Genetic Risk Factors and Inhibitor Development in Hemophilia: What Is Known and Searching for the Unknown

2018 ◽  
Vol 44 (06) ◽  
pp. 509-516 ◽  
Author(s):  
Mariano Intrieri ◽  
Maurizio Margaglione
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Significant Risk ◽  
Immunological Response ◽  
Clinical Score ◽  
Accurate Estimation ◽  
Inhibitor Development ◽  
The Past ◽  
Personal Risk ◽  
Score Systems

AbstractOver the past few decades, important knowledge on why inhibitors develop and better information about significant risk factors have become available. A series of both genetic and nongenetic factors are recognized and clinical score systems were proposed to quantify the risk for each patient. In addition, modulation of the immunological response was acknowledged to play a pivotal role in the occurrence of inhibitors. However, with the exception of mutation testing in severe hemophilia B patients, no single risk factor or clinical score is currently utilized in clinical practice. “Omics” technologies are large-scale hypothesis-generating approaches, which provide the tools to study issues contributing to a complex and multifactorial phenomenon, such as inhibitor development. Newer cutting edge technologies may enable a more accurate estimation of the personal risk profile and provide a reliable tool to accurately measure the risk periodically, thereby enabling strategies to foresee and prevent inhibitor formation.

scholarly journals 186. Risk Factors for Extended Spectrum β-Lactamase Bacteremia and External Application of a Clinical Prediction Tool

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S113-S114
Author(s):  
Jacqueline Burnell ◽  
Rebecca Fallis ◽  
Peter Axelrod ◽  
Daniel Mueller
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Klebsiella Oxytoca ◽  
Significant Risk ◽  
University Hospital ◽  
Prediction Tool ◽  
External Application ◽  
The Past ◽  
Extended Spectrum ◽  
History Of

Abstract Background Extended spectrum β-lactamase (ESBL) bacteria are resistant to many antibiotics, which increases the risk of inadequate early antibiotic therapy. A previous single-center study had created a prediction tool to assist clinicians in identifying patients at risk for ESBL bloodstream infections. The purpose of our research project was to assess validity of this tool while also identifying risk factors for ESBL bacteremia within our own institution, which would allow for assessment of alternative prediction tools. Methods We performed a retrospective chart review of adult patients admitted to an urban university hospital who were found to have bacteremia with Escherichia coli, Klebsiella pneumoniae, and/or Klebsiella oxytoca between October 2016 and April 2018. Demographics and comorbidities were assessed, along with other potential risk factors including exposure to antibiotics and hospitalizations within the past 6 months. Results A total of 214 instances of bacteremia were identified and 14% were due to ESBL organisms. Risk factors for ESBL bacteremia in our cohort included history of positive culture for ESBL (RR = 5.9) or MRSA (RR = 3.5) and antibiotic usage in the past 6 months (RR = 2.3). Patients with ESBL bacteremia were hospitalized longer (mean 16 days vs. 6 days for non-ESBL), received longer durations of antibiotic therapy (11.7 days vs. 5.3 days), and were exposed to greater numbers of different antibiotics (1.9 vs. 0.7) in the previous 6 months. Multivariate logistic regression showed that history of prior ESBL infection (OR 14.7, CI 1.8–120) and increasing number of different antibiotic classes administered in the prior 6 months (OR 4.3, CI 1.7–11.2) were significant risk factors for ESBL bacteremia. The previously created prediction tool did not sufficiently differentiate higher and lower risk for ESBL bacteremia in our cohort. Conclusion Although risk factors were similar, the previously derived stepwise prediction tool did not predict ESBL bacteremia in our external cohort. Point-based prediction modeling might better assess risk across institutions. Additionally, the number of different antibiotics received was associated with risk for ESBL bacteremia and should be investigated further. Disclosures All authors: No reported disclosures.

scholarly journals Occupational Injuries among Latino/a Immigrant Cattle Feedyard Workers in the Central States Region of the United States

