Staphylococcus aureus carriage in care homes: identification of risk factors, including the role of dementia

2010 ◽  
Vol 138 (5) ◽  
pp. 686-696 ◽  
Author(s):  
G. LASSETER ◽  
A. CHARLETT ◽  
D. LEWIS ◽  
I. DONALD ◽  
R. HOWELL-JONES ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Care Homes ◽  
Prevalence Survey ◽  
Nasal Swabs ◽  
Agar Media ◽  
Associated Risk Factors

SUMMARYThe aim of this study was to investigate the prevalence and associated risk factors of methicillin-susceptible and methicillin-resistant Staphylocccus aureus (MSSA and MRSA) carriage in care homes, with particular focus on dementia. A point-prevalence survey of 748 residents in 51 care homes in Gloucestershire and Greater Bristol was undertaken. Dementia was assessed by the clock test or abbreviated mini-mental test. Nasal swabs were cultured for S. aureus on selective agar media. Multivariable analysis indicated that dementia was not a significant risk factor for MSSA (16·2%) or MRSA (7·8%); and that residents able to move around the home unassisted were at a lower risk of MRSA (P=0·04). MSSA carriage increased with increasing age (P=0·03) but MRSA carriage decreased with increasing age (P=0·05). Hospitalization in the last 6 months increased the risk of MSSA (P=0·04) and MRSA (P=0·10). We concluded that cross-infection through staff caring for more dependent residents may spread MRSA within care homes and from the recently hospitalized. Control of MSSA and MRSA in care homes requires focused infection control interventions.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents

2018 ◽  
Vol 41 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Frédéric Rafflenbeul ◽  
Catherine-Isabelle Gros ◽  
François Lefebvre ◽  
Sophie Bahi-Gross ◽  
Raphaëlle Maizeray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Root Resorption ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Data Sets ◽  
Maxillary Canine ◽  
3D Data ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.

Preoperative in-hospital mortality in neonates with critical CHD

2021 ◽  
pp. 1-7
Author(s):  
Dennis R. Delany ◽  
Shahryar M. Chowdhury ◽  
Corinne Corrigan ◽  
Jason R. Buckley
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Patient Care ◽  
Multivariable Analysis ◽  
Health Information System ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Interrupted Aortic Arch ◽  
Administrative Dataset ◽  
Care Improvement

Abstract Objective: Data regarding preoperative mortality in neonates with critical CHD are sparse and would aid patient care and family counselling. The objective of this study was to utilise a multicentre administrative dataset to report the rate of and identify risk factors for preoperative in-hospital mortality in neonates with critical CHD across US centres. Study design: The Pediatric Health Information System database was utilised to search for newborns ≤30 days old, born 1 January 2009 to 30 June 2018, with an ICD-9/10 code for d-transposition of the great arteries, truncus arteriosus, interrupted aortic arch, or hypoplastic left heart syndrome. Preoperative in-hospital mortality was defined as patients who died prior to discharge without an ICD code for cardiac surgery or interventional catheterisation. Results: Overall preoperative mortality rate was at least 5.4% (690/12,739) and varied across diagnoses (d-TGA 2.9%, TA 8.3%, IAA 5.5%, and HLHS 7.3%) and centres (0–20.5%). In multivariable analysis, risk factors associated with preoperative mortality included preterm delivery (<37 weeks) (OR 2.3, 95% CI: 1.8–2.9; p < 0.01), low birth weight (<2.5 kg) (OR 3.8, 95% CI: 3.0–4.7; p < 0.01), and genetic abnormality (OR 1.6, 95% CI: 1.2–2.2; p < 0.01). Centre average surgical volume was not a significant risk factor. Conclusion: Approximately 1 in 20 neonates with critical CHD suffered preoperative in-hospital mortality, and rates varied across diagnoses and centres. Better understanding of the factors that drive the variation (e.g. patient factors, preoperative care models, surgical timing) could help identify patient care improvement opportunities and inform conversations with families.

