Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for fracture in postmenopausal women. The WHILA study

Hyponatremia (HN) is one of the leading water-electrolyte disorders in daily medical practice. A decrease in sodium level is dangerous with the development of various complications. Therefore, for effective prevention of HN and its complications, special attention should be paid to modifiable risk factors. One of the important causes leading to HN is drugs. Most often, HN develops during therapy with thiazide and thiazidelike diuretics. Risk factors for its development are history of thiazide-induced HN, advanced age, female sex, low body weight, and hypokalemia. The problem of thiazide-induced HN requires further study of the pathogenetic mechanisms and determination of the genetic factors underlying it. It is also necessary to remember about the possibility of HN development against the background of such drugs widely used in therapeutic practice as blockers of the renin-angiotensin-aldosterone system and proton pump inhibitors. In patients receiving therapy with the listed drugs, it is necessary to pay attention to the possible clinical manifestations of HN and to determine the sodium level in dynamics, which will effectively prevent the development of this disorder.

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Proton Pump Inhibitors Raise Hip Fracture Risk in Postmenopausal Women

AJN American Journal of Nursing ◽

10.1097/01.naj.0000414308.18589.04 ◽

2012 ◽

Vol 112 (5) ◽

pp. 18

Author(s):

Carol Potera

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

Postmenopausal Women ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Hip Fracture Risk

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Differences in initial versus recurrent diabetic foot ulcers at a specialized tertiary diabetic foot care center in China

Journal of International Medical Research ◽

10.1177/0300060520987398 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098739

Author(s):

Yuxia Cheng ◽

Ping Zu ◽

Jie Zhao ◽

Lintao Shi ◽

Hongyan Shi ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Blood Glucose Control ◽

Diabetes Duration ◽

Chinese Patients ◽

Foot Care ◽

Vascular Intervention ◽

History Of ◽

Independent Risk Factors ◽

Recurrence Group

Objective To investigate the characteristics of diabetic foot ulcer (DFU) recurrence. Methods A total of 573 patients with DFUs were recruited and divided into an initial group (395 patients) and a recurrence group (178 patients). The factors related to recurrence were analyzed using multivariate regression. Results The recurrence group had longer diabetes duration (odds ratio [OR] 192; 95% confidence interval 120, 252 vs. 156; 96, 240); lower glycated hemoglobin levels (OR 8.1; 95% CI 6.8, 9.6 vs. 9.1; 7.4, 10.5), and higher rates than the initial group of amputation (37.5% vs. 2.0%), history of vascular intervention (21.3% vs. 3.9%), retinopathy (77.7% vs. 64.7%), callus (44.4% vs. 20.8%), foot deformity (51.2% vs. 24.6%), and outdoor sports shoe wearing (34.0% vs. 21.2%). Multiple factor logistic regression analysis showed that diabetes duration (OR 1.004), callus (OR 2.769), vascular intervention (OR 2.824) and amputation (OR 22.256) were independent risk factors for DFU recurrence. Conclusion Diabetes duration, callus, history of vascular intervention, and amputation were independent risk factors for recurrent DFUs in a cohort of Chinese patients with active DFU. The prevention and treatment of DFUs, especially callus treatment, foot care, and blood glucose control, should be improved in China.

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Stroke prediction in patients presenting with isolated dizziness in the emergency department

Scientific Reports ◽

10.1038/s41598-021-85725-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

June-sung Kim ◽

Hong Jun Bae ◽

Muyeol Kim ◽

Shin Ahn ◽

Chang Hwan Sohn ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Multivariate Analysis ◽

Acute Stroke ◽

Neurological Deficits ◽

Cerebrovascular Injury ◽

Risk Patients ◽

History Of ◽

Independent Risk Factors ◽

Record Review

AbstractDiagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. The aim of this study was to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

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Dysmotility and proton pump inhibitor use are independent risk factors for small intestinal bacterial and/or fungal overgrowth

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.12304 ◽

2013 ◽

Vol 37 (11) ◽

pp. 1103-1111 ◽

Cited By ~ 82

Author(s):

C. Jacobs ◽

E. Coss Adame ◽

A. Attaluri ◽

J. Valestin ◽

S. S. C. Rao

Keyword(s):

Risk Factors ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Independent Risk Factors ◽

