scholarly journals Optimizing assessment of risk factors for severe bronchial asthma

2020 ◽  
Vol 65 (1) ◽  
pp. 59-64
Author(s):  
N. L. Potapova ◽  
I. N. Gaymolenko ◽  
Yu. N. Smolyakov
Keyword(s):  
Risk Factors ◽  
Bronchial Asthma ◽  
Odds Ratio ◽  
Prognostic Model ◽  
Early Disease ◽  
Patient Age ◽  
Patient Âgé ◽  
High Incidence ◽  
Asthma In Children ◽  
Sick Children

Purpose. To determine the anamnestic predictors of severe bronchial asthma in children. Material and methods. We analyzed risk factors of 335 patients with bronchial asthma. We statistically selected 287 patients and developed a prognostic model. Results. The predictors of severe bronchial asthma are combination of factors such as high incidence of ARVI in the first 3 years of life (odds ratio – OR 4.5; p<0.0001), smoking parents (OR 3.9; p<0.01), female (OR 2.06; p=0.041), patient age (OR 1.44; p<0.0001) and the early disease debut (OR 0.58; p<0.0001). Conclusion. The results obtained should be used to predict the severe course of bronchial asthma based on the analysis of anamnestic data complex available in practical healthcare, to organize dispensary observation of sick children.

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Risk of hemorrhage from de novo cerebral aneurysms

2013 ◽  
Vol 118 (1) ◽  
pp. 58-62 ◽  
Author(s):  
William J. Kemp ◽  
Daniel H. Fulkerson ◽  
Troy D. Payner ◽  
Thomas J. Leipzig ◽  
Terry G. Horner ◽  
...  
Keyword(s):  
Risk Factors ◽  
De Novo ◽  
Patient Age ◽  
Patient Âgé ◽  
Long Term Follow Up ◽  
De Novo Aneurysm ◽  
The Mean ◽  
Risk Of Hemorrhage

Object A small percentage of patients will develop a completely new or de novo aneurysm after discovery of an initial aneurysm. The natural history of these lesions is unknown. The authors undertook this statistical evaluation a large cohort of patients with both ruptured and unruptured de novo aneurysms with the aim of analyzing risk factors for rupture and estimating a risk of subarachnoid hemorrhage (SAH). Methods A review of a prospectively maintained database of all aneurysm patients treated by the vascular neurosurgery service of Goodman Campbell Brain and Spine from 1976–2010 was performed. Of the 4718 patients, 611 (13%) had long-term follow-up imaging. The authors identified 27 patients (4.4%) with a total of 32 unruptured de novo aneurysms from routine surveillance imaging. They identified another 10 patients who presented with a new SAH from a de novo aneurysm after treatment of their original aneurysm. The total study group was thus 37 patients with a total of 42 de novo aneurysms. The authors then compared the 27 patients with incidentally discovered aneurysms with the 10 patients with SAH. A statistical analysis was performed, comparing the 2 groups with respect to patient and aneurysm characteristics and risk factors. Results Thirty-seven patients were identified as having true de novo aneurysms. This group had a female predominance and a high percentage of smokers. These 37 patients had a total of 42 de novo aneurysms. Ten of these 42 aneurysms hemorrhaged. De novo aneurysms in both the SAH and non-SAH group were anatomically small (< 10 mm). The estimated risk of hemorrhage over 5 years was 14.5%, higher than the expected SAH risk of small, unruptured aneurysms reported in the ISUIA (International Study of Unruptured Intracranial Aneurysms) trial. There was no statistically significant correlation between hemorrhage and any of the following risk factors: hypertension, diabetes, tobacco and alcohol use, polycystic kidney disease, or previous SAH. There was a statistically significant between-groups difference with respect to patient age, with the mean patient age being significantly older in the SAH aneurysm group than in the non-SAH group (p = 0.047). This is likely reflective of longer follow-up and discovery time, as the mean length of time between initial treatment and discovery of the de novo aneurysm was longer in the SAH group (p = 0.011). Conclusions While rare, de novo aneurysms may have a risk for SAH that is comparatively higher than the risk associated with similarly sized, small, initially discovered unruptured saccular aneurysms. The authors therefore recommend long-term follow-up for all patients with aneurysms, and they consider a more aggressive treatment strategy for de novo aneurysms than for incidentally discovered initial aneurysms.

