First-Time Patellofemoral Dislocation: Risk Factors for Recurrent Instability

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

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Skin microvascular dysfunction in systemic lupus erythematosus patients with and without cardiovascular risk factors

Rheumatology ◽

10.1093/rheumatology/keaa722 ◽

2020 ◽

Author(s):

Nikolaos Koletsos ◽

Eugenia Gkaliagkousi ◽

Antonios Lazaridis ◽

Areti Triantafyllou ◽

Panagiota Anyfanti ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Lupus Erythematosus ◽

Arterial Occlusion ◽

Microvascular Dysfunction ◽

Laser Speckle ◽

Control Group ◽

Reperfusion Period ◽

Contrast Analysis ◽

First Time

Abstract Objectives Patients with SLE have increased cardiovascular mortality. Alterations in both macro- and micro-circulation have been associated with cardiovascular disease. We sought to assess skin microvascular function by using laser speckle contrast analysis (LASCA) in patients with SLE, with and without cardiovascular disease and risk factors. Methods Continuous blood flow was recorded using a LASCA device during baseline, a 5-min arterial occlusion and a 5-min reperfusion period. Results Thirty-five patients with SLE (85.7% women) with a median disease duration 12.0 (6.5–17.5) years and a mean age of 46.3 (8.6) years and 31 controls matched for age, sex and BMI were enrolled. During reperfusion, SLE patients exhibited a smaller peak magnitude compared with controls (161.0 (47.1) vs 197.2 (41.4)%, respectively, P =0.002). Results remained unchanged among 24 SLE patients without cardiovascular disease compared with the control group (169.2 (48.1) vs 195.6 (34.0)%, respectively, P =0.002). Conclusion Our study shows, for the first time, that patients with SLE, even without overt cardiovascular disease or risk factors, exhibit a blunted microvascular reactivity during reperfusion compared with controls. These results show that skin microvascular dysfunction is present in SLE independently of the CV burden that these patients bear and may represent an early sign of vascular damage.

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Immobilization in External Rotation After First-Time Traumatic Anterior Shoulder Instability Reduces Recurrent Instability - A Meta-Analysis

OrthoMedia ◽

10.1302/3114-220847 ◽

2022 ◽

Keyword(s):

Shoulder Instability ◽

External Rotation ◽

Meta Analysis ◽

Anterior Shoulder Instability ◽

Recurrent Instability ◽

First Time

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Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.2979 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Wahrenberg ◽

P Magnusson ◽

R Kuja-Halkola ◽

H Habel ◽

K Hambraeus ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Family History ◽

Cardiovascular Events ◽

Cardiovascular Death ◽

Funding Source ◽

History Of ◽

First Time ◽

Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

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Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

10.21203/rs.3.rs-32553/v1 ◽

2020 ◽

Author(s):

Nan Cheng ◽

Dezhao Liu ◽

Yue Guo ◽

Jingyi Du ◽

Ping Xiang ◽

...

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Data Analysis ◽

Electroconvulsive Therapy ◽

Chinese Patients ◽

High Heart Rate ◽

Detailed Knowledge ◽

Electroconvulsive Treatment ◽

Hemodynamic Variables ◽

First Time

Abstract Aim: This study aimed to elucidate the incidence and risk factors for postictal delirium (PID) among Chinese patients undergoing electroconvulsive therapy (ECT). Methods: In this retrospective study, 203 patients who underwent ECT in the Third Affiliated Hospital of Sun Yat-Sen University from July 2016 to July 2017 had their PID severity measured by a previously developed scale. For data analysis, two groups were created: PID patients and non-PID patients. The groups were analyzed based on three types of independent variables: patient-related, electroconvulsive treatment, and hemodynamic variables. Data analysis was performed through descriptive statistics, Chi-squared tests, Fisher exact tests, and/or independent sampled t-tests. Logistic regression analysis was used to identify independent risk factors for postictal delirium (P < 0.05).Results: Results showed that 81 patients (39.9%) developed moderate to severe PID in their first ECT session. Patients receiving ECT for the first time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identified as risk factors for PID, and they were significantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the first time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID. The medical staff related to this type of treatment may benefit from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.

