitudinal cohort studies are needed to replicate these findings and further characterize potential risk factors for agitation, such as apathy and delusions.

scholarly journals Fall-related efficacy is a useful and independent index to detect fall risk in Japanese community-dwelling older people: a 1-year longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Miki Sakamoto ◽  
Haruhiko Sato ◽  
Akie Kawamura
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Potential Risk Factors ◽  
Community Dwelling Older People ◽  
Walking Time

Abstract Background Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people. Methods The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors. Results The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls. Conclusions The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

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