scholarly journals Study of Symptomatic vs. Silent Brain Infarctions on MRI in Elderly Subjects

2021 ◽  
Vol 12 ◽  
Author(s):  
Sheelakumari Raghavan ◽  
Jonathan Graff-Radford ◽  
Eugene Scharf ◽  
Scott A. Przybelski ◽  
Timothy G. Lesnick ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Right Hemisphere ◽  
Image Data ◽  
Clinical History ◽  
Population Based ◽  
Elderly Subjects ◽  
Symptomatic Carotid ◽  
Factors Associated ◽  
Medical Chart Review ◽  
History Of

Brain infarctions are closely associated with future risk of stroke and dementia. Our goal was to report (i) frequency and characteristics that differentiate symptomatic vs. silent brain infarctions (SBI) on MRI and (ii) frequency and location by vascular distribution (location of stroke by major vascular territories) in a population based sample. From Mayo Clinic Study of Aging, 347 participants (≥50 years) with infarcts detected on their first MRI were included. Infarct information was identified visually on a FLAIR MRI image and a vascular territory atlas was registered to the FLAIR image data in order to identify the arterial territory of infarction. We identified the subset with a clinical history of stroke based on medical chart review and used a logistic regression to evaluate the risk factors associated with greater probability of a symptomatic stroke vs. SBI. We found that 14% of all individuals with infarctions had a history of symptomatic stroke (Silent: n = 300, symptomatic: n = 47). Factors associated with a symptomatic vs. SBI were size which had an odds ratio of 3.07 (p < 0.001), greater frequency of hypertension (odds ratio of 4.12, p = 0.025) and alcohol history (odds ratio of 4.58, p = 0.012). The frequency of infarcts was greater in right hemisphere compared to the left for SBI. This was primarily driven by middle cerebral artery (MCA) infarcts (right = 60%, left = 40%, p = 0.005). While left hemisphere strokes are more common for symptomatic carotid disease and in clinical trials, right hemispheric infarcts may be more frequent in the SBI group.

Readmission after Adult Uvulopalatopharyngoplasty: A Population-Based Inpatient Cohort Study in Taiwan

2018 ◽  
Vol 160 (3) ◽  
pp. 559-566 ◽  
Author(s):  
Ying-Shuo Hsu ◽  
Wei-Chung Hsu ◽  
Jenq-Yuh Ko ◽  
Te-Huei Yeh ◽  
Chia-Hsuan Lee ◽  
...  
Keyword(s):  
Odds Ratio ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Factors Associated ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Classification Of Diseases ◽  
Insurance Database ◽  
Population Based Survey

Objective To investigate readmissions among adult inpatients who underwent uvulopalatopharyngoplasty (UPPP) in Taiwan. Design Population-based survey. Setting Retrospective study with the National Health Insurance Database. Methods All cases of inpatient adult UPPP (age >20 years) from 1997 to 2012 were identified through International Classification of Diseases, Ninth Revision, Clinical Modification. Factors associated with readmission within 30 days after surgery were analyzed. Results A total of 38,839 adults with UPPP were identified (mean age, 39.3 years; men, 73.7%). The incidence of UPPP was 14.6 per 100 000 adults, which increased from 1997 to 2012 (6.7 to 16.7 per 100,000, Ptrend < .001). The rates of readmission for any reason, readmission for bleeding, reoperation for bleeding, and 30-day mortality were 4.2%, 1.7%, 1.0%, and 0.14%, respectively. Young age increased the risk of reoperation for bleeding, and old age increased the risk of readmission for any reason and mortality. Men had an increased risk of readmission and reoperation. Hypertension was associated with an increased risk of readmission for any reason (odds ratio [OR], 1.29; 95% CI, 1.10-1.51), bleeding-related readmission (OR, 1.89; 95% CI, 1.52-2.36), and reoperation (OR, 2.47; 95% CI, 1.84-3.30). Concurrent hypopharyngeal surgery was associated with an increased risk of readmission for any reason (OR, 1.34; 95% CI, 1.07-1.66) and bleeding-related readmission (OR, 1.69; 95% CI, 1.25-2.27). Finally, the use of steroids was associated with an increased risk of bleeding-related readmission and reoperation. Conclusions The incidence of adult UPPP increased from 1997 to 2012 in Taiwan. Age, sex, comorbidity, concurrent hypopharyngeal surgery, and drug administration were associated with readmission after inpatient UPPP.

