Lifetime Prevalence of Upper-body Musculoskeletal Problems in a Professional-level Symphony Orchestra: Age, Gender, and Instrument-specific Results

Instrumentalists are at risk to develop upper-body musculoskeletal problems (MSKPs). Identified risk factors include age, gender, instrument played, joint laxity, and poor technique or posture. In this study, we established the prevalence of MSKPs that affect the ability to play an instrument in the population of a professional-level symphonic orchestra and the relation of these problems to gender, age, and instrument. The members of the Puerto Rico Symphony Orchestra were recruited voluntarily. A questionnaire was used to obtain information on demographics, instrument played, and history of MSKP severe enough to affect their playing ability. Questions also covered alleviating and aggravating factors, upper-body areas involved, type of symptoms, and type of treatment sought. After the questionnaire was completed, all players underwent a neuromusculoskeletal upper-body examination. Of the 75 musicians participating, 81.3% reported having had an MSKP that affected their ability to play. Of these, 83.6% reported their MSKP was directly associated to playing. Females were more commonly affected, 87.5% vs. 79.7% for males. Lower-body strings (cello, bass) players and percussionists (93.3% and 100%, respectively) and younger (22-29 yrs) and older (50-61 yrs) populations (83.3% and 90.9%, respectively) reported more MSKPs. These age groups played more hours per week (28.7 and 32.0 hrs, respectively). In all groups, low back pain was the most common complaint, present in 75.4% of those with MSKPs. Upper-body strings (violin, viola) players also reported neck and left shoulder problems. Contributing factors include hours of exposure and technical expertise. Female gender, age, and instrument played were found to be risk factors for developing MSKPs in this population.

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The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

10.35262/jiag.v16i1.5-10 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

H Tuna ◽

Ö Bozan ◽

B Gürpınar ◽

N İlçin

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Risk ◽

Fear Of Falling ◽

Dynamic Balance ◽

Upper Body ◽

Functional Fitness ◽

Fall Risk Factors ◽

Rest Home ◽

History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

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Predicting COVID-19 mortality with electronic medical records

npj Digital Medicine ◽

10.1038/s41746-021-00383-x ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Hossein Estiri ◽

Zachary H. Strasser ◽

Jeffy G. Klann ◽

Pourandokht Naseri ◽

Kavishwar B. Wagholikar ◽

...

Keyword(s):

Risk Factors ◽

Medical Information ◽

Age Groups ◽

Prognostic Models ◽

Smoking History ◽

Risk Scores ◽

Gradient Boosting ◽

Chronic Obstructive ◽

Clinical Expertise ◽

History Of

AbstractThis study aims to predict death after COVID-19 using only the past medical information routinely collected in electronic health records (EHRs) and to understand the differences in risk factors across age groups. Combining computational methods and clinical expertise, we curated clusters that represent 46 clinical conditions as potential risk factors for death after a COVID-19 infection. We trained age-stratified generalized linear models (GLMs) with component-wise gradient boosting to predict the probability of death based on what we know from the patients before they contracted the virus. Despite only relying on previously documented demographics and comorbidities, our models demonstrated similar performance to other prognostic models that require an assortment of symptoms, laboratory values, and images at the time of diagnosis or during the course of the illness. In general, we found age as the most important predictor of mortality in COVID-19 patients. A history of pneumonia, which is rarely asked in typical epidemiology studies, was one of the most important risk factors for predicting COVID-19 mortality. A history of diabetes with complications and cancer (breast and prostate) were notable risk factors for patients between the ages of 45 and 65 years. In patients aged 65–85 years, diseases that affect the pulmonary system, including interstitial lung disease, chronic obstructive pulmonary disease, lung cancer, and a smoking history, were important for predicting mortality. The ability to compute precise individual-level risk scores exclusively based on the EHR is crucial for effectively allocating and distributing resources, such as prioritizing vaccination among the general population.

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Incidence of postural headache after lumbar puncture requiring epidural blood patch: Effects of needle caliber; 2-year experience

The Neuroradiology Journal ◽

10.1177/19714009211000630 ◽

2021 ◽

pp. 197140092110006

Author(s):

Warren Chang ◽

Ajla Kadribegic ◽

Kate Denham ◽

Matthew Kulzer ◽

Tyson Tragon ◽

...

