Endemic versus Non-Endemic Gonorrhoea in Stockholm: Results of Contact Tracing

1993 ◽  
Vol 4 (5) ◽  
pp. 284-292 ◽  
Author(s):  
A-K Rudén ◽  
A Jonsson ◽  
P Lidbrink ◽  
P Allebeck ◽  
S M Bygdeman
Keyword(s):  
Risk Factors ◽  
Medical Care ◽  
Social Workers ◽  
Partner Notification ◽  
Risk Groups ◽  
Contact Tracing ◽  
Study Group ◽  
Steady Partner ◽  
Period 2 ◽  
Increased Risk

The aim of the present study was to characterize endemic versus non-endemic gonorrhoea to identify risk groups for transmission and to evaluate the effects of intensified contact tracing performed by specially trained social workers at venereal clinics. A total of 671 gonorrhoea patients (283 women and 388 men) comprised the study group. Seventy percent of the women and 48% of the men had an endemic infection ( P<0.001). Men without a steady partner had an increased risk of non-endemic infection. A decrease from 75% to 40% was noted in the proportion of endemic infection in Stockholm from the first quarter of the study period (2 years) to the last. Contact tracing resulted in 1.2 identified partners per patient. A total of 736 partners were examined either as a result of contact tracing efforts or because they had sought medical care on their own prior to intervention. Forty-seven percent of these partners were infected, 44% were not infected and 9% were examined outside the study with results unknown to us. The partner notification efforts yielded 161 new untreated cases. Contact tracing of women generated one new case per 4.0 interviewed women and contact tracing of men one new case per 4.3 interviewed men. Interviewing index patients with endemic infection yielded the highest number of new cases. Forty-three percent of the patients were infected outside Stockholm but only a smaller part of these patients spread their infection further into the community. The experiences of the contact tracing and analysis of risk factors for transmission of gonorrhoea provide valuable knowledge that can be used to discourage spread of gonorrhoea.

scholarly journals Features of the structure of cardiovascular diseases risk factors for complicated myocardial rupture myocardial infarction in young and middle-aged men

2021 ◽  
Vol 40 (2) ◽  
pp. 49-54
Author(s):  
Al’farabi S. Izmuhanov ◽  
Aleksandr V. Gordienko
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Risk Groups ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Increased Risk ◽  
Myocardial Rupture

AIM: Myocardial rupture currently remains in most cases a fatal complication of myocardial infarction. OBJECTIVE: To study the features of the structure of cardiovascular risk factors in men under 60 years old with complicated myocardial infarction to improve prevention. MATERIALS AND METHODS: The study included men 1960 years old with type I myocardial infarction. The patients were divided into two groups age-comparable: I studied, with myocardial rupture seven patients; II control, without breaks 558 patients. A comparative analysis of the frequency of observation of the main and additional factors of cardiovascular risk in the selected groups was performed. RESULTS OF THE STUDY: In the patients of the study group, frequent (four or more times a year) colds were observed more often than in the control group (42.9 and 14.8%, respectively; p = 0.04), the internal organs foci of infections (85.7 and 40.3%; p = 0.049), bypass surgery (57.1 and 10.2%; p 0.0001) and continuous cardiac pacing (28.6 and 0.5%; p 0.0001) in medical history. The presence of arterial hypertension (28.5 and 67.6%; p = 0.03) and foci of oral cavity infections (0 and 20.3%; p = 0.049) reduced the risk of myocardial rupture. In the study group, the levels of total cholesterol (4.3 0.3 and 5.8 1.2 mmol/l); p = 0.02), low-density lipoproteins (2.7 0.1 and 4.2 1.2 mmol/l); p = 0.04) and triglycerides (0.7 0.1 and 2.6 1.8 mmol/l); p = 0.008) were lower than in the control. CONCLUSION: Combinations of these cardiovascular risk factors indicate an increased risk of myocardial rupture. It is advisable to use them for predictive modeling of this event and the formation of risk groups for the purpose of timely prevention, (bibliography: 18 refs.).

scholarly journals 1373. Clinical Presentation, Demographics, and Outcomes of Cases of Tuberculosis (TB) at Princess Margaret Hospital, Nassau, The Bahamas 2014–2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S498-S498
Author(s):  
Javardo McIntosh ◽  
Nikkiah Forbes ◽  
Kevin Moss ◽  
M Anthony C Frankson
Keyword(s):  
Risk Factors ◽  
Retrospective Chart Review ◽  
Risk Groups ◽  
World Health ◽  
Contact Tracing ◽  
Hiv Positive ◽  
The Bahamas ◽  
Princess Margaret Hospital ◽  
Migrant Populations ◽  
Night Sweats