scholarly journals A study to assess the risk factors of bronchial asthma in children below 10 years of age

2020 ◽  
Vol 11 (4) ◽  
pp. 5238-5242
Author(s):  
Kalabarathi S ◽  
Kavya K. Nair
Keyword(s):  
Risk Factors ◽  
Bronchial Asthma ◽  
Demographic Variables ◽  
Interview Method ◽  
Descriptive Research ◽  
Asthma Child ◽  
Convenience Sampling ◽  
Asthma In Children ◽  
Structured Questionnaire ◽  
Gas Stoves

Children are profoundly powerless against the negative wellbeing resulting in numerous ecological exposures. Children get proportionately more significant portions of natural toxicants than grown-ups, and the way that their organs and tissues are quickly creating makes them especially vulnerable to synthetic abuse. Asthma is a constant fiery infection of the aviation routes at present influencing over 300 million individuals around the world. The risk factors of asthma include genetic predisposition, irresistible respiratory contamination, allergens, environment, workouts, medications, additives, and occupational stimuli. The descriptive research design was used with 100 samples, which matched Non- probability convenience sampling techniques selected the inclusion criteria. Demographic variables were collected by interview method followed by assessed the risk factors of bronchial asthma in children (below ten years of age) by using a self-structured questionnaire. Out of 100 samples, 50(50%) risk factor of heredity, 71(71%) have problems in taking asthma medications, 44(44%) only use zipped pillow covers, 34(34%) do not use gas stoves in the kitchen, 10(10%) have moisture in the walls, 6(6%) have cases of asthma emergencies, 56(56%) find helpless in dealing with an asthma child.

scholarly journals IP127. Risk Factors for Major Adverse Clinical Events After Carotid Endarterectomy Based on Patient Age and Symptoms

2018 ◽  
Vol 67 (6) ◽  
pp. e120
Author(s):  
Anjeza Zholanji ◽  
David O'Connor ◽  
Tracey Andrews ◽  
Erica Amianda ◽  
Themba Nyirenda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Endarterectomy ◽  
Patient Age ◽  
Clinical Events ◽  
Patient Âgé

The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks

2013 ◽  
Vol 14 (4) ◽  
pp. 141-148
Author(s):  
Sibel Dogru ◽  
Fikret Kanat ◽  
Faruk Ozer ◽  
Emin Maden ◽  
Sebahat Akoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Age ◽  
Patient Âgé ◽  
The Relationship

Understanding risk factors for perioperative ischemic events with carotid stenting: is patient age over 80 years or is unfavorable arch anatomy to blame?

2013 ◽  
Vol 6 (3) ◽  
pp. 219-224 ◽  
Author(s):  
Travis M Dumont ◽  
Maxim Mokin ◽  
Michael M Wach ◽  
Patrick S Drummond ◽  
Adnan H Siddiqui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Stenting ◽  
Patient Age ◽  
Patient Âgé ◽  
Ischemic Events

scholarly journals Predictors of Serious Complications Associated with Lower Gastrointestinal Endoscopy in a Major City-Wide Health Region

2010 ◽  
Vol 24 (7) ◽  
pp. 425-430 ◽  
Author(s):  
Harminder Singh ◽  
Robert B Penfold ◽  
Carolyn De Coster ◽  
Wendy Au ◽  
Charles N Bernstein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Hospital Admissions ◽  
Patient Age ◽  
Index Procedure ◽  
Gi Endoscopy ◽  
Patient Âgé ◽  
Usual Clinical Practice ◽  
Low Volume ◽  
And Performance