Peripherally inserted central catheter-related complications in cancer patients: a prospective study of over 50,000 catheter days

2017 ◽  
Vol 18 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Junren Kang ◽  
Wei Chen ◽  
Wenyan Sun ◽  
Ruibin Ge ◽  
Hailong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Multivariable Logistic Regression Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Multicenter Cohort Study ◽  
Related Factors

Purpose To evaluate incidence and risk factors of peripherally inserted central catheter (PICC)-related complications in cancer patients. Methods A prospective, multicenter, cohort study of cancer patients with PICC insertion was performed from February 1, 2013 to April 24, 2014. All patients were monitored in clinic until PICCs were removed. The primary endpoint was PICC removal due to complications. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression analysis to identify significant independent risk factors for PICC-related complications. Results There were 477 cancer patients included, for a total of 50,841 catheter-days. Eighty-one patients (17.0%) developed PICC-related complications, with an incidence of 1.59 per 1000 catheter days. Thirty-six (7.5%) PICCs were removed because of complications. The most common complications were skin allergy (4.6%), catheter occlusion (3.4%) and accidental withdrawal (2.3%). Nine (1.9%) patients developed symptomatic upper extremity deep venous thrombosis (UEDVT) and central line associated bloodstream infection (CLABSI) was shown in six (1.3%) PICCs with an infection rate 0.12 per 1000 catheter days. In multivariable analysis, body mass index (BMI) >25 (odds ratio, 2.09; 95% confidence interval, 1.26-3.47, p = 0.004) was shown to be a significant risk factor for PICC complications. Conclusions Cancer patients with BMI greater than 25 were more likely to have PICC complications.

Atrial fibrillation and obesity

ESC CardioMed ◽  
2018 ◽  
pp. 2232-2235
Author(s):  
Rajiv Mahajan ◽  
Dennis H. Lau ◽  
Prashanthan Sanders
Keyword(s):  
Atrial Fibrillation ◽  
Randomized Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Therapeutic Benefit ◽  
Sleep Apnoea ◽  
Attributable Risk ◽  
Associated Risk Factors ◽  
Epidemiological Link

Obesity is increasingly recognized as a significant risk factor for the burgeoning prevalence of atrial fibrillation (AF). With the growing epidemic of obesity, it is poised to soon have the highest attributable risk of AF. While often associated with co-morbid conditions such as hypertension, diabetes, and sleep apnoea, all known to be associated with AF, there is increasing evidence of a direct pathogenic role of obesity in forming the substrate for AF. Interestingly, a randomized study and observational cohorts have reported that weight loss and treatment of associated risk factors is associated with a reduction in AF symptoms and burden and improved likelihood of maintaining sinus rhythm. This chapter focuses on the epidemiological link between these conditions, the potential mechanisms of this association, and the emerging evidence that treating obesity may have a therapeutic benefit in the management of AF.

scholarly journals Evaluation of Risk Factors for Peste des Petits Ruminants Virus in Sheep and Goats at the Wildlife-Livestock Interface in Punjab Province, Pakistan

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Aziz-ul-Rahman ◽  
Muhammad Abubakar ◽  
Muhammad Hidayat Rasool ◽  
Shumaila Manzoor ◽  
Muhammad Saqalein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Small Ruminants ◽  
Significant Risk Factor ◽  
N Gene ◽  
High Morbidity ◽  
Peste Des Petits Ruminants ◽  
Sheep And Goats ◽  
Wild Ruminants ◽  
Nasal Swabs

Peste des petits ruminants virus (PPRV) is causing infectious disease with high morbidity and mortality rate in domestic and wild small ruminants of Pakistan with valuable economical losses. The present study was carried out to investigate risk factors of PPRV in domestic small ruminants which were present in the vicinity of wildlife parks. A total of 265 sera samples (27 wild ruminants and 238 domesticated small ruminants) from apparently healthy animals from two different wildlife parks were collected and analysed for PPRV antibodies. Also, 20 nasal swabs from domestic small ruminants showing respiratory signs were collected to check for presence of PPRV antigen. Competitive ELISA revealed highest proportions of anti-PPRV antibodies in domestic small ruminants around the Wildlife Park at Lahore (35%) as compared to Faisalabad (13%), with no existence of PPRV antibodies in tested serum of wild ruminants at these parks. Higher seropositivity was observed in females (25.6%) than in males (5.1%) and in goats (34.5%) compared to sheep (11.2%). The results of N-gene based RT-PCR highlight the absence of PPRV due to lack of current PPR outbreak in the region during study period. Even though grazing was not a significant risk factor, there is still a possibility of wildlife-livestock interactions for feed and water reservoirs, resulting in spillover of PPR to wildlife. Keeping in view the high seropositivity and risk of PPR, vaccination should be adopted to avoid circulation of PPRV among wild and domestic small ruminants (sheep and goats).