Abstract 3584: The Prevalence and Factors Associated With 1-Year Angina among Post-MI Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Thomas M Maddox ◽  
Kimberly J Reid ◽  
John A Spertus ◽  
Susmita Parashar ◽  
Harlan M Krumholz ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Multivariable Analysis ◽  
Clinical History ◽  
Hospital Treatment ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Risk Patients ◽  
History Of ◽  
Socio Demographic Factors ◽  
Persistent Smoking

Background: A primary goal of in-hospital treatment and outpatient care following myocardial infarction (MI) is the eradication of angina. However, the prevalence of angina and the factors associated with angina in the year after MI are unknown. Methods: The primary outcome of the PREMIER multi-center prospective study was presence of angina, as measured by the Seattle Angina Questionnaire (SAQ), 1 year after MI hospitalization. Multivariable regression modeling identified the socio-demographic factors, clinical history, MI presentation, inpatient therapies and complications, and outpatient treatment characteristics associated with 1-year angina, adjusted for site. . Results: Of 1957 patients in the cohort, 83 patients (4.2%) reported daily or weekly angina, and 306 patients (15.6%) reported less than weekly angina 1 year after their index MI. After multivariable analysis (figure ), angina 1 year after an index MI was associated with younger age, non-white race, baseline angina, history of CABG surgery, no inpatient revascularization, recurrent rest angina during MI hospitalization, persistent smoking after MI hospitalization, outpatient revascularization after MI hospitalization, and depressive symptoms (either as an inpatient or during the year after MI hospitalization). Conclusions: Angina 1 year after MI hospitalization is associated with several modifiable factors, including persistent smoking and depressive symptoms in the year after MI discharge. Recognition of these relationships will be important in monitoring and treating at-risk patients for post-MI angina.

Factors associated with morbidity during the 2003 heat wave in two population-based cohorts of elderly subjects: PAQUID and Three City

2008 ◽  
Vol 23 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Sophie Larrieu ◽  
Laure Carcaillon ◽  
Agnès Lefranc ◽  
Catherine Helmer ◽  
Jean-François Dartigues ◽  
...  
Keyword(s):  
Heat Wave ◽  
Population Based ◽  
Elderly Subjects ◽  
Factors Associated

Epidemiology of Methicillin-ResistantStaphylococcus aureusBloodstream Coinfection Among Adults With Candidemia in Atlanta, GA, 2008–2012

2015 ◽  
Vol 36 (11) ◽  
pp. 1298-1304 ◽  
Author(s):  
Jessica Reno ◽  
Saumil Doshi ◽  
Amy K. Tunali ◽  
Betsy Stein ◽  
Monica M. Farley ◽  
...  
Keyword(s):  
Nursing Home ◽  
Medical Records ◽  
Odds Ratio ◽  
Nursing Home Residents ◽  
Population Based ◽  
Emerging Infections ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Active Population ◽  
Invasive Infections

BACKGROUNDPatients with candidemia are at risk for other invasive infections, such as methicillin-resistantStaphylococcus aureus(MRSA) bloodstream infection (BSI).OBJECTIVETo identify the risk factors for, and outcomes of, BSI in adults withCandidaspp. and MRSA at the same time or nearly the same time.DESIGNPopulation-based cohort study.SETTINGMetropolitan Atlanta, March 1, 2008, through November 30, 2012.PATIENTSAll residents withCandidaspp. or MRSA isolated from blood.METHODSThe Georgia Emerging Infections Program conducts active, population-based surveillance for candidemia and invasive MRSA. Medical records for patients with incident candidemia were reviewed to identify cases of MRSA coinfection, defined as incident MRSA BSI 30 days before or after candidemia. Multivariate logistic regression was performed to identify factors associated with coinfection in patients with candidemia.RESULTSAmong 2,070 adult candidemia cases, 110 (5.3%) had coinfection within 30 days. Among these 110 coinfections, MRSA BSI usually preceded candidemia (60.9%; n=67) or occurred on the same day (20.0%; n=22). The incidence of coinfection per 100,000 population decreased from 1.12 to 0.53 between 2009 and 2012, paralleling the decreased incidence of all MRSA BSIs and candidemia. Thirty-day mortality was similarly high between coinfection cases and candidemia alone (45.2% vs 36.0%,P=.10). Only nursing home residence (odds ratio, 1.72 [95% CI, 1.03–2.86]) predicted coinfection.CONCLUSIONSA small but important proportion of patients with candidemia have MRSA coinfection, suggesting that heightened awareness is warranted after 1 major BSI pathogen is identified. Nursing home residents should be targeted in BSI prevention efforts.Infect. Control Hosp. Epidemiol.2015;36(11):1298–1304

scholarly journals Food-induced anaphylaxis in early childhood and factors associated with its severity