BACKGROUND: There are limited data regarding complications associated with colonoscopy and flexible sigmoidoscopy in usual clinical practice in Canada.OBJECTIVE: To determine the risk factors for lower gastrointestinal (GI) endoscopy-associated complications in usual clinical practice.METHODS: All outpatient lower GI endoscopies performed in Winnipeg (Manitoba) between April 1, 2004 and March 31, 2006, were identified from the provincial physicians’ claims database. All subsequent hospital admissions within 30 days that documented potential complications associated with lower GI endoscopies were identified from the electronic hospital discharges database and reviewed. Multivariate generalized estimating equation regression analysis was performed to determine independent factors (patient, endoscopist and procedure) associated with the risk of developing complications.RESULTS: There were 29,990 outpatient lower GI endoscopies performed in Winnipeg during the years studied. Seventy-seven (0.26%) procedures were associated with complications requiring hospitalization within 30 days of the index procedure. Stricture dilation (rate ratio [RR] 23.14; 95% CI 6.70 to 76.51), polypectomy (RR 5.93; 95% CI 3.66 to 9.62), increasing patient age (for each year increase in age, RR 1.03; 95% CI 1.01 to 1.05) and performance of endoscopy by low-volume endoscopists (fewer than 200 procedures per year, RR 2.28; 95% CI 1.18 to 4.42) and family physicians (RR 2.23; 95% CI 1.39 to 3.58) were independently associated with complications.CONCLUSIONS: The results of the present study suggest that increasing patient age, complex procedures and performance of the index procedure by low-volume endoscopists are independent risk factors for lower GI endoscopy-associated complications in usual clinical practice. This suggests that it may be time to consider implementing minimum volume requirements for endoscopists performing non-screening lower GI endoscopies.

scholarly journals Food Insecurity in a Pediatric Emergency Department and the Feasibility of Universal Screening

2021 ◽  
Vol 22 (6) ◽  
pp. 1295-1300
Author(s):  
Jaqueline Valdez Gonzalez ◽  
Emily Hartford ◽  
Jennifer Moore ◽  
Julie Brown
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Food Insecurity ◽  
Private Insurance ◽  
Care Quality ◽  
Screening Methods ◽  
Patient Age ◽  
Cross Sectional ◽  
Patient Âgé ◽  
Medical Complexity

Introduction: Children with food insecurity (FI) experience adverse health outcomes due to inadequate quantity or quality of food. Food insecurity may be high among families seeking emergency care. The Hunger Vital Sign (HVS) is a two-question validated tool used to screen families for FI. Our goal in this study was to assess prevalence of FI among emergency department (ED) patients, patient-level risk factors for FI, and the feasibility of screening. Methods: This was a cross-sectional analysis of FI in the ED. Parents or guardians of ED patients and adult patients (18 years or older) were approached for screening using the HVS during screening periods spanning weekdays/weekends and days/evenings. All ED patients were eligible, excluding siblings, repeat visits, critically ill patients, minors without a guardian, and families that healthcare staff asked us not to disturb. Families answered the HVS questions verbally or in writing, based on preference. Families with positive screens received information about food resources. We summarized patient and visit characteristics and defined medical complexity using a published algorithm. Multivariable logistic regression was used to assess FI risk factors. Results: In July-August 2019, 527 patients presented during screening periods: 439 agreed to screening, 18 declined, 19 met exclusions, and 51 were missed. On average the screening tool required five minutes (range 3-10 minutes) to complete. Most families (328; 75%) preferred to answer in writing rather than verbally. Overall, 77 participants (17.5%) screened positive for FI. In regression analyses, FI was associated with self-reported race/ethnicity (combined variable) of African American or Black (odds ratio [OR] 5.21, 95% confidence interval [CI], 2.13-12.77), Hispanic (OR 3.47, 95% CI, 1.48-8.15), or mixed/other (OR 3.81, 95% CI, 1.54-9.39), compared to non-Hispanic white. FI was also associated with public insurance type (OR 5.74, 95% CI, 2.52-13.07, reference: private insurance), and each year of increasing patient age (OR 1.05, 95% CI, 1.01-1.09). There were no associations between FI and medical complexity or preferred language. Conclusion: Food insecurity was common among our ED patients. Race and ethnicity, insurance status, and increasing patient age were associated with increased odds of FI. Efforts to include universal FI screening for ED patients with immediate connection to resources will enhance overall care quality and address important health needs.