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New Insight into the Prevalence and Risk Factors for Three Distinct Hoof Conformation Traits in UK Commercial Sheep Flocks

Veterinary Sciences ◽

10.3390/vetsci8090176 ◽

2021 ◽

Vol 8 (9) ◽

pp. 176

Author(s):

Caroline M. Best ◽

Janet Roden ◽

Kate Phillips ◽

Alison Z. Pyatt ◽

Malgorzata C. Behnke

Keyword(s):

Risk Factors ◽

Global Health ◽

Prospective Studies ◽

Exploratory Study ◽

Predisposing Factors ◽

Farm Level ◽

Time Points ◽

First Time ◽

Insight Into

Lameness in sheep continues to be a global health, welfare and economic concern. Damaged, misshapen or overgrown feet have the potential to cause lameness either directly, or indirectly. There is a lack of understanding of the predisposing factors for different hoof conformation traits in sheep. Our exploratory study aimed to investigate the prevalence of, and risk factors for, three distinct hoof conformation traits relating to the sole and heel, hoof wall, and hoof wall overgrowth. Feet of 400 ewes from four UK commercial sheep farms were inspected at four time points across 12 months. For each conformation trait, a four-point ordinal system was used to score each individual claw, and foot-level scores were calculated. We present 92.4% of foot-level observations to be affected by ≥1 conformation traits. Whilst hoof conformation traits were correlated to some degree, a unique set of sheep-, foot- and farm-level factors were associated with each distinct conformation trait. We provide, for the first time, key insight into the multifaceted and multifactorial aetiology of hoof conformation in sheep, building upon previous landmark studies. Our results inform hypotheses for future prospective studies investigating the risk factors for adverse hoof conformation in sheep.

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Low HDL Cholesterol, Smoking and IL-13 R130Q Polymorphism are Associated with Myocardial Infarction in Greek Cypriot Males. A Pilot Study

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192400802010052 ◽

2008 ◽

Vol 2 (1) ◽

pp. 52-59 ◽

Cited By ~ 1

Author(s):

Stavroulla Xenophontos ◽

Marilena Hadjivassiliou ◽

Alexandros Karagrigoriou ◽

Nafsika Demetriou ◽

George Miltiadous ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Lipoprotein Cholesterol ◽

Greek Cypriot ◽

Low Hdl ◽

First Time ◽

Control Study

This study was carried out in Greek Cypriot males to identify risk factors that predispose to myocardial infarction (MI). Genetic and lipid risk factors were investigated for the first time in a Greek Cypriot male case-control study.Contrary to other studies, mean low density lipoprotein cholesterol did not differ between cases and controls. High density lipoprotein cholesterol on the other hand, although within normal range in cases and controls, was significantly higher in the control population. In agreement with many other studies, smoking was significantly more prevalent in cases compared with controls. In pooled cases and controls, smokers had a significantly lower HDL-C level compared with non-smokers. The frequency of the IL-13 R130Q homozygotes for the mutation (QQ), as well as the mutant allele were significantly higher in cases compared with controls. The IL-13 R130Q variant, or another locus, linked to it, may increase the risk of MI.

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Quality of life and the prevalence of urinary incontinence after surgical treatment for gynecologic cancer

10.21203/rs.2.11879/v1 ◽

2019 ◽

Author(s):

Noriko Nakayama ◽

Tetsuya Tsuji ◽

Makoto Aoyama ◽

Takafumi Fujino ◽

Meigen Liu

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Stress Incontinence ◽

Gynecologic Cancer ◽

Cesarean Sections ◽

Mixed Incontinence ◽

Post Surgery ◽

Significant Difference ◽

First Time

Abstract Purpose To examine the rates, causes, and impact on quality of life (QOL) of urinary storage symptoms after gynecologic cancer surgery. Methods A questionnaire survey, including Japanese-language versions of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Overactive Bladder Symptom Score (OABSS), and Incontinence Impact Questionnaire-7 (IIQ-7), was distributed to gynecologic cancer patients who underwent hysterectomy between 2008 and 2013. Results Of the 145 patients analyzed, 49 (33.8%) had urinary incontinence (UI) pre-surgery and 76 (52.4%) had UI post-surgery, including 34 (35.4%) first-time UI patients, with a significant difference between pre- and post-surgery. Of the 49 subjects with UI pre-surgery, 43 (87.7%) had stress incontinence, while of the 76 patients with UI post-surgery, 44 (57.1%) had stress incontinence, and 24 (31.2%) had mixed incontinence. Seven (4.8%) subjects had overactive bladder (OAB) pre-surgery, whereas 19 (13.1%) had OAB symptoms post-surgery (including 15 first-time OAB patients), with a significant difference between pre- and post-surgery. IIQ-7 scores were markedly higher for patients with mixed incontinence post-surgery than for those with stress incontinence, indicating a lower QOL. Logistic regression analysis identified the number of Cesarean sections and days of urinary bladder catheterization as risk factors for postoperative UI. Conclusions UI and OAB rates were higher after gynecologic cancer surgery than in the general female population. The mixed incontinence rate was markedly higher post-surgery; QOL was low for such patients due to the combination of urgency and stress incontinence. Multiple Cesarean sections and urinary bladder catheterization post-surgery were risk factors for post-surgical UI.

