Maternal Characteristics and Migraine Pharmacotherapy During Pregnancy: Cross-Sectional Analysis of Data from a Large Cohort Study

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1267-1276 ◽  
Author(s):  
K Nezvalová-Henriksen ◽  
O Spigset ◽  
H Nordeng
Keyword(s):  
Body Mass Index ◽  
Odds Ratio ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Narcotic Analgesics ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Large Cohort Study ◽  
Sectional Analysis

Little is known about factors associated with migraine pharmacotherapy during pregnancy. Of 60 435 pregnant women in a population-based cohort, 3480 (5.8%) reported having migraine during the first 5 months of pregnancy. Of these, 2525 (72.6%) reported using migraine pharmacotherapy, mostly non-narcotic analgesics (54.1%) and triptans (25.4%). After adjustment for sociodemographic factors and comorbidities in logistic regression analysis, high pregestational body mass index [odds ratio (OR) 1.3, 95% confidence interval (CI) 1.2, 1.4], sleep < 5 h (OR 1.6, 95% CI 1.3, 1.9), being on sick-leave (OR 1.3, 95% CI 1.2, 1.5) and acute back/shoulder/neck pain (OR 0.6, 95% CI 0.6, 0.7) were associated with migraine pharmacotherapy during pregnancy. Many women need drug treatment for migraine during pregnancy, and the choice of pharmacotherapy during this period may be influenced by maternal sociodemographic factors and comorbidities.

scholarly journals Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018524 ◽  
Author(s):  
Paula Byrne ◽  
John Cullinan ◽  
Catríona Murphy ◽  
Susan M Smith
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Sociodemographic Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Base Category ◽  
Sectional Analysis ◽  
Prevention Of Cardiovascular Disease

ObjectiveTo describe the prevalence of statin utilisation by people aged over 50 years in Ireland and the factors associated with the likelihood of using a statin, focusing particularly on those using statins for primary prevention of cardiovascular disease (CVD).MethodsThis is a cross-sectional analysis of cardiovascular risk and sociodemographic factors associated with statin utilisation from wave 1 of The Irish Longitudinal Study on Ageing. A hierarchy of indications for statin utilisation, consisting of eight mutually exclusive levels of CVD-related diagnoses, was created. Participants were assigned one level of indication. The prevalence of statin utilisation was calculated. The likelihood that an individual was using a statin was estimated using a multivariable logistic regression model, controlling for cardiovascular risk and sociodemographic factors.ResultsIn this nationally representative sample (n=5618) of community-dwelling participants aged 50 years and over, 1715 (30.5%) were taking statins. Of these, 65.0% (57.3% of men and 72.7% of women) were doing so for the primary prevention of CVD. Thus, almost two-thirds of those taking statins did so for primary prevention and there was a notable difference between women and men in this regard. We also found that statin utilisation was highest among those with a prior history of CVD and was significantly associated with age (compared with the base category 50–64 years; 65–74 years OR 1.38 (95% CI 1.16 to 1.65); 75+ OR 1.33 (95% CI 1.04 to 1.69)), living with a spouse or partner (compared with the base category living alone; OR 1.35 (95% CI 1.10 to 1.65)), polypharmacy (OR 1.74 (95% CI 1.39 to 2.19)) and frequency of general practitioner visits (compared with the base category 0 visits per year; 1–2 visits OR 2.46 (95% CI 1.80 to 3.35); 3–4 visits OR 3.24 (95% CI 2.34 to 4.47); 5–6 visits OR 2.98 (95% CI 2.08 to 4.26); 7+ visits OR 2.51 (95% CI 1.73 to 3.63)), even after controlling for clinical need. There was no association between using statins and gender, education, income, social class, health insurance status, location or Systematic Coronary Risk Evaluation (SCORE) risk in the multivariable analysis.ConclusionStatin utilisation among those with no history of CVD accounted for almost two-thirds of all statin use, in part reflecting the high proportion of the population with no history of CVD, although utilisation rates were highest among those with a history of CVD.

scholarly journals Factors Associated with Colonoscopy Performed in Nonhospital Settings

2010 ◽  
Vol 24 (7) ◽  
pp. 419-424 ◽  
Author(s):  
Othman Alharbi ◽  
Linda Rabeneck ◽  
Lawrence F Paszat ◽  
Duminda N Wijeysundera ◽  
Rinku Sutradhar ◽  
...  
Keyword(s):  
Outcome Measure ◽  
High Volume ◽  
Population Based ◽  
Income Quintile ◽  
Physician Specialty ◽  
Cross Sectional ◽  
Health Administrative Data ◽  
Factors Associated ◽  
Sectional Analysis