scholarly journals FEATURES OF CLINICAL SYMPTOMS AND THE INFLUENCE OF RISK FACTORS ON THE OCCURRENCE OF BRONCHIAL ASTHMA IN CHILDREN OF LVIV REGION OF DIFFERENT AGES

2021 ◽  
pp. 96-101
Author(s):  
O. R. Trutiak ◽  
O. L. Lychkovska ◽  
R. R. Holovyn ◽  
M. I. Dats-Opoka
Keyword(s):  
Risk Factors ◽  
Preschool Children ◽  
Bronchial Asthma ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Physical Development ◽  
Shortness Of Breath ◽  
Different Ages ◽  
Asthma In Children

Bronchial asthma (BA) is a common chronic pathology of the lower respiratory tract in children. The first manifestations of the disease can begin at any age, but the clinical features, of the course, are different in different periods of childhood. Manifestations and course of asthma may disappear or progress with age. Therefore, it is likely that there are differences in the pathophysiology, inflammatory response of the body and the features of the clinic of asthma in children of different ages, which affects the diagnosis and treatment. The aim of the study was to determine the features of clinical symptoms and the influence of risk factors for asthma on its occurrence in children of different ages. Materials and methods. We analyzed the anamnesis and clinical symptoms of 57 children aged 3 to 18 years, who were treated from September 2020 to June 2021 in the Lviv Regional Children's Clinical Hospital “OHMATDYT” and in the Lviv Municipal City Children's Clinical Hospital. The age groups did not differ statistically in the severity of asthma (P> 0.05). Thus, in group 1 was 1 patient (9.09%) with mild form, 1 patient (9.09%) - moderate persistent form, 8 patients (72.73%) - with severe persistent form. Among patients of age group 2 was 1 patient (3.85%) with mild persistent form, 3 children (11.54%) - moderate and 21 children (80.77%) - with severe persistent form. In group 3 was 1 patient (5%) with a mild persistent form, 6 patients (30%) - moderate and 12 children (80%) - with a severe persistent form. The vast majority of patients were boys (84.21 ± 4.83%). All patients underwent general clinical examinations, spirometry, and allergy tests. We used the clinical-anamnestic method to perform the tasks of the work, which consisted in collecting a detailed somatic and genealogical anamnesis during the parents` questionnaire. Physical development of children was assessed using centile tables. Statistics were evaluated by calculating Student's t-test and Pearson's consistency test. Preschool children with asthma were more likely to experience shortness of breath during exercise and a wet low-yielding cough, and children of primary and secondary school age were more characterized by concomitant allergic rhinitis. Autumn was more unfavorable period for the exacerbation of clinical manifestations of asthma in children of Lviv region was period. We did not find correlation of birth weight on the timing of asthma. However, a burdensome obstetric history contributed to the early development of clinical manifestations of asthma. Preschool children were more likely to be exposed to nicotine during the antenatal period and had a shorter duration of breastfeeding, which may be a probable risk factor for asthma in preschool children. In 77% of children from different age groups were burdened with a history of allergies, with 66% of cases more pronounced in the maternal line. An analysis of physical development revealed that most preschool children were overweight. Conclusions. Asthma has features of clinical symptoms in children of different ages - shortness of breath during exercise and whooping cough are characteristic of preschool children, and concomitant chronic persistent rhinitis - for older age groups. Seasonal exacerbations are characteristic of asthma in children; in particular, the autumn period is more unfavorable, common for asthmatics in children of all ages among patients in Lviv region. Maternal smoking during pregnancy has a significant effect on the risk of developing asthma in children. Also, a burdened maternal allergy history and overweight child contributes to the development of asthma in children.

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