Abstract Background Tuberculosis (TB) is one of the oldest diseases known to man, yet the world health organization reports that Tuberculosis is one of the top 10 causes of death worldwide. There are various factors that have made the eradication of tuberculosis in the Bahamas difficult such as high rates of HIV infection and immigrants migrating from countries with high TB prevalence. In understanding the epidemiology and risk factors of TB cases in the Bahamas, the development of protocols can improve screening procedures and decrease disease burden. Methods A retrospective chart review of cases of Tuberculosis diagnosed at the Princess Margaret Hospital, Nassau, Bahamas. 189 cases of active tuberculosis diagnosed between 2014–2016 and all cases were evaluated for demographics, risk factors, clinical manifestation, method of diagnosis, symptoms, and treatment outcomes. Results Of the 189 cases of notified tuberculosis between 2014 and 2016, 46 cases were reported in 2014, 60 cases in 2015 and 83 cases in 2016. The mean age was 37.96 (±18.20) years old. 164 (86.8%) presented with symptoms, 19 (10.1%) of cases were diagnosed by routine screening and 6 (3.2%) of cases were diagnosed by contact tracing. 109 (59.9%) were HIV negative and 73 (40.1%) were HIV positive. 144 (76.2%) presented with cough, 84 (44.7%) weight-loss, 80 (42.3%) fever, 44 (23.3%) night sweats, 43 (22.8%) chills, 32 (16.9%) fatigue, and 25 (13.2%) hemoptysis. 126(66.7%) completed the full course of antibiotic therapy, 29(15.3%) patients expired before completing treatment and 18(9.5%) of patients defaulted. Conclusion HIV is a major risk factor for Tuberculosis in the Bahamas and it is advised that all patients diagnosed with TB be tested for HIV. We also advise screening HIV-positive patients for TB. Screening other high-risk groups such as migrant populations would also benefit to reduce the amount of latent TB cases which may progress to active TB. Disclosures All authors: No reported disclosures.

Impact of Melanoma Diagnosis on Sun-Awareness and Protection: Efficacy of Education Campaigns in a High-Risk Population

2004 ◽  
Vol 8 (5) ◽  
pp. 303-309 ◽  
Author(s):  
Anatoli Freiman ◽  
John Yu ◽  
Antoine Loutfi ◽  
Beatrice Wang
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Groups ◽  
High Risk Population ◽  
Awareness Campaigns ◽  
Number Of Patients ◽  
Increased Risk ◽  
Patients At Risk ◽  
And Behavior ◽  
Attitudes And Behavior

Background: Malignant melanoma is a significant cause of morbidity and mortality worldwide. Sun-awareness campaigns increase public knowledge but may not translate into behavioral changes in practice, which is particularly alarming when reported for individuals in high-risk groups. In particular, patients diagnosed with melanoma are at increased risk of developing subsequent primary melanomas compared with the general population. Objectives: The study was undertaken (1) to assess whether patients with known risk factors for developing melanoma had been exposed to preventative campaign messages prior to their diagnosis, (2) to quantify whether the diagnosis of melanoma changed sun-related attitudes and behavior, and (3) to assess the adequacy of sun-related advice given to patients with melanoma, as well as their compliance with the advice. Methods: Using an anonymous questionnaire, 217 patients previously diagnosed with melanoma were interviewed on the source and frequency of received sun-related advice, as well as on their knowledge, attitudes, and behavior toward sun protection before and after the diagnosis. Results: The number of patients who reported receiving sun-related advice after being diagnosed with melanoma increased by 36% (52% pre-vs. 88% postDiagnosis), with advice being given more frequently and more often by a physician (19% pre- vs. 49% postdiagnosis). Furthermore, sun-related attitudes and behavioral practices were positively altered. Yet, patients with known risk factors were not preferentially targeted for advice before their diagnosis. Conclusions: The diagnosis of melanoma leads to increased sunwareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.

scholarly journals The Effect of Ethnicity on Preterm Birth and its Influence on the Risk Factors for Prematurity

