scholarly journals Temporal Analysis of Factors Associated with EAT-10 in Outpatients with Oropharyngeal Dysphagia from a Tertiary Care Clinic

Dysphagia ◽  
2018 ◽  
Vol 33 (4) ◽  
pp. 457-467 ◽  
Author(s):  
R. S. Bartlett ◽  
J. E. Moore ◽  
S. L. Thibeault
Keyword(s):  
Tertiary Care ◽  
Oropharyngeal Dysphagia ◽  
Temporal Analysis ◽  
Care Clinic ◽  
Factors Associated

scholarly journals Prevalence of Overweight And Obesity And Associated Factors Among People Living With Hiv Attending A Tertiary Care Clinic In Uganda

2022 ◽  
Author(s):  
Esther Alice Nalugga ◽  
Eva Laker ◽  
Maria Sarah Nabaggala ◽  
Ahmed Ddungu ◽  
Charles Batte ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Overweight And Obesity ◽  
Noncommunicable Disease ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Care Clinic ◽  
Factors Associated ◽  
Living With Hiv

Abstract Background: Overweight and obesity are significantly increasing among people living with HIV (PLWH), contributing to the risk of major adverse cardio-metabolic events. However, little is known on its prevalence among PLWH in sub-Saharan Africa. In this study, we report the prevalence and factors associated with overweight and obesity among PLWH in a large tertiary HIV clinic in Kampala, Uganda. Methods: A cross-sectional, retrospective review of electronic database of all PLWH that attended the Adult Infectious Diseases Institute clinic between November 2018 and April 2019 was conducted. Demographic, body mass index (BMI) [kg/m2] and clinical variables were extracted. Based on BMI, nutritional status was classified as undernutrition (< 18.5kg/m2), normal (≥18.5 < 25kg/m2), overweight (≥25 < 30kg/m2) and obesity (≥ 30kg/m2). Poisson regression analysis was performed to determine factors associated with overweight and obesity.Results: Overall, 7,818 participants were included in the analysis, 64% (n=4,976) were female, with a median age of 44 years (interquartile range (IQR): 36 — 51) and a median BMI of 24.2 (IQR: 21.2 — 28.1). The prevalence of overweight and obesity combined was 46% (55% female versus 30% male), obesity 18.2% (24.6% female versus 7.1% male) and overweight 27.8% (30.4% female versus 22.9% male). Factors associated with overweight and obesity were: Female sex (adjusted prevalence ratio [aPR]: 1. 8, 95%CI:1.69 — 1.87), age category 25—59 years (aPR: 1.9, 95%CI: 1.63 — 2.24) and ≥ 60 years (aPR: 1.8, 95%CI:1.49 — 2.12); duration on antiretroviral therapy (ART) for 6—10 years (aPR: 1.1, 95%CI:1.08 — 1.18), CD4 count ≥500 (aPR:1.3, 95%CI:1.21 — 1.30) and having at least one noncommunicable disease (NCD) (aPR: 1.1, 95%CI:1.07 — 1.18). Conclusions: There is a high burden of overweight and obesity among PLWH in Uganda. Nutrition and weight management programs particularly targeting high risk groups such as female and persons with underlying NCDs should be integrated into HIV care.

Neonatal Outcome of Macrosomia

2020 ◽  
Vol 40 (2) ◽  
pp. 114-119
Author(s):  
Subhash Chandra Shah ◽  
Anusmriti Guragain ◽  
Shreejana Pandey ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Maternal Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Pregnancy Induced Hypertension ◽  
Factors Associated ◽  
Adverse Neonatal Outcome ◽  
Induced Hypertension ◽  
Appropriate For Gestational Age ◽  
Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

scholarly journals EVALUATION OF FACTORS ASSOCIATED WITH MORTALITY AMONGST PATIENTS ADMITTED TO A TERTIARY CARE MEDICAL CENTER FOR COVID-19 INFECTION

2021 ◽  
Vol 77 (18) ◽  
pp. 3123
Author(s):  
Anish Samuel ◽  
Ashesha Mechineni ◽  
Robin Craven ◽  
Wilbert Aronow ◽  
Mourad Ismail ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Factors Associated ◽  
Tertiary Care Medical Center

scholarly journals Sociocultural and health system factors associated with mortality among febrile inpatients in Tanzania: a prospective social biopsy cohort study

2018 ◽  
Vol 3 (1) ◽  
pp. e000507 ◽  
Author(s):  
Michael E Snavely ◽  
Michael J Maze ◽  
Charles Muiruri ◽  
Lilian Ngowi ◽  
Flora Mboya ◽  
...  
Keyword(s):  
Health System ◽  
Community Education ◽  
Conditional Logistic Regression ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Seeking ◽  
Factors Associated ◽  
Northern Tanzania ◽  
System Factors ◽  
At Home

IntroductionCommunicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Tanzania.MethodsWe interviewed febrile inpatients to determine prevalence of barriers in seeking or receiving care and grouped these barriers using the Three Delays model (delays at home, in transport and at healthcare facilities). We assessed 6-week mortality and, after matching on age, gender and severity of illness, measured the association between delays and mortality using conditional logistic regression.ResultsWe enrolled 475 children, of whom 18 (3.8%) died, and 260 adults, of whom 34 (13.0%) died. For children, home delays were not associated with mortality. Among adults, a delay in care-seeking due to not recognising severe symptoms was associated with mortality (OR: 3.01; 95% CI 1.24 to 7.32). For transport delays, taking >1 hour to reach a facility increased odds of death in children (OR: 3.27; 95% CI 1.11 to 9.66) and adults (OR: 3.03; 95% CI 1.32 to 6.99). For health system delays, each additional facility visited was associated with mortality for children (OR: 1.59; 95% CI 1.06 to 2.38) and adults (OR: 2.00; 95% CI 1.17 to 3.41), as was spending >4 days between the first facility visit and reaching tertiary care (OR: 4.39; 95% CI 1.49 to 12.93).ConclusionOur findings suggest that delays at home, in transport and in accessing tertiary care are risk factors for mortality from febrile illness in northern Tanzania. Interventions that may reduce mortality include community education regarding severe symptoms, expanding transportation infrastructure and streamlining referrals to tertiary care for the sickest patients.

scholarly journals Glioblastoma Multiforme: an Advanced Analysis of 153 Patients and Review of the Literature

2017 ◽  
Vol 36 (02) ◽  
pp. 080-090 ◽  
Author(s):  
Mohammad Nikdad ◽  
Farshid Farhan ◽  
Milad Shafizadeh ◽  
Atefeh Mirmohseni ◽  
Mohsen Afarideh ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Local Recurrence ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tertiary Care ◽  
Cox Proportional Hazards ◽  
Recurrence Rates ◽  
Operative Method ◽  
Factors Associated ◽  
Advanced Analysis

Objective Glioblastoma multiforme (GBM) is an aggressive primary tumor with frequent recurrences that leaves patients with a short survival time and a low quality of life. The aim of this study was to review the prognostic factors in patients with glioblastoma multiforme. Material and Methods The focus of this retrospective study was a group of 153 patients with supratentorial GBM tumors, who were admitted to a tertiary-care referral academic center from 2005 to 2013. The factors associated with survival and local recurrence were assessed using the hazard ratio (HR) function of Cox proportional hazards regression and neural network analysis. Results Out of the 153 patients, 99 (64.7%) were male. The average age of the patients was 55.69 ± 15.10 years. The median overall survival (OS) and progression-free survival (PFS) rates were 14.0 and 7.10 months respectively. In the multivariate analysis, age (HR = 2.939, p < 0.001), operative method (HR = 7.416, p < 0.001), temozolomide (TMZ, HR = 11.723, p < 0.001), lomustine (CCNU, HR = 8.139, p < 0.001), occipital lobe involvement (HR = 3.088, p < 0.001) and Karnofsky Performance Status (KPS, HR = 4.831, p < 0.001) scores were shown to be significantly associated with a higher OS rate. Furthermore, higher KPS (HR = 7.292, p < 0.001) readings, the operative method (HR = 0.493, p = 0.005), the use of CCNU (HR = 2.047, p = 0.003) and resection versus chemotherapy (HR = 0.171, p < 0.001) were the significant factors associated with the local recurrence of the tumor. Conclusion Our findings suggest that the use of CCNU and TMZ, the operative method and higher KPS readings are associated with both higher survival and lower local recurrence rates.

scholarly journals Risk factors associated with birth defects at a tertiary care center in Pakistan

2012 ◽  
Vol 38 (1) ◽  
pp. 68 ◽  
Author(s):  
Mohammad Zeeshan Raza ◽  
Asfandyar Sheikh ◽  
Syed Salman Ahmed ◽  
Sajid Ali ◽  
Syed Mumtaz Ali Naqvi
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Factors Associated

scholarly journals Acromegaly and the information gap: patient perceptions of the journey from primary to tertiary care

2020 ◽  
Vol 9 (10) ◽  
pp. 971-977
Author(s):  
Hei Yi Vivian Pak ◽  
Andrew Lansdown ◽  
Peter Taylor ◽  
Dafydd Aled Rees ◽  
John Stephen Davies ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Rare Condition ◽  
Structured Interview ◽  
Online Resources ◽  
Care Clinic ◽  
Tertiary Centre ◽  
Information Gap ◽  
Long Term Impact ◽  
A Prospective Study ◽  
Patient Relationships