Keyword(s):

Risk Factors ◽

Lumbar Puncture ◽

Conservative Management ◽

Epidural Blood Patch ◽

Female Gender ◽

Regional Hospital ◽

Younger Age ◽

Blood Patch ◽

History Of ◽

The Difference

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.

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Blood Donation-Related Adverse Reactions: Results of an Online Survey among Donors in Germany (2018)

Transfusion Medicine and Hemotherapy ◽

10.1159/000516049 ◽

2021 ◽

pp. 1-11

Author(s):

Stefano Orru’ ◽

Kay Poetzsch ◽

Marcus Hoffelner ◽

Margarethe Heiden ◽

Markus B. Funk ◽

...

Keyword(s):

Risk Factors ◽

Whole Blood ◽

Online Survey ◽

Adverse Reactions ◽

Blood Donation ◽

Age Groups ◽

Female Gender ◽

Online Questionnaire ◽

Logistic Analysis ◽

German Legislation

Introduction: According to German legislation, reports of suspected serious adverse reactions (AR) associated with the donation of blood and its components are continuously being evaluated by the Paul-Ehrlich-Institut. This survey aimed at providing a more complete picture of the AR associated with the donation of blood and blood components. Materials and Methods: Eligible donors had the opportunity to anonymously report all AR occurring during or after their last donation by completing an online questionnaire. Reported AR were classified according to the Standard for Surveillance of Complications Related to Blood Donation. Donors’ self-assessment of AR seriousness was compared with the official severity classification as laid down by German legislation. Besides a descriptive statistical analysis, a multiple logistic analysis was performed to identify risk factors for AR. Results: A total of 8,138 data records were evaluated. Slightly more males (57.9%) participated in the survey and, except for donors aged ≥60 years, all age groups were equally represented. The majority of participants were whole blood donors (85.4%), repeat donors (97.2%), and stayed under observation in the blood establishment (BE) for more than 5 min (63.1%) after donation. Most participants did not report any reaction (72.5%), whereas 2,237 reported at least one AR (27.5%), 475 of whom underwent apheresis and 1,762 donated whole blood. Most AR occurred after leaving the BE (64.4%). Only a minority of participants required medical treatment (5.1%) or assessed the experienced AR as serious (3.9%). The most frequently reported donor AR were haematoma and other local reactions (57.6%). Vasovagal reactions without and with loss of consciousness were developed in 17 and 2% of the participants, respectively, whilst 7.6% experienced citrate reactions. New AR (i.e., allergic reactions and symptoms associated with iron deficiency) were reported as well. The occurrence of AR was linked to risk factors (i.e., female gender, young age, first-time donation, and thrombocytapheresis). Discussion: This survey yielded a more comprehensive AR spectrum, revealed a prolonged time to symptom onset, and identified risk factors for AR. This novel information could be implemented in an amended informed consent addressing common and rare AR.

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Prevalence of Work-Related Musculoskeletal Disorders: Psychological and Physical Risk Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179361 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9361

Author(s):

K. Saraswathi Krishnan ◽

Gunasunderi Raju ◽

Omar Shawkataly

Keyword(s):

Risk Factors ◽

Female Gender ◽

Cross Sectional Study ◽

Musculoskeletal Symptoms ◽

Body Region ◽

Left Shoulder ◽

Body Parts ◽

Cross Sectional ◽

Work Related ◽

Lower Back

Purpose—This study aimed to estimate the prevalence and risk factors of MSD pain in various anatomical regions among nurses. Method—A cross-sectional study involving a self-administered questionnaire by registered nurses with clinical experience. Data was collected using convenience sampling after obtaining informed consent. The results were drawn from a total of 300 nurses. Results—The nurses presented with occasional mental exhaustion (44.3%) and often physical exhaustion (44.0%). Almost all (97.3%) the nurses complained of having work-related pain during the last 12 months. Body parts with the most pain were the lower back (86.7%), ankles (86.7%), neck (86.0%), shoulders (85.0%), lower legs (84.7%) and upper back (84.3%). The pain frequency was rated as occasional pain for the neck and upper back, pain was often felt for the rest of the parts. Nurses complained of severe pain in the lower back (19.7%), right shoulder (29.7%) and left shoulder (30.3%). The frequency of having musculoskeletal symptoms in any body region was increased with age, lower education level, female gender, high BMI, job tenure and lifestyle. Conclusions—Nurses’ WRMSD complaints should be taken seriously to curb further risk and musculoskeletal hazards.