2021 ◽  
Vol 42 (5) ◽  
pp. e135-e144 ◽  
Author(s):  
Metin Aydogan ◽  
Erdem Topal ◽  
Nalan Yakıcı ◽  
Hazal Cansu Acar ◽  
Zeynep Hızlı Demirkale ◽  
...  
Keyword(s):  
Early Childhood ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Factors Associated ◽  
Pediatric Allergy ◽  
Severe Anaphylaxis ◽  
Medical Chart Review ◽  
Allergy And Immunology ◽  
Hen’S Egg ◽  
History Of

Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6‐18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

scholarly journals Nephrolithiasis in gout: prevalence and characteristics of Brazilian patients

2019 ◽  
Vol 60 (1) ◽  
Author(s):  
Leonardo Santos Hoff ◽  
Claudia Goldenstein-Schainberg ◽  
Ricardo Fuller
Keyword(s):  
Uric Acid ◽  
Clinical History ◽  
Potassium Citrate ◽  
Male Gender ◽  
Inverse Association ◽  
Tertiary Referral Hospital ◽  
Urine Ph ◽  
Factors Associated ◽  
Primary Gout ◽  
History Of

Abstract Background The aims of this article were to assess the prevalence of nephrolithiasis and the factors associated with nephrolithiasis in Brazilian patients with primary gout. Methods One hundred twenty-three patients with primary gout were recruited from a tertiary referral hospital in São Paulo, Brazil. All patients underwent ultrasonography and had their clinical and laboratory characteristics assessed. Results One hundred fifteen (93.5%) patients were male, with a mean age of 62.9 ± 9.4 years. Twenty-three (18.7%) patients had asymptomatic nephrolithiasis (detected only by ultrasonography), 7 (6.0%) had symptomatic nephrolithiasis (detected by ultrasonography and a positive clinical history), and 13 (10.0%) had a history of kidney stones, but ultrasonography at evaluation did not show nephrolithiasis. Therefore, 35.0% of the patients had nephrolithiasis (detected either by ultrasonography and/or a positive clinical history). Nephrolithiasis was associated with male gender (43 [100%] vs 72 [90%], p = 0.049), the use of potassium citrate (13 [30.2%] vs 0, p <  0.001) and the use of medications for diabetes (10 [23.3%] vs 8 [10%], p = 0.047) and dyslipidemia (15 [34.9%] vs 10 [12.5%], p = 0.003); benzbromarone had an inverse association with nephrolithiasis (21 [48.8%] vs 55 [68.8%], p = 0.030). In patients with and without nephrolithiasis, no differences were found in the laboratory and ultrasonography characteristics, including serum uric acid levels, urinary uric acid excretion and urine pH. Conclusions The prevalence of nephrolithiasis in primary gout was 35.0%, and 18.7% of the patients were asymptomatic. Nephrolithiasis was associated with male gender, diabetes and dyslipidemia. A positive history of nephrolithiasis probably biased the prescription of potassium citrate and benzbromarone.

Bilateral Solar Retinopathy After Gazing at the Great American Eclipse

2018 ◽  
Vol 2 (5) ◽  
pp. 316-320
Author(s):  
Himanshu K. Banda ◽  
Sabin Dang ◽  
Anjali G. Shah ◽  
Gaurav K. Shah
Keyword(s):  
Multimodal Imaging ◽  
Vision Loss ◽  
Clinical History ◽  
Total Solar Eclipse ◽  
Visual Recovery ◽  
Protective Measures ◽  
Factors Associated ◽  
History Of ◽  
Funduscopic Examination ◽  
Over Time

Purpose: We report a case of bilateral solar retinopathy following the Great American Eclipse on August 21, 2017. We summarize findings on multimodal imaging and risk factors associated with solar retinopathy. Methods: A teenage boy presented with painless vision loss 4 days following viewing a total solar eclipse. Funduscopic examination, optical coherence tomography, and fluorescein angiography revealed findings characteristic of solar retinopathy. Multifocal electroretinography was also performed. We add to the literature the first reported case of solar retinopathy following the Great American Eclipse. Results: The patient was observed with serial examinations over several weeks. Gradual trend toward visual recovery was noted on imaging. Conclusions: In combination with clinical history of sungazing and funduscopic examination, distinct findings on imaging help secure a diagnosis of solar retinopathy. Visual symptoms in solar retinopathy generally improve over time. Appropriate protective measures with counseling and filtered eyewear are recommended for eclipse viewers.

