Transition readiness in adolescents with juvenile idiopathic arthritis and their parents: Our single-center experience

Objectives: We aimed to identify characteristics of juvenile idiopathic arthritis (JIA) patients associated with good self-management skills in the transition readiness process and to investigate the readiness of JIA patients and their families for the transition into the adult healthcare system. Patients and methods: Between March 2021 and June 2021, a total of 44 JIA patients (9 males, 35 females; median age: 15.1 years; range, 12.3 to 19.3 years) admitted to the pediatric rheumatology outpatient and inpatient clinics and their parents were included. Transition Readiness Assessment Questionnaire (TRAQ) was cross-culturally adapted. The TRAQ was administered to all JIA patients and their parents at one point. Demographic and clinical data were collected. Results: Fourteen (31.8%) of 44 JIA patients had a concomitant disease, while 10 (22.7%) of them had uveitis. Eleven (25%) of them had a family history of autoimmune diseases. In total, 21 (47.7%) of JIA patients were receiving biologics. There was a strong correlation between older age and total TRAQ scores among patients (ρ=0.799, p<0.001) and a moderate correlation between older patient age and total TRAQ scores among parents (ρ=0.522, p<0.001). Patient and parent total TRAQ scores were strongly correlated (ρ=0.653, p<0.001). There was no significant association of JIA patient characteristics (JIA disease subtypes, disease duration, gender, concomitant diseases, uveitis, family history of autoimmune diseases, number of hospitalizations, and treatment with biologics) with TRAQ scores and JIA patients' and parents' readiness for transition. Conclusion: Transition readiness of JIA patients increases with advancing age. There is no significant difference between transition readiness for JIA patients and their parents.

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1641. A Comparative Analysis Of Lymph Node Tuberculosis Between Children And Adults

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1821 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S810-S810

Author(s):

Fatma Hammami ◽

Makram Koubaa ◽

Amal Chakroun ◽

Khaoula Rekik ◽

Fatma Smaoui ◽

...

Keyword(s):

Lymph Node ◽

Family History ◽

Extrapulmonary Tuberculosis ◽

Diagnostic Delay ◽

Disease Evolution ◽

Evolutionary Features ◽

Significant Difference ◽

History Of ◽

Adults And Children ◽

Lymph Node Tuberculosis

Abstract Background Lymph node tuberculosis (LNTB) represents the most common site of extrapulmonary tuberculosis. Among children, due to non-specific clinical features, the diagnosis is often delayed. We aimed to compare the clinical, therapeutic and evolutionary features of LNTB between adults and children. Methods We conducted a retrospective study including patients hospitalized for LNTB in the infectious diseases and pediatric department between 1993 and 2018. Children aged ≤18 years were included. Results Overall, we encountered 231 cases of LNTB. There were 40 children (17.3%) with a mean age of 11±4 years and 191 adults (82.7%) with a mean age of 42±16 years. As to gender, females were more affected (adults: 67% vs children: 70%), with no significant difference (p >0.05). A family history of tuberculosis was significantly more frequent among children (20% vs 6.3%; p=0.01). Raw milk consumption (38.2% vs 30%; p >0.05) and close contact with animals (29.8% vs 35%; p >0.05) were noted among both adults and children. Fever (53.4% vs 32.5%; p=0.01), night sweats (35.8% vs 10%; p=0.001), loss of appetite (38.2% vs 17.5%; p=0.01) and weight loss (35.1% vs 15%; p=0.01) were significantly more frequent among adults. Tuberculin skin test was positive in 75.8% of the cases among adults and in 86.2% of the cases among children (p >0.05). Multifocal tuberculosis was significantly more frequent among adults (23.8% vs 5.7%; p=0.01). Antitubercular therapy was prescribed for a mean duration of 10±4 months among adults and for 9±3 months among children, with no significant difference (p >0.05). Side effects of antitubercular drugs were more frequent among adults (33% vs 10.3%), with a significant difference (p=0.004). Comparison of the disease evolution showed no significant difference between adults and children, regarding recovery (94.8% vs 90%), relapse (5.2% vs 5%) and death (0.5% vs 2.5%). Conclusion The clinical presentation of LNTB among children was less common and misleading. A family history of tuberculosis and a high index of suspicion might shorten the diagnostic delay. Disclosures All Authors: No reported disclosures

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Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1696947 ◽

2019 ◽

Vol 41 (11) ◽

pp. 647-653 ◽

Cited By ~ 1

Author(s):

Inês Carolina Siqueira Freitas ◽

Micheli Cristiane Hintz ◽

Larissa Chaiane Orth ◽

Tamara Gonçalves da Rosa ◽

Betine Moehlecke Iser ◽

...

