Sample records for major predisposing factor

  1. Predisposing factors for early retirement in patients with schizophrenia in Germany.

    PubMed

    Schnabel, Reinhard; Friedel, Heiko; Erfurth, Andreas; Angermayer, Matthias; Clouth, Johannes; Eichmann, Florian

    2008-08-01

    Although early retirement causes major changes in the life of schizophrenic patients and is among the major cost factors to be covered by payers, the causes leading to early retirement of schizophrenic patients have not been investigated in detail. Therefore, the objective of this retrospective non-interventional case-control study was to generate hypotheses on predisposing factors for early retirement in schizophrenia. Logistic regression was used to explore potential predisposing parameters with regard to their effect on the outcome early retirement. As the study results indicate, schizophrenia severity, assistance or care in the patient's everyday life, age and antipsychotic treatment with typical antipsychotics are linked to the occurrence of early retirement. Further research should be planned to confirm or refute the hypotheses determined in this retrospective analysis and to determine whether atypical antipsychotics could help to avoid early retirement and to improve the situation of schizophrenic patients.

  2. Moraxella keratitis: predisposing factors and clinical review of 95 cases

    PubMed Central

    Das, S; Constantinou, M; Daniell, M; Taylor, H R

    2006-01-01

    Aim To analyse the clinical presentation, identify predisposing risk factors and evaluate the outcome of treatment of Moraxella keratitis. Methods A retrospective analysis was carried out of culture‐proved cases of Moraxella keratitis from hospital records during a 10‐year period (from December 1995 to November 2005) at the Corneal Unit of the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Results 95 episodes of Moraxella keratitis were identified in 92 patients. 3 (3.2%) patients had recurrent keratitis. The mean age of the patients was 70 (range 17–93) years. Multiple predisposing factors were identified in 23 (24%) eyes, including corneal graft (n = 15), previous herpes keratitis (n = 15) and eye lid diseases (n = 15). Adjunctive procedures were carried out in 42 eyes. These included botulinum toxin injection (n = 17), tarsorraphy (n = 12), penetrating keratoplasty (n = 8), enucleation (n = 3), tissue adhesive and bandage contact lens (n = 4), and conjunctival flap (n = 5). Polymicrobial infection was present in 17 eyes. Final visual acuity was counting finger or less in 25 (26%) eyes. Conclusions Local ocular predisposing factors play a major role in Moraxella keratitis. This infection has a poor visual outcome attributable to both the nature of the infection and the predisposing factors. PMID:16825274

  3. Factors determining poor prognostic outcomes following diabetic hand infections

    PubMed Central

    Ince, Bilsev; Dadaci, Mehmet; Arslan, Abdullah; Altuntas, Zeynep; Evrenos, Mustafa Kursat; Fatih Karsli, Mehmet

    2015-01-01

    Background and Objective: Hand ulcers are seen in a small percentage of patients with diabetes. The predisposing factors of diabetic hand varies between different countries. However, the effects of predisposing factors on prognosis are not clear in diabetic hand infections. In this study, our aim was to determine the effects of predisposing factors on poor prognostic outcomes in patients with diabetes mellitus. Methods: Thirty-four patients with diabetes mellitus who were treated and followed up for a hand infection in between 2008 and 2014 were investigated retrospectively. Patients were evaluated according to predisposing factors defined in the literature that included disease period, age, gender, admission time, presence of neuropathy, smoking habits, HbA1c levels at admission time, peripheral vascular disease, end-stage renal disease (ESRD), and trauma. Death and minor/major amputation cases during treatment were defined as poor prognosis. Results: Patients who had ESRD, peripheral neuropathy, or an HbA1c level greater than 10% had significantly higher amputation rates. Conclusions: Peripheral neuropathy, ESRD, and HbA1c levels greater than 10% at the time of admission were determined as poor prognosis criteria for diabetic hand treatment. PMID:26150838

  4. Absence of the predisposing factors and signs and symptoms usually associated with overreaching and overtraining in physical fitness centers.

    PubMed

    Ackel-D'Elia, Carolina; Vancini, Rodrigo Luiz; Castelo, Adauto; Nouailhetas, Viviane Louise Andrée; Silva, Antonio Carlos da

    2010-01-01

    The aim of this study was to evaluate the occurrence of the well-known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil. A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1-7) or signs and symptoms (8-13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups. The psychological evaluation by POMS Mood State Questionnaire indicated a normal non-inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n = 60). According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n = 60).

  5. Absence of the predisposing factors and signs and symptoms usually associated with overreaching and overtraining in physical fitness centers

    PubMed Central

    Ackel‐D'Elia, Carolina; Vancini, Rodrigo Luiz; Castelo, Adauto; Nouailhetas, Viviane Louise Andrée; da Silva, Antonio Carlos

    2010-01-01

    OBJECTIVE: The aim of this study was to evaluate the occurrence of the well‐known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil. METHOD: A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1‐7) or signs and symptoms (8‐13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups. RESULTS: The psychological evaluation by POMS Mood State Questionnaire indicated a normal non‐inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n  =  60). CONCLUSION: According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n  =  60). PMID:21243291

  6. Stress-related sleep vulnerability and maladaptive sleep beliefs predict insomnia at long-term follow-up.

    PubMed

    Yang, Chien-Ming; Hung, Chih-Ying; Lee, Hsin-Chien

    2014-09-15

    Vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs has been proposed to be predisposing factors for insomnia. Yet previous studies addressing these factors have been cross-sectional in nature and could not be used to infer the time sequences of the association. The current study used a six-year follow-up to examine the predisposing roles of these two factors and their interactions with major life stressors in the development of insomnia. One hundred seventeen college students recruited for a survey in 2006 participated in this follow-up survey in 2012. In 2006, they completed a packet of questionnaires including the Dysfunctional Beliefs and Attitudes about Sleep Questionnaire, 10-item version (DBAS-10), the Ford Insomnia Response to Stress Test (FIRST), and the Pittsburgh Sleep Quality Index (PSQI); in 2012 they completed the Insomnia Severity Index (ISI) and the modified Life Experiences Survey (LES). Fourteen of the participants were found to suffer from insomnia as measured by the ISI. Logistic regression showed that scores on both DBAS-10 and FIRST could predict insomnia at follow-up. When the interaction of DBAS-10 and LES and that of FIRST and LES were added, both DBAS-10 and FIRST remained significant predictors, while the interaction of FIRST and LES showed a near-significant trend in predicting insomnia. The results showed that both vulnerability to stress-related sleep disturbances and maladaptive sleep beliefs are predisposing factors for insomnia. The hypothesized interaction effect between sleep vulnerability and major life stressors was found to be marginal. The maladaptive sleep beliefs, on the other hand, showed a predisposing effect independent from the influences of negative life events. © 2014 American Academy of Sleep Medicine.

  7. Syndromes with salivary dysfunction predispose to tooth wear: Case reports of congenital dysfunction of major salivary glands, Prader-Willi, congenital rubella, and Sjögren's syndromes.

    PubMed

    Young, W; Khan, F; Brandt, R; Savage, N; Razek, A A; Huang, Q

    2001-07-01

    Four cases-of congenital dysfunction of the major salivary glands as well as of Prader-Willi, congenital rubella, and Sjögren's syndromes-were identified in a series of 500 patients referred for excessive tooth wear. Although there was evidence of consumption of highly acidic drinks, some occlusal parafunction, and unacceptable toothbrushing habits, salivary dysfunction was the salient factor predisposing a patient to tooth wear in these syndromal cases. The 500 subjects have been characterized either as having medical conditions and medications that predispose them to xerostomia or lifestyles in which workplace- and sports-related dehydration lead to reduced salivary flow. Normal salivation, by buffering capacity, clearance by swallowing, pellicle formation, and capacity for remineralization of demineralized enamel, protects the teeth from extrinsic and intrinsic acids that initiate dental erosion. Thus, the syndromes, unrelated in many respects, underline the importance of normal salivation in the protection of teeth against tooth wear by erosion, attrition, and abrasion.

  8. Melioidosis Acquired by Traveler to Nigeria

    PubMed Central

    Salam, Alex P.; Khan, Nisa; Malnick, Henry; Kenna, Dervla T.D.; Dance, David A.B.

