scholarly journals Demographic and Risk-Factor Differences between Users and Non-Users of Unscheduled Healthcare among Pediatric Outpatients with Persistent Asthma

2020 ◽  
Vol 17 (8) ◽  
pp. 2704 ◽  
Author(s):  
Pavani Rangachari ◽  
Dixie D. Griffin ◽  
Santu Ghosh ◽  
Kathleen R. May
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Childhood Asthma ◽  
Persistent Asthma ◽  
Retrospective Chart Review ◽  
Asthma Severity ◽  
Future Research ◽  
Significant Finding ◽  
Healthcare Use ◽  
Pediatric Outpatients

This study assesses differences between users and non-users of unscheduled healthcare for persistent childhood asthma, with regard to select demographic and risk factors. The objectives are to provide important healthcare utilization information and a foundation for future research on self-management effectiveness (SME), informed by a recently developed “holistic framework” for measuring SME in childhood asthma. An 18-month retrospective chart review was conducted on 59 pediatric outpatients with persistent asthma—mild, moderate, or severe, to obtain data on various demographic and risk factors, and healthcare use for each child. The study examined five types of “unscheduled” healthcare use. Users had non-zero encounters (at least one) in any of the five types; non-users had zero encounters (not even one) in all five types. Differences between users and non-users were assessed using contingency table and logistic regression analysis. There were 25 users and 34 non-users of unscheduled healthcare. Each severity category contained users and non-users. The only statistically significant finding was that the mild persistent category had fewer users than severe persistent (p < 0.05). There were no significant differences between users and non-users for any other demographic or risk factor examined. After adjusting for asthma severity, there were no other significant differences between users and non-users of unscheduled healthcare. This is a crucial finding which suggests that something else is driving unscheduled healthcare use in these children, given there were users and non-users in each asthma severity category. These results provide impetus for future research on the role of other aspects of the "holistic framework" in explaining differences in uses of unscheduled healthcare in persistent childhood asthma.

scholarly journals Demographic and Risk Factor Differences between Children with “One-Time” and “Repeat” Visits to the Emergency Department for Asthma

2021 ◽  
Vol 18 (2) ◽  
pp. 486
Author(s):  
Pavani Rangachari ◽  
Jie Chen ◽  
Nishtha Ahuja ◽  
Anjeli Patel ◽  
Renuka Mehta
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Risk Factor ◽  
Childhood Asthma ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Primary Research ◽  
Ed Visits ◽  
The Individual

This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once (“one-time”) and more than once (“repeat”) over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0–17 years) who visited the ED for asthma in 2019–2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were “one-time” and 92 (37%) were “repeat” ED patients. Demographic and risk factor differences between “one-time” and “repeat” ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8–17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except age, none of the individual demographic or risk factors were statistically significant in predicting of “repeat” ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including age, race, gender, insurance, and asthma severity, among others) were statistically significant in predicting “repeat” ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving “repeat” ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.

scholarly journals Estimating risk and cost: An analysis of patients with risk factors for Type 2 Diabetes in rural Jalisco, Mexico

2019 ◽  
Vol 10 (3) ◽  
pp. 98
Author(s):  
Katie Morales ◽  
Emily Hall ◽  
Ella Harris ◽  
Alden Blair ◽  
Sharon Rose ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Health Care Systems ◽  
Retrospective Chart Review ◽  
Health Clinic ◽  
Middle Income ◽  
Borderline Hypertension ◽  
Life Years

The global age standardized prevalence of type 2 diabetes (T2DM) has doubled (4.7% to 8.5%) over the last three decades and is increasing more rapidly in low and middle-income countries (LMICs). The global economic burden of diabetes affects individuals and health care systems and is estimated to cost $825 billion USD a year. Within Mexico, T2DM is the second leading cause of mortality and the leading cause of morbidity using disability associated life years (DALYs). A retrospective chart review and cost analysis, analyzing those at risk of diabetes, was conducted at a rural community health clinic in Jalisco, Mexico. The goal was to project the cost of providing an appropriate scope of care and plan prevention-based population health programs. The results demonstrated that out of 264 charts reviewed, 218 (83%) had one or more diabetic risk factor. The estimated per patient per visit cost is $127.22 MP (Mexican Peso, 2018) and as the number of diabetes risk factors increases for an individual patient, the mean cost of their care to the system increases (p < .001). Those with at least one risk factor comprise the majority in both males and females with a median age of 36 and median BMI of 28, and this group also has the highest percentage of borderline hypertension (46%). This data demonstrates an opportunity to intervene in a group of young adults (ages 27-46) with a cluster of high-risk borderline risk factors and preventing them from developing obesity, hypertension and diabetes later in life.