Keyword(s):

Family History ◽

Gestational Diabetes ◽

Statistical Significance ◽

Positive Family History ◽

Previous History ◽

Diabetes Diagnosis ◽

Fetal Outcomes ◽

Family History Of Diabetes ◽

Significant Difference ◽

History Of

Abstract Objective The present study aims to compare the maternal and fetal outcomes of parturients with and without a gestational diabetes diagnosis. Methods A case-control study including parturients with (cases) and without (control) a gestational diabetes diagnosis, who delivered at a teaching hospital in Southern Brazil, between May and August 2018. Primary and secondary data were used. Bivariate analysis and a backward conditional multivariate logistic regression were used to make comparisons between cases and controls, which were expressed by odds ratio (OR), with a 95% confidence interval (95%CI) and a statistical significance level of 5%. Results The cases (n = 47) were more likely to be 35 years old or older compared with the controls (n = 93) (p < 0.001). The cases had 2.56 times greater chance of being overweight (p = 0.014), and a 2.57 times greater chance of having a positive family history of diabetes mellitus (p = 0.01). There was no significant difference regarding weight gain, presence of a previous history of gestational diabetes, height, or delivery route. The mean weight at birth was significantly higher in the infants of mothers diagnosed with diabetes (p = 0.01). There was a 4.7 times greater chance of macrosomia (p < 0.001) and a 5.4 times greater chance of neonatal hypoglycemia (p = 0.01) in the infants of mothers with gestational diabetes. Conclusion Therefore, maternal age, family history of type 2 diabetes, obesity and pregestational overweightness are important associated factors for a higher chance of developing gestational diabetes.

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Interaction Analysis of Lipid Accumulation Product and Family History of Diabetes on Impaired Fasting Glucose and Diabetes Risk in Population with Normotension in Eastern China: A Community-based Cross-sectional Survey

10.21203/rs.3.rs-226460/v1 ◽

2021 ◽

Author(s):

Li Shu ◽

Yingying Zhao ◽

Yanqi Shen ◽

Xiaolu Li ◽

Mengting Qiu ◽

...

Keyword(s):

Family History ◽

Impaired Fasting Glucose ◽

Lipid Accumulation ◽

Significant Interaction ◽

Fasting Glucose ◽

Diabetes Risk ◽

Lipid Accumulation Product ◽

Family History Of Diabetes ◽

Significant Difference ◽

History Of

Abstract Background: Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. However, the association between LAP and family history of diabetes remains an undetermined concept. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults.Methods: A multistage stratified cluster sampling method was conducted to select urban residents aged 45-86 years in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. LAP was calculated and divided into four categories according to quartile. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). If the 95% CI of RERI and AP do not include 0, the 95% CI of SI do not include 1, the interactions are statistically significant. Results: 6467 normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. It was revealed that the prevalence rates of IFG and diabetes were gradually increased according to increasing LAP quartiles (P for trend <0.001). When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI=1.538, 95%CI: 0.167 to 3.612; AP=0.375, 95%CI: 0.118 to 0.631; SI=1.980, 95%CI: 1.206 to 3.251), but there is no statistically significant difference between LAP and general obesity. However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). Conclusion: LAP significantly associates with IFG and diabetes risk in the study population, it has better performance than BMI, WC and WHtR. Apart from that, our results also demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.

