scholarly journals Post phototherapy bilirubin rebound: incidence and risk factors

2017 ◽  
Vol 5 (9) ◽  
pp. 4112
Author(s):  
Richa Soni ◽  
Shayam L. Kaushik ◽  
Rajni Kaushik ◽  
Parveen Bhardwaj ◽  
S. Mohabey
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
American Academy ◽  
G6pd Deficiency ◽  
Significant Risk ◽  
Factors Associated ◽  
American Academy Of Pediatrics ◽  
Rh Incompatibility ◽  
Associated Risk Factors

Background: Rebound hyperbilirubinemia may occur after cessation of phototherapy in new-borns in certain high-risk situations. However, data regarding the phenomenon of bilirubin rebound is lacking from India. Aim was to study the incidence and associated risk factors of post phototherapy rebound hyperbilirubinemia.Methods: The study subjects included all neonates (gestation >34 weeks) admitted to newborn unit who required phototherapy for hyperbilirubinemia. Unit protocol based on American academy of pediatrics (AAP) guidelines were used to start and stop phototherapy. Rebound bilirubin was measured 24±6 hours after stopping phototherapy. Significant bilirubin rebound (SBR) was defined as post phototherapy bilirubin level needing reinstitution of phototherapy. The risk factors associated with significant rebound were studied.Results: Out of total 509 neonates who received phototherapy due to hyperbilirubinemia, 63 (12%) had significant bilirubin rebound requiring reinstitution of phototherapy. There was significant risk for rebound in neonates who had prematurity (p <0.01), ABO (<0.001) and Rh incompatibility (p<0.005) with mother, G6PD deficiency (p < 0.001) and onset of hyperbilirubinemia less than 72 hours of postnatal age (p< 0.001). However, neonates with extravasations of blood, polycythaemia, sepsis, other causes of haemolysis and idiopathic group did not have significant risk of developing rebound.Conclusions: Post phototherapy bilirubin estimation and follow up should be ensured in high-risk neonates.

scholarly journals RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

2006 ◽  
Vol 13 (04) ◽  
pp. 687-690
Author(s):  
MUNIR AKMAL LODHI ◽  
GHULAM SHABBIR ◽  
NASIR ALI SHAH
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Birth Asphyxia ◽  
Neonatal Hypoglycemia ◽  
Factors Associated ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors ◽  
Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

Abstract P023: Risk Factors Associated with Progression of Subclinical Diastolic Dysfunction in a Multiethnic Population

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lili Zhang ◽  
Jian Shan ◽  
Cynthia Taub
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Diastolic Dysfunction ◽  
Significant Risk ◽  
Left Ventricular ◽  
Cumulative Probability ◽  
Factors Associated ◽  
Hispanic Patients ◽  
Multiethnic Population

Background: Subclinical diastolic dysfunction is defined as echocardiographic evidence of left ventricular diastolic dysfunction and normal ejection fraction (EF) without congestive heart failure (HF) symptoms/diagnosis. Our study, for the first time, sought to examine risk factors associated with progression from subclinical diastolic dysfunction to overt HF in a large multiethnic population. Methods: The study population included patients with asymptomatic diastolic dysfunction and EF ≥ 50% assessed by transthoracic echocardiogram between 2003 and 2008 at Montefiore Medical Center, Bronx, NY. Patients with preexisting HF, valvular heart disease or atrial fibrillation prior were excluded. The end point was the development of HF by September 1, 2013. Multivariable adjusted Cox proportional hazards models, determined by stepwise selection method, were performed to examine risk factors associated with the development of HF. All analyses were also performed with adjustment and stratification of race. Results: A total of 7,879 patients, with 21% European Americans (EA), 36% African Americans (AA), 31% Hispanics, and 12% others or unknown, were included in the analysis. Mean follow up time was 6.3 years. Mean age of the cohort was 68±12, with 63% women. The overall cumulative probability of development of HF was 17% (19% in EA, 17% in AA, 19% in Hispanic patients) during the follow up period. In multivariable Cox proportional hazard regression analysis, renal disease (hazard ratio (HR)=1.6, 95% confidence interval (CI) 1.3-2.0, P<0.001) and hemoglobin levels (HR=0.9, 95% CI 0.9-1.0, P=0.001) were significantly associated with the development of HF in overall population. In stratification analysis, age (P=0.012) and hypertension (P=0.007) were independent risk factors for HF in Hispanic patients, but not in EA and AA. Conclusions: In a large multiethnic population with subclinical diastolic dysfunction, renal disease and hemoglobin levels were independently associated with development of HF in overall population.. Age and hypertension were significant risk factors for HF only in Hispanic patients. These results may have important implications in preventing the development of HF from subclinical stage.

