Obesity Increases the Odds of Acquiring and Incarcerating Noninguinal Abdominal Wall Hernias

2012 ◽  
Vol 78 (10) ◽  
pp. 1118-1121 ◽  
Author(s):  
Briana Lau ◽  
Hanjoo Kim ◽  
Philip I. Haigh ◽  
Talar Tejirian
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Significant Risk ◽  
Female Gender ◽  
Current Data ◽  
Current Prevalence ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Relationship Of

The current data available describing the relationship of obesity and abdominal wall hernias is sparse. The objective of this study was to investigate the current prevalence of noninguinal abdominal wall hernias and their correlation with body mass index (BMI) and other demographic risk factors. Patients with umbilical, incisional, ventral, epigastric, or Spigelian hernias with or without incarceration were identified using the regional database for 14 hospitals over a 3-year period. Patients were stratified based on their BMI. Univariate and multivariate analyses were performed to distinguish other significant risk factors associated with the hernias. Of 2,807,414 patients, 26,268 (0.9%) had one of the specified diagnoses. Average age of the patients was 52 years and 61 per cent were male. The majority of patients had nonincarcerated umbilical hernias (74%). Average BMI was 32 kg/m2. Compared with patients with a normal BMI, the odds of having a hernia increased with BMI: BMI of 25 to 29.9 kg/m2 odds ratio (OR) 1.63, BMI of 30 to 39.9 kg/m2 OR 2.62, BMI 40 to 49.9 kg/m2 OR 3.91, BMI 50 to 59.9 kg/m2 OR 4.85, and BMI greater than 60 kg/m2 OR 5.17 ( P < 0.0001). Age older than 50 years was associated with a higher risk for having a hernia (OR, 2.12; 95% [CI], 2.07 to 2.17), whereas female gender was associated with a lower risk (OR, 0.53; 95% CI, 0.52 to 0.55). Those with incarcerated hernias had a higher average BMI (32 kg/m2 vs 35 kg/m2; P < 0.0001). Overall, BMI greater than 40 kg/m2 showed an increased chance of incarceration, and a BMI greater than 60 kg/m2 had the highest chance of incarceration, OR 12.7 ( P < 0.0001). Age older than 50 years and female gender were also associated with a higher risk of incarceration (OR, 1.28; 95% CI, 1.02 to 1.59 and OR, 1.80; CI, 1.45 to 2.24). Increasing BMI and increasing age are associated with a higher prevalence and an increased risk of incarceration of noninguinal abdominal wall hernias.

scholarly journals Metastatic Bladder Cancer Presenting with Persistent Hematuria in Young Man with Cystic Fibrosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Premal Patel ◽  
Harvey R. Rabin ◽  
Michael M. Vickers ◽  
Michael D. Parkins
Keyword(s):  
Risk Factors ◽  
Cystic Fibrosis ◽  
Bladder Cancer ◽  
Renal Colic ◽  
Atypical Symptoms ◽  
Metastatic Bladder Cancer ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Rule Out

We report a case of metastatic bladder cancer developing in a young man with cystic fibrosis (CF) that was initially diagnosed as ureterolithiasis and managed as renal colic. With the improved survival of patients with CF, an increasing burden of extrapulmonary disease manifestations is apparent. Renal colic is observed at an increased frequency in patients with CF relative to the general population and is a commonly recognized cause of hematuria. However, CF patients harboring a malignancy are recognized to be at increased risk of delayed identification owing to atypical symptoms and lack of demographic risk factors. This case illustrates how investigations to rule out malignancy are warranted in those CF patients not responding to therapies directed towards presumptive diagnoses.

Retrospective analysis of risk factors for fatigue in clinical trial patients (pts) with metastatic renal cell carcinoma (mRCC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15624-e15624
Author(s):  
Martin Eric Gore ◽  
Viktor Gruenwald ◽  
Robert John Motzer ◽  
David I. Quinn ◽  
Brian I. Rini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Analysis ◽  
Kinase Inhibitors ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Female Gender ◽  
Phase Iii ◽  
Phase Ii Trials ◽  
Increased Risk ◽  
Ecog Ps