scholarly journals Trends in HIV Prevalence, Condom Use and Associated Factors among Female Sex Workers in Denpasar, Bali, Indonesia

2014 ◽  
Vol 2 (1) ◽  
pp. 2
Author(s):  
Dewa Nyoman Wirawan ◽  
Emily Rowe ◽  
Made Suarjaya ◽  
Luh Putu Sri Armini
Keyword(s):  
Risk Factors ◽  
Condom Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Significant Risk ◽  
Hiv Prevalence ◽  
High Price ◽  
Female Sex ◽  
Associated Risk Factors

Objectives: The purpose of this paper is to review trends of HIV prevalence, condom use and associated risk factors among the female sex workers (FSW) in Denpasar, Bali.  Methods: To analyze trends of HIV prevalence, surveillance data from 2000-2013 was used. Survey data from 2007 to 2013 was referenced for analysis of condom use trends. Data on associated risk factors was taken from 2012 integrated HIV and behavior survey. Results and conclusion: HIV prevalence among direct FSW in 2000 was as low as 1.6% (95%CI: 0.05-3.15) and continued to rise, reaching a prevalence peak of 22.5% (95%CI: 16.4-26.6) in 2010.  HIV prevalence began to decline in 2011, 2012 and 2013. Analysis unearthed similar prevalence trends among indirect FSW albeit with a much lower prevalence of 0.25% in 2001, rising to 7.2% in 2010 and declining to 2.2% in 2013. The proportion of direct FSW reporting to always wear condoms in the last working week increased from 38% in 2007 (95%CI: 33.3-42.7) to 65% in 2013 (95%CI: 60.4-69.6). Multivariate analysis with logistic regression indicated that the significant risk factor with HIV prevalence was the specific grouping of FSW, in that low/mid-price are more at risk in comparison to high price with OR=4.37 (95%CI: 1.42-13.38). Risk factors associated with condom use was also the specific group of FSW, high price reported higher condom use with OR=4.04 (95%CI:2.03-8.04) and greater role of sex work site ‘pimps’ in encouraging their FSW to reject clients refusing to wear condoms with OR=2.06 (95%CI: 1.29-3.30). HIV prevalence among indirect and high-price direct FSW was much lower compared to prevalence in low/mid-price direct FSW. HIV prevalence and condom use among direct FSW population are significantly associated with group price range and the role of ‘pimps’.

scholarly journals Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the south western Nepal: a comparative study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Tulsi Ram Gompo ◽  
Rubina Shah ◽  
Ishwari Tiwari ◽  
Yam Bahadur Gurung
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Small Ruminants ◽  
Control Program ◽  
Significant Risk Factor ◽  
Serum Samples ◽  
Cross Sectional ◽  
Sheep Population ◽  
Goat Population ◽  
Associated Risk Factors