BACKGROUND: Colonoscopy is being increasingly performed in facilities outside of hospitals. Regulation of these facilities is variable, and concerns regarding the quality of procedures in nonhospital (NH) settings have been raised. Further study is needed to better understand endoscopic practice in these facilities.OBJECTIVES: To describe NH-based colonoscopy practice in Ontario from 1993 to 2005, and to identify patient (age, sex, income quintile and comorbidity) and physician (specialty and colonoscopy volume) factors associated with this practice.METHODS: The present study was a population-based, cross-sectional analysis using health administrative data from Ontario adults who underwent at least one outpatient colonoscopy between 1993 and 2005. A total of 1,240,781 patients underwent 1,917,714 colonoscopies. The main outcome measure was the receipt of colonoscopy in an NH facility.RESULTS: An increase in NH-based colonoscopy from 10.0% in 1993 to 15.1% in 2005 (P<0.0001) was found. In the multivariate model, younger, healthier men living in higher income areas were significantly more likely to undergo NH-based colonoscopy. Surgeons and other practitioners (eg, nongastroenterologists and noninternists) were significantly more likely to practice in NH settings. Physicians in the highest colonoscopy volume quintile were 25 times more likely to practice in NH settings than those in the lowest volume quintile (P<0.0001).CONCLUSION: Rates of NH-based colonoscopy are rising in Ontario. High-volume endoscopists and surgeons are most likely to practice in NH settings. Given its increasing use, further study of the practice and the regulation of NH colonoscopy is warranted.

Healthful grain foods consumption by São Paulo residents: a 12-year analysis and future trends

2020 ◽  
pp. 1-11
Author(s):  
Mariane de M Fontanelli ◽  
Cristiane H Sales ◽  
Michelle A de Castro ◽  
Regina M Fisberg
Keyword(s):  
Family Income ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Sao Paulo ◽  
São Paulo ◽  
Older Individuals ◽  
Cross Sectional ◽  
Population Based Study ◽  
Factors Associated ◽  
Grain Foods

Abstract Objective: Understanding trends in grain consumption is essential to tackle the low consumption of healthful grain foods. This study aimed to evaluate trends and determinants of grain foods meeting the ≤10:1 carbohydrate:fibre ratio (≤10:1 ratio) in Brazil and to estimate this intake for the next years. Design: Three editions of the cross-sectional, population-based study Health Survey of São Paulo (2003, 2008 and 2015). Setting: Urban area of São Paulo, Brazil. Participants: The sample included 5801 participants aged 12 years or more. Results: A growing trend in the intake of these foods (0·9 percentage of energy (%E) in 2003 to 1·5 %E in 2015) was observed. Also, the proportion of the population consuming at least one grain food meeting the ≤10:1 ratio increased from 8·7 % in 2003 to 15·8 % in 2015, and 20·3 % of the population would be consuming some kind of healthful grain food by 2030. Sociodemographic factors associated with the consumption of grain foods meeting the ≤10:1 ratio changed according to study edition, but overall, older individuals (+79 %), females (+28 %), those with higher education (+138 %) and higher family income (+135 %) were more likely to consume grain foods meeting the ratio, whereas participants who self-reported black, brown or indigenous ethnicity were less likely to consume these foods (–30 %). Conclusions: There was a growing trend to consume grain foods meeting the ≤10:1 ratio from 2003 to 2015, but this consumption continues to be far from recommended levels. Intersectoral changes are urgently needed in order to increase the intake of healthful grain foods.

scholarly journals Relationship between prescribed psychotropic medications and co-ingested alcohol in intentional self-poisonings

2017 ◽  
Vol 210 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Kate M. Chitty ◽  
Timothy Dobbins ◽  
Andrew H. Dawson ◽  
Geoffrey K. Isbister ◽  
Nicholas A. Buckley
Keyword(s):  
Risk Factor ◽  
Alcohol Consumption ◽  
Odds Ratio ◽  
Psychiatric Illness ◽  
Psychotropic Medications ◽  
Cross Sectional ◽  
Factors Associated ◽  
Acute Distress ◽  
Self Harm ◽  
Sectional Analysis