e15624 Background: Fatigue is a common toxicity in pts with mRCC, often associated with therapy, particularly with tyrosine kinase inhibitors (TKI). We performed a pooled retrospective analysis of pts with mRCC treated in clinical studies in order to explore predictors for fatigue. Methods: Data from pts treated in Pfizer mRCC trials (2003-2011) from phase III (NCT00083899, NCT00065468, NCT00678392) and phase II trials (NCT00054886, NCT00077974, NCT00083889, NCT00338884, NCT00137423) were included. Adverse event (CTCAE v3.0) terms of “fatigue” and “asthenia” were used. Hypothyroidism was defined as TSH>ULN or T4<LLN. A multivariate logistic regression analysis was performed to identify significant risk factors for grade (G) 2 (moderate or causing difficulty performing some ADL) or higher fatigue. Results: 2749 pts (71% male) with a median age 60 (33% ≥65) were treated (median 162 days) with axitinib (n=359), sunitinib (n=1059), temsirolimus (TEM) (n=208), interferon-alfa (IFN) (n=560), sorafenib (n=335), or TEM + IFN (n=208). Most pts had baseline ECOG PS of 0 (47%) or 1 (51%), clear cell histology (91%), and nephrectomy (84%). 553 (20%) pts reported fatigue prior to starting study therapy. During study, fatigue was reported in 1794 (65%) pts (21% G1, 26% G2, 17% G3, 1% G4); in 61% pts worst grade was reported within the first 2 months of therapy. Fatigue led to discontinuation in 2%, and dose interruption or adjustment in 8%. Of 1773 pts treated with TKIs, 42% had ≥G2 fatigue. Of pts treated with TEM, IFN or both, 39%, 50% and 50%, respectively, had ≥G2 fatigue. Baseline factors [Odds Ratio] associated (p < 0.05) with ≥G2 fatigue were pretreatment fatigue [1.7] or hypothyroidism [1.6], age ≥65 [1.6], time from diagnosis ≥1 yr [1.4], female gender [1.3], ECOG PS 0 [0.7], and Asian vs Caucasian race [0.5]. Baseline LDH, calcium, and anemia were not significant. Conclusions: Pt attributes and comorbidities at baseline, independent of therapy, are associated with increased risk of clinically significant fatigue in pts treated for mRCC, and can be used to generate a predictive model. Appropriate counseling and control of co-morbid conditions may be important in managing fatigue in pts on TKI therapy.

scholarly journals Analysis of clinico-demographic risk factors for postoperative pulmonary complications following gastrointestinal surgery

2019 ◽  
Vol 7 (1) ◽  
pp. 93
Author(s):  
Vijay Sinouvassan ◽  
Hemalatha Dayalane ◽  
Subalakshmi Balagurunathan ◽  
Ashok Kumar Sahoo ◽  
Vishnu Kanth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Gastrointestinal Surgery ◽  
Pulmonary Complications ◽  
Lung Pathology ◽  
Postoperative Pulmonary Complications ◽  
Increased Risk ◽  
Education Status ◽  
Demographic Risk ◽  
Demographic Risk Factors

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increased mortality, increased length of intensive care unit (ICU) stay, and higher cost of treatment. Identifying the risk factors of PPC helps in predicting its occurrence and to develop preventive measures. The objectives of the present study were to study the clinical and demographic risk factors for PPC following gastrointestinal surgery.Methods: The study was designed as an observational descriptive analytic study. All the patients ≥18 years of age undergoing gastrointestinal surgery were included. The patients with preoperative lung pathology requiring ICU care or ventilatory support and patients with lung metastasis were excluded. The demographic and clinical parameters at admission were recorded. The details of pulmonary complications like the time of occurrence after surgery and the mode of treatment for pulmonary complications were noted. The risk association was assessed for statistical significance.Results: A total of 100 patients were underwent various gastrointestinal surgeries during the study period. The incidence of PPC was 34% in our study. Age, education status, smoking, and presence of comorbidities were found to be positively associated with an increased incidence of PPCs. The serum albumin of less than 3.5gm and the haemoglobin of less than 8 gm were also associated with an increased incidence of PPC. Pleural effusion was the commonest PPC seen in 15 (44.1%) patients followed by pneumonia in 9 (26.5%).Conclusions: Age, smoking, education status, serum albumin, haemoglobin, emergency surgery, elective postoperative ventilation, nasogastric intubation and blood loss in the intraoperative period were found to associated with increased risk of PPCs. 

