Antiretrovirals increase risk factors for CVD

2003 ◽  
Vol &NA; (959) ◽  
pp. 3
Author(s):  
&NA;
Keyword(s):  
Risk Factors ◽  
Increase Risk

Major Depression and Generalised Anxiety Disorder

1996 ◽  
Vol 168 (S30) ◽  
pp. 68-75 ◽  
Author(s):  
Kenneth S. Kendler
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Major Depression ◽  
Environmental Risk ◽  
Genetic Factors ◽  
Environmental Risk Factors ◽  
Generalised Anxiety Disorder ◽  
Increase Risk ◽  
Twin Models ◽  
One Year

In both clinical and epidemiological samples, major depression (MD) and generalised anxiety disorder (GAD) display substantial comorbidity. In a prior analysis of lifetime MD and GAD in female twins, the same genetic factors were shown to influence the liability to MD and to GAD. A follow-up interview in the same twin cohort examined one-year prevalence for MD and GAD (diagnosed using a one-month minimum duration of illness). Bivariate twin models were fitted using the program Mx. High levels of comorbidity were observed between MD and GAD. The best-fitting twin models, when GAD was diagnosed with or without a diagnostic hierarchy, found a genetic correlation of unity between the two disorders. The correlation in environmental risk factors was +0.70 when GAD was diagnosed non-hierarchically, but zero when hierarchical diagnoses were used. Our findings provide further support for the hypothesis that in women, MD and GAD are the result of the same genetic factors. Environmental risk factors that predispose to ‘pure’ GAD episodes may be relatively distinct from those that increase risk for MD.

scholarly journals Reference Values of D-Dimers and Fibrinogen in the Course of Physiological Pregnancy: the Potential Impact of Selected Risk Factors—A Pilot Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Aldona Siennicka ◽  
Magdalena Kłysz ◽  
Kornel Chełstowski ◽  
Aleksandra Tabaczniuk ◽  
Zuzanna Marcinowska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gestational Diabetes ◽  
Reference Values ◽  
Venous Blood ◽  
Fibrinogen Concentration ◽  
Reference Ranges ◽  
Second Trimester ◽  
Increase Risk ◽  
Potential Impact ◽  
D Dimer

Pregnancy predisposes to thrombotic hemostasis, reflected in the laboratory as, e.g., increased levels of D-Dimers and fibrinogen, but in physiological pregnancy, the risk of venous thrombosis does not increase. Risk may increase if gestational diabetes mellitus (GDM) or nicotinism coexists. Study aims were to determine reference values ​​for D-Dimers and fibrinogen concentrations in each trimester of pregnancy, corrected for GDM and nicotinism. Subjects and Methods. The study involved 71 pregnant women aged 25-44 y. Venous blood was collected three times: in the first (11-14 weeks), second (20-22 weeks), and third (30-31 weeks) trimesters. D-Dimer concentrations were determined by an enzyme-linked fluorescence assay, fibrinogen concentrations by a coagulation method according to Clauss. Results. Significant increases in D-Dimers and fibrinogen concentrations were observed, increasing with successive trimesters (p ANOVA<0.0001). Furthermore, a positive correlation between D-Dimers and fibrinogen was detected in the second trimester of pregnancy (r=0.475; p<0.0001). In addition, a significantly higher fibrinogen concentration was found in women with GDM compared to without GDM (p=0.0449). Reference ranges for D-Dimers were established, in trimester order, as follows: 167-721 ng/mL, 298-1653 ng/mL, and 483-2256 ng/mL. After adjusting for risk factors, significantly higher D-Dimer values ​​(mainly second and third trimesters) were obtained: 165-638 ng/mL, 282-3474 ng/mL, and 483-4486 ng/mL, respectively. Reference ranges for fibrinogen were, in trimester order, 2.60-6.56 g/L, 3.40-8.53 g/L, and 3.63-9.14 g/L and, after adjustment for risk factors, 3.34-6.73 g/L, 3.40-8.84 g/L, and 3.12-9.91 g/L. Conclusions. We conclude that the increase in D-Dimers and fibrinogen levels in women with physiological pregnancy was compounded by gestational diabetes (GDM) and nicotinism. Therefore, D-Dimers and fibrinogen pregnancy reference values require correction for these risk factors.

scholarly journals Risk Factors Associated with Carbapenemase-Producing Enterobacterales (CPE) Positivity in the Hospital Wastewater Environment

2020 ◽  
Vol 86 (24) ◽  
Author(s):  
Stacy C. Park ◽  
Hardik Parikh ◽  
Kasi Vegesana ◽  
Nicole Stoesser ◽  
Katie E. Barry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Hospital Environment ◽  
Hospital Wastewater ◽  
Content Type ◽  
The Past ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Increase Risk ◽  
Gram Negative Organisms