    2011-01-01

    We describe melioidosis associated with travel to Nigeria in a woman with diabetes, a major predisposing factor for this infection. With the prevalence of diabetes projected to increase dramatically in many developing countries, the global reach of melioidosis may expand. PMID:21762592

  9. Microbial Keratitis in Kingdom of Bahrain: Clinical and Microbiology Study

    PubMed Central

    Al-Yousuf, Nada

    2009-01-01

    Background: Microbial keratitis is a potentially vision threatening condition worldwide. Knowing the predisposing factors and etiologic microorganism can help control and prevent this problem. This is the first study of its kind in Kingdom of Bahrain. Objective: To study the profile of microbial keratitis in Bahrain with special focus on risk factors, clinical outcome and microbilogical results. Methods: A retrospective analysis of all patients admitted in Salmaniya Medical Complex over a period of three years from January 2005 to January 2007 was performed. A total of 285 patients with keratitis were analysed. Non infectious corneal ulceration were excluded. Data collected from medical records were demographic features, predisposing factors, history of corneal trauma, associated ocular conditions, visual acuity at the time of presentation and the clinical course. Predisposing risk factors measured were contact lens use, presence of blepharitis, diabetes, lid abnormalities, dry eyes, keratoplasty and refractive surgery. For contact lens wearers any contact lens related risk factors that can lead to keratitis were measured. Pearson's chi-square test was used to carry out statistical analysis wherever required. Results: Contact lens wear, as a risk factor for microbial keratitis, formed 40% of the total study population. Other risk factors identified were dry eyes 24 cases (8%), 10 blepharitis (3%), 22 trauma (8%), abnormal lid position 14 cases (5%). 6 patients keratitis in a graft (2%), 3 had refractive surgery (1%). The most common causative organism isolated was pseudomonas aeroginosa (54%) followed by streptococcus 12%, staph 10%, other organisms 6%. 95% of contact lens wearers had pseudomonas Aeroginosa. This was statistically significant (p< 0.0001). The vast majority, 92% healed with scarring. 1% needed therapeutic keratoplasty and 7% lost to follow up. Risk factors in contact lens wearers were; 41 patients (36%) slept with the contact lenses. 12 (8%) had contact lens related trauma and 8 (7%) had poor hygiene. Sleeping with the contact lenses was statistically significant (p< 0.0001). Conclusion & Recommendation: Contact lens wear is the major risk factor for microbial keratitis in Bahrain. Pseudomonas aeroginosa was the commonest bacteria isolated. Sleeping with the contact lenses is the major risk factor among contact lens wearers. Majority of keratitis patients resulted in permanent scarring on the cornea. Educating the public, especially on contact lens care and precaution, can help reduce this visual morbidity. PMID:20142952

  10. Burkholderia gladioli sepsis in newborns.

    PubMed

    Dursun, Arzu; Zenciroglu, Aysegul; Karagol, Belma Saygili; Hakan, Nilay; Okumus, Nurullah; Gol, Nese; Tanir, Gonul

    2012-10-01

    Burkholderia gladioli is a rare cause of bacteremia and sepsis in the absence of such predisposing factors as chronic granulomatous disease, cystic fibrosis, and immunosuppression. Little is known about B. gladioli infection in newborns. The aim of this study was to present the features of B. gladioli infection in newborns. Clinicopathological characteristics, patterns of antimicrobial susceptibility, predisposing factors, and outcomes of B. gladioli bloodstream infection were retrospectively analyzed in newborns treated between 2008 and 2011. During the 3-year study period, B. gladioli was isolated from the blood cultures of 14 patients (3.7 per 1,000 admissions). In all, 5 (35.7 %) of the 14 cases had a positive blood culture at the time of initial admission. Primary diagnoses in the neonates were severe major congenital anomalies, congenital leukemia, prematurity with respiratory distress syndrome, pneumonia, and parapneumonic pleural effusion. In total, 10 (71.4 %) of the patients underwent ≥2 invasive procedures. The overall in-hospital mortality rate was 21.4 %, whereas the mortality rate due to B. gladioli infection was 7 %. B. gladioli might be a causative microorganism of both early neonatal and nosocomial sepsis in newborns. To the best of our knowledge, this is the first study on B. gladioli infection in newborns. Invasive procedures and severe major congenital anomalies may be predisposing factors for B. gladioli bloodstream infection in neonates. Although it appears to have low pathogenic potential and an insidious clinical course in newborns, resistance to antibiotics may be a potential problem. Mortality was primarily associated with underlying diseases.

  11. Incidence and predisposing factors of common upper respiratory tract infections in vocal students during their professional training.

    PubMed

    Zimmer-Nowicka, Joanna; Januszewska-Stańczyk, Henryka

    2011-07-01

    Upper respiratory tract infections (URTI) are among the major causes of dysphonia. There are only scarce data available on the incidence and predisposing factors of URTI in young singers, in particular, during a period of intense voice training. The data were obtained from medical records and a 43-item questionnaire distributed among 94 students of the vocal faculty (66 females and 28 males-age: 23.5±3.7 years) at all levels of their studies. The questions were divided into several categories, that is, personal, anthropometric, demographic, history of vocal education, and both general and singer-specific health risk factors. The rate of URTI showed a steady decrease during vocal studies. The strongest factor predisposing to infections in the multivariate regression model was nonadherence to vocal hygiene. There was also a weak protective effect of a regular holiday rest and negative effect of allergy. The prevalence of several recognized risk factors of URTI was exceptionally high in the group of vocal students, for example, passive smoking (42.5%), poor dental status (39.4%), frequent gastric complaints (44.7%), and allergy (50%). Despite the persistence of many risk factors throughout the vocal studies, the frequency of URTI significantly decreases most likely because of vocal hygiene education and growing professional experience. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  12. Infective Endocarditis in Children in Italy from 2000 to 2015.

    PubMed

    Esposito, Susanna; Mayer, Alessandra; Krzysztofiak, Andrzej; Garazzino, Silvia; Lipreri, Rita; Galli, Luisa; Osimani, Patrizia; Fossali, Emilio; Di Gangi, Maria; Lancella, Laura; Denina, Marco; Pattarino, Giulia; Montagnani, Carlotta; Salvini, Filippo; Villani, Alberto; Principi, Nicola; Italian Pediatric Infective Endocarditis Registry

    2016-01-01

    The Italian Society for Pediatric Infectious Diseases created a registry on children with infective endocarditis (IE) hospitalized in Italy. A cross-sectional survey was conducted on patients hospitalized due to IE in Italian paediatric wards between January 1, 2000, and June 30, 2015. Over the 15-year study period, 47 IE episodes were observed (19 males; age range, 2-17 years). Viridans Streptococci were the most common pathogens among patients with predisposing cardiac conditions and Staphylococcus aureus among those without (37.9% vs. 5.5%, p = 0.018, and 6.9% vs. 27.8%, p = 0.089, respectively). Six of the 7 (85.7%) S. aureus strains were methicillin-resistant. The majority of patients with and without predisposing cardiac conditions recovered without any complications. In Italy, paediatric IE develops without any previous predisposing factors in a number of children, methicillin-resistant S. aureus has emerged as a common causative agent and the therapeutic approach is extremely variable.

  13. Influenza A Virus as a Predisposing Factor for Cryptococcosis

    PubMed Central

    Oliveira, Lorena V. N.; Costa, Marliete C.; Magalhães, Thaís F. F.; Bastos, Rafael W.; Santos, Patrícia C.; Carneiro, Hellem C. S.; Ribeiro, Noelly Q.; Ferreira, Gabriella F.; Ribeiro, Lucas S.; Gonçalves, Ana P. F.; Fagundes, Caio T.; Pascoal-Xavier, Marcelo A.; Djordjevic, Julianne T.; Sorrell, Tania C.; Souza, Daniele G.; Machado, Alexandre M. V.; Santos, Daniel A.

    2017-01-01

    Influenza A virus (IAV) infects millions of people annually and predisposes to secondary bacterial infections. Inhalation of fungi within the Cryptococcus complex causes pulmonary disease with secondary meningo-encephalitis. Underlying pulmonary disease is a strong risk factor for development of C. gattii cryptococcosis though the effect of concurrent infection with IAV has not been studied. We developed an in vivo model of Influenza A H1N1 and C. gattii co-infection. Co-infection resulted in a major increase in morbidity and mortality, with severe lung damage and a high brain fungal burden when mice were infected in the acute phase of influenza multiplication. Furthermore, IAV alters the host response to C. gattii, leading to recruitment of significantly more neutrophils and macrophages into the lungs. Moreover, IAV induced the production of type 1 interferons (IFN-α4/β) and the levels of IFN-γ were significantly reduced, which can be associated with impairment of the immune response to Cryptococcus during co-infection. Phagocytosis, killing of cryptococci and production of reactive oxygen species (ROS) by IAV-infected macrophages were reduced, independent of previous IFN-γ stimulation, leading to increased proliferation of the fungus within macrophages. In conclusion, IAV infection is a predisposing factor for severe disease and adverse outcomes in mice co-infected with C. gattii. PMID:29018774

  14. Shin splints. Diagnosis, management, prevention.

    PubMed

    Moore, M P

    1988-01-01

    Our knowledge of the etiology of shin splints is incomplete. Biomechanical abnormalities are likely to be major factors in predisposing certain persons to such injury. Also, training errors are major etiologic factors. Because shin splints result from mechanical overload of various elements of the musculoskeletal system of the leg that exceed their adaptive remodeling capacity, rest and recovery should be emphasized as an important aspect of sports training. Accurate and prompt diagnosis reduces the severity and duration of the injury. Management should consist of measures to reduce inflammation and pain and to identify possible biomechanical factors that may be correctable by strengthening and flexibility exercises or by the use of an orthotic device.

