Characteristics of circumferential vesico-vaginal fistulas: A cross-sectional and multicentric study

The objective of the study was to determine the risk factors for development of circumferential fistula. We carried out a crosssectional, multicentric and analytical study over 7 years period, from 1st January, 2010 to 31 December, 2016. We compared circumferential and non- circumferential fistula patients in order to determine the risk factors for circumferential fistula development. Circumferential fistula accounted for 20% (91/456) of all vesico-vaginal fistulas. The mean age of the 456 patients was 35.9 years±12.15 (min 15 years; max 72 years). On univariate analysis, factors associated with the risk of circumferential fistula were: residence (P=0.039; OR=1.7), parity (P=0.04; OR=0.47), marital status before fistula (P=0.002; 4.3), duration of labor (P=0.041; OR=2.7) and fistula aetiology (P=0.038; OR=2.54). In a logistic regression model, two factors remained significant: marital status before fistula (P=0.029; OR=0.13) and duration of labor (P=0.017; OR=0.26). Circumferential fistula occurs in urban, primiparous, unmarried women who have been in labor for more than 41 hours.

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Risk factors associated with cows' lying time, stall and cows' own cleanliness in smallholder dairy farms in Kenya

Veterinary World ◽

10.14202/vetworld.2019.1085-1092 ◽

2019 ◽

Vol 12 (7) ◽

pp. 1085-1092

Author(s):

E. K. Kathambi ◽

J. A. VanLeeuwen ◽

G. K. Gitau ◽

C. Kamunde

Keyword(s):

Risk Factors ◽

Management Practices ◽

Production Systems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Farm Level ◽

Logistic Regression Models ◽

Factors Associated ◽

The Mean ◽

Smallholder Dairy

Background and Aim: The welfare of animals kept in livestock production systems has raised concerns around the world. Adult dairy cattle require adequate rest and spend approximately 12 h/day lying down. This cross-sectional study aimed to determine the stall factors and management practices affecting cows' lying time, stall cleanliness, and cows' cleanliness (udder and upper leg), in smallholder dairy cows in Meru County of Kenya. Materials and Methods: A total of 106 milking cows from 73 farms were assessed for daily lying time and cleanliness. Data loggers were used to record the lying time of cows for 3 days. Stall, udder, and upper leg cleanliness were assessed using a 5-score system: 1 (very clean) to 5 (very dirty). Management information was acquired using a questionnaire that was administered face-to-face to the farmers in their native Kimeru language. Univariable and multivariable linear and logistic regression models were fit to determine factors associated with cows' lying time and dichotomized stall and cows' own cleanliness, respectively. Results: The mean daily lying time was 10.9±2.2 h, and the mean stall cleanliness score was 2.4±1.0. The mean average cleanliness scores of the udder and upper legs were 1.9±0.7 and 2.5±1.1, respectively. Overall, 35% of the stalls were categorized as dirty (>2.5), whereas 13% and 47% of the cows had udder and leg cleanliness scores >2.5, respectively. From the final multivariable models (p<0.05), daily lying time increased by 1.0 h for cows older than 5.25 years versus younger cows. Conversely, lying time decreased by 1.0 h with stall cleanliness scores >2.5 and by 1.6 h with poorly positioned neck rails. In an interaction term, addition of new bedding at least once a day without removing stall manure at least once a day decreased the daily lying time of the cows by 1.5 h, whereas failure to add new bedding at least once a day but removing stall manure at least once a day decreased the lying time of the cows by 1.2 h. Farm-level risk factors for stall dirtiness (>2.5) included delayed cleaning of the alley (odds ratio [OR]=6.6, p=0.032), lack of bedding (OR=4.9, p=0.008), and standing idle and/or backward in the stall (OR=10.5, p=0.002). Stalls categorized as dirty (OR=2.9, p=0.041) and lack of bedding (OR=2.7, p=0.065) were cow- and farm-level risk factors for dirtiness of the udder (>2.5), respectively, whereas the stall being dirty (OR=2.3, p=0.043) was the only risk factor (cow level) for dirtiness of the upper legs (>2.5). Conclusion: It was recommended that farmers should pay attention to the specific factors identified regarding the stall design (e.g., neck rail position) and bedding/manure management that impact the cleanliness of cows and their lying time.

