scholarly journals Factors Associated With Diagnostic Delays in Human Brucellosis in Tongliao City, Inner Mongolia Autonomous Region, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Jingbo Zhai ◽  
Ruihao Peng ◽  
Ying Wang ◽  
Yuying Lu ◽  
Huaimin Yi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inner Mongolia ◽  
Older Age ◽  
Agricultural Area ◽  
Human Brucellosis ◽  
Factors Associated ◽  
Inner Mongolia Autonomous Region ◽  
Diagnostic Delays ◽  
Age Category ◽  
Group 1

The diagnostic delays pose a huge challenge to human brucellosis (HB), which increases the risk of chronicity and complications with a heavy disease burden. This study aimed to quantify and identify the associated factors in the diagnostic delays to its prevention, reduction, and elimination. This study analyzed risk factors associated with the diagnostic delays in a cross-sectional study with data collected from Tongliao City, Inner Mongolia Autonomous Region of China. Diagnostic delays were defined with a cutoff of 30, 60, and 90 days. In different delay groups, risk factors of diagnostic delays were analyzed by univariate analysis and modeled by multivariate logistic regression analysis. A total of 14,506 cases were collected between January 1, 2005, and December 31, 2017, of which the median diagnostic delays was 29 days [interquartile range (IQR): 14–54 days]. Logistic regression analysis indicated that the older age category was associated with longer diagnostic delays across all groups. Longer diagnostic delays increase with age among three delay groups (p for trend <0.001). Occupation as herdsman was associated with shorter diagnostic delays in group 1 with 30 days [adjusted odds ratio (aOR), 0.890 (95% CI 0.804–0.986)]. Diagnostic delays was shorter in patients with brucellosis who were reported in CDC in all delay groups [aOR 0.738 (95% CI 0.690–0.790), 0.539 (95% CI 0.497–0.586), and 0.559 (95% CI 0.504–0.621)]. Pastoral/agricultural area was associated with shorter diagnostic delays in group 1 with 30 days [aOR, 0.889 (95%CI 0.831–0.951)] and group 3 with 90 days [aOR, 0.806 (95%CI 0.727–0.893)]. Stratified analysis showed that the older age category was associated with an increased risk of a long delay in both genders (p < 0.05). The older age group-to-youth group OR increased along with increased delay time (p for trend <0.001). Furthermore, the pastoral/agricultural area was associated with a shorter delay in males (p < 0.05). Delays exist in the diagnosis of HB. We should pay great attention to the risk factors of diagnostic delays, such as older population, non-herdsman, non-pastoral/agricultural area, non-disease prevention, and control agencies. Effective measures should shorten the diagnostic delays, achieve early detection, diagnosis, and treatment, and reduce the risk of HB's chronicity, complications, and economic burden.

scholarly journals POS0875 MYOSITIS-SPECIFIC ANTIBODIES IN A RETROSPECTIVE SINGLE-CENTER OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 693.2-694
Author(s):  
J. Álvarez Troncoso ◽  
S. Carrasco Molina ◽  
J. Valdivieso ◽  
P. Nozal ◽  
Á. Robles Marhuenda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Older Age ◽  
Single Center ◽  
Specific Antibodies ◽  
Factors Associated ◽  
Risk Of Cancer ◽  
Single Center Observational Study