  15. Study of Pre-disposing Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Antibiotic Prescribing Pattern with Reference to Antibiotic Sensitivity Test.

    PubMed

    Shrestha, R; Shrestha, B; Shakya Shrestha, S; Pant, A; Prajapati, B; Karmacharya, B M

    2015-01-01

    Background Chronic Obstructive Pulmonary Disease (COPD) affects about 329 million people worldwide, which is nearly 5% of the entire global population. In the context of Nepal, COPD accounts for 43% of the non-communicable disease burden and 2.56% of hospitalizations. Various pre-disposing factors like bacterial, viral, fungal, smoking, occupational exposures and genetic factors have been proposed to precipitate COPD and its exacerbation though, the definitive pre-disposing factors and factors related to acute exacerbation have not been determined in the context of Nepal. Objective To find out the pre-disposing factors and the related causative agents for COPD. Method A cross sectional study was conducted in a tertiary care hospital. Patients of all age group who were diagnosed as COPD and admitted in the hospital were included in this study. Patients were interviewed using structured questionnaire. The sociodemographic data including personal and medical history were recorded from those participants. In addition, sputum from those patients was sent for culture to investigate the possible responsible pathogens as well as its antibiotic sensitivity pattern. Result A total of 150 patients having Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) who have admitted from either emergency or out-patient department of the hospital were included in this study. Among the total number of patients, more than half of them were female (n=82). In addition, analysis of occupations shows that most of them were either farmer (36.0%) or housewife (30.7%). In total studied patients (n=150), most of them were using traditional firewood (83%) for cooking purpose and majority of patients (91%) were smokers. Most of the sputum samples show growth of gram-positive cocci (26.7%) and gram negative bacilli (27.5%). Considering the overall sensitivity pattern, the higher sensitivity was recorded for Co-trimoxazole and Ciprofloxacin while higher rate of resistance was noted for Penicillin group of drugs. The most widely used antibiotics were found to be Cephalosporin group of drugs (68%). Conclusion The present study revealed that the case of COPD is more in female and the commonest pre-disposing factor is found to be smoke/firewood. Cephalosporin group of drugs is the most commonly prescribed drug.

  16. Need, Enabling, Predisposing, and Behavioral Determinants of Access to Preventative Care in Argentina: Analysis of the National Survey of Risk Factors

    PubMed Central

    Jahangir, Eiman; Irazola, Vilma; Rubinstein, Adolfo

    2012-01-01

    Introduction Health care utilization is an important step to disease management, providing opportunities for prevention and treatment. Anderson’s Health Behavior Model has defined utilization by need, predisposing, and enabling determinants. We hypothesize that need, predisposing, and enabling, highlighting behavioral factors are associated with utilization in Argentina. Methods We performed a logistic regression analysis of the 2005 and 2009 Argentinean Survey of Risk Factors, a cohort of 41,392 and 34,732 individuals, to explore the association between need, enabling, predisposing, and behavioral factors to blood pressure measurement in the last year. Results In the 2005 cohort, blood pressure measurement was associated with perception of health, insurance coverage, basic needs met, and income. Additionally, female sex, civil state, household type, older age groups, education, and alcohol use were associated with utilization. The 2009 cohort showed similar associations with only minor differences between the models. Conclusions We explored the association between utilization of clinical preventive services with need, enabling, predisposing, and behavioral factors. While predisposing and need determinants are associated with utilization, enabling factors such as insurance coverage provides an area for public intervention. These are important findings where policies should be focused to improve utilization of preventive services in Argentina. PMID:22984608

  17. Species-level correlates of susceptibility to the pathogenic amphibian fungus Batrachochytrium dendrobatidis in the United States

    Treesearch

    Betsy A. Bancroft; Barbara A. Han; Catherine L. Searle; Lindsay M. Biga; Deanna H. Olson; Lee B. Kats; Joshua J. Lawler; Andrew R. Blaustein

    2011-01-01

    Disease is often implicated as a factor in population declines of wildlife and plants. Understanding the characteristics that may predispose a species to infection by a particular pathogen can help direct conservation efforts. Recent declines in amphibian populations world-wide are a major conservation issue and may be caused in part by a fungal pathogen, ...

  18. Conversion Therapies for Same-Sex Attracted Clients in Religious Conflict: Context, Predisposing Factors, Experiences, and Implications for Therapy

    ERIC Educational Resources Information Center

    Morrow, Susan L.; Beckstead, A. Lee

    2004-01-01

    Despite a long history of viewing homosexuality as pathological and in need of change, the majority of mental health professions have, during the past 30 years, adopted statements that have depathologized lesbian, gay, and bisexual individuals. However, concurrent with these advances has been a rise in religious and therapeutic approaches to…

  19. [Major nutrition-related risk factors of ischemic heart disease: dyslipoproteinemia, obesity, hypertension, glucose intolerance].

    PubMed

    Pados, G

    1999-07-11

    Of the major risk factors of coronary heart disease dyslipoproteinemia, obesity, hypertension, and diabetes are nutrition related and can be considered of metabolic origin. Dyslipoproteinemia affects 2/3 of the adult population. The risk of coronary heart disease can be decreased 2-5 fold by lowering hypercholesterinemia; atherosclerosis in the coronaries may regress and total mortality may decrease. Atherogenic dyslipidemia (i.e. hypertriglyceridaemia, low HDL cholesterol levels, elevated concentrations of small dense LDL) increases the risk as part of the metabolic syndrome. Obesity is already highly prevalent, and it is affecting ever growing proportions of the adult population. Abdominal obesity furthermore predisposes patients to complications. No effective therapy is available for obesity. 3/4 of hypertensive patients are obese and more than half of them have insulin resistance. By decreasing blood pressure, the risk of stroke decreases by about 40%, that of coronary heart disease by 14-30%. Slimming cures are the most important non-pharmacological way of treating hypertension. 5% of the population has diabetes mellitus, and a further 5% has impaired glucose tolerance. Type 2 diabetes predisposes patients to macrovascular complications. The risk of coronary heart disease can be decreased by controlling diabetes by e.g. metformin.

  20. Prosthetic Joint Infections

    PubMed Central

    Aslam, Saima; Darouiche, Rabih O.

    2012-01-01

    Prosthetic joint infections represent a major therapeutic challenge for both healthcare providers and patients. This paper reviews the predisposing factors, pathogenesis, microbiology, diagnosis, treatment and prophylaxis of prosthetic joint infection. The most optimal management strategy should be identified based on a number of considerations including type and duration of infection, antimicrobial susceptibility of the infecting pathogen, condition of infected tissues and bone stock, patient wishes and functional status. PMID:22847032

  1. Correlates of specific childhood feeding problems.

    PubMed

    Field, D; Garland, M; Williams, K

    2003-01-01

    The correlates of specific childhood feeding problems are described to further examine possible predisposing factors for feeding problems. We report our experience with 349 participants evaluated by an interdisciplinary feeding team. A review of records was conducted and each participant was identified as having one or more of five functionally defined feeding problems: food refusal, food selectivity by type, food selectivity by texture, oral motor delays, or dysphagia. The prevalence of predisposing factors for these feeding problems was examined. Predisposing factors included developmental disabilities, gastrointestinal problems, cardiopulmonary problems, neurological problems, renal disease and anatomical anomalies. The frequencies of predisposing factors varied by feeding problem. Differences were found in the prevalence of the five feeding problems among children with three different developmental disabilities: autism, Down syndrome and cerebral palsy. Gastro-oesophageal reflux was the most prevalent condition found among all children in the sample and was the factor most often associated with food refusal. Neurological conditions and anatomical anomalies were highly associated with skill deficits, such as oral motor delays and dysphagia. Specific medical conditions and developmental disabilities are often associated with certain feeding problems. Information concerning predisposing factors of feeding problems can help providers employ appropriate primary, secondary and tertiary prevention measures to decrease the frequency or severity of some feeding problems.

