scholarly journals Lower Education Level is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up

2013 ◽  
Vol 33 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Yahn-Bor Chern ◽  
Pei-Shan Ho ◽  
Li-Chueh Kuo ◽  
Jin-Bor Chen
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Univariate Analysis ◽  
Education Level ◽  
Time Dependent ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education

BackgroundPeritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis.MethodsOur single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis.ResultsThe study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053).ConclusionsA lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level.

P3131Evolution of subclinical rheumatic heart disease: a multi-centre retrospective cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Sanyahumbi ◽  
G Karthikeyan ◽  
T Aliku ◽  
A Beaton ◽  
J Carapetis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multivariable Analysis ◽  
Subtype C ◽  
Factors Associated ◽  
Rheumatic Heart

Abstract Background Screening echocardiography (echo) detects subclinical rheumatic heart disease (RHD) which is categorised as definite or borderline. The natural history of subclinical RHD is not known. Follow up single centre studies have included a relatively small number of participants, and have shown variable progression rates. Aim To determine incidence of and factors associated with progression and regression among a cohort of children with baseline subclinical RHD across multiple countries and regions. Methods This is a retrospective cohort study of RHD evolution in children with subclinical RHD. Study sites were Australia, Fiji, Malawi, New Zealand, and Uganda. Progression or regression was determined from echos obtained at baseline and most recent follow-up. Factors associated with echo progression or regression were identified using multivariable logistic regression. Results 482 participants (131 with definite, 351 with borderline subclinical RHD) from 5 countries were included (mean age 11.5 years, range 5–19 years). Mean follow up was 3.4 yrs (range 0.4–9.5 yrs). Of 482 participating children, 204 (42%) regressed. Among 131 children with definite lesions, 48 (37%) regressed to borderline or normal, and 83 (63%) remained definite. Among 351 children with borderline lesions, 39 (11.1%) progressed, 156 (44.4%) remained borderline, and 156 (44.4%) regressed to normal. World Heart Federation defines subcategories based on characteristics of affected valves. By subcategory, children with definite C (pathological aortic regurgitation and 2 morphologic characteristics of the aortic valve) and borderline A (at least 2 morphologic features of the mitral valve without pathologic mitral regurgitation or stenosis) were less likely to regress, and borderline A was more likely to progress. In univariable analysis, good adherence (>80%) to penicillin prophylaxis (BPG) was associated with more regression among all patients (definite + borderline) (OR 1.9, CI 1, 3.5; p=0.04) but this association did not remain significant after adjustment. With multivariable analysis, borderlines prescribed BPG was the only factor related to progression from borderline to definite (OR 4.1, CI 1.8, 9.3, p<0.01). Conclusion This is the largest reported subclinical RHD cohort followed to report outcomes. 42% of definite RHD regressed with subtype C more likely to regress. 11% of borderline RHD progressed. Borderline A was more likely to progress and less likely to regress. We have also identified that being prescribed BPG is associated with borderline progression. This is likely because children with more advanced borderline disease may be more likely to be prescribed BPG. This study highlights that RHD evolution is variable out to 3–4 years post echo detection. While borderline disease is likely, in some cases, to reflect the earliest change of RHD, how this should be monitored and whether it should be treated with BPG should be a priority for future prospective evaluation.

scholarly journals Medicine package inserts from the users’ perspective: are they read and understood?

2019 ◽  
Vol 22 ◽  
Author(s):  
Tatiane da Silva Dal Pizzol ◽  
Cassia Garcia Moraes ◽  
Paulo Sérgio Dourado Arrais ◽  
Andréa Dâmaso Bertoldi ◽  
Luiz Roberto Ramos ◽  
...  
Keyword(s):  
Population Based ◽  
Education Level ◽  
Descriptive Statistics ◽  
Cross Sectional ◽  
Population Based Study ◽  
Package Inserts ◽  
Factors Associated ◽  
Written Information ◽  
Lower Education Level ◽  
Lower Education

ABSTRACT: Introduction: The written information on medicines has been acknowledged as an important tool for health education. Objective: To analyze the use and understanding of medicine package inserts by users and assess sociodemographic and medical factors associated with their comprehension. Method: Data in this analysis are part of the PNAUM National Survey - a cross-sectional population-based study conducted in Brazil. Descriptive statistics and the Pearson χ2 tests were performed to compare proportions between sociodemographic and medical characteristics, as well as use and understanding of medicine package inserts. Results: A total of 28.427 individuals responded to questions related to medicine package inserts. From these, 59.6% (95%CI 57.7 - 61.5) said they usually read the inserts, and 98.4% (95%CI 98.0 - 98.8) considered them necessary. Among people who read the medicine package inserts, more than half indicated difficulties with legibility (57.4%; 95%CI 55,2 - 59,6) and readability (54.1%; 95%CI 52.1 - 56.1). People from a lower education level reported greater difficulty in understanding them. Conclusion: The larger portion of the population usually read medicine package inserts. Nevertheless, people have difficulty in reading and understanding them.

