scholarly journals Negative latent tuberculosis at time of incarceration: identifying a very high-risk group for infection

2017 ◽  
Vol 145 (12) ◽  
pp. 2491-2499 ◽  
Author(s):  
L. ARROYAVE ◽  
Y. KEYNAN ◽  
L. LÓPEZ ◽  
D. MARIN ◽  
M. P. ARBELÁEZ ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Latent Tuberculosis ◽  
Risk Groups ◽  
High Risk Group ◽  
World Health ◽  
Formerly Incarcerated ◽  
Adjusted Risk ◽  
Number Needed To Screen ◽  
Health Organization

SUMMARYThe main aim was to measure the incidence of latent tuberculosis infection (LTBI) and identify risk factors associated with infection. In addition, we determined the number needed to screen (NNS) to identify LTBI and active tuberculosis. We followed 129 prisoners for 2 years following a negative two-step tuberculin skin test (TST). The cumulative incidence of TST conversion over 2 years was 29·5% (38/129), among the new TST converters, nine developed active TB. Among persons with no evidence of LTBI, the NNS to identify a LTBI case was 3·4 and an active TB case was 14·3. The adjusted risk factors for LTBI conversion were incarceration in prison number 1, being formerly incarcerated, and overweight. In conclusion, prisoners have higher risk of LTBI acquisition compared with high-risk groups, such as HIV-infected individuals and children for whom LTBI testing should be performed according to World Health Organization guidance. The high conversion rate is associated with high incidence of active TB disease, and therefore we recommend mandatory LTBI screening at the time of prison entry. Individuals with a negative TST at the time of entry to prison are at high risk of acquiring infection, and should therefore be followed in order to detect convertors and offer LTBI treatment. This approach has a very low NNS for each identified case, and it can be utilized to decrease development of active TB disease and transmission.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

scholarly journals Triglyceride glucose-body mass index in identifying high-risk groups of pre-diabetes

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chunyuan Jiang ◽  
Ruijuan Yang ◽  
Maobin Kuang ◽  
Meng Yu ◽  
Mingchun Zhong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
High Risk ◽  
Diagnostic Criteria ◽  
Body Mass ◽  
Cox Regression ◽  
Risk Groups ◽  
World Health ◽  
Obese People ◽  
Cox Regression Analysis ◽  
Health Organization

Abstract Background Triglyceride glucose-body mass index (TyG-BMI) has been recommended as an alternative indicator of insulin resistance. However, the association between TyG-BMI and pre-diabetes remains to be elucidated. Methods More than 100,000 subjects with normal glucose at baseline received follow-up. The main outcome event of concern was pre-diabetes defined according to the diagnostic criteria recommended by the American Diabetes Association (ADA) in 2018 and the World Health Organization (WHO) in 1999. A Cox proportional hazard regression model was used to evaluate the role of TyG-BMI in identifying people at high risk of pre-diabetes. Results At a mean observation period of 3.1 years, the incidence of pre-diabetes in the cohort was 3.70 and 12.31% according to the WHO and ADA diagnostic criteria for pre-diabetes, respectively. The multivariate Cox regression analysis demonstrated that TyG-BMI was independently positively correlated with pre-diabetes, and there was a special population dependence phenomenon. Among them, non-obese people, women and people under 50 years old had a significantly higher risk of TyG-BMI-related pre-diabetes (P-interaction< 0.05). Conclusions These findings suggest that a higher TyG-BMI significantly increases an individual’s risk of pre-diabetes, and this risk is significantly higher in women, non-obese individuals, and individuals younger than 50 years of age.

scholarly journals High risk individuals in COVID-19 pandemic; an updated review

2020 ◽  
Vol 7 (2) ◽  
pp. e25-e25
Author(s):  
Rojin Chegini ◽  
Alireza Bolurian ◽  
Zahra Mojtahedi ◽  
Masoud Hafizi
Keyword(s):  
High Risk ◽  
Organ Transplant ◽  
Risk Groups ◽  
World Health ◽  
Chronic Obstructive ◽  
Solid Organ ◽  
Obstructive Pulmonary Disease ◽  
Gastrointestinal Complications ◽  
Control And Prevention ◽  
Health Organization