scholarly journals Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Kyung-Hee Kim ◽  
Min-Hee Kim ◽  
Ye-Jee Lim ◽  
Ihn Suk Lee ◽  
Ja-Seong Bae ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Significant Risk ◽  
Disease Status ◽  
Radioactive Iodine Therapy ◽  
Papillary Thyroid ◽  
Independent Risk Factors

Background. The measurement of stimulated thyroglobulin (sTg) after total thyroidectomy and remnant radioactive iodine (RAI) ablation is the gold standard for monitoring disease status in patients with papillary thyroid carcinomas (PTCs). The aim of this study was to determine whether sTg measurement during follow-up can be avoided in intermediate- and high-risk PTC patients.Methods. A total of 346 patients with PTCs with an intermediate or high risk of recurrence were analysed. All of the patients underwent total thyroidectomy as well as remnant RAI ablation and sTg measurements. Preoperative and postoperative parameters were included in the analysis.Results. Among the preoperative parameters, age below 45 years and preoperative Tg above 19.4 ng/mL were significant risk factors for predicting detectable sTg during follow-up. Among the postoperative parameters, thyroid capsular invasion, lymph node metastasis, and ablative Tg above 2.9 ng/mL were independently correlated with a detectable sTg range. The combination of ablative Tg less than 2.9 ng/mL with pre- and postoperative independent risk factors for detectable sTg increased the negative predictive value for detectable sTg up to 98.5%.Conclusions. Based on pre- and postoperative parameters, a substantial proportion of patients with PTCs in the intermediate- and high-risk classes could avoid aggressive follow-up measures.

scholarly journals Audiological screening of high risk infants and prevalence of risk factors

2017 ◽  
Vol 4 (2) ◽  
pp. 507
Author(s):  
Regina M. ◽  
Sanu P. Moideen ◽  
Mohan M. ◽  
Mohammed M.T.P. ◽  
Khizer Hussain Afroze M.
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
High Risk ◽  
Low Birth Weight ◽  
Hearing Impairment ◽  
Significant Risk ◽  
Research Centre ◽  
Auditory Brain Stem Response ◽  
Factors Associated ◽  
High Risk Infants

Background: Hearing loss in early life can have deleterious effects on child’s psychosocial, scholastic and social-emotional development. Early identification and timely intervention can provide the child with better speech and language development. This study has been done to estimate the prevalence of hearing impairment among high risk infants as per Joint Committee on Infant Hearing (JCIH) criteria and to study the risk factors associated with neonatal hearing impairment.Methods: This multicentric observational study was conducted among 613 high risk infants admitted and discharged from neonatal intensive care units (NICU) of Academy of Medical Sciences, Kannur, Kerala and Sri Siddhartha Medical College and Research Centre, Tumakuru, Karnataka, India (level III neonatology units with an NICU admissions of average around 1200 per year), during the period August 2015 - August 2016 (12 months). The babies were selected based on the JCIH 2007 criteria. All babies were subjected to behavioral audiometry (BA) and Oto Acoustic Emissions (OAE), preferably within 3 weeks. Those failing OAE were reevaluated at 6th week and with Auditory brain stem response (ABR) within 3 months time. Results: A total of 613 high risk babies were screened. 42 (6.76%) among them were having hearing impairment. The most common risk factors associated with hearing impairment was NICU stay for more than 24 hours, prematurity, low birth weight and meningitis/sepsis etc.Conclusions: Hearing impairment among high risk babies is not a rare condition. In our study, the prevalence was 6.76%. Low birth weight, admission to NICU for more than 24 hours, low APGAR, meningitis/sepsis, maternal and neonatal complications are significant risk factors for hearing impairment among neonates. This highlights the need for neonatal screening. Though we recommend a universal screening program, at least a targeted approach should be practiced in neonatal care. Those babies who are found to have hearing impairment should be closely followed up with early intervention and rehabilitation.  

scholarly journals Periodontitis Prevalence, Severity and Risk Factors: A Comparison of the AAP/CDC Case Definition and the EFP/AAP Classification

2021 ◽  
Vol 18 (7) ◽  
pp. 3459
Author(s):  
Meliha Germen ◽  
Ulku Baser ◽  
Cagdas Caglar Lacin ◽  
Erhan Fıratlı ◽  
Halim İşsever ◽  
...  
Keyword(s):  
Risk Factors ◽  
American Academy ◽  
Smoking Status ◽  
Significant Risk ◽  
Case Definition ◽  
European Federation ◽  
Case Definitions ◽  
Pocket Depth ◽  
Standard Case ◽  
Associated Risk Factors

