scholarly journals Cigarette Smoking and Risk of Subarachnoid Hemorrhage: Does Cessation of Smoking Really Help?

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 362-362
Author(s):  
Abutaher M Yahia ◽  
Adnan Qureshi ◽  
M Fareed K Suri ◽  
Zulfiqar Ali ◽  
Lee R Guterman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Cigarette Smoking ◽  
University Hospital ◽  
Health And Nutrition ◽  
Johns Hopkins University ◽  
Increased Risk ◽  
Cerebrovascular Risk ◽  
Nationally Representative ◽  
Independent Association

P128 BACKGROUND AND PURPOSE: Smoking has been shown to increase the risk of subarachnoid hemorrhage (SAH). It remains unclear whether cessation of smoking decreases this risk. To address this issue, we performed a case control study examining the effect of smoking and other known risk factors for cerebrovascular disease on the risk of SAH. METHODS: We reviewed the medical records of all patients with a diagnosis of SAH (n=323) admitted to the Johns Hopkins University hospital between January 1990 and June 1997. Controls matched for age, sex, and ethnicity (n=969) were selected from the nationally representative sample of the Third National Health and Nutrition Examination Survey. We determined the independent association between smoking (present and previous) and various cerebrovascular risk factors and SAH using logistic regression analysis. RESULTS: Of 323 patients admitted with SAH (mean age 52.7±14 years; 93 were men), 149 (46%) were currently smoking and 125(39%) were previous smokers. In the multivariate analysis, both previous cigarette smoking (OR = 3.4; 95% CI, 2.3–5.1) and present cigarette smoking (OR = 2.0; 95% CI, 1.3–3.0) were significantly associated with SAH. Hypertension was also significantly associated with SAH (OR = 2.4; 95% CI, 1.8–3.3). CONCLUSION: Cigarette smoking increases the risk for SAH as suggested in previous studies. However, the increased risk persists even after cessation of cigarette smoking suggesting the importance of early abstinence from smoking.

scholarly journals 754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S271-S271
Author(s):  
Eun Ju Choo ◽  
Se Yoon Park
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
University Hospital ◽  
Increased Risk ◽  
High Prevalence ◽  
Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

scholarly journals Duration of Methicillin-ResistantStaphylococcus aureusCarriage, According to Risk Factors for Acquisition

2006 ◽  
Vol 27 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Jonas Marschall ◽  
Kathrin Mühlemann
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
University Hospital ◽  
Modifiable Risk Factor ◽  
Lower Probability ◽  
Increased Risk ◽  
Antibiotics Use ◽  
Definition Of

Objective.To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens.Design.Retrospective cohort study.Setting.A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance amongS. aureusisolates is less than 5%.Patients.A total of 116 patients with first-time MRSA detection identified at University Hospital Bern between January 1, 2000, and December 31, 2003, were followed up for a mean duration of 16.2 months.Results.Sixty-eight patients (58.6%) cleared colonization, with a median time to clearance of 7.4 months. Independent determinants for shorter carriage duration were the absence of any modifiable risk factor (receipt of antibiotics, use of an indwelling device, or presence of a skin lesion) (hazard ratio [HR], 0.20 [95% confidence interval {CI}, 0.09-0.42]), absence of immunosuppressive therapy (HR, 0.49 [95% CI, 0.23-1.02]), and hemodialysis (HR, 0.08 [95% CI, 0.01-0.66]) at the time MRSA was first MRSA detected and the administration of decolonization regimen in the absence of a modifiable risk factor (HR, 2.22 [95% CI, 1.36-3.64]). Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P= .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI, 0.17-0.67]) and an increased risk of MRSA infection during follow-up.Conclusions.Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

2005 ◽  
Vol 26 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Piret Mitt ◽  
Katrin Lang ◽  
Aira Peri ◽  
Matti Maimets
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Fetal Monitoring ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Increased Risk ◽  
Multi Method Approach ◽  
Method Approach

AbstractObjectives:To evaluate a multi-method approach to postdischarge surveillance of surgical-site infections (SSIs) and to identify infection rates and risk factors associated with SSI following cesarean section.Design:Cross-sectional survey.Setting:Academic tertiary-care obstetric and gynecology center with 54 beds.Patients:All women who delivered by cesarean section in Tartu University Women's Clinic during 2002.Methods:Infections were identified during hospital stay or by postdischarge survey using a combination of telephone calls, healthcare worker questionnaire, and outpatient medical records review. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System.Results:The multi-method approach gave a follow-up rate of 94.8%. Of 305 patients, 19 (6.2%; 95% confidence interval [CI95)], 3.8-9.6) had SSIs. Forty-two percent of these SSIs were detected during postdischarge surveillance. We found three variables associated with increased risk for developing SSI: internal fetal monitoring (odds ratio [OR], 16.6; CI95, 2.2-125.8; P = .007), chorioamnionitis (OR, 8.8; CI95, 1.1-69.6; P = .04), and surgical wound classes III and IV (OR, 3.8; CI95, 1.2-11.8; P=.02).Conclusions:The high response rate validated the effectiveness of this kind of surveillance method and was most suitable in current circumstances. A challenge exists to decrease the frequency of internal fetal monitoring and to treat chorioamnionitis as soon as possible (Infect Control Hosp Epidemiol 2005;26:449-454).

