scholarly journals Age-Related Risk Factors at the First Stroke Event

2020 ◽  
Vol 9 (7) ◽  
pp. 2233 ◽  
Author(s):  
Raúl Soto-Cámara ◽  
Jerónimo J. González-Bernal ◽  
Josefa González-Santos ◽  
José M. Aguilar-Parra ◽  
Rubén Trigueros ◽  
...  

(1) Background: Stroke is a multifactorial disease, which can affect individuals at any age. Risk factors (RFs) associated with the first stroke event have been well identified; however, the influence of these RFs on the patient’s age needs to be studied. (2) Objective: This study aimed to examine the effect of modifiable RFs on the age at which a stroke occurs. (3) Methods: A cross-sectional study was conducted on patients admitted consecutively with a first-ever acute stroke at the Burgos University Hospital (Spain). Data on sociodemographic and clinical parameters were collected (high blood pressure (HBP), smoking habit, diabetes mellitus (DM), dyslipemia, abdominal obesity, sedentary lifestyle, alcohol consumption, and cardiovascular diseases). The possible associations between RFs and age were studied using univariate and multivariate regression analyses and a decision tree. (4) Results: A total of 436 patients with a mean age of 75.39 years (standard deviation (SD) ± 12.67) were included. HBP and overweight/obesity were the most prevalent stroke RFs. Being an active smoker (OR 21.48; 95% confidence interval (CI) 8.80–52.41), having a sedentary lifestyle (OR 3.24; 95% CI 1.97–5.31), being an excessive alcohol drinker (OR 2.36; 95% CI 1.45–3.84), or being overweight or obese (OR 1.95; 95% CI 1.14–3.34) increased the risk of having an acute cerebrovascular event in individuals aged 75 years or below. However, a personal history of HBP (OR 0.40; 95% CI 0.24–0.67) was significantly associated with a greater likelihood of having an acute stroke in individuals aged more than 75 years. (5) Conclusions: This study showed that the modifiable RFs strongly influence the first stroke event in patients aged below 75 years, which will be useful in guiding different prevention strategies.

Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lizhen Ye ◽  
Liset E. M. Elstgeest ◽  
Xuxi Zhang ◽  
Tamara Alhambra-Borrás ◽  
Siok Swan Tan ◽  
...  

Abstract Background Frailty is an age-related condition resulting in a state of increased vulnerability regarding functioning across multiple systems. It is a multidimensional concept referring to physical, psychological and social domains. The purpose of this study is to identify factors (demographic characteristics, lifestyle factors and health indicators) associated with overall frailty and physical, psychological and social frailty in community-dwelling older people from five European countries. Methods This cross-sectional study used baseline data from 2289 participants of the Urban Health Center European project in five European countries. Multivariable logistic regression models were used to assess associations of the factors with overall frailty and the three frailty domains. Results The mean age was 79.7 (SD = 5.7). Participants who were older, were female, had secondary or equivalent education, lived alone, not at risk of alcohol use, were less physically active, had multi-morbidity, were malnourished or with a higher level of medication risk, had higher odds of overall frailty (all P < 0.05). Age was not associated with psychological and social frailty; sex was not associated with social frailty; smoking and migration background was not associated with overall frailty or any of its domains. There existed an interaction effect between sex and household composition regarding social frailty (P < 0.0003). Conclusions The present study contributed new insights into the risk factors for frailty and its three domains (physical, psychological and social frailty). Nurses, physicians, public health professionals and policymakers should be aware of the risk factors of each type of frailty. Furthermore, examine these risk factors more comprehensively and consider overall frailty as well as its three domains in order to further contribute to decision-making more precisely on the prevention and management of frailty. Trial registration The intervention of the UHCE project was registered in the ISRCTN registry as ISRCTN52788952. The date of registration is 13/03/2017.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Nicole Karazurna ◽  
Caitlin Porter ◽  
Jesse Stabile Morrell ◽  
Sherman Bigornia

