scholarly journals Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

2021 ◽  
Vol 11 ◽  
Author(s):  
Liwen Peng ◽  
Lok Sum Yang ◽  
Perri Yam ◽  
Chun Sing Lam ◽  
Agnes Sui-yin Chan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Conditions ◽  
Lymphoblastic Leukemia ◽  
Behavioral Outcomes ◽  
Attention Problems ◽  
Chronic Health Conditions ◽  
Sluggish Cognitive Tempo ◽  
Health Conditions ◽  
Modifiable Risk Factors ◽  
Factors Associated

BackgroundIncreasing attention has been dedicated to investigate modifiable risk factors of late effects in survivors of childhood cancer. This study aims to evaluate neurocognitive and behavioral functioning in a relatively young cohort of survivors of childhood acute lymphoblastic leukemia (ALL) in Hong Kong, and to identify clinical and socio-environmental factors associated with these outcomes.MethodsThis analysis included 152 survivors of childhood ALL who were ≥5 years post-diagnosis (52% male, mean [SD] age 23.5[7.2] years at evaluation, 17.2[7.6] years post-diagnosis). Survivors completed performance-based neurocognitive tests, and reported their emotional and behavioral symptoms using the Child/Adult Behavior Checklist. Socio-environmental variables (living space, fatigue, physical activity, family functioning, and academic stress) were self-reported using validated questionnaires. Clinical variables and chronic health conditions were extracted from medical charts. Multivariable linear modeling was conducted to test identify factors associated with neurocognitive/behavioral outcomes, adjusting for current age, sex, age at diagnosis and cranial radiation. An exploratory mediation analysis was performed to examine the mediating effects of risk factors on neurocognitive and behavioral outcomes.ResultsAs compared to population norms, a minority of survivors developed mild-moderate impairment in motor processing speed (36.2%), memory (9.2%) and attention measures (4.0%-10.5%). Survivors also reported attention problems (12.5%), sluggish cognitive tempo (23.7%) and internalizing (depressive, anxiety and somatic symptoms) problems (17.1%). A minority of survivors developed mild-moderate treatment-related chronic conditions (n=37, 24.3%). As compared to survivors without chronic conditions, survivors with chronic conditions had more executive dysfunction (B=5.09, standard error [SE]=2.05; P=0.014) and reported more attention problems (B=5.73, SE=1.43; P<0.0001). Fatigue and poor family functioning was associated with multiple measures of behavior problems (all P<0.001). A lower level of physical activity was correlated with more self-reported symptoms of inattention (B= -1.12, SE=0.38, P=0.004) and sluggish cognitive tempo (B=-1.22, SE=0.41, P=0.003). Exploratory analysis showed that chronic health conditions were associated with behavioral measures through fatigue as the mediator.ConclusionThe majority of young Chinese survivors of ALL had normal cognitive and behavioral function. Regular monitoring of behavioral function should be performed on survivors who develop treatment-related chronic conditions. Health behavior and socio-environment factors may be potentially modifiable risk factors associated with health outcomes in survivors.

scholarly journals Sex-Specific Associations Between Chemotherapy, Chronic Conditions, and Neurocognitive Impairment in Acute Lymphoblastic Leukemia Survivors: A Report From the Childhood Cancer Survivor Study

2020 ◽  
Author(s):  
Ellen van der Plas ◽  
Weiyu Qiu ◽  
Brian J Nieman ◽  
Yutaka Yasui ◽  
Qi Liu ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Cancer ◽  
Chronic Conditions ◽  
Lymphoblastic Leukemia ◽  
Neurocognitive Impairment ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Impaired Memory ◽  
Childhood Cancer Survivor Study ◽  
Task Efficiency

