Risk Factors and Clinical Characteristics of Metabolic Bone Disease of Prematurity

2021 ◽  
Author(s):  
Mehmet Mutlu ◽  
Filiz Aktürk-Acar ◽  
Şebnem Kader ◽  
Yakup Aslan ◽  
Gülay Karagüzel
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Drug Use ◽  
Clinical Features ◽  
Premature Infants ◽  
Potential Risk ◽  
Clinical Characteristics ◽  
Metabolic Bone Disease ◽  
Metabolic Bone ◽  
Potential Risk Factors

Objective The study aimed to analyze the risk factors and clinical features of metabolic bone disease of prematurity (MBDP) in premature infants compared with infants of similar gestational age and birthweight without MBDP. Study Design This retrospective case–control study was performed by comparing 81 cases of MBDP with 63 controls to identify potential risk factors. Premature infants with a gestational age ≤33 weeks and birthweight <1,500 g were included. Medical records were examined in terms of maternal conditions, potential risk factors, and clinical characteristics. Results Bone fractures and invasive ventilator dependence were the most common clinical features of MBDP. Duration of invasive ventilation and total mechanical ventilation days, necrotizing enterocolitis, corticosteroid use, anticonvulsive drug use, duration of dexamethasone and caffeine use, total parenteral nutrition, and length of hospitalization were significantly higher in neonates with MBDP (p < 0.05). Breastfed neonates and those receiving human milk fortifier had a lower incidence of MBDP than those premature formula or mixed feeding (p < 0.05). Anticonvulsive drug use (odds ratio: 2.935; 95% confidence interval: 1.265–6.810) was identified as a risk factor for MBDP at multiple regression analysis. Conclusion Our results show that anticonvulsive drug use is a significant risk factor for the development of MBDP. If long-term use is not required, anticonvulsive drugs should be stopped as soon as possible. Further studies involving patients with MBDP are required to determine the risk factors and clinical features. Key Points

scholarly journals Potential risk factors and triggers for back pain in children and young adults. A scoping review, part I: incident and episodic back pain

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Amber M Beynon ◽  
Jeffrey J Hebert ◽  
Charlotte Lebouef-Yde ◽  
Bruce F Walker
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Risk Factor ◽  
Back Pain ◽  
Young People ◽  
Scoping Review ◽  
Potential Risk ◽  
Older Age ◽  
Potential Risk Factors ◽  
Children And Young Adults

Abstract Background The one-month prevalence of back pain in children and adolescents has been reported at 33, 28 and 48% at ages 9, 13 and 15 respectively. There are many suspected risk factors and triggers of back pain in young people. Objective The purpose of this scoping review was to identify potential risk factors and potential triggers for back pain in young people. The purpose of part I was to identify potential risk factors for incident and episodic back pain in young people. Part II included all eligible studies with unclear or mixed types of back pain. Methods Due to the vast number of studies on “risk factors” for back pain, a two-part scoping review of the literature was chosen as the best way to summarise the evidence. We adhered to the PRISMA-ScR guideline for scoping reviews. General potential risk factors and triggers for back pain in children and young adults (≤ 24 years) were included, incorporating physical, environmental, and/or physiological factors. A search was conducted using PubMed and Cochrane databases from inception to September 2018, limited to the English language. Within part I, and because of their importance, only the results of the studies that investigated risk factors of incident back pain and back pain episodes are presented. Results The search identified 7356 articles, of which 91 articles were eligible for this scoping review. The majority of the eligible articles had an unclear definition of back pain (results presented in scoping review part II). There were 7 inception cohort studies included and 1 cohort study that met the criteria for part I. The most consistent risk factors for incident and episodic back pain are female sex and older age. Conclusion Due to inconsistent ways of reporting on the type of back pain, no definitive risk factor for back pain has been identified. In general, females often report more symptoms, also for other diseases, and older age is not a useful risk factor as it merely indicates that the onset may not be in childhood. Clearly, the time has come to study the causes of back pain from different angles.

Speech-like vocalizations in infancy: an evaluation of potential risk factors

1994 ◽  
Vol 21 (1) ◽  
pp. 33-58 ◽  
Author(s):  
D. Kimbrough Oller ◽  
Rebecca E. Eilers ◽  
Michele L. Steffens ◽  
Michael P. Lynch ◽  
Richard Urbano
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Premature Infants ◽  
Potential Risk ◽  
Economic Status ◽  
Low Ses ◽  
Vocal Development ◽  
Laboratory Personnel ◽  
Socio Economic Status ◽  
Potential Risk Factors

