scholarly journals P106 Increased risk of subsequent chlamydia infection among women not tested at the anorectal anatomical location

2021 ◽  
Author(s):  
M Visser ◽  
M Dvorakova ◽  
F van Aar ◽  
J Heijne
Keyword(s):  
Chlamydia Infection ◽  
Anatomical Location ◽  
Increased Risk

Increased risk of subsequent chlamydia infection among women not tested at the anorectal anatomical location

2021 ◽  
pp. sextrans-2021-054991
Author(s):  
Maartje Visser ◽  
Milada Dvorakova ◽  
Fleur van Aar ◽  
Janneke C M Heijne
Keyword(s):  
Health Centre ◽  
Partner Notification ◽  
Significant Risk ◽  
Chlamydia Infection ◽  
Anatomical Location ◽  
Anatomical Site ◽  
Main Determinant ◽  
Repeat Test ◽  
Increased Risk

BackgroundUniversal anorectal testing for Chlamydia trachomatis (chlamydia) among women is not recommended in many countries, while anorectal chlamydia infections are common. Missed anorectal infections might cause sequelae at the genital site if autoinoculation from the anorectum is possible, but evidence is limited. This study investigates the association between potentially missed anorectal infections and subsequent genital chlamydia infections in women, using not being tested at the anorectal site as a proxy for having a potentially missed anorectal infection.MethodsWe included all women with a repeat chlamydia test within 1 year (with at least a genital test) from the Dutch sexual health centre surveillance between 2014 and 2019. Multilevel logistic regression analyses were used to identify determinants of genital chlamydia infection at the repeat test, with anorectal testing at the previous chlamydia test as the main determinant.ResultsA total of 40 217 women were included in the analyses, of whom 15.4% tested chlamydia-positive genitally at their second test. Not being tested anorectally at the first test was an independent risk factor for genital chlamydia infection at the repeat test (adjusted OR 1.24, 95% CI 1.15 to 1.33). This association was in the same range as most other significant risk factors in the model: low education level, no condom use, STI symptoms and previous STI diagnosis. Young age (<20 years) (2.67, 2.39–2.98) and those who received partner notification (3.11, 2.91–3.31) showed stronger associations. The findings were robust; correcting for interactions and a sensitivity analysis stratifying by chlamydia infection at first visit did not show significant differences in the adjusted OR of not being tested anorectally at first test.ConclusionThe results are suggestive of an autoinoculation process from the anorectal to the genital anatomical site in women. To enhance chlamydia control, future studies on the role of extragenital testing and autoinoculation in chlamydia transmission are needed.

Abstract P462: Myosteatosis: Differences in Association With Type 2 Diabetes by Anatomical Location

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Curtis Tilves ◽  
Allison Kuipers ◽  
Joseph Zmuda ◽  
J. J Carr ◽  
James G Terry ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
African Ancestry ◽  
Lifestyle Factor ◽  
Cardiometabolic Health ◽  
Anatomical Location ◽  
Quantitative Ct ◽  
Muscle Area ◽  
Cross Sectional ◽  
Increased Risk

Background: CT-derived muscle density (MD) reflects the degree of adiposity in muscle (i.e., myosteatosis) with lower MD indicating greater adiposity. Previous research indicates lower MD is associated with increased risk of type 2 diabetes (T2D). However, few studies have compared the association of simultaneously measured MD by anatomic location. The relationship between myosteatosis and cardiometabolic health may differ by body site and influence which location(s) is most useful for risk assessment. We investigated potential differential relationships between T2D and MD of the locomotor muscles of the abdomen (psoas), thigh, and calf among 539 African Caribbean men from Tobago. Methods: Men were aged 50-91 years (mean 64.4 years, mean BMI 27.5 kg/m 2 ). Calf MD was measured at 66% of calf length using peripheral quantitative CT; calf MD was defined as the ratio of muscle mass to cross-sectional muscle area. Psoas MD was measured in the abdomen (between L3/L4) and thigh MD was measured in the mid-thigh using CT; for these, MD was defined as the average muscle attenuation across each site. MDs were converted to per-SD units for comparability. T2D was defined as a fasting serum glucose level of ≥126 mg/dL or currently taking antidiabetic medication. Results: Psoas and thigh MDs were more highly correlated (r = 0.70) than psoas and calf (r = 0.33) or thigh and calf (r = 0.53) MDs, and calf MD was moderately correlated with BMI (r = -0.38) compared to lower BMI correlations for thigh (r = -0.18) or psoas (r = -0.16) MDs (all significant p < 0.05). After age and lifestyle factor adjustment (Table), a 1-SD lower MD of the thigh or calf was significantly associated with higher odds of T2D. Additional adjustment for BMI completely attenuated the association with T2D for thigh MD, but not calf MD. Conclusion: In our study of African Ancestry men, only calf MD was associated with higher odds of T2D independent of BMI and other muscle groups. Longitudinal studies are needed to better characterize specific muscle myosteatosis and metabolic abnormalities.