2021 ◽  
Vol 18 (16) ◽  
pp. 8821
Author(s):  
Athena K. Ramos ◽  
Suraj Adhikari ◽  
Aaron M. Yoder ◽  
Risto H. Rautiainen
Keyword(s):  
United States ◽  
Risk Factors ◽  
Occupational Injuries ◽  
Significant Risk ◽  
The United States ◽  
Safety Training ◽  
Structured Interviews ◽  
The Past ◽  
Risk Of Injury ◽  
Latino Immigrant

Agriculture is a dangerous industry with high rates of occupational injuries. Immigrants comprise the majority of the hired agricultural workforce in the United States, and these workers may be at a higher risk for job-related injuries. This study addressed the frequency, characteristics, and risk factors of occupational injuries among Latino immigrant cattle feedyard workers. Data were collected through structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska (n = 243; 90.9% male). Descriptive statistics and logistic regression were used to identify risk factors for injury. Nearly three-fourths of participants (71.2%) reported having experienced one or more injuries in the past while working on a cattle feedyard. The most frequent types of reported injuries, including those not requiring medical care, were bruises/contusions (40%), cuts/lacerations (21%), and sprains/strains (12%). These injuries were mainly caused by animals/livestock (33%), chemicals (23%), falls (12%), and tools (9%). Significant risk factors for injury included male gender (OR 5.9), being over age 35 (OR 2.6), working on a large or an extra-large feedyard (OR 5.4), having 11 or more employees on the feedyard (OR 3.6), and working more than eight hours a day (OR 4.7). Having received safety training was also associated with greater risk of injury in a univariable model (OR 2.6). Cattle feedyard workers are at high risk for injury and require more effective preventive measures.

Emerging and Reemerging Infection Threats to Society

2009 ◽  
Vol 4 (5) ◽  
pp. 291-297
Author(s):  
Masayuki Saijo ◽  
Keyword(s):  
Risk Factors ◽  
Economic Activity ◽  
Large Scale ◽  
Disease Outbreak ◽  
Lifestyle Changes ◽  
Infectious Disease Outbreak ◽  
Influenza Pandemics ◽  
The Past ◽  
Food Borne ◽  
Heavy Burden

In societies where infectious disease outbreak potential is steadily rising, the heavy burden on society may adversely influence health status, social activities, and the economy. Influenza pandemics, for instance, threaten society internationally, while infectious outbreaks such as food-borne problems are usually limited to local or domestic levels. Risk factors in infectious outbreaks include destruction of the natural environment, increased international trade and travel, economic activity, lifestyle changes, medical practice, political instability including terrorist activity, and natural disasters. Recent emerging and reemerging infection did not originate naturally and spontaneously, but occurred through the above risk factors. Infectious outbreaks have increased in both size and frequency over those in the past. Risk factors for large-scale infectious emergence and reemergence threatening society should be scientifically analyzed and measures implemented in advance whenever possible.

scholarly journals Risk Factors for Crop Health Under Global Change and Agricultural Shifts: A Framework of Analyses Using Rice in Tropical and Subtropical Asia as a Model

2011 ◽  
Vol 101 (6) ◽  
pp. 696-709 ◽  
Author(s):  
S. Savary ◽  
A. Mila ◽  
L. Willocquet ◽  
P. D. Esker ◽  
O. Carisse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Risks ◽  
Large Scale ◽  
Plant Protection ◽  
Significant Risk ◽  
Global Changes ◽  
Agricultural Change ◽  
Data Set ◽  
Holistic View ◽  
Crop Health