ABSTRACT Hospital wastewater is an increasingly recognized reservoir for resistant Gram-negative organisms. Factors involved in establishment and persistence of Klebsiella pneumoniae carbapenemase-producing organisms (KPCOs) in hospital wastewater plumbing are unclear. This study was conducted at a hospital with endemic KPCOs linked to wastewater reservoirs and robust patient perirectal screening for silent KPCO carriage. Over 5 months, both rooms occupied and rooms not occupied by KPCO-positive patients were sampled at three wastewater sites within each room (sink drain, sink P-trap, and toilet or hopper). Risk factors for KPCO positivity were assessed using logistic regression. Whole-genome sequencing (WGS) identified environmental seeding by KPCO-positive patients. A total of 219/475 (46%) room sampling events were KPCO positive in at least one wastewater site. KPCO-positive patient exposure was associated with increased risk of environmental positivity for the room and toilet/hopper. Previous positivity and intensive care unit room type were consistently associated with increased risk. Tube feeds were associated with increased risk for the drain, while exposure to patients with Clostridioides difficile was associated with decreased risk. Urinary catheter exposure was associated with increased risk of P-trap positivity. P-trap heaters reduced risk of P-trap and sink drain positivity. WGS identified genomically linked environmental seeding in 6 of 99 room occupations by 40 KPCO-positive patients. In conclusion, KPCO-positive patients seed the environment in at least 6% of opportunities; once positive for KPCOs, wastewater sites are at greater risk of being positive subsequently. Increased nutrient exposure, e.g., due to tube food disposal down sinks, may increase risk; frequent flushing may be protective. IMPORTANCE Klebsiella pneumoniae carbapenemase-producing organisms (KPCOs) are bacteria that are resistant to most antibiotics and thus are challenging to treat when they cause infections in patients. These organisms can be acquired by patients who are hospitalized for other reasons, complicating their hospital stay and even leading to death. Hospital wastewater sites, such as sink drains and toilets, have played a role in many reported outbreaks over the past decade. The significance of our research is in identifying risk factors for environmental positivity for KPCOs, which will facilitate further work to prevent transmission of these organisms to patients from the hospital environment.

scholarly journals Risk Factors That Increase Risk of Estrogen Receptor–Positive and –Negative Breast Cancer

2016 ◽  
Vol 109 (5) ◽  
pp. djw276 ◽  
Author(s):  
Karla Kerlikowske ◽  
Charlotte C. Gard ◽  
Jeffrey A. Tice ◽  
Elad Ziv ◽  
Steven R. Cummings ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Estrogen Receptor ◽  
Increase Risk ◽  
Estrogen Receptor Positive

Thrombotic events in metastatic colorectal cancer patients treated with FOLFIRI plus bevacizumab.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14630-e14630
Author(s):  
Humaid O. Al-Shamsi ◽  
Mahraz Anjum ◽  
Abdulaziz Mohammed Al Farsi ◽  
Hua Shen ◽  
Richard J. Cook ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Control Groups ◽  
Single Institution ◽  
Increase Risk ◽  
Treatment Data ◽  
Metastatic Sites ◽  
Colorectal Cancer Patients

e14630 Background: To determine the incidence and risk factors for thrombotic events (TEs) (arterial and venous) in patients with metastatic colorectal cancer (mCRC) who received Bevacizumab and FOLFIRI (Leucovorin, Fluorouracil and Irinotican ) compared to FOLFIRI alone. Methods: Single institution retrospective study of 450 mCRC patients who received either Bevacizumab plus FOLFIRI or FOLFIRI alone between October 2006 and September 2012. Demographics , TE risk factors and treatment data were abstracted from patients records. Multivariate analysis was used to determine factors that contributed to increased TE incidence. Results: 261 mCRC patients received Bevacizumab plus FOLFIRI ( 64.8 % males , mean Body Mass Index (BMI) 26.1 ) compared to 189 control patients who received FOLFIRI alone ( 61.1 % males ,BMI 27). The incidence of TEs was 15 % (arterial 1.8% + venous 13.2%) in the Bevacizumab plus FOLFIRI group compared to 15.8% (arterial 2.1% + venous 13.7%) in the control groups. Multivariate analysis controlled for age, BMI, gender, malignancy, metastatic sites , line of treatment, and risk factors did not suggest a significant increase in risk of TE associated with Bevacizumab (OR=0.83 95% CI: 0.40 - 1.70; p=0.602). No difference in locations of TEs was observed between both groups . The only statistically significant factor for thrombosis in Bevacizumab group was increased BMI (OR=1.05; 95% CI: 1.01- 1.10; p=0.016). Conclusions: Our data suggest that bevacizumab did not significantly increase the rate of thrombosis in patients with mCRC when added to FOLFIRI. To our knowledge this is the first study reporting the rate of TEs (arterial and venous) in this population.Our data suggest that BMI may be a risk factor for increase risk of thrombosis in patients treated with bevacizumab . Clinician should consider risk factors assessment prior to initiating bevacizumab .