scholarly journals Prevalence of and Risk Factors for Cerebral Microbleeds in Moyamoya Disease and Syndrome in the American Population

2019 ◽  
Vol 9 (3) ◽  
pp. 139-147
Author(s):  
Nadeem I. Khan ◽  
Ali A. Saherwala ◽  
Mo Chen ◽  
Sepand Salehian ◽  
Hisham Salahuddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Moyamoya Disease ◽  
Hemorrhagic Stroke ◽  
Medical Center ◽  
Cerebral Microbleeds ◽  
Age At Diagnosis ◽  
University Hospital ◽  
Vascular Events ◽  
Increased Risk

Background and Purpose: Cerebral microbleeds (CMB) are reported to be frequent in moyamoya disease (MMD) and moyamoya syndrome (MMS) in the Asian population. It is associated with an increased risk of intracerebral hemorrhage. The significance of CMB in MMD/MMS in non-Asian populations has not been well established. Our study aimed to investigate the prevalence of CMB in MMD/MMS in a moymoya cohort with a majority of non-Asians and to identify risk factors for developing a CMB and its predictive value for subsequent vascular events. Methods: The moyamoya database was compiled by screening for MMD/MMS among patients admitted to the Zale-Lipshy University Hospital at the University of Texas Southwestern Medical Center. We identified and analyzed data of 67 patients with MMD or MMS. Patients were characterized as CMB+ or CMB– based on MRI findings. In CMB+ patients, the total number and location of CMB were identified. Univariate and multivariate logistic regression were used to identify risk factors for developing CMB and whether CMB are associated with the development of subsequent vascular events. Results: Out of a total of 67 patients, 11 (16%) had CMB. Males had significantly higher odds of having CMB as compared to females (OR 1.76; 95% CI 1.40–24.3, p = 0.021). The incidence of CMB was also associated with age at diagnosis (mean age of CMB+ patients vs. CMB– patients: 44 vs. 34 years, respectively, p = 0.024), smoking (p = 0.006), and hemorrhagic stroke at presentation (p = 0.034). Logistic regression with multivariate analysis found that gender and age at diagnosis remained statistically significant. New ischemic events occurred in 2 (20%) out of 10 CMB+ patients and 13 (23%) out of 55 CMB– patients, respectively (p = 0.79). While 2 (3%) CMB– patients had a new cerebral hemorrhage during follow-up, none of the CMB+ patients did. Conclusions: CMB are less prevalent in MMD/MMS in the USA than in Asia. An older age at diagnosis and male gender were associated with CMB. The presence of CMB was not associated with an increased risk of a subsequent ischemic or hemorrhagic stroke.

scholarly journals Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Margo S. Harrison ◽  
Tewodros Liyew ◽  
Ephrem Kirub ◽  
Biruk Teshome ◽  
Andrea Jimenez-Zambrano ◽  
...  
Keyword(s):  
Risk Factors ◽  
University Teaching ◽  
University Hospital ◽  
Study Cohort ◽  
Convenience Sample ◽  
Cesarean Birth ◽  
Group 4 ◽  
Increased Risk ◽  
Group 2 ◽  
Failed Induction

Background. Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives. The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4. Methods. This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019. Results. Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by “failed induction or augmentation,” which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by “failed induction or augmentation.” In multivariable modeling of Robson Group 2, having a labor duration of “not applicable” increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)). Conclusion. Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity.

Association between Neuroleptics and Venous Thromboembolism: A Case-Control Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2601-2601
Author(s):  
Karine Lacut ◽  
Gregoire Le Gal ◽  
Emmanuel Oger ◽  
Dominique Mottier
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Antipsychotic Drugs ◽  
Case Control Study ◽  
Case Control ◽  
University Hospital ◽  
Number Of Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Control Study

Abstract Background: Preliminary reports suggest that use of antipsychotic drugs is associated with an increased risk of venous thromboembolism (VTE), but others did not confirm these results. Objective: To evaluate the relationship between antipsychotic drugs and VTE. Design: Case-control study (EDITH) designed to investigate genetic and environmental risk factors of VTE. Setting: Brest University Hospital. Participants: 857 patients consecutively hospitalized for a documented venous thromboembolic event were included between May 2000 and May 2004. Controls were matched on age, sex and the main risk factors of venous thromboembolism (cancer, surgery, pregnancy…). Results: The mean age of patients was 67.7 year. No significant difference was found between cases and controls concerning the main characteristics, except for smocking and body mass index. Among cases, 89 (10.4%) were current users of neuroleptics compared to 35 (4.8%) among controls. Current use of neuroleptics was associated with a significant increased risk of venous thromboembolism (OR = 2.32, 95% CI: 1.55–3.48). Excluding neuroleptics used for non psychiatric disorders, and after adjustment on the main confounding factors, this association remained significant (OR = 3.48, 95% CI: 2.00–6.04). No difference was found between the different chemical categories of neuroleptics, but the number of patients in some groups had limited statistical power to demonstrate significant differences. Biological mechanisms of action have been proposed to explain this relation. Analyses are ongoing for anti-phospholipid antibodies and homocysteine. Conclusion: In this case-control study of hospitalized patients, neuroleptics use was associated with a significant increased risk of venous thromboembolism. These results are concordant with previous reports. Nevertheless, further investigations are needed to explain wich mechanisms may be involved in such association and before use of neuroleptics can be definitely considered as risk factor for venous thromboembolism.