  2. Clinical Characteristics of 17 Patients with Moraxella Keratitis.

    PubMed

    Tobimatsu, Yui; Inada, Noriko; Shoji, Jun; Yamagami, Satoru

    2018-01-08

    To retrospectively investigate the clinical characteristics of Moraxella keratitis. We reviewed the medical records of 17 patients with Moraxella keratitis. Onset age, sex, predisposing factors, initial clinical presentations, culture and antimicrobial susceptibility testing, and management and outcome of medical treatment were investigated. Moraxella keratitis was more common in patients older than 40 years of age, and its representative initial presentation was a round-shaped ulcer with endothelial plaque (70.6%) and hypopyon (58.8%). Local predisposing factors were significantly more frequent than systemic predisposing factors (P < 0.005). Isolated strains of Moraxella (M. catarrhalis, M. osloensis, and other Moraxella spp.) were sensitive to all antibiotics tested except ampicillin. The common disease contraction period was <2 weeks. Moraxella keratitis (including the first report of M. osloensis keratitis) had local predisposing factors, high sensitivity to antibiotics, and a tendency to recover within 2 weeks.

  3. Epidemiology and predisposing factors of obesity in Greece: from the Second World War until today.

    PubMed

    Roditis, Maria L; Parlapani, Elisavet S; Tzotzas, Themistoklis; Hassapidou, Maria; Krassas, Gerasimos E

    2009-05-01

    Over the last 30 years overweight and obesity among adults and children have been on the rise, and since 1997 WHO has designated obesity as a major public health problem. In Greece both adult and childhood obesity is now recognized as an epidemic problem, probably more important than in other European countries. The issue is more serious in male adolescents and adults. There is also a tendency for weight increase along the last 30 years. Metabolic syndrome and type 2 diabetes mellitus are also rising rapidly in the Greek population. The reasons for this epidemic in Greece are not clear. Possible explanations could emerge from the delayed but sharp economic evolution of the country, as well as the abandonment of the traditional Mediterranean diet. Other predisposing factors in Greek children are parental obesity, frequent television viewing, low rates of breastfeeding and, in adolescent girls, smoking and alcohol consumption. Emerging measures are needed to confront this epidemic.

  4. CFTR and/or pancreatitis susceptibility genes mutations as risk factors of pancreatitis in cystic fibrosis patients?

    PubMed

    Gaitch, Natacha; Hubert, Dominique; Gameiro, Christine; Burgel, Pierre-Régis; Houriez, Florence; Martinez, Brigitte; Honoré, Isabelle; Chapron, Jeanne; Kanaan, Reem; Dusser, Daniel; Girodon, Emmanuelle; Bienvenu, Thierry

    2016-01-01

    Currently, factors that promote the occurrence of pancreatitis episodes in patients affected with cystic fibrosis (CF) and pancreatic sufficiency (PS) are largely unknown. Six genes involved in pancreatitis or in ion transport into the pancreatic duct were investigated by next generation sequencing in 59 adult CF-PS patients with two identified CF mutations. Data on predisposing environmental factors were also recorded. 19 experienced at least one episode of acute pancreatitis (AP) (AP+) and 40 patients did not (AP-). No influence of environmental factor was evidenced. No specific CFTR genotype was found predictive of pancreatitis. Patients sharing the same CFTR genotype may or may not experience AP episodes. Frequent and rare missense variants were found in 78.9% patients in group AP+ and 67.5% in group AP- but a few of them were pathogenic. AP or recurrent AP (RAP) is a frequent complication in our series of adult CF-PS patients. The majority of mild CFTR mutations found in group AP+ were located in the first transmembrane region. No clear other genetic factor could be found predictive of AP/RAP. Further experiments in large homogenous cohorts of CF-PS patients, including whole genome sequencing, may identify genetic predisposing factors to pancreatitis. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  5. Clinical and microbiological profile of infectious keratitis in children

    PubMed Central

    2013-01-01

    Background Infectious keratitis is a sight-threatening condition for children. The purpose of this study was to describe the clinical profile, risk factors and microbiological profile of infectious keratitis in children. Methods Retrospective review of clinical records of patients under 16 years of age with history of microbial keratitis seen at a tertiary referral center. Clinical characteristics, risk factors, visual and surgical outcomes as well as the microbiological profile are analyzed. Results Forty-one eyes of 41 patients. Mean age was 8.7 years. Time between the onset of symptoms and ophthalmological examination was 12.7 days. Predisposing factors were found in 78%; ocular trauma was the most common (25%). Visual acuity equal or worse than 20/200 at admission correlated positively with a poorer visual outcome, p=0.002. Positivity of cultures was 34%. Gram-positive bacteria were isolated in 78.5%; Staphylococcus epidermidis (28.6%) was the most common microorganism. Conclusions Our study emphasizes the importance of a prompt diagnosis and treatment of infectious corneal ulcers in children. Trauma and contact lenses were the main predisposing factors. Gram-positive organisms were isolated in the vast majority of cases and visual outcomes are usually poor. PMID:24131681

  6. Anthropogenic sinkholes in the territory of the city of Naples (Southern Italy)

    NASA Astrophysics Data System (ADS)

    Guarino, Paolo M.; Nisio, Stefania

    About 190 anthropogenic sinkholes occurred within the territory of the city of Naples (Southern Italy) between 1915 and 2010. In the study area, the genesis of sinkholes can be ascribed to two major factors, often strongly interacting with each other: the existence of a complex network of underground man-made cavities, and the inadequacy of the sewage disposal system. Rainfall has been identified as the main triggering factor combined with anthropogenic activity. Based on such predisposing factors, in addition to the geological setting, a susceptibility map of the territory has been realised.

  7. Predisposing factors for atrial fibrillation in the elderly

    PubMed Central

    Wasmer, Kristina; Eckardt, Lars; Breithardt, Günter

    2017-01-01

    Atrial fibrillation (AF) in the elderly occurs as a consequence of cardiovascular aging and an age related increase of comorbidity. Several predisposing factors for AF have been identified for the overall AF population. Most of them, cardiovascular disease in particular, play a role in younger and older patients. The longer time period during which these risk factors can cause structural changes that ultimately lead to AF may, at least in part, explain the association between age and AF. In addition, less well defined age-related changes in cellular electrophysiologic properties and structure predispose to AF in the elderly. PMID:28592961

  8. Effects of calcium fertilization and acid mist on calcium concentration and cold tolerance of red spruce needles

    Treesearch

    G. R. Strimbeck; David R. Vann; Arthur H. Johnson

    1996-01-01

    Several studies have shown that exposure to acid mist impairs cold tolerance of red spruce foliage, predisposing it to winter injury, which appears to be a major factor in the decline of montane populations of the species. Other studies have shown increases in calcium (Ca) concentration in canopy throughfall in montane spruce-fir forests, and decreases in foliar Ca...

  9. Factors Predisposing Drug Abuse.

    ERIC Educational Resources Information Center

    Cheney, Carl D.; Phelps, Brady J.

    The exact nature of the events which may predispose a person to substance abuse is not known. This paper provides a theoretical discussion and review which emphasizes three contexts which have been shown to predispose on individual to drug abuse: (1) prenatal exposure to a given substance; (2) environmental conditions present upon first exposure…

  10. COMPARATIVE EVALUATION OF RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD) IN GENETICALLY PREDISPOSED RATS

    EPA Science Inventory

    Rodent CVD models are increasingly used for understanding individual differences in susceptibility to environmental stressors such as air pollution. We characterized pathologies and a number of known human risk factors of CVD in genetically predisposed, male young adult Spontaneo...

  11. Factors Influencing Cecal Intubation Time during Retrograde Approach Single-Balloon Enteroscopy

    PubMed Central

    Chen, Peng-Jen; Shih, Yu-Lueng; Huang, Hsin-Hung; Hsieh, Tsai-Yuan

    2014-01-01

    Background and Aim. The predisposing factors for prolonged cecal intubation time (CIT) during colonoscopy have been well identified. However, the factors influencing CIT during retrograde SBE have not been addressed. The aim of this study was to determine the factors influencing CIT during retrograde SBE. Methods. We investigated patients who underwent retrograde SBE at a medical center from January 2011 to March 2014. The medical charts and SBE reports were reviewed. The patients' characteristics and procedure-associated data were recorded. These data were analyzed with univariate analysis as well as multivariate logistic regression analysis to identify the possible predisposing factors. Results. We enrolled 66 patients into this study. The median CIT was 17.4 minutes. With univariate analysis, there was no statistical difference in age, sex, BMI, or history of abdominal surgery, except for bowel preparation (P = 0.021). Multivariate logistic regression analysis showed that inadequate bowel preparation (odds ratio 30.2, 95% confidence interval 4.63–196.54; P < 0.001) was the independent predisposing factors for prolonged CIT during retrograde SBE. Conclusions. For experienced endoscopist, inadequate bowel preparation was the independent predisposing factor for prolonged CIT during retrograde SBE. PMID:25505904

  12. Hemorrhagic shock as a sequela of splenic rupture in a patient with infectious mononucleosis: focus on the potential role of salicylates.