Optic disc haemorrhage and primary open-angle glaucoma: a clinical review

2020 ◽  
pp. bjophthalmol-2019-314583 ◽  
Author(s):  
Uma Jasty ◽  
Alon Harris ◽  
Brent Siesky ◽  
Lucas W Rowe ◽  
Alice C Verticchio Vercellin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optic Disc ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Treatment Strategies ◽  
Significant Risk ◽  
Female Gender ◽  
Open Angle ◽  
Increased Risk ◽  
Disc Haemorrhage

Studies have confirmed that optic disc haemorrhage (ODH) is a significant risk factor for the development and progression of primary open-angle glaucoma (POAG). Various populations have differing risk factors for developing POAG. As such, a literature review was conducted examining seven studies published in India, China, Japan, Australia, Korea and the USA. The goal of this review was to better identify ODH risk factors and their relationship to development and progression of POAG. Ultimately, patients with ODH have a greater risk for developing POAG across all populations analysed in this review. However, some populations demonstrated additional risk factors for ODH, such as increasing age and female gender. Paradoxically, data from several studies show that people of African descent have a reduced risk of ODH despite having increased risk of open-angle glaucoma than their Caucasian counterparts. By parsing out the complex relations between ODH and open-angle glaucoma stratified by age, gender and race, we may gain a broader understanding of glaucoma pathogenesis and derive individualised treatment strategies.

Emotional and Behavioral Problems in Early Adolescents and Association with Socio-demographic Risk Factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S128-S128
Author(s):  
L. Dostovic Hamidovic
Keyword(s):  
Risk Factors ◽  
Behavioral Problems ◽  
Parental Education ◽  
Early Adolescents ◽  
Emotional And Behavioral Problems ◽  
Behavioural Problems ◽  
Emotional And Behavioural Problems ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors

AimThe aim is to analyse the frequency emotional and behavioural problems early adolescents and association with socio-demographic risk factors.Subject and methodsWe analysed a group of 240 early adolescents (11–15 years) from the area of Tuzla Canton, Bosnia and Herzegovina, in the general population. For the assessment of children's emotional and behavioural problems, the Strength and Difficulties Questionnaire – SDQ is used. Data were processed by descriptive statistics. For the assessment association between socio-demographic risk factors and emotional and behavioural problems in early adolescents we used Pearson correlation test.ResultsThe result show that the frequency of emotional and behavioural problems are present in 3% of cases, The results of correlation sociodemographic risk factors and emotional and behavioral problems, showed that unemployed mothers have a significant increased risk of developing behavioral disorders in early adolescents (P < 0.05). Low family economic status leads to a significantly higher frequency of emotional symptoms in early adolescents, poor attitude towards society and significantly higher overall difficulties (P < 0.05). Higher levels of parental education was significantly associated with a higher frequency of behavioral problems and illness in the family leads to a much more emotional problems (P < 0.05).ConclusionThe obtained results of this study indicate that early adolescents showed low levels of emotional and behavioral problems. There is a significant correlation between socio-demographic risk factors and emotional and behavioral problems early adolescents.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Risk factors for Clostridium difficile infection in pediatric inpatients: A meta-analysis and systematic review

2019 ◽  
Vol 40 (4) ◽  
pp. 420-426 ◽  
Author(s):  
Scott Anjewierden ◽  
Zheyi Han ◽  
Charles B. Foster ◽  
Chaitanya Pant ◽  
Abhishek Deshpande
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Meta Analysis ◽  
Significant Risk ◽  
Female Gender ◽  
Significant Risk Factor ◽  
Antibiotic Exposure ◽  
H2 Receptor Antagonist ◽  
Increased Risk