2019 ◽  
pp. 180-192
Author(s):  
P Bachkangi ◽  
AH Taylor ◽  
JC Konje
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Birth ◽  
High Risk ◽  
Risk Groups ◽  
Individual Risk ◽  
Individual Risk Factor ◽  
Increased Risk ◽  
Gestational Age At Delivery ◽  
Very High

Preterm birth (PTB) affects 9.6% of pregnancies worldwide and is associated with a very high perinatal mortality that depends on the gestational age at delivery. As a result, PTB has a significant health and financial impact on health systems, families and societies. Its aetiology is not fully understood, but in most cases it is multifactorial, with several maternal, paternal, and epidemiological factors associated with increased risk. Other factors include parental ethnicity, maternal age and body mass index, socioeconomic status, and where the families live. This review examines the influence of ethnicity as an individual risk factor for PTB. It also explores its influence on the epidemiology of PTB and demonstrates that data on certain ethnicities are lacking, despite the fact that these ethnic clusters are within the very ‘high-risk groups’ that are adequately represented in some Western societies. This review examines the influence of ethnicity as an individual risk factor for PTB and also explores its influence on the different epidemiological aspects. A thorough revisit of the ethnic epidemiology unveiled other unnoticed risk factors that if addressed appropriately prematurity can be prevented. Moreover, certain ethnicities were not within the attention of researchers, despite the facts that they are very ‘high-risk groups’ and are also adequately represented in some Western societies.

Abstract P252: Health Professional Shortage Areas and Their Association With Cardiovascular Risk Factor Prevalence, Awareness, and Control: Findings From the Coronary Artery Risk Development in Young Adults (CARDIA) Study

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Norrina B Allen ◽  
Mercedes Carnethon ◽  
Penny Gordon-Larsen ◽  
Catarina Kiefe ◽  
Ana Diez-Roux ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Risk Factor ◽  
Health Professional ◽  
Medical Care ◽  
Low Income ◽  
Cvd Risk ◽  
Increased Risk ◽  
And Control ◽  
Neighborhood Ses

Background: Over 65 million Americans live in Primary Care Health Professional Shortage Areas (HPSAs) which are associated with less preventive care, poorer general health and an increased risk for hospitalizations. However, little is known about how living in a HPSA impacts primary prevention for CVD. Methods: We used data from CARDIA, a multi-center cohort study of black and white men and women. Participants who had risk factor data and geocoded addresses available at year 20 (2005) were included in this analysis (n=3479). Primary care HPSAs were defined using data from US HRSA. Diabetes, hypertension and hyperlipidemia prevalence and control were defined according to ADA Guidelines 2000, JNC VI, and ATP III, respectively. Individuals who reported being diagnosed or reported use of medications were considered aware of the risk factor. The prevalence of smoking and obesity was also examined. Neighborhood (census block) characteristics were derived from Census 2000 and ACCRA. Multivariable Poisson models were used to examine the independent association of HPSA residence with each outcome. Results: Over 11% of CARDIA participants live in a HPSA. Residents of HPSAs were more likely to be female (64% vs 56%), African American (81% vs 43%), have low education, and low income. HPSA residents had more difficulty paying for food/basics and medical care, had poorer access to medical care and lived in areas with a higher cost of healthcare and low neighborhood SES. HPSA residents had a higher prevalence of hypertension (PR 1.39, 95% CI 1.18-1.65), obesity (1.30, 1.16-1.45) and smoking (1.72, 1.46-2.03) and were less likely to have their hypertension (0.79, 0.66-0.95) or hyperlipidemia (0.66, 0.44-0.99) controlled as compared to non-residents. The association between HPSA and risk factors prevalence was explained by race and neighborhood SES. The cost of medical care and having a usual source of care were the largest mediators of the association between HPSA residence and risk factor control. Conclusion: The increased prevalence and poorer control of CVD risk factors in HPSAs, can be explained by the demographic and neighborhood characteristics of their residents. Future interventions should be targeted to these high-risk populations found within HPSAs.