Background:Myositis-specific antibodies (MSA) are highly specific and useful to classify patients as having syndromes with distinct clinical features and prognosis. MSA are almost always mutually exclusive and quite specific, adding value as a useful biomarker for diagnosis. Although individual autoantibodies aren’t sensitive enough to detect the full spectrum of idiopathic inflammatory myopathies (IIM), the sensitivity of a myositis panel is increasing as more autoantibodies are discovered, and as better assays become available.Objectives:We aimed to analyze the usefulness of a myositis-specific immunoblot for the diagnosis of IIM in a hospital cohort from January 2019 to December 2020. We also seek to correlate immunological findings with the risk of associated interstitial lung disease (ILD), cancer, or death.Methods:Retrospective single-center observational study conducted in a Spanish tertiary hospital. In patients with high clinical suspicion of IIM, a myositis immunoblot was performed including Jo1, PL-7, PL-12, EJ, SRP, Mi2, Ku, MDA-5, TIF1-γ, HMGCR, PM-Scl and Ro52 antibodies. The demographic characteristics, the risk of ILD, cancer and death were analyzed.Results:In a cohort of 313 patients with high suspicion of IIM, 87 patients (27.8%) presented a positive MSA (MSA+ve). The mean age at diagnosis was 56.7±16.9 years, with no significant differences between MSA+ve and MSA-ve (p=0.597). Most of the patients were women with significant differences between both groups (80.5% MSA+ve vs 68.1% MSA-ve, p=0.030).IIM were classified as antisynthetase syndrome (ARS) (38%), dermatomyositis (DM) (31%), overlap myopathy (OM) (16.9%) and necrotizing myopathy (NM) (14.1%) according to the manifestations and MSA found (Jo1, PL-12, PL-7, EJ in ARS; Mi-2, MDA-5 and TIF1-γ in DM; Ku and PM-Scl in OM; HMGCR and SRP in NM). The most frequent MSA were anti-Jo1 (16.9%), TIF1-γ (15.5%), Ku (12.7%), Mi-2 (9.9%), PL-7 (9.9%), HMCGR (8.5%), PL-12 (7%), MDA-5 (5.6%), SRP (5.6%) and EJ (4.2%). The presence of Ro52 associated with other MSA was found in 20 patients (22.9%).ILD was the most frequent manifestation (45.2% of the MSA+ve). Non-specific interstitial pneumonia (NSIP) was the most frequent ILD (39.5%), followed by usual interstitial pneumonia (34.2%). The main risk factors associated with IIM-ILD were some subtypes of the MSAs (p<0.001), the association of Ro52 (p<0.001), and older age (p=0.027). Among the IIM, ARS and OM (p<0.001) were more frequently associated with IIM-ILD. The MSAs most associated with IIM-ILD were Jo1, PL-7, PM-Scl, Ku and SRP (p<0.001).Cancer was found in 9.6% of MSA+ve patients. The most frequent tumors were gynecological (37.5%), followed by gastrointestinal (25%) and breast cancer (12.5%). Factors associated with cancer were age (p=0.010), TIF1-γ (p<0.001), SRP (p=0.004), PL-12 (p=0.013), PL-7 (p=0.047) and HMGCR (p=0.027).The mortality of these patients was 3.5%. There were no differences regarding MSA+ve/-ve (p = 0.911). However, MDA-5 (p=0.033) and older age (p=0.001) were associated with higher mortality. There were no significant differences between the IIM classifications, the associated SAD, the presence of cancer or ILD. However, longer follow-up periods and future studies are necessary to confirm these results.Conclusion:The use of a myositis blot allowed classifying, stratifying the risk of ILD, the risk of cancer and the risk of mortality in IIM. IIM-ILD was the most frequent complication, usually manifested as NSIP. The associated risk factors were ARS, OM, some MSAs, Ro52+ and older age. Cancer was a serious and frequent manifestation in these patients, especially in patients with TIF1-γ and other MSAs, so it is essential to know the risk factors and perform an early screening, especially in older patients.A better knowledge of the serological profiles of IIM will provide more individualized approaches and better risk stratification, helping in the management and treatment of these patients.References:[1]Satoh et al. Clin Rev Allergy Immunol. 2017 Feb;52(1):1-19.[2]Betteridge et al. J Intern Med. 2016 Jul;280(1):8-23.Disclosure of Interests:None declared

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Hand ◽  
2021 ◽  
pp. 155894472110068
Author(s):  
Joanne Y. Zhang ◽  
Aneesh V. Samineni ◽  
David C. Sing ◽  
Alyssa Rothman ◽  
Andrew B. Stein
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Patient Characteristics ◽  
Distal Radioulnar Joint ◽  
Older Age ◽  
Radioulnar Joint ◽  
Factors Associated ◽  
Shaft Fractures ◽  
Male Sex ◽  
Preoperative Patient

Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

scholarly journals Risk Factors Associated with Older Age in Treatment-Naive HIV-Positive Patients

Intervirology ◽  
2012 ◽  
Vol 55 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Stefan Reuter ◽  
Mark Oette ◽  
Rolf Kaiser ◽  
Thomas Lengauer ◽  
Gerd Fätkenheuer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Age ◽  
Hiv Positive ◽  
Factors Associated ◽  
Treatment Naïve

scholarly journals Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Older Age ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

scholarly journals Prevalence and associated factors for Pterygium in Han and Mongolian adults: across-sectional study in inner Mongolian, China

2019 ◽  
Author(s):  
Yuhan Wang ◽  
Guangliang Shan ◽  
Linyang Gan ◽  
Yonggang Qian ◽  
Ting Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Rural Areas ◽  
Inner Mongolia ◽  
Univariate Analysis ◽  
Education Level ◽  
Study Cohort ◽  
Sectional Study ◽  
Factors Associated ◽  
Significant Difference

