scholarly journals Prospective Analysis of Prevalence, Trajectories of Change, and Correlates of Cannabis Misuse in Older Adolescents from Coastal Touristic Regions in Croatia

2019 ◽  
Vol 16 (16) ◽  
pp. 2924
Author(s):  
Lejla Obradovic Salcin ◽  
Vesna Miljanovic Damjanovic ◽  
Anamarija Jurcev Savicevic ◽  
Divo Ban ◽  
Natasa Zenic
Keyword(s):  
Rural Communities ◽  
Social Status ◽  
Maternal Education ◽  
Drug Misuse ◽  
Protective Effects ◽  
Related Factors ◽  
Adult Supervision ◽  
Increased Risk ◽  
Cannabis Consumption

The prevalence of illicit drug misuse, including cannabis, in Croatian touristic regions is alarming. This study aimed to identify the prevalence of cannabis consumption (CC), to identify associations between sociodemographic and sport factors and CC, and to evaluate the predictors of CC initiation in adolescents residing in touristic regions. This study enrolled 644 adolescents from two touristic regions in Croatia (Split-Dalmatia and Dubrovnik-Neretva County) who were tested at baseline (16 years of age) and follow-up (18 years of age). The study instrument consisted of questions focused on predictors (age, gender (male, female), place of residence (urban or rural environment), familial social status, and different sport-related factors) and CC outcome. The results indicated a high prevalence of cannabis consumption (>30% of adolescents consumed cannabis), with a higher prevalence in males, and adolescents from rural communities. The prevalence of CC increased by 10% during the study period, with no significant differences between genders in trajectories of changes. Quitting sports was a risk factor for CC at baseline and follow-up. Better sport competitive results (odds ratio (OR): 0.80, 95% confidence interval (CI): 0.65–0.96) and familial social status (socioeconomic status: OR: 0.66, 95% CI: 0.39–0.91; maternal education: OR: 0.65, 95% CI: 0.48–0.88) were associated with lower likelihood of CC at baseline. The adolescents who reported better sport competitive results were at increased risk for initiation of CC during the course of the study (OR: 1.40, 95% CI: 1.03–2.01). The protective effects of sports at baseline were most likely related to various factors that prevent the consumption of substances in youth athletes (i.e., commitment to results, adult supervision); with the end of active participation, adolescent athletes are at high risk for CC initiation.

Risk of arterial (ATE) and venous thromboembolism (VTE) in a population-based cohort of bevacizumab-treated metastatic colorectal cancer (mCRC) patients.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 545-545 ◽  
Author(s):  
Irene S. Yu ◽  
Winson Y. Cheung
Keyword(s):  
Clinical Trials ◽  
Population Based ◽  
Related Effect ◽  
Related Factors ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Lost To Follow Up ◽  
Study Setting ◽  
Trial Setting

545 Background: Bevacizumab is associated with both arterial (ATE) and venous thromboembolic (VTE) events, estimated to be </=15% from clinical trials. Our objectives were to 1) characterize the incidence of ATE or VTE among mCRC patients receiving bevacizumab in a non-clinical trial setting; 2) determine patient and treatment-related factors that predispose to an increased risk of ATE or VTE; and 3) explore how thromboembolism is managed and whether bevacizumab is discontinued and/or resumed after an event. Methods: A random sample of mCRC patients diagnosed between 2008 and 2009, referred to 1 of 5 regional cancer centers in British Columbia, and who were offered bevacizumab was reviewed. Summary statistics were used to describe and compare clinical factors between those who experienced an ATE or VTE and those who did not. Results: Of the 200 mCRC patients offered bevacizumab, 10 never received the drug and 12 were lost to follow up. Among the 178 remaining patients, median age was 61 years, 103 (58%) were male, and 121 (85%) had ECOG 0 to 1. A total of 39 patients (28%) experienced at least 1 documented thromboembolic event. Compared to patients who developed a clot, those who did not had similar median age (62 vs 61), gender distribution (23% men and 20% women), ECOG 0 to 1 (84% vs 85%) and body mass index (26.4 vs 25.3). However, the mean number of bevacizumab doses was higher in the group with thromboembolism (12.6 vs 9.0), suggesting a potential dose-related effect. There were a total of 43 VTE and 5 ATE events documented, with 7 of the 39 patients (18%) experiencing more than 1 event. Bevacizumab was held or discontinued in 60% of cases, but it was continued in 25% of the cases; 4% of the events were fatal, and 10% of the VTE/ATE occurred after bevacizumab was stopped. Conclusions: The incidence of ATE and VTE in a non-study setting appears to be higher than that reported in clinical trials. There may be a dose-related effect. Bevacizumab was not consistently held or discontinued in the setting of a VTE or ATE. Development of guidelines for the management of thromboembolism with bevacizumab may be warranted.