AbstractObjective:To summarize risk factors for Clostridioides (formerly Clostridium) difficile infection (CDI) in hospitalized pediatric patients as determined by previous observational studies.Design:Meta-analysis and systematic review.Patients:Studies evaluating risk factors for CDI in pediatric inpatients were eligible for inclusion.Method:We systematically searched MEDLINE, Web of Science, Scopus, and EMBASE for subject headings and text words related to CDI and pediatrics from 1975 to 2017. Two of the investigators independently screened studies, extracted and compiled data, assessed study quality, and performed the meta-analysis.Results:Of the 2,033 articles screened, 14 studies reporting 10,531,669 children met the inclusion criteria. Prior antibiotic exposure (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31–3.52) and proton pump inhibitor (PPI) use (OR, 1.33; 95% CI, 1.07–1.64) were associated with an increased risk of CDI in children. Subgroup analyses using studies reporting only adjusted results suggested that prior antibiotic exposure is not a significant risk factor for CDI. H2 receptor antagonist (H2RA) use (OR, 1.36; 95% CI, 0.31–5.98) and that female gender (OR, 0.87; 95% CI, 0.74–1.03) did not play a significant role as a risk factor for developing CDI.Conclusion:Prior antibiotic exposure appears to be an important risk factor for CDI based on the combined analysis but not significant using adjusted studies. PPI use was associated with an increased risk of CDI. Judicious and appropriate use of antibiotics and PPIs may help reduce the risk of CDI in this vulnerable population.

scholarly journals Risk factors and protective factors of depression in older people 65+. A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251326
Author(s):  
Alexander Maier ◽  
Steffi G. Riedel-Heller ◽  
Alexander Pabst ◽  
Melanie Luppa
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Older People ◽  
Smoking Behavior ◽  
Significant Risk ◽  
Female Gender ◽  
Assessment Tools ◽  
Mobility Impairment ◽  
Increased Risk ◽  
Potential Risk Factors

Objectives Identifying risk factors of depression can provide a better understanding of the disorder in older people. However, to minimize bias due to the influence of confounders and to detect reverse influence, a focus on longitudinal studies using multivariate analysis is required. Design A systematic literature search was conducted by searching the databases MEDLINE, Cochrane, PsycINFO and Web of Science for all relevant articles published from January 2000 to the end of March 2020. The following inclusion criteria were used: prospective design, nationally or regionally representative sample, published in English or German, analyzed risk factors for depression of individuals 65+ identified by multivariate analysis, and provided validity of diagnostic instrument. All results of multivariate analysis were reported and summarized. Results Thirty articles were identified. Heterogeneous results were found for education, female gender, self-rated health, cognitive impairment and older age, although significant in several studies. Findings hinted at a protective quality of physical activity. In terms of physical health, chronic disease and difficulty initiating sleep homogeneously increased risk of depression. Mobility impairment resulted as a risk factor in three studies. IADL impairment and vision impairment were mostly identified as significant risk factors. Alcohol consumption and smoking behavior yielded heterogenous results. Psychosocial factors were assessed similarly in multiple studies and yielded heterogenous results. Limitations Research was limited to articles published in English or German. Length of follow up was not considered for the presentation of results. Adjustments for and inclusion of different variables in the studies may distort results. Conclusion Our findings demonstrate the necessity of refined, more comparable assessment tools for evaluating potential risk factors.

scholarly journals EPID-02. HEIGHT AND THE RISK OF MENINGIOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi74-vi74
Author(s):  
Shlomit Yust-Katz ◽  
Alexandra Amiel ◽  
Ramiz Abu Shkara ◽  
Tali Siegal ◽  
Gilad Twig
Keyword(s):  
Risk Factors ◽  
Autoimmune Diseases ◽  
Cancer Registry ◽  
Large Population ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Female Gender ◽  
Total Study Population ◽  
Increased Risk ◽  
History Of

Abstract BACKGROUND Meningiomas are the most common primary central nervous system tumors. Risk factors for meningiomas including obesity, height, history of allergy/atopy or autoimmune diseases, have been previously assessed with conflicting results. We reviewed a large cohort of Israeli adolescents in order to assess potential risk factors for the development of meningiomas. METHODS This study analyzed a cohort of 2,035,915 Jewish men and women who underwent obligatory physical examination when aged 16 to 19 years, from 1967 to 2011. Meningioma incidence was identified by linkage to the national cancer registry. Cox proportional hazard models were used to estimate the hazard ratios for meningioma according to sex, body mass index (BMI), height, history of allergic and autoimmune disease. RESULTS Linkage of the adolescent military database with the Israeli cancer registry identified 480 cases (152 males and 328 females) of meningioma during a follow up of 40,304,078-person years. The median age at diagnosis of meningioma was 42.1 ± 9.4 (range 17.4–62.6). On univariate analysis, only female gender (p< 0.01) and height (p< 0.01) were associated with risk for meningioma in the total study population. When stratified by gender, height remained a significant risk factor only in men. Spline analysis in the men group showed the minimum risk at a height of 1.62 meters and a statistically significant increase in the risk for meningioma at heights taller than 1.85 meters. BMI, past medical history including asthma, diabetes, and atopic and autoimmune diseases, were not associated with meningioma risk. CONCLUSION in this large population study, we found that sex and taller height in adolescent males was associated with an increased risk of adult meningioma.

