Epidemiology and risk factors for varicose veins among older people: cross-sectional population study in the UK

2010 ◽  
Vol 25 (5) ◽  
pp. 236-240 ◽  
Author(s):  
A Clark ◽  
I Harvey ◽  
F G R Fowkes

Background There are many hypotheses concerning risk factors for the development of varicose veins based mostly on pathophysiological plausibility. Population studies have been carried out mostly on the middle aged with relatively few on elderly populations. Objectives To investigate epidemiological risk factors for varicose veins in an elderly population in the UK. Methods The South Wales Skin Cancer study – an examination survey undertaken between 1988 and 1991 of a random sample ( n = 792) drawn from all patients aged 60 and over registered with a general practitioner in South Glamorgan. Exposure variables were obtained from a structured administered questionnaire combined with clinical examination. Unadjusted and adjusted odds ratios were estimated using logistic regression. Results The response rate was 71% with an average age of 71 years (range 60–97). The age-adjusted prevalence of trunk varices was 63.2% (95% confidence interval [CI] 57.9–68.4%) in men and 57.0% (95% CI 50.6–63.4%) in women. In a multiple logistic regression the significant risk factors for varicose veins were increasing age ( P value = 0.001), obesity (odds ratio [OR] 3.28, 95% CI 1.25–8.63, P = 0.042), self-reported history of deep vein thrombosis (DVT) (OR 3.19, 1.16–8.78, P = 0.024) and history of hypertension (OR 0.58, 0.38–0.89, P = 0.013). The results for gender suggested that women were at greater risk than men, but this was not statistically significant (OR 1.53, 0.99–2.38, P = 0.056). Conclusion Trunk varices occur very commonly in older age groups with increasing age, obesity and possibly female sex as risk factors. Associations found with DVT and hypertension were based on history alone and must be interpreted with caution.

2021 ◽  
pp. 1-8
Author(s):  
Michael Beraki Mengistu ◽  
◽  
Yonatan Mehari Andemeske ◽  
AriamTsegay Emhatsion ◽  
HabtomTareke Wrieta ◽  
...  

Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD


2020 ◽  
Author(s):  
Endale Alemayehu Ali ◽  
Tsigereda Tilahun ◽  
Eshetu Mebrate

Abstract Introductions: Cholera is a diarrheal disease caused by infection of the intestine with the gram-negative bacteria Vibrio cholera. According to updated global burden of cholera estimate 2019 in Ethiopia 68,805,272 populations are at risk of cholera with incidence rate of 4 per 1000 population and case fatality of 3.8% estimated annual number of cases 275,221.Methods: The main objective of this study is to identify the significant risk factors of dehydration status of cholera outbreak in Oromia regional state of Ethiopia. Ordinal logistic regression was used to model the data by incorporating the assumption behind this novel model. Results: The results of the study indicated that of the total 965 cholera patients, most of them 560(58%) were severely dehydrated by cholera. The overall goodness of model (p-valu=0.07) shows that the model fits the data well. Besides, the proportional odds assumption also revealed that the slop coefficients in the model are the same across dehydration status (p-value=0.094). For those have history of travel, the odds of severely dehydrated versus the combined some dehydrated and no dehydrated was exp(1.133804)=3.11 times higher than those have no history of travel (p-value<0.01). All the other factors like history of contact with other patients, other sick patients in the family, Intravenous and Antibiotics drugs are statistically significant with 5% level of significance to determine the status of dehydration. Conclusions: The ordinal logistic regression was fitted the data well and most of the included factors were significant for the dehydration status of cholera outbreak.


2019 ◽  
Author(s):  
Masoud Mirzaei ◽  
Mohsen Mirzaei ◽  
Somayeh Gholami ◽  
Hossein Abolhosseini

