scholarly journals RISK FACTORS FOR PREMATURE BIRTH. IS EVERYTHING UNAMBIGU-OUS?

2021 ◽  
Vol 9 (1) ◽  
pp. 77-90
Author(s):  
I.V. Galinova ◽  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Premature Birth ◽  
Risk Group ◽  
Polycystic Ovary ◽  
Asymptomatic Bacteriuria ◽  
High Risk Group ◽  
Ovary Syndrome ◽  
History Of

Aim. Despite the fact that ischemic-cervical insufficiency (ICI) is considered to be a risk factor for preterm birth (PB), a comparative analysis of the risk factors for each complication of gestation (ICI and PB) showed considerable differences. This was the reason for conducting a study to identify the most significant risk factors for PB and ICI. Materials and Methods. A questionnaire survey of 267 pregnant women was carried out to study the anamnestic risk factors for PR and for assessment of the course and outcomes of the current pregnancy. The existence of statistically significant differences was determined using Fishers exact test, and the ranking of risk factors was performed by the value of x2 criterion, adjusted for likelihood. Results. Pregnancy ended prematurely in 14 women (5.2%). Extremely early PB made 14.3% among all PB, premature births – 21.4%, late births – 64.3%, early PB were absent. Spontaneous and induced PB occurred with the same frequency – 50% each in the PB structure. Based on the x2 calculation, a rating of the PB risk factors was made. The 1st place – history of induced PB, 2 – history of polycystic ovary syndrome; 3 – in vitro fertilization; 4 – arterial hypertension; 5 – asymptomatic bacteriuria; 6 – ICI; 7 – hypothyroidism; 8 – the premature birth of the father. Also, an assessment of the risk factors for ICI was carried out and their rating was compiled: 1 – intra-uterine interventions before the first birth; 2 – repeated intrauterine interventions; 3 – history of ICI. Conclusion. Women with endocrine disorders (thyroid disease, polycystic ovary syndrome), arterial hypertension before and during pregnancy, physical inactivity before pregnancy should be considered a high risk group for PB. Asymptomatic bacteriuria is a risk factor not only for PB, but also for ICI, in which connection its early detection and rehabilitation is advisable. In the course of our study, the necessity for cervicometry during the 1st ultrasound screening was confirmed, and dynamic cervicometry can be recommended not only for women with PB, late spontaneous miscarriages, history of ICI and ICI in the current pregnancy, but also for pregnant women with repeated intrauterine interventions and with intrauterine interventions before the first forthcoming birth, for the earlier detection of ICI and formation of a high-risk group for PR for arrangement of preventive measures.

A risk-factor analysis of medical litigation judgments related to fall injuries in Korea

2017 ◽  
Vol 58 (1) ◽  
pp. 16-24
Author(s):  
Insook Kim ◽  
Seonae Won ◽  
Mijin Lee ◽  
Won Lee
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Environmental Factors ◽  
Fall Prevention ◽  
Systems Approach ◽  
Risk Group ◽  
Past History ◽  
High Risk Group ◽  
Fall Injuries

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

scholarly journals TINGKAT KECEMASAN IBU HAMIL TRIMESTER III BERDASARKAN KELOMPOK FAKTOR RESIKO KEHAMILAN

2020 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Ika Septiana Saputri ◽  
Ika Yudianti
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
P Value ◽  
Pregnancy Risk ◽  
Cross Sectional ◽  
Work Area ◽  
Anxiety Levels