Abstract Background: To investigate the prevalence of and factors associated with pterygium in Han and Mongolian adults at four survey sites in Inner Mongolia, China. Methods: A population-based, cross-sectional study was conducted. Using a stratified sampling method, we eventually included 2,651 participants of at least30 years of age from a total of 3,468 eligible residents. Factors associated with pterygium were analysed using univariate analysis and logistic regression models. Results: There were 1,910 Han adults and 741 Mongolian adults included in this study. The mean± standard deviation of age for individuals in the study cohort was 48.93±11.06 years. The overall prevalence of pterygium was 6.4% (n=169), and the prevalences of bilateral and unilateral pterygium were 1.4% (n=38) and 4.8% (n=128), respectively. The most common grade of pterygium was Grade 2. After univariate analysis, eleven factors were considered in a multivariate analysis. The results indicated that age (P<0.001), education level (P<0.001), outdoor occupation (P=0.026), and time spent in rural areas (P<0.001) were significantly associated with pterygium, whereas gender and ethnicity were not risk factors. In subgroup analysis, BMI≥28 was a protective factor for Han individuals (OR 0.42, 95% CI 0.21-0.81, P=0.01), but a risk factor for Mongolian individuals (OR 2.39, 95% CI 1.02-5.58, P=0.044). The BF% in Han and Mongolian individuals had significant difference (P<0.001). Conclusions: Our results indicated that an outdoor occupation, old age and time spent in rural areas are risk factors for pterygium in Inner Mongolia. Living near an urban survey site (Hohhot and Tsining District) and having a higher education level are protective factors for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium. Different dietary structures in Han and Mongolian adults may lead to different fat content of body and therefore contributes to the prevalence of pterygium. Keywords: Pterygium, prevalence, Han and Mongolian, risk factors, protective factors

Pressure From Superiors and Older Age Increase the Risk of Burnout Syndrome Among Psychiatric Trainees: A Nation-wide Survey in Turkey

2017 ◽  
Vol 41 (S1) ◽  
pp. S298-S298 ◽  
Author(s):  
N. Capraz ◽  
D. Ceylan Tufan Ozalp ◽  
M. Yalcin ◽  
E. Tellioglu Can ◽  
T. Alkin
Keyword(s):  
Risk Factors ◽  
Maslach Burnout Inventory ◽  
Older Age ◽  
Burnout Syndrome ◽  
Personal Factors ◽  
Factors Associated ◽  
Personal Rights ◽  
Dichotomous Variable ◽  
Competing Interest ◽  
Nation Wide Survey

IntroductionPrevious studies reported high burnout rates and indicated significant factors associated with burnout syndrome among psychiatric trainees, such as hard working conditions, lack of supervision and not opting for psychiatry as a first career choice.ObjectivesA substantial amount of variance was reported in psychiatry training across countries. However, there is not sufficient national data regarding the rates and risk factors of burnout syndrome among psychiatric trainees in Turkey.AimsTo determine the burnout syndrome rates and the risk factors associated with burnout syndrome among psychiatric trainees.MethodsA questionnaire of occupational, educational and personal factors and Maslach burnout inventory (MBI) were answered by 180 of 450 psychiatric trainees in Turkey. The data was collected from 167 (56% females) trainees who completed the survey material. Converting the scores of three subscales by using MBI manual, a dichotomous variable (severe/non-severe burnout) was obtained for each participant and the data was analyzed using descriptive statistics and regression models.ResultsMean age was 28.85 ± 2.99-year-old and mean duration of residency was 2.61 ± 1.31 years. Severe burnout was found in 38.3% of the trainees. Logistic regression confirmed that older age (P = 0.02) and pressure from superiors (P = 0.04) are predictive factors associated with severe burnout. The high number of patient visits (P = 0.001), violation of employee personal rights (P = 0.04) and pressure from superiors (P = 0.01) were significantly associated with the “wish working in another institution”.ConclusionsPressure from superiors and older age can be described as risk factors associated with burnout syndrome among psychiatric trainees in Turkey.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids

2019 ◽  
Vol 185 (3) ◽  
pp. 82-82 ◽  
Author(s):  
Katya Potter ◽  
Kim Stevens ◽  
Nicola Menzies-Gow
Keyword(s):  
Risk Factors ◽  
Body Condition ◽  
Corticosteroid Treatment ◽  
Treated Animal ◽  
Untreated Animal ◽  
Univariable Analysis ◽  
Factors Associated ◽  
Referral Hospitals ◽  
History Of ◽  
Group 1

