Subgroups of survivors with distinct aggravating factors associated with chemotherapy-induced neuropathy (CIN) in the feet.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 151-151
Author(s):  
Judy Mastick ◽  
Grace Mausisa ◽  
Melissa Mazor ◽  
Steven M. Paul ◽  
Bruce A. Cooper ◽  
...  
Keyword(s):  
Latent Class ◽  
Symptom Burden ◽  
Individual Variability ◽  
Neurologic Complication ◽  
Platinum Compound ◽  
Timed Up And Go ◽  
Cold Temperatures ◽  
Factors Associated ◽  
Temperature Group ◽  
Activity Groups

151 Background: CIN is the most prevalent neurologic complication of cancer treatment. Inter-individual variability exists in survivors’ reports of the factors that aggravate CIN in their feet. The purpose of this study was to identify groups of survivors with CIN in their feet based on distinct aggravating factors and evaluate for differences in demographic, clinical, symptom characteristics and quality of life (QOL) based on group membership. Methods: Cancer survivors (n = 403) who received a platinum and/or a taxane and rated their altered sensation/pain in their feet at > 3 on 0-10 scale were enrolled and completed study questionnaires, including a list of 22 factors that could make pain worse. Medical records were reviewed and sensory and motor tests were done. Latent class analysis was used to identify groups of survivors based on the occurrence rates for aggravating factors. Differences among the groups were evaluated using parametric and nonparametric statistics. Results: Three groups were identified based on occurrence rates for aggravating factors in the feet (i.e., Activity and Temperature (40.2%), Activity (25.8%), Few Factors (34.0%)). No differences were found among the groups in demographic characteristics, or sensory (light touch, temperature, pain, vibration) and motor (Timed Up and Go, Fullerton Assessment of Balance) tests. Compared to the Few Factors group, the other two groups had higher BMI, worse foot pain, poorer functional status and sleep, more depressive symptoms, and lower QOL. Survivors who received a platinum compound were more likely to be in the Activity and Temperature group. Those that received a taxane compound were more likely to be in the Few Factors or Activity groups. Conclusions: Survivors who reported a higher occurrence of aggravating factors had a higher symptom burden and poorer QOL. Objective measures did not differ among the groups. Aggravating factors associated with the CTX received supports previous work in that the survivors who received platinum drugs noted cold temperatures aggravated their CIN. Findings suggest that subgroups of survivors can be identified based on their reports of CIN aggravating factors.

Subgroups of survivors with distinct aggravating factors associated with chemotherapy-induced neuropathy (CIN) in the hands.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 157-157
Author(s):  
Grace Mausisa ◽  
Judy Mastick ◽  
Melissa Mazor ◽  
Steven M. Paul ◽  
Bruce A. Cooper ◽  
...  
Keyword(s):  
Latent Class ◽  
Small Sample Size ◽  
Symptom Burden ◽  
Individual Variability ◽  
Small Sample ◽  
Neurologic Complication ◽  
Platinum Compound ◽  
Temperature Group ◽  
Motor Tests ◽  
Activity Groups

157 Background: CIN is the most prevalent neurologic complication of cancer treatment. Inter-individual variability exists in survivors’ reports of the factors that aggravate CIN in their hands. The purpose of this study was to identify groups of survivors with CIN in their hands based on distinct aggravating factors and evaluate for differences in demographic, clinical, symptom characteristics and quality of life (QOL) based on group membership. Methods: Cancer survivors (n = 307) who received a platinum and/or a taxane and rated their altered sensation/pain in their hands at > 3 on 0-10 scale were enrolled and completed study questionnaires, including a list of 22 factors that could make pain worse. Medical records were reviewed and sensory and motor tests were done. Latent class analysis was used to identify groups of survivors based on the occurrence rates for aggravating factors. Differences among the groups were evaluated using parametric and nonparametric statistics. Results: Three groups were identified based on occurrence rates for aggravating factors in the hands (i.e., Activity and Temperature (41.0%), Activity (8.7%), Few Factors (52.2%)). No differences were found among the groups in demographic characteristics, or sensory (light touch, temperature, pain, vibration) and motor (grip strength, pegboard) tests. Compared to the Few Factors group, the Activity and Temperature group had more comorbidities, poorer sleep, greater fatigue, and more anxious and depressive symptoms. Survivors who received a platinum compound were more likely to be in the Activity and Temperature group. Those who received a taxane compound were more likely to be in the Few Factors or Activity groups. Conclusions: Survivors who reported a higher occurrence of aggravating factors had a higher symptom burden and poorer QOL. Most differences were found between the Few Factors group and the Activity and Temperature group which may be due to the small sample size of the Activity group. Objective measures did not differ among the groups. Findings suggest that subgroups of survivors can be identified based on their reports of CIN aggravating factors.