scholarly journals Are Sports-Related Factors Correlated to the Prevalence and Initiation of Illicit Drug Misuse in Adolescence? Prospective Study in Older Adolescents

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Zoran Zubak ◽  
Admir Terzic ◽  
Natasa Zenic ◽  
Ljerka Ostojic ◽  
Ivana Zubak ◽  
...  
Keyword(s):  
Drug Use ◽  
Sport Participation ◽  
Illicit Drug ◽  
Sports Participation ◽  
Drug Misuse ◽  
Related Factors ◽  
Older Adolescents ◽  
And Gender ◽  
Individual Sports

Sport participation is considered as a factor of potential influence on illicit drug misuse (IDM) in adolescence, but there is an evident lack of studies which prospectively investigated this problem. This study aimed to prospectively investigate the sports-related factors related to IDM and the initiation of IDM among older adolescents. The participants were 436 adolescents (202 females; 16 years old at study baseline). They were tested at baseline and follow-up (two years later). The predictors included variables associated with different facets of sports participation and success in sports. The criteria were (i) baseline IDM, (ii) follow-up IDM, and (iii) initiation of IDM between baseline and follow-up. Crude and adjusted (controlled for parental conflict, age, socioeconomic status, and gender) logistic regressions were applied to establish correlations between predictors and criteria. There were higher odds for baseline IDM in adolescents who quit individual sports (OR: 4.2, 95% CI: 1.3-13.9), who had better competitive sports achievements (OR: 1.8, 95% CI: 1.0-3.3), and those involved in sports for a longer time (OR: 1.6, 95% CI: 1.0-2.5). The IDM at follow-up was more prevalent in adolescents who were involved in sports for a longer time (OR: 1.7, 95% CI: 1.1-2.6). Initiation of drug use was predicted by longer experience in sports (OR: 1.8, 95% CI: 1.1-3.1). Sports-related factors were more negatively than positively related to illicit drug use. Most probably, the transition from junior to senior level in sports put specific stress on those adolescents who were highly committed to sports until that time, but who then had to question their own sports abilities and future potential in sports. Sport-authorities should be informed on established results and specific public-health efforts aimed at preventing IDM in athletic adolescents are urgently needed.

scholarly journals Attending Informal Preschools and Daycare Centers Is a Risk Factor for Underweight, Stunting and Wasting in Children under the Age of Five Years in Underprivileged Communities in South Africa

2019 ◽  
Vol 16 (14) ◽  
pp. 2589 ◽  
Author(s):  
Sphiwe Madiba ◽  
Paul Kiprono Chelule ◽  
Mathildah Mpata Mokgatle
Keyword(s):  
South Africa ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Daycare Centers ◽  
Increased Risk ◽  
Nutritional Status Of Children

The study objectives were to determine the nutritional status of children between the ages of 12–60 months and to establish the association between attending preschool and the prevalence of undernutrition. This was a cross-sectional survey conducted in health facilities in Tshwane district in South Africa, consisting of both a questionnaire and anthropometric measures of 1256 mothers and their children. Weight-for-age (WAZ), height-for age (HAZ) and BMI-for-age (BAZ) were calculated and bivariate and multivariable analysis was performed to establish association. The results showed that child-related factors, namely birthweight, age, gender, and attending preschool increased the risk of undernutrition. Children over the age of 24 months were likely to be stunted and underweight. Maternal education reduced the odds of underweight. Children who stayed at home had reduced odds of underweight and stunting. High birthweight reduced the odds of wasting and underweight. The risks for undernutrition are multifaceted, but children who attend preschool have an increased risk of undernutrition. The risk of undernutrition increased with age and coincided with the time of cessation of breast-feeding and attendance at daycare or preschool. The complementary role of quality childcare in preschools and daycare centers is vital in alleviating the problem of undernutrition in underprivileged communities.

scholarly journals The impact of volume overload on technique failure in incident peritoneal dialysis patients

2019 ◽  
Author(s):  
François Vrtovsnik ◽  
Christian Verger ◽  
Wim Van Biesen ◽  
Stanley Fan ◽  
Sug-Kyun Shin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Risk Model ◽  
Volume Overload ◽  
Competing Risk ◽  
Related Factors ◽  
Time Points ◽  
Increased Risk ◽  
The Impact ◽  
Technique Failure

