scholarly journals CURRENT OPPORTUNITIES FOR DETERMINING OF PREDICTORS OF THREATENED PRETERM LABOR

Author(s):  
Yu. Ya. Krut ◽  
A. A. Shevchenko ◽  
V. G. Syusyuka

The aim of the study – to ascertain predictors of a threat of premature birth. Materials and Methods. 63 patients participated in the gestation period of 22–34 weeks in a prospective open study. Pregnant women were divided into two groups. Thus, the group I included 44 pregnant women, with the threat of PL, and the group II included 19 patients with normal course of pregnancy. All women were tested for body mass index (BMI), progesterone, insulin and cortisol on the day of admission. Statistical processing of materials was carried out by using the software package "Statistica 6.0" (StatSoft, USA) and MedCalc. 10.2.0.0. To determine the predictors of the occurrence of a TPL, the method of binary logistic regression analysis was used. All statistical tests were two-sided; the p-0.05 level was considered as significant. Results and Discussion. An analysis of the results of the observation of 63 pregnant women was provided. In 12 women, pregnancy ended in preterm labor, which was 19 % of the total. The following indicators fell to the dependent predictors of TPL occurrence: body mass index (BMI) ≤ 24 kg/m² significantly increased the odds ratio (OR) of TPL 7.76 times; insulin level <8.65 µMU/ml significantly increased ORR of TPL 5.14 times; OR of TPL increases in 7.02 times, in case that the level of cortisol is less than 577.9 ng/ml; progesterone <139.5 ng/ml increases the odds ratio of TPL in 4.39 times. Taking into account the data of univariate regression analysis, multivariate models of independent predictors of TPL were created. According to the first model (p = 0.0001), independent risk factors for miscarriage include: the age of pregnant women over 25 years, an insulin level more than 8.7 μMO/ml, and the level of cortisol less than 577.9ng/ml. According to the second model (p <0.0001), independent risk factors which increase the risk of TPL occurrence are: BMI less than 24 kg/m2, insulin level more than 8.7 μMO/ml, cortisol level less than 577.9ng / ml. However, the most interesting is the third model (p <0.0001) of independent risk factors for TPL. It includes four indicators: the level of progesterone, less than 139.5 ng/ml, the level of cortisol, less than 577.9 ng/ml, the BMI, less than 24 kg/m2 and the age of pregnant, more than 25 years. Conclusions. It was found that in pregnant women with a threat of preterm birth the age and BMI are the most informative, and in combination with the hormonal examination of women are of primary importance. The obtained results indicate the expedien­cy of inclusion to the standard examination of pregnant women with a threat of premature birth, a comprehensive determination of the level of progesterone, insulin and cortisol, which will enable to identify the risk group for this complication in time and to propose preventive measures.

PEDIATRICS ◽  
1985 ◽  
Vol 75 (5) ◽  
pp. 813-818
Author(s):  
Raymond R. Fripp ◽  
James L. Hodgson ◽  
Peter O. Kwiterovich ◽  
John C. Werner ◽  
H. Gregg Schuler ◽  
...  

Correlations between aerobic capacity, obesity, and atherosclerotic risk factors were evaluated in adolescents with low-to-moderate levels of physical fitness. Subjects with higher levels of fitness had a more favorable risk profile with decreased body mass index, lower systolic and diastolic blood pressure and plasma triglyceride levels, and higher plasma high-density lipoprotein-cholesterol levels. Simple linear regression analysis revealed an association between body mass index and blood pressure, plasma triglyceride and plasma highdensity lipoprotein-cholesterol. The level of aerobic fitness as determined by exercise duration was also associated with the same atherosclerotic risk factors. However, multiple linear regression analysis demonstrated that body mass index provided the largest explanation, by those variables examined, of the interindividual variance in blood pressure, plasma triglyceride, and high-density lipoprotein-cholesterol. Aerobic fitness contributed only minimally to the variation in these risk factors. These findings suggest that if aerobic conditioning is used to modify atherosclerotic risk factors, it should be accompanied by a reduction in weight in adolescents with low-to-moderate levels of physical fitness.


2020 ◽  
Author(s):  
Toshihiko Yanase ◽  
Ikumi Yanagita ◽  
Yuya Fujihara ◽  
Chikayo Iwaya ◽  
Yuichi Kitajima ◽  
...  

Abstract Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty, evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices. Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis. Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p <0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p =0.009), and low body mass (BM) (<53 kg) (OR=3.85, p =0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM. Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients.


