An outbreak of haemorrhagic fever with renal syndrome linked with mountain recreational activities in Zagreb, Croatia, 2017

AbstractIn 2017 Zagreb faced the largest outbreak of haemorrhagic fever with renal syndrome (HFRS) to date. We investigated to describe the extent of the outbreak and identify risk factors for infection. We compared laboratory-confirmed cases of Hantavirus infection in Zagreb residents with the onset of illness after 1 January 2017, with individually matched controls from the same household or neighbourhood. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression. During 2017, 104 cases were reported: 11–81 years old (median 37) and 71% (73) male. Compared with 104 controls, cases were more likely to report visiting Mount Medvednica (amOR 60, 95% CI 6–597), visiting a forest (amOR 46, 95% CI 4.7–450) and observing rodents (amOR 20, 95% CI 2.6–159). Seventy per cent of cases (73/104) had visited Mount Medvednica prior to infection. Among participants who had visited Mount Medvednica, cases were more likely to have drunk water from a spring (amOR 22, 95% CI 1.9–265), observed rodents (amOR 17, 95% CI 2–144), picked flowers (amOR 15, 95% CI 1.2–182) or cycled (amOR 14, 95% CI 1.6–135). Our study indicated that recreational activity around Mount Medvednica was associated with HFRS. We recommend enhanced surveillance of the recreational areas during an outbreak.

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Characteristics of Adenocarcinoma of the Gallbladder Following Cholecystectomies in the Hispanic Population

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.067 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S64-S65

Author(s):

David Gustafson ◽

Osvaldo Padilla

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Incidental Finding ◽

Conditional Logistic Regression ◽

Gallbladder Disease ◽

Predictor Variables ◽

Wall Thickening ◽

Conditional Logistic Regression Analysis

Abstract Introduction Gallbladder adenocarcinoma (GBC) is a rare malignancy. Frequency of incidental adenocarcinoma of the gallbladder in the literature is approximately 0.2% to 3%. Typically, GBC is the most common type and is discovered late, not until significant symptoms develop. Common symptoms include right upper quadrant pain, nausea, anorexia, and jaundice. A number of risk factors in the literature are noted for GBC. These risk factors are also more prevalent in Hispanic populations. This study sought to compare patients with incidental gallbladder adenocarcinomas (IGBC) to those with high preoperative suspicion for GBC. Predictor variables included age, sex, ethnicity, radiologic wall thickening, gross pathology characteristics (wall thickness, stone size, stone number, and tumor size), histologic grade, and staging. Methods Cases of GBC were retrospectively analyzed from 2009 through 2017, yielding 21 cases. Data were collected via Cerner EMR of predictor variables noted above. Statistical analysis utilized conditional logistic regression analysis. Results The majority of patients were female (n = 20) and Hispanic (n = 19). There were 14 IGBCs and 7 nonincidental GBCs. In contrast with previous research, exact conditional logistic regression analysis revealed no statistically significant findings. For every one-unit increase in AJCC TNM staging, there was a nonsignificant 73% reduction in odds (OR = 0.27) of an incidental finding of gallbladder carcinoma. Conclusion This study is important in that it attempts to expand existing literature regarding a rare type of cancer in a unique population, one particularly affected by gallbladder disease. Further studies are needed to increase predictive knowledge of this cancer. Longer studies are needed to examine how predictive power affects patient outcomes. This study reinforces the need for routine pathologic examination of cholecystectomy specimens for cholelithiasis.