Abstract Background Technique failure in peritoneal dialysis (PD) can be due to patient- and procedure-related factors. With this analysis, we investigated the association of volume overload at the start and during the early phase of PD and technique failure. Methods In this observational, international cohort study with longitudinal follow-up of incident PD patients, technique failure was defined as either transfer to haemodialysis or death, and transplantation was considered as a competing risk. We explored parameters at baseline or within the first 6 months and the association with technique failure between 6 and 18 months, using a competing risk model. Results Out of 1092 patients of the complete cohort, 719 met specific inclusion and exclusion criteria for this analysis. Being volume overloaded, either at baseline or Month 6, or at both time points, was associated with an increased risk of technique failure compared with the patient group that was euvolaemic at both time points. Undergoing treatment at a centre with a high proportion of PD patients was associated with a lower risk of technique failure. Conclusions Volume overload at start of PD and/or at 6 months was associated with a higher risk of technique failure in the subsequent year. The risk was modified by centre characteristics, which varied among regions.

Highly Active Antiretroviral Therapy and the Incidence of Non–AIDS-Defining Cancers in People With HIV Infection

2009 ◽  
Vol 27 (6) ◽  
pp. 884-890 ◽  
Author(s):  
Thomas Powles ◽  
David Robinson ◽  
Justin Stebbing ◽  
Jonathan Shamash ◽  
Mark Nelson ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Related Factors ◽  
Incidence Data ◽  
Highly Active ◽  
Number Of Factors ◽  
Increased Risk

Purpose The effect of highly active antiretroviral therapy (HAART) on the incidence of non–AIDS-defining cancers (NADCs) is unclear. Methods We have investigated the occurrence of NADCs in a prospective cohort of 11,112 HIV-positive individuals, with 71,687 patient-years of follow-up. Standardized incidence ratios (SIRs) were calculated using general population incidence data. We investigated the effect of calendar period, HIV parameters, and immunologic and treatment-related factors on the incidence of these cancers using univariate and multivariate analyses. Results The SIR for all NADCs was 1.96 (95% CI, 1.66 to 2.29). There was no significant excess in incidence in the pre-HAART era (1983 to 1995; SIR, 0.95; 95% CI, 0.58 to 1.47). However, the incidence increased in the early HAART period (1996 to 2001) and remains elevated in the most recent established HAART period (2002 to 2007; SIR, 2.05; 95% CI, 1.51 to 2.72, and SIR 2.49; 95% CI, 2.00 to 3.07, respectively). Multivariate analysis showed that use of HAART (hazard ratio [HR] = 1.64; 95% CI, 1.13 to 2.39) and a nadir CD4 count less than 200/μL (HR = 1.67; 95% CI, 1.10 to 2.54) were associated with an increased risk. Only the non-nucleoside reverse transcriptase inhibitors (NNRTIs) were associated with a significantly increased risk of NADCs (HR = 1.45; 95% CI, 1.01 to 2.08). Much of this association was attributable to an increased risk of Hodgkin's lymphoma with NNRTIs (HR = 2.20; 95% CI, 1.03 to 4.69). Conclusion Since the introduction of HAART, there has been a significantly increased risk of NADCs, which has now stabilized. A number of factors are associated with this increased risk, including HAART use. There may be an association between the use of NNRTIs and the development of Hodgkin's lymphoma.

scholarly journals Chronic Inflammation Toward Cancer Incidence: An Epidemiological Systematic Review

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 24s-24s
Author(s):  
N. Michels ◽  
C. van Aart ◽  
J. Morisse ◽  
I. Huybrechts
Keyword(s):  
Ovarian Cancer ◽  
Chronic Inflammation ◽  
Inflammatory Markers ◽  
Critical Role ◽  
Chronically Ill ◽  
Cancer Development ◽  
Related Factors ◽  
Proinflammatory Mediators ◽  
Increased Risk