2020 ◽  
Vol 15 (1) ◽  
pp. 31-38
Author(s):  
Fatimat Motunrayo Akinlusi ◽  
Tawaqualit Abimbola Ottun ◽  
Yusuf Abisowo Oshodi ◽  
Bilkees Oluwatoyin Seriki ◽  
Folasade D. Haleemah Olalere ◽  
...  

Aims: To determine the prevalence of urinary incontinence, risk factors and impact on the quality of life in gynecological clinic attendees of a University Hospital. Methods: A cross sectional descriptive study was conducted amongst gynecological clinic attendees in a Teaching Hospital in Nigeria from 1st February to 31st July 2017. Structured questionnaires were used to ascertain the presence of urinary incontinence. Socio-demographic and medical factors; impact on daily activities and treatment history were assessed. Women with and without urinary incontinence were compared. Univariate, bivariate and multivariable analyses were performed. Results: There were 395 women of 25 - 67 years (mean age = 38.81±10.1). About 33% had experienced urinary incontinence in the previous 6 months with Urgency, Mixed and Stress urinary incontinence occurring in 18.0%, 7.6% and 7.3% respectively. Independent risk factors for urinary incontinence were age (odds ratio=0.49, 95% confidence interval [CI] =0.26 - 0.92, P =0.026), higher body mass index (odds ratio=1.92, 95% CI =1.53 - 3.00, P =0.004) and history of constipation (odds ratio=2.11, 95% CI =1.30 - 3.43, P =0.003). About 47% of those with urinary incontinence admitted to negative feelings like anxiety and depression; 45% had moderate to severe impact on their quality of life in all domains but only 27.7% sought help. Conclusions: Urinary incontinence is common and risk factors include older age, high body mass index and constipation. Despite its substantial impact on the quality of life, majority do not seek help. Addressing modifiable risks factors and improving treatment seeking behaviour will assist in reducing the prevalence of urinary incontinence. Keywords: female urinary incontinence; quality of life; risk factors; stress incontinence; urgency incontinence.


2020 ◽  
Author(s):  
Toshihiko Yanase ◽  
Ikumi Yanagita ◽  
Yuya Fujihara ◽  
Chikayo Iwaya ◽  
Yuichi Kitajima ◽  
...  

Abstract Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty as evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices.Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis.Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p<0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p=0.009), and low body mass (BM) (<53 kg) (OR=3.85, p=0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM.Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients. trial registration number: UMIN (number 000031357)


2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 165-165
Author(s):  
Hiromi Mohizuki ◽  
Shinji Mine ◽  
Takashi Nakahama ◽  
Masayuki Watanabe ◽  
Naoki Hiki

Abstract Background Post-operative body weight loss (BWL) of patients who underwent esophagectomy is common. One month after esophagectomy, some patients lose weight remarkably, and others not. If preoperative or operative risk factors influencing body weight loss are identified, it will be possible that nutritional intervention is given to the patient having these risk factors. Methods In our department, the dietician stays in a surgical ward for nutritional management of patients. Ninety-two patients who underwent esophagectomy for esophageal cancer in 2016 were reviewed. Pre-operative and operative factors were correlated with post-operative BWL. The cut-off value of BWL 1 month after esophagectomy was defined with 75 percentile. Results The median body weight change was -4.8% (-18.5% ∼11.7%). The patients were divided into two groups; 24 patients with ≥ 7.3% of BWL (severe BWL group) and 68 with < 7.3% of BWL (mild BWL group). Patients’ characteristics or post-operative morbidities were not statistically different in these 2 groups. The incidence of patients with reconstruction using a colon or jejunum was higher in severe BWL group. Pre-operative body weight, body mass index, and the value of prealbumin was higher in severe BWL group. On postoperative 14 day, the patients in severe BWL group were likely to have lower energy intake per kilogram of pre-operative body weight. On multivariate analysis, high body mass index [odds ratio = 5.90; 95% confidence interval (CI) = 1.03–47.8; P = 0.046], upper location of tumor [odds ratio = 3.38; 95%, CI = 1.04–11.4; P = 0.043] were independently associated with severe BWL at 1 month after surgery. Conclusion High body mass index of ≥ 25, upper location of tumor were unfavorable risk factors for weight loss 1 month after esophagectomy for esophageal cancer. Disclosure All authors have declared no conflicts of interest.