scholarly journals Subsequent Injury is Common after Foot and Ankle Surgery in Patients Receiving Workers’ Compensation

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0017
Author(s):  
Gabrielle Bui ◽  
Phinit Phisitkul ◽  
Natalie Glass ◽  
Chris Cychosz ◽  
Sean Boarini
Keyword(s):  
Retrospective Chart Review ◽  
Anatomical Location ◽  
Workers Compensation ◽  
Foot And Ankle ◽  
Chi Square ◽  
Legal Representation ◽  
Increased Risk ◽  
Ankle Surgery ◽  
Poor Outcomes ◽  
Subsequent Injury

Category: Ankle Introduction/Purpose: Workers’ compensation (WC) has been associated with poor outcomes following a variety of injuries and surgeries. Previous studies have investigated surgical outcomes via satisfaction surveys, but rates of subsequent injury following surgery have not been specifically studied. The purpose of this study was to investigate the rates, locations and risk factors for subsequent injuries in WC patients and non-WC patients who underwent the same surgeries. Methods: With IRB approval, we identified the records of patients with a foot or ankle surgery performed by a single surgeon from 2009-2015. We included only surgeries with one of the most common current procedural terminology (CPT) codes from the WC population. A retrospective chart review was performed on all WC and non-WC patients with at least one of these CPT codes. A subsequent injury was defined as a new injury at a different anatomical location that occurred from 2 months to 2 years after the index surgery. Chi-square and two-tailed t-tests were used to compare WC and non-WC patient populations, and to determine factors associated with subsequent injuries. Results: Overall, the WC population had higher rates of subsequent injury than the non-WC population 23.21% versus 7.27%, p=.0011. Within the WC patient population, patients with subsequent injuries were older than patients without subsequent injuries 48.78±7.30 versus 41.58±12.40, p=.0137. In a blinded review of the charts and Iowa Courts Online, legal representation was found to be more common in WC patients with subsequent injuries than WC patients without subsequent injuries (76.92% versus 37.21%, p=.0240). In the non-WC population, there were more males in the group without subsequent injuries than in the group with subsequent injuries 42.48% versus 8.33%, p=.0287. There were no significant differences in locations of subsequent injury. Hip, knee and contralateral foot and ankle were common areas of subsequent injury in both groups. Conclusion: Overall, WC patients had higher rates of subsequent injury than non-WC patients. Within the WC group, legal representation further raised the risk of subsequent injury. Gender may mediate variable reporting of subsequent injuries in non-WC populations. While the reason for this increased risk of subsequent injury is not known, the differences are enough that they should be considered when counseling WC patients considering these surgeries. Additionally, if further study supported these findings, knowledge of the areas at risk for subsequent injury might lead to preventative strategies that could decrease the risk of subsequent injury.

The Intraosseous Blood Supply of the Fifth Metatarsal: Implications for Proximal Fracture Healing

Foot & Ankle ◽  
1992 ◽  
Vol 13 (3) ◽  
pp. 143-152 ◽  
Author(s):  
Judith W. Smith ◽  
Steven P. Arnoczky ◽  
Alexander Hersh
Keyword(s):  
Fracture Healing ◽  
Blood Supply ◽  
Vascular Anatomy ◽  
Delayed Union ◽  
Nonoperative Treatment ◽  
Anatomical Location ◽  
Nutrient Artery ◽  
India Ink ◽  
Increased Risk ◽  
Fresh Frozen