A retrospective treated versus untreated study (study 1) and multicentre prospective cohort study (study 2) were undertaken to determine the prevalence of, and risk factors associated with, acute laminitis in horses treated with corticosteroids. All old treated with corticosteroids January–December 2014 (study 1) and January 2015–February 2017 (study 2) by two first opinion and referral hospitals in UK were included. Additionally, an untreated animal was identified for each treated animal (study one). Signalment, body condition (study 2 only), relevant medical history, primary condition, corticosteroid therapy prescribed and occurrence of acute laminitis during or within 14 days of cessation of corticosteroid treatment were recorded.For study 1, 205 cases and 205 controls were identified; two animals within each group (1 per cent) developed laminitis. In total, 1565 animals were included in study 2; laminitis period prevalence was 0.6 per cent (95 per cent CI 0.4 per cent to 1.2 per cent), with 10 cases in 1565 treated animals. There were significant associations between laminitis and breed (pony vs horse; p=0.01; univariable analysis only), the presence of a laminitis risk factor (history of laminitis or an underlying endocrinopathy; p<0.001; OR (95 per cent CI) 18.23 (5.05 to 65.87)) and body condition (overweight/obese vs not; p=0.04; OR (95 per cent CI) 4.0 (1.09 to 14.75)).

scholarly journals Long-Term Outcome of Patients Followed by Nephrologists after an Acute Tubular Necrosis Episode

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
G. A. Brito ◽  
A. L. Balbi ◽  
J. M. G. Abrão ◽  
D. Ponce
Keyword(s):  
Risk Factors ◽  
Acute Tubular Necrosis ◽  
Older Age ◽  
Chronic Dialysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Late Mortality ◽  
Factors Associated ◽  
Tubular Necrosis

Aims of our study were to describe the long-term survival in patients surviving an acute tubular necrosis (ATN) episode and determine factors associated with late mortality. We performed a prospective cohort study that evaluated the long-term outcome of 212 patients surviving an ATN episode. Mortality at the end of followup was 24.5%, and the probability of these patients being alive 5 years after discharge was 55%. During the followup, 4.7% of patients needed chronic dialysis. Univariate analysis showed that previous CKD (), cardiovascular disease (), age greater than 60 years (), and higher SCr baseline (), after 12 months () and 36 months (), were predictors of long-term mortality. In multivariate analysis, older age (HR = 6.4, CI 95% = 1.2–34.5, ) and higher SCr after 12 months (HR = 2.1, 95% CI 95% = 1.14–4.1, ) were identified as risk factors associated with late mortality. In conclusion, 55% of patients surviving an ATN episode were still alive, and less than 5% required chronic dialysis 60 months later; older age and increased Scr after 12 months were identified as risk factors associated with late death.

scholarly journals Trastuzumab-Related Cardiotoxicity Among Older Patients With Breast Cancer

2013 ◽  
Vol 31 (33) ◽  
pp. 4222-4228 ◽  
Author(s):  
Mariana Chavez-MacGregor ◽  
Ning Zhang ◽  
Thomas A. Buchholz ◽  
Yufeng Zhang ◽  
Jiangong Niu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Older Patients ◽  
Cox Proportional Hazards ◽  
Older Age ◽  
Coding System ◽  
Breast Cancer Patients ◽  
Common Procedure ◽  
Factors Associated

Purpose The use of trastuzumab in the adjuvant setting improves outcomes but is associated with cardiotoxicity manifested as congestive heart failure (CHF). The rates and risk factors associated with trastuzumab-related CHF among older patients are unknown. Patients and Methods Breast cancer patients at least 66 years old with full Medicare coverage, diagnosed with stage I-III breast cancer between 2005 and 2009, and treated with chemotherapy were identified in the SEER-Medicare and in the Texas Cancer Registry–Medicare databases. The rates and risk factors associated with CHF were evaluated. Chemotherapy, trastuzumab use, comorbidities, and CHF were identified using International Classification of Diseases, version 9, and Healthcare Common Procedure Coding System codes. Analyses included descriptive statistics and Cox proportional hazards models. Results In total, 9,535 patients were included, of whom 2,203 (23.1%) received trastuzumab. Median age of the entire cohort was 71 years old. Among trastuzumab users, the rate of CHF was 29.4% compared with 18.9% in nontrastuzumab users (P < .001). Trastuzumab users were more likely to develop CHF than nontrastuzumab users (hazard ratio [HR], 1.95; 95% CI, 1.75 to 2.17). Among trastuzumab-treated patients, older age (age > 80 years; HR, 1.53; 95% CI, 1.16 to 2.10), coronary artery disease (HR, 1.82; 95% CI, 1.34 to 2.48), hypertension (HR, 1.24; 95% CI, 1.02 to 1.50), and weekly trastuzumab administration (HR, 1.33; 95% CI, 1.05 to 1.68) increased the risk of CHF. Conclusion In this large cohort of older breast cancer patients, the rates of trastuzumb-related CHF are higher than those reported in clinical trials. Among patients treated with trastuzumab, those with cardiac comorbidities and older age may be at higher risk. Further studies need to confirm the role that the frequency of administration plays in the development of trastuzumab-related CHF.

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