In December 2019, cases of pneumonia with an unknown pathogen were reporting in Wuhan city, China. The World Health Organization (WHO) recognized it as a pandemic, on March 11, 2020. The most frequent site of involvement is the respiratory system. The most common symptoms include cough, fatigue and fever. In some cases, neurological, respiratory and gastrointestinal complications can lead to death. Inflammatory cytokines can play a major role in pathogen damage. Due to the pandemic of COVID-19 and its severe complications, it is critical to identify the high-risk groups. Since this disease has a rapid transmission, following the instructions announced by the WHO, prevention is vital, especially in people with risk factors for disease complications and mortality. According to the latest reports by CDC (Center for Disease Control and Prevention), older age and having some medical conditions such as smoking, obesity (BMI ≥30 kg/m2 ), chronic obstructive pulmonary disease (COPD), heart disease, cancer, solid organ transplant, type 2 diabetes mellitus, chronic renal failure, and sickle cell anemia in younger adults are known disease severity risk factor.

scholarly journals Guidelines on controlling latent tuberculosis infection to support tuberculosis elimination

2021 ◽  
Vol 23 (1) ◽  
pp. 28-36
Author(s):  
P Godoy
Keyword(s):  
Treatment Guidelines ◽  
Latent Tuberculosis ◽  
Homeless People ◽  
Risk Groups ◽  
World Health ◽  
Sufficient Evidence ◽  
Short Treatment ◽  
Short Period ◽  
Latent Tb Infection ◽  
Health Organization

Objectives: Latent TB infection (LTBI) affects 25% of the world’s population. As long as this reservoir exists, the elimination of TB will not be feasible. The Assembly of the World Health Organization adopted the “Global End TB” strategy for the elimination of TB in 2014. The objective of this review is to present strategies for risk groups that are candidates for the detection and treatment of LTBI. Material and method: There is sufficient evidence of screening in: immunocompromised people (HIV-infected, biological therapies, alternative renal therapy, organ transplantation), recent immigrants, inmates in prison, people injecting drugs and homeless people, and workers from at-risk settings. Tests to diagnose LTBI include tuberculin skin test (TST) and gamma release assay interferon (IGRA). There is no reference test and the choice of one or the other will depend on logistical considerations, such as avoiding injection (TST) or not needing a second visit (IGRA). Treatment of LTBI is based on the use of isoniazide and rifampicin in short period of 3 or 4 months, using associations of rifampicin and isoniazide or rifampicin alone. Discussion: Given the estimated high prevalence of LTBI, renewed efforts are required to reduce the number of people with LTBI that includes a registration and monitoring system to observer progress, increased testing, and the use of short treatment guidelines.

scholarly journals Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

2019 ◽  
Vol 69 (12) ◽  
pp. 2101-2108 ◽  
Author(s):  
Lisa A Ronald ◽  
Jonathon R Campbell ◽  
Caren Rose ◽  
Robert Balshaw ◽  
Kamila Romanowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
World Health Organization ◽  
Retrospective Cohort ◽  
Latent Tuberculosis ◽  
World Health ◽  
Administrative Databases ◽  
Ltbi Screening ◽  
Immunosuppressive Medications ◽  
Health Organization ◽  
The Impact

Abstract Background Latent tuberculosis infection (LTBI) screening and treatment is a key component of the World Health Organization (WHO) EndTB Strategy, but the impact of LTBI screening and treatment at a population level is unclear. We aimed to estimate the impact of LTBI screening and treatment in a population of migrants to British Columbia (BC), Canada. Methods This retrospective cohort included all individuals (N = 1 080 908) who immigrated to Canada as permanent residents between 1985 and 2012 and were residents in BC at any time up to 2013. Multiple administrative databases were linked to identify people with risk factors who met the WHO strong recommendations for screening: people with tuberculosis (TB) contact, with human immunodeficiency virus, on dialysis, with tumor necrosis factor-alpha inhibitors, who had an organ/haematological transplant, or with silicosis. Additional TB risk factors included immunosuppressive medications, cancer, diabetes, and migration from a country with a high TB burden. We defined active TB as preventable if diagnosed ≥6 months after a risk factor diagnosis. We estimated the number of preventable TB cases, given optimal LTBI screening and treatment, based on these risk factors. Results There were 16 085 people (1.5%) identified with WHO strong risk factors. Of the 2814 people with active TB, 118 (4.2%) were considered preventable through screening with WHO risk factors. Less than half (49.4%) were considered preventable with expanded screening to include people migrating from countries with high TB burdens, people who had been prescribed immunosuppressive medications, or people with diabetes or cancer. Conclusions The application of WHO LTBI strong recommendations for screening would have minimally impacted the TB incidence in this population. Further high-risk groups must be identified to develop an effective LTBI screening and treatment strategy for low-incidence regions.