Abstract Objectives Evidence suggests that omega-3 fatty acid (n-3 FA) and fish consumption may reduce the risk of the metabolic syndrome (MetS) in older adults. We previously reported that MetS components are prevalent among college students. Identifying modifiable risk factors of developing MetS and its components in young adults will inform potential targets to reduce the risk of age-related health conditions. Our objectives were to measure the cross-sectional impacts of n-3 FA and fish consumption on ≥2 or ≥3 MetS criteria and individual criteria among college students. Methods The College Health and Nutrition Assessment Survey is an on-going cross-sectional study at a public New England college. We examined data from Jan 2008 – May 2017. After excluding those with missing data our final sample size was n = 4271 for n-3 FA & n = 2072 for fish intake analyses. Diet was assessed by a 3 day food record; MetS criteria were collected in fasted state. We expressed n-3 FAs as g/1000 kcals/d. Servings of fish/week was obtained via an online survey. Individuals were categorized as consuming ≥ 2 servings/week or not. MetS was defined as meeting ≥ 3 criteria: elevated glucose, triglycerides, blood pressure, waist circumference, and low HDL. Analyses were conducted by logistic regression. Results The average n-3 FA intake was 0.4 g/1000 kcal/d ± 0.25 & 40% consumed ≥ 2 servings of fish/week. Prevalence estimates for meeting ≥ 2 criteria was 18.8% and 4.8% for MetS. In sex- and energy- adjusted models, n-3 FA consumption was inversely associated with MetS (OR = 0.38; 95%CI: 0.20, 0.71) and ≥2 MetS criteria (OR = 0.67; 95%CI: 0.49, 0.91). Associations were no longer significant after considering additional confounders. Fish consumption was not significantly associated with MetS or ≥2 criteria in any model. Further n-3 FAs and fish consumption was not associated with any individual MetS criteria. Conclusions In this cross-sectional study among college students, n-3 FA and fish consumption were not significantly associated with MetS outcomes. Further research is needed in this population using longitudinal study designs to understand long-term impact of n-3 consumption on the development of MetS and associated cardio metabolic risk factors in young adults. Funding Sources New Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1010738.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Sidra Hameed ◽  
Faisal Faiyaz Zuberi ◽  
Sagheer Hussain ◽  
Syed Khalid Ali

Objective: To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods: A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results: Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion: Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases. doi: https://doi.org/10.12669/pjms.35.5.919 How to cite this:Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.919 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Bushra . ◽  
Ambreen Ghori ◽  
Azra Ahmed ◽  
Najma Dalwani ◽  
Mushtaque Ali Shah ◽  
...  

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Terence J Quinn ◽  
Robert Shaw ◽  
Martin Taylor-Rowan

Introduction: Guidelines recommend screening all stroke admissions for cognitive impairment. Delirium may be an important contributor to cognitive problems, but available data are limited by potential selection biases and imperfect delirium assessment. We aimed to describe robust estimates of delirium occurrence (incidence and prevalence) and risk factors in an acute stroke unit (ASU). Methods: We collected data from sequential admissions to our University Hospital ASU over a 20 week period (Feb-July 2016). The only exclusion was where the clinical team felt that any form of assessment was inappropriate. We aimed to perform cognitive assessments at 48 hours post stroke. Cognitive assessments were based on mini Montreal Cognitive Assessment (m-MoCA) and GP-Cog informant interview to assess for pre-stroke dementia. We assessed for delirium based on DSM-V criteria. We described univariable and multivariable associations with delirium occurrence. Results: Across the study period, 184 strokes were admitted; median age 71 years (IQR:61-79). Some form of cognitive assessment was available for 178 (97%). In total. 152 had evidence of cognitive impairment on m-MOCA, 55 (31%) met criteria for delirium and 25 (15%) had pre-stroke dementia. Significant univariable associations with delirium were:age and pre-existing cognitive decline. On logistic regression:age, history of drug or alcohol misuse and pre-stroke mRS were all independently associated with delirium. Discussion: In an unselected ASU population a substantial proportion will have cognitive impairment based on screening. Delirium is common and contributes to this cognitive problems seen in acute stroke. Independent associations with delirium occurrence were identified but were non-modifiable. Our results have implications for policy and practice. As post-stroke cognitive impairment is multifactorial, screening delirium and pre-existing cognitive issues should form part of the initial assessment.


2019 ◽  
Vol 104 (8) ◽  
pp. 1064-1069
Author(s):  
Vincent Daien ◽  
Vuong Nguyen ◽  
Rohan W Essex ◽  
Robin Guymer ◽  
Jennifer J Arnold ◽  
...  

BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.


Author(s):  
Inas Mohamed Elhassan Abd. Alkareem ◽  
Mohamed Ahmed A/Gadir Ounsa ◽  
Elsadig Yousif Mohamed ◽  
Elsadig Mohamed ◽  
Sawsan Abdalla

Background: Postpartum dyspareunia affects many women following childbirth: however, the extent of the problem is difficult to estimate. The objectives of the current study were to determine the prevalence of postpartum dyspareunia and to estimate its risk factors.Methods: This is a cross-sectional study conducted at the National Ribat University Hospital, Sudan. The study was carried out on women attended the refer clinics of obstetrics and gynecology and pediatrics departments in the hospital. The sample size was calculated as 380. The data were collected by a pre-tested questionnaire along with a clinical examination of the vulva and vagina after obtaining the ethical approval. The SPSS was used to analyze the data.Results: The prevalence of postpartum dyspareunia in women attended the National Ribat University hospital was 42.6 %. Regarding age, 8 (61.5%) of women less than 20 years of age experienced dyspareunia, 102 (46.4%) and 52 (35.4%) of women whose age was 20-29 years; and more than 29 years experienced the condition. One hundred forty (51.7%) of women who delivered by normal vaginal delivery developed postpartum dyspareunia. Eight (72.7%), 8 (12.5%) and 6 (17.6%) of women delivered by Operative vaginal, Elective C/S and Emergency C/S developed postpartum dyspareunia respectively. One hundred forty-eight (62.4%), 153 (51.3%) women who had decircumcision and episiotomy in last delivery had postpartum dyspareunia respectively. Forty-six (93.3%), fifty-three (86.9%) and 60 (87%) women who had infected episiotomy, scar tissue at episiotomy and tight interoitus developed the condition respectively.Conclusions: The prevalence of postpartum dyspareunia in women attended the National Ribat University hospital was 42.6 %. Regarding age, 8 (61.5%) of women less than 20 years of age experienced dyspareunia, 102 (46.4%) and 52 (35.4%) of women whose age was 20-29 years; and more than 29 years experienced the condition. One hundred forty (51.7%) of women who delivered by normal vaginal delivery developed postpartum dyspareunia. Eight (72.7%), 8 (12.5%) and 6 (17.6%) of women delivered by Operative vaginal, Elective C/S and Emergency C/S developed postpartum dyspareunia respectively. One hundred forty-eight (62.4%), 153 (51.3%) women who had decircumcision and episiotomy in last delivery had postpartum dyspareunia respectively. Forty-six (93.3%), fifty-three (86.9%) and 60 (87%) women who had infected episiotomy, scar tissue at episiotomy and tight interoitus developed the condition respectively.