scholarly journals A Review of Psychosocial Risk Factors for Pediatric Atopy

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Christina L. Duncan ◽  
Stacey L. Simon
Keyword(s):  
Risk Factors ◽  
Young Children ◽  
Disease Onset ◽  
Allergic Diseases ◽  
Children And Families ◽  
Intrauterine Environment ◽  
Childhood Experiences ◽  
Social Challenges ◽  
Increase Risk

Pediatric atopy is increasing in prevalence and creates a significant financial and quality of life burden for children and families (e.g., frequent clinic visits, academic, and social challenges). Thus, it is important to understand modifiable risk factors related to disease onset or exacerbation in young children. The existing research base suggests that while a genetic link has been identified, specific family psychological factors (e.g., parent stress) also appear to play a significant role in the development of pediatric atopy. The function of psychological stress in the clinical expression and exacerbation of allergic diseases in young children is hypothesized to be due to neuroendocrine and immunologic systems. Specifically, stress-related activation of the sympathetic and adrenomedullary (SAM) system as well as the hypothalamic-pituitary-adrenocortical (HPA) axis from both the intrauterine environment and early childhood experiences may increase risk of childhood atopy above and beyond genetic risk. Consequently, prevention and intervention strategies aimed at reducing children’s early exposure to stress and psychological difficulties in parents may prove beneficial in preventing or reducing the likelihood that their children will develop atopy.

Prevalence and Characteristics of Intracranial Hemorrhages in Neonates with Hypoxic Ischemic Encephalopathy

2017 ◽  
Vol 35 (07) ◽  
pp. 676-681 ◽  
Author(s):  
Rani Bashir ◽  
Sakeer Vayalthrikkovil ◽  
Liza Espinoza ◽  
Leigh Irvine ◽  
James Scott ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Mri ◽  
Mode Of Delivery ◽  
Hypoxic Ischemic Encephalopathy ◽  
Severe Thrombocytopenia ◽  
Intracranial Hemorrhages ◽  
Increase Risk ◽  
Magnetic Resonance Imaging Mri ◽  
The Impact ◽  
Ischemic Encephalopathy

Introduction The risk factors of intracranial hemorrhages (ICH) in the context of neonatal hypoxic ischemic encephalopathy (HIE) and related interventions are unclear. Objective This article examines the prevalence and risk factors associated with ICH in neonates with HIE. Study Design This is a retrospective cohort study of neonates with HIE in Southern Alberta. ICH (subdural [SDH], subarachnoid [SAH], intraventricular [IVH], intraparenchymal [IPH]) were diagnosed by magnetic resonance imaging (MRI). Perinatal and neonatal characteristics were examined. Relation of hemorrhages with hypoxic changes on MRI and HIE stages were assessed. Results Number of HIE patients, n = 157; brain MRI was done in 138 infants; median gestation, 40 weeks; and cooled = 103 (66%). Prevalence of SDH, IPH, IVH, and SAH were 47, 22, 11, and 10 (34.1%, 15.9%, 7.8%, 7.2%), respectively. There was no significant increase in hemorrhage with mode of delivery, seizures, hypo/hypercarbia, severe thrombocytopenia, or deranged coagulation. All hemorrhages increased with higher HIE stage, regardless of the HIE severity in MRI. Adjusting for HIE staging, cooling, and gestation, IPH was observed more in infants who received inotropes (odds ratio [OR], 3.32; 95% confidence interval [CI], 1.20, 9.20). Conclusion SDH followed by IPH were the most common ICH. Thrombocytopenia and deranged coagulation did not increase risk of hemorrhages in HIE. Our study was not powered to determine the impact of inotrope use on the risk of IPH.

scholarly journals Risk factors associated with severe outcomes of COVID-19: An updated rapid review to inform national guidance on vaccine prioritization in Canada

2021 ◽  
Author(s):  
Michelle Gates ◽  
Jennifer Pillay ◽  
Aireen Wingert ◽  
Samantha Guitard ◽  
Sholeh Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Pediatric Population ◽  
Rapid Review ◽  
Future Research ◽  
Adult Males ◽  
Online Databases ◽  
National Guidance ◽  
Increase Risk ◽  
End Stage