Author(s):  
Inês Francisco ◽  
Francisco Caramelo ◽  
Maria Helena Fernandes ◽  
Francisco Vale

(1) Background: The etiology of orofacial cleft (OC) is not completely known but several genetic and environmental risk factors have been identified. Moreover, a knowledge gap still persists regarding neonatal characteristics. This study evaluated the effect of parental age and mothers’ body mass index on the risk of having an OC child, in a matched year and sex group (cleft/healthy control). Additionally, birth data were analyzed between groups. (2) Methods: 266 individuals born between 1995 to 2015 were evaluated: 133 OC individuals (85 males/48 females) and 133 control (85 males/48 females). A logistic model was used for the independent variables. ANOVA or Kruskal-Wallis tests were used for comparison between the OC phenotypes. (3) Results: Regarding statistically significant parental related factors, the probability of having a cleft child decreases for each maternal year increase (odds ratio = 0.903) and increases for each body mass index unit (kg/m2) increase (odds ratio = 1.14). On the child data birth, for each mass unit (kg) increase, the probability of having a cleft child decrease (odds ratio = 0.435). (4) Conclusions: In this study, only maternal body mass index and maternal age found statistical differences in the risk of having a cleft child. In the children’s initial data, the cleft group found a higher risk of having a lower birth weight but no relation was found regarding length and head circumference.


2021 ◽  
pp. 216507992199483
Author(s):  
Yannik Faes ◽  
Achim Elfering

Background: Auxiliary tasks such as administrative work often include tasks that are unnecessary in the view of workers but still have to be done. These tasks can threaten a worker’s self-esteem. The purpose of this study was to examine the effects of unnecessary and unreasonable tasks on musculoskeletal pain. Methods: Fifty-five office workers (29 male; mean age = 41.96, SD = 14.2 years) reported their unnecessary and unreasonable tasks at the beginning of the study and kept a diary of their daily musculoskeletal pain over 5 weeks, using a visual analogue scale. Other work-related risk factors (prolonged sitting), job resources (participation in decision-making), and individual risk factors (sex, smoking, exercise, body mass index, maladaptive back beliefs) were controlled for in multilevel regression analysis. Findings: Multilevel regression analysis with 742 reports showed unnecessary tasks ( B = 4.27, p = .006)—but not unreasonable tasks ( B = 3.05, p = .074)—to predict the daily intensity of musculoskeletal pain, beyond other significant risk factors, such as prolonged sitting ( B = 2.06, p = .039), body mass index ( B = 1.52, p < .001), and maladaptive back beliefs ( B = 3.78, p = .003). Participation in decision-making was not a significant protective factor ( B = −1.67, p = .176). Conclusions/Application to Practice: The higher frequency of unnecessary tasks—compared with unreasonable tasks—could place workers at risk for musculoskeletal pain. Work redesign that reduces unnecessary and unreasonable tasks can make a valuable contribution to worker health and safety among office workers.


2015 ◽  
Vol 64 (5) ◽  
pp. 87-95 ◽  
Author(s):  
Roman Victorovich Kapustin ◽  
Ol’ga Nikolaevna Arzhanova ◽  
Olesya Nikolaevna Bespalova ◽  
Vladimir Stepanovich Pakin ◽  
Andrey Gennadievich Kiselev

Objective: on the basis of a systematic review, clarify the role of overweight and obesity as a predictor of gestational diabetes mellitus (GDM). Materials and methods: an analysis of the literature data of the leading bibliographic sources - MEDLINE, Cochrane col., EMBASE. To evaluate the body mass index and standards of weight gain during pregnancy used the WHO guidelines and criteria of the Institute of Medicine (2009). The frequency and the odds ratio (OR) of developing GDM was estimated separately for each of the three groups in BMI. Results: A systematic review included 23 different design studies involving 740 510 women. It was found that the odds ratio of the risk of GDM in a group of pregnant women with excess weight is doubled - 2.22 (95 % CI 1.72 - 3.64), and almost four in obesity - 3.88 (95 % CI 2.97 - 5.32). The incidence of GDM in a group of pregnant women with normal body mass index - 3.77 % in the group with excess body weight - 6.59 %, in the group with obesity - 9.88 %. Conclusions: The obtained strong evidence of a direct connection between the linear increase in maternal BMI and the risk of developing gestational diabetes. Pregnant women with excess weight and obesity are at high risk for carbohydrate disorders during pregnancy.


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