2021 ◽  
Vol 8 (1) ◽  
pp. e001004
Author(s):  
Angelita Cabrera ◽  
Cesar Picado ◽  
Alejandro Rodriguez ◽  
Luis Garcia-Marcos

BackgroundIn 2003, the International Study of Asthma and Allergies in Childhood (ISAAC) estimated the prevalence of asthma, rhinitis and eczema symptoms in Quito, Ecuador. Since then, no update of this study has been done in the last years. This study examined changes in the prevalence of asthma–rhinitis–eczema symptoms over a 16 years period in Quito and explored possible risk factors.MethodsWe conducted a comparative cross-sectional study in an adolescent population following the Global Asthma Network (GAN) methodology. A written questionnaire was used to explore symptoms of asthma–rhinitis–eczema. We calculated the prevalence and 95% CIs for each of the symptoms and compared them with the ISAAC results. We conducted bivariate and multivariate analysis using logistic regression to identify possible risk factors for recent wheeze, rhinitis and eczema.ResultsA total of 2380 adolescents aged between 13 and 14 years were evaluated. The prevalence of doctor diagnosis for asthma, rhinitis and eczema was 3.4%, 8.5% and 2.2%, respectively. Compared with ISAAC results, we found a lower prevalence of wheeze and eczema symptoms: wheeze ever (37.6% vs 12.7%), recent wheeze (17.8% vs 6.5%), asthma ever (6.9% vs 4.6%), recent rush (22.4% vs 13.9%) and eczema ever (11.7% vs 3.6%). The prevalence of rhinitis symptoms in the GAN study was higher than the ISAAC results: nose symptoms in the past 12 months (36.6% vs 45.8%) and nose and eye symptoms in the past 12 months (23.1% vs 27.9). Significant associations were observed between symptoms of asthma–rhinitis–eczema and sex, race/ethnicity, smoking habit, physical exercise and sedentary activities.ConclusionsIn the last two decades, the prevalence of asthma and eczema symptoms in adolescent population in the city of Quito has significantly declined; however, the prevalence of rhinitis symptoms has increased. The reduction in asthma symptoms could be related to better managing the disease and changes in local environmental risk factors in the last years. Further studies must be conducted in the country to evaluate the change in trends in asthma and other related allergic diseases.


2021 ◽  
Author(s):  
Mário Luciano de Mélo Silva Júnior ◽  
Gabriella Camelo Oliveira ◽  
Lucas Pereira Ferreira ◽  
Roberto Carlos de Sousa Alves Junior ◽  
Yuri de Almeida Oliveira ◽  
...  

Background: Stroke is one of the main causes of death in the Brazil and worldwide. The level of lay people’s knowledge on risk factors for stroke have yet to be fully described. Objectives: To assess the level of information on risk factors for stroke among lay people Design and setting: Cross-sectional study applying a survey to people in public spaces in cities of Brazil’s Northeast, in 2020. Methods: Individuals who were passing by in such places were invited in a quasi- random strategy, to be interviewed. We exposed the volunteers to a typical case of a stroke presentation and asked what risk factors for it. We did not provide alternatives for the question. Ethical principles were followed. Results: We enrolled 1,477 individuals (52.5% female, 36.2±14.8yo). Stroke was identified for 1,226/1,477 (83.0%) individuals. From these, 423/1,226 (34.5%) did not mention any risk factors for stroke; and 393/1,226 (32.1%) reported two or more factors. The often-indicated risk factors were hypertension (418, 34.1%), stress (201, 16.4%), inappropriate diet (125, 10.2%), diabetes (124, 10.1%) and sedentary lifestyle (109, 8.9%). There was not differences on mention or not risk factors in relation to sex (p=.290) and age (p=.085), but those who known had more years of formal education (p <.001) and more frequently had health insurance (p=.010). Conclusion: The knowledge of general population on risk factors for stroke is poor. It is necessary to provide public campaigns in order to improve knowledge on this theme and to encourage screening in individuals at risk.


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