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Association of Adiponectin Gene Variations with Risk of Incident Myocardial Infarction and Ischemic Stroke: A Nested Case-Control Study

Clinical Chemistry ◽

10.1373/clinchem.2006.074476 ◽

2006 ◽

Vol 52 (11) ◽

pp. 2021-2027 ◽

Cited By ~ 45

Author(s):

Hillary H Hegener ◽

I-Min Lee ◽

Nancy R Cook ◽

Paul M Ridker ◽

Robert YL Zee

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Logistic Regression ◽

Regression Analysis ◽

Ischemic Stroke ◽

Conditional Logistic Regression ◽

Adiponectin Gene ◽

Conditional Logistic Regression Analysis ◽

Caucasian Men ◽

Potential Risk Factors

Abstract Background: Adiponectin (ADIPOQ) gene variations are associated with risk of cardiovascular disease in patients with diabetes. No prospective data are available, however, on the risk of atherothrombotic disorders in persons with ADIPOQ variations who do not have diabetes. Methods: From a group of DNA samples collected at baseline in a prospective cohort of 14 916 initially healthy American men, we assessed the presence of 5 ADIPOQ genetic variants (rs266729, rs182052, rs822396, rs2241766, and rs1501299) in samples from 600 Caucasian men who subsequently suffered an atherothrombotic event (incident myocardial infarction or ischemic stroke) and from 600 age- and smoking-matched Caucasian men who remained free of reported vascular disease during follow-up (controls). Results: Genotype distributions for the variations tested were in Hardy-Weinberg equilibrium. Marker-by-marker conditional logistic regression analysis, adjusted for potential risk factors, showed an association of rs266729 [recessive: odds ratio (OR), 0.26; 95% confidence interval (CI), 0.10–0.64; P = 0.004] and rs182052 (recessive: OR, 0.40; 95% CI, 0.21–0.76; P = 0.006) with decreased risk of ischemic stroke. These findings remained significant after Bonferroni correction. Haplotype-based (constituted by rs266729, rs182052, and rs822396) conditional logistic regression analysis, adjusted for the same potential risk factors, showed an association of haplotype G-A-G (OR, 0.28; 95% CI, 0.09–0.87; P = 0.03) with decreased risk of ischemic stroke. Prespecified analysis limited to participants without baseline diabetes showed similar significant findings. Conclusions: The present prospective investigation provides further evidence for a protective role of adiponectin gene variation in the risk of ischemic stroke that was independent of the presence of diabetes.

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Faktor risiko obesitas pada ibu rumah tangga miskin

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.15361 ◽

2012 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Digna Niken Purwaningrum ◽

Hamam Hadi ◽

I Made Alit Gunawan

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Food Insecurity ◽

Energy Intake ◽

Conditional Logistic Regression ◽

Control Group ◽

Case Group ◽

Fat Intake

Background: Food insecurity is associated with allocation of income for high energy density food consumption that may cause obesity in poor family. In addition, low physical activity may lead to obesity, particularly in individual living in disadvantaged situation.Objective: To identify risk factors of obesity among poor housewives in Yogyakarta.Method: This was a case control study, case group was obese housewives and the control group was non obese housewives. The locations of the study were Bumijo and Pringgokusuman which have high population density. The samples were taken purposively. Each group consisted of 70 housewives (1:1) and were matched according to age. Mc.Nemar test and conditional logistic regression were used to identify the risk factors of obesity.Results: There was no difference in characteristics between the two groups. Food insecurity reached 91,43% in the control group, proportion of excessive energy intake reached 37.86% in the case group, higher than in control group (24.29%). Excessive fat intake in the case group reached 30% whereas in the control group was 28.57%. Low physical activity reached 40% in the case group, and 10% in the control group. The result of Mc.Nemar test showed that food insecurity, energy and fat intake had no significant association with obesity (p>0.05). While physical activity was associated with obesity (p=0.0001). The result of conditional logistic regression showed physical activity was dominant risk factor for obesity among poor housewives (R2=0.1916).Conclusion: Food security status was not a risk factor for obesity in poor families; energy intake and fat intake contributed to the prevalence of obesity though the influence was smaller than physical activity.