ABSTRACTThis work reports longitudinal evaluation of the speech-like vocal development of infants born at risk due to prematurity or low socio-economic status (SES) and infants not subject to such risk. Twenty infants were preterm (10 of low SES) and 33 were full term (16 of low SES), and all were studied from 0;4 through 1;6. The study provides the indication that at-risk infants are not generally delayed in the ability to produce well-formed speech-like sounds as indicated in taperecorded vocal samples. At the same time, premature infants show a tendency to produce well-formed syllables less consistently than full terms after the point at which parents and laboratory personnel note the onset of the canonical babbling stage (the point after which well-formed syllables are well established in the infant vocal repertoires). Further, even though low SES infants produce well-formed speech-like structures on schedule, they show a reliably lower tendency to vocalize in general, as reflected by fewer utterances per minute in recorded samples.

scholarly journals Analysis of the Clinical Features of Intrauterine Ureaplasma urealyticum Infection in Preterm Infants: A Case-Control Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Tong Sun ◽  
Jianhua Fu
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Clinical Characteristics ◽  
Case Control Study ◽  
Metabolic Bone Disease ◽  
Ureaplasma Urealyticum ◽  
Case Control ◽  
Infection Group ◽  
Metabolic Bone ◽  
Control Study

Objective: To analyze the clinical characteristics of intrauterine Ureaplasma urealyticum (UU) infection in premature infants.Method: In this single-center retrospective case-control study, 291 preterm infants born in our hospital and hospitalized in our department and gestational age no more than 32 weeks, birth weight no more than 2000 g were included from January 2019 to January 2021. Lower respiratory tract secretion, gastric fluid and urine were collected for UU RNA detection within 48 h after birth. Intrauterine UU infection is defined by at least one positive UU-PCR test of secreta or excreta of preterm infants after birth. The UU infection group included 86 preterm infants and the non-UU infection group included 205 preterm infants. We compared their clinical features, hemogram changes and disease outcomes using statistical analyses.Results: The clinical characteristics of premature infants such as the duration of oxygen use and ventilator use in hospital were significantly prolonged in the UU infection group (P &lt; 0.05). The levels of leukocytes, platelet and procalcitonin in the UU infection group were significantly higher than in the non-UU infection group (P &lt; 0.05). In terms of preterm complications, only the incidences of bronchopulmonary dysplasia, retinopathy of prematurity and metabolic bone disease in premature infants in the UU infection group were significantly higher than those in the non-UU infection group (P &lt; 0.05). The mode of delivery, maternal premature rupture of membranes, and postnatal leukocyte level were independent risk factors for UU infection, while gestational hypertension was a protective factor for UU infection. The level of leukocytes in postnatal hemogram of premature infants could be used as a diagnostic index of UU infection, but the diagnostic accuracy was poor.Conclusion: In our study, UU infection can increase the incidence of bronchopulmonary dysplasia, retinopathy of prematurity and metabolic bone disease in preterm infants, but have no effect on the incidence of necrotizing enterocolitis, intracranial hemorrhage, white matter damage and other diseases in preterm infants. For high-risk premature infants, UU should be detected as soon as possible after birth, early intervention and drug treatment necessarily can improve the prognosis as much as possible.

scholarly journals Sheep gastrointestinal helminthiasis in the Sertão region of Paraíba State, Northeastern Brazil: prevalence and risk factors

2014 ◽  
Vol 23 (4) ◽  
pp. 488-494 ◽  
Author(s):  
Vanessa Diniz Vieira ◽  
Vinícius Longo Ribeiro Vilela ◽  
Thais Ferreira Feitosa ◽  
Ana Célia Rodrigues Athayde ◽  
Sérgio Santos Azevedo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Potential Risk ◽  
Northeastern Brazil ◽  
Blood Samples ◽  
Fatal Infection ◽  
High Prevalence ◽  
Potential Risk Factors ◽  
Relevant Risk Factor ◽  
Pasture Area

In this study, we aimed to establish the prevalence and risk factors relating to gastrointestinal helminthiasis, and to characterize the sanitary management practiced among sheep herds in the Sertão region of the state of Paraíba, northeastern Brazil, based on factors that condition the ways of controlling these parasites in these herds. The research was carried out between April and July 2012. We visited 54 farms, where fecal and blood samples were individually collected from 465 animals. On each farm, a questionnaire was applied to gather information on variables relating to potential risk factors. The prevalence of sheep gastrointestinal helminthiasis in the region was 75.9%. At least one animal tested positive for this helminthiasis on 53 (98.1%) of the 54 farms evaluated. The eggs per gram of feces (EPG) analysis showed the following infection burdens: 51.8% with mild infection, 27.1% moderate infection, 9.9% heavy infection and 11.2% fatal infection. Among the sheep farms visited, anthelmintics were used on 81.5% (p <0.05). The most relevant risk factor in this study was the farm area, because it defines the area available for grazing animals. Properties with many animals and little pasture area, which are the most abundant type in the Sertão region of Paraíba, tend to have high prevalence of gastrointestinal helminthiasis, because the animals are more prone to reinfection. The Sertão region of Paraíba presents high prevalence of gastrointestinal helminthiasis among sheep, and the farm area is the most relevant risk factor for the development of these parasites.