scholarly journals Recovery Trajectories Over Six Weeks in Patients Selected for A High-Intensity Physiotherapy Program After Total Knee Arthroplasty: A Latent Class Analysis

2020 ◽  
Author(s):  
K.E.M. Harmelink ◽  
R. Dandis ◽  
P.J. Wees ◽  
A.V.C.M. Zeegers ◽  
M.W. Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Physical Functioning ◽  
Latent Class ◽  
Class Analysis ◽  
Timed Up And Go ◽  
Surgery Outcome ◽  
Post Surgery ◽  
Multivariable Regression ◽  
The Difference ◽  
One Year

Abstract Background: Recovery trajectories differ between individual patients and it is hypothesizes that they can be used to predict if an individual patient is likely to recover earlier or later. Primary aim of this study was to determine if it is possible to identify recovery trajectories for physical functioning and pain during the first six weeks in patients after TKA. Secondary aim was to explore the association of these trajectories with one-year outcomes. Methods: Prospective cohort study of 218 patients with the following measurement time points: preoperative, and at three days, two weeks, six weeks, and one year post-surgery. Outcome measures were performance-based physical functioning (Timed Up and Go [TUG]), self-reported physical functioning (Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living [KOOS-ADL]), and pain (Visual Analogue Scale [VAS]). Latent Class Analysis was used to distinguish classes based on recovery trajectories over the first six weeks postoperatively. Multivariable regression analyses were used to identify associations between classes and one year outcomes.Results: TUG showed three classes: “gain group” (n=203), “moderate gain group” (n=8) and “slow gain group” (n=7), KOOS showed two classes: “gain group” (n=86) and “moderate gain group” (n=132), and VAS-pain three classes: “no/very little pain” (n=151), “normal decrease of pain” (n=48) and “sustained pain” (n=19). The ”low gain group” scored 3.31 [95% CI 1.52, 5.09] seconds less on the TUG than the “moderate gain group” group, and the KOOS “gain group” scored 11.97 [95% CI 8.62, 15.33] points better than the “moderate gain group” after one year.Patients who had an early trajectory of “sustained pain” had less chance to become free of pain at one year than those who reported “no or little pain” (odds ratio 0.11 [95% CI 0.03,0.42]. Conclusion: The findings of this study indicate that different recovery trajectories can be detected. Especially the difference in TUG and KOOS-ADL between the “gain” and “moderate gain” group was considered clinically relevant, while for VAS scores differences between “no/very little pain,” and “sustained pain” were statistically significant but small.

scholarly journals Socio-economic factors associated with a healthy diet: results from the E3N study

2017 ◽  
Vol 20 (9) ◽  
pp. 1574-1583 ◽  
Author(s):  
Aurélie Affret ◽  
Gianluca Severi ◽  
Courtney Dow ◽  
Grégoire Rey ◽  
Cyrille Delpierre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Dietary Patterns ◽  
Latent Class ◽  
Contextual Factors ◽  
Healthy Diet ◽  
Individual Factors ◽  
Processed Meat ◽  
Economic Factors ◽  
Factors Associated ◽  
Socio Economic Factors