Incidence and risk factors for pressure injuries in adults in specialised medical care: a prospective observational study

2021 ◽  
Vol 30 (11) ◽  
pp. 945-953
Author(s):  
Sanna Stoltenberg ◽  
Jaana Kotila ◽  
Anniina Heikkilä ◽  
Tarja Kvist ◽  
Kristiina Junttila
Keyword(s):  
Risk Factors ◽  
Medical Care ◽  
Injury Risk ◽  
Assessment Tool ◽  
Conflicts Of Interest ◽  
Target Group ◽  
Older Age ◽  
Increased Risk ◽  
Pressure Injury ◽  
Hospital Stays

Introduction: Hospital-acquired pressure injuries are one of the most important indicators of quality patient care. It is important to identify high-risk patients to guide the implementation of appropriate prevention strategies. This can be done by using an assessment tool that covers the main risk factors for pressure injuries. Aim: The purpose of the study was to describe the incidence of pressure injuries and the associated risk factors among patients assessed with the Prevent Pressure Injury (PPI) risk assessment tool developed by the Helsinki University Hospital. Method: The study was conducted by selecting six wards from medical, surgical and neurological units. The target group were the patients being treated in the study units who gave their informed consent. The research data were retrieved from electronic patient records. Results: From the target group, 332 patients were eligible to participate in the study. The pressure injury risk was found to increase with longer hospital stays and older age. Surgical patients had an increased risk of pressure injuries compared to other specialty fields. A primary diagnosis of musculoskeletal or connective tissue disease, and secondary diagnoses of hypertension and cerebral haemorrhage, were linked with an increased pressure injury risk. A total of nine pressure injuries occurred in nine patients, with an incidence of 2.5% (stages II−IV). Conclusion: The observation and recording of pressure injuries in specialised medical care remain insufficient. Longer hospital stays, older age and surgery increase pressure injury risk. Also, patients' primary and secondary diagnoses may increase the pressure injury risk. Declaration of interest: The authors have no conflicts of interest to declare.

Environmental factors explain socioeconomic prevalence differences in myopia in 6-year-old children

2017 ◽  
Vol 102 (2) ◽  
pp. 243-247 ◽  
Author(s):  
J Willem L Tideman ◽  
Jan Roelof Polling ◽  
Albert Hofman ◽  
Vincent WV Jaddoe ◽  
Johan P Mackenbach ◽  
...  
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Environmental Factors ◽  
Maternal Education ◽  
Family Income ◽  
Risk Groups ◽  
Lifestyle Factors ◽  
Birth Cohort Study ◽  
Family Socioeconomic Status ◽  
Increased Risk

PurposeHigh myopia (≤−6 D) usually has its onset before 10 years of age and can lead to blinding complications later in life. We examined whether differences in myopia prevalences in socioeconomic risk groups could be explained by differences in lifestyle factors.MethodsA total of 5711 six-year-old children participating in the prospective population-based birth cohort study Generation R underwent a stepwise ophthalmic examination, which included visual acuity and objective cycloplegic refraction to identify children with myopia (≤−0.5D). Daily activities, ethnicity, factors representing family socioeconomic status and housing were ascertained by questionnaire. Risk assessments of myopia and mediation analyses were performed using logistic regression; attenuation of risks was calculated by bootstrapping.ResultsPrevalence of myopia was 2.4% (n=137). Myopic children spent more time indoors and less outdoors than non-myopic children (p<0.01), had lower vitamin D (p=0.01), had a higher body mass index and participated less in sports (p=0.03). Children of non-European descent (OR 2.60; 95% CI 1.84 to 3.68), low maternal education (OR 2.27; 95% CI 1.57 to 3.28) and low family income (OR 2.62; 95% CI 1.8 to 3.74) were more often myopic. Lifestyle factors explained the majority of the increased risk for ethnicity (82%; 95% CI 55 to 120), maternal education (69%; 95% CI 45 to 109) and family socioeconomic status (71%; 95% CI 46 to 104).ConclusionThis study found environmental factors to be strong risk factors for myopia already at the age of 6 years. The myopia prevalence differences in socioeconomic groups were greatly determined by differences in distribution of these environmental risk factors, highlighting the importance of lifestyle adjustments in young children developing myopia.

scholarly journals Incidence Rate and Risk Factors for Recurrent Clostridium difficile Infection in Pediatric At-Risk Groups

2020 ◽  
Vol 41 (S1) ◽  
pp. s294-s294
Author(s):  
Verinsa Mouajou ◽  
Lucila Baldassarre
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Clostridium Difficile ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Risk Groups ◽  
Fisher Exact Test ◽  
Targeted Prevention ◽  
Secondary Immunodeficiency ◽  
Increased Risk