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ПОРІВНЯЛЬНА ХАРАКТЕРИСТИКА ФАКТОРІВ РИЗИКУ

Medical Informatics and Engineering ◽

10.11603/mie.1996-1960.2012.1.173 ◽

2012 ◽

Author(s):

І. К. Чурпій

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Pulmonary Embolism ◽

High Risk ◽

Significant Risk ◽

Female Gender ◽

Electrolyte Composition ◽

Terminal Phase ◽

Phase Flow ◽

History Of

To optimize the therapeutic tactics and improve the treatment of peritonitis on the basis of retrospective analysis there are determined the significant risk factors: female gender, age 60 – 90 years, time to hospitalization for more than 48 hours, a history of myocardial infarction, stroke, cardiac arrhythmia, biliary, fecal and fibrinous purulent exudate, the terminal phase flow, operations with resection of the intestine and postoperative complications such as pulmonary embolism, myocardial infarction, pleurisy, early intestinal obstruction. Changes in the electrolyte composition of blood and lower albumin <35 % of high risk prognostic course of peritonitis that requires immediate correction in the pre-and postoperative periods. The combination of three or more risk factors for various systems, creating a negative outlook for further treatment and the patient's life.

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Adult Victimization over Time

In the Fullness of Time ◽

10.1093/med-psych/9780195370607.003.0016 ◽

2018 ◽

pp. 171-174

Author(s):

Mary C. Zanarini

Keyword(s):

Risk Factors ◽

Sexually Abused ◽

Female Gender ◽

Physical Assault ◽

Clinical Implications ◽

Axis Ii ◽

Borderline Patients ◽

History Of ◽

Over Time

At baseline, borderline patients reported higher rates of adult rape and physical assault by a partner than Axis II comparison subjects. Four risk factors were found to significantly predict whether borderline patients had an adult history of being a victim of physical and/or sexual violence before their index admission: female gender, a substance use disorder that began before the age of 18, childhood sexual abuse, and emotional withdrawal by a caretaker (a form of neglect). At six-year and 10-year follow-up, borderline patients reported higher rates of being verbally, emotionally, physically, and sexually abused or assaulted than did Axis II comparison subjects. However, each of these forms of abuse declined significantly over time. The clinical implications of these prevalence and predictive findings are discussed.

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Risk factors of vitamin K antagonist overcoagulation

Thrombosis and Haemostasis ◽

10.1160/th08-04-0265 ◽

2008 ◽

Vol 100 (10) ◽

pp. 685-692 ◽

Cited By ~ 11

Author(s):

Gwenaëlle Cadiou ◽

Rémi Varin ◽

Hervé Levesque ◽

Vanessa Grassi ◽

Jacques Benichou ◽

...

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Medical History ◽

Vitamin K ◽

Female Gender ◽

Vitamin K Antagonist ◽

High Morbidity ◽

Duration Of Hospitalization ◽

History Of ◽

Previous Medical History

SummaryThe aims of this case-control study were to identify in vitamin K antagonist (VKA)-treated unselected patients, factors associated with international normalised ratio (INR) values: (i) greater than 6.0.;and (ii) ranging from 4.0 to 6.0 complicated with bleeding. We also assessed VKA-related morbidity in these patients. During a two-month period, 4,188 consecutive and unselected patients were referred to our Emergency Department. At admission, the medical records of each patient and two age- and sex-matched controls were reviewed for: both duration and indication of VKA therapy, previous medical history of VKA-related haemorrhage, underlying co-morbidities, concomitant medications other than VKA, duration of hospitalization and deaths’ causes. Of these 4,188 subjects,50 case-patients (1.19%) were identified; both case-patients and controls did not differ as regards indications and patterns of VKA therapy. Interestingly, two-thirds of case-patients were women, suggesting that female gender may be a risk factor of VKA over-coagulation onset. We identified the following risk factors of VKA over-coagulation: previous medical history of INR levels over therapeutic range, therapy with antibiotics, amiodarone and proton pump inhibitors, as well as fever. A total of 88% of case-patients were hospitalized; mean duration of patients’ hospitalization was seven days [range:1–56 days];no patient died from major bleeding. Our study underscores that it is of utmost importance to consider the strength of indication before starting VKA therapy, as this therapy has been responsible for as high as 1.19% of admissions in unselected subjects referred to an Emergency Department. Our data therefore suggest that internists should be aware of VKA-related high morbidity, particularly in situations at risk of VKA over-coagulation.