PREVALENCE AND FACTORS ASSOCIATED WITH EARLY MARRIAGE IN CHIPULUKUSU TOWNSHIP OF NDOLA, ZAMBIA:cross sectional study (Preprint)

2019 ◽  
Author(s):  
Satiel Banda
Keyword(s):  
Economic Status ◽  
Cross Sectional Study ◽  
Education Level ◽  
Early Marriage ◽  
Child Marriage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education

BACKGROUND In the statistics taken from media brief on ending child marriage in Zambia, (2014) states, “Zambia is the third highest country with cases of child marriages in the SADC region and 19th in the world. In Zambia, about 42 per cent of women aged 20-24 years are married by the age of 18 – a rate that has not evolved since 2002. The rates of child marriages vary from province to province, and are as high as 60 per cent in the Eastern Province. (www.girlsnotbrides.org.) accessed on 20th November 2014. At 13.42) The ZDHS [Zambia Demographic Health Survey] indicates that among married girls aged 15-19 in Zambia, 68 percent have already given birth. In addition, most of the births occurring to girls before age 18 are first births (85 percent), and a majority of these first births occur within marriage. A Central Statistical Office (CSO) report of 2010 carried out by Plan Zambia indicates that “only a few adolescent girls and boys complete upper primary education while the enrolment ratio in secondary education is 13.4% for males and 12.9% for females.” The report concludes that child marriage is the critical driver for this state of affairs. OBJECTIVE This study is aimed at determining the prevalence and factors associated with child marriage in Chipulukusu township of Ndola. Zambia. METHODS A cross-sectional study was conducted in Chipulukusu Township within the location of Ndola. A pretest questionnaire was used to collect information on child marriage prevalence and factors towards the practice of child marriage and other relevant socio-demographic characteristics. RESULTS the prevalence of early marriage in Chipulukusu township of Ndola district, Zambia was 20.7 % with it being significantly associated with lower social economic status (poverty), lower education level, orphanhood and teen pregnancies CONCLUSIONS the prevalence of early marriage in this study was high. Its prevalence was significantly associated with people of poor backgrounds (poverty), teen pregnancies, lower education level, and orphan hood.

scholarly journals Comparative Analysis of Cage Subsidence in Anterior Cervical Decompression and Fusion: Zero Profile Anchored Spacer (ROI-C) vs. Conventional Cage and Plate Construct

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhe-yu Jin ◽  
Yun Teng ◽  
Hua-zheng Wang ◽  
Hui-lin Yang ◽  
Ying-jie Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Factors Associated ◽  
Subsidence Rate ◽  
Cage Subsidence ◽  
Conventional Plate ◽  
Male Sex ◽  
Significant Factors

Background: Anterior cervical discectomy and fusion (ACDF) has been widely performed to treat cervical generative diseases. Cage subsidence is a complication after ACDF. Although it is known that segmental kyphosis, acceleration of adjacent segmental disease, and restenosis may occur due to cages subsidence; however detailed research comparing zero-profile cages (ROI-C) and conventional plate and cage construct (CPC) on cage subsidence has been lacking.Objective: The objectives of this study was to compare the rate of postoperative cage subsidence between zero profile anchored spacer (ROI-C) and conventional cage and plate construct (CPC) and investigate the risk factors associated with cage subsidence following ACDF.Methods: Seventy-four patients with ACDF who received either ROI-C or CPC treatment from October 2013 to August 2018 were included in this retrospective cohort study. Clinical and radiological outcomes and the incidence of cage subsidence at final follow up-were compared between groups. All patients were further categorized into the cage subsidence (CS) and non-cage subsidence (NCS) groups for subgroup analysis.Results: The overall subsidence rate was higher in the ROI-C group than in the CPC group (66.67 vs. 38.46%, P = 0.006). The incidence of cage subsidence was significantly different between groups for multiple-segment surgeries (75 vs. 34.6%, P = 0.003), but not for single-segment surgeries (54.55 vs. 42.30%, P = 0.563). Male sex, operation in multiple segments, using an ROI-C, and over-distraction increased the risk of subsidence. Clinical outcomes and fusion rates were not affected by cage subsidence.Conclusion: ROI-C use resulted in a higher subsidence rate than CPC use in multi-segment ACDF procedures. The male sex, the use of ROI-C, operation in multiple segments, and over-distraction were the most significant factors associated with an increase in the risk of cage subsidence.