Abstract Background: Hypertension, the most important risk factor for cardiovascular disease, is a public health concern in world. Its prevalence varies between countries, due to differences in lifestyle and other risk factors' profile across the regions. The aim of this study was to investigate the prevalence of hypertension and its related risk factors among adults in Yazd Greater Area. Methods: This cross-sectional study is a community-based study of 20-69 year-old adults living in Yazd. The participants were selected by multi-stage random cluster sampling. A valid questionnaire completed in a home visit. Blood pressure (BP), Body Mass Index and Waist Circumference were measured by standard protocol. Self-reported hypertension was recorded. levels of Physical Activity (PA) were categorized by IPAQ-SF. Chi-square test was used for categorical variables to analyze the differences. Multivariate logistic regression was carried out to determine the association of risk factors to hypertension. All statistical analyses were performed using SPSS 16 software. A p-value less than 0.05 were considered statistically significant. Results: With 95% responding(n=9975), half of adults have a low PA and two thirds were overweight or obese. Positive history of hypertension was 18.5% (21.9% in females vs. 15.2% in males). The mean systolic and diastolic BP were 126.5 ± 18.4 mmHg and 80.2 ± 12.5 mmHg, respectively. Prevalence of hypertension was 36% (34.7% for women and 37.3% for men). The prevalence of hypertension is reduced with higher education, more PA, lower BMI and no history of diabetes (P value < 0.0001). Higher BP is less common in smokers (P value < 0.0001). By logistic regression analysis, hypertension were higher among men (OR: 1.83, 95% CI: 1.64-2.03), eldest (OR: 5.15, 95% CI: 4.20-6.31), low-educated (OR: 1.40, 95% CI: 1.17-1.67) and diabetics (OR: 1.20, 95% CI: 1.05-1.38).Hypertension was doubled in obese. There was no significant relationship between PA level, place of residence, smoking and hypercholesterolemia with high BP. Conclusion: Prevalence of hypertension in adults was high. By identifying common modifiable risk factors, health policy makers should prioritize health interventions to control risk factors. It is necessary to inform younger adult groups about ways to select healthy lifestyle and nutritional habits.


2020 ◽  
Author(s):  
Endale Alemayehu Ali ◽  
Tsigereda Tilahun ◽  
Eshetu Mebrate

Abstract Introductions: Cholera is a diarrheal disease caused by infection of the intestine with the gram-negative bacteria Vibrio cholera. According to updated global burden of cholera estimate 2018 in Ethiopia 68,805,272 populations are at risk of cholera with incidence rate of 4 per 1000 population and case fatality of 3.8% estimated annual number of cases 275,221.Methods: The main objective of this study is to identify the significant risk factors of dehydration status of cholera outbreak in Oromia regional state of Ethiopia. Ordinal logistic regression was used to model the data by incorporating the assumption behind this novel model. Results: The results of the study indicated that of the total 965 cholera patients, most of them 560(58%) were severely dehydrated by cholera. The overall goodness of model (p-valu=0.07) shows that the model fits the data well. Besides, the proportional odds assumption also revealed that the slop coefficients in the model are the same across dehydration status (p-value=0.094). For those have history of travel, the odds of severely dehydrated versus the combined some dehydrated and no dehydrated was exp(1.133804)=3.11 times higher than those have no history of travel (p-value<0.01). All the other factors like history of contact with other patients, other sick patients in the family, Intravenous and Antibiotics drugs are statistically significant with 5% level of significance to determine the status of dehydration. Conclusions: The ordinal logistic regression was fitted the data well and most of the included factors were significant for the dehydration status of cholera outbreak.


2020 ◽  
Vol 7 (11) ◽  
pp. 1626
Author(s):  
Ivany Lestari Goutama ◽  
Hendsun . ◽  
Yohanes Firmansyah ◽  
Ernawati Su

Background: Cardiovascular relative risk (CVRISK) is the latest cardiovascular relative risk score to evaluate the magnitude of cardiovascular risk in healthy people regardless of age and cardiovascular risk severity. The aim of the study is to determine the correlation between each independent variables of CVRISK score in individuals with and without history of cardiovascular diseases (CVD).Methods: The study design is cross-sectional study. We conducted it online through social media using Google forms from June to August 2020. Participants include all productive age groups from 16 to 60 years. The data were processed using excel and statistically tested. Descriptive data analysis uses tabulated data which is displayed in numbers or proportions (categorical) and single data distribution (numeric). Statistical association analysis uses the categorical-correlation test with 2 statistical tests that use eta on nominal-ordinal variables and contingency coefficients on nominal-nominal variables.Results: There is a strong autocorrelation between hypertension and high tryglyceride levels (p value 0.001; correlation 0.549; risks 30.14%), nutritional status and low-density lipoprotein cholesterol (LDL-C) levels in CVD group (p value 0.002; correlation 0.774; risks 59.90%) and non-CVD group (p value 0.000; correlation 0.757; risks 57.3%). Hypertension and risky LDL-C levels firmly proves a very strong correlations and significant relationship in CVD groups (p value 0.014; correlation 0.947; risks 89.68%).Conclusions: There is a correlation that varies from weak to very strong among the independent variables in the CVRISK scoring of the participants. Further research is needed to determine the potentiality of CVRISK as an early prevention in determining the cardiovascular risk of individuals with and without history of CVD.