Abstract Background Brucellosis is a zoonotic disease caused by Brucella spp. In Nepal, the presence of brucellosis in small ruminants, namely sheep and goats, has impacted farmers’ livelihood and the food safety of consumers. A cross-sectional study was conducted in Rupandehi district of Nepal during January to March 2020 to investigate the seroepidemiology and associated risk factors of brucellosis in the sheep and goat population. Altogether, 19 sheep and 60 goat farms in the district were visited. Owners were interviewed to get information on animals, including their management and movement patterns. Three hundred fifty-seven samples (80 sheep and 277 goat samples) were collected proportionately based on farm sizes. Each serum sample was tested with Rose Bengal Test and ELISA to estimate the seropositivity of brucellosis. Logistic regression was carried out to calculate corresponding odds ratios of each variable associated with detection of brucellosis. Results At the farm level, 31.6% (6/19; 95% CI: 12, 54%) of sheep farms and 3.3% (2/60, 95% CI: 0.9, 11.4%) of goat farms were seropositive to brucellosis. Out of 80 sheep serum samples, 12 (15%; 95% CI: 8.79–24.41%) and out of 277 goat serum samples, three (1.1%; 95% CI: 0.37–3.14%) were seropositive to brucellosis. Age greater than 1.5 years (OR = 5.56, 95% CI: 1.39, 29.38; p = 0.02) and herd size of greater than 100 (OR = 4.74, 95% CI: 1.23, 20.32, p = 0.03) were identified as significant risk factors for seropositivity of brucellosis in the sheep population. While in the goat population, none of the variables was identified as a significant risk factor. Conclusion The study provides evidence that the older sheep and the sheep from the large herds were at higher risk of brucellosis. A control program should be put in place immediately in the sheep population because they may transmit infections to other livestock as they were regularly moved for grazing and selling purposes. Also, strict biosecurity measures should be implemented among pastoralists to prevent brucellosis transmission in them. We suggest further one health-based study to reveal the transmission dynamics of brucellosis between animals and humans.

scholarly journals Risk Factors for COVID-19 versus non-COVID-19 related in-hospital and community deaths by Local Authority District in Great Britain

2020 ◽  
Author(s):  
Samuel Paul Leighton ◽  
Danielle Jane Leighton ◽  
James Herron ◽  
Rachel Upthegrove ◽  
Jonathan Cavanagh ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Air Pollution ◽  
Great Britain ◽  
Public Health Policy ◽  
Hospital Care ◽  
Local Authority ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Care Homes

Objectives: To undertake a preliminary hypothesis-generating analysis exploring putative risk factors for coronavirus diseae 2019 (COVID-19) population-adjusted deaths, compared with non-COVID-19 related deaths, at a local authority district (LAD) level in hospital, care homes and at home. Design: Ecological retrospective cohort study Setting Local authority districts (LADs) in England, Scotland and Wales (Great Britain (GB)). Participants All LAD deaths registered by week 16 of 2020. Main Outcome Measures Death registration where COVID-19 is mentioned as a contributing factor per 100,000 people in all settings, and in i) cares homes, ii) hospitals or iii) home only, in comparison to non-COVID-19 related deaths. Results Across GB by week 16 of 2020, 20,684 deaths had been registered mentioning COVID-19, equivalent to 25.6 per 100,000 people. Significant risk factors for LAD COVID-19 death in comparison to non-COVID-19 related death were air pollution and proportion of the population who were female. Significant protective factors were higher air temperature and proportion of the population who were ex-smokers. Conversely, for all COVID-19 unrelated deaths in comparison to COVID-19 deaths, higher rates of communal living, higher population rates of chronic kidney disease, chronic obstructive pulmonary disease, cerebrovascular disease deaths under 75 and dementia were predictive of death, whereas, higher rates of flight passengers was protective. Looking at individual setttings, the most notable findings in care homes was Scotland being a significant risk factor for COVID-19 related deaths compared to England. For hospital setting, the proportion of the population who were from black and Asian minority ethnic (BAME) groups significantly predicted COVID-19 related death. Conclusions This is the first study within GB to assess COVID-19 related deaths in comparison to COVID-19 unrelated deaths across hospital, care homes and home combined. As an ecological study, the results cannot be directly extrapolated to individuals. However, the analysis may be informative for public health policy and protective measures. From our hypothesis-generating analysis, we propose that air pollution is a significant risk factor and high temperature a significant protective factor for COVID-19 related deaths. These factors cannot readily be modelled at an individual level. Scottish local authorities and local authorities with a higher proportion of individuals of BAME origin are potential risk factors for COVID-19 related deaths in care homes and in hospitals, respectively. Altogether, this analysis shows the benefits of access to high quality open data for public information, public health policy and further research.

scholarly journals Complications of biliary-enteric anastomoses

2017 ◽  
Vol 99 (3) ◽  
pp. 210-215 ◽  
Author(s):  
RS Kadaba ◽  
KA Bowers ◽  
S Khorsandi ◽  
RR Hutchins ◽  
AT Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anastomotic Leak ◽  
Anastomotic Stricture ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Late Complications ◽  
Biliary Reconstruction ◽  
Tertiary Referral Centre ◽  
Younger Age