Background: Recurrence rates and risk factors of Clostridium difficile infection (CDI) are well established in adults, though little is known about the rate of recurrent CDI (rCDI) within the pediatric population. The purpose of this study was to identify rates and risk factors of rCDI in pediatric at-risk groups to guide the optimization of targeted prevention efforts against disease recurrence. Methods: We report on the ongoing retrospective cohort study of pediatric patients at the CHU Sainte-Justine with a laboratory confirmed diagnosis of CDI between April 1, 2012, and March 31, 2017. Incidence rates of rCDI were obtained per 100 cases. Frequencies of rCDI were compared using the Fisher exact test. Univariate and multivariate logistic regression were used to identify risk factors for rCDI. Two-tailed P < .05 was considered significant. All statistical calculations were performed using R version 3.5.2 software. Results: Of 80 patients analyzed with CDI, 16 had rCDI, for a rCDI rate in this population of 20%. Most recurrences were observed in secondarily immunosuppressed patients including, but not limited to, oncology patients undergoing chemotherapy and/or radiotherapy (30.4%) and patients with inflammatory bowel disease (IBD, 29.2%). Patients that were administered vancomycin orally (PO) had recurrent infection less often than patients that administered metronidazole PO or IV (8.3% vs 23.4%, respectively). This trend was observed in all at-risk patient groups. Patients with secondary immunodeficiency had 7.4 times increased odds of recurrence compared to nonimmunodeficient patients (adjusted OR, 7.43,; 95% CI, 1.84–50.4; P = .0126). Conclusions: Initial vancomycin PO therapy seems to be associated with a lower risk of recurrence. Pediatric patients with IBD and with secondary immunodeficiency are at increased risk of rCDI. Given that these populations have an increased underlying risk of diarrhea, it would be worthwhile to determine whether toxin is actually produced (EIA testing) and to prioritize prevention efforts.Funding: NoneDisclosures: None

scholarly journals Gout as a Risk Factor for Dry Eye Disease: A Population-Based Cohort Study

2019 ◽  
Vol 8 (1) ◽  
pp. 62 ◽  
Author(s):  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
Chi-Chin Sun ◽  
Hung-Yu Lin ◽  
Ko-Hsiu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Age Related Macular Degeneration ◽  
Eye Disease ◽  
Cumulative Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Increased Risk

This study evaluated the effect of gout on the risk of dry eye disease (DED) by using the National Health Insurance Research Database (NHIRD). Data for 30,192 gout patients (21,081 men and 9111 women) and 30,192 non-gout patients (21,005 men and 9187 women) were analyzed. Approximately 1 million patients were randomly sampled from the NHIRD registry. After applying exclusion criteria, patients diagnosed with gout were enrolled in the study group. Thereafter, each individual in the study group underwent the matching process via the propensity score with another non-gout individual, which constituted the control group. The main outcome was defined as the development of DED in accordance with the corresponding International Classification of Diseases, Ninth Revision. In addition to DED, other risk factors including age, sex, and urbanization, and several co-morbidities were included in the multivariate model. The incidence of DED with the adjusted hazard ratio (aHR) and cumulative probability were evaluated in the gout and non-gout patients. A total of 2913 DED events were observed in the study group, whereas 2631 DED events were observed in the control group. A higher incidence rate ratio was found in the study group after adjustment (aHR: 1.065). Moreover, the cumulative probability indicated a significantly increased risk of DED in the study group (p = 0.001). The other potential risk factors of DED according to the multivariate analysis include older age, female gender, higher degree of urbanization, keratopathy, age-related macular degeneration, glaucoma, cataract, ischemic heart disease, hyperlipidemia, peripheral vascular disease, chronic pulmonary disease, rheumatic disease, peptic ulcer disease, liver disease, and malignancy. In conclusion, gout increased the risk of DED after adjustment, and the risk is positively correlated to a longer disease period.

scholarly journals Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4086
Author(s):  
Judith Gecht ◽  
Ioannis Tsoukakis ◽  
Kim Kricheldorf ◽  
Frank Stegelmann ◽  
Martine Klausmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Arterial Hypertension ◽  
Estimated Glomerular Filtration Rate ◽  
Myeloproliferative Neoplasms ◽  
Multiple Logistic Regression Analysis ◽  
Study Group ◽  
Kidney Dysfunction ◽  
German Study ◽  
Increased Risk ◽  
History Of

Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m2)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.

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