Fractures of the proximal fifth metatarsal can be divided into two distinct groups based on anatomical location and clinical course. Fractures of the tuberosity often heal well with nonoperative treatment, whereas fractures occurring in the proximal diaphysis (up to 1.5 cm distal to the tuberosity) have significantly increased risk for delayed union or nonunion. It is the purpose of this paper to describe the intraosseous vascular anatomy of the fifth metatarsal, and the clinical implications for basilar fracture healing. Ten fresh-frozen amputation or cadaver specimens were studied following arterial injection with India ink or barium sulfate suspension. The intraosseous blood supply to the fifth metatarsal tuberosity arose from numerous metaphyseal vessels penetrating the nonarticular surfaces of the tuberosity in a random, radiate pattern. The blood supply to the proximal diaphysis was derived primarily from the nutrient artery, which gave rise to longitudinal intramedullary branches. The arterial supply to the tuberosity joined the supply of the proximal diaphysis in the area just distal to the tuberosity, corresponding to the region of poor prognosis for fracture healing. This suggests that a relative lack of blood supply following a proximal diaphyseal fracture may contribute to delayed union and nonunion.

scholarly journals Prevalence of Intracranial Aneurysm in Patients with Aortopathy: A Systematic Review with Meta-Analyses

2020 ◽  
Vol 22 (1) ◽  
pp. 76-86 ◽  
Author(s):  
Xinyu Yu ◽  
Liangtao Xia ◽  
Qingqing Jiang ◽  
Yupeng Wei ◽  
Xiang Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intracranial Aneurysm ◽  
Random Effect ◽  
Aortic Disease ◽  
Anatomical Location ◽  
Cross Sectional ◽  
Increased Risk ◽  
Meta Analyses ◽  
The Impact

Background and Purpose Patients with aortic disease might have an increased risk of intracranial aneurysm (IA). We conducted this research to assess the prevalence of IA in patients with aortopathy, considering the impact of gender, age, and cardiovascular risk factors.Methods We searched PubMed and Scopus from inception to August 2019 for epidemiological studies reporting the prevalence of IA in patients with aortopathy. Random-effect meta-analyses were performed to calculate the overall prevalence, and the effect of risk factors on the prevalence was also evaluated. Anatomical location of IAs in patients suffered from distinct aortic disease was extracted and further analyzed.Results Thirteen cross-sectional studies involving 4,041 participants were included in this systematic review. We reported an estimated prevalence of 12% (95% confidence interval [CI], 9% to 14%) of IA in patients with aortopathy. The pooled prevalence of IA in patients with bicuspid aortic valve, coarctation of the aorta, aortic aneurysm, and aortic dissection was 8% (95% CI, 6% to 10%), 10% (95% CI, 7% to 14%), 12% (95% CI, 9% to 15%), and 23% (95% CI, 12% to 34%), respectively. Gender (female) and smoking are risk factors related to an increased risk of IA. The anatomical distribution of IAs was heterogeneously between participants with different aortic disease.Conclusions According to current epidemiological evidence, the prevalence of IA in patients with aortic disease is quadrupled compared to that in the general population, which suggests that an early IA screening should be considered among patients with aortic disease for timely diagnosis and treatment of IA.

scholarly journals A serum protein network predicts the need for systemic immunomodulatory therapy in autoimmune uveitis

2021 ◽  
Author(s):  
Jonas J.W. Kuiper ◽  
Fleurieke H. Verhagen ◽  
Sanne Hiddingh ◽  
Roos A.W. Wennink ◽  
Anna M. Hansen ◽  
...  
Keyword(s):  
Serum Protein ◽  
Clinical Decision Making ◽  
Severe Disease ◽  
Protein Network ◽  
Immunomodulatory Therapy ◽  
Anatomical Location ◽  
Disease Course ◽  
Autoimmune Uveitis ◽  
Increased Risk

Objective biomarkers that can predict a severe disease course of autoimmune uveitis are lacking, and warranted for early identification of high-risk patients to improve visual outcome. The need for non-steroid immunomodulatory therapy (IMT) to control autoimmune uveitis is indicative of a more severe disease course. We used aptamer-based proteomics and a bioinformatic pipeline to uncover the serum protein network of 52 treatment-free patients and 26 healthy controls, and validation cohorts of 114 and 67 patients. Network-based analyses identified a highly co-expressed serum signature (n=85 proteins) whose concentration was consistently low in controls, but varied between cases. Patients that were positive for the signature at baseline showed a significantly increased risk for IMT during follow-up, independent of anatomical location of disease. In an independent cohort (n=114), we established robust risk categories and confirmed that patients with high levels of the signature at diagnosis had a significantly increased risk to start IMT during follow-up. Finally, we further validated the predictive association of the signature in a third cohort of 67 treatment-naive North-American patients. A serum protein signature was highly predictive for IMT in human autoimmune uveitis and may serve as an objective blood biomarker to aid in clinical-decision making.