Kecemasan pada ibu bahkan yang mempunyai resiko kehamilan yang tinggi dapat memicu terjadinya rangsangan kontraksi rahim sehingga mampu mengakibatkan preeklampsi dan keguguran, kelahiran Bayi Berat Lahir Rendah dan bayi prematur. Perlunya melakukan pengkajian tingkat kecemasan sehingga tidak mengakibatkan komplikasi dalam kehamilan. Tujuan dari penelitian ini yaitu untuk mengetahui perbedaan tingkat kecemasan ibu hamil trimester III berdasarkan kelompok faktor resiko kehamilan Desain penelitian menggunakan analitik komparasi dengan pendekatan cross-sectional. Penelitian ini menggunakan teknik Purposive sampling. Sampel berjumlah 51 orang yang memenuhi kriteria inklusi yaitu tercatat didalam kohort dengan usia kehamilan 28-37 minggu di Wilayah Kerja Puskesmas Gribig, mengetahui faktor resiko kehamilannya, dapat membaca dan menulis, serta bersedia menjadi responden. Analisis data menggunakan uji Kruskall Wallis. Pengumpulan data menggunakan kuesioner ZSAS yang telah dimodifikasi. Hasil uji statistik p value (0,000) < α = (0,05) maka Ho ditolak yang berarti terdapat perbedaan antara Tingkat Kecemasan Ibu Hamil Trimester III berdasarkan Kelompok Faktor Resiko Kehamilan di Wilayah Kerja Puskesmas Gribig Kecamatan Kedungkandang Kota Malang. Mayoritas responden yang termasuk kelompok resiko rendah (88,9%) mengalami tingkat kecemasan ringan, kelompok resiko tinggi (86,7%) mengalami tingkat kecemasan sedang, dan kelompok resiko sangat tinggi (66,7%) mengalami tingkat kecemasan berat. Dari hasil penelitian tersebut, menunjukkan bahwa semakin tinggi faktor resiko yang dialami akan semakin tinggi pula tingkat kecemasan. Sehingga diharapkan bidan dapat memberikan KIE tentang hasil skrinning kelompok faktor resiko kehamilan, serta meningkatkan perhatian dan empati pada ibu hamil yang sangat membutuhkan infomasi lebih mengenai kehamilan guna dapat mengatasi kecemasan yang terjadi. Anxiety in mothers even who have a high risk of pregnancy can trigger stimulation of uterine contractions so that it can lead to preeclampsia and miscarriage, low birth weight birth (LBW) and premature babies. The need to assess anxiety levels so that they do not cause complications in pregnancy. The purpose of this study is to determine differences in anxiety levels of third trimester pregnant women based on pregnancy risk factor groups. The study design uses comparative analytics with cross-sectional approaches. This research uses purposive sampling technique. A sample of 51 people who met the inclusion criteria was recorded in a cohort with 28-37 weeks' gestation in the Gribig Community Health Center Work Area, knew the risk factors for pregnancy, could read and write, and was willing to be respondents. Data analysis using the Kruskall Wallis test. Data collection uses a modified ZSAS questionnaire. Statistical test results p value (0,000) <α = (0.05) then Ho is rejected, which means there is a difference between the Anxiety Levels of Trimester III Pregnancy based on Pregnancy Risk Factors in Gribig Puskesmas Work Area in Kedungkandang District, Malang. The majority of respondents who belong to the low risk group (88.9%) experienced mild anxiety levels, the high risk group (86.7%) experienced moderate anxiety levels, and the very high risk group (66.7%) experienced severe anxiety levels. From the results of the study, showed that the higher the risk factors experienced the higher the level of anxiety. It is hoped that midwives can provide IEC about the screening results of pregnancy risk factor groups, and increase the attention and empathy of pregnant women who really need more information about pregnancy in order to overcome the anxiety that occurs.

scholarly journals Epidemiologic Analysis of Gastric Carcinoma in the Western Region of Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 26-32
Author(s):  
Arnab Ghosh ◽  
Brijesh Sathian ◽  
Dilasma Ghartimagar ◽  
Raghavan Narasimhan ◽  
Om Prakash Talwar
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Gastric Carcinoma ◽  
Ethnic Groups ◽  
Risk Group ◽  
High Risk Group ◽  
Endoscopic Biopsy ◽  
Type Iv ◽  
History Of ◽  
H Pylori

BackgroundGastric cancer is among the most common malignancies in Asia, comprising 74% of all global cases. Identifying the environmental risk factors may possibly shed more light on effective treatment and the prevention of this disease. The aim of our study is to document  different histologic types of gastric cancer as per age, sex and ethnic groups in the patients in Nepal, to know the frequency of different gross and microscopic subtypes (according to Lauren's classification) of tumor and to find out the association of H. pylori and other major risk factors with gastric cancer.Materials and Methods  The present study is a hospital based retrospective study done in the Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal, from Jan 1999 to July 2010. All the endoscopic biopsies and gastrectomy specimens from patients with diagnosed gastric carcinoma were reviewed and the clinical and other data were analyzed.ResultsIn this study period, a total of 1223 cases related to stomach were received in Department of Pathology. Considering the inclusion and exclusion criteria, a total of 397 cases - 315 cases of endoscopic biopsy and 82 cases of gastrectomy - were included in the study. In our study, the most affected age group and caste were 61-70 years ( 47.36%, CI 42.44% to 52.27%) and Gurungs (32%, CI 27.16% to 36.32%). The commonest gross and microscopic types were Borrmann's type IV (40%, CI 29.63% to 50.86%) and intestinal type (53%, CI 47.99% to 57.81%). Gastric antrum was the most affected site (70%, CI 65.26% to 74.29%). Among the cases with H pylori, antrum (62.5% CI 45.73% to 79.27%) was found to be the commonest site. Among all cases in Gurung, Chhetri and Brahmin communities, we retrieved data regarding risk factors in 93, 65 and 50 cases respectively. Significant relationship was found between the three risk factors studied and the ethnic groups. Smoked meat and alcohol were found to be associated with gastric carcinoma more in Gurungs and Chhetris than in Brahmins (p= 0.0001). On the contrary, cases among Brahmins are found to more associated with smoking than Gurungs and Chhetris (p= 0.0001).ConclusionGastric carcinoma is a common malignancy in this part of world. The most high risk group includes elderly males with history of alcoholism and smoked meat consumption in Gurung community and with history of smoking from Brahmin family. We advise that regular endoscopic surveillance should be done at least in high risk group for the early detection of cancer.Key Words: Gastric Carcinoma; Ethnicity; Risk Factors; Epidemiology; Helicobacter pylori; NepalDOI: 10.3126/nje.v1i1.4109Nepal Journal of Epidemiology 2010;1 (1):27-32