Chemotherapy-associated thrombosis in cancer outpatients: Risk factors and decision making of a prophylactic approach.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20647-e20647
Author(s):  
Martina Torchio ◽  
Benvenuto Franceschetti ◽  
Carla Cavali ◽  
Sonia Zanirato ◽  
Angelo Olgiati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
High Risk ◽  
Scoring System ◽  
Risk Group ◽  
Venous Catheter ◽  
Risk Groups ◽  
High Risk Group ◽  
Factors Analysis ◽  
Negative Predictor

e20647 Background: Venous thromboembolism (VTE), is a negative predictor of survival in pts with advanced cancer. International guidelines don’t recommend routine prophlaxis but suggest to consider pts, undergoing chemotherapy (CT), with high risk of VTE. Many clinical risk factors for cancer-associated VTE have been evaluated in a 5 parameter-based (body mass index, platelet and leucocyte counts, hemoglobin value and tumor site) scoring system, the Khorana score, utilized to indicate a prophylactic approach. We prospectively applied this score in cancer outpts beginning CT and an implementation based on 6 addictional factors analysis (sex, age, central venous catheter, CT-agents, antiangiogenetic drugs, erithropoiesis stimulating agent) to evaluate their impact in pts assignment into risk groups. Methods: We studied adult pts, followed at our Department from August 2011 to December 2012, with advanced cancers (breast, NSCLC, colorectal, pancreatic/gastric, urogenital, LNH, Hodgkin's disease, HD, and MM), receiving a first or second line standard CT. We stratified pts into three risk groups (score 0= low; score 1-2=intermediate; score 3-4-5=high) considering both the Khorana scoring system and its implementation. Results: We analyzed 169 pts (103F/66M, median age 62.3, range 35-80 yrs), pt population included: 38 breast, 32 colorectal, 31 LNH, HD and MM, 27 urogenital, 22 NSCLC and 19 pancreatic/gastric. With the Khorana score 49 pts were assigned to the low risk, 87 pts to the intermediate risk (57 with score=1, 28 with score=2), 16 pts (9.4%) to the high risk group (9 with score=3, 4 with score=4, 3 with score=5). When we considered 11 parameters 37 pts (21.8%) were assigned to the high risk group. Conclusions: A more comprehensive quantification of VTE risk, also considering new independent factors, is mandatory for a correct decision making of an antithrombotic-prophylactic approach.

scholarly journals Risk Factors of Burst Abdomen in Emergency Laparotomy

2019 ◽  
Vol 46 (2) ◽  
pp. 38-42
Author(s):  
Muhammad Harun Ar Rashid ◽  
Liton Kumer Shaha ◽  
Sanjana Sharmin Shashi ◽  
Imtiaz Faruk
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Surgical Techniques ◽  
Abdominal Distension ◽  
Risk Groups ◽  
High Risk Group ◽  
Emergency Laparotomy ◽  
Burst Abdomen ◽  
Cross Sectional ◽  
Medical College

Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study was carried out to find out various risk factors of burst abdomen following emergency laparotomy, to find out the high risk group of patients for burst abdomen, to determine the predictors of burst abdomen, to prevent the rate of burst abdomen & find out morbidity and mortality of burst abdomen. This cross sectional study was done among 100 cases of burst abdomen occurring in Sir Salimullah Medical College & Mitford Hospital, Dhaka and Dhaka Medical college,Dhaka during the period of July,2011 to December,2011. The patients were admitted for various surgical problems and underwent emergency laparotomy. Burst abdomen was taken into account. Another group of 100 patients who undergone emergency laparotomy but did not develop burst abdomen were also taken into account to make a comparison with the burst group. Patients who undergone elective laparotomy,paediatric age group,patients undergone exploration through mini laparotomy or transverse incision,patients with pregnancy were excluded from the study populations.Patients were assessed by history taking, examination and appropriate investigation before surgery and observed post operatively for any complication. The results were prepared on 100 patients underwent emergency laparotomy in SSMCMH & DMCH. Burst abdomen following emergency laparotomy results from multifactorial causes. The main outcome measure found significant as the risk factors of burst abdomen in this study were peritonitis (95%),anaemia (26%),malnutrition (18%), in the preoperative period; inadequate peritoneal toileting and faulty surgical techniques in the per operative period; and wound infection (62%), postoperative cough (28%), abdominal distension (22%). The result also shows that the rate of burst abdomen is still very high in SSMCMH & DMCH and most of them occur in operations done by trainee surgeons (86%) and in those patients who has 3 or more of the risk factors (44%). We hope this study will arouse awareness and concern about this problem, so that more active steps will be taken for its prevention by identifying the high risk groups. This will certainly reduce the incidence of burst abdomen. Bangladesh Med J. 2017 May; 46 (2): 38-42

Comparison of Prognostic Models for Autologous Hematopoietic Stem Cell Transplantation (AHCT) for Relapsed Hodgkin Lymphoma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1215-1215
Author(s):  
Theresa Hahn ◽  
Philip L. McCarthy ◽  
Jeanette Carreras ◽  
Mei-Jie Zhang ◽  
Hillard M. Lazarus ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Group ◽  
Patient Characteristics ◽  
Risk Groups ◽  
High Risk Group ◽  
Prognostic Models ◽  
Brier Score ◽  
Model Risk ◽  
Resistant Disease

Abstract Abstract 1215 Poster Board I-237 AHCT is standard therapy for relapsed or refractory Hodgkin Lymphoma (HL). Prognostic risk score models for HL patients receiving AHCT aim to predict post transplant outcomes based on factors measured at the time of AHCT. We performed a comparison of 3 such models from Dana-Farber Cancer Institute (DFCI), Roswell Park Cancer Institute (RPCI) and University of Minnesota (UMinn) in an independent multicenter dataset of 597 relapsed or refractory HL patients receiving AHCT from 1996-2004, reported to the CIBMTR by 150 centers. Patient characteristics at diagnosis: 60% male, 52% stage III-IV, 59% B symptoms, 33% extranodal disease. Patient characteristics at AHCT: median (range) age 32 (7-74) years; 73% KPS≥90; 19% with extranodal disease; 39% had ≥3 prior chemotherapy regimens; 18% had resistant disease; median (range) time from diagnosis to AHCT 22 (3-238) months. High dose therapy regimens were primarily BEAM (72%) or CBV (12%) with 91% receiving peripheral blood stem cells. Progression free (PFS) and overall survival (OS) estimates at 3 years were 59% and 72%, respectively. The 3 prognostic models each measured 3 prognostic variables at AHCT that were combined into a prognostic score and assigned to a risk group (low, intermediate, high). The DFCI model risk factors were: chemo-resistant disease, KPS<90, ≥1 extranodal site; with corresponding risk groups low (0 factors), intermediate, (1 factor) and high (2-3 factors). The RPCI model risk factors were: chemo-resistant disease, KPS<90, ≥3 prior regimens with risk groups low (0-1 factor) and high (2-3 factors). The UMinn model risk factors were: chemo-resistant disease, B symptoms, not in CR at BMT with risk groups low (0-1 factor), intermediate (2 factors) and high (3 factors). Only 1 factor (chemo- resistant disease) was included in all 3 models. We quantified the predictive capabilities of the models using Brier score (B) and R2 for each model. Brier score as a function of time is a measure of the accuracy of the model calculated as the average deviation between the predicted probabilities and the actual outcome. R2 measures goodness of fit based on the observed vs. predicted difference in the regression model. A smaller Brier score and a larger R2 indicate better predictive performance. The models are compared in Table 1 with regards to prediction of 36 month PFS: Table 1 DFCI Model RPCI model UMinn model Brier Score 0.2344 0.2360 0.2394 R2 3.24% 2.57% 1.17% The high risk group PFS (Figure 1) was similar for the DFCI and RPCI models but the DFCI model separated a low and intermediate risk group which were not significantly different from each other. The UMinn model high risk group had a higher PFS than either of the other 2 models' high risk group and the intermediate group in this model was not significantly different from the high risk group. The relative incremental change in R2 was 26% higher for the DFCI than the RPCI model and 120% higher for the RPCI than the UMinn model. From the B and R2 values, the DFCI model had marginal superiority over RPCI model while both performed better than the UMinn model. Newer prognostic systems incorporating other prognostic variables are needed to distinguish lower and intermediate risk patients. Figure 1 Figure 1. Disclosures: No relevant conflicts of interest to declare.

