Risk Factors for Lassa Fever Infection Among Survivours at Federal Medical Centre, Owo, Ondo State, Nigeria.

2020 ◽  
Author(s):  
Olayinka Stephen Ilesanmi ◽  
Oluwatosin Temitope Owoeye-Lawal ◽  
Adewale Johnson Aro ◽  
Aanuoluwapo Adeyimika Afolabi ◽  
Adesola Olawumi Kareem ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Mass Media ◽  
Perceived Risk ◽  
Lassa Fever ◽  
Medical Centre ◽  
Sources Of Information ◽  
Preventive Practices ◽  
Ondo State

Abstract BackgroundThere exists paucity of information regarding successfully managed Lassa Fever (LF) patients. This study is aimed at determining the perceived risk factors for LF infection among patients who had been managed and on follow up at Federal Medical Centre, Owo, Ondo State. MethodsA cross sectional study of 101 LF survivors who had been managed and attending follow up clinic at Federal Medical Centre, Owo was done. Data were collected using semi-structured interviewer-administered questionnaire. Respondents were assessed for symptoms and factors that may have predisposed them to LF, and data analyzed with SPSS version 23. Those who had more than three identifiable risks were categorised as high risk. Descriptive statistics was done, and association between socio-demographic characteristics and high risk were explored using chi square test. ResultsThe median age of respondents was 33 years (range 8-85 years), 61.4% were males, 92.1% have heard of LF prior to being diagnosed, 55.9% heard through the mass media. The perceived cause of Lassa fever infection among respondents included consumption of food contaminated by rats’ feces among 57(56.4%) persons, while 16 (15.8) attributed their infection to contact with LF-infected persons. Among respondents with primary education and below, 5 (29.4%) had high risk of Lassa fever infection compared to 7 (8.3%) with secondary education and above (p=0.014). ConclusionMass media and other sources of information should be well harnessed in the communication of risks and preventive practices for LF. Health education should be intensified both in hospitals and schools to capture both young and old in LF prevention activities.

scholarly journals Risk factors for Lassa fever infection among survivors at the Federal Medical Center, Owo, Ondo State, Nigeria

2021 ◽  
Vol 7 (1) ◽  
pp. 128-134
Author(s):  
Olayinka Stephen Ilesanmi ◽  
Oluwatosin Temitope Owoeye-Lawal ◽  
Adewale Johnson Aro ◽  
Aanuoluwapo Adeyimika Afolabi ◽  
Adesola Olawumi Kareem ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Medical Center ◽  
Public Information ◽  
Lassa Fever ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Preventive Practices ◽  
Ondo State

Background and Aim: There is insufficient information about the successfully managed Lassa fever (LF) patients in Nigeria. This study aimed to utilize the One Health approach to identify the risk factors for LF infection among LF patients who were managed and on follow-up at the Federal Medical Center, Owo, Ondo State, Nigeria. Materials and Methods: A cross-sectional study was done on 101 LF survivors who were managed and on follow-up at the Federal Medical Center. The data were collected using a semi-structured interviewer-administered questionnaire. The respondents were assessed for symptoms and factors that might have predisposed them to LF, and the data were analyzed with SPSS version 23 (IBM Corp., NY, USA). Those who had more than 3 identifiable risks were categorized as high risk. Descriptive statistics were done, and the association between sociodemographic characteristics and high risk was explored using Chi-square test. Results: The median age of the respondents was 33 years (8-85 years); 62 (61.4%) were male, and 93 (92.1%) have heard of LF before diagnosis. The perceived cause of LF infection among the respondents included the consumption of food contaminated by rats' feces among 57 (56.4%) persons, while 16 (15.8) attributed their infection to contact with LF-infected persons. Among the respondents with primary education and below, 5 (29.4%) were at higher risk for LF infection compared to 7 (8.3%) with secondary education and above (p=0.014). Conclusion: The mass media and other sources of information should be well-harnessed in the communication of risks and preventive practices for LF. Public information campaigns should be organized to discourage bush burning in affected communities.