scholarly journals Modifiable Demographic Factors that Differentiate Bronchiolitis from Pneumonia in Nepalese Children Less Than Two Years – A Hospital Based Study

2015 ◽  
Vol 12 (3) ◽  
pp. 175-180 ◽  
Author(s):  
T Malla ◽  
P Poudyal ◽  
KK Malla
Keyword(s):  
Risk Factors ◽  
Maternal Age ◽  
Winter Season ◽  
Significant Risk ◽  
P Value ◽  
Maternal Knowledge ◽  
Mortality And Morbidity ◽  
Animal Milk ◽  
Demographic Risk ◽  
Demographic Risk Factors

Background Bronchiolitis and pneumonia is an important cause of mortality and morbidity in children. Various risk factors make these children more prone for this illness. There is limited data on the risk factors from this part of the world. Moreover there is a significant clinical overlap between bronchiolitis and pneumonia thus necessitating the need for evaluating their demographic difference.Objective To evaluate the modifiable demographic risk factors for bronchiolitis and pneumonia in children less than 2 years.Method A prospective, comparative hospital based study undertaken during March 2012- March 2013 in Manipal Teaching Hospital, Pokhara. Altogether 200 cases of bronchiolitis and 200 cases of pneumonia, in the age group of 2 to 24 months, were randomly selected for comparison of risk factors as per a predesigned proforma. A ‘p’ value of <0.05 was considered statistically significant. Data was analyzed by using SPPS version 16.Result The significant risk factors for bronchiolitis were age < 6 months (p<0.001), prematurity (p<0.001),male(P<0.04), younger maternal age (p< 0.009), poor maternal knowledge (p<0.013), air pollution and lack of ventilation (p<0.001), exposure to cooking fuel – kerosene (p<0.007), firewood (p<0.001) , tobacco smoke (p<0.001), overcrowding (0.008), winter season (p<0.015), domestic pets (p<0.003), low birth weight (p<003), use of animal milk (p<0.001).The significant risk factors for pneumonia were age 13 months- 24 months, maternal age 26- 35 yrs (p<0.009), female (p< 0.04), malnutrition, lack of Vitamin A supplementation and immunization (p<0.001).Conclusion Most of the risk factors for bronchiolitis and pneumonia identified in this study were modifiable; hence could be prevented to decrease the burden of both the diseases.Kathmandu University Medical Journal Vol.12(3) 2014; 175-180

scholarly journals Depression, Anxiety and Stress in Women with Breech Pregnancy - "Be not Afraid": A Prospective Study

2021 ◽  
Author(s):  
Madeleine Schauer ◽  
Elisabetta Latartara ◽  
Maria Alonso-Espias ◽  
Emma Rossetti ◽  
Pimrapat Gebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Cesarean Section ◽  
Mental Disorder ◽  
Pregnant Women ◽  
Clinical Care ◽  
Breech Presentation ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background: Breech presentation at term is associated with higher perinatal complications through the increased incidence of cesarean section and complications by vaginal breech birth. The decision-making process between breech delivery, trial of external cephalic version or cesarean section may lead to maternal depression, stress and anxiety. Mental disorder in itself is associated with poorer maternal and fetal outcomes, such as preterm birth, small for gestational age infants, lower birth weight and increased risk for postnatal depression. This study aims to evaluate the level of psychological distress for women with breech presentation compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety than other pregnant women. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy. Methods: The breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression-Anxiety-Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t-test or Mann-Whitney-U-test. Demographic risk factors were identified using a binary logistic regression model.Results: Prevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress.Conclusions: Breech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress.Clinical Trial Registration: Ethical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226)

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