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The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

10.21203/rs.3.rs-19763/v1 ◽

2020 ◽

Author(s):

Ruifang Liu ◽

Fangxing Xu ◽

Yujie Zhou ◽

Tongku Liu

Keyword(s):

Risk Factors ◽

Family History ◽

Young Women ◽

Early Onset ◽

Young Female ◽

Cardiac Insufficiency ◽

Control Group ◽

Significant Difference ◽

Gynecological Diseases ◽

History Of

Abstract Background In recent years, the prevalence rate of ACS in Chinese young women has been increasing significantly, becoming the main cause of death in young female. This study aimed to investigate the characteristics and difference of risk factors in Chinese young women with ACS and to provide references for ACS prevention and treatment. Methods A 1:1 case-control study was conducted to evaluate risk factors of 415 young female patients with ACS (ACS group) who underwent PCI treatment and 415 young female cases without ACS (control group) who were hospitalized and confirmed by coronary angiography to exclude coronary heart disease from January 2010 to August 2016. The average age of the cases in the two groups was respectively (40.77±4.02) years-old and (40.57±4.01) years-old (P> 0.05). Results The risk factors in ACS group were overweight (64.10%), hypertension (49.88%), hyperlipidemia (35.66%), diabetes (23.37%), depression or anxiety disorder (16.62%), gynecological diseases (16.39%), Hyperuricemia (15.18%), family history of early onset coronary heart disease (14.94%), hyperhomocysteinemia (11.33%), hypothyroidism(14.96%), hypercholesterolemia (8.43%) and high c-reactive protein (7.47%), and were statistically significant difference (P<0.01) compared with that of control group. The average number of risk factors per case in ACS group was significantly more than that of control groups (P<0.01). There was a statistically significant difference in the number of combined risk factors of the overweight cases compared between two groups (P<0.01). Regression analysis showed that hyperlipidemia, hyperhomocysteinemia, overweight（obesity）, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases were independent risk factors (P<0.01). The bivariate correlation analysis between CRP level and age was r= -0.158 (P<0.01). This result showed the younger ACS patient is the higher serum CRP. Conclusion The independent risk factors of ACS in young women are hyperlipidemia, hyperhomocysteinemia, overweight, high CRP, hypertension, hypothyroidism, gynecological diseases, depression or anxiety, cardiac insufficiency, hypercholesterolemia, diabetes, oral contraceptives, family history of early onset CHD, and autoimmune diseases. The co-existence of multiple risk factors is the main cause suffering from ACS in young women.

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Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.3397 ◽

2020 ◽

Vol 27 (05) ◽

pp. 891-894

Author(s):

Shahid Ishaq ◽

Ejaz Mazari ◽

Fazal ur Rehman

Keyword(s):

Risk Factors ◽

Family History ◽

Febrile Seizures ◽

Study Groups ◽

Clinical Risk Factors ◽

P Value ◽

Chi Square ◽

Clinical Risk ◽

Significant Difference ◽

History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

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Clinical, epidemiological and autoimmune associations in childhood vitiligo in Qatar

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200594 ◽

2020 ◽

Vol 6 (2) ◽

pp. 151

Author(s):

Haya Al Mannai ◽

Mohamed Allam ◽

Hassan Riad

Keyword(s):

Family History ◽

Autoimmune Diseases ◽

Age Of Onset ◽

Positive Family History ◽

Thyroid Peroxidase ◽

Base Line ◽

Adult Onset ◽

Prognostic Features ◽

History Of ◽

The Mean

Background: Childhood vitiligo although clinically similar to adult onset vitiligo but it has distinct clinical, epidemiological and prognostic features compared to adult onset vitiligo.Methods: This is a retrospective study that was carried out on 85 pediatric patients up to age of 18 years old with the diagnosis of vitiligo, where the clinical and epidemiological data including clinical type of vitiligo, family history of autoimmune diseases like thyroid disorders and diabetes mellitus and laboratory results including anti-thyroid peroxidase antibodies (anti-TPO antibodies), anti-parietal cell antibodies, antinuclear antibodies (ANA), Vitamin D and Vitamin B12 were retrieved from the files of these patients.Results: The mean age of the children affected by vitiligo was 10.4 years, the mean age of onset of vitiligo was 5.4 years, 54 (63.5%) percent were girls and 31 (36.5%) were boys. A positive family history of vitiligo was found in 44.7% of the participants, family history of DM was found in 64.7% of patients and family history of thyroid disease was found in 32.9% of the participants. The prevalence of thyroid autoimmunity was found to be in 22.4% of total participants.Conclusions: Childhood vitiligo has distinct clinical features, more common family history for autoimmune diseases and thyroid autoantibodies rather than overt clinical diseases, which raise the necessity to perform a routine initial immunological and thyroid screening in children with vitiligo and to repeat them at annual bases if there were abnormal values at base line or strong family history.