Pharmacogenomic Prediction of Anthracycline-Induced Cardiotoxicity in Children

2012 ◽  
Vol 30 (13) ◽  
pp. 1422-1428 ◽  
Author(s):  
Henk Visscher ◽  
Colin J.D. Ross ◽  
S. Rod Rassekh ◽  
Amina Barhdadi ◽  
Marie-Pierre Dubé ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Genetic Variants ◽  
Risk Group ◽  
Treatment Options ◽  
Risk Groups ◽  
High Risk Group ◽  
Clinical Risk Factors ◽  
Nucleotide Polymorphisms ◽  
Clinical Risk

Purpose Anthracycline-induced cardiotoxicity (ACT) is a serious adverse drug reaction limiting anthracycline use and causing substantial morbidity and mortality. Our aim was to identify genetic variants associated with ACT in patients treated for childhood cancer. Patients and Methods We carried out a study of 2,977 single-nucleotide polymorphisms (SNPs) in 220 key drug biotransformation genes in a discovery cohort of 156 anthracycline-treated children from British Columbia, with replication in a second cohort of 188 children from across Canada and further replication of the top SNP in a third cohort of 96 patients from Amsterdam, the Netherlands. Results We identified a highly significant association of a synonymous coding variant rs7853758 (L461L) within the SLC28A3 gene with ACT (odds ratio, 0.35; P = 1.8 × 10−5 for all cohorts combined). Additional associations (P < .01) with risk and protective variants in other genes including SLC28A1 and several adenosine triphosphate–binding cassette transporters (ABCB1, ABCB4, and ABCC1) were present. We further explored combining multiple variants into a single-prediction model together with clinical risk factors and classification of patients into three risk groups. In the high-risk group, 75% of patients were accurately predicted to develop ACT, with 36% developing this within the first year alone, whereas in the low-risk group, 96% of patients were accurately predicted not to develop ACT. Conclusion We have identified multiple genetic variants in SLC28A3 and other genes associated with ACT. Combined with clinical risk factors, genetic risk profiling might be used to identify high-risk patients who can then be provided with safer treatment options.

scholarly journals Nurses Role in Prevention of HIV/AIDS

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Vijayaraddi Vandali
Keyword(s):  
High Risk ◽  
Risk Groups ◽  
World Health ◽  
Threatening Condition ◽  
Life Threatening ◽  
Nurses Role ◽  
Health Organization ◽  
Immunodeficiency Syndrome ◽  
Prevention Of Hiv ◽  
Hiv Aids

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition as per World Health Organization there are about 37.9 Million peoples living with AIDS/HIV in the world and out of which only 23.3 Million peoples accessing antiretroviral therapy but remaining are still not under treatment and such peoples may spread/transmit HIV more and rapid. Awareness is required among peoples living with HIV and high risk groups should consider on high priority. Nurses play key role in prevention of HIV/AIDS by significant functions such as health education to youths, high risk groups and eligible couples and prophylaxis. There is no treatment or vaccine not available to cure this syndrome, so for this deadly syndrome prevention is much better than cure is possible.

Sign in / Sign up

Export Citation Format

Share Document