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Treatment of first-time traumatic anterior shoulder dislocation: the UK TASH-D cohort study

Health Technology Assessment ◽

10.3310/hta23180 ◽

2019 ◽

Vol 23 (18) ◽

pp. 1-104

Author(s):

Jonathan L Rees ◽

Anjali Shah ◽

Katherine Edwards ◽

Maria T Sanchez-Santos ◽

Danielle E Robinson ◽

...

Keyword(s):

Risk Factors ◽

Shoulder Dislocation ◽

Recurrent Dislocation ◽

Incidence Rates ◽

Anterior Shoulder Dislocation ◽

Traumatic Anterior Shoulder Dislocation ◽

The Uk ◽

First Time ◽

Residual Confounding ◽

Age And Sex

Background Shoulder dislocations are the most common joint dislocations seen in emergency departments. Most traumatic cases are anterior and cause recurrent dislocations. Management options include surgical and conservative treatments. There is a lack of evidence about which method is most effective after the first traumatic anterior shoulder dislocation (TASD). Objectives To produce UK age- and sex-specific incidence rates for TASD. To assess whether or not surgery within 6 months of a first-time TASD decreases re-dislocation rates compared with no surgery. To identify clinical predictors of recurrent dislocation. Design A population-based cohort study of first-time TASD patients in the UK. An initial validation study and subsequent propensity-score-matched analysis to compare re-dislocation rates between surgery and no surgery after a first-time TASD. Prediction modelling was used to identify potential predictors of recurrent dislocation. Setting UK primary and secondary care data. Participants Patients with a first-time TASD between 1997 and 2015. Interventions Stabilisation surgery within 6 months of a first-time TASD (compared with no surgery). Stabilisation surgery within 12 months of a first-time TASD was also carried out as a sensitivity analysis. Main outcome measure Re-dislocation rate up to 2 years after the first TASD. Methods Eligible patients were identified from the Clinical Practice Research Datalink (CPRD) (1997–2015). Accuracy of shoulder dislocation coding was internally validated using the CPRD General Practitioner questionnaire service. UK age- and sex-specific incidence rates for TASD were externally validated against rates from the USA and Canada. A propensity-score-matched analysis using linked CPRD and Hospital Episode Statistics (HES) data compared re-dislocation rates for patients aged 16–35 years, comparing surgery with no surgery. Multivariable Cox regression models for predicting re-dislocation were developed for the surgical and non-surgical cohorts. Results Shoulder dislocation was coded correctly for 89% of cases in the CPRD [95% confidence interval (CI) 83% to 95%], with a ‘primary’ dislocation confirmed for 76% of cases (95% CI 67% to 85%). Far fewer patients than expected received stabilisation surgery within 6 months of a first TASD, leading to an underpowered study. Around 20% of re-dislocation rates were observed for both surgical and non-surgical patients. The sensitivity analysis at 12 months also showed little difference in re-dislocation rates. Missing data on risk factors limited the value of the prediction modelling; however, younger age, epilepsy and sex (male) were identified as statistically significant predictors of re-dislocation. Limitations Far fewer than the expected number of patients had surgery after a first-time TASD, resulting in an underpowered study. This and residual confounding from missing risk factors mean that it is not possible to draw valid conclusions. Conclusions This study provides, for the first time, UK data on the age- and sex-specific incidence rates for TASD. Most TASD occurs in men, but an unexpected increased incidence was observed in women aged > 50 years. Surgery after a first-time TASD is uncommon in the NHS. Re-dislocation rates for patients receiving surgery after their first TASD are higher than previously expected; however, important residual confounding risk factors were not recorded in NHS primary and secondary care databases, thus preventing useful recommendations. Future work The high incidence of TASD justifies investigation into preventative measures for young men participating in contact sports, as well as investigating the risk factors in women aged > 50 years. A randomised controlled trial would account for key confounders missing from CPRD and HES data. A national TASD registry would allow for a more relevant data capture for this patient group. Study registration Independent Scientific Advisory Committee (ISAC) for the Medicines and Healthcare Products Regulatory Agency (ISAC protocol 15_0260). Funding The National Institute for Health Research Health Technology Assessment programme.

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