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Evaluation of blood pressure in school children aged 12-16 years

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172607 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1218

Author(s):

Balakrishnan Nadesan ◽

Mani Madhavan Sachithananthamoorthi ◽

Sivaraman Thirumalaikumarasamy ◽

Ezhilarasu Ramalingam

Keyword(s):

Blood Pressure ◽

Family History ◽

Diastolic Blood Pressure ◽

School Children ◽

Diastolic Pressure ◽

Systolic Pressure ◽

Cross Sectional ◽

Significant Difference ◽

History Of ◽

Family History Of Hypertension

Background: Hypertension is considered as a major health issue in developed as well as developing countries and its possible origin during childhood prompts pediatricians to routinely include measurement of blood pressure (BP) as an integral part of pediatric physical examination. The objectives of the study were to evaluate the normal range of blood pressure in adolescent school going students of 12-16 years, prevalence of hypertension and relationship of BP with variables like age, body mass index (BMI), socioeconomic status and family history of hypertension.Methods: A cross sectional study was undertaken for a period of one year in adolescent school children in age groups between 12-16 years. Detailed clinical examination was done in 1060 adolescent school children and BP was recorded in right upper limb and correlation of BP with BMI, family history of hypertension and diabetes were studied.Results: Mean systolic and diastolic pressure showed linear relationship with age. There was a highly statistically significant difference between mean systolic and diastolic blood pressure between lower and middle socio-economic class. Prevalence of obesity in our study was 1.13%, overweight was 7.83%. Prevalence of hypertension in obese children was 33.33% and in overweight children 18.07%. Family history of hypertension and diabetes carry a significant correlation with elevated systolic and diastolic blood pressure in adolescents.Conclusions: This study revealed that socio economic factors play a significant role in determining the blood pressure of the individual. Children of middle class have significantly elevated mean systolic pressure and mean diastolic pressure than low socio-economic groups.

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Family history of rheumatologic, autoimmune, and non‐autoimmune diseases and risk of rheumatoid arthritis

Arthritis Care & Research ◽

10.1002/acr.24115 ◽

2019 ◽

Cited By ~ 1

Author(s):

Vanessa L Kronzer ◽

Cynthia S Crowson ◽

Jeffrey A Sparks ◽

Elena Myasoedova ◽

John Davis

Keyword(s):

Rheumatoid Arthritis ◽

Family History ◽

Autoimmune Diseases ◽

History Of

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Factors Associated with Non-Adherence to Antihypertensive Medication among Hypertensive Patients in Community

Journal of Karnali Academy of Health Sciences ◽

10.3126/jkahs.v2i1.24417 ◽

2019 ◽

Vol 2 (1) ◽

pp. 53-59

Author(s):

Tirtha Man Shrestha ◽

Laxman Bhusal ◽

Shankar Raut ◽

Rajan Ghimire ◽

Poonam Shrestha

Keyword(s):