Background: This cross-sectional study evaluated the utility of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) classifications of epidemiological studies in terms of periodontitis severity, prevalence and associated risk factors and the 2012 American Academy of Periodontology/Centers for Disease Control and Prevention (AAP/CDC) case definitions. Methods: We included 488 participants aged 35–74 years. Measurements were recorded at six sites per tooth by two qualified examiners. The evaluated parameters included pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP). Periodontitis prevalence and severity were reported using the 2018 EFP/AAP classification and the AAP/CDC case definitions. The data were stratified by recognized risk factors (age, diabetes and smoking status). Results: The 2018 EFP/AAP classification indicated that all patients suffered from periodontitis. When CAL served as the main criterion, the frequency of patients with severe (Stages III–IV) periodontitis was 54%. When the AAP/CDC case definitions were applied, the prevalence of periodontitis was 61.9% and that of severe periodontitis 16.8%. Age was the most significant risk factor, regardless of the chosen case definition. Conclusion: It is essential to employ a globalized standard case definition when monitoring periodontitis and associated risk factors.

scholarly journals PSV-1 A prospective longitudinal study of the incidence and risk factors associated with footrot in feedlot lambs in Southern Alberta

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 227-227
Author(s):  
Karen S Schwartzkopf-Genswein ◽  
Wiolene M Nordi ◽  
Désirée Gellatly ◽  
Daniela M Meléndez ◽  
Timothy D Schwinghamer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Prospective Longitudinal Study ◽  
Factors Associated ◽  
Southern Alberta ◽  
Unit Increase ◽  
Feedlot Lambs ◽  
Potential Strategy ◽  
Associated Risk Factors ◽  
Prospective Longitudinal

Abstract Lameness in sheep caused by footrot (FR) is a significant health, welfare, and economic concern worldwide. To date, no studies have documented the incidence of FR or associated risk factors in feedlot lambs in Alberta. The objectives of this study were to determine 1) FR incidence and 2) animal, managerial and environmental risk factors associated with FR in one Southern Alberta, lamb feedlot. Assessments were conducted biweekly (average of 10 pens per visit) by 2 experienced observers. A total of 73,150 lambs were assessed between October 2017 and March 2019. All lame lambs were scored according to a 3-point mobility scale (1 = mild, 2 = moderate, and 3 = severe lameness) and physically examined to diagnose the cause of lameness. Risk factors associated with FR were documented and included gender, days on feed (DOF), diet composition, and season. Multivariable regression models (SAS PROC GLIMMIX) were used to determine significant risk factors. A total of 473 lambs were identified as lame, 107 of which were diagnosed with FR (incidence of 22.6%). Footrot affected lambs had greater mobility scores (≥ 2; P &lt; 0.0001) than all other lame diagnoses. Footrot was 4.40 and 0.10 times more likely (P &lt; 0.0001) in female and wether than ram lambs, and 0.60 and 0.23 times more likely (P &lt; 0.0001) in fall and summer than winter and spring seasons. The odds of being diagnosed with FR increased for each additional DOF and each unit increase of barley in the diet (P = 0.0268), while the odds decreased (P = 0.0016) for each additional unit of supplement in the diet. Based on our findings, footrot is an issue to lambs in Alberta, and further studies are still necessary to understand the risk factors associated with potential strategy for mitigating FR in feedlot lambs.

scholarly journals Risk factors and the occurrence of cerebral palsy in high risk infants

2018 ◽  
Vol 58 (2) ◽  
pp. 95-100
Author(s):  
Setyo Handryastuti ◽  
Sofyan Ismael ◽  
Sudigdo Sastroasmoro ◽  
Asril Aminulah ◽  
Ferial Hadipoetro Idris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
High Risk ◽  
Survival Rates ◽  
Significant Risk ◽  
Hypoxic Ischemic Encephalopathy ◽  
First Year ◽  
Factors Associated ◽  
Cerebral Ultrasound ◽  
Ischemic Encephalopathy

Background The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

Hypercholesterolemia in Adolescents: Effectiveness of Screening Strategies Based on Selected Risk Factors

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 269-275
Author(s):  
Nancy J. Steiner ◽  
Lawrence S. Neinstein ◽  
Julia Pennbridge
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
American Academy ◽  
Cholesterol Level ◽  
Health Assessment ◽  
Screening Strategy ◽  
American Academy Of Pediatrics ◽  
Normal Cholesterol Level ◽  
Elevated Cholesterol ◽  
Study Population

