Violation of prophylactic vancomycin administration timing is a potential risk factor for rate of surgical site infections in cardiac surgery patients: a prospective cohort study

Abstract Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.

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Risk Factors for the Occurrence and Protraction of Anterior Knee Pain in Children and Adolescents: a Prospective Cohort Study of 3 Years

10.21203/rs.3.rs-1095827/v1 ◽

2021 ◽

Author(s):

Manato Horii ◽

Ryuichiro Akagi ◽

Sho Takahashi ◽

Shotaro Watanabe ◽

Yuya Ogawa ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Children And Adolescents ◽

Knee Pain ◽

Prospective Cohort Study ◽

Anterior Knee Pain ◽

Prospective Cohort ◽

Activity Level ◽

Anterior Knee

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

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