Family History ◽

Marital Status ◽

Antihypertensive Medication ◽

Health Clinic ◽

P Value ◽

Hypertensive Patients ◽

Adherence To Medication ◽

Significant Difference ◽

History Of ◽

Family History Of Hypertension

Objective: Hypertension is one of the common non-communicable health problems. While pharmacologic intervention is the most efficient way to control hypertension; non-adherence to medication is accounted as a significant cause for complications. This study was to address and to determine the magnitude of non-adherence among hypertensive patients by summarizing the associated risks factors among patients in community level. Method: This is a cross sectional study conducted on hypertensive patients who visited the community health clinic at Dhading, Nepal on 9th and 10th June 2018 using a pre structured questionnaire. Patients were sampled by nonprobability purposive sampling method. Effect of age, gender, marital status, employment, education level, presence of diabetes, cerebrovascular disease, current smoker, and family history of hypertension were analyzed by compliance of antihypertensive drugs using frequency distribution, chi-square test, and logistic regression. For all of the analysis p value <0.5 was considered as significance. Results: 150 patients were included in the study, out of whom 48 patients were found adherent and 102 patients non-adherent to antihypertensive medication. Out of total population 46% (n=69) were male and 54% (n=81) were female with no significant difference between compliant and noncompliant groups (OR= 1.512, p-=0.292). Mean age of patients in complaint group was 57 years and in non-compliant group was 52 years with odds ratio of 0.959 (p= 0.004, 95% C.I =0.933-0.987). However, there was no significant effect of marital status, employment status, and family history of hypertension on adherence to anti-hypertensive medication. Presence of diabetes had significant effect on adherence to medication (OR= 8.494, p= 0.014). The most common reason for non-adherence was the fear of getting stuck with medication for lifetime (n=31, 30.3%) followed by the use of ayurvedic/home remedy (n=27, 26.5%), unaware of complications (n=16, 15.7%), life style modification (n=14, 13.7%), and financial weakness (n=9, 8.8%). Pearson’s correlation of these reasons was between -1 to 0 with p value <0.5. Conclusion: Fear of taking medication lifelong was the major reason for non-adherence; however, age and comorbid health conditions like diabetes have a significant effect on adherence to medication. Health care awareness and counseling can help these patients to overcome the fear of taking medication for lifetime, which can increase the medication compliance rate.

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Prevalence of gastric cancer precursors in gastroscopy-screened adults by family history of gastric cancer and of cancers other than gastric

BMC Cancer ◽

10.1186/s12885-020-07612-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rui Wu ◽

Cheng Yang ◽

Lin Ji ◽

Zhi-Ning Fan ◽

Yu-Wen Tao ◽

...

Keyword(s):

Gastric Cancer ◽

Family History ◽

High Risk ◽

Intraepithelial Neoplasia ◽

Cross Sectional Study ◽

Cross Sectional ◽

Younger Age ◽

Significant Difference ◽

History Of ◽

Cancer Precursors

Abstract Background People are at a high risk of gastric cancer if their first-degree relatives suffered from atrophic gastritis (AG), intestinal metaplasia (IM), intraepithelial neoplasia (IEN), dysplasia (DYS), or gastric cancer (GC). This study was performed to analyse the association between FDR-GC and GC precursors. Methods A cross-sectional study was performed to screen the prevalence of GC precursors from November 2016 to September 2019. A total of 1329 participants with FDR-GC, 193 participants with a family history of non-gastric cancer in FDRs (FDR-nGC), and 860 participants without a family history of cancer in FDRs (FDR-nC) were recruited in this study. The logistic regression model was used in this study. Results The prevalence of normal, Non-AG, AG/IM, IEN/DYS, and GC was 31.91, 44.21, 13.81, 8.73, and 1.34%, respectively. The prevalence of IEN/DYS was higher in people with FDR-GC and FDR-nGC (FDR-GC: odds ratio (OR) = 1.655; 95%CI, 1.153–2.376; FDR-nGC: OR = 1.984; 95%CI, 1.122–3.506) than those with FDR-nC. The younger the age at which FDRs were diagnosed with GC, the more likely the participants were to develop AG/IM (Ptrend = 0.019). The risk of precursors to GC was higher in participants whose FDR-GC was the mother than in those whose FDR-GC was the father or sibling (OR, non-AG: 1.312 vs. 1.007, 1.274; AG/IM: 1.430 vs. 1.296, 1.378; IEN/DYS: 1.988 vs. 1.573, 1.542). There was no statistically significant difference in non-AG (OR = 1.700; 95%CI, 0.940–3.074), AG/IM (OR = 1.291; 95%CI, 0.579–2.877), and IEN/DYS (OR = 1.265; 95%CI, 0.517–3.096) between participants with one or more FDR-GC. Conclusion People with FDR-GC and FDR-nGC are at a high risk of IEN/DYS. When an FDR was diagnosed at a younger age, the risk of AG/IM was higher. The risk of GC precursors was higher in people whose FDR-GC was the mother.

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