Incidence of Carboplatin-Related Hypersensitivity Reactions in Japanese Patients With Gynecologic Malignancies

2009 ◽  
Vol 19 (3) ◽  
pp. 460-465 ◽  
Author(s):  
H. Koshiba ◽  
K. Hosokawa ◽  
A. Kubo ◽  
Y. Miyagi ◽  
T. Oda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ovarian Carcinoma ◽  
Clinical Features ◽  
Potential Risk ◽  
Japanese Patients ◽  
Hypersensitivity Reactions ◽  
Careful Attention ◽  
Gynecologic Malignancies ◽  
Multiple Doses ◽  
Potential Risk Factors

Carboplatin is one of the most commonly used and well-tolerated agents for gynecologic malignancies. The rate of hypersensitivity reactions (HSRs) in the overall population of patients receiving carboplatin has been reported to increase after multiple doses of the agent. We retrospectively analyzed the incidence, clinical features, management, or outcome of carboplatin-related HSRs in 113 Japanese patients with gynecologic malignancies and the possibility of rechallenge with the drug. We intravenously administered carboplatin after paclitaxel or docetaxel. Mild HSRs are resolved by temporary interruption of carboplatin infusion, an additional antihistamine, and/or a corticosteroid. If HSRs arose, carboplatin was diluted, not exceeding 1 mg/mL, and slowly infused over 2 hours in subsequent cycles. Ten patients experienced carboplatin HSRs, with an overall incidence of 8.85%. The first HSR episode was mild in all cases. When retreated with carboplatin, 4 exhibited severe HSRs. More than 9 cycles and/or more than 5000 mg of carboplatin administration significantly increased the incidence of HSRs. In particular, carboplatin treatment beyond 15 cycles and/or 8000 mg increased the risk of severe HSRs (P < 0.0001). The incidence of HSRs in the ovarian carcinoma group was significantly greater than that in the uterine carcinoma group (P = 0.0046). Careful attention should be paid to HSRs during carboplatin treatment beyond 9 cycles and/or 5000 mg. The rate of severe HSRs greatly increases beyond 15 cycles and/or 8000 mg. Further studies are needed to identify potential risk factors that may contribute to the development of carboplatin HSRs and to decrease the risk of reactions.

scholarly journals 2013. Blood Culture Contamination in the Emergency Department: A Risk Factor Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S675-S676
Author(s):  
Justin Klucher ◽  
Mrinmayee Lakkad ◽  
Jacob Painter ◽  
Ryan K Dare
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Factor Analysis ◽  
Risk Factor ◽  
High Risk ◽  
Potential Risk ◽  
False Positive ◽  
Univariate Analysis ◽  
Sterile Technique ◽  
Potential Risk Factors

Abstract Background Blood cultures (BCx) guide treatment for hospitalized patients, yet contaminated BCx lead to clinical uncertainty, impacting care. The Clinical and Laboratory Standards Institute (CLSI) recommends contamination rates should be <3%, yet our Emergency Department (ED) rate is consistently above this benchmark. Reasons for this are unclear, thus it is imperative to investigate potential risk factors for BCx contamination. Methods We performed a retrospective case–control risk factor analysis of patients with BCx collected in our ED between 2014 and 2018. Contaminated BCx were identified by the microbiology laboratory per American Society of Microbiology recommendations. Demographics, comorbidities, and clinical characteristics were evaluated in patients with false-positive/contaminated BCx (cases) and patients with negative BCx (controls). Potential risk factors identified in univariate analysis were included in a logistic regression model. Unadjusted and adjusted analyses were performed using SAS 9.4. Results 25,668 BCx from 13,782 patients were included in analysis. 20,907 BCx from 11,266 (82%) patients were negative, 2,856 BCx from 1,504 (11%) patients were true positives, and 1,905 BCx from 1,012 (7%) patients were contaminated. Yearly ED contamination rates ranged from 5.0–9.3%. Collector contamination rates varied, though 38 (19%), 75 (35%), and 7 (3%) of 209 collectors had a contamination rate <3%, ≥ 10%, and ≥ 20%, respectively. Significant patient-specific risk factors identified in univariate analysis are listed in the attached table along with adjusted analysis. Conclusion In our analysis, we identified that older age, African American race, higher BMI, COPD, paralysis, and presenting in septic shock independently increases risk of having a contaminated BCx. Difficulty obtaining venipuncture in patients with these risk factors, often requiring multiple collection attempts, likely leads to decreased sterile technique. It is imperative to have a process assuring sterile technique in these high-risk individuals to minimize consequences associated with having a false-positive BCx result in these high-risk patients. Additionally, variable collector contamination rates seen in this study highlight the necessity for frequent technique in-service training. Disclosures All authors: No reported disclosures.

Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease

2020 ◽  
pp. 174749302096722
Author(s):  
Hecheng Yang ◽  
Limin Zhang ◽  
Menghan Wang ◽  
Jingtao Wang ◽  
Lijie Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Logistic Regression Analysis ◽  
Potential Risk ◽  
Intracranial Aneurysms ◽  
Age Of Onset ◽  
Potential Risk Factors

Background The clinical features of aneurysms associated with moyamoya disease (MMD) and risk factors for the formation and rupture of aneurysms are not well defined. Aims In this study, we retrospectively analyzed clinical data of MMD patients and examined the potential risk factors for the formation and rupture of aneurysms in these patients. Methods The medical records of all MMD patients in our hospital from April 2012 to May 2019 were reviewed. The logistic regression analysis was used to determine the independent association between various potential risk factors and the presence or rupture of intracranial aneurysms in MMD patients. Results Of 2230 MMD patients, 182 (8.2%) cases had intracranial aneurysms. The mean age of onset in patients with aneurysms was 47.2 years, which was significantly higher when compared with those without aneurysms ( p < 0.001). In logistic regression analysis, age of onset remained significantly associated with the presence of intracranial aneurysms, while female gender, hypertension, diabetes mellitus, and coronary artery disease were not. Besides, intracranial aneurysms were significantly associated with intracranial hemorrhage in MMD patients (odds ratio [OR] = 5.19; 95% confidence interval [CI], 3.80–7.09). About 60% aneurysms >5 mm in size, and 62.1% aneurysms with irregularly shaped morphology were ruptured. Aneurysms located in basilar tip, collateral or moyamoya vessels were more likely to present with rupture. Conclusions Age was an important risk factor for intracranial aneurysms formation in MMD patients. Aneurysms increased the risk of intracerebral hemorrhage in MMD patients, and their ruptures were correlated with aneurysms size, location, and morphology.

The significance of ultrasound biomicroscopy in the objective assessment of post-trabeculectomy bleb success

2021 ◽  
pp. 112067212199058
Author(s):  
Bediz Özen ◽  
Berna Yüce ◽  
Hakan Öztürk
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Drug Use ◽  
Clinical Characteristics ◽  
Objective Assessment ◽  
Ultrasound Biomicroscopy ◽  
Potential Risk Factors ◽  
Group 2 ◽  
Antiglaucoma Drug ◽  
Group 1

Purpose: To compare clinical characteristics and ultrasound biomicroscopy (UBM) measurements of cases with functional and non-functional blebs, and to identify potential risk factors capable of affecting UBM parameters. Methods: Thirty-one patients aged 40–79 were included. Following trabeculectomy, cases were divided into two groups as those with functional bleb (Group 1, n = 20) and those with non-functional bleb (Group 2, n = 11). UBM was performed. Results: In Group 1 compared to Group 2, lower postoperative intraocular pressure (IOP) (12.1 ± 1.7 vs 27.2 ± 3.2 mmHg, p < 0.001), greater bleb height (1.0 ± 0.2 vs 0.5 ± 0.3 mm, p < 0.001), greater scleral route visibility [16/20 (80%) vs 4/11 (36.4%), p = 0.023] and lower bleb reflectivity (1.8 ± 0.2 vs 2.4 ± 0.4, p = 0.015) were observed. In Group 1, as postoperative IOP decreased, bleb height and scleral route visibility increased ( r = −0.387, p = 0.029 for bleb height; r = −0.374, p = 0.033 for scleral route), and bleb reflectivity decreased ( r = 0.359, p = 0.042). In Group 1, as duration of preoperative antiglaucoma drug use increased, bleb reflectivity increased ( r = 0.348, p = 0.046). Preoperative IOP and number of preoperative antiglaucoma drug use had no effect on UBM parameters in groups ( p > 0.05). Conclusion: UBM is useful in assessing bleb success. Lower bleb reflectivity, greater bleb height and greater scleral route visibility indicate that the bleb is functional. To the best of our knowledge, this is the first study investigating effects of preoperative IOP, number and duration of preoperative antiglaucoma drug use on UBM parameters. In cases with functional bleb, duration of preoperative drug use affects only bleb reflectivity, while postoperative IOP affects bleb height, scleral route visibility and bleb reflectivity.

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