scholarly journals The Identification of Risk Factors for Chronic Chikungunya Arthralgia in Grenada, West Indies: A Cross-Sectional Cohort Study

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Claire J Heath ◽  
Jason Lowther ◽  
Trevor P Noël ◽  
Idis Mark-George ◽  
Derek B Boothroyd ◽  
...  

Abstract Background Chikungunya virus (CHIKV) is a re-emerging arboviral pathogen. In 2014, an explosive CHIKV outbreak occurred in Grenada, West Indies, infecting approximately 60% of the population. In approximately 50% of cases, CHIKV infection transitions to painful arthralgia that can persist for years. Elucidation of the risk factors for chronic disease is imperative to the development of effective risk management strategies and specific therapeutics. Methods We conducted a cross-sectional study of 240 people who were tested for CHIKV during the outbreak. We administered questionnaires to examine demographic, behavioral, psychological, social, and environmental factors to identify associations with chronic disease. Physical examinations were performed and persistent symptoms were recorded. Results Ethnicity and socioeconomic status were not associated with risk of chronic joint pain. Female sex increased risk, and age was demonstrated to be predictive of chronic CHIKV sequelae. Mosquito avoidance behaviors did not reduce risk. Patients suffering joint pains, generalized body ache, and weakness in the extremities during acute infection were more likely to develop chronic arthralgia, and an increased duration of acute disease also increased risk. Conclusions These data demonstrate that chronic CHIKV affects people across the ethnic and socioeconomic spectrum, and it is not reduced by vector avoidance activity. Increased duration of acute symptoms, in particular acute joint pain, was strongly correlated with the risk of persistent arthralgia, thus effective clinical management of acute CHIKV disease could reduce burden of chronic CHIKV.

Background: Exodontia is one of the most frequently carried out procedures by a dental surgeon, mostly on an outpatient department basis. The reasons for performing exodontia include non-restorable teeth, periodontal disease, dental trauma, impacted tooth, orthodontic treatment and toothache. Complications in dental extraction are a commonly encountered problem in dental clinics. This knowledge can help dental surgeons make extractions less invasive, traumatic and complicated, enabling quicker recovery of the socket. The aim of this study was to recognize types, frequency and risk factors for complications after exodontia. Methods: This cross-sectional study enrolled patients who had exodontia done from July- September 2019, visiting OPD of the Oral surgery department of Altamash Institute of Dental Medicine, Karachi. Risk factors included demographic data, general health, past medical and dental history. Spearman’s correlation test was used to establish any relationship of variables with complications. Results: The study patients (126) included 72 females (mean age 39.1±13.39) and 54 males (mean age 41.1±14.93). The overall complications rate was found to be 7.1%, mainly arising from maxillary and mandibular third molars. The most common complications encountered were Hemorrhage, Pain, and Trismus. Increasing age and specific teeth extracted were associated with an increased risk for complications. However, post-operative complications which were encountered most of them were minor and handled on an outpatient department basis. Conclusion: Frequency and risk factors for complications after exodontia were found low3 (37.5%). While age and teeth extracted cannot be directly altered, these factors maybe indirectly modified, resulting in a potential decrease of postoperative complications.


2020 ◽  
Vol 41 (spe) ◽  
Author(s):  
Viviane Maria Osmarin ◽  
Fernanda Guarilha Boni ◽  
Taline Bavaresco ◽  
Amália de Fátima Lucena ◽  
Isabel Cristina Echer

Abstract Objective: To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. Methods: This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. Results: The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. Conclusion: The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.


2018 ◽  
Vol 7 (2) ◽  
pp. 2-7
Author(s):  
Nicholas R Fuggle ◽  
Joseph Singer ◽  
Michael A. Clynes ◽  
Beth Curtis ◽  
Pallavi Wyawahare ◽  
...  

Aims: Alcoholism is known to be associated with increased risk of fracture. This study aimed to study bone turnover following alcohol detoxification and to investigate lifestyle factors for low bone density that might coexist with alcohol dependency, which might be amenable to modification. Method: Pre-menopausal female participants were recruited from an alcohol-use dependency unit to a cross-sectional study. A lifestyle questionnaire, including alcohol history, smoking, physical activity, dietary calcium intake, falls, and fracture history was completed. Quantitative heel ultrasonography was performed and broadband ultrasound attenuation (BUA), speed of sound (SOS), t score, and z score were recorded. Blood was taken for bone-turnover markers at baseline and day 5 following admission for alcohol withdrawal.Results: The mean age (SD) of alcohol dependent participants was 41.6 (8.3) years, with participants reporting high levels of current cigarette smoking, physical inactivity, and falls. BUA, SOS, t scores, and z scores were lower than the age-matched reference range in alcohol-dependent participants. Levels of type 1 procollagen (P1NP) increased significantly after five days (p < .001). Conclusions: Alcohol-dependent, pre-menopausal individuals have multiple risk factors for fracture, beyond alcohol excess. These should be addressed and targeted as modification may reduce fracture risk, especially given the apparent recovery of bone turnover on the withdrawal of alcohol.