AbstractObjectiveTo identify individual and contextual socio-economic factors associated with a healthy diet.DesignDietary data from a large cohort study were used to derive two mutually exclusive dietary patterns through a latent class analysis. Associations between dietary patterns and socio-economic factors were studied with logistic regression.SettingE3N, a French prospective cohort study composed of women recruited from a national health insurance plan covering people working in the national education system.SubjectsE3N participants (n 73 031) with dietary and socio-economic data available.ResultsThe ‘Healthy’ pattern was characterized by a large consumption of fruits and vegetables and the ‘Less Healthy’ pattern by a large consumption of pizza and processed meat. When all socio-economic factors were analysed together, all of the individual factors considered were associated with a healthy diet (e.g. women with three or more children were less likely to follow a healthy diet v. women with no children, OR (95 % CI): 0·70 (0·66, 0·75)) while the contextual factors associated with a healthy diet included the size of the agglomeration of residence and the area of birth and residence (e.g. women living in the West of France were less likely to follow a healthy diet v. those living in the South of France: 0·78 (0·72, 0·83)).ConclusionsWe demonstrated that individual and contextual factors are both associated with diet. Rather than focusing only on individual factors, we recommend future studies or public health and nutritional strategies on diet to consider both types of factors.

scholarly journals Short- and long-term effects of diving on pulmonary function

2017 ◽  
Vol 26 (143) ◽  
pp. 160097 ◽  
Author(s):  
Kay Tetzlaff ◽  
Paul S. Thomas
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Ambient Pressure ◽  
Small Airways ◽  
Long Term Effects ◽  
Cold Temperatures ◽  
Factors Associated ◽  
Stress Changes ◽  
The Impact

The diving environment provides a challenge to the lung, including exposure to high ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affect pulmonary function acutely and can potentially cause prolonged effects that may accumulate gradually with repeated diving exposure. Evidence from experimental deep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airways disease and accelerated loss of lung function. In addition, there is an accumulating body of evidence that diving with self-contained underwater breathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus, the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.

Factors Associated With Multimorbidity Patterns in Older Adults in England: Findings From the English Longitudinal Study of Aging (ELSA)

2019 ◽  
Vol 32 (9) ◽  
pp. 1120-1132 ◽  
Author(s):  
Hai Nguyen ◽  
Kia-Chong Chua ◽  
Alexandru Dregan ◽  
Silia Vitoratou ◽  
Ivet Bayes-Marin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Latent Class ◽  
Future Research ◽  
Factors Associated ◽  
Lifestyle Risk Factors ◽  
Class B ◽  
Lifestyle Risk ◽  
English Longitudinal Study

Objective: We aimed to identify the patterns of multimorbidity in older adults and explored their association with sociodemographic and lifestyle risk factors. Method: The sample included 9,171 people aged 50+ from Wave 2 of the English Longitudinal Study of Aging (ELSA). Latent Class Analysis (LCA) was performed on 26 chronic diseases to determine clusters of common diseases within individuals and their association with sociodemographic and lifestyle risk factors. Result: Three latent classes were identified: (a) a cardiorespiratory/arthritis/cataracts class, (b) a metabolic class, and (c) a relatively healthy class. People aged 70 to 79 were 9.91 times (95% Confidence Interval [CI] = [5.13, 19.13]) more likely to be assigned to the cardiorespiratory/arthritis/cataracts class, while regular drinkers and physically inactive people were 0.33 times (95% CI = [0.24, 0.47]) less likely to be assigned to this class. Conclusion: Future research should investigate these patterns further to gain more insights into the needs of people with multimorbidity.