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HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032011000200008 ◽

2011 ◽

Vol 48 (2) ◽

pp. 124-130 ◽

Cited By ~ 6

Author(s):

Jéfferson Luis de Almeida Silva ◽

Veridiana Sales Barbosa de Souza ◽

Tatiana Aguiar Santos Vilella ◽

Ana Lúcia C. Domingues ◽

Maria Rosângela Cunha Duarte Coêlho

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Cross Sectional Study ◽

University Hospital ◽

Northeastern Brazil ◽

Serological Markers ◽

Sectional Study ◽

Serum Samples ◽

Cross Sectional ◽

Factors Associated

CONTEXT: Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE: To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS: A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS: The prevalence was 30% for anti-HBc total and/or HBsAg and 7.4% for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS: We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

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838. Drivers of empiric carbapenem use: How important is history of extended-spectrum beta-lactamase (ESBL) infection?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1027 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S460-S460

Author(s):

Tyler J Stone ◽

James Beardsley ◽

James Johnson ◽

Christopher Ohl ◽

...

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Research Support ◽

Factors Associated ◽

Negative Culture ◽

Increased Risk ◽

Culture Characteristics ◽

The Mean ◽

Culture Positive ◽

Research Grant

Abstract Background CARs are first line agents for serious infections caused by ESBL producers. Likelihood of developing subsequent ESBL infection is unknown. In patients (pts) with a history (hx) of ESBL positive (ESBLP) culture, empiric therapy with a CAR has become common in hospitals. The purpose of this study was to evaluate the microbiology of subsequent infections (SI) among pts with hx of ESBLP culture and determine risk factors associated with ESBLP SI that may justify an empiric CAR. Methods This retrospective observational study was conducted at a multicenter health system. The electronic medical record (EMR) was used to generate a report of all E. coli (EC) or K. pneumoniae (KP) ESBLP cultures during 2017, an analogous report was generated for ESBL-negative (ESBLN) EC or KP. These were termed index cultures (IC). Pts were randomly selected from each report until 200 total pts were enrolled. Inpatients, outpatients, and all culture specimens were included. Pts with an ESBLP culture prior to 2017 were excluded. The EMR was reviewed up to 1 year after the IC. Pt and culture characteristics were recorded. The primary outcome was proportion of pts who developed an ESBLP SI. Risk factors associated with ESBLP SI were determined. Relapsed infection (same site, same bacteria) that occurred within 2 weeks of the IC was excluded. Results 200 pts were included, 100 with ESBLP IC and 100 with ESBLN IC. The mean age was 58 years, 84% were female, and 69% were outpatients. 86% of IC were EC and 86% were urine specimens. Within 1 year of IC, 100 pts (50%) developed a SI. 22 of these were ESBLP, 43 were ESBLN, and 35 had no or negative culture. The mean time since IC for ESBLP SI and ESBLN SI was 85 (26-226) days and 140 (15-363) days, respectively (p=0.014). When comparing time to SI, 21 (96%) ESBLP and 26 (61%) ESBLN occurred < 6 months after IC (p=0.003). Among SI with culture data (n= 65), the number of ESBLP SI was higher if the IC was ESBLP (22 vs 0, p< 0.001). Incidence of ESBLP or ESBLN SI in all pts with an ESBLP IC was similar (22 vs 18, p=0.428). Factors associated with ESBLP SI were hx of ESBLP IC, male gender, and time between IC and SI. Table 1. Index Culture Characteristics of Culture Positive Subsequent Infections Figure 1. Cumulative rate of ESBL-positive SI in 180 days (6 months) following IC Table 2. Univariate Analysis of Patient Characteristics Comparing ESBL-positive and ESBL-negative Culture Positive Subsequent Infections Conclusion Hx of positive culture for ESBL-producing EC or KP is associated with SI caused by ESBLP EC or KP. Pts presenting < 6 months after ESBLP IC are at increased risk for ESBLP SI, justifying empiric CAR therapy. Disclosures Tyler J. Stone, PharmD, Paratek (Research Grant or Support) Elizabeth Palavecino, MD, Paratek (Grant/Research Support)Paratek (Grant/Research Support) John Williamson, PharmD, Paratek (Research Grant or Support)