scholarly journals Risk factors associated with ectopic pregnancy in our sociodemographic setup

2020 ◽  
Vol 9 (10) ◽  
pp. 4150
Author(s):  
Nikita Gandotra ◽  
Shazia Zargar
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Contraceptive Use ◽  
Intrauterine Device ◽  
Chlamydia Infection ◽  
Contraceptive Device ◽  
Pelvic Infection ◽  
Barrier Methods ◽  
Increased Risk ◽  
History Of

Background: Ectopic pregnancy (EP) is assuming greater importance because of its increasing incidence and its impact on woman’s fertility.Aim: To assess the frequency and to determine an association between the studied risk factors and ectopic pregnancy.Methods: A retrospective study was conducted for the role of several risk factors in the occurrence of EP in department of obstetrics and Gynaecology, SMGS Hospital. A total of 110 cases and 110 controls were compared for socio demographic characteristics, cigarette smoking, obstetrical and gynaecological history, PID, past exposure to Chlamydia, surgical histories, the presence of assisted conception and contraceptive usage.Results: The main risk factors for ectopic pregnancy were history of tuberculosis (TB) (odds ratio (OR)=12.11), history of infertility (p=0.001), abortions (p=0.01) and a history of prior ectopic pregnancy (OR=8.549). Other risk factors found to be associated with an increased risk for ectopic pregnancy were Pelvic inflammatory disease (PID)/Chlamydia infection (OR=5.63), endometriosis (5.40), induced conception cycle (OR=3.063), intrauterine device usage (OR=3.55), prior caesarean section (OR=2.83) and appendectomy (OR=2.25). On the contrary, barrier methods (OR=0.28) and oral contraceptive use (OR=0.28) were protective from ectopic pregnancy.Conclusion: Pelvic infection particularly TB was found to be a major etiological factor for EP in our setup. Furthermore, other factors found to be associated with ectopic pregnancy, such as prior ectopic pregnancy and infertility history may be the result of a previous pelvic infection that caused tubal sequele. Thus, these factors are potential targets for intervention and modification. Further, patients with previous abortions, pelvic surgeries, induced conception cycle and intrauterine contraceptive device (IUCD) users should be counselled about the possible risk when they conceive.

IDENTIFYING INDIVIDUALS ENGAGING IN RISKY SEXUAL BEHAVIOUR FOR CHLAMYDIA INFECTION IN THE UK: A LATENT CLASS APPROACH

2009 ◽  
Vol 42 (1) ◽  
pp. 27-42 ◽  
Author(s):  
BETH STUART ◽  
ANDREW HINDE
Keyword(s):  
Latent Class ◽  
Minority Groups ◽  
Sexual Partners ◽  
Chlamydia Infection ◽  
Risky Behaviour ◽  
Transmitted Infection ◽  
The Past ◽  
Increased Risk ◽  
Risky Behaviours ◽  
The Uk

SummaryChlamydia trachomitis is the most common sexually transmitted infection in the UK and the number of cases diagnosed each year continues to rise. Although much is known about the risk factors for chlamydia from previous observational studies, less is known about how individuals put themselves at risk. Do they engage in just one risky type of behaviour or are certain individuals ‘risky’, engaging in multiple risky behaviours? This paper uses latent class analysis, applied to the National Survey of Sexual Attitudes and Lifestyles II (2000–2001), to determine whether a subgroup of high-risk individuals can be identified and explores which features of their behaviour distinguish them from other groups of lower risk individuals. A 3-class solution was obtained, splitting the sample on the basis of the number of sexual partners in the past year. Those with no sexual partners in the past year (8%) and one sexual partner in the past year (71%) were much less likely to have engaged in any of the other behaviours known to increase chlamydia risk. However, the group who had two or more sexual partners in the past year (21%) were much more likely to have also engaged in other risky behaviours. The number of partners in the past year is therefore a useful marker for identifying those at increased risk of chlamydia infection. Individuals under 25 years old, males and those who were single or previously married were more likely to be allocated to the risky group. However, in spite of observed higher incidence of chlamydia infection, individuals in the black ethnic minority groups did not show an increased prevalence of risky behaviour, after controlling for age, sex and marital status.

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