Prognostic Factors for Developing Thrombosis in Polycytemia Vera: A Retrospective Analysis of 331 Patients with Long-Term Follow-up Highlights the Importance of White Blood Cells Levels

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 48-49
Author(s):  
Samantha Ferrari ◽  
Chiara Pagani ◽  
Mariella D'Adda ◽  
Nicola Bianchetti ◽  
Annamaria Pelizzari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
High Risk ◽  
Board Of Directors ◽  
Advisory Board ◽  
Advisory Committees ◽  
Risk Status ◽  
History Of ◽  
Wbc Count

Polycythemia Vera (PV) is a chronic myeloproliferative neoplasm characterized by erythrocytosis, constitutively active mutations in JAK2 and an increased susceptibility to thrombotic events (TEs). There is still controversy about the role of increased hematocrit and of other variables including elevated white blood cell count as risk factors for the occurrence of TEs. A better definition of the relative prognostic importance of hematologic parameters would help us to better tailor the therapeutic approach to PV patients (pts), which is currently mainly based on the use of acetilsalycilic acid (ASA), venesection and hydroxyurea . The aim of our study was to analyze if any clinical or laboratory variables were significantly associated to the occurrence of TEs both at PV diagnosis and during the course of the disease in a large series of PV pts uniformly followed at a single Center over a period of 29.5 years from January 1986 to June 2019. Clinical and laboratory data were obtained from the time of diagnosis until death, progression to acute leukemia or last follow-up. Hematocrit (Hct), hemoglobin (Hb), white blood cell (WBC) and platelet (PLT) levels were recorded for each patient at least every 6 months. Among a total of 331 pts, the median age was 65 years (range 30-92 years), and 56% were male. "High risk" features (age ≥ 60 years and/or history of prior thrombosis) were present in 221 pts (66.7%). The incidence of cardiovascular risk factors was: hypertension 64%, diabetes 15%, hyperlipidemia 28%, history of active or remote smoking 41%. Patients on ASA were 279 (84%), 19 (6%) were on oral anticoagulation, while 27 (8%) were on ASA+oral anticoagulant. At PV diagnosis 54 pts (16%) presented with thrombosis, arterial in 32 (59%) and venous in 22 (41%). A previous TE was recorded in 57 pts (17%): in 43 (75%) arterial, in 12 (22%) venous and in 2 (3%) mixed (arterial+venous). Previous thrombosis was the only variable significantly associated with the presence of a TE at PV diagnosis (P=0.02). After PV diagnosis, with a median follow-up of 81 months (range 1-374 months), 63 pts (19%) experienced a TE and 11 of them a further episode, for a total of 74 TEs. The incidence rate (pts/year) of TEs was 2.7%. Forty-two events were arterial (57%), 31 were venous (42%) and 1 (1%) was mixed. It was the first TE for 37 pts. Cerebrovascular accidents and deep-venous thrombosis were the most frequent arterial and venous TEs both at PV diagnosis and throughout the disease course, with a relative incidence of 50% and 32% respectively. The table compares the characteristics of patients who did or did not develop a TE after PV diagnosis. At univariate analysis, PV high risk status, a previous TE and hyperlipidemia at PV diagnosis were significantly associated with a subsequent TE. Among hematologic variables an elevated WBC count at the time of thrombosis, but not Hct or PLT levels, was highly significantly associated with the development of a TE. At multivariate analysis, WBC count ≥10.4 x 10^9/L and hyperlipidemia maintained their independent prognostic value, while high risk status and a previous TE lost their prognostic significance. Both at univariate and multivariate analysis, hyperlipidemia at diagnosis (P=0.009 and P=0.002) and high WBC count at thrombosis (P=0.001 and P=<0.0001) predicted for arterial thromboses, while only a history of prior thrombosis (P=0.03) predicted for venous ones. In conclusion, our analysis confirms that elevated WBC count at the moment of the event more than increased hematocrit is associated to the development of thrombosis in PV pts. We also found that hyperlipidemia was an independent risk factor for arterial thrombosis, calling for an accurate management of increased lipid levels. Whether a reduction of the WBC count during the course of PV may reduce the frequency of TE remains to be demonstrated by prospective studies. Table Disclosures D'Adda: Novartis: Other: Advisory board; Incyte: Other: Advisory board; Pfizer: Other: Advisory board. Rossi:Daiichi Sankyo: Consultancy, Honoraria; Sanofi: Honoraria; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees; Novartis: Other: Advisory board; Alexion: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria; Celgene: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Jazz: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees.