    PubMed

    Bouliaris, Konstantinos; Karangelis, Dimos; Daskalopoulos, Marios; Spanos, Konstantinos; Fanariotis, Michael; Giaglaras, Anargyros

    2012-01-01

    Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

  13. Predisposing, Precipitating, Perpetuating, Professional Help, and Prevention Factors of Eating Disorders.

    ERIC Educational Resources Information Center

    Moriarty, Dick; Chanko, Cathy

    This report describes an eating disorder as a multi-dimensional physiological, psychological, social, and cultural illness. A chart describing the typical anorexic and bulimic is included which has on its horizontal axis the predisposing, precipitating, perpetuating, professional help, and prevention factors of anorexia nervosa and bulimia. On its…

  14. Psychosocial correlates of healthful diets: baseline results from the Working Well Study.

    PubMed

    Kristal, A R; Patterson, R E; Glanz, K; Heimendinger, J; Hebert, J R; Feng, Z; Probart, C

    1995-05-01

    This report examines psychosocial factors related to selection of healthful diets. Understanding why people select healthful diets can lead to rational design and evaluation of nutrition intervention programs. Data are from 16,287 respondents to the baseline survey for the Working Well Trial, a randomized, controlled trial of worksite-based health promotion. The psychosocial constructs we measured were predisposing factors (beliefs, perceived benefits, and motivation; 5 items, Cronbach's alpha = 0.65) and enabling factors (barriers, norms, and social support; 6 items, Cronbach's alpha = 0.57). The healthful diet outcomes were intakes of fat, fiber, and servings of fruits and vegetables (from a food frequency questionnaire) and intention and self-efficacy to decrease fat and increase fruits and vegetables. Based on a 5-point scale (1 = low to 5 = high), the mean predisposing factor scale score was much higher than the enabling factor scale score (3.77 vs 2.50, P < 0.001). Comparing respondents in the highest category of the predisposing scale to those in the lowest, mean percentage of energy from fat was 22.4% lower (-9 percentage points), fiber was 85.2% higher (+4.6 g/1,000 kcal), and fruits and vegetables were 100% higher (+1.6 servings/day) (all trends, P < 0.001). Associations were similar, but much weaker, for the enabling scale. Multiple regression models, which included covariates related to diet and the predisposing and enabling scales, explained a total of between 13 and 26% of the variance in diet and intention to change diet. After control for covariates, the predisposing scale remained a significant and strong predictor of diet and intention to change diet but the enabling scale explained small and nonsignificant amounts of variance. Predisposing factors are strong predictors of current diet and intention to change diet. Final results from the Working Well Trial will provide more information on whether enabling factors can be enhanced by intervention and whether these changes result in healthier eating patterns.

  15. Predisposing factors and susceptibility assessment for deep-seated gravitational slope deformations (DSGSDs): a case study (NW Alps, Italy)

    NASA Astrophysics Data System (ADS)

    Lo Russo, S.; Forno, M. G.; Taddia, G.; Gnavi, L.

    2012-04-01

    KEY WORDS: Deep-seated gravitational slope deformation (DSGSD); Risk; Hazard; Susceptibility; Piemonte; Italy Deep-seated gravitational slope deformations (DSGSDs) and "sackung" deformations are complex processes of gravitational movement that involve large volumes of rock, often several tens of meters thick and several kilometers long. The development and characteristics of deep-seated gravitational slope deformations (DSGSDs) have not yet been fully explained. If unrecognized, these deformations can cause serious damage to rigid infrastructures such as dams, tunnels, and water conduits. Early identification of these phenomena and their predisposing factors through detailed geological and geomorphological surveys is therefore necessary for the correct location, construction, and expansion of fixed infrastructures. The hazard evaluation component of landslide risk assessment combines measures of susceptibility and triggering variables. This approach may not be applicable to DSGSDs, given the difficulty of quantifying the probability of occurrence within a specified period of time without well-defined DSGSD triggering factors. Evaluation of DSGSDs should thus be restricted to the assessment of susceptibility. Zones of DSGSD susceptibility can be identified through geological and geomorphological analysis, by overlapping maps of the four main predisposing factors (lithology, neotectonic activity, relief energy, morphological deglaciation evidence). The attribution of a susceptibility level to a certain zone cannot replace a hazard evaluation, but it can be a good index of the potential presence of a DSGSD. A DSGSD is most likely in a territory characterized by the worst combination of predisposing factors (high susceptibility): poor rock mechanics, intense neotectonic activity (high seismicity, active faults), high energy relief, and evidence of past glacialism. The probability of a DSGSD correspondingly decreases if one or more of the predisposing factors are absent (low susceptibility). A case study of two DSGSDs located in the Rodoretto Valley (northwestern Alps, Italy) has been examined. After detailed field survey provided morphological identification of these features, the authors conducted a back-analysis to assess the susceptibility of the entire valley. Each main predisposing factor has been independently mapped, and the level of susceptibility to DSGSD has been identified through geographic information system (GIS) overlapping of the four maps. The results confirm the combined presence of four main predisposing factors for the examined DGSDs, indicating high susceptibility.

  16. Identifying Some Factors That Might Predispose Drug Abuse among Learners in a South African Township School

    ERIC Educational Resources Information Center

    Grobler, R.; Khatite, M.

    2012-01-01

    This study inquires into some of the factors that might predispose the use and abuse of drugs among secondary school learners in a township school. The objective of this research is to identify these factors and to offer a few suggestions on how the abuse may be prevented. A quantitative research strategy is used and a document analysis technique…

  17. Screening for Alcohol Risk in Predominantly Hispanic Youths: Positive Rates and Behavioral Consequences

    ERIC Educational Resources Information Center

    Tomaka, Joe; Salaiz, Rebekah A.; Morales-Monks, Stormy; Thompson, Sharon; McKinnon, Sarah; O'Rourke, Kathleen

    2012-01-01

    The present study examined relationships between CAGE alcohol risk scores and predisposing factors for alcohol use, current alcohol use, and behavioral consequences in a large sample of secondary students. Students completed the CAGE, measures of demographics, potential predisposing factors, and consequences of alcohol use. More than 18% of…

  18. Correlates of Home Health Care Services Use among the Elderly.

    ERIC Educational Resources Information Center

    Starrett, Richard A.; And Others

    The use of health and social services is influenced by economic, community, geographic, organizational, societal, and environmental factors. A study was conducted to examine predisposing, enabling, and need-for-care factors related to the use of home health care services by a stratified random sample of 400 older adults. Predisposing factors…

  19. Examining the Diet of Post-Migrant Hispanic Males Using the Precede-Proceed Model: Predisposing, Reinforcing, and Enabling Dietary Factors

    ERIC Educational Resources Information Center

    Castellanos, Diana Cuy; Downey, Laura; Graham-Kresge, Susan; Yadrick, Kathleen; Zoellner, Jamie; Connell, Carol L.

    2013-01-01

    Objective: To examine socio-environmental, behavioral, and predisposing, reinforcing, and enabling (PRE) factors contributing to post-migration dietary behavior change among a sample of traditional Hispanic males. Design: In this descriptive study, semistructured interviews, a group interview, and photovoice, followed by group interviews, were…

  20. Calcium oxalate crystal related kidney injury in a patient receiving Roux-en Y hepaticojejunostomy due to gall bladder cancer.

    PubMed

    Tsai, Jun-Li; Tsai, Shang-Feng

    2017-03-29

    Calcium oxalate nephropathy is rare in current practice. It was a common complication during jejunoileal bypass, but much less seen in modern gastric bypass surgery for morbid obesity. The major cause of it is enteric hyperoxaluria. We report on a patient here with acute kidney disease due to calcium oxalate nephropathy, rather than the conditions mentioned above. The male patient received a Roux-en Y hepaticojejunostomy and common bile duct drainage. In addition to enteric hyperoxaluria, chronic kidney disease related metabolic acidosis, chronic diarrhea related volume depletion, a high oxalate and low potassium diet, long term ascorbic acid intake and long term exposure to antibiotics, all predisposed him to having oxalate nephropathy. This is the first case with such conditions and we recommend that similarly diagnosed patients avoid all these predisposing factors, in order to avoid this rare disease and its undesired outcome.

