1280Natural history, developmental trajectories, and determinants of eczema from infancy to 26 years of age

Abstract Background Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns. This study sought to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of early life risk factors. Methods The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18, and 26 years. At each assessment, eczema was ascertained based on established clinical criteria. Developmental trajectories of eczema between 1-or-2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results In both males and females, the following eczema trajectories were identified: unaffected/transient (77.7% vs. 73.0%), mid-onset late-resolving (7.8% vs. 4.4%), late-onset (5.2% vs. 9.5%), and early-onset persistent (9.3% vs. 5.4%). In females, an additional trajectory was identified: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34-4.46) and paternal eczema (2.66, 1.39-5.08) were associated with the early-onset persistent trajectory. Among females, maternal eczema (2.84, 1.42-5.70) and high birthweight (2.25, 1.08-4.69) were associated with the early-onset persistent trajectory. Conclusions Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Key messages Males and females may experience a different course of eczema and also sex-specific risk factors.

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Risk Factors for Early-onset, Ventilator-associated Pneumonia in Critical Care Patients

Anesthesiology ◽

10.1097/00000542-200009000-00011 ◽

2000 ◽

Vol 93 (3) ◽

pp. 638-645 ◽

Cited By ~ 55

Author(s):

Ozan Akça ◽

Kemalettin Koltka ◽

Serdar Uzel ◽

Nahit Çakar ◽

Kamil Pembeci ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Glasgow Coma Score ◽

Early Onset ◽

Odds Ratio ◽

Late Onset ◽

Multidrug Resistant ◽

Ventilator Associated Pneumonia ◽

Clinical Criteria ◽

Potential Risk Factors

Background Ventilator-associated pneumonia is the leading nosocomial infection in critically ill patients. The frequency of ventilator-associated pneumonia caused by multidrug-resistant bacteria has increased in recent years, and these pathogens cause most of the deaths attributable to pneumonia. The authors, therefore, evaluated factors associated with selected multidrug-resistant ventilator-associated pneumonia in critical care patients. Methods The authors prospectively recorded potential risk factors at the time of intensive care unit admission. An endotracheal aspirate was obtained in all patients who met clinical criteria for pneumonia. Patients were considered to have ventilator-associated pneumonia only when they met the clinical criteria and aspirate culture was positive for bacteria 48 h or more after initiation of mechanical ventilation. Pediatric patients were excluded. Adult patients with ventilator-associated pneumonia were first grouped as "early-onset" (< 5 days) and "late-onset," determined by episodes of ventilator-associated pneumonia, and then, assigned to four groups based on the bacteria cultured from their tracheal aspirates: Pseudomonas aeruginosa, Acinetobacter baumanii, methicillin-resistant staphylococci, and all others. The first three bacteria were considered to be multidrug resistant, whereas the others were considered to be antibiotic susceptible. Potential risk factors were evaluated with use of univariate statistics and multivariate regression. Results Among 486 consecutive patients admitted during the study, 260 adults underwent mechanical ventilation for more than 48 h. Eighty-one patients (31%) experienced 99 episodes of ventilator-associated pneumonia, including Pseudomonas(33 episodes), methicillin-resistant staphylococci (17 episodes), Acinetobacter(9 episodes), and nonresistant bacteria (40 episodes). Sixty-six of these episodes were early onset and 33 episodes were late onset. Logistic regression analysis identified three factors significantly associated with early-onset ventilator-associated pneumonia caused by any one of the multidrug-resistant bacterial strains: emergency intubation (odds ratio, 6.4; 95% confidence interval, 2.0-20.2), aspiration (odds ratio, 12.7; 95% confidence interval, 2.4-64.6), and Glasgow coma score of 9 or less (odds ratio, 3.9; 95% confidence interval, 1.3-11.3). A. baumanii-related pneumonia cases were found to be significantly associated with two of these factors: aspiration (odds ratio, 14.2; 95% confidence interval, 1.5-133.8) and Glasgow coma score (odds ratio, 6.0; 95% confidence interval, 1.1-32.6). Conclusions The authors recommend that patients undergoing emergency intubation or aspiration or who have a Glasgow coma score of 9 or less be monitored especially closely for early-onset multidrug-resistant pneumonia. The occurrence of aspiration and a Glasgow coma score of 9 or less are especially associated with pneumonia caused by A. baumanii.