Small Intestinal

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Risk of Clostridium difficile-Associated Disease Among Patients Receiving Proton-Pump Inhibitors in a Quebec Medical Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1086/521664 ◽

2007 ◽

Vol 28 (11) ◽

pp. 1305-1307 ◽

Cited By ~ 40

Author(s):

Mathieu Beaulieu ◽

David Williamson ◽

Gilbert Pichette ◽

Jean Lachaine

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Clostridium Difficile ◽

Gastric Acid ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Medical Intensive Care Unit ◽

Antibiotic Use ◽

Medical Intensive Care

Our study was conducted to determine whether use of gastric acid-suppressive agents increased the risk of Clostridium difficile-associated disease (CDAD) in a medical intensive care unit of one of the first hospitals to be threatened by the current CDAD epidemic in Quebec, Canada. Our findings suggest that efforts to determine risk factors for CDAD should focus on other areas, such as older age and antibiotic use.

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Carbapenem-ResistantKlebsiella pneumoniaein Post-Acute-Care Facilities in Israel

Infection Control and Hospital Epidemiology ◽

10.1086/661279 ◽

2011 ◽

Vol 32 (9) ◽

pp. 845-853 ◽

Cited By ~ 71

Author(s):

Debby Ben-David ◽

Samira Masarwa ◽

Shiri Navon-Venezia ◽

Hagit Mishali ◽

Ilan Fridental ◽

...

Keyword(s):

Risk Factors ◽

Acute Care ◽

Case Control Study ◽

Case Control ◽

Antibiotic Exposure ◽

Care Facilities ◽

History Of ◽

Independent Risk Factors ◽

Acute Care Facilities ◽

Control Study

Objective.To assess the prevalence of and risk factors for carbapenem-resistantKlebsiella pneumoniae(CRKP) carriage among patients in post-acute-care facilities (PACFs) in Israel.Design, Setting, and Patients.A cross-sectional prevalence survey was conducted in 12 PACFs. Rectal swab samples were obtained from 1,144 patients in 33 wards. Risk factors for CRKP carriage were assessed among the cohort. Next, a nested, matched case-control study was conducted to define individual risk factors for colonization. Finally, the cohort of patients with a history of CRKP carriage was characterized to determine risk factors for continuous carriage.Results.The prevalence of rectal carriage of CRKP among 1,004 patients without a history of CRKP carriage was 12.0%. Independent risk factors for CRKP carriage were prolonged length of stay (odds ratio [OR], 1.001;P< .001), sharing a room with a known carrier (OR, 3.09;P= .02), and increased prevalence of known carriers on the ward (OR, 1.02;P= .013). A policy of screening for carriage on admission was protective (OR, 0.41;P= .03). Risk factors identified in the nested case-control study were antibiotic exposure during the prior 3 months (OR, 1.66;P= .03) and colonization with other resistant pathogens (OR, 1.64;P= .03). Among 140 patients with a history of CRKP carriage, 47% were colonized. Independent risk factors for continued CRKP carriage were antibiotic exposure during the prior 3 months (OR, 3.05;P= .04), receipt of amoxicillin-clavulanate (OR, 4.18;P= .007), and screening within 90 days of the first culture growing CRKP (OR, 2.9;P= .012).Conclusions.We found a large reservoir of CRKP in PACFs. Infection-control polices and antibiotic exposure were associated with patient colonization.

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Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

10.20944/preprints201912.0205.v2 ◽

2020 ◽

Author(s):

Abhishek Sharma ◽

Aditya Mathur ◽

Cecilia Stålsby Lundborg ◽

Ashish Pathak

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

World Health ◽

Respiratory Pattern ◽

Care Hospital ◽

Severe Dehydration ◽

Cross Sectional ◽

Oral Rehydration ◽

History Of ◽

Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

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Stroke prediction in patients presenting with isolated dizziness in the emergency department

10.21203/rs.3.rs-118052/v1 ◽

2020 ◽

Author(s):

June-sung Kim ◽

Hong Jun Bae ◽

Muyeol Kim ◽

Shin Ahn ◽

Chang Hwan Sohn ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Multivariate Analysis ◽

Acute Stroke ◽

Neurological Deficits ◽

Cerebrovascular Injury ◽

Risk Patients ◽

History Of ◽

Independent Risk Factors ◽

Record Review

Abstract Diagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. This study tried to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2,215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1,239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1,239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

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