Plant disease epidemiology requires expansion of its current methodological and theoretical underpinnings in order to produce full contributions to global food security and global changes. Here, we outline a framework which we applied to farmers' field survey data set on rice diseases in the tropical and subtropical lowlands of Asia. Crop health risks arise from individual diseases, as well as their combinations in syndromes. Four key drivers of agricultural change were examined: labor, water, fertilizer, and land availability that translate into crop establishment method, water shortage, fertilizer input, and fallow period duration, respectively, as well as their combinations in production situations. Various statistical approaches, within a hierarchical structure, proceeding from higher levels of hierarchy (production situations and disease syndromes) to lower ones (individual components of production situations and individual diseases) were used. These analyses showed that (i) production situations, as wholes, represent very large risk factors (positive or negative) for occurrence of disease syndromes; (ii) production situations are strong risk factors for individual diseases; (iii) drivers of agricultural change represent strong risk factors of disease syndromes; and (iv) drivers of change, taken individually, represent small but significant risk factors for individual diseases. The latter analysis indicates that different diseases are positively or negatively associated with shifts in these drivers. We also report scenario analyses, in which drivers of agricultural change are varied in response to possible climate and global changes, generating predictions of shifts in rice health risks. The overall set of analyses emphasizes the need for large-scale ground data to define research priorities for plant protection in rapidly evolving contexts. They illustrate how a structured theoretical framework can be used to analyze emergent features of agronomic and socioecological systems. We suggest that the concept of “disease syndrome” can be borrowed in botanical epidemiology from public health to emphasize a holistic view of disease in shifting production situations in combination with the conventional, individual disease-centered perspective.

scholarly journals Parascaris spp. eggs in horses of Italy: a large-scale epidemiological analysis of the egg excretion and conditioning factors

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Antonio Scala ◽  
Claudia Tamponi ◽  
Giuliana Sanna ◽  
Giulio Predieri ◽  
Luisa Meloni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Anthelmintic Resistance ◽  
Animal Health ◽  
Large Population ◽  
Significant Risk ◽  
Treatment Protocols ◽  
Conditioning Factors ◽  
Epidemiological Surveys ◽  
Young Horses

Abstract Background Equine ascariosis, caused by Parascaris spp., is a worldwide endoparasitic disease affecting young horses in particular. Despite the great number of horses reared in Italy, large-scale epidemiological surveys dealing with ascariosis prevalence in the country are not reported in the current literature. For this reason, the present survey aims to describe, for the first time, the spread and infestation of Parascaris spp. in a large population of Italian horses (6896 animals) using faecal egg counts, and further to identify risk factors associated with ascarid egg shedding. Methods Individual rectal faecal samples collected during routine veterinary examinations were used and Parascaris spp. prevalence was tested against the animal’s age, sex, housing conditions, geographic provenance as well as the respective sampling season. Results Among the examined stables, 35.8% showed at least one horse to be positive for Parascaris spp. eggs and an overall prevalence of 6.3% was found. Ascariosis rates tended to decrease significantly with age and, proportionally, 80.0% of the recorded Parascaris spp. eggs were found in 0.7% of the examined animals. Statistically significant differences among prevalence rates were found between the different geographic areas of provenance and prevalence was found to be higher in horses reared outdoors compared to those raised indoors. Analysis of data based on sex and season did not show any significant differences. Despite the lower prevalence found compared to other European countries, ascariosis was concluded to represent a significant health challenge for horses reared in Italy, especially foals. Age (foals and yearlings) and outdoor rearing were identified to be significant risk factors for Parascaris spp. egg shedding. Furthermore, the relevance of the infected horses over 6 years of age should not be underestimated as these represent a significant source of contamination for younger animals. Conclusions The development of improved treatment protocols based on regular faecal examination combined with follow-up assessment of the efficacy of integrated action plans would prove beneficial in regard to animal health and anthelmintic resistance reduction in the field. Graphic Abstract

scholarly journals Prevalence and correlates of neurodevelopmental disorders among children in India: a narrative review

2020 ◽  
Vol 8 (1) ◽  
pp. 200
Author(s):  
Leena Gaikwad ◽  
Sravani Lagala
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Neurodevelopmental Disorders ◽  
Large Scale ◽  
English Language ◽  
Perinatal Asphyxia ◽  
National Level ◽  
Age Groups ◽  
Significant Risk ◽  
Diagnostic Tools