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Polycystic Ovary ◽  
High Risk Group ◽  
Stress Factors ◽  
Control Group ◽  
Fertilization In Vitro ◽  
Infertile Women ◽  
Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals Intensive Multiagent Therapy, Including Dose-Compressed Cycles of Ifosfamide/Etoposide and Vincristine/Doxorubicin/Cyclophosphamide, Irinotecan, and Radiation, in Patients With High-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group

2016 ◽  
Vol 34 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Brenda J. Weigel ◽  
Elizabeth Lyden ◽  
James R. Anderson ◽  
William H. Meyer ◽  
David M. Parham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Bone Marrow Involvement ◽  
High Risk Group ◽  
Historical Cohort ◽  
Dismal Prognosis ◽  
Risk Patients ◽  
Metastatic Sites

Purpose Patients with metastatic rhabdomyosarcoma (RMS), except those younger than 10 years with embryonal RMS, have an estimated long-term event-free survival (EFS) of less than 20%. The main goal of this study was to improve outcome of patients with metastatic RMS by dose intensification with interval compression, use of the most active agents determined in phase II window studies, and use of irinotecan as a radiation sensitizer. Patients and Methods Patients with metastatic RMS received 54 weeks of therapy: blocks of therapy with vincristine/irinotecan (weeks 1 to 6, 20 to 25, and 47 to 52), interval compression with vincristine/doxorubicin/cyclophosphamide alternating with etoposide/ifosfamide (weeks 7 to 19 and 26 to 34), and vincristine/dactinomycin/cyclophosphamide (weeks 38 to 46). Radiation therapy occurred at weeks 20 to 25 (primary) but was also permitted at weeks 1 to 6 (for intracranial or paraspinal extension) and weeks 47 to 52 (for extensive metastatic sites). Results One hundred nine eligible patients were enrolled, with a median follow-up of surviving patients of 3.8 years (3-year EFS for all patients, 38% [95% CI, 29% to 48%]; survival, 56% [95% CI, 46% to 66%]). Patients with one or no Oberlin risk factor (age > 10 years or < 1 year, unfavorable primary site of disease, ≥ three metastatic sites, and bone or bone marrow involvement) had a 3-year EFS of 69% (95% CI, 52% to 82%); high-risk patients with two or more risk factors had a 3-year EFS of 20% (95% CI, 11% to 30%). Toxicity was similar to that on prior RMS studies. Conclusion Patients with metastatic RMS with one or no Oberlin risk factor had an improved 3-year EFS of 69% on ARST0431 compared with an historical cohort from pooled European and US studies; those with two or more risk factors have a dismal prognosis, and new approaches are needed for this very-high-risk group.

scholarly journals A model for predicting carotid instability plaque in high risk group of stroke individuals

2019 ◽  
Author(s):  
Junxiong Yin ◽  
Chuanyong Yu ◽  
Hongxing Liu ◽  
Mingyang Du ◽  
Feng Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Predictive Model ◽  
Doppler Ultrasound ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
High Risk Population ◽  
Auc Value ◽  
Validation Set

Abstract Objective: To establish a predictive model of carotid vulnerable plaque through systematic screening of high-risk population for stroke.Patients and methods: All community residents who participated in the screening of stroke high-risk population by the China National Stroke Screening and Prevention Project (CNSSPP). A total of 19 risk factors were analyzed. Individuals were randomly divided into Derivation Set group and Validation Set group. According to carotid ultrasonography, the derivation set group patients were divided into instability plaque group and non-instability plaque group. Univariate and multivariable logistic regression were taken for risk factors. A predictive model scoring system were established by the coefficient. The AUC value of both derivation and validation set group were used to verify the effectiveness of the model.Results: A total of 2841 high-risk stroke patients were enrolled in this study, 266 (9.4%) patients were found instability plaque. According to the results of Doppler ultrasound, Derivation Set group were divided into instability plaque group (174 cases) and non-instability plaque group (1720 cases). The independent risk factors for carotid instability plaque were: male (OR 1.966, 95%CI 1.406-2.749)，older age (50-59, OR 6.012, 95%CI 1.410-25.629; 60-69, OR 13.915, 95%CI 3.381-57.267;≥70, OR 31.267, 95%CI 7.472-130.83) , married(OR 1.780, 95%CI 1.186-2.672)，LDL-c(OR 2.015, 95%CI 1.443-2.814), and HDL-C(OR 2.130, 95%CI 1.360-3.338). A predictive scoring system was created, range 0-10. The cut-off value of prediction model score is 6.5. The AUC value of derivation and validation set group were 0.738 and 0.737.Conclusion：For a high risk group of stroke individual, We provide a model that could distinguishing those who have a high probability of having carotid instability plaque. When resident’s predictive model score exceeds 6.5, the incidence of carotid instability plaque is high, carotid artery Doppler ultrasound would be checked immediately. This model can be helpful in the primary prevention of stroke.

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