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Risk factors of primary open-angle glaucoma: the first case-control hospital-based study in Vietnam

10.21203/rs.2.10312/v1 ◽

2019 ◽

Author(s):

Anh Van Bui ◽

Tung Thanh Hoang ◽

Ngoc Bich Nguyen ◽

Anh Kim Le ◽

Jennifer L. Patnaik

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Conditional Logistic Regression ◽

Case Control ◽

Open Angle ◽

Over The Counter ◽

Vietnamese Population ◽

History Of

Abstract Purpose: To identify risk factors for primary open-angle glaucoma (POAG) in a Vietnamese population. Methods: A matched case-control study was conducted at Vietnam National Institute of Ophthalmology. Cases were patients clinically diagnosed with POAG. Controls were caregivers of patients with other eye diseases, free from any ocular and systemic abnormalities, and were selected and then matched with the cases by gender and age. Cases and controls were examined by a glaucoma specialist to confirm presence or absence of POAG. Data on demographic, ophthalmic and medical conditions were collected via interview at time of examination. Associations between POAG and potential factors were examined by univariate conditional logistic regression analysis (OR – Odd Ratios) and multivariate conditional logistic regression (AOR – Adjusted Odd Ratios) with level of significance is 0.05. Results: In total, 128 cases with POAG and 128 controls were recruited. Multivariate conditional (fixed-effects) logistic regression analysis resulted in several significant risk factors, including hypertension AOR =4.7 (95% CI: 1.8–12.0; p=0.002); family history of glaucoma AOR = 6.4 (95% CI: 1.3 – 32.2; p = 0.026); over–the–counter eye medication AOR = 3.1 (95% CI: 1.5 – 6.5; p = 0.006), and a protective role for marriage AOR = 0.2 (95% CI: 0.1 – 0.7; p = 0.006) and weekly exercise AOR = 0.3 (95% CI: 0.1 – 0.8; p = 0.021). Conclusions: Hypertension, family history of glaucoma and over–the–counter eye medication were risk factors while marriage and weekly exercise were protective factors for POAG in Vietnamese population.

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Risk Factors that Affect The Incidence of Dengue Haemorrhagic Fever in The Work Area of Puskesmas Pare

JURNAL KESEHATAN LINGKUNGAN ◽

10.20473/jkl.v10i4.2018.417-423 ◽

2018 ◽

Vol 10 (4) ◽

pp. 417

Author(s):

Ericha Fitria Widyatama

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Dengue Hemorrhagic Fever ◽

Community Health Center ◽

Binary Logistic Regression ◽

Hemorrhagic Fever ◽

Haemorrhagic Fever ◽

Cross Sectional ◽

Independent Variables ◽

Work Area

Pare Community Health Center or Puskesmas is one of Puskesmas in Kecamatan Pare which has the highest number of Dengue Hemorrhagic Fever incidence that is 64 incidence in 2016. The purpose of this study is to analyze the risk factors that affect the incidence of Dengue Hemorrhagic Fever in the work area of Puskesmas Pare. It was an observational study with cross sectional approach. Interviews and environmental observations were conducted on 100 respondents, randomly, in the working area of Puskesmas Pare, Desa Tulungrejo. The independent variables of the research were larvae existence , maya index status and 4M Plus behavior, with the dependent variable of the research was Dengue Hemorrhagic Fever incidence in 2016.This data was analized by binary logistic regression test.The results of this study indicate that risk factors that affect the incidence of Dengue Hemorrhagic Fever is the action of 4M Plus (p = 0,017).Therefore, the 4M Plus actions should be further improved independently and promoted evenly to the community in order to suppress the incidence of Dengue Hemorrhagic Fever.

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Risk Factors for Inpatient Acute Venous Thromboembolism (VTE) Despite Thromboprophylaxis.