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Normalisation of Patella Alta with MPFL Reconstruction Reduces the Prevalence of Risk Factors Associated With Recurrent Patella Dislocations - A Prospective Cross Sectional Study

10.21203/rs.3.rs-73486/v1 ◽

2020 ◽

Author(s):

SHANNON SHIH ◽

CHUNG LIANG KUO ◽

DAVE LEE

Keyword(s):

Risk Factors ◽

Patella Alta ◽

Mpfl Reconstruction ◽

Cross Sectional ◽

Patella Height ◽

Factors Associated ◽

Outcome Scores ◽

Patella Dislocations ◽

Lateral Patella ◽

The Mean

Abstract Background: Patella alta is a well-established risk factor for recurrent lateral patella dislocations. Medial patellofemoral ligament (MPFL) reconstruction has been shown to consistently reduce patella height. Our hypothesis is that MPFL reconstruction reduces the number of risk factors for recurrent dislocations through the correction of patella alta, resulting in a decreased risk of recurrence.Methods: A prospective cross-sectional case series of 33 knees which underwent MPFL reconstruction for lateral patella dislocations. Information on patellar height utilising the Insall-Salvati (IS) and Caton-Deschamps (CD) ratios, Tibial Tuberosity–Trochlear Groove (TT-TG) distance, trochlear dysplasia, and outcome scores were recorded pre-operatively and post-operatively. The mean change in patella height and the number of knees which achieved normalisation of patella alta were determined. Student’s paired samples T-tests were used to compare the differences in the means scores of the groups pre-operatively and post-operatively. The McNemar test for paired categorical data was used to compare the number of the patella alta corrected after MPFL reconstruction. A pre-determined significance of alpha level of 0.05 was used.Results: The mean age of 33 patients included in the study was 21.5 years (range, 16 – 34 years). There was statistically significant reduction in patella height between pre-operative and post-operative measurements using the various patella height indices for all patients (p<0.001), and normalisation of patella alta (CD ≥1.3) for 90% of patients post-operatively (p<0.004). One third of patients 33.3% had at least 3 risk factors pre-operatively. This was reduced to 18.2% after MPFL reconstruction, representing a 45.5% decrease. A statistically significant improvement in the outcome scores was found – Kujala score 57.1 ± 14.1 pre-operatively to 94.8 ± 5.1 post-operatively (p<0.0001). The recurrent dislocation rate was 3.0%.Conclusion: MPFL reconstruction for lateral patella dislocation results in a statistically significant improvement in clinical outcomes and decrease in patellar height ratios. Normalisation of abnormal patella height culminated in the reduction of anatomical risk factors associated with recurrent dislocations.

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Study prevalence of risk factors and clinical presentation of ventral incisional hernia an observational study

International Surgery Journal ◽

10.18203/2349-2902.isj20201874 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1587

Author(s):

Anjana Nigam ◽

S. L. Nirala ◽

Niraj Bhusakhare

Keyword(s):