Neurodevelopmental disorders (NDD) are seen disproportionately affecting the low-income communities. Paucity of consistent and large-scale studies in India and variations in assessment and diagnostic tools reduce the scope for generalization of prevalence estimates to national level. This review tried to consolidate the existing community-based evidence of the prevalence of NDDs, risk factors and comorbidities among children in India. We searched studies related to the review objectives on search engines PubMed and Google Scholar. The community or school-based studies in India, published in English language were included. The prevalence of each of these NDDs differed in different locations and age groups. The prevalence appeared to be increasing with increase in age. Non-institutional delivery, perinatal asphyxia or delayed crying, low birth weight or prematurity, neonatal illness or neurological infections were significantly associated with the NDDs. Most of the significant risk factors are modifiable with the help of effective programs to improve maternal and child healthcare and nutrition. Further large-scale, good-quality epidemiological studies in community settings are needed to develop and prioritize the delivery of the prevention and rehabilitation interventions.

scholarly journals Risk factors and prevalence of work-related injuries and accidents among veterinarians in India

2020 ◽  
Vol 13 (11) ◽  
pp. 2555-2564
Author(s):  
SukhDev Mishra ◽  
Rajendra Palkhade
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Needlestick Injury ◽  
Large Animal ◽  
Cross Sectional ◽  
Automobile Accidents ◽  
Work Related ◽  
The Past ◽  
Physical Hazards

Background and Aim: Veterinary medicine is a high-risk occupation and imparts a risk of physical injuries due to the unpredictable nature of the animals and workplace conditions. This study aimed to identify the associated risk factors and prevalence of work-related injuries, and automobile accidents among veterinarians in India. Materials and Methods: A cross-sectional study was carried out among veterinarians (n=565). The responses were recorded using a self-administered questionnaire on work-related injuries, automobile accidents, and physical hazards. Results: Work-related injuries due to animals in the past 2 years were reported by more than half of veterinarians (prevalence=54.7%, 95% confidence interval [CI]=50.58-58.79), while two-thirds experienced workplace injuries due to animals during any time of their career. The risk for injury was 1.1 times higher (odds ratio=1.1, 95% CI=0.611, 1.981) for veterinarians with a long job duration (>10 years). Large animal practicing veterinarians faced a higher (2.03 times) risk of injury. Workplace absenteeism due to animal-related injury (up to 15 or more days) was reported by 25.9% (95% CI=22.44-29.68) of respondents, including hospitalizations for 7.8% of veterinarians. More than half of veterinarians suffered from automobile injuries (prevalence=60.9%, 95% CI=6.8-64.8) due to work-related travel in the past 2 years, resulting in workplace absenteeism for 56.2% (95% CI=51.46-60.97) of subjects. The prevalence of needlestick injury among veterinarians was very high and reported as 80.9% (95% CI=77.49-83.99). Recapping of needles significantly increased the risk of needlestick injury by 1.67 times. Conclusion: Veterinarians are at risk of work-related injuries, including automobile accidents. Kicking by animals and needlestick injuries were the most frequent physical hazards. Recapping of needles and responding to emergency calls at night were significant risk factors for needlestick injury and automobile accidents, respectively.

scholarly journals Risk Factors for Clostridium Difficile Infection in a Tertiary Care Hospital

2018 ◽  
Vol 3 (3) ◽  
pp. 124
Author(s):  
Muralidhar Varma ◽  
Neha Agrawal ◽  
Pallavi Uppal ◽  
Rahul Singh ◽  
Karunya Jayasimha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
The Past ◽  
Appropriate Treatment ◽  
Control Study