Blood ◽

10.1182/blood.v120.21.2248.2248 ◽

2012 ◽

Vol 120 (21) ◽

pp. 2248-2248

Author(s):

Tzu-Fei Wang ◽

Catherine A Wong ◽

Paul Milligan ◽

Mark S Thoelke ◽

Keith F Woeltje ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Venous Thromboembolism ◽

Conflicts Of Interest ◽

Conditional Logistic Regression ◽

Hospital Setting ◽

Care Facility ◽

Conditional Logistic Regression Model ◽

Term Care ◽

Pooled Data

Abstract Abstract 2248 Background: Venous thromboembolism (VTE) is the most common preventable cause of morbidity and mortality in the hospital. Adequate thromboprophylaxis has reduced the rate of hospital-acquired VTE by 50–70%; however, some inpatients still develop VTE despite thromboprophylaxis. Predictors associated with thromboprophylaxis failure are undefined. Objectives: We aimed to identify risk factors for VTE despite use of inpatient thromboprophylaxis. Patients/Methods: We used a case-control study to determine independent predictors of inpatient VTE. We matched 94 cases discharged from the BJC HealthCare system from January 1st, 2010 to May 31st, 2011who developed in-hospital VTE despite thromboprophylaxis (including either pharmacological or mechanical prophylaxis or both) to 272 controls without VTE. Matching was done by hospital, age, and date of discharge. Two thirds of the sample was used as derivation model, while one third was used for validation. We used multivariate conditional logistic regression on the derivation sample to develop a VTE prediction model and validated the model. We repeated conditional logistic regression on the pooled data. Results: Age and sex were well-matched. Mean age was 62.8 years-old in the VTE group and 63.2 years-old in the no-VTE group. Forty-three percent were female in the VTE group, while 49% were female in the no-VTE group. Using conditional logistic regression model in the pooled data, we identified five independent risk factors for in-hospital VTE: hospitalization for cranial surgery (Odds ratio [OR] 16.1, 95% confidence interval [CI] 3.2–80.4, p<0.001), hospitalization in a critical care unit (OR 3.0, 95% CI 1.5–5.9, p=0.002), admission leukocyte count > 13 × 103/mm3(OR 2.7, 95% CI 1.4–5.1, p=0.003), presence of an indwelling central venous catheter (OR 2.5, 95% CI 1.3–4.7, p=0.007), and admission from a long-term care facility (OR 2.1, 95% CI 1.0–4.2, p=0.04). Conclusions: In the hospital setting, we derived and validated five risk factors associated with the development of VTE despite thromboprophylaxis. Clinicians should be vigilant for VTE in these patients and ensure that they have aggressive VTE prophylaxis. Disclosures: No relevant conflicts of interest to declare.

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Differential Impact of Risk Factors on Stroke Occurrence Among Men Versus Women in West Africa

Stroke ◽

10.1161/strokeaha.118.022786 ◽

2019 ◽

Vol 50 (4) ◽

pp. 820-827 ◽

Cited By ~ 11

Author(s):

Albert Akpalu ◽

Mulugeta Gebregziabher ◽

Bruce Ovbiagele ◽

Fred Sarfo ◽

Henry Iheonye ◽

...

Keyword(s):