scholarly journals Uptake and detection rate of a stepwise cardiometabolic disease detection program in primary care—a cohort study

2019 ◽  
Vol 30 (3) ◽  
pp. 402-407
Author(s):  
Daphne M Stol ◽  
Monika Hollander ◽  
Ilse F Badenbroek ◽  
Mark M J Nielen ◽  
François G Schellevis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Cohort Study ◽  
High Risk ◽  
Newly Diagnosed ◽  
Additional Risk ◽  
High Risk Patients ◽  
Detection Program ◽  
Risk Patients

Abstract Background Early detection and treatment of cardiometabolic diseases (CMD) in high-risk patients is a promising preventive strategy to anticipate the increasing burden of CMD. The Dutch guideline ‘the prevention consultation’ provides a framework for stepwise CMD risk assessment and detection in primary care. The aim of this study was to assess the outcome of this program in terms of newly diagnosed CMD. Methods A cohort study among 30 934 patients, aged 45–70 years without known CMD or CMD risk factors, who were invited for the CMD detection program within 37 general practices. Patients filled out a CMD risk score (step 1), were referred for additional risk profiling in case of high risk (step 2) and received lifestyle advice and (pharmacological) treatment if indicated (step 3). During 1-year follow-up newly diagnosed CMD, prescriptions and abnormal diagnostic tests were assessed. Results Twelve thousand seven hundred and thirty-eight patients filled out the risk score of which 865, 6665 and 5208 had a low, intermediate and high CMD risk, respectively. One thousand seven hundred and fifty-five high-risk patients consulted the general practitioner, in 346 of whom a new CMD was diagnosed. In an additional 422 patients a new prescription and/or abnormal diagnostic test were found. Conclusions Implementation of the CMD detection program resulted in a new CMD diagnosis in one-fifth of high-risk patients who attended the practice for completion of their risk profile. However, the potential yield of the program could be higher given the considerable number of additional risk factors—such as elevated glucose, blood pressure and cholesterol levels—found, requiring active follow-up and presumably treatment in the future.

Predicting reattendance at a high-risk breast cancer clinic

2015 ◽  
Vol 13 (5) ◽  
pp. 1441-1448 ◽  
Author(s):  
Sarah R. Ormseth ◽  
David K. Wellisch ◽  
Adam E. Aréchiga ◽  
Taylor L. Draper
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Perceived Risk ◽  
Depressive Symptomatology ◽  
High Risk Breast Cancer ◽  
High Risk Breast ◽  
Risk Breast Cancer ◽  
Cancer Clinic ◽  
High Risk Clinic

AbstractObjective:The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.Method:Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES–D score ≥ 16), current level of anxiety (State–Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).Results:A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted “U” relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.Significance of Results:Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

Letters to the Editor

PEDIATRICS ◽  
1981 ◽  
Vol 68 (2) ◽  
pp. 304-305
Author(s):  
Michael A. Baron ◽  
Howard D. Fink
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Clinical Judgment ◽  
Physical Sign ◽  
Single Test ◽  
Letters To The Editor ◽  
Blood Tests ◽  
Young Infants

We agree completely with Dr Mangravite'ss comments and have been advising parents as he suggests. Implicit in Mangravite's remarks is the observation that a single test is no more reliable for diagnosis than is any single historical datum or physical sign. The constant exercise of clinical judgment and careful follow-up of patients is therefore essential and can prevent excessive reliance on "blood tests." It should be kept in mind that young infants are at especially high risk for bacteremia; that this risk varies directly with temperature and inversely with age: and that one or many of the risk factors for bacteremia may be absent in culture-proven bacteremia.