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NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.1215 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pramod P. Singhavi

Keyword(s):

Risk Factors ◽

Neonatal Sepsis ◽

Early Onset ◽

Late Onset ◽

Signs And Symptoms ◽

Premature Rupture ◽

Maternal Risk ◽

Late Onset Sepsis ◽

Early Onset Sepsis ◽

Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

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Faculty Opinions recommendation of Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725298358.793542862 ◽

2018 ◽

Author(s):

Andrew Shennan ◽

Kate Duhig

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Early Onset ◽

Disease Risk ◽

Late Onset ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Early Onset Preeclampsia

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Comparison of risk factors and perinatal outcomes in early onset and late onset preeclampsia: A cohort based study in Reunion Island

Journal of Reproductive Immunology ◽

10.1016/j.jri.2017.08.005 ◽

2017 ◽

Vol 123 ◽

pp. 12-16 ◽

Cited By ~ 16

Author(s):

Silvia Iacobelli ◽

Francesco Bonsante ◽

Pierre-Yves Robillard

Keyword(s):

Risk Factors ◽

Early Onset ◽

Late Onset ◽

Perinatal Outcomes ◽

Reunion Island ◽

Réunion Island

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Gender and Schizophrenia: Association of Age at Onset with Antecedent, Clinical and Outcome Features

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679809065536 ◽

1998 ◽

Vol 32 (3) ◽

pp. 415-423 ◽

Cited By ~ 13

Author(s):

Oye Gureje ◽

Rotimi W. Bamidele

Keyword(s):

Functional Outcome ◽

Early Onset ◽

Late Onset ◽

Age At Onset ◽

Early Age ◽

Illness Onset ◽

Gender And Age ◽

Males And Females ◽

Clear Method ◽

Illness Outcome

Objective: There is evidence that gender and age at onset may have a bearing on schizophrenia. The extent to which this differential age at onset influences the clinical features of schizophrenia and its outcome in males and females is not clear. Method: One hundred and twenty outpatients with DSM-III-R schizophrenia were studied to determine the association of antecedent, historical, clinical and 13–year outcome features with age at onset in females (n = 64) and in males (n = 56). Results: Males were significantly younger at illness onset but were not otherwise different from females in antecedent features of illness. For males, age at onset bore little relationship to outcome after 13 years. Females with early onset of illness were more likely to have experienced obstetric complications, to evidence poorer premor-bid functioning, and to have a worse clinical, social and functional outcome than females with late onset. Conclusions: Even though females may have a more benign illness than males, among females, those with early age at onset may be characterised by neurodevel-opmental deviance and worse illness outcome.

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Early intervention in personality disorders

Early Intervention in Psychiatric Disorders Across Cultures ◽

10.1093/med/9780198820833.003.0014 ◽

2019 ◽

pp. 167-174

Author(s):

John M. Oldham

Keyword(s):

Risk Factors ◽

Early Intervention ◽

Personality Disorders ◽

Early Development ◽

Early Identification ◽

Early Onset ◽

Early Adulthood ◽

Critical Component ◽

Personality Functioning ◽

Attachment Process

Personality disorders have their onset in adolescence or early adulthood. It is now well-established that these conditions emerge in individuals who have heritable risk factors and who experience disruptions in the attachment process, a critical component of early development that, when successful, sets the stage for healthy, stable personality functioning in adulthood. The importance of early identification of, and intervention for, emerging personality disorders is increasingly recognized. A new dimensional model for personality disorders relies on assessing self and interpersonal functioning, impairment of which during adolescence may signal the early onset of potentially disabling personality disorders.