2016 ◽  
Vol 56 (2) ◽  
pp. 101
Author(s):  
Sherly Yuniarchan ◽  
Risky Vitria Prasetyo ◽  
Ninik Asmaningsih Soemyarso ◽  
Mohammad Sjaifullah Noer

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.


2016 ◽  
Vol 78 (11-3) ◽  
Author(s):  
Noor Khairiah A. Karim ◽  
Rohayu Hami ◽  
Nur Hashamimi Hashim ◽  
Nizuwan Azman ◽  
Ibrahim Lutfi Shuaib

The risk factors of breast cancer among women, such as genetic, family history and lifestyle factors, can be divided into high-, intermediate- and average-risk. Determining these risk factors may actually help in preventing breast cancer occurrence. Besides that, screening of breast cancer which include mammography, can be done in promoting early breast cancer detection. Breast magnetic resonance imaging (MRI) has been recommended as a supplemental screening tool in high risk women. The aim of this study was to identify the significant risk factor of breast cancer among women and also to determine the usefulness of breast MRI as an addition to mammography in detection of breast cancer in high risk women. This retrospective cohort study design was conducted using patients’ data taken from those who underwent mammography for screening or diagnostic purposes in Advanced Medical and Dental Institute, Universiti Sains Malaysia, from 2007 until 2015. Data from 289 subjects were successfully retrieved and analysed based on their risk factors of breast cancer. Meanwhile, data from 120 subjects who had high risks and underwent both mammography and breast MRI were further analysed. There were two significant risk factors of breast cancer seen among the study population: family history of breast cancer (p-value=0.012) and previous history of breast or ovarian cancer (p-value <0.001). Breast MRI demonstrated high sensitivity (90%) while mammography demonstrated high specificity (80%) in detection of breast cancer in all 120 subjects. The number of cases of breast cancer detection using breast MRI [46 (38.3%)] was higher compared to mammography [24 (20.0%)]. However, breast MRI was found to be non-significant as an adjunct tool to mammography in detecting breast cancer in high risk women (p-value=0.189). A comprehensive screening guideline and surveillance of women at high risk is indeed useful and should be implemented to increase cancer detection rate at early stage


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 630-630
Author(s):  
Camilla Ryge ◽  
Michael Rud Lassen ◽  
Soeren Solgaard ◽  
Stig Sonne-Holm