  1. Tendinopathy in diabetes mellitus patients-Epidemiology, pathogenesis, and management.

    PubMed

    Lui, P P Y

    2017-08-01

    Chronic tendinopathy is a frequent and disabling musculo-skeletal problem affecting the athletic and general populations. The affected tendon is presented with local tenderness, swelling, and pain which restrict the activity of the individual. Tendon degeneration reduces the mechanical strength and predisposes it to rupture. The pathogenic mechanisms of chronic tendinopathy are not fully understood and several major non-mutually exclusive hypotheses including activation of the hypoxia-apoptosis-pro-inflammatory cytokines cascade, neurovascular ingrowth, increased production of neuromediators, and erroneous stem cell differentiation have been proposed. Many intrinsic and extrinsic risk/causative factors can predispose to the development of tendinopathy. Among them, diabetes mellitus is an important risk/causative factor. This review aims to appraise the current literature on the epidemiology and pathology of tendinopathy in diabetic patients. Systematic reviews were done to summarize the literature on (a) the association between diabetes mellitus and tendinopathy/tendon tears, (b) the pathological changes in tendon under diabetic or hyperglycemic conditions, and (c) the effects of diabetes mellitus or hyperglycemia on the outcomes of tendon healing. The potential mechanisms of diabetes mellitus in causing and exacerbating tendinopathy with reference to the major non-mutually exclusive hypotheses of the pathogenic mechanisms of chronic tendinopathy as reported in the literature are also discussed. Potential strategies for the management of tendinopathy in diabetic patients are presented. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Homozygous parent affected sib pair method for detecting disease predisposing variants: application to insulin dependent diabetes mellitus.

    PubMed

    Robinson, W P; Barbosa, J; Rich, S S; Thomson, G

    1993-01-01

    For complex genetic diseases involving incomplete penetrance, genetic heterogeneity, and multiple disease genes, it is often difficult to determine the molecular variant(s) responsible for the disease pathogenesis. Linkage and association studies may help identify genetic regions and molecular variants suspected of being directly responsible for disease predisposition or protection, but, especially for complex diseases, they are less useful for determining when a predisposing molecular variant has been identified. In this paper, we expand upon the simple concept that if a genetic factor predisposing to disease has been fully identified, then a parent homozygous for this factor should transmit either of his/her copies at random to any affected children. Closely linked markers are used to determine identity by descent values in affected sib pairs from a parent homozygous for a putative disease predisposing factor. The expected deviation of haplotype sharing from 50%, when not all haplotypes carrying this factor are in fact equally predisposing, has been algebraically determined for a single locus general disease model. Equations to determine expected sharing for multiple disease alleles or multiple disease locus models have been formulated. The recessive case is in practice limiting and therefore can be used to estimate the maximum proportion of putative susceptibility haplotypes which are in fact predisposing to disease when the mode of inheritance of a disease is unknown. This method has been applied to 27 DR3/DR3 parents and 50 DR4/DR4 parents who have at least 2 children affected with insulin dependent diabetes mellitus (IDDM). The transmission of both DR3 and DR4 haplotypes is statistically different from 50% (P < 0.05 and P < 0.001, respectively). An upper estimate for the proportion of DR3 haplotypes associated with a high IDDM susceptibility is 49%, and for DR4 haplotypes 38%. Our results show that the joint presence of non-Asp at DQ beta position 57 and Arg at DQ alpha position 52, which has been proposed as a strong IDDM predisposing factor, is insufficient to explain the HLA component of IDDM predisposition.

  3. Taeniasis in non-descript dogs in Ngorongoro, Tanzania: Prevalence and predisposing factors.

    PubMed

    Swai, Emmanuel S; Miran, Miran B; Kasuku, Ayubu A; Nzalawahe, Jahashi

    2016-05-24

    The prevalence of taeniasis was determined during the period January to April 2013 in a cross-sectional study of non-descript domestic dogs from the livestock-wildlife ecosystem of Ngorongoro, Tanzania. Taeniid eggs were determined by screening faecal samples using the formalin-ether sedimentation technique. Predisposing factors for dog infection were assessed in relation to demographic, husbandry and management data. Of the 205 faecal samples screened, 150 (73.2%) were positive for taeniid eggs. The prevalence of dogs harbouring taeniid eggs was 80%, 30.2% and 75.3% in the less than 1 year, 1-3 years and greater than 3 years of age groups, respectively. Age group and sex prevalence in dogs did not differ significantly (P > 0.05), although the females showed a marginally higher prevalence (73.8%) in comparison to the males (72.7%). Taeniid eggs were significantly more likely to be found in the faeces of dogs located in Waso (80.6%) and Endulen (75%) than in Malambo (63.2%, P < 0.05). The study revealed that dogs owned and raised by agro-pastoralists were at a lower risk of acquiring Taenia spp. infection (P = 0.001) than those that were raised by pastoralists. The majority of dog owners were not aware of the predisposing factors and the mode of transmission of taeniids. Dogs were frequently fed on viscera, trimmings and the heads of slaughtered animals, and they were not treated for parasitic infections. The findings of this study indicate that taeniasis is prevalent among non-descript dogs in Ngorongoro, underscoring the need for further research and active surveillance to better understand the transmission cycle of Taenia spp. in a wider geographical area in Tanzania.

  4. Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

    PubMed Central

    Bouliaris, Konstantinos; Karangelis, Dimos; Daskalopoulos, Marios; Spanos, Konstantinos; Fanariotis, Michael; Giaglaras, Anargyros

    2012-01-01

    Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed. PMID:22431933

  5. Drivers of international variation in prevalence of disabling low back pain: Findings from the Cultural and Psychosocial Influences on Disability study.

    PubMed

    Coggon, D; Ntani, G; Palmer, K T; Felli, V E; Harari, F; Quintana, L A; Felknor, S A; Rojas, M; Cattrell, A; Vargas-Prada, S; Bonzini, M; Solidaki, E; Merisalu, E; Habib, R R; Sadeghian, F; Kadir, M M; Warnakulasuriya, S S P; Matsudaira, K; Nyantumbu-Mkhize, B; Kelsall, H L; Harcombe, H

    2018-06-08

    Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Baseline information about musculoskeletal pain and risk factors was elicited from 11 710 participants aged 20-59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline ('pain propensity index'). After a mean interval of 14 months, 9055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2-3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age. © 2018 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  6. Contextual and individual determinants of periodontal disease: Multilevel analysis based on Andersen's model.

    PubMed

    Valente, Maria I B; Vettore, Mario V

    2018-04-01

    To investigate the relationship of contextual and individual factors with periodontal disease in dentate adults and older people using the Andersen's behavioural model. Secondary individual data from 6011 adults and 2369 older people from the Brazilian Oral Health Survey (2010) were combined with contextual data for 27 cities. Attachment loss (AL) categories for each sextant were coded and summed to obtain the periodontal disease measure. The association of predisposing, enabling and need characteristics at city and individual level with periodontal disease was assessed using an adapted version of the Andersen's behavioural model. Multilevel Poisson regression was used to estimate rate ratios (RR) and 95% CIs. Periodontal disease was associated with contextual predisposing (RR 0.93; 95% CI = 0.87-0.99) and enabling factors (RR 0.99; 95% CI = 0.98-0.99) in adults. Contextual predisposing was also associated with periodontal disease in older people (RR 0.82; 95% CI = 0.73-0.92). Individual predisposing (age, sex and schooling) and need characteristics (perceived treatment need) were common predictors of periodontal disease in adults and older people. Periodontal disease was also associated with behaviours in the latter age group. Contextual predisposing factors and individual characteristics influenced periodontal disease experience in adults and older people. Contextual enabling factors were also meaningful determinants of periodontal disease in the former age group. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Root caries: a survey of Queensland dentists.

    PubMed

    Garton, B J; Ford, P J

    2013-08-01

    Root caries stands to be a significant burden for Australia's ageing population. The objective of this study was to describe Queensland dental practitioners' perceptions of root caries prevalence, presentation and predisposing factors as well as diagnosis and recording practices. Using the Queensland Dental Board register, all 2,515 dentists and dental specialists practising in Queensland were invited to participate in a questionnaire-based postal survey. Of the 660 responses received, 638 were included for final analysis. Use of diagnostic measures such as surface elasticity and contour were reported frequently. A majority of respondents (77%) reported not recording root caries in a way that could be distinguished from coronal caries. Dietary analysis was the most commonly reported adjunctive aid for risk assessment. Recommendations for use of remineralizing agents were frequently reported (home use 90%; in office use 71%). Salivary impairment was reported to be an important risk factor for root caries by 93% of respondents, but only 18% reported performing salivary analysis. A large proportion of respondents (32%) considered patients with diabetes to be of low or no risk of root caries. While the Queensland dental practitioners who participated in this survey demonstrated an awareness of root caries and its predisposing factors, clinical risk assessment particularly for patients with diabetes should be further examined. © 2013 John Wiley & Sons A/S.

  8. Predisposing and Enabling Factors Associated with Mammography Use among Hispanic and Non-Hispanic White Women Living in a Rural Area

    ERIC Educational Resources Information Center

    Tejeda, Silvia; Thompson, Beti; Coronado, Gloria D.; Martin, Diane P.; Heagerty, Patrick J.