Treatment adherence and persistence in adult ADHD: Results from a twenty-four week controlled clinical trial with extended release methylphenidate

2014 ◽  
Vol 29 (5) ◽  
pp. 324-330 ◽  
Author(s):  
E. Sobanski ◽  
W. Retz ◽  
R. Fischer ◽  
C. Ose ◽  
B. Alm ◽  
...  
Keyword(s):  
Family History ◽  
Education Level ◽  
Treatment Discontinuation ◽  
Factors Associated ◽  
Lower Education Level ◽  
Titration Phase ◽  
Increased Risk ◽  
History Of ◽  
Lower Education ◽  
Medication Efficacy

AbstractPurpose:The aim of this analysis is to describe medication adherence, and treatment persistence, in adults with attention deficit/hyperactivity disorder (ADHD) treated for 24 weeks with extended release methylphenidate (MPH-ER). Additionally, patient-, disorder- and treatment-related factors associated with adherence and persistence will be identified.Method:Post-hoc analysis of the active treatment group of a placebo-controlled, randomised, 24 week trial with MPH-ER with univariate description and multiple logistic regression models and Hosmer and Lemeshow tests.Results:In the sample of 241 adults with ADHD (mean age of 35.2 ± 10.1 years), 9.4% of the patients were non-adherent, taking less than 80% of the dispensed medication. Factors associated with non-adherence included age < 25 years, education level lower than secondary education, lacking family history of ADHD, lower ADHD baseline severity and lower self- and observer-rated medication efficacy. Lacking family history of ADHD, lower education level and lower self-rated medication efficacy, predicted non-adherence with a prediction accuracy of 16%. Seventeen percent of the patients discontinued early with most discontinuing within the first five weeks of the MPH-ER titration phase. Mean persistence in the discontinuing group was 63.4 ± 49.4 days. Factors associated with discontinuation included male gender, lower education level, lacking family history of ADHD and lower self- and observer-rated medication efficacy. Treatment non-response, male gender and lower education level predicted treatment discontinuation with a prediction accuracy of 22.7%.Conclusion:Male adults without relatives with ADHD, with lower educational level and lower self- and observer-rated medication efficacy, who are newly treated with MPH-ER, are at increased risk of non-adherence and treatment discontinuation. Patients are at increased risk of treatment discontinuation during the medication titration phase.

scholarly journals Prognostic factors for chronic kidney disease and end-stage renal disease in patients with lupus nephritis: A retrospective cohort study

2021 ◽  
Vol 5 (1) ◽  
pp. 034-041
Author(s):  
Ferreira Braga Fernanda Nogueira Holanda ◽  
das Chagas Medeiros Marta Maria ◽  
Viana Jr. Antônio Brazil ◽  
Maia Barros Levi Coelho ◽  
Pontes Marcelo Ximenes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Prognostic Factors ◽  
End Stage Renal Disease ◽  
Retrospective Cohort ◽  
Tertiary Hospital ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage

Background: Lupus Nephritis (LN) occurs in approximately half of all patients with Systemic Lupus Erythematosus (SLE) and it is the most common cause of morbidity and mortality in patients with SLE. Factors associated with poor renal outcome vary among studies, and researches coming from Brazil are scarce. Objectives: To identify the prognostic factors associated to the development of Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) in LN patients followed in a tertiary hospital. Design and Settings: We conducted a retrospective cohort study set in a tertiary hospital in Fortaleza, Ceará, Brazil. Methods: We compiled a total of 214 LN patients diagnosed between 1983 and 2015. Data was collected from medical records and further analyzed using logistic regression. Results: LN prevalence was 53.9%. The cohort had a mean follow-up of 11.2 years (SD ± 7.2 years). At the end of follow-up, 93 of 197 patients (47.2%) had CKD, and 49 of 191 (25.6%) were on regular dialysis. The main factors associated for developing CKD after logistic regression analysis were the following predictors: hypertension (HR 2.80; 95% CI 1.30-6.01; p = 0.008), time between diagnosis of SLE and diagnosis of LN (HR 0.98; 95% CI 0.97-0.99; p = 0.009) and discontinuation of medications (HR 2.41; 95% CI 1.08-5.37; p = 0.03). Conclusion: Hypertension, discontinuation of medications, and time between diagnosis of SLE and diagnosis of LN are independent variables associated with the development of CKD and ESDR in our study.

scholarly journals Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients

2021 ◽  
Vol 18 (22) ◽  
pp. 11957
Author(s):  
Cristina J. González-Flores ◽  
Guillermo García-García ◽  
Abel Lerma ◽  
Héctor Pérez-Grovas ◽  
Rosa M. Meda-Lara ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Protective Factor ◽  
Education Level ◽  
Cognitive Distortion ◽  
Psychological Resilience ◽  
Depression And Anxiety ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education ◽  
Esrd Patients

Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18–65 years. Beck’s depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26–52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.

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