Objective Acromegaly is a rare condition and there is often a long path to diagnosis for many patients. We sought to explore patient’s perceptions and understanding of acromegaly, to examine the quality of communication and find gaps in the information provided at diagnosis. Design A prospective study using qualitative research methodology and grounded theory. A semi-structured interview was conducted with 18 patients treated for acromegaly in a single tertiary centre and verbatim transcripts were thematically analysed for overarching themes. Results Eighteen patients with acromegaly were interviewed. The mean age of participants was 52 (range 30–72). Four overarching themes emerged; (1) Patients rely on online resources to understand acromegaly in the time between diagnosis and tertiary care clinic; (2) There is not enough support available for patients; (3) Patients have a basic understanding of acromegaly and associated conditions, but the long-term impact is underestimated; and (4) Patients initially felt intimidated by the multidisciplinary team panel, but overall found it useful. Conclusion Acromegalic patients have a strong need for information at the point of initial diagnosis, in particular online resources and interaction with other experienced patients. Wider dissemination of patient educational resources into primary and secondary care settings may improve overall patient satisfaction, treatment adherence and subsequent health care provider–patient relationships.

scholarly journals COVID-19 vaccine intentions and uptake in a tertiary care healthcare system: A longitudinal study

2021 ◽  
pp. 1-19
Author(s):  
Charlesnika T. Evans ◽  
Benjamin J. DeYoung ◽  
Elizabeth L. Gray ◽  
Amisha Wallia ◽  
Joyce Ho ◽  
...  
Keyword(s):  
Healthcare System ◽  
Tertiary Care ◽  
The Public ◽  
Factors Associated ◽  
Chicago Area ◽  
Clinical Procedures ◽  
System A ◽  
Serology Test ◽  
Vaccine Mandates

Abstract Objective Healthcare workers (HCWs) are a high priority group for COVID-19 vaccination and serve as sources for information for the public. This analysis assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys (November 25, 2020-January 9, 2021 and April 24-July 12, 2021) on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status. Results Of 4,180 HCWs who responded to a survey, 77.1% indicated they intended to get the vaccine; in this group, 23.2% had already received at least one dose of the vaccine (23.2%), 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures) and having a negative serology test for COVID-19 (vs no test) (adjusted odds ratio (AOR)=1.39, 95% Confidence Interval (CI) 1.16-1.65, AOR=1.46, 95% CI 1.24-1.73, respectively). Nurses (vs physicians, AOR=0.24 95% CI 0.17-0.33), non-Hispanic Black (vs Asians, AOR=0.35, 95% CI 0.21-0.59), and women (vs men, AOR=0.38, 95% CI 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, over 90% of those who had previously been unsure were vaccinated, while 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

scholarly journals One-year postoperative mortality rate among the elderly with hip fractures at a single tertiary care center

2020 ◽  
Vol 40 (4) ◽  
pp. 298-304
Author(s):  
Khalid A. Alsheikh ◽  
Firas M. Alsebayel ◽  
Faisal Abdulmohsen Alsudairy ◽  
Abdullah Alzahrani ◽  
Ali Alshehri ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Surgical Intervention ◽  
Care Center ◽  
Tertiary Care ◽  
The Elderly ◽  
Tertiary Care Center ◽  
Factors Associated ◽  
One Year

ABSTRACT BACKGROUND: Hip fractures are one of the leading causes of disability and dependency among the elderly. The rate of hip fractures has been progressively increasing due to the continuing increase in average life expectancy. Surgical intervention is the mainstay of treatment, but with an increasing prevalence of comorbid conditions and decreased functional capacity in elderly patients, more patients are prone to postoperative complications. OBJECTIVES: Assess the value of surgical intervention for hip fractures among the elderly by quantifying the 1-year mortality rate and assessing factors associated with mortality. DESIGN: Medical record review. SETTING: Tertiary care center. PATIENTS AND METHODS: All patients 60 years of age or older who sustained a hip fracture between the period of 2008 to 2018 in a single tertiary healthcare center. Data was obtained from case files, using both electronic and paper files. MAIN OUTCOME MEASURES: The 1-year mortality rate for hip fracture, postoperative complications and factors associated with mortality. SAMPLE SIZE: 802 patients. RESULTS: The majority of patients underwent surgical intervention (93%). Intra- and postoperative complications were 3% and 16%, respectively. Four percent of the sample died within 30 days, and 11% died within one year. In a multivariate analysis, an increased risk of 1-year mortality was associated with neck of femur fractures and postoperative complications ( P =.034, <.001, respectively) CONCLUSION: The 1-year mortality risk in our study reinforces the importance of aggressive surgical intervention for hip fractures. LIMITATION: Single-centered study. CONFLICT OF INTEREST: None.

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