Risk Factors ◽

Observational Study ◽

Incisional Hernia ◽

Clinical Presentation ◽

Cross Sectional ◽

Factors Associated ◽

Ventral Incisional Hernia ◽

The Mean ◽

Obesity Hypertension ◽

Surgery Department

Background: Incisional hernia is the second most common type of hernia after inguinal hernia. It is a complication of abdominal surgery, reported in up to 11% of patients generally and in up to 20% of those who developed post operative wound infection. The list of predictive factors associated with development of incisional hernia is obesity, diabetes mellitus, steroid, smoking, old age, malnutrition, COPD and type of incision.Methods: This was a hospital based cross sectional observational study carried out from February 2018 - October 2019 in surgery department of Dr. B.R.A.M. Hospital Raipur C.G, with diagnosis of incisional hernia. Total 100 patients were included in the study.Results: In present study the mean age of study subjects was 47.27±13.16 years. Around two-third 64% were females. 40% of perforation and 35% of LSCS cases later develop to Incisional hernia. Risk factors profile showed that 31% were alcoholic, 27% smokers, 48% pre-obese and 5% were obese. 36% were hypertensive, 48% diabetic, and 12% had constipation. 25% had prolonged cough, 35% had surgical site infection, 45% had anemia. Clinical presentation of study subjects showed that 63% had swelling, 33% had swelling and pain and 4% had obstruction.Conclusions: Incisional hernia is more common in female than males and in cases above the age of 45 years. It is more common in patients who underwent the previous surgery on an emergency basis especially in perforation and obstruction and LSCS cases. Risk factors associated with incisional hernia are smoker, alcoholic, obesity, hypertension, diabetes, constipation, prolong cough and anemia.

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Factors Associated With Delayed Menopause in Iran, Based On Fasa Cohort Study, A Branch Of Persian Cohort Study

Galen Medical Journal ◽

10.31661/gmj.v7i0.922 ◽

2018 ◽

Vol 7 ◽

pp. e922

Author(s):

Mojtaba Farjam ◽

Zahra Amiri ◽

Mehdi Sharafi ◽

Ehsan Bahramali

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Marital Status ◽

Age At Menarche ◽

Natural Menopause ◽

Cross Sectional ◽

Contraceptive Pills ◽

Menopausal Women ◽

The Mean ◽

Socio Demographic Factors

Background: Investigation of middle-aged women’s mental and physical health measures should be focused on menopause that is a predictable physiological phenomenon in their lives, because the prevalence of the majority of chronic diseases increases after this period. This study aimed to determine the risk factors of delayed menopause (climacterium tardum). Material and Methods: The current cross-sectional research was conducted on 1930 menopausal women who had referred to the cohort study of Fasa University of Medical Sciences during 2014-2015. The data were extracted from the database, and then, the variables were checked for accuracy. Finally, the data were analyzed using logistic regression analysis. Results: This study was conducted on menopausal women with the mean age of 57.98±5.8 years. Among the women, 1555 (80.6%) were married, and the rest were single and widowed. Besides, the mean age at menarche was 13.7±1.64 years. Additionally, 1726 women (89.4%) had experienced natural menopause, while the rest had experienced delayed menopause. The results of the multivariate analysis indicated that delayed menopause was associated with marital status, education level, age at menarche, occupation, abortion, and use of contraceptive methods. However, no significant relationship was found between delayed menopause and smoking, duration of lactation, duration of using contraceptive pills, and the number of childbirths. Conclusions: Considering the increased life expectancy among women, delayed menopause, and its risk factors should be taken into account. Although genetic factors play key roles in menopause age, the role of socio-demographic factors, such as marital status and pregnancy, should not be ignored. [GMJ.2018;7:e922]

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Risk factors associated with recurrent cholangitis in pancreatic and hepatobiliary cancers.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.428 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 428-428

Author(s):