2012 ◽  
Vol 8 (3) ◽  
pp. 144 ◽  
Author(s):  
Nyoman Kertia

Background: Knee osteoarthritis (OA) is a common disorder that is associated with significant morbidity, disability, and medical costs, particularly in its advanced stages. While the cause of knee OA remains unclear, it has been associated with various risk factors, such as age, sex, genetic predisposition, biomechanical, and obesity. Pain in osteoarthritis occurs due to combination of various factors. Pain significantly increases the medical and non medical cost in OA. Data showed that obesity will increase the mechanical stress and pain of knee OA. However, uncertainty remains regarding potential relationship between body mass index (BMI) and pain in osteoarthritis. Moreover, since obesity is one of modifiable and preventable risk factors for the onset and progression of the disease, it is important to know the correlation between BMI and severity of pain in knee OA.Objectives: To investigate the relationship between body mass index and severity of joint pain in knee osteoarthritis.Methods: A cross sectional study was conducted and subjects were osteoarthritis patients in rheumatology clinic of Sardjito general hospital. Body mass index and visual analogue scale (VAS) score were measured. Correlation between BMI and VAS score were analyzed by bivariate correlation test.Results: There were 80 patients with osteoarthritis who participated in the study. Mean BMI was 26.36 +4.23 kg/m2 and VAS score was 52.40+24.53 mm. The correlation test showed that there was a positive but non significant correlation between BMI and VAS scores (r = 0,11; p = 0,33).Conclusion: There was a positive but non significant correlation between body mass index and the severity of joint pain in knee osteoarthritis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kushupika Dube ◽  
Tina Lavender ◽  
Kieran Blaikie ◽  
Christopher J. Sutton ◽  
Alexander E. P. Heazell ◽  
...  

Abstract Introduction 98% of the 2.6 million stillbirths per annum occur in low and middle income countries. However, understanding of risk factors for stillbirth in these settings is incomplete, hampering efforts to develop effective strategies to prevent deaths. Methods A cross-sectional study of eligible women on the postnatal ward at Mpilo Hospital, Zimbabwe was undertaken between 01/08/2018 and 31/03/2019 (n = 1779). Data were collected from birth records for maternal characteristics, obstetric and past medical history, antenatal care and pregnancy outcome. A directed acyclic graph was constructed with multivariable logistic regression performed to fit the corresponding model specification to data comprising singleton pregnancies, excluding neonatal deaths (n = 1734), using multiple imputation for missing data. Where possible, findings were validated against all women with births recorded in the hospital birth register (n = 1847). Results Risk factors for stillbirth included: previous stillbirth (29/1691 (2%) of livebirths and 39/43 (91%) of stillbirths, adjusted Odds Ratio (aOR) 2628.9, 95% CI 342.8 to 20,163.0), antenatal care (aOR 44.49 no antenatal care vs. > 4 antenatal care visits, 95% CI 6.80 to 291.19), maternal medical complications (aOR 7.33, 95% CI 1.99 to 26.92) and season of birth (Cold season vs. Mild aOR 14.29, 95% CI 3.09 to 66.08; Hot season vs. Mild aOR 3.39, 95% CI 0.86 to 13.27). Women who had recurrent stillbirth had a lower educational and health status (18.2% had no education vs. 10.0%) and were less likely to receive antenatal care (20.5% had no antenatal care vs. 6.6%) than women without recurrent stillbirth. Conclusion The increased risk in women who have a history of stillbirth is a novel finding in Low and Middle Income Countries (LMICs) and is in agreement with findings from High Income Countries (HICs), although the estimated effect size is much greater (OR in HICs ~ 5). Developing antenatal care for this group of women offers an important opportunity for stillbirth prevention.