Risk Factors ◽

West Africa ◽

Salt Intake ◽

Comprehensive Evaluation ◽

Conditional Logistic Regression ◽

Population Attributable Risk ◽

Leafy Vegetables ◽

Sub Saharan Africa ◽

Odds Ratios ◽

Modifiable Factors

Background and Purpose— The interplay between sex and the dominant risk factors for stroke occurrence in sub-Saharan Africa has not been clearly delineated. We compared the effect sizes of risk factors of stroke by sex among West Africans. Methods— SIREN study (Stroke Investigative Research and Educational Networks) is a case-control study conducted at 15 sites in Ghana and Nigeria. Cases were adults aged >18 years with computerized tomography/magnetic resonance imaging confirmed stroke, and controls were age- and sex-matched stroke-free adults. Comprehensive evaluation for vascular, lifestyle, and psychosocial factors was performed using validated tools. We used conditional logistic regression to estimate odds ratios and reported risk factor specific and composite population attributable risks with 95% CIs. Results— Of the 2118 stroke cases, 1193 (56.3%) were males. The mean±SD age of males was 58.1±13.2 versus 60.15±14.53 years among females. Shared modifiable risk factors for stroke with adjusted odds ratios (95% CI) among females versus males, respectively, were hypertension [29.95 (12.49–71.77) versus 16.1 0(9.19–28.19)], dyslipidemia [2.08 (1.42–3.06) versus 1.83 (1.29–2.59)], diabetes mellitus [3.18 (2.11–4.78) versus 2.19 (1.53–3.15)], stress [2.34 (1.48–3.67) versus 1.61 (1.07–2.43)], and low consumption of green leafy vegetables [2.92 (1.89–4.50) versus 2.00 (1.33–3.00)]. However, salt intake and income were significantly different between males and females. Six modifiable factors had a combined population attributable risk of 99.1% (98.3%–99.6%) among females with 9 factors accounting for 97.2% (94.9%–98.7%) among males. Hemorrhagic stroke was more common among males (36.0%) than among females (27.6%), but stroke was less severe among males than females. Conclusions— Overall, risk factors for stroke occurrence are commonly shared by both sexes in West Africa favoring concerted interventions for stroke prevention in the region.

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Risk Factors for Adverse Drug Events: A 10-Year Analysis

Annals of Pharmacotherapy ◽

10.1345/aph.1e642 ◽

2005 ◽

Vol 39 (7-8) ◽

pp. 1161-1168 ◽

Cited By ~ 88

Author(s):

R Scott Evans ◽

James F Lloyd ◽

Gregory J Stoddard ◽

Jonathan R Nebeker ◽

Matthew H Samore

Keyword(s):

Risk Factors ◽

Creatinine Clearance ◽

Drug Administration ◽

Adverse Drug Events ◽

Conditional Logistic Regression ◽

Patient Characteristics ◽

Patient Specific ◽

Administration Route ◽

Odds Ratios ◽

Tertiary Teaching

BACKGROUND Many adverse drug events (ADEs) are the result of known pharmacologic properties, and some result from medication errors. However, some are the result of patient-specific risk factors. OBJECTIVE To identify inpatient risk factors for ADEs. METHODS Conditional logistic regression was used to analyze all pharmacist-verified ADEs by therapeutic class of drugs and severity during a 10-year study period. All inpatients ≥18 years of age from a 520-bed tertiary teaching hospital were included. Each case patient was matched with up to 16 control patients. Odds ratios for patient factors associated with ADEs were calculated from different therapeutic classes of drugs. RESULTS Odds ratios for numerous risk factors were identified for 4376 ADEs and were found to vary depending on therapeutic classification. The risk factors for the different classifications were grouped by (1) patient characteristics—female (OR 1.5–1.7), age (0.7–0.9), weight (1.2–1.4), creatinine clearance (0.8–4.7), and number of comorbidities (1.1–12.6); (2) drug administration—dosage (1.2–3.7), administration route (1.4–149.9), and number of concomitant drugs (1.2–2.4); and (3) patient type—service (1.2–4.9), nursing division (1.5–3.8), and diagnosis-related group (1.5–5.7). CONCLUSIONS Some risk factors are consistent for all ADEs and across multiple therapeutic classes of drugs, while others are class specific. High-risk agents should be closely monitored based on patient characteristics (gender, age, weight, creatinine clearance, number of comorbidities) and drug administration (dosage, administration route, number of concomitant drugs).