The 50 Most Cited Articles in the Indications, Risk Factors, Techniques, and Outcomes of ACL Revision Surgery

2020 ◽  
Author(s):  
Hayley E. Ennis ◽  
Kevin Bondar ◽  
Johnathon McCormick ◽  
Clark Jia-Long Chen ◽  
Chester J. Donnally ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Future Research ◽  
Revision Acl Reconstruction ◽  
Anterior Cruciate ◽  
Number Of Citations

AbstractThe rate of anterior cruciate ligament (ACL) retear remains high and revision ACL reconstruction has worse outcomes compared with primaries. To make advances in this area, a strong understanding of influential research is necessary. One method for systematically evaluating the literature is by citation analysis. This article aims to establish and evaluate “classic” articles. With consideration of these articles, this article also aims to evaluate gaps in the field and determine where future research should be directed. The general approach for data collection and analysis consisted of planning objectives, employing a defined strategy, reviewing search results using a multistep and multiauthor approach with specific screening criteria, and analyzing data. The collective number of citations for all publications within the list was 5,203 with an average of 104 citations per publication. “Biomechanical Measures during Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury after Anterior Cruciate Ligament Reconstruction and Return to Sport” by Paterno et al contained both the highest number of total citations and the highest number of citations per year, with 403 total citations and 43.9 citations per year. The most recurring level of evidence were level II (n = 18) and level III (n = 17). “Clinical Outcomes” was the most common article type (n = 20) followed by “Risk Factors” (n = 10). The American Journal of Sports Medicine had the highest recorded Cite Factor with over 50% of the articles (n = 27) published. The most productive authors included R.W. Wright (n = 6), S.D. Barber-Westin (n = 5), F.R. Noyes (n = 5), and K.P. Spindler (n = 5). Historically, influential studies have been published in the realms of clinical outcome and risk factor identification. It has been established that revision ACL reconstruction has worse outcomes and more high-level studies are needed. Additionally, prospective studies that apply the knowledge for current known risk factor mitigation are needed to determine if graft tear rates can be lowered.

scholarly journals Why do some children of short stature develop psychologically well while others have problems?

2004 ◽  
pp. S35-S39 ◽  
Author(s):  
A Erling
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Short Stature ◽  
Psychological Adjustment ◽  
Psychosocial Stress ◽  
Future Research ◽  
Resistance Factors ◽  
Familial Support ◽  
Test Models ◽  
And Coping

The present paper addresses the question: why do some children of short stature develop psychologically well while others have problems? Based on the work of Wallander and Varni, a model is presented to illustrate risk as well as resistance factors that are important for children of short stature.It is suggested that important risk factors for the psychological adjustment of children of short stature are the child's satisfaction with its height and the aetiology of the short stature. Another possible risk factor is the tendency for people in the child's environment to treat the child as if he or she were younger than is actually the case. The most important risk factor, however, seems to be the psychosocial stress related to being teased or bullied due to the short stature. Important resistance factors for children of short stature might be the child's temperament, familial support and coping strategies.It is concluded that an important aim for future research is, in a multi-disciplinary setting, to empirically test models of risk and resistance factors that are relevant for children of short stature.

scholarly journals Subsequent Pain or Injury After Foot and Ankle Surgery in Patients Receiving Workers’ Compensation

2019 ◽  
Vol 41 (1) ◽  
pp. 17-24
Author(s):  
Gabrielle Bui ◽  
Yubo Gao ◽  
Natalie Glass ◽  
Christopher Cychosz ◽  
John Lawrence Marsh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Chart Review ◽  
Anatomical Location ◽  
Workers Compensation ◽  
Foot And Ankle ◽  
Chi Square ◽  
Level Of Evidence ◽  
Legal Representation ◽  
Ankle Surgery

Background: Workers’ compensation (WC) has been associated with poor outcomes following a variety of injuries and surgeries, but rates of subsequent pain or injury (SPI) following surgery have not been studied. The purpose of this study was to investigate the rates, locations, and risk factors of SPI in WC patients and non-WC patients who underwent the same surgeries. Methods: With institutional review board approval, records from foot or ankle surgery performed by author P.P. from 2009 to 2015 were obtained. A retrospective chart review was performed on all WC and non-WC patients with at least 1 Current Procedural Terminology code of interest. SPI was defined as a new injury at a different anatomical location occurring 2 months to 2 years after the index surgery. Chi-square and 2-tailed t tests were used to compare risk factors and rates of SPI in both groups. Results: The WC population had higher rates of SPI than the non-WC population. Specifically, 13 of 56 WC patients (23.2%) vs 12 of 165 non-WC patients (7.3%) reported SPI ( P = .001). The hip, knee, and contralateral foot and ankle were common areas of SPI in both groups. Legal representation and increased age were risk factors for SPI in the WC population. Specifically, 10 of 13 WC patients with SPI had legal representation vs 16 of 43 WC patients without SPI ( P = .02). Female sex was a risk factor for SPI in the non-WC population. Conclusions: WC patients had higher rates of subsequent pain or injury than non-WC patients. Legal representation was a risk factor for SPI in the WC population. Level of Evidence: Level III, comparative series.