BackgroundAcute alcohol consumption is a major risk factor for suicide, therefore investigating factors associated with alcohol-related self-harm warrant attention.AimsTo investigate the influence of prescribed psychotropic medications on the odds of co-ingesting alcohol preceding or during intentional efforts to self-poison.MethodA cross-sectional analysis of consecutive hospital presentations following intentional self-poisoning was conducted. A total of 7270 patients (4363 women) aged 18–96 were included.ResultsThe odds of alcohol co-ingestion were increased in those not prescribed any medication (odds ratio (OR) = 1.27, 99% CI 1.10–1.46, P50.001) and in impulsive self-poisonings (OR= 1.39, 99% CI 1.11–1.74, P50.001). Odds were decreased in those prescribed anticonvulsants (OR = 0.69, 99% CI 0.51–0.93), antipsychotics (OR = 0.55, 99% CI 0.45–0.66) and antidepressants (OR = 0.87, 99% CI 0.77–0.99).ConclusionsFindings indicate that being medicated for a psychiatric illness may reduce the likelihood of alcohol consumption during times of acute distress, hence perhaps may reduce the risk of intentional self-poisoning.

Modifiable factors associated with patient-reported pain during and after screening colonoscopy

Gut ◽  
2017 ◽  
Vol 67 (11) ◽  
pp. 1958-1964 ◽  
Author(s):  
Marek Bugajski ◽  
Paulina Wieszczy ◽  
Geir Hoff ◽  
Maciej Rupinski ◽  
Jaroslaw Regula ◽  
...  
Keyword(s):  
Population Based ◽  
Screening Colonoscopy ◽  
Case Volume ◽  
Cross Sectional ◽  
Propofol Sedation ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Patient Reported ◽  
Sectional Analysis

ObjectivePain associated with colonoscopy is a major burden for patients. We investigated modifiable factors associated with patient-reported pain during and after colonoscopy.DesignThis cross-sectional analysis included database records from 23 centres participating in a population-based colonoscopy screening programme in Poland. Colonoscopies were performed under three sedation modalities: none, benzodiazepine-opioid sedation or propofol sedation. We used Gastronet (a validated tool) to assess patients’ pain during and after colonoscopy; pain was scored on a four-point scale (no, little, moderate or severe pain), with moderate to severe defined as painful. We used multivariate logistic regression models to estimate ORs for painful colonoscopy and calculated risk-adjusted ratios of painful colonoscopies per endoscopist and compared it to the mean rate.ResultsOf 35 216 screening colonoscopies in 2014 and 2015 included in our study, 22 725 (64.5%) patients returned valid Gastronet questionnaires. The proportion of examinations described as causing pain during (after) the procedure was 22.5% (14.2%) for unsedated, 19.9% (13.5%) for benzodiazepine-opioid sedation and 2.5% (7.5%) for propofol sedation. Propofol sedation, higher case volume of endoscopists, newest endoscope generation and adequate bowel preparation were significantly associated with lower odds of painful colonoscopy. Pain scores after colonoscopy showed similar associations. Adjusted pain rates during and after colonoscopy varied 11 and over 23-fold, respectively, between endoscopists.ConclusionWe identified several independent, modifiable factors associated with pain during and after colonoscopy, of which individual endoscopist was the most important. Dedicated training should be considered to decrease variability among endoscopists.

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (&gt;140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

scholarly journals Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

2021 ◽  
Vol 10 (12) ◽  
pp. 2740
Author(s):  
Efrat L. Amitay ◽  
Tobias Niedermaier ◽  
Anton Gies ◽  
Michael Hoffmeister ◽  
Hermann Brenner
Keyword(s):  
Risk Factors ◽  
Bowel Preparation ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Screening Colonoscopy ◽  
Cross Sectional ◽  
Factors Associated ◽  
Screening Practice ◽  
Abdominal Symptoms ◽  
Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

scholarly journals The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajing Jia ◽  
Ying Yang ◽  
Fangchao Liu ◽  
Minjin Zhang ◽  
Qin Xu ◽  
...  
Keyword(s):  
Alanine Aminotransferase ◽  
Elevated Serum ◽  
Population Based ◽  
Reproductive Age ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Serum Alanine Aminotransferase ◽  
Cross Sectional Analysis ◽  
Registration Data ◽  
Sectional Analysis

Abstract Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.

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