Abstract Background The purpose was to examine associations between treatment and chronic health conditions with neurocognitive impairment survivors of acute lymphoblastic leukemia (ALL) treated with chemotherapy only. Methods This cross-sectional study included 1207 ALL survivors (54.0% female; mean age 30.6 years) and 2273 siblings (56.9% female; mean age 47.6 years), who completed the Childhood Cancer Survivor Study Neurocognitive Questionnaire. Multivariable logistic regression compared prevalence of neurocognitive impairment between survivors and siblings by sex. Associations between neurocognitive impairment with treatment exposures and chronic conditions (graded according to Common Terminology Criteria for Adverse Events) were also examined. Statistical tests were 2-sided. Results Relative to same-sex siblings, male and female ALL survivors reported increased prevalence of impaired task efficiency (males: 11.7% vs 16.9%; adjusted odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.31 to 2.74; females: 12.5% vs 17.6%; OR = 1.50, 95% CI = 1.07 to 2.14), as well as impaired memory (males: 11.6% vs 19.9%, OR = 1.89, CI = 1.31 to 2.74; females: 14.78% vs 25.4%, OR = 1.96, 95% CI = 1.43 to 2.70, respectively). Among male survivors, impaired task efficiency was associated with 2-4 neurologic conditions (OR = 4.33, 95% CI = 1.76 to 10.68) and with pulmonary conditions (OR = 4.99, 95% CI = 1.51 to 16.50), and impaired memory was associated with increased cumulative dose of intrathecal methotrexate (OR = 1.68, 95% CI = 1.16 to 2.46) and with exposure to dexamethasone (OR = 2.44, 95% CI = 1.19 to 5.01). In female survivors, grade 2-4 endocrine conditions were associated with higher risk of impaired task efficiency (OR = 2.19, 95% CI = 1.20 to 3.97) and memory (OR = 2.26, 95% CI = 1.31 to 3.92). Conclusion Neurocognitive impairment is associated with methotrexate, dexamethasone, and chronic health conditions in a sex-specific manner, highlighting the need to investigate physiological mechanisms and monitor impact through survivorship.

scholarly journals Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics

2011 ◽  
Vol 79 (2) ◽  
pp. 218-227 ◽  
Author(s):  
Patrick H. Pun ◽  
Ruediger W. Lehrich ◽  
Emily F. Honeycutt ◽  
Charles A. Herzog ◽  
John P. Middleton
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Modifiable Risk Factors ◽  
Factors Associated

scholarly journals Chronic health conditions related to quality of life for federal civil servants

2015 ◽  
Vol 36 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Luciana Eduardo Fernandes Saraiva ◽  
Lays Pinheiro de Medeiros ◽  
Marjorie Dantas Medeiros Melo ◽  
Manuela Pinto Tiburcio ◽  
Isabelle Katherinne Fernandes Costa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Conditions ◽  
Civil Servant ◽  
Civil Servants ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Daily Work ◽  
Work And Life

OBJECTIVE: The aim of this study is to correlate the QOL domains of the civil servants to the type and number of chronic health conditions. METHOD: A transversal, quantitative study, conducted at the Department of Civil Servant Assistance of the Federal University of Rio Grande do Norte with 215 civil servants, during the period from March to May 2011. RESULTS: Among the chronic health conditions studied, there was significant relationship between non-communicable chronic disease and QOL scores, correlating weakly (r <-376; p <0.008) in the other fields. It was found that the greater the number of chronic conditions, the lower the values on the QOL scale. CONCLUSION: The quality of life of civil servants is negatively influenced by chronic health conditions, compromising, in general, their daily work and life activities.

scholarly journals Associations Between Potentially Modifiable and Nonmodifiable Risk Factors and Gait Speed in Middle- and Older-Aged Adults: Results From the Canadian Longitudinal Study on Aging

2021 ◽  
Author(s):  
Erica Figgins ◽  
Yun-Hee Choi ◽  
Mark Speechley ◽  
Manuel Montero-Odasso
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Gait Speed ◽  
Chronic Conditions ◽  
Serum Vitamin ◽  
Lifestyle Factors ◽  
Community Dwelling ◽  
Life Course Perspective ◽  
Factors Associated ◽  
Modifiable Factors

Abstract Background Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and nonmodifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults. Methods We examined cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort. The study sample included 20 201 community-dwelling adults aged 45–85 years. The associations between sociodemographic and anthropometric factors, chronic conditions, and cognitive, clinical, and lifestyle factors and 4-m usual gait speed (m/s) were estimated using hierarchical multivariable linear regression. Results The coefficient of determination, R  2, of the final regression model was 19.7%, with 12.9% of gait speed variability explained by sociodemographic and anthropometric factors, and nonmodifiable chronic conditions and 6.8% explained by potentially modifiable chronic conditions, cognitive, clinical, and lifestyle factors. Potentially modifiable factors significantly associated with gait speed include cardiovascular conditions (unstandardized regression coefficient, B = −0.018; p &lt; .001), stroke (B = −0.025; p = .003), hypertension (B = −0.007; p = .026), serum Vitamin D (B = 0.004; p &lt; .001), C-reactive protein (B = −0.005; p = .005), depressive symptoms (B = −0.003; p &lt; .001), physical activity (B = 0.0001; p &lt; .001), grip strength (B = 0.003; p &lt; .001), current smoking (B = −0.026; p &lt; .001), severe obesity (B = −0.086; p &lt; .001), and chronic pain (B = −0.008; p = .018). Conclusions The correlates of gait speed in adulthood are multifactorial, with many being potentially modifiable through interventions and education. Our results provide a life-course-perspective framework for future longitudinal assessments risk factors affecting gait speed.