    2009-01-01

    Context: Women who do not receive regular mammograms are more likely than others to have breast cancer diagnosed at an advanced stage. Purpose: To examine predisposing and enabling factors associated with mammography use among Hispanic and non-Hispanic White women. Methods: Baseline data were used from a larger study on cancer prevention in rural…

  9. Unerupted lower third molar extractions and their risks for mandibular fracture.

    PubMed

    Corrêa, Ana Paula Simões; Faverani, Leonardo Perez; Ramalho-Ferreira, Gabriel; Ferreira, Sabrina; Ávila Souza, Francisley; de Oliveira Puttini, Igor; Rangel Garcia-Júnior, Idelmo

    2014-05-01

    As every surgical procedure extraction of third molars can result in several complications, among them the mandibular angle fracture. Predisposing factors for fracture should be analyzed during and after the surgery. This paper aims to discuss the predisposing factors to the occurrence of mandibular angle fractures during and after the procedure for third molars extraction, as well as surgical principles to avoid this complication.

  10. Identifying the predisposing factors, signs and symptoms of overreaching and overtraining in physical education professionals

    PubMed Central

    Viana, Ricardo B.; Gentil, Paulo; Lorenço, Vinício S.; Vieira, Carlos A.; Campos, Mário H.; Santos, Douglas A.T.; Silva, Wellington F.; Andrade, Marilia S.; Vancini, Rodrigo L.

    2018-01-01

    Background It is possible that physical education professionals, especially those who participate in aerobic activities, have predisposing factors, signs and symptoms of overreaching (OVR) and overtraining (OVT) due to a high load and volume of exercise followed by suboptimal recovery time. The present study aimed to identify the predisposing factors, signs and symptoms of OVR and OVT in physical education professionals. Methods A questionnaire consisting of 42 questions (10 questions group) about predisposing factors and signs/symptoms was answered by 132 physical education professionals from both sexes (83 men and 49 women) who were allocated into a resistance training group (RG, n = 74), aerobic training group (AG, n = 20) and resistance and aerobic training group (RAG, n = 38). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence of predisposing factors and signs and symptoms of OVR and OVT was considered to be a question group score 4 or lower. Profile of Mood State Questionnaire (POMS) was also applied. Results A mean score of 2.5 ± 0.7, 2.7 ± 0.7 and 2.7 ± 0.8 was found for all question groups for RG, AG and RAG, respectively. Of the total sample, 40.6% trained at least five times/week. The POMS revealed that 67.5% of the RG (n = 50), 80% of the AG (n = 16) and 60.5% of the RAG (n = 23) were classified as having no mood disorders and a standard graphic iceberg was presented. There were no statistical differences (p > 0.05) in the total mood disorders among RG (13.9 ± 24.5), AG (10.3 ± 25.1) and RAG (14.6 ± 27.9) groups. Conclusion Despite the volume of training/body working performed by the physical education professionals surveyed being greater than the recommended to achieve improvements on physical fitness, they did not show predisposing factors, signs or symptoms of OVR and OVT.

  11. Perceptions of predisposing, enabling, and reinforcing factors influencing the use of a continuity of care document in special needs PLWH.

    PubMed

    Odlum, Michelle; Gordon, Peter; Camhi, Eli; Schnall, Rebecca; Teixeira, Paul; Bakken, Suzanne

    2012-11-01

    The provision of personal health information through electronic personal health management tools (EPHMT) has the potential to improve health outcomes. However, little is known about factors that affect EPHMT use in special needs people living with HIV/AIDS (PLWH). The purpose of this study was to describe PLWH perceptions of predisposing, enabling, and reinforcing factors affecting use of one type of EPHMT, a continuity of care document (CCD). Data were collected through focus groups and qualitative interviews with PLWH (n=35), health care providers (N=19) and care site managers (N=5). All participant types identified predisposing barriers to CCD use including literacy, privacy, and technology access and enabling factors to promote CCD use including user support and password simplicity. People living with HIV/AIDS also identified reinforcing factors for recurring CCD use including emergent situations and reducing test redundancy. Results inform methods to promote use of the CCD and other EPHMT by special needs PLWH.

  12. Prevalence of Tinea Capitis Infection Among Primary School Children in a Rural Setting in South-West Nigeria

    PubMed Central

    Ayanlowo, Olusola; Oladele, Rita; Balogun, Mobolanle

    2014-01-01

    Dermatophyte infection is a common skin disorder. Tinea capitis, infection of the scalp and hair shaft, is the most common dermatophytosis in children aged between six months and pre-pubertal age. The aim of the study was to determine the prevalence, causative agents and to identify predisposing factors among primary school children in a rural community in Sagamu, Ogun state, Nigeria. This was a descriptive cross sectional study. Interviewer administered questionnaire was used. Following a physical examination, children with a clinical diagnosis of tinea capitis had scalp and hair scrapings for microscopy and culture. Tinea capitis was confirmed in 15.4%. Trichophyton mentagrophyte (51.7%) and Microsporum aoudouinii (20.7%) were the most prevalent organisms in this study. The most common predisposing factors were carrying of objects on the scalp; sharing of hair clippers, scissors, combs, towels and fomites. Low socioeconomic status coupled with overcrowding and poor hygiene was the major determinant of tinea capitis among the children. Tinea capitis remains a common infection among Nigerian school children. Health promotion and health education interventions are recommended to promote good hygiene, better living conditions, early identification and treatment. PMID:28299118

  13. Prevalence of Tinea Capitis Infection Among Primary School Children in a Rural Setting in South-West Nigeria.

    PubMed

    Ayanlowo, Olusola; Akinkugbe, Ayesha; Oladele, Rita; Balogun, Mobolanle

    2014-02-04

    Dermatophyte infection is a common skin disorder. Tinea capitis , infection of the scalp and hair shaft, is the most common dermatophytosis in children aged between six months and pre-pubertal age. The aim of the study was to determine the prevalence, causative agents and to identify predisposing factors among primary school children in a rural community in Sagamu, Ogun state, Nigeria. This was a descriptive cross sectional study. Interviewer administered questionnaire was used. Following a physical examination, children with a clinical diagnosis of tinea capitis had scalp and hair scrapings for microscopy and culture. Tinea capitis was confirmed in 15.4%. Trichophyton mentagrophyte (51.7%) and Microsporum aoudouinii (20.7%) were the most prevalent organisms in this study. The most common predisposing factors were carrying of objects on the scalp; sharing of hair clippers, scissors, combs, towels and fomites. Low socioeconomic status coupled with overcrowding and poor hygiene was the major determinant of tinea capitis among the children. Tinea capitis remains a common infection among Nigerian school children. Health promotion and health education interventions are recommended to promote good hygiene, better living conditions, early identification and treatment.

  14. Computed tomography assessment of hip joints in asymptomatic individuals in relation to femoroacetabular impingement.

    PubMed

    Kang, Alan C L; Gooding, Andrew J; Coates, Mark H; Goh, Tony D; Armour, Paul; Rietveld, John

    2010-06-01

    Femoroacetabular impingement has become a well-recognized entity predisposing to acetabular labral tears and chondral damage, and subsequently development of osteoarthritis of the hip joint. In the authors' experience, it is common to see bony abnormalities predisposing to femoroacetabular impingement in the contralateral asymptomatic hips in patients with unilateral femoroacetabular impingement. This study was undertaken to investigate the prevalence of bony abnormalities predisposing to femoroacetabular impingement in asymptomatic individuals without exposing study participants to unnecessary radiation. Cross-sectional study; Level of evidence, 4. Fifty individuals (100 hip joints), ranging from 15 to 40 years of age, who were seen at a local hospital between March and August 2008 with abdominal trauma or nonspecific abdominal pain in whom abdominal computed tomography was performed to aid diagnosis were prospectively studied. These patients were not known to have any history of hip-related problems. Raw data from the abdominal computed tomography scan, performed on a 64-slice multidetector computed tomography scanner, were reformatted using bone algorithm into several different planes. Several measurements and observations of the hip joints were made in relation to femoroacetabular impingement. The 100 hip joints from 50 patients with no history of hip problems demonstrated that 39% of the joints (31% of female, 48% of male joints) have at least 1 morphologic aspect predisposing to femoroacetabular impingement. The majority (66% to 100% ) of the findings were bilateral; 33% of female and 52% of male asymptomatic participants in our study had at least 1 predisposing factor for femoroacetabular impingement in 1 or both of their hip joints. Based on the data collected from this study, the acetabular crossover sign had a 71% sensitivity and 88% specificity for detecting acetabular retroversion. Nonquantitative assessment of the femoral head at the anterior, anterolateral, and lateral head/neck junctions demonstrated that 74% of the joints had an aspherical femoral head. The study demonstrated substantial prevalence of bony characteristics predisposing to femoroacetabular impingement in asymptomatic individuals according to the established measurement parameters in current literature.

