scholarly journals Decreased mobility, lack of social support, haemosiderosis and use of antidepressant medications may predict recurrent venous leg ulcers within 12 months of healing: A prospective longitudinal study

2021 ◽  
pp. 026835552110639
Author(s):  
KJ Finlayson ◽  
CN Parker ◽  
C Miller ◽  
HE Edwards ◽  
J Campbell
Keyword(s):  
Social Support ◽  
Longitudinal Study ◽  
Statistical Significance ◽  
Ulcer Recurrence ◽  
Leg Ulcers ◽  
Prospective Longitudinal Study ◽  
Factors Associated ◽  
Antidepressant Medications ◽  
Venous Leg Ulcers ◽  
Prospective Longitudinal

Aim To identify clinical, medical and psychosocial predictors of venous leg ulcer recurrence within 12 months of healing. Methods A multi-site study was conducted in Australia in community and hospital outpatient settings. Adults with venous leg ulcers were recruited within 4 weeks of healing and data were collected on preventative treatments and health, medical, clinical and psychosocial factors. Follow-up data on recurrences were collected every 3 months until ulcer recurrence, or until 12 months after healing pending which occurred first. Factors associated with time to recurrence were analysed using a Cox proportional hazards regression model. Design Secondary data analysis of a multi-site, prospective longitudinal study to validate a risk assessment tool for recurrence. Results A sample of 143 participants was recruited (51% male, M age = 73 years, SD 13.6). Almost half (49.6%) had an ulcer recurrence within 12 months, with a mean time to ulcer recurrence of 37 weeks ( SE 1.63, 95% CI 33.7–40.1). Factors measured at the time of healing that were significant independent predictors of recurrence were: prescribed antidepressant medications ( p = .035), presence of haemosiderosis ( p = .006), decreased mobility (longer sitting times) ( p = .007) and lower social support scale scores ( p = .002). Participants who wore compression systems providing 20 mmHg or higher for at least 5 days/week were less likely to recur, although not reaching statistical significance ( p = .06). Conclusion Results provide evidence that antidepressant medications, haemosiderosis, decreased mobility and lack of social support are risk factors associated with ulcer recurrence; therefore, these variables are modifiable and could guide early intervention.

scholarly journals Factors associated with changes in creatine phosphokinase (CPK) in trauma patients submitted to the “Red Wave”, with evolution to rhabdomyolysis

2018 ◽  
Vol 45 (2) ◽  
Author(s):  
MARIO PASTORE NETO ◽  
RAFAEL VALÉRIO GONÇALVES ◽  
CARLA JORGE MACHADO ◽  
VIVIAN RESENDE
Keyword(s):  
Compartment Syndrome ◽  
Blunt Trauma ◽  
Renal Injury ◽  
Creatine Phosphokinase ◽  
Statistical Significance ◽  
Thoracic Injury ◽  
Acute Renal Injury ◽  
Prospective Longitudinal Study ◽  
Factors Associated ◽  
Prospective Longitudinal

ABSTRACT Objective: to identify and analyze factors associated with plasma creatine phosphokinase (CPK) levels in trauma victims with progression to rhabdomyolysis. Methods: we conducted a prospective, longitudinal study, with 50 patients submitted to the “Red Wave” protocol, with evolution to rhabdomyolysis after hospital admission. We studied the variables age, gender, trauma scores, mechanism and outcome, CPK at admission and final, intervals of days between laboratory evaluations, surgery and complications. We stratified CPK values in <500U/L, ≥500 - <1000 U/L, and ≥1000U/L, with calculation of the difference between the initial and final values. Results: at admission, 83% of patients (n=39) had CPK≥1000U/L, with predominance of blunt trauma and thoracic injury (p<0.05), as well as orthopedic fracture, acute renal failure and gastrointestinal bleeding, CPK being lower in those without acute renal injury, with a trend towards statistical significance. There were no differences in final CPK stratification. Factors that were independently associated with the greater CPK variation were, positively, hospitalization time greater than one week and compartment syndrome, and negatively, acute renal injury. Conclusion: the CPK level of 1000U/L remains the lower limit, with importance for early intervention in worsening conditions such as digestive hemorrhage, acute renal injury and compartment syndrome, which implied greater absolute differences between initial and final CPK, in addition to blunt trauma, thoracic injury and orthopedic fracture.

scholarly journals Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038953
Author(s):  
Jane Frankland ◽  
Sally Wheelwright ◽  
Natalia V Permyakova ◽  
David Wright ◽  
Nicole Collaço ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Social Support ◽  
Longitudinal Study ◽  
Self Efficacy ◽  
Well Being ◽  
Prospective Longitudinal Study ◽  
Adult Cancer Survivors ◽  
Prospective Longitudinal

ObjectivesTo describe prevalence and predictors of poor sexual well-being for men and women over 5 years following treatment for colorectal cancer.DesignProspective longitudinal study, from presurgery to 5 years postsurgery, with eight assessment points. Logistic regression models predicted sexual well-being from presurgery to 24 months and 24 months to 60 months; time-adjusted then fully adjusted models were constructed at each stage.SettingTwenty-nine hospitals in the UK.ParticipantsPatients with Dukes’ stage A–C, treated with curative intent, aged ≥18 years and able to complete questionnaires were eligible.Outcome measuresThe dependent variable was the Quality of Life in Adult Cancer Survivors sexual function score. Independent variables included sociodemographic, clinical and psychosocial characteristics.ResultsSeven hundred and ninety participants provided a sexual well-being score for at least one time point. Thirty-seven per cent of men and 14% of women reported poor sexual well-being at 5 years. Baseline predictors for men at 24 months included having a stoma (OR 1.5, 95% CI 1.02 to 2.20) and high levels of depression (OR 2.69/2.01, 95% CI 1.68 to 4.32/1.12 to 3.61); men with high self-efficacy (OR confident 0.33/0.48, 95% CI 0.18 to 0.61/0.24 to 1.00; very confident 0.25/0.42, 95% CI 0.13 to 0.49/0.19 to 0.94) and social support (OR 0.52/0.56, 95% CI 0.33 to 0.81/0.35 to 0.91) were less likely to report poor sexual well-being. Predictors at 60 months included having a stoma (OR 2.30/2.67, 95% CI 1.22 to 4.34/1.11 to 6.40) and high levels of depression (OR 5.61/2.58, 95% CI 2.58 to 12.21/0.81 to 8.25); men with high self-efficacy (very confident 0.14, 95% CI 0.047 to 0.44), full social support (OR 0.26; 95% CI 0.13 to 0.53) and higher quality of life (OR 0.97, 95% CI 0.95 to 0.98) were less likely to report poor sexual well-being. It was not possible to construct models for women due to low numbers reporting poor sexual well-being.ConclusionsSeveral psychosocial variables were identified as predictors of poor sexual well-being among men. Interventions targeting low self-efficacy may be helpful. More research is needed to understand women’s sexual well-being.

Sign in / Sign up

Export Citation Format

Share Document