scholarly journals Factores de riesgo asociados a distocias del mecanismo del parto en gestantes primíparas atendidas en el Hospital Dr. Verdi Cevallos Balda

2020 ◽  
Vol 4 (2) ◽  
pp. 1
Author(s):  
Olga Katherine Veintimilla Chinga ◽  
María Alicia Fernanda Ledezma Hurtado ◽  
Dadier Marrero González ◽  
Lizeet López ◽  
Hugo Loor Lino
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Rural Areas ◽  
Overweight And Obesity ◽  
Modifiable Risk Factors ◽  
Maternal Complications ◽  
Factors Associated ◽  
Factores De Riesgo ◽  
Uterine Malformations ◽  
Delivery Mechanism

  Las distocias del mecanismo del parto en gestantes pueden generar consecuencias significativas tanto maternas como fetales y neonatales, existiendo diversos factores de riesgo asociados a dicha condición. La prevalencia de las distocias es variable para cada localidad, presentándose en el 0,3 % a de los casos. En este sentido, el objetivo de este trabajo fue determinar los principales factores de riesgo que se asocian a distocias del mecanismo del parto en gestantes primíparas atendidas en el Hospital Dr. Verdi Cevallos Balda. Se realizó un estudio descriptivo y retrospectivo, con 250 embarazadas atendidas en el periodo de enero 2018 a diciembre 2019. Las distocias de los mecanismos del parto en primíparas en el Hospital Dr. Verdi Cevallos se presentaron con más frecuencia en las edades entre los 20 y 34 años, con grado de instrucción secundaria, y de zonas rurales. Los principales factores de riesgos modificables asociados a distocias fueron los controles prenatales insuficientes, sobrepeso y obesidad de las gestantes; además de ganancia de peso inadecuada durante el embarazo, bajo peso fetal, duración prolongada de la primera fase del trabajo de parto e inducción del mismo. Los factores de riesgos no modificables identificados fueron la presentación de cara, estrechez pélvica, malformaciones uterinas, hipertensión arterial como enfermedad crónica asociada, talla materna menor a 140 cm y parto prolongado de más de 20 horas. Las complicaciones maternas tuvieron una alta incidencia y dentro de ellas, las cesáreas fueron las más frecuentes, mientras que el distress respiratorio fue la complicación neonatal más presentada.   Palabras clave: Distocia, factores de riesgo, peso elevado, malformaciones uterinas, complicaciones.   Abstract Dystocia of the delivery mechanism in pregnant women can generate significant maternal, fetal and neonatal consequences, with various risk factors associated with this condition. The prevalence of dystocia is variable for each locality, occurring in 0.3% of cases. In this sense, the objective of this study was to determine the main risk factors associated with dystocia in the delivery mechanism in primiparous pregnant women treated at the Dr. Verdi Cevallos Balda Hospital. A descriptive and retrospective study was carried out, with 250 pregnant women seen in the period from January 2018 to December 2019. Dystocia of the labor mechanisms in primiparous women at the Dr. Verdi Cevallos Hospital occurred more frequently in the ages between 20 and 34 years old, with a secondary education degree, and from rural areas. The main modifiable risk factors associated with dystocia were insufficient prenatal care, overweight and obesity in pregnant women; as well as inadequate weight gain during pregnancy, low fetal weight, prolonged duration of the first phase of labor and its induction. The non-modifiable risk factors identified were face presentation, pelvic narrowing, uterine malformations, arterial hypertension as an associated chronic disease, maternal height less than 140 cm and prolonged labor of more than 20 hours. Maternal complications had a high incidence and within them, caesarean sections were the most frequent, while respiratory distress was the most common neonatal complication.   Keywords: Dystocia, risk factors, high weight, uterine malformations, complications.

scholarly journals The identification of modifiable risk factors associated with postpartum readmission for preeclampsia

2022 ◽  
Vol 226 (1) ◽  
pp. S645-S646
Author(s):  
Alexa Giacobbo ◽  
Brittney Gaudet ◽  
Joanne N. Quinones ◽  
Danielle Durie
Keyword(s):  
Risk Factors ◽  
Modifiable Risk Factors ◽  
Factors Associated

scholarly journals Modifiable Risk Factors Associated With Disposal of Unused Prescription Drugs by Parents of Adolescents