Abstract Purpose: To describe the rate and time of onset of serious thromboembolic (TE) complications within the first 90 postoperative days in an unselected population of THR patients. Secondary to analyse the data base for possible risk factors of TE. Material and method: Five hundred (430 primary THR and 70 revision THR) consecutive patients undergoing THR in Frederiksborg County, Denmark from January 2004 until May 2005 participated. The patients were interviewed the day before surgery for medical history. On the 5th postoperative day and at a telephone interview 90 days postoperatively patients were asked about signs and symptoms of acute myocardial infarction (AMI), pulmonary embolism (PE), deep vein thrombosis (DVT), transitory cerebral ischemia (TCI)/stroke, retinal vein thrombosis (RVT) and other cardio vascular events. All events were validated in hospital and/or the general practitioners files, using international criteria. All patients except 1 had chemical thromboprophylaxis during hospitalization. No patients had extended thromboprophylaxis after discharge. 498 patients had 90 days follow-up. Two patients withdrew their consent. Results: 24 patients (4.8%) experienced at least one serious TE complication during the first 90 days after the operation. Two (0.4%) patients died in relation to the operation (no autopsy was performed). Five patients (1.0%) had PE. One patient (0.2%) had AMI, 10 (2.0%) had DVT, two (0.4%) had RVT and four (0.8%) had TCI. Two patients experienced two events - one had AMI and later on a TCI, another had PE and TCI on the same day. Nine patients had their first event during the first five postoperative days - 15 patients had their first event after the 5th postoperative day. The only significant risk factor found in a backward logistic regression analysis including interaction (test for confounder/bias) was the length of the operation P=0.003 OR= 1.016 (1.005–1.026). This study has not been able to show any significant correlation between age, gender, co-morbidities, preoperative hemoglobin value ore platelet count, high ASA-score, kind of anesthesia, indication for operation or use of cement or interactions between the above in the logistic regression analysis, but individually all these factors were significant risk factors in the introductory bivariate analysis. Discussion: This study shows that venous and arterial thrombotic complications persist to be a major contribution to postoperative morbidity and mortality after elective total hip replacement, despite of rigorous early mobilization and optimized regimens of prevention of thromboembolism. After this study has been performed ACCP has recommended extend prophylaxis by LMWH, pentasaccharide or warfarin up to 4–5 weeks after total hip replacement. Further research to identify patients at risk is warranted to optimize risk/benefit of total hip replacement and prevention of venous and arterial thromboembolism. The majority of events occurred after discharge calling for improvement of the post-discharge period to reduce the risk of serious thromboembolism.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2487-2487 ◽  
Author(s):  
Francoise Bernaudin ◽  
Suzanne Verlhac ◽  
Annie Kamdem ◽  
Cécile Arnaud ◽  
Lena Coïc ◽  
...  

Abstract Background Silent infarcts are associated with impaired cognitive functioning and have been shown to be predictors of stroke (Miller ST J Pediatr 2001). Until now, reported risk factors for silent infarcts were low pain event rate, history of seizures, high leukocyte count and Sen bS haplotype (Kinney TR Pediatrics 1999). Here, we seek to define the prevalence and risk factors of silent infarcts in the Créteil SCA pediatric cohort comprising patients assessed at least yearly by transcranial doppler (TCD) since 1992, and by MRI/MRA. Methods This study retrospectively analyzed data from the Créteil cohort stroke-free SS/Sb0 children (280; 134 F, 146 M), according to institutional review board. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities (&lt; 170 cm/sec) and normal MRA on TP, although TP was re-initiated in case of abnormal velocities recurrence. Patients with “conditional” velocities (170–199 cm/sec) were assessed by TCD 4 times yearly. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF, LDH levels; MCV; SpO2) were obtained a minimum of 3 months away from a transfusion, one month from a painful episode, after 12 months of age, before the first TCD, and always before therapy intensification. Results. Patients were followed for a total of 2139 patient-years. Alpha-Thal was present in 114/254 patients (45%) and 27/241 (11.2%) had G6PD deficiency. Beta genotype, available in 240 patients, was BaBa in 102 (42.5%), BeBe in 54 (22.5%), SeSe in 19 (7.9%) and “other” in 65 (27.1%); TCD was abnormal in 52 of 280 patients (18.6%). MRA showed stenoses in 30 of 226 evaluated patients (13.3%) while MRI demonstrated presence of silent infarcts in 81/280 patients (28.9%). Abnormal TCD (p&lt;0.001), G6PD deficiency (p=0.008), high LDH (p=0.03), and low Hb (p=0.026) were significant risk factors for stenoses by univariate analysis while multivariate analysis retained only abnormal TCD as a significant risk factor for stenoses ([OR= 10.6, 95% CI (4.6–24.4)]; p&lt;0.001). Univariate logistic regression analysis showed that the risk of silent infarcts was not related to alpha-Thal, beta genotype, abnormal TCD, WBC, PMN, platelets, reticulocyte counts, MCV, LDH level, HbF %, pain or ACS rates but was significantly associated with stenoses detected by MRA (p&lt;0.001), gender (male; p=0.04), G6PD deficiency (p=0.05), low Hb (p=0.016) and Hct (p=0.012). Multivariate logistic regression analysis showed that gender ([OR= 2.1, 95% CI (1.03–4.27)]; p=0.042), low Hb ([OR= 1.4, 95% CI (1.0–1.1)]; p=0.05) and stenoses ([OR= 4.8, 95% CI (1.88–12.28)]; p=0.001) were all significant independent risk factors for silent infarcts. The presence of stenoses was the only significant risk factor for silent infarcts in patients with a history of abnormal TCD ([OR= 5.9, 95% CI (1.6–21.7)]; p=0.008). Conclusion We recently showed that G6PD deficiency, absence of alpha-Thal, and hemolysis are independent significant risk factors for abnormal TCD in stroke-free SCA patients (Bernaudin et al, Blood, 2008, in press). Here, we report that an abnormal TCD is the most significant risk factor for stenoses and, expanding previous studies, we demonstrate that stenoses, low Hb and gender are significant independent risk factors for silent infarcts.