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Maternofetal outcomes in early versus late onset pre-eclampsia: a comparative study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190282 ◽

2019 ◽

Vol 8 (2) ◽

pp. 548

Author(s):

Poornima Shankar ◽

Kavitha Karthikeyan ◽

Amrita Priscilla Nalini ◽

Sindhura M. ◽

Gowtham Kim

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Early Onset ◽

Age Of Onset ◽

Late Onset ◽

Fetal Outcomes ◽

Chi Square ◽

Onset Type ◽

Significant Difference ◽

Early Onset Preeclampsia

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.

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Risk Factors for Ventilator-associated Pneumonia by Pseudomonas aeruginosa in Presence of Recent Antibiotic Exposure

Anesthesiology ◽

10.1097/00000542-200610000-00016 ◽

2006 ◽

Vol 105 (4) ◽

pp. 709-714 ◽

Cited By ~ 26

Author(s):

Jordi Rello ◽

Camilla Allegri ◽

Alejandro Rodriguez ◽

Loreto Vidaur ◽

Gonzalo Sirgo ◽

...

Keyword(s):

Risk Factors ◽

Pseudomonas Aeruginosa ◽

Relative Risk ◽

Confidence Interval ◽

Early Onset ◽

Late Onset ◽

Interquartile Range ◽

Ventilator Associated Pneumonia ◽

Antibiotic Exposure ◽

Retrospective Case

Background To facilitate the decision-making process for therapy and prevention of ventilator-associated pneumonia (VAP) in patients undergoing recent antibiotic exposure, this study investigated whether the development of VAP episodes caused by Pseudomonas aeruginosa or other pathogens are related to different risk factors, thereby distinguishing two risk population for this serious complication. Methods A 5-year retrospective case-control observational study was conducted. Cases of VAP caused by P. aeruginosa were compared with those caused by other pathogens. Univariate and multivariate analysis was performed using SPSS 11.0 software (SPSS Inc., Chicago, IL). Results Two groups were identified: P. aeruginosa (group P) was isolated in 58 (63.7%) episodes, and 33 episodes served as controls (group C), after a median of 12 days (interquartile range, 4-28 days) and 9 days (interquartile range, 3-12.5 days) of mechanical ventilation, respectively. P. aeruginosa was identified in 34.7% of episodes with early-onset pneumonia and in 73.5% with late-onset pneumonia. In a logistic regression analysis, P. aeruginosa was independently associated with duration of stay of 5 days or longer (relative risk = 3.59; 95% confidence interval, 1.04-12.35) and absence of coma (relative risk = 8.36; 95% confidence interval, 2.68-26.09). Risk for pathogens different from P. aeruginosa (group C) in early-onset pneumonia associated with coma was estimated to be 87.5%. Conclusions Risk factors in episodes under recent antibiotic treatment caused by P. aeruginosa or other microorganism are not the same, a fact that could have implications for preventive and therapeutic approaches for this infection.

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Early Onset versus Late Onset Peripherally Inserted Central Venous Catheter Infections: An Analysis of Risk Factors and Microbiology

Infection Control and Hospital Epidemiology ◽

10.1086/671726 ◽

2013 ◽

Vol 34 (9) ◽

pp. 980-983 ◽

Cited By ~ 6

Author(s):

Paul Chittick ◽

Sobia Azhar ◽

Kalyani Movva ◽

Paula Keller ◽

Judith A. Boura ◽

...

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Early Onset ◽

Late Onset ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous ◽

Peripherally Inserted Central Catheters ◽

Catheter Infections ◽

Central Catheters

The risks and microbiology for peripherally inserted central catheters (PICCs) are less well described than those for traditional central catheters, particularly as they pertain to duration of catheterization. We compared patients with early- and late-onset PICC bloodstream infections at our institution and found significant differences in microbiologic etiologies.

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