2020 ◽  
Vol 41 (6) ◽  
pp. 529-545
Author(s):  
Kathleen L. Egan ◽  
Eric Gregory ◽  
Samantha E. Foster ◽  
Melissa J. Cox
Keyword(s):  
Risk Factors ◽  
Prescription Drugs ◽  
Modifiable Risk Factors ◽  
Factors Associated

scholarly journals The Contribution of Fluoride to the Pathogenesis of Eye Diseases: Molecular Mechanisms and Implications for Public Health

2019 ◽  
Vol 16 (5) ◽  
pp. 856 ◽  
Author(s):  
Declan Waugh
Keyword(s):  
Risk Factors ◽  
Molecular Mechanisms ◽  
Inflammatory Diseases ◽  
Eye Diseases ◽  
Age Related Macular Degeneration ◽  
Hsp70 Expression ◽  
Modifiable Risk Factors ◽  
Factors Associated ◽  
Age Related ◽  
Lines Of Evidence

This study provides diverse lines of evidence demonstrating that fluoride (F) exposure contributes to degenerative eye diseases by stimulating or inhibiting biological pathways associated with the pathogenesis of cataract, age-related macular degeneration and glaucoma. As elucidated in this study, F exerts this effect by inhibiting enolase, τ-crystallin, Hsp40, Na+, K+-ATPase, Nrf2, γ -GCS, HO-1 Bcl-2, FoxO1, SOD, PON-1 and glutathione activity, and upregulating NF-κB, IL-6, AGEs, HsP27 and Hsp70 expression. Moreover, F exposure leads to enhanced oxidative stress and impaired antioxidant activity. Based on the evidence presented in this study, it can be concluded that F exposure may be added to the list of identifiable risk factors associated with pathogenesis of degenerative eye diseases. The broader impact of these findings suggests that reducing F intake may lead to an overall reduction in the modifiable risk factors associated with degenerative eye diseases. Further studies are required to examine this association and determine differences in prevalence rates amongst fluoridated and non-fluoridated communities, taking into consideration other dietary sources of F such as tea. Finally, the findings of this study elucidate molecular pathways associated with F exposure that may suggest a possible association between F exposure and other inflammatory diseases. Further studies are also warranted to examine these associations.

scholarly journals Factors Associated With Insidious and Noninsidious Disability

2020 ◽  
Vol 75 (11) ◽  
pp. 2125-2129 ◽  
Author(s):  
Thomas M Gill ◽  
Terrence E Murphy ◽  
Evelyne A Gahbauer ◽  
Linda Leo-Summers ◽  
Ling Han
Keyword(s):  
Risk Factors ◽  
Chronic Conditions ◽  
Emergency Department Visits ◽  
Recurrent Event ◽  
Factors Associated ◽  
Shared Set ◽  
Lower Extremity Muscle ◽  
Multivariable Analyses ◽  
Restricted Activity ◽  
Hispanic White

Abstract Background Although disability is often precipitated by an illness/injury, it may arise insidiously. Our objectives were to identify the factors associated with the development of insidious and noninsidious disability and to determine whether these risk factors differ between the two types of disability. Methods We prospectively evaluated 754 community-living persons, 70+ years, from 1998 to 2016. The unit of analysis was an 18-month person-interval, with risk factors assessed at the start of each interval. Disability in four activities of daily living and exposure to intervening events, defined as illnesses/injuries leading to hospitalization, emergency department visits, or restricted activity, were assessed each month. Insidious and noninsidious disability were defined based on the absence and presence of an intervening event. Results The rate of noninsidious disability (21.7%) was twice that of insidious disability (10.8%). In multivariable recurrent-event Cox analyses, six factors were associated with both disability outcomes: non-Hispanic white race, lower extremity muscle weakness, poor manual dexterity, and (most strongly) frailty, cognitive impairment, and low functional self-efficacy. Three factors were associated with only noninsidious disability (older age, number of chronic conditions, and depressive symptoms), whereas four were associated with only insidious disability (female sex, lives with others, low SPPB score, and upper extremity weakness). The modest differences in risk factors identified for the two outcomes in multivariable analyses were less apparent in the bivariate analyses. Conclusions Although arising from different mechanisms, insidious and noninsidious disability share a similar set of risk factors. Interventions to prevent disability should prioritize this shared set of risk factors.

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