2020 ◽  
Vol 10 (2) ◽  
pp. 89-99
Author(s):  
Chahya Kharin Herbawani ◽  
Dadan Erwandi

Abstract Background: HIV/AIDS reports show an increasing number of AIDS cases and the cumulative number of AIDS among housewives at first rank. Objective: to determine factors related to HIV/AIDS prevention efforts for housewives in the Bagor Health Center area. Method: Quantitative research with cross-sectional design. Independent variable; age; education; family income; age at first sexual intercourse; knowledge of HIV/AIDS; risk perception; husband's work; history of VCT; access to condoms and information about HIV/AIDS. The dependent variable is HIV/AIDS prevention efforts. Total respondent were 150 housewives, data collection using a questionnaire that was adopted/modified from the Integrated Biological and Behavioral Surveillance questionnaire (STBP) 2011. Multivariate data analysis with multiple logistic regression Results: Factors related to HIV/AIDS prevention efforts in housewives were a history of VCT (p=0.028) and exposure to information about HIV/AIDS (p=0.014). History of VCT is the most influencing factor in HIV/AIDS prevention efforts in housewives (p value=0.040; OR=3.79 95% CI=1.06-13.537). Housewives who have done VCT are 3.79 times more likely to make HIV/AIDS prevention efforts than those who did not. Conclusion: Providing education and VCT testing can provide better HIV prevention behavior for housewives. Historical factors of VCT and information exposure play a role in HIV prevention behavior in housewives Key words: HIV/AIDS, reproductive health, VCT Abstrak Latar belakang: Laporan HIV/AIDS menunjukkan peningkatan jumlah kasus AIDS dan jumlah kumulatif AIDS pada ibu rumah tangga yang menempati urutan pertama Tujuan: mengetahui faktor-faktor yang berhubungan dengan upaya pencegahan HIV/AIDS pada ibu rumah tangga di wilayah Puskesmas Bagor. Metode: Penelitian kuantitatif dengan desain cross-sectional. Variabel independen; umur; pendidikan; penghasilan keluarga; umur pertama kali berhubungan seksual; pengetahuan HIV/AIDS; persepsi berisiko; pekerjaan suami; riwayat VCT; akses terhadap kondom dan keterpaparan informasi tentang HIV/AIDS. Variabel dependen adalah upaya pencegahan HIV/AIDS. Responden berjumlah 150 ibu rumah tangga, Pengumpulan data menggunakan kuesioner yang diadopsi/dimodifikasi dari kuesioner Surveilans Terpadu Biologis dan Perilaku (STBP) Tahun 2011. Analisis data multivariate dengan multiple logistic regression Hasil: Faktor yang berhubungan dengan upaya pencegahan HIV/AIDS pada ibu rumah tangga adalah riwayat VCT (p=0,028) dan keterpaparan informasi tentang HIV/AIDS (p=0,014). Riwayat VCT merupakan faktor paling mempengaruhi upaya pencegahan HIV/AIDS pada ibu rumah tangga (p value=0,040; OR=3,79 95% CI=1,06-13,537). Ibu rumah tangga yang telah melakukan VCT 3,79 kali lebih cenderung untuk melakukan upaya pencegahan HIV/AIDS baik dibandingkan yang tidak melakukan VCT. Kesimpulan: Pemberian edukasi dan pemeriksaan VCT dapat memberikan perilaku pencegahan HIV yang lebih baik pada ibu rumah tangga. Faktor riwayat VCT dan keterpaparan informasi berperan dalam perilaku pencegahan HIV pada ibu rumah tangga.   Kata kunci: HIV/AIDS, kesehatan reproduksi, VCT


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