scholarly journals Rates and risk factors for nephrotoxicity and ototoxicity among tuberculosis patients in Tbilisi, Georgia

2019 ◽  
Vol 23 (9) ◽  
pp. 1005-1011 ◽  
Author(s):  
M. Buziashvili ◽  
V. Mirtskhulava ◽  
M. Kipiani ◽  
H. M. Blumberg ◽  
D. Baliashvili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Multinomial Logistic Regression ◽  
Significant Risk ◽  
Retrospective Chart Review ◽  
Significant Risk Factor ◽  
Multidrug Resistant ◽  
Disease Classification ◽  
Second Line ◽  
Multinomial Logistic Regression Analysis

SETTING: Treatment of multidrug-resistant tuberculosis (MDR-TB) is lengthy and utilizes second-line anti-TB drugs associated with frequent adverse drug reactions (ADRs).OBJECTIVE: To evaluate the prevalence of and risk factors for ADRs among patients with MDR- and extensively drug-resistant TB (XDR-TB).DESIGN: A retrospective chart review of patients initiating treatment for M/XDR-TB in 2010–2012 in Tbilisi, Georgia.RESULTS: Eighty (54%) and 38 (26%) of 147 patients developed nephrotoxicity per RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification and ototoxicity, respectively. Twenty-five (17%) patients required permanent interruption of injectables due to an ADR. Median hospital stay, total treatment duration and number of regimen changes were higher among those with nephrotoxicity and/or ototoxicity, compared to those without (P < 0.01). Multinomial logistic regression analysis identified increasing age (per year) as a risk factor for nephrotoxicity (aOR 1.08, 95%CI 1.03–1.12) and for both, nephro- and ototoxicity (aOR 1.11, 95%CI 1.05–1.17). Low baseline creatinine clearance (CrCl) was a significant risk factor for developing nephrotoxicity (aOR 1.05, 95%CI 1.02–1.07).CONCLUSION: Second-line injectable drug-related ADRs are common among M/XDR-TB patients. Patients with increasing age and low baseline CrCl should be monitored closely for injectable-related ADRs. Notably, our findings support WHO's latest recommendations on introduction of injectable free anti-TB treatment regimens.

scholarly journals An Overview of Atherosclerosis: A Look to the Future*

1990 ◽  
Vol 18 (4a) ◽  
pp. 623-635 ◽  
Author(s):  
Godfrey S. Getz
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Risk Factor ◽  
Family History ◽  
Experimental Atherosclerosis ◽  
Major Risk Factor ◽  
Future Research ◽  
Atherosclerotic Plaques ◽  
The Future

This overview briefly summarizes the cellular pathobiology of experimental atherosclerosis and is then followed by a consideration of how 3 major risk factors interact with the hypothesized pathogenetic process. First, since hemodynamics and blood flow influence the localization of atherosclerotic plaques, possible mechanisms and directions of research are considered. Secondly, the recent hypothesis relating the oxidation of LDL to several of the early processes of atherogenesis is briefly discussed in view of the fact that hyperlipidemia is a major risk factor. The possibility that subsets of LDL and lipoproteins other than LDL might be involved is also discussed. Family history is the last of the 3 contributors to atherosclerosis reviewed and some prototypes of gene abnormalities are considered. Finally, the needs and prospects of future research are summarized.

scholarly journals Pneumomediastinum in marijuana users: a retrospective review of 14 cases

2019 ◽  
Vol 6 (1) ◽  
pp. e000391 ◽  
Author(s):  
Zoe Freeman Weiss ◽  
Sara Gore ◽  
Andrew Foderaro
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Marijuana Use ◽  
Pulmonary Injury ◽  
Air Leakage ◽  
Male Predominance ◽  
Free Air ◽  
Closed Glottis

IntroductionInhaled marijuana has been infrequently identified as a potential risk factor for the development of spontaneous pneumomediastinum (SPM), a rare finding of free air in the mediastinum likely caused by barotrauma during breathing manoeuvres. The mechanism of inhalation drug use is often not ascertained by physicians, thus little is known about how different smoking techniques precipitate pulmonary injury. We aimed to evaluate the frequency of marijuana use in patients with non-traumatic pneumomediastinum over a 12-month period, identifying additional relevant clinical features or risk factors, and determining the extent to which clinicians record smoking techniques.MethodsWe performed a retrospective chart review over a 1-year period, identifying patients presenting to the hospital with a diagnosis of pneumomediastinum in the absence of trauma, malignancy or iatrogenic cause.ResultsWe identified 21 cases, 14 of which (66.7%) were associated with marijuana use, average age was 22.5 years (range 18–30), with male predominance (64.2%). Daily or more use was reported in 50% of cases. Concurrent risk factors including vomiting (57.1%) and coughing (42.9%) were commonly present. The mechanism of smoking was described in only two cases (14.3%).DiscussionInhaled marijuana may be an underappreciated risk factor for the development of SPM, caused by air leakage around the bronchovascular sheaths during successive inhalation through a high-resistance smoking apparatus or forced exhalation against a closed glottis. Physicians should be aware of this association in order to provide appropriate counselling. Further research is needed to direct the safe use of smoking devices and techniques.