This study evaluates the efficacy of the American Academy of Pediatrics' current recommendations for identifying hypercholesterolemia in teenagers. These guidelines advocate a screening strategy that is targeted only at high-risk individuals. Detailed information regarding risk factors for hypercholesterolemia was obtained from 1001 adolescents or their parents at three urban teen clinics during routine health assessments. In addition, serum cholesterol was measured in all adolescents. The population under study was 38.2% Hispanic, 33.5% white, 15.4% black, and 11.3% Asian, with a mean age of 15.6 years (range: 12 through 21 years); 52% were female. Based on the cholesterol values, the study population was divided into two groups: (1) normal cholesterol level, &lt;200 mg/dL (n = 937, mean cholesterol value = 157 mg/dL) and (2) elevated cholesterol level, ≥200 mg/dL (n = 64, mean cholesterol value = 228 mg/dL, range = 200 through 366 mg/dL). Application of the 1985 American Academy of Pediatrics criteria for selected screening identified 30 of 64 individuals with hypercholesterolemia (sensitivity = 47%). Criteria similar to 1988 recommendations identified 40 of 64 teenagers (sensitivity = 62%). A combination of 1985 and 1988 criteria yielded a sensitivity of 44 of 64, or 69%. The specificity of these criteria was 74%, 60%, and 53%, respectively. Despite the utilization of the 1985, 1988, or a combination of both American Academy of Pediatrics criteria for hypercholesterolemia screening, this study demonstrates that many adolescents with abnormal cholesterol levels would not be identified. Rather than relying on selected screening which is targeted at high-risk individuals, practitioners should consider cholesterol screening in all adolescents as part of a routine health assessment.

Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD

2018 ◽  
Vol 28 (4) ◽  
pp. 554-560 ◽  
Author(s):  
Eméfah C. Loccoh ◽  
Sunkyung Yu ◽  
Janet Donohue ◽  
Ray Lowery ◽  
Jennifer Butcher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
High Risk ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Private Insurance ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Factors Associated

AbstractBackgroundNeurodevelopmental impairment is increasingly recognised as a potentially disabling outcome of CHD and formal evaluation is recommended for high-risk patients. However, data are lacking regarding the proportion of eligible children who actually receive neurodevelopmental evaluation, and barriers to follow-up are unclear. We examined the prevalence and risk factors associated with failure to attend neurodevelopmental follow-up clinic after infant cardiac surgery.MethodsSurvivors of infant (<1 year) cardiac surgery at our institution (4/2011-3/2014) were included. Socio-demographic and clinical characteristics were evaluated in neurodevelopmental clinic attendees and non-attendees in univariate and multivariable analyses.ResultsA total of 552 patients were included; median age at surgery was 2.4 months, 15% were premature, and 80% had moderate–severe CHD. Only 17% returned for neurodevelopmental evaluation, with a median age of 12.4 months. In univariate analysis, non-attendees were older at surgery, had lower surgical complexity, fewer non-cardiac anomalies, shorter hospital stay, and lived farther from the surgical center. Non-attendee families had lower income, and fewer were college graduates or had private insurance. In multivariable analysis, lack of private insurance remained independently associated with non-attendance (adjusted odds ratio 1.85, p=0.01), with a trend towards significance for distance from surgical center (adjusted odds ratio 2.86, p=0.054 for ⩾200 miles).ConclusionsThe majority of infants with CHD at high risk for neurodevelopmental dysfunction evaluated in this study are not receiving important neurodevelopmental evaluation. Efforts to remove financial/insurance barriers, increase access to neurodevelopmental clinics, and better delineate other barriers to receipt of neurodevelopmental evaluation are needed.

scholarly journals Incidence and Associated Factors of Type 2 Diabetes: A Community-Based Cohort Study in the Central Region of Rural Community in Thailand

2019 ◽  
Vol 31 (1) ◽  
pp. 72-83
Author(s):  
Annop Kittithaworn ◽  
Royal Dy ◽  
Panadda Hatthachote ◽  
Ram Rangsin ◽  
Mathirut Mungthin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Rural Community ◽  
Community Based ◽  
Factors Associated ◽  
Obesity Hypertension ◽  
Associated Risk Factors

The present study aimed to evaluate the incidence of type 2 diabetes mellitus (T2DM) and associated risk factors among adults in a rural community of Thailand. A prospective cohort study was conducted in a rural community of Thailand. Among 1358 nondiabetics ≥18 years, fasting plasma glucose (FPG) was measured at baseline in 2008 to 2010 and at follow-up evaluation in 2015. After follow-up of 5213 person-years, 122 new cases of T2DM were ascertained corresponding to cumulative incidence of 23.40 per 1000 person-years. The independent factors associated with T2DM were age, male, prehypertension, hypertension, waist circumference, and impaired FPG. The incidence of T2DM in Thailand is high, and many risk factors are converging. The focus of public health efforts should be on abdominal obesity, hypertension, and impaired FPG. Special attention in terms of preventive strategies must be paid to individuals with impaired FPG, as this state is the most prominent predictor of developing T2DM.

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