Maternal Characteristics and Migraine Pharmacotherapy During Pregnancy: Cross-Sectional Analysis of Data from a Large Cohort Study

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1267-1276 ◽  
Author(s):  
K Nezvalová-Henriksen ◽  
O Spigset ◽  
H Nordeng
Keyword(s):  
Body Mass Index ◽  
Odds Ratio ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Narcotic Analgesics ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Large Cohort Study ◽  
Sectional Analysis

Little is known about factors associated with migraine pharmacotherapy during pregnancy. Of 60 435 pregnant women in a population-based cohort, 3480 (5.8%) reported having migraine during the first 5 months of pregnancy. Of these, 2525 (72.6%) reported using migraine pharmacotherapy, mostly non-narcotic analgesics (54.1%) and triptans (25.4%). After adjustment for sociodemographic factors and comorbidities in logistic regression analysis, high pregestational body mass index [odds ratio (OR) 1.3, 95% confidence interval (CI) 1.2, 1.4], sleep < 5 h (OR 1.6, 95% CI 1.3, 1.9), being on sick-leave (OR 1.3, 95% CI 1.2, 1.5) and acute back/shoulder/neck pain (OR 0.6, 95% CI 0.6, 0.7) were associated with migraine pharmacotherapy during pregnancy. Many women need drug treatment for migraine during pregnancy, and the choice of pharmacotherapy during this period may be influenced by maternal sociodemographic factors and comorbidities.

Previous STI and risk of HIV infection in men

2003 ◽  
Vol 14 (5) ◽  
pp. 341-343 ◽  
Author(s):  
M Vall Mayans ◽  
J M Escribá
Keyword(s):  
Hiv Infection ◽  
Odds Ratio ◽  
Previous History ◽  
Heterosexual Men ◽  
Bisexual Men ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Hiv Test ◽  
History Of

To determine the prevalence of a previous history of sexually transmitted infection (STI) and its influence as a risk factor for HIV infection among men tested for HIV, data from men having a voluntary HIV test at the STI Unit of Barcelona during a 6-month period of 1998 were analysed. Descriptive and logistic regression analysis were done to examine the prevalence of previous STI and factors associated with HIV infection. Prevalences of HIV were 5.6% in homo/bisexual and 0.5% in heterosexual men ( P<0.001). Risk factors for HIV were STI history: odds ratio (OR)=8.7 and homo/bisexual behaviour: OR=6.6; 19.8% of heterosexuals had a history of STI compared with 44.2% of homo/bisexual men ( P<0.01). A previous STI was associated with HIV seropositivity in homosexual men.

SporadicSalmonella entericaserotype Javiana infections in Georgia and Tennessee: a hypothesis-generating study

2009 ◽  
Vol 138 (3) ◽  
pp. 340-346 ◽  
Author(s):  
L. S. CLARKSON ◽  
M. TOBIN-D'ANGELO ◽  
C. SHULER ◽  
S. HANNA ◽  
J. BENSON ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Disease Surveillance ◽  
Population Based ◽  
Well Water ◽  
Surveillance Programme ◽  
Factors Associated ◽  
Exposure Data ◽  
Animal Contact ◽  
The U.S ◽  
Population Based Survey

SUMMARYFrom 1996 to 2004, the incidence ofSalmonellaJaviana infections increased in FoodNet, the U.S. national active foodborne disease surveillance programme. Contact with amphibians and consumption of tomatoes have been associated with outbreaks ofS. Javiana infection. To generate and test hypotheses about risk factors associated with sporadicS. Javiana infections, we interviewed patients with laboratory-confirmedS. Javiana infection identified in Georgia and Tennessee during August–October 2004. We collected data on food and water consumption, animal contact, and environmental exposure from cases. Responses were compared with population-based survey exposure data. Seventy-two of 117 identifiedS. Javiana case-patients were interviewed. Consumption of well water [adjusted odds ratio (aOR) 4·3, 95% confidence interval (CI) 1·6–11·2] and reptile or amphibian contact (aOR 2·6, 95% CI 0·9–7·1) were associated with infection. Consumption of tomatoes (aOR 0·5, 95% CI 0·3–0·9) and poultry (aOR 0·5, 95% CI 0·2–1·0) were protective. Our study suggests that environmental factors are associated withS. Javiana infections in Georgia and Tennessee.

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