Second Primary Melanoma: Risk Factors, Histopathologic Features, Survival, and Implications for Follow-Up

2016 ◽  
Vol 82 (10) ◽  
pp. 1009-1013 ◽  
Author(s):  
Maris S. Jones ◽  
Hitoe Torisu-Itakura ◽  
Devin C. Flaherty ◽  
Hans F. Schoellhammer ◽  
Jihey Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cutaneous Melanoma ◽  
Primary Melanoma ◽  
Second Primary ◽  
Melanoma Risk ◽  
Impact On Survival ◽  
The Impact ◽  
Histopathologic Features

The impact on survival of a second primary melanoma (SPM) is unclear. We used our melanoma center's database to examine clinicopathologic risk factors and outcomes of stage 0 to IV cutaneous melanoma in patients with one versus two primaries. Among 12,325 patients with primary melanoma, 969 (7.86%) developed SPM. SPMs were significantly thinner than autologous primary melanomas ( P = 0.01), and 451 SPM patients had better overall and melanoma-specific survival than 451 prognostically matched non-SPM patients ( P < 0.0001 and 0.0001, respectively) at a median follow-up of 142.37 months. Patients with cutaneous melanoma are at high risk for development of SPM, but the development of SPM does not seem to impair survival.

scholarly journals Hydroxycarbamide Plus Aspirin Versus Aspirin Alone in Patients With Essential Thrombocythemia Age 40 to 59 Years Without High-Risk Features

2018 ◽  
Vol 36 (34) ◽  
pp. 3361-3369 ◽  
Author(s):  
Anna L. Godfrey ◽  
Peter J. Campbell ◽  
Cathy MacLean ◽  
Georgina Buck ◽  
Julia Cook ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Platelet Count ◽  
High Risk ◽  
Vascular Events ◽  
End Point ◽  
High Risk Factors ◽  
Patient Reported

Purpose Cytoreductive therapy is beneficial in patients with essential thrombocythemia (ET) at high risk of thrombosis. However, its value in those lacking high-risk features remains unknown. This open-label, randomized trial compared hydroxycarbamide plus aspirin with aspirin alone in patients with ET age 40 to 59 years and without high-risk factors or extreme thrombocytosis. Patients and Methods Patients were age 40 to 59 years and lacked a history of ischemia, thrombosis, embolism, hemorrhage, extreme thrombocytosis (platelet count ≥ 1,500 × 109/L), hypertension, or diabetes requiring therapy. In all, 382 patients were randomly assigned 1:1 to hydroxycarbamide plus aspirin or aspirin alone. The composite primary end point was time to arterial or venous thrombosis, serious hemorrhage, or death from vascular causes. Secondary end points were time to first arterial or venous thrombosis, first serious hemorrhage, death, incidence of transformation, and patient-reported quality of life. Results After a median follow-up of 73 months and a total follow-up of 2,373 patient-years, there was no significant difference between the arms in the likelihood of patients reaching the primary end point (hazard ratio, 0.98; 95% CI, 0.42 to 2.25; P = 1.0). The incidence of significant vascular events was low, at 0.93 per 100 patient-years (95% CI, 0.61 to 1.41). There were also no differences in overall survival; in the composite end point of transformation to myelofibrosis, acute myeloid leukemia, or myelodysplasia; in adverse events; or in patient-reported quality of life. Conclusion In patients with ET age 40 to 59 years and lacking high-risk factors for thrombosis or extreme thrombocytosis, preemptive addition of hydroxycarbamide to aspirin did not reduce vascular events, myelofibrotic transformation, or leukemic transformation. Patients age 40 to 59 years without other clinical indications for treatment (such as previous thrombosis or hemorrhage) who have a platelet count < 1,500 × 109/L should not receive cytoreductive therapy.