INTRODUCTION Biliary-enteric anastomoses are performed for a range of indications and may result in early and late complications. The aim of this study was to assess the risk factors and management of anastomotic leak and stricture following biliary-enteric anastomosis. METHODS A retrospective analysis of the medical records of patients who underwent biliary-enteric anastomoses in a tertiary referral centre between 2000 and 2010 was performed. RESULTS Four hundred and sixty-two biliary-enteric anastomoses were performed. Of these, 347 (75%) were performed for malignant disease. Roux-en-Y hepaticojejunostomy or choledocho-jejunostomy were performed in 440 (95%) patients. Perioperative 30-day mortality was 6.5% (n=30). Seventeen patients had early bile leaks (3.7%) and 17 had late strictures (3.7%) at a median of 12 months. On univariable logistic regression analysis, younger age was a significant risk factor for biliary anastomotic leak. However, on multivariable analysis only biliary reconstruction following biliary injury (odds ratio [OR]=6.84; p=0.002) and anastomosis above the biliary confluence (OR=4.62; p=0.03) were significant. Younger age and biliary reconstruction following injury appeared to be significant risk factors for biliary strictures but multivariable analysis showed that only younger age was significant. CONCLUSIONS Biliary-enteric anastomoses have a low incidence of early and late complications. Biliary reconstruction following injury and a high anastomosis (above the confluence) are significant risk factors for anastomotic leak. Younger patients are significantly more likely to develop an anastomotic stricture over the longer term.

scholarly journals Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the south western Nepal: A comparative study

2020 ◽  
Author(s):  
Tulsi Ram Gompo ◽  
Rubina Shah ◽  
Ishwari Tiwari ◽  
Yam Bahadur Gurung
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Small Ruminants ◽  
Control Program ◽  
Significant Risk Factor ◽  
Serum Samples ◽  
Cross Sectional ◽  
Sheep Population ◽  
Goat Population ◽  
Associated Risk Factors

Abstract BackgroundBrucellosis is a zoonotic disease of animals and humans caused by the Brucella spp. In Nepal, the presence of brucellosis in small ruminants, such as sheep and goats, has impacted farmers' livelihood and the food safety of the consumer. A cross-sectional study was conducted in the Rupandehi district of Nepal to investigate the seroepidemiology and associated risk factors of brucellosis in the sheep and goat population. Altogether, nineteen sheep and sixty goat farms located in the district were visited. The owners were interviewed to get information on animals, including their management and movement patterns. Three hundred fifty-seven samples (80 sheep and 277 goat samples) were collected proportionately based on the farm sizes. Each serum sample was tested with Rose Bengal Test and ELISA to estimate the seropositivity of brucellosis. Logistic regression was applied to calculate corresponding odds ratios of each variable associated with detection brucellosis. Results At the farm level, 31.6% (6/19; 95% CI: 12%, 54%) of sheep farms and 3.3% (2/60, 95% CI: 0.9%, 11.4 %) of the goat farms were seropositive to brucellosis. Out of 80 sheep serum samples, 12 (15%; 95% CI: 8.79%-24.41%) and out of 277 goat serum samples 3 (1.1%; 95% CI: 0.37%-3.14%) were seropositive to brucellosis. Age greater than 1.5 years (OR= 5.56, 95% CI: 1.39, 29.38, p = 0.02) and herd size of greater than a hundred (OR= 4.74, 95% CI: 1.23, 20.32, p = 0.03) were identified as significant risk factors for seropositivity of brucellosis in the sheep population. While in the goat population, none of the variables was identified as a significant risk factor. ConclusionThe study provides evidence that the older sheep and the sheep from the large herd sizes were at higher risk of detecting brucellosis. A control program should be applied immediately in the sheep population because they may transmit infections to other livestock as they were regularly moved for grazing and selling purposes. Also, strict biosecurity measures should be implemented among pastoralists to prevent brucellosis transmission in them. We suggest further one health-based study to reveal the transmission dynamics of brucellosis between animals and humans.

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