scholarly journals A study on epidemiology, etiology, risk factor and treatment management in chronic kidney disease on children, adult and geriatric patients in a tertiary care teaching hospital: A systematic mini-review

2020 ◽  
Vol 11 (4) ◽  
pp. 7175-7181
Author(s):  
Naveena B ◽  
Karthikeyan E
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
Age Groups ◽  
Systemic Review ◽  
Future Research ◽  
Treatment Management

Chronic kidney disease (CKD) was recognized as universal health problem for population. It can result in a systemic review of epidemiology, etiology, risk factors, and treatment management was reporting the incidence of CKD about children, adult, and geriatric patients by using the research articles from 1982 to 2020. The object of study to find out a incidence about epidemiology, etiology, risk factor, and treatment management for all age groups with CKD patients in review articles. The discussion in this study systemic mini-review was about CKD in children, adult, and geriatric patients. In 2012, 2018 and 2019 epidemiology is mostly geriatrics are effected with CKD compared with children and adults but in 2016 children and geriatrics are equally effected with CKD. In 2017 to 2019 etiology is mostly geriatrics are effected with CKD  when compared with children and adults. From 2000 to 2010 and 2011 to 2020 risk factors are mostly children’s are effected with CKD having risk factors  to compare with adults and geriatrics. The treatment management from 1982 to 2020 the medications are intervented like radioactive iodine,  Azathioprine, methotrexate, lisinopril, hemodialysis,  methotrexate, and lisinopril for all age groups of CKD patients. The study was concluded that patients with CKD has increased the epidemiology, etiology, risk factor, and treatment management on children, adult, and geriatric patients with CKD. Future research should investigate adequate information about children, adults, and geriatric patients with CKD for better outcomes in further study.

scholarly journals Meta-analysis of risk factors associated with suicidal ideation after stroke

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuangmei Zhang ◽  
Anrong Wang ◽  
Weifeng Zhu ◽  
Zhaoyang Qiu ◽  
Zhaoxu Zhang
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Suicidal Ideation ◽  
Sleep Disorders ◽  
Family Income ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Future Research ◽  
Factors Associated ◽  
Complications Of Stroke

Abstract Background Over the past decade, increasing attention has been paid on post stroke suicide (PSS), which is one of complications of stroke. The rates of stroke and suicide are relatively high, especially in Asian populations. Thus, a deeper understanding of the prevalence and epidemiological impact of suicide after stroke is urgently needed. Clinical diagnosis and prevention of PSS are at the incipient stage, but the risk factors responsible for the occurrence of PSS in different regions and stages of the disease remain largely unknown. The present meta-analysis aimed to determine the incidence of PSS at different stages and time courses, and to identify the underlying risk factors for PSS. Methods We systematically searched the Cochrane library, Embase, PubMed, CNKI and Web of Science databases from their inception until April 2019.The research articles reporting on the risk factor for PSS were screened and included in the meta-analysis. The data from the included studies were extracted according to the predefined criteria. Results A total of 12 studies (n = 2,693,036) were included for meta-analyses. Of these studies, 7 reporting suicide prevalence were meta-analyzed. The pooled estimate of suicidal ideation rates after stroke was 12%, which could be influenced by multiple risk factors, including sex, smoking, depression, sleep disorders, previous stroke and low household income. Studies conducted in Asia demonstrated higher suicide prevalence (approximately 15%) compared to other regions. Smoking, low family income, depression, heart disease and sleep disorders were important risk factors for PSS. When compared to PSS of more than 1 year, the incidence of suicide within 1 year after stroke was more likely to be statistically significant. It was found that 4 out of every 1000 stroke survivors tended to commit suicide. The results of this meta-analysis showed that depression (OR = 2.32; p < 0.01) was significantly associated with suicidal ideation, regardless of stroke duration. Conclusion PSS is one of the common complications of stroke. Despite some limitations, we successfully identified the risk factors associated with suicidal ideation after stroke. Notably, depression was significantly associated with suicidal ideation, regardless of stroke duration. Targeting this risk factor may be helpful to improve stroke patient care and prevent suicidal ideation after stroke. Future research will be carried out to assess whether suicidal ideation or thoughts and actual suicide attempts are strongly predictive of suicide deaths after stroke (Registration No. CRD42019128813).

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