Background: To inform vaccine prioritization guidance by the National Advisory Committee on Immunization (NACI), we reviewed evidence on the magnitude of association between risk factors and severe outcomes of COVID-19. Methods: We updated our existing review by searching online databases and websites for cohort studies providing multivariate adjusted associations. One author screened studies and extracted data. Two authors estimated the magnitude of association between exposures and outcomes as little-to-no (odds, risk, or hazard ratio <2.0, or >0.50 for reduction), large (2.0-3.9, or 0.50-0.26 for reduction), or very large (>=4.0, or <=0.25 for reduction), and rated the evidence certainty using GRADE. Results: Of 7,819 unique records we included 111 reports. There is probably (moderate certainty) at least a large increase in mortality from COVID-19 among people aged 60-69 vs. <60 years (11 studies, n=517,217), with 2+ vs. no comorbidities (4 studies, n=189,608), and for people with (vs. without): Down syndrome (1 study, n>8 million), type 1 and 2 diabetes (1 study, n>8 million), end-stage kidney disease (1 study, n>8 million), epilepsy (1 study, n>8 million), motor neuron disease, multiple sclerosis, myasthenia gravis, or Huntingtons disease (as a grouping; 1 study, n>8 million). The magnitude of association with mortality is probably very large for Down syndrome and may (low certainty) be very large for age 60-69 years, and diabetes. There is probably little-to-no increase in severe outcomes with several cardiovascular and respiratory conditions, and for adult males vs. females. Interpretation: Future research should focus on risk factors where evidence is low quality (e.g., social factors) or non-existent (e.g., rare conditions), the pediatric population, combinations of comorbidities that may increase risk, and long-term outcomes. Systematic review registration: PROSPERO #CRD42021230185.

scholarly journals 1142. A multicenter cohort study to identify differences between methicillin-susceptible and methicillin-resistant Staphylococcus aureus infections in pediatrics in Bogotá, Colombia, 2014-2018

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S662-S663
Author(s):  
Jhon Camacho ◽  
Ivan Felipe Gutiérrez Tobar ◽  
Katherine Brand ◽  
Yeni Sosa ◽  
Pablo Vásquez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Laboratory ◽  
Pediatric Population ◽  
Panel Member ◽  
Inotropic Support ◽  
Multicenter Cohort Study ◽  
Material Support ◽  
Methicillin Resistant ◽  
Increase Risk ◽  
Previous Hospitalization

Abstract Background The epidemiology of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus in pediatrics has changed in recent years. MRSA infections have been reported to be more severe than MSSA. Methods Multicenter retrospective cohort, in 6 pediatric hospitals in Bogotá, Colombia, between January 1, 2014, and December 31, 2018, 1 isolate was included for patient from the same origin. Infections were classified into: SSTI, osteoarticular, bacteremia, or pneumonia.The objective is to establish differences between clinical, laboratory, and outcomes of MSSA and MRSA infections, according to origin of the infection in a pediatric population from Bogotá, Colombia. Results 551 patients were included; 211 (38%) MRSA and 340 (62%) MSSA, in total 703 cultures. Figure 1. Some risk factors were statistically associated with MSSA: Heart disease (3.3% Vs. 0.5%) neurologic disease (5.9% vs. 2.4%), surgery in last 6 months (11% vs. 5%), use of vascular or external devices (3% vs 11%) and previous hospitalization &gt;3 days (11% vs 17%) Table 2. In 84/159 (52%) cases, bacteremia was associated with osteoarticular infection (OI), 19/159 (13%) with pneumonia, 21/159 (13%) with SSTI, 14/159 (9%) with other foci, 21/159 (13%) were primary. Independently of the origin, PICU admittance was more frequent in MRSA (52% vs. 28), as well as mechanical ventilation (MV) (30% vs. 13%) and inotropic support (IS )(38% vs 17%). Of 136 osteoarticular infections, 59 (43,4%) were MRSA and 77 (56,6%) MSSA. MRSA isolates required more than 3 surgical procedures (45% vs 24%), more PICU admittance (36% vs. 12%) and IS (27% vs. 5%). Complicated pneumonia was more frequently associated to MRSA in comparison with MSSA (57% vs. 23%). In pneumonia, MRSA also was significantly associated with PICU. (74%vs 50%), MS (61%vs 32%), and VS (52% vs 27%). SSTI was not associated with greater severity or worse outcome (PICU, MV, IS) according to S. aureus susceptibility. Table 3b. Infection groups depending on the presence or not of resistance Conclusion MRSA was associated with more severe course in bacteremia, OI and pneumonia. It is interesting that some classically risk factors associated with MRSA infections were found to be related to MSSA. In general, with SSTI exception, MRSA increase risk of PICU, mechanical support and inotropic support in a pediatric population in Bogotá, Colombia. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Sandra Beltran, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

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