scholarly journals Analysis of intracranial aneurysms treated at a University Hospital in Curitiba

2012 ◽  
Vol 31 (02) ◽  
pp. 55-60
Author(s):  
Johnni Oswaldo Zamponi Junior ◽  
Paulo Eduardo Carneiro da Silva ◽  
Guilherme Zandavalli Ramos ◽  
Guilherme Mailio Buchaim ◽  
Lucas Cunha de Andrade ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Treatment Outcome ◽  
Subarachnoid Hemorrhage ◽  
Hospital Admission ◽  
Intracranial Aneurysms ◽  
Smoking Habit ◽  
University Hospital ◽  
Anterior Circulation ◽  
History Of

Abstract Objective: The aim of this paper is analyze the population and the types of intracranial aneurysms treated in the neurosurgery service of the Hospital Universitário Evangélico of Curitiba (HUEC), checking possible relations of this pathology with some risk factors and analyzing also the result of the treatment of this patients. Method: We reviewed the hospital files, surgical and out-patient notes of all patients operated on for the treatment of intracranial aneurysms from January 2006 to December 2010, composing a sample of 93 patients. The variables analyzed were gender, age, history of hypertension, smoking habit, diabetes mellitus, site of aneurysm, score scales Hunt-Hess and Fisher at hospital admission and treatment outcome of aneurysms using the Glasgow Outcome Scale (GOS). Results: The patients studied were predominantly women (73%), ranging in age from 51 to 60 years (38%), with a history of hypertension (61%). At admission, the grade 1 in a Hunt-Hess scale was most frequent (31%), while grade 4 on a scale of Fisher was more prevalent (26%). Aneurysms were more frequent in the anterior circulation, mainly affecting the middle cerebral artery. The most frequent score in GOS was 5 (40%). Conclusion: Subarachnoid hemorrhage is an event that may worsen the outcome of treatment of patients with intracranial aneurysms, so there is a correlation between the amount of bleeding identified on CT and prognostic evolution.

scholarly journals Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid hemorrhage.

Stroke ◽  
1993 ◽  
Vol 24 (5) ◽  
pp. 639-646 ◽  
Author(s):  
S Juvela ◽  
M Hillbom ◽  
H Numminen ◽  
P Koskinen
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Alcohol Consumption ◽  
Cigarette Smoking ◽  
Aneurysmal Subarachnoid Hemorrhage

scholarly journals Dynamics in Anemia Development and Dysregulation of Iron Homeostasis in Hospitalized Patients with COVID-19

Metabolites ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 653
Author(s):  
Lukas Lanser ◽  
Francesco Robert Burkert ◽  
Rosa Bellmann-Weiler ◽  
Andrea Schroll ◽  
Sophie Wildner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Homeostasis ◽  
Clinical Course ◽  
Severe Disease ◽  
University Hospital ◽  
Hospital Death ◽  
Icu Admission ◽  
Increased Risk ◽  
Discharge From Hospital ◽  
New Onset

Anemia and disturbances of iron metabolism are frequently encountered in patients with COVID-19 and associated with an adverse clinical course. We retrospectively analyzed 645 consecutive COVID-19 patients hospitalized at the Innsbruck University Hospital. Pre-existing anemia was associated with increased risk for in-hospital death. We further found that the decline in hemoglobin levels during hospital stay is more pronounced in patients with signs of hyperinflammation upon admission, the latter being associated with a nearly two-fold higher risk for new onset anemia within one week. Anemia prevalence increased from 44.3% upon admission to 87.8% in patients who were still hospitalized after two weeks. A more distinct decrease in hemoglobin levels was observed in subjects with severe disease, and new-onset anemia was associated with a higher risk for ICU admission. Transferrin levels decreased within the first week of hospitalization in all patients, however, a continuous decline was observed in subjects who died. Hemoglobin, ferritin, and transferrin levels normalized in a median of 122 days after discharge from hospital. This study uncovers pre-existing anemia as well as low transferrin concentrations as risk factors for mortality in hospitalized COVID-19 patients, whereas new-onset anemia during hospitalization is a risk factor for ICU admission. Anemia and iron disturbances are mainly driven by COVID-19 associated inflammation, and cure from infection results in resolution of anemia and normalization of dysregulated iron homeostasis.

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