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A Hospital Epidemic of Vancomycin-Resistant Enterococcus Risk Factors and Control

Infection Control and Hospital Epidemiology ◽

10.1086/501880 ◽

2001 ◽

Vol 22 (03) ◽

pp. 140-147 ◽

Cited By ~ 96

Author(s):

Karin E. Byers ◽

Anne M. Anglim ◽

Cynthia J. Anneski ◽

Teresa P. Germanson ◽

Howard S. Gold ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Gel Electrophoresis ◽

Conditional Logistic Regression ◽

Significant Risk ◽

Pulsed Field Gel Electrophoresis ◽

Stepwise Logistic Regression ◽

Multivariate Models ◽

Pulsed Field ◽

Vancomycin Resistant

AbstbactObjective:To determine risk factors for vancomycin-resistantEnterococcus(VRE) colonization during a hospital outbreak and to evaluate Centers for Disease Control and Prevention (CDC)-recommended control measures.Design:Epidemiological study involving prospective identification of colonization and a case-control study.Setting:A university hospital.Participants:Patients on eight wards involved in outbreak from late 1994 through early 1995.Methods:Cases were matched by ward and culture date with up to two controls. Risk factors were evaluated with four multivariate models using conditional logistic regression. The first evaluated proximity to other VRE patients and isolation status. The second evaluated proximity to unisolated VRE cases and three variables independently predictive after adjustment for proximity. The third evaluated seven significant univariate predictors in addition to proximity to unisolated VRE in backward, stepwise logistic regression. The fourth assessed proximity to VRE with all other variables collected, clustered in a principal components analysis. Pulsed-field gel electrophoresis was performed to assess clonality of two outbreak strains.Results:The incidence of transmission declined significantly after CDC guidelines were implemented. Proximity to unisolated VRE cases during the prior week was a significant predictor of acquisition in each of four multivariate models. Other significant risk factors in multivariate models included a history of major trauma and treatment with metronidazole. Pulsed-field gel electrophoresis confirmed the clonality of two outbreak strains.Conclusions:VRE was transmitted between patients during a hospital epidemic, with proximity to previously unisolated VRE patients being an important risk factor. Weekly surveillance cultures and contact isolation of colonized patients significantly reduced spread.

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Familial clustering of erosive hand osteoarthritis in a large statewide cohort

10.1101/2020.04.04.20053264 ◽

2020 ◽

Author(s):

Nikolas H. Kazmers ◽

Huong D. Meeks ◽

Kendra A. Novak ◽

Zhe Yu ◽

Gail L. Fulde ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

High Risk ◽

Regression Models ◽

Conditional Logistic Regression ◽

Hand Osteoarthritis ◽

Genetic Contribution ◽

Familial Clustering ◽

Erosive Hand Osteoarthritis ◽

High Risk Families

AbstractObjectivesErosive hand osteoarthritis (EOA) is a severe and rapidly progressing form of osteoarthritis. Its etiology remains largely unknown, which has hindered development of successful treatments. Our primary goal was to test the hypothesis that EOA would demonstrate familial clustering in a large statewide population linked to genealogical records, which would suggest a genetic contribution to the pathogenesis of this condition. Our secondary purpose was to determine the association of potential risk factors with EOA.MethodsPatients diagnosed with EOA were identified by searching medical records from a comprehensive statewide database, the Utah Population Database (UPDB). Affected individuals were then mapped to pedigrees to identify high-risk families with excess clustering of EOA as defined by a Familial Standardized Incidence Ratio (FSIR) of ≥ 2.0. The magnitude of familial risk of EOA in related individuals was calculated using Cox regression models. Association of potential EOA risk factors was analyzed using conditional logistic regression and logistic regression models.ResultsWe identified 703 affected individuals linked to 240 unrelated high-risk pedigrees with excess clustering of EOA (FSIR ≥ 2.0). The relative risk of developing EOA was significantly elevated in first-degree relatives. There was a significant association with the diagnosis of EOA and age, sex, diabetes, and obesity.ConclusionsFamilial clustering of EOA observed in a statewide database indicates a potential genetic contribution to the etiology of the disease. Identification of causal gene variants in these high-risk families may provide insight into the genes and pathways that contribute to EOA onset and progression.

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