Background: It is well accepted that environment- and lifestyle-related factors (e.g., tobacco, diet, obesity and environmental pollutants) play a critical role in the development of nearly all cancers. Inflammation seems to be a major process that all of these risks factors have in common. Insight in the role of inflammation toward cancer development might have implications in prevention, early diagnosis and treatment of cancer (e.g., by selectively suppressing certain proinflammatory mediators). Aim: The aim of this review is to provide epidemiologic data on the correlation between chronic inflammation as measured by inflammatory blood parameters and the incidence of cancer. Methods: PubMed and Embase databases were searched until 2017 for English-written articles and screened by two independent authors. In vitro studies, animal studies or studies with chronically-ill subjects were excluded. Quality was assessed with the Newcastle-Ottawa scale. Results: The selected 22 observational studies included 14 nested case-control, 2 nested case-cohort and 6 prospective cohort studies. The articles originated from either Europe or the US. More than 70 different inflammatory markers were considered but C-reactive protein (CRP) was the most frequent one (followed by TNF-alpha and IL-6) and six studies combined markers of chronic inflammation into a score. Articles reported on the incidence of overall cancer (n=3) and eight site-specific cancers: non-Hodgkin lymphoma (NHL, n=1), breast (n=4), colorectal (n=6), endometrium (n=3), lung (n=3), pancreatic (n=2), prostate (n=3) and ovarian cancer (n=3). Evidence showed that elevated levels of circulating inflammatory markers are linked to an increased risk of overall, colon, endometrium, lung and ovarian cancer. The most robust and strong associations were found for colon cancer with five studies reporting significant results. Herein, CRP had the most consistent relation with odds/relative ratios ranging from 1.30 to 2.29. A definitive statement cannot be made for NHL, breast and prostate cancer due to a shortage of qualitative studies (short follow-up time, small case sample sizes) and/or inconclusive results. For pancreatic cancer, no significant results at all were found (even though these studies received the highest possible methodological quality score). Conclusion: Overall, chronic inflammation seems to play a pivotal role in cancer development. However, further research is necessary to resolve the inconclusive results and to clarify the mechanisms behind this association. Study quality improvements can be done by increasing the frequency of cytokine measures (instead of only one baseline measurement) and prolonging the follow-up.

scholarly journals Cardiovascular mortality risk in young adults with isolated systolic hypertension: findings from population-based MONICA/KORA cohort study

2021 ◽  
Author(s):  
Atasoy Seryan ◽  
Middeke Martin ◽  
Johar Hamimatunnisa ◽  
Peters Annette ◽  
Heier Margit ◽  
...  
Keyword(s):  
Young Adults ◽  
Systolic Hypertension ◽  
Antihypertensive Medication ◽  
Population Based ◽  
Protective Effects ◽  
Isolated Systolic Hypertension ◽  
Cvd Risk ◽  
Increased Risk ◽  
Cvd Mortality

AbstractThe clinical significance of isolated systolic hypertension in young adults (ISHY) remains a topic of debate due to evidence ISHY could be a spurious condition resulting from exageratted pulse pressure amplification in “young tall men with elastic arteries”. Hence, we aimed to investigate whether ISHY is associated with an increased risk of cardivascular (CVD) mortality in a sample of 5597 young adults (49.8% men, 50.2% women) between 25 and 45 years old from the prospective population-based MONICA/KORA cohort. ISHY was prevalent in 5.2% of the population, affecting mostly men (73.1%), and associated with increased smoking, obesity, and hypercholesterolemia in comparison to participants with normal blood pressure (BP). Within a follow-up period of 25.3 years (SD ± 5.2; 141,768 person–years), 133(2.4%) CVD mortality cases were observed. Participants with ISHY had a hazard ratio (HR) of 1.89(1.01–3.53, p < 0.05) times higher risk of CVD mortality than participants with normal BP, even following adjustment for CVD risk factors. However, adjustment for antihypertensive medication (HR 0.46; 0.26–0.81, p < 0.001) and increasing height (HR 0.96; 0.93–0.99, p < 0.05) revealed independently protective effects against CVD mortality, suggesting that although ISHY is associated with an increased risk of CVD mortality, the protective effects of increasing height or antihypertensive medication should be considered in treatment rationale.

No Protective Effect of Alcohol Consumption on Coronary Heart Disease (CHD) in African Americans: Average Volume of Drinking over the Life Course and CHD Morbidity and Mortality in a U.S. National Cohort

2002 ◽  
Vol 29 (4) ◽  
pp. 805-820 ◽  
Author(s):  
Christopher T. Sempos ◽  
Jürgen Rehm ◽  
Carlos Crespo ◽  
Maurizio Trevisan
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
African Americans ◽  
Morbidity And Mortality ◽  
Protective Effects ◽  
Average Volume ◽  
Increased Risk ◽  
National Cohort ◽  
The Life Course

The association between average volume of drinking and coronary heart disease (CHD) morbidity and mortality in African Americans compared with whites was explored, based on a representative US sample. A prospective cohort study with interview follow-up after 10 years and outcome follow-up over about 15 years was used. The sample consisted of 1,158 African Americans and 6,607 whites, all 40 years of age and older with no history of heart disease at baseline. Alcohol intake was measured with a quantity-frequency measure. Incidence of CHD was the sum of non-fatal and fatal events as determined from hospital records and death certificates. The event with the earliest date was defined as the incident event. With respect to CHD, African Americans showed markedly higher risks and significantly fewer protective effects compared with whites. Thus the cardioprotective effects of alcohol were not present in a representative sample of African Americans. On the contrary: Moderate to high average volume of alcohol was associated with increased risk of CHD in African Americans. Patterns of drinking as a potential cause for this finding are discussed.