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Factors Associated With Early-Onset Esophageal Cancer in Tanzania: A Case-Control Study

Journal of Global Oncology ◽

10.1200/jgo.18.23000 ◽

2018 ◽

Vol 4 (Supplement 1) ◽

pp. 29s-29s

Author(s):

Geoffrey Buckle ◽

Elia J. Mmbaga ◽

Alan Paciorek ◽

Larry Akoko ◽

Katrina Deardorff ◽

...

Keyword(s):

Risk Factors ◽

Household Income ◽

Early Onset ◽

Case Control Study ◽

Age Groups ◽

Young Patients ◽

Second Hand Smoke ◽

Factors Associated ◽

History Of ◽

Control Study

Abstract 89 Purpose Previous studies have characterized geographic clusters of esophageal cancer (EC) in East Africa. Many of the epidemiologic features of EC in this context are shared globally with other clusters, including high rates, male predominance, and squamous cell histology. A unique feature in East Africa is the high proportion of young patients, with a recent case series reporting up to 24% of patients age < 45 years. The aim of the current study was to assess factors that are associated with early-onset EC in Tanzania (TZ). Methods We performed a secondary analysis of a previous case-control study. Patients with newly diagnosed EC were recruited at Muhimbili National Hospital and Ocean Road Cancer Institute in 2014 to 2016. Hospital controls were identified from patients with nonmalignant conditions and matched 1:1 for gender and age ± 10 years. Risk factors were assessed through interviews. Logistic regression was used to estimate age-specific odds ratios (ORs) of EC for exposures across age groups (30 to 44 years, 45 to 59 years, and ≥ 60 years) and for interactions with age. Results A total of 473 cases and 473 controls were enrolled. Median ages were 59 years (range, 30 to 91 years) for cases and 55 years (range, 31 to 88 years) for controls. Among cases, 102 patients (22%) were age 30 to 44 years, 144 patients (30%) were age 45 to 59 years, and 227 patients (48%) were age ≥ 60 years. High household income was protective for those age 30 to 44 years (OR, 0.08; 95% CI, 0.01 to 0.69) and 45 to 59 years (OR, 0.13; 95% CI, 0.04 to 0.45), but not for those age ≥ 60 years (effect modification P = .047). Family history of EC was associated with a higher risk of EC among those age 45 to 59 years (OR, 3.8; 95% CI, 1.02 to 14.47) and age ≥ 60 years (OR, 6.63; 95% CI, 1.50 to 29.37), with no effect among those age 30 to 44 years (effect modification P = .019). Second-hand smoke and infrequent teeth cleaning were also associated with early-onset EC, but did not differ significantly across age groups. Additional factors associated with EC risk across all ages were firewood use (cooking), kerosene use (lighting), work on a maize farm, and in-home grain and nut storage. Protective factors were the regular use of medication, surrogates of high socioeconomic status (TV, radio, refrigerator, indoor toilet, and electricity), and charcoal or gas cooking. Conclusion Multiple exposures were identified as risk factors for early-onset EC in TZ. In age-stratified analyses, household income, second-hand smoke, and poor dental hygiene emerged as possible risk factors, whereas family history of EC had strong associations among the older but not the young age group. Our results suggest that environmental factors may underlie the high incidence of young patients with EC in TZ. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

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Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19

Biology ◽

10.3390/biology11010061 ◽

2022 ◽

Vol 11 (1) ◽

pp. 61

Author(s):

Angel Yun-Kuan Thye ◽

Jodi Woan-Fei Law ◽

Loh Teng-Hern Tan ◽

Priyia Pusparajah ◽

Hooi-Leng Ser ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Psychological Symptoms ◽

Female Gender ◽

Health Consequences ◽

Post Traumatic Stress ◽

Angiotensin Converting Enzyme 2 ◽

History Of ◽

The Central Nervous System ◽

Psychiatric Sequelae

There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.

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