Introduction: Clostridium difficile infections have had significant morbidity and mortality in the last decade leading to high healthcare costs. Our prospective case-control study from October 2013 to May 2015 in a tertiary care hospital in rural India aimed to evaluate the risk factors, treatment, outcome, and complications of Clostridium difficile infections in hospitalized patients.Materials and Methods: The study involved a total of 183 patients, of which 61 were cases, and 122 were controls. Data was analyzed using multivariate logistic regression.Results: Antibiotic intake in the past four weeks (p=0.003), hypoalbuminemia (p=0.001) and duration of hospital stay before the onset of diarrhea (p<0.001) were proven to have significant risk. We subdivided cases into severe and non-severe cases, and we found that complications were statistically higher in severe cases (OR= 1.685, <0.001).Conclusion: Identifying severe cases and administering timely and appropriate treatment is prudent.

scholarly journals EVALUATION OF RISK FACTORS FOR MORBIDITY AND MORTALITY IN CHILDREN AGED 6 MONTH- 5 YEARS PRESENTING WITH LOWER RESPIRATORY TRACT INFECTION TO A REFERRAL HOSPITAL

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Tarun Kumar ◽  
Bhupendra Narain ◽  
A.K. Jaiswal
Keyword(s):  
Risk Factors ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Significant Risk ◽  
Clinical Score ◽  
Urban Setting ◽  
Mortality And Morbidity

Acute lower respiratory tract infection in children is a major cause of mortality and morbidity worldwide. A simple clinical score predicting the probability of death and poor outcome in a young child with lower respiratory tract infection (LRTI) could aid clinicians in case management and provide a standardized severity measure during epidemiologic studies. Therefore, our study was aimed to assess the usefulness of one such scoring model, the RISC score, in an urban setting in eastern part of India and also to determine significant risk factors for LRTI in young children Our study concluded that the RISC score maybe used as an index of severity in children with LRTI, as a complementary tool to the current IMCI framework, to ensure appropriate treatment and hospitalization in children, who are most in need. Also, recognizing the risk factors at presentation, may facilitate decisions about the most appropriate site of treatment (i.e., home vs. hospital) or the need for additional supportive care (i.e., supplemental oxygen or intensive care). Keywords: Morbidity, Mortality in Children, Lower Respiratory Tract Infection, LRTI, etc.

scholarly journals Prediction of the Rehabilitation Duration and Risk Management for Mild-Moderate COVID-19

2020 ◽  
Vol 14 (5) ◽  
pp. 652-657 ◽  
Author(s):  
Qiong-Na Zheng ◽  
Mei-Yan Xu ◽  
Yong-Le Zheng ◽  
Xiu-Ying Wang ◽  
Hui Zhao
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Risk Management ◽  
Large Scale ◽  
Clinical Decision Making ◽  
Risk Model ◽  
Linear Regression Analysis ◽  
Significant Risk ◽  
Clinical Decision ◽  
Clinical Practices

ABSTRACTObjectives:More than 80% of coronavirus disease 2019 (COVID-19) cases are mild or moderate. In this study, a risk model was developed for predicting rehabilitation duration (the time from hospital admission to discharge) of the mild-moderate COVID-19 cases and was used to conduct refined risk management for different risk populations.Methods:A total of 90 consecutive patients with mild-moderate COVID-19 were enrolled. Large-scale datasets were extracted from clinical practices. Through the multivariable linear regression analysis, the model was based on significant risk factors and was developed for predicting the rehabilitation duration of mild-moderate cases of COVID-19. To assess the local epidemic situation, risk management was conducted by weighing the risk of populations at different risk.Results:Ten risk factors from 44 high-dimensional clinical datasets were significantly correlated to rehabilitation duration (P < 0.05). Among these factors, 5 risk predictors were incorporated into a risk model. Individual rehabilitation durations were effectively calculated. Weighing the local epidemic situation, threshold probability was classified for low risk, intermediate risk, and high risk. Using this classification, risk management was based on a treatment flowchart tailored for clinical decision-making.Conclusions:The proposed novel model is a useful tool for individualized risk management of mild-moderate COVID-19 cases, and it may readily facilitate dynamic clinical decision-making for different risk populations.

Sign in / Sign up

Export Citation Format

Share Document