2019 ◽  
Author(s):  
Zhao Hu ◽  
Xidi Zhu ◽  
Yunhan Yu ◽  
Huilan Xu

Abstract Background: Sleep problems have become the most common complaints among elderly adults. There are a few studies indentified prevalence of poor sleep quality and its associated factors in nursing home setting.Therefore, our study aim to examine the prevalence of poor sleep quality, its risk factors, and their interactions among Chinese elderly adults in nursing homes. Methods: A total of 817 elderly residents from 24 nursing homes were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) between risk factors and poor sleep quality. An additional interaction model was used to analyse the interaction between risk factors. Results: The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among elderly adults in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70-79 years old (AOR: 1.81, 95% CI: 1.10, 2.97) or 80 years old and above (AOR: 2.64, 95% CI: 1.67, 4.17); having less than 7 years of education (AOR: 1.59, 95% CI: 1.08, 2.33); having one to two kinds of chronic diseases (AOR: 2.26, 95% CI: 1.53, 3.32) or three or more kinds of chronic disease (AOR: 2.81, 95% CI: 1.65, 4.76); having depression (AOR: 3.13, 95% CI: 2.04, 4.81), anxiety (AOR: 3.42, 95% CI: 1.68, 6.97), and lower social support (AOR: 1.57, 95% CI: 1.11, 2.21). Additive interactions were detected between age and anxiety (AOR: 8.34, 95% CI: 4.43, 15.69), between chronic disease and anxiety (AOR: 8.61, 95% CI; 4.28, 17.31) and between social support and anxiety (AOR: 6.43, 95% CI: 3.22, 12.86). Conclusions: The prevalence of poor sleep quality in nursing homes is relatively high. Anxiety has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.


Author(s):  
Melanie Schubert ◽  
Daniel Kämpf ◽  
Marlena Wahl ◽  
Samuel Hofmann ◽  
Maria Girbig ◽  
...  

People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed to identify risk factors for MRSA transmission. We invited all staff (i.e., with and without patient contact from 22 participating rehabilitation centers; n = 2499) to participate. Study participation included a questionnaire on personal characteristics, lifestyle, personal and occupational risk factors for MRSA and nasal swabs taken by the study team. In total, 1005 persons participated in the study (response: 40.2%). Only four participants carried MRSA (0.40 (95% CI 0.00–1.00) per 100). MRSA carriage did not seem to be occupationally related, as it was found in different occupations with and without direct contact with MRSA patients, as well as in different clinics with different indications and patient clientele. We could not find a clear association between MRSA carriage and potential risk factors due to the low number of cases found. Genotyping revealed the spa types t032 (Barnim epidemic strain) and t1223. Our results suggest a low point prevalence of nasal MRSA colonization in a non-outbreak setting in employees from rehabilitation centers.


Author(s):  
Alireza Gheini ◽  
Ali Pooria ◽  
Afsoun Pourya

Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. Methods: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. Results: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. Conclusion: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Xing Chu ◽  
Guangquan Shen ◽  
Qinghai Hu ◽  
Hongyi Wang ◽  
Jing Zhang ◽  
...  

Abstract Background Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex. Methods Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection. Results A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD, practicing RD before sex, the interaction between RD and CRAI using a shower hose for RD and other risk factors, practicing RD after sex, CRAI, using nitrite inhalants, main sexual role with males as bottom and syphilis infection. Conclusions RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that further studies should be conducted to understand the detailed mechanism between RD and increased HIV prevalence.


2021 ◽  
Vol 12 ◽  
Author(s):  
Bojan Mirkovic ◽  
Vincent Belloncle ◽  
Hugues Pellerin ◽  
Jean-Marc Guilé ◽  
Priscille Gérardin

Background: Suicide attempts in adolescence represent a major public health concern, since these behaviors are associated with psychosocial burden and an increased risk of suicide. This cross-sectional study aimed to explore possible gender differences related to protective and risk factors in adolescents who have attempted suicide.Methods: Participants were French adolescents hospitalized for attempt suicide in five French pediatric departments. The participants were evaluated on 12 instruments measuring individual risk and protective factors.Results: Our sample included 320 adolescents aged 13–17 years (M = 14.43, SD = 1.29), of whom 82% were female and 35% were repeat attempters. Boys had greater difficulties at school and used more lethal means such as strangulation. We failed to find any differences between the two groups as regards the main Axis I psychiatric diagnoses. Boys tend to use more non-productive coping skills such as tension reduction or wishful thinking and girls use more reference to other strategies such as seeking social support. Although spirituality scores were low overall sample, they were significantly higher among girls.Conclusions: In the end, we find little difference between the two groups in terms of risk factors. However, we have shown gender differences in spirituality and some coping strategies. These results should be taken into consideration when designing suicide prevention programs.


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