scholarly journals Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study

2011 ◽  
Vol 70 (6) ◽  
pp. 1083-1086 ◽  
Author(s):  
Amelia Ruffatti ◽  
Teresa Del Ross ◽  
Manuela Ciprian ◽  
Maria T Bertero ◽  
Sciascia Salvatore ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Univariate Analysis ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Ischaemic Attack ◽  
Independent Risk Factors

ObjectivesTo assess risk factors for a first thrombotic event in confirmed antiphospholipid (aPL) antibody carriers and to evaluate the efficacy of prophylactic treatments.MethodsInclusion criteria were age 18–65 years, no history of thrombosis and two consecutive positive aPL results. Demographic, laboratory and clinical parameters were collected at enrolment, once a year during the follow-up and at the time of the thrombotic event, whenever that occurred.Results258 subjects were prospectively observed between October 2004 and October 2008. The mean±SD follow-up was 35.0±11.9 months (range 1–48). A first thrombotic event (9 venous, 4 arterial and 1 transient ischaemic attack) occurred in 14 subjects (5.4%, annual incidence rate 1.86%). Hypertension and lupus anticoagulant (LA) were significantly predictive of thrombosis (both at p<0.05) and thromboprophylaxis was significantly protective during high-risk periods (p<0.05) according to univariate analysis. Hypertension and LA were identified by multivariate logistic regression analysis as independent risk factors for thrombosis (HR 3.8, 95% CI 1.3 to 11.1, p<0.05, and HR 3.9, 95% CI 1.1 to 14, p<0.05, respectively).ConclusionsHypertension and LA are independent risk factors for thrombosis in aPL carriers. Thromboprophylaxis in these subjects should probably be limited to high-risk situations.

The use of dual-mobility bearings in patients at high risk of dislocation

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 41-45 ◽  
Author(s):  
C. W. Jones ◽  
I. De Martino ◽  
R. D’Apolito ◽  
A. A. Nocon ◽  
P. K. Sculco ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
High Risk ◽  
High Body Mass Index ◽  
High Volume ◽  
Consecutive Series ◽  
Dual Mobility ◽  
Radiographic Outcomes ◽  
Stable Reconstruction

Aims Instability continues to be a troublesome complication after total hip arthroplasty (THA). Patient-related risk factors associated with a higher dislocation risk include the preoperative diagnosis, an age of 75 years or older, high body mass index (BMI), a history of alcohol abuse, and neurodegenerative diseases. The goal of this study was to assess the dislocation rate, radiographic outcomes, and complications of patients stratified as high-risk for dislocation who received a dual mobility (DM) bearing in a primary THA at a minimum follow-up of two years. Materials and Methods We performed a retrospective review of a consecutive series of DM THA performed between 2010 and 2014 at our institution (Hospital for Special Surgery, New York, New York) by a single, high-volume orthopaedic surgeon employing a single prosthesis design (Anatomic Dual Mobility (ADM) Stryker, Mahwah, New Jersey). Patient medical records and radiographs were reviewed to confirm the type of implant used, to identify any preoperative risk factors for dislocation, and any complications. Radiographic analysis was performed to assess for signs of osteolysis or remodelling of the acetabulum. Results There were 151 patients who met the classification of high-risk according to the inclusion criteria and received DM THA during the study period. Mean age was 82 years old (73 to 95) and 114 patients (77.5%) were female. Mean follow-up was 3.6 years (1.9 to 6.1), with five patients lost to follow-up and one patient who died (for a reason unrelated to the index procedure). One patient (0.66%) sustained an intraprosthetic dislocation; there were no other dislocations. Conclusion At mid-term follow-up, the use of a DM bearing for primary THA in patients at high risk of dislocation provided a stable reconstruction option with excellent radiographic results. Longer follow-up is needed to confirm the durability of these reconstructions.

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