Use of a Multitheoretic Model to Understand and Classify Juvenile Computer Hacking Behavior

2020 ◽  
pp. 009385482096975
Author(s):  
Bryanna Fox ◽  
Thomas J. Holt
Keyword(s):  
Risk Factors ◽  
Latent Class ◽  
National Sample ◽  
Treatment Modalities ◽  
Structural Level ◽  
Factors Associated ◽  
Computer Hacking ◽  
Criminological Inquiry ◽  
Insight Into ◽  
Cross National

Criminological inquiry has identified a range of risk factors associated with juvenile delinquency. However, little research has assessed juvenile computer hacking, despite the substantial harm and opportunities for delinquent behavior online. Therefore, understanding the applicability of criminological risk factors among a cross-national sample of juvenile hackers is important from a theoretical and applied standpoint. This study aimed to address this gap using a logistic regression and latent class analysis (LCA) of risk factors associated with self-reported hacking behavior in a sample of more than 60,000 juveniles from around the globe. Results demonstrated support for individual- and structural-level predictors of delinquency, although distinct risk factors for hacking among three subtypes are identified in the LCA. This study examines criminological risk factors for juvenile hacking in a cross-national sample and provides insight into the distinct risk factors of hacking, so more tailored prevention and treatment modalities can be developed.

scholarly journals Factors Associated with the Timed Up and Go Test Score in Elderly Women

2010 ◽  
Vol 22 (3) ◽  
pp. 273-278 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Hunkyung Kim ◽  
Hideyo Yoshida ◽  
Yuko Yoshida ◽  
Kyoko Saito ◽  
...  
Keyword(s):  
Test Score ◽  
Elderly Women ◽  
Timed Up And Go ◽  
Factors Associated

Phosphoramide Mustard (PM) Population Pharmacokinetics to Estimate Inter-Individual Variability in Exposure and Identify Clinical Factors Associated with Variability in Reduced Intensity Conditioning (RIC) Hematopoietic Stem Cell Transplant (HCT) Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2478-2478
Author(s):  
Kinjal Sanghavi ◽  
Anthony C. Wiseman ◽  
Mark Kirstein ◽  
Richard Brundage ◽  
Pamala A. Jacobson
Keyword(s):  
Body Weight ◽  
Conversion Rate ◽  
Individual Variability ◽  
Pharmacokinetic Analysis ◽  
Cell Transplant ◽  
Clinical Factors ◽  
Reduced Intensity Conditioning ◽  
Factors Associated ◽  
Clinical Covariates ◽  
Reduced Intensity

Abstract Reduced intensity conditioning regimend have successfully extended the use of HCT to older individuals and in those with co-morbidities. Cyclophosphamide (CY) is a commonly used alkylating agent in RIC regimens. It is an inactive pro-drug that is hepatically metabolized to the active form, PM. It exerts its cytoreductive action by further non-enzymatic conversions leading to formation of DNA adducts and cellular death. There is wide inter-patient variability in toxicity of CY, which may be due to variability in systemic exposure. The aim of our study was to characterize pharmacokinetics of PM and to identify clinical factors associated with pharmacokinetic variability. Forty-one adults undergoing allogeneic RIC HCT with CY, fludarabine and TBI were prospectively studied for PM pharmacokinetics from March 2013 to May 2014. CY 50mg/kg x one dose was administered intravenously over 2 hr at constant rate on days -6 and pharmacokinetic sampling was conducted at 2, 4, 6, 21, 24 and 45 hrs after the end of infusion. PM was derivatized with diethyldithiocarbamate and measured by a validated HPLC assay with ultraviolet detection. The lower limit of quantification was 50ng/ml. A population pharmacokinetic analysis was conducted using non-linear mixed effects model to obtain typical value of apparent clearance (Cl/fm), apparent volume of distribution (V/fm) of the metabolite and conversion rate constant (kf) of conversion to the metabolite. Clinical covariates such as weight, ideal body weight, age, gender, CrCl, total bilirubin, albumin, previous transplant, SCr, ALT, AST, and alkaline phosphatase were tested to explain the observed variability in kf, Cl/fm and V/fm. A step-wise covariate model building strategy of forward inclusion and backward elimination was used to identify the effect of clinical covariates on PM pharmacokinetics. A first order one-compartment absorption model described PM kinetics. The typical kf from parent CY to PM was 0.189 hr-1, with inter-individual variability of 42%. The typical Cl/fm and V/fm in the central comapartment were 39.1 L/hr and 264 L, respectively. The inter-individual variability in Cl/fm was 22.4% and 33.2% for V/fm. Gender was a significant covariate affecting kf, where females had 59% higher conversion rate than males, thus showing higher metabolite concentrations. Cl/fm and V/fm were allometrically scaled using total body weight. CrCl was also an important covariate affecting Cl/fm where 32% of PM was renally cleared. No other tested covariates were important within the range of our data. Model evaluations performed using visual predictive checks and non-parametric bootstrap determined that the pharmacokinetic model adequately described the observed data. Gender and CrCl significantly affected PM pharmacokinetics. Females had a significantly higher formation of PM than males. PM appears to be approximately 32% renally cleared and is affected by CrCl. These data may ultimately guide dose reduction decisions in patient with organ dysfunction. Disclosures No relevant conflicts of interest to declare.