Factors Associated with Attrition of Adult Participants in a Longitudinal Database: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study

2019 ◽  
Vol 41 (2) ◽  
pp. 270-279 ◽  
Author(s):  
Alyssa M Bamer ◽  
Kara McMullen ◽  
Nicole Gibran ◽  
Radha Holavanahalli ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Independent Living ◽  
Model System ◽  
Stepwise Logistic Regression ◽  
Research Projects ◽  
Related Factors ◽  
Time Points ◽  
Factors Associated ◽  
Increased Risk ◽  
Study Results

Abstract Participant attrition in longitudinal studies can lead to substantial bias in study results, especially when attrition is nonrandom. A previous study of the Burn Model System (BMS) database prior to 2002 identified participant and study-related factors related to attrition. The purpose of the current study was to examine changes in attrition rates in the BMS longitudinal database since 2002 and to revisit factors associated with attrition. Individuals 18 years and older enrolled in the BMS database between 2002 and 2018 were included in this study. Stepwise logistic regression models identified factors significantly associated with attrition at 6, 12, and 24 months postburn injury. The percentage of individuals lost to follow-up was 26% at 6 months, 33% at 12 months, and 42% at 24 months. Factors associated with increased risk of loss to follow-up across two or more time points include male sex, lower TBSA burn size, being unemployed at the time of burn, shorter duration of acute hospital stay, younger age, not having private health insurance or workers’ compensation, and a history of drug abuse. Retention levels in the BMS have improved by at least 10% at all time points since 2002. The BMS and other longitudinal burn research projects can use these results to identify individuals at high risk for attrition who may require additional retention efforts. Results also indicate potential sources of bias in research projects utilizing the BMS database.

scholarly journals Identifying Predictors of Changes in Physical Activity Level in Adolescence: A Prospective Analysis in Bosnia and Herzegovina

2019 ◽  
Vol 16 (14) ◽  
pp. 2573 ◽  
Author(s):  
Vesna Miljanovic Damjanovic ◽  
Lejla Obradovic Salcin ◽  
Natasa Zenic ◽  
Nikola Foretic ◽  
Silvester Liposek
Keyword(s):  
Physical Activity ◽  
Rural Communities ◽  
Bosnia And Herzegovina ◽  
Illicit Drugs ◽  
Maternal Education ◽  
Negative Relationship ◽  
Total Sample ◽  
Activity Level ◽  
Activity Levels

It is known that physical activity levels (PA levels) decline during adolescence, but there is a lack of knowledge on possible predictors of changes in PA levels in this period of life. This study aimed to prospectively investigate the relationship between sociodemographic and behavioral factors (predictors), PA levels and changes in PA levels in older adolescents from Bosnia and Herzegovina. The sample comprised 872 participants (404 females) tested at baseline (16 years of age) and at follow-up (18 years of age). Predictors were sociodemographic characteristics (age, gender, socioeconomic status, urban/rural residence, paternal and maternal education level) and variables of substance misuse (consumption of cigarettes, alcohol and illicit drugs). The PA level, as measured by the Physical Activity Questionnaire for Adolescents (PAQ-A), was observed as a criterion. Boys had higher PAQ-A scores than girls at baseline and follow-up. Paternal education levels were correlated with PAQ-A scores at baseline (Spearman’s R: 0.18, 0.15 and 0.14, p < 0.05, for the total sample, females and males, respectively) and at follow-up (Spearman’s R: 0.12, p < 0.01 for the total sample). Logistic regression, which was used to calculate changes in PA levels between baseline and follow-up as a binomial criterion (PA decline vs. PA incline), evidenced a higher likelihood of PA incline in adolescents whose mothers were more educated (OR: 1.29, 95% CI: 1.05–1.60) and who live in urban communities (OR: 1.56, 95% CI: 1.16–2.10). The consumption of illicit drugs at baseline was evidenced as a factor contributing to the lower likelihood of PA incline (OR: 0.36, 95% CI: 0.14–0.92). The negative relationship between illicit drug consumption and PA decline could be a result of a large number of children who quit competitive sports in this period of life. In achieving appropriate PA-levels, special attention should be placed on children whose mothers are not highly educated, who live in rural communities, and who report the consumption of illicit drugs. The results highlighted the importance of studying correlates of PA levels and changes in PA levels during adolescence.

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