Apurva Jain ◽

Juhee Song ◽

Milind M. Javle ◽

Marina C. George

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Acute Cholangitis ◽

Endoscopic Drainage ◽

Metallic Stent ◽

Factors Associated ◽

Increased Risk ◽

Covered Metallic Stent ◽

Significant Difference ◽

The Mean

428 Background: Acute cholangitis due to malignant biliary obstruction is frequent in patients with pancreatic and hepatobiliary cancers. Recurrent cholangitis (RC) results in repeated hospitalization and delayed cancer care. The risk factors associated with RC are not yet defined. Methods: A pilot review was done on 146 patients admitted with a diagnosis of cholangitis from 2005 to 2014. We included demographics, cancer stage, details of first admission (FA) and interventions. Univariate and multivariate Fine-Gray models were used for statistical analysis. Results: The mean age at FA was 62 yrs, 84 (58%) were males and 99 (68%) were white. Most common cancer was pancreatic 100(69%) and 27(19%) pts had primary cholangitis at FA. During FA, interventions were performed in 114(78%), of whom 51 (45%) had percutaneous drainage (PTBD) and 63 (55%) had endoscopic drainage (ED). Readmission with cholangitis was noted in 35 (24%) cases. Univariate analysis did not show a difference between PTBD and ED. However, subgroup analysis showed external only PTBD and covered metallic stent ED had lower risk of RC. These variables remained significant on multivariate analysis (Subdistribution HR= 0.00, p<.0001 for both). Multiple previous PTBD (≥2) before FA was significantly associated with increased risk of RC (Subdistribution HR= 2.64, p= 0.01) on univariate analysis. Conclusions: Having multiple previous PTBD is associated with recurrent cholangitis. Though no significant difference was noted between PTBD and ED, the subgroups indicated a trend towards less recurrent cholangitis with covered metallic stent. [Table: see text]

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Unintended Pregnancy in Iran: Prevalence and Risk Factors

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2019.53 ◽

2018 ◽

Vol 7 (3) ◽

pp. 319-323

Author(s):

Amir Almasi-Hashiani ◽

Reza Omani-Samani ◽

Mahdi Sepidarkish ◽

Farzad Khodamoradi ◽

Mehdi Ranjbaran

Keyword(s):

Risk Factors ◽

Unintended Pregnancy ◽

Economic Status ◽

Multiple Logistic Regression Analysis ◽

Univariate Analysis ◽

Unwanted Pregnancy ◽

Cross Sectional ◽

Unintended Pregnancies ◽

Study Results ◽

The Mean

Objectives: Unintended pregnancy, as one of the main issues in reproductive health, is defined as a mistimed or unwanted pregnancy all over the worlds. This study aimed to determine the prevalence and risk factors of unintended pregnancy among Iranian women. Materials and Methods: As part of a survey on twin or multiple pregnancies in Tehran, Iran, this cross-sectional study considered a total of 5152 deliveries in 103 hospitals during 2015. The required data were gathered at the time of delivery or within the next 2-3 days from physically unstable women. The sampling was carried out within two weeks. All women, regardless of method of delivery, being primiparous or multiparous, and pregnancy outcome were included in the study. Results: According to the results, the prevalence of unintended pregnancy in Iran was estimated 19.81%. Based on univariate analysis, the mean age of mothers, the mean age of fathers, number of pregnancies, and number of deliveries in unintended pregnancies were significantly higher than those in intended pregnancies. In addition, the prevalence of unintended pregnancy among housewives, as well as women with low levels of education and income was high. According to multiple logistic regression analysis, economic status and number of deliveries were the main predicting factors of unintended pregnancy. Conclusions: In general, the prevalence of unintended pregnancy in Iran is lower than that in other countries. However, preventive actions and health education programs still should be undertaken for mothers in order to minimize the prevalence of unintended pregnancies, thereby reducing the consequences for mother and baby.

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Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

Current Hypertension Reviews ◽

10.2174/1573402115666191121120228 ◽

2019 ◽

Vol 15 ◽

Author(s):

Bekalu Getachew Gebreegziabher ◽

Tesema Etefa Birhanu ◽

Diriba Dereje Olana ◽

Behailu Terefe Tesfaye

Keyword(s):

Risk Factors ◽

Stroke Unit ◽

Medical Center ◽

Data Entry ◽

Public Health Problem ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

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Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

Journal of Clinical Medicine ◽

10.3390/jcm10122740 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2740

Author(s):

Efrat L. Amitay ◽

Tobias Niedermaier ◽

Anton Gies ◽

Michael Hoffmeister ◽

Hermann Brenner

Keyword(s):

Risk Factors ◽

Bowel Preparation ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Screening Colonoscopy ◽

Cross Sectional ◽

Factors Associated ◽

Screening Practice ◽

Abdominal Symptoms ◽

Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

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