scholarly journals Symptoms in the general Norwegian adult population - prevalence and associated factors

2020 ◽  
Author(s):  
Hilde Krogstad ◽  
Jon Håvard Loge ◽  
Kjersti Grotmol ◽  
Stein Kaasa ◽  
Cecilie Essholt Kiserud ◽  
...  
Keyword(s):  
Reference Values ◽  
Adult Population ◽  
Population Sample ◽  
Symptom Burden ◽  
Related Factors ◽  
Level Of Education ◽  
Factors Associated ◽  
Sum Score ◽  
Patient Reported ◽  
Patient Health

Abstract Background Patients´ own perceptions and evaluations of symptoms, functioning and other health-related factors, i.e. Patient Reported Outcomes (PROs), are important elements for providing good patient care. Symptoms are subjective and best elicited by the patient orally or by using PRO measures (PROMs). Reference values on frequently used PROMs facilitate the interpretation of PROMs scores both in clinics and research settings, by comparing patient data with relevant samples from the general population. Objectives Study objectives were to (1) present reference values for the M.D. Anderson Symptom inventory (MDASI) (2) examine the occurrence and intensity of symptoms assessed by the MDASI in a general Norwegian adult population sample, and (3) examine factors associated with higher symptom burden defined as the sum score of all symptoms, and factors associated with symptoms` interference on functions Methods In 2015, MDASI was sent by mail to a representative sample of the general Norwegian adult population (N = 6165). Medical comorbidities were assessed by the Self-Administered Comorbidity Questionnaire. Depression was self-reported on the Patient Health Questionnaire 9 (PHQ-9). Linear multivariable regression analysis was used to examine for factors associated with MDASI sum score and factors associated with symptoms’ interference on functions. Results The response rate was 36%. More females (54%) than males (46%) responded. Mean age was 55 years (SD 14). The most frequent symptoms were fatigue (59.7%), drowsiness (56.2%) and pain (56.1%). Fatigue, pain and disturbed sleep had the highest mean scores. The presence of one or more comorbidities, increasing PHQ-9 score and lower level of education were associated with higher MDASI sum score (p<0.001). The MDASI sum score and the PHQ-9 score were positively associated with all interference items (p<0.001) except for walking (p=0.22). Conclusion This study provides the first Norwegian reference values for the MDASI. The presence of one or more comorbidities, higher level of depressive symptoms and lower level of education were significantly associated with higher MDASI sum score. These covariates must be controlled for when using the reference values.

scholarly journals Symptom Burden and Factors Associated with Acute Respiratory Infections in the First Two Years of Life—Results from the LoewenKIDS Cohort

2022 ◽  
Vol 10 (1) ◽  
pp. 111
Author(s):  
Susan Langer ◽  
Johannes Horn ◽  
Cornelia Gottschick ◽  
Bianca Klee ◽  
Oliver Purschke ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Respiratory Infections ◽  
Average Duration ◽  
Symptom Burden ◽  
Birth Cohort Study ◽  
Acute Respiratory Infections ◽  
Factors Associated ◽  
Childhood Illnesses ◽  
Specific Symptoms ◽  
Insight Into

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10–17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7–14). The median age for the first ARI episode was 91 days (IQR: 57–128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

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