  15. The predisposing factors for the heterotopic ossification after cervical artificial disc replacement.

    PubMed

    Yi, Seong; Shin, Dong Ah; Kim, Keung Nyun; Choi, Gwihyun; Shin, Hyun Chul; Kim, Keun Su; Yoon, Do Heum

    2013-09-01

    Heterotopic ossification (HO) is defined as a formation of bone outside the skeletal system. The reported HO occurrence rate in cervical artificial disc replacement (ADR) is unexpectedly high and is known to vary. However, the predisposing factors for HO in cervical ADR have not yet been elucidated. Investigation of the predisposing factors of HO in cervical arthroplasty and the relationship between degeneration of the cervical spine and HO occurrence. Retrospective study to discover predisposing factors of HO in cervical arthroplasty. A total of 170 patients who underwent cervical ADR were enrolled including full follow-up clinical and radiologic data. Radiologic outcomes were assessed by identification of HOs according to McAfee's classifications. This study enrolled a total of 170 patients who underwent cervical ADR. Pre-existing degenerative change included anterior or posterior osteophytes, ossification of the anterior longitudinal ligament, posterior longitudinal ligament, or ligamentum nuchae. The relationships between basic patient data, pre-existing degenerative change, and HO were investigated using linear logistic regression analysis. Among all 170 patients, HO was found in 69 patients (40.6%). Among the postulated predisposing factors, only male gender and artificial disc device type were shown to be statistically significant. Unexpectedly, preoperative degenerative changes in the cervical spine exerted no significant influence on the occurrence of HOs. The odds ratio of male gender compared with female gender was 2.117. With regard to device type, the odds ratios of Mobi-C (LDR medical, Troyes, France) and ProDisc-C (Synthes, Inc., West Chester, PA, USA) were 5.262 and 7.449, respectively, compared with the Bryan disc. Definite differences in occurrence rate according to the gender of patients and the prosthesis type were identified in this study. Moreover, factors indefinably expected to influence HO in the past were not shown to be risk factors thereof, the results of which may be meaningful to future studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Cervical spine joint hypermobility: a possible predisposing factor for new daily persistent headache.

    PubMed

    Rozen, T D; Roth, J M; Denenberg, N

    2006-10-01

    The objective of this study was to suggest that joint hypermobility (specifically of the cervical spine) is a predisposing factor for the development of new daily persistent headache (NDPH). Twelve individuals (10 female, 2 male) with primary NDPH were evaluated by one of two physical therapists. Each patient was tested for active cervical range of motion and for the presence of excessive intersegmental vertebral motion in the cervical spine. All patients were screened utilizing the Beighton score, which determines degree of systemic hypermobility. Eleven of the 12 NDPH patients were found to have cervical spine joint hypermobility. Ten of the 12 NDPH patients had evidence of widespread joint hypermobility with the Beighton score. Based on our findings we suggest that joint hypermobility, specifically of the cervical spine, may be a predisposing factor for the development of NDPH.

  17. Gout: a review of non-modifiable and modifiable risk factors

    PubMed Central

    MacFarlane, Lindsey A.; Kim, Seoyoung C.

    2014-01-01

    Gout is a common inflammatory arthritis triggered by the crystallization of uric acid within the joints. Gout affects millions worldwide and has an increasing prevalence. Recent research has been carried out to better qualify and quantify the risk factors predisposing individuals to gout. These can largely be broken into non-modifiable risk factors such as sex, age, race, and genetics, and modifiable risk factors such as diet and lifestyle. Increasing knowledge of factors predisposing certain individuals to gout could potentially lead to improved preventive practices. This review summarizes the non-modifiable and modifiable risk factors associated with development of gout. PMID:25437279

  18. Complement deficiency predisposes for meningitis due to nongroupable meningococci and Neisseria-related bacteria.

    PubMed

    Fijen, C A; Kuijper, E J; Tjia, H G; Daha, M R; Dankert, J

    1994-05-01

    Nongroupable meningococci or bacteria related to the genus Neisseria rarely cause meningitis. Complement deficiency has been identified as a major predisposing factor for meningococcal disease. To assess whether patients with meningitis due to such strains have a complement deficiency, we studied 12 persons. Six patients had meningitis due to nongroupable strains of meningococci, and six patients had meningitis due to Moraxella species or Acinetobacter species. Inherited complement component C7 or C8 deficiency was found in two persons who had had meningitis due to nongroupable meningococci, and one C8-deficient person had had meningitis caused by Moraxella osloensis. Hypocomplementemia resulting from CSF drain-associated shunt nephritis was found in one person with meningitis due to Moraxella nonliquefaciens and in one person with meningitis due to Acinetobacter lwoffi. This rather high frequency of inherited or acquired complement deficiencies among patients with meningitis due to nongroupable meningococci, Moraxella species, and Acinetobacter species justifies the recommendation that such patients must be studied for complement deficiency.

  19. Expediting support for the pregnant mothers to obtain antenatal care at public health facilities in rural areas of Balochistan province, Pakistan.

    PubMed

    Ghaffar, Abdul; Pongpanich, Sathirakorn; Ghaffar, Najma; Chapman, Robert Sedgwick; Mureed, Sheh

    2015-01-01

    To identify, and compare relative importance of, factors associated with antenatal care (ANC) utilization in rural Balochistan, toward framing a policy to increase such utilization. This cross sectional study was conducted among 513 pregnant women in Jhal Magsi District, Balochistan, in 2011. A standardized interviewer-administered questionnaire was used. Predisposing, enabling, and reinforcing factors were evaluated with generalized linear models (Poisson distribution and log link). Prevalence of any ANC was only 14.4%. Predisposing, enabling, and reinforcing factors were all important determinants of ANC utilization. Reinforcing factors were clearly most important, husband's support for ANC was more important than support from other community members. Among predisposing factors, higher income, education, occupation, and better knowledge regarding benefits of ANC were positively and statistically significantly associated with ANC However increased number of children showed negative association. Complications free pregnancy showed positive significant association with ANC at public health facility among enabling factors. It is very important to increase antenatal care utilization in the study area and similar areas. Policy to achieve this should focus on enhancing support from the husband.

  20. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association.

    PubMed

    Goldstein, Benjamin I; Carnethon, Mercedes R; Matthews, Karen A; McIntyre, Roger S; Miller, Gregory E; Raghuveer, Geetha; Stoney, Catherine M; Wasiak, Hank; McCrindle, Brian W

    2015-09-08

    In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications. © 2015 American Heart Association, Inc.

  1. Canine intervertebral disc disease: a review of etiologic and predisposing factors.

    PubMed

    Verheijen, J; Bouw, J

    1982-01-01

    In this report the literature on etiologic and predisposing factors of disc disease in the dog is reviewed and discussed. Hypochondroplasia is considered to be important in the etiology of disc disease. After some consideration on nomenclature and morphology, the genetic background of hypochondroplasia is described. The histochemical morphological and developmental similarities and differences between and within various dog breeds are discussed. Macroscopically visible features that predispose to disc disease are outlined. The biomechanical bow-string model of the vertebral column is reviewed. In the discussion the various literature data are interrelated to show how disc disease might be reduced by breeding measures without implicating the breed characteristics. Literature recommendations to help the individual dog are included.

  2. Bowel Angioedema Associated With Iodinated Contrast Media: Incidence and Predisposing Factors.

    PubMed

    Seo, Nieun; Chung, Yong Eun; Lim, Joon Seok; Song, Mi Kyung; Kim, Myeong-Jin; Kim, Ki Whang

    2017-09-01

    Bowel angioedema is an acute adverse reaction to iodinated contrast media (CM) that involves the gastrointestinal tract. We aimed to investigate the incidence and predisposing factors of iodinated CM-associated bowel angioedema during computed tomography (CT) examinations. This study was approved by our institutional review board, and informed consent was waived due to its retrospective design. From July 2013 to July 2015, adult patients with a history of adverse reactions to iodinated CM during CT (group A, n = 427) and patients without adverse reactions matched for age and sex with the propensity-score matching method (group B, n = 427) were studied. Contrast media-associated bowel angioedema was determined when bowel wall thickness increased after contrast enhancement compared with the precontrast scan. Potential predisposing factors including patient demographics, symptoms and time of adverse reactions, and CM-related factors were compared between patients with and without angioedema in group A. In addition, the incidence of bowel angioedema was compared between groups A and B. The incidence of CM-associated bowel angioedema in group A was 3.3% (14/427) in the per-patient analysis and 2.6% (15/578) in the per-examination analysis. The CM-associated bowel angioedema involved the distal duodenum and/or proximal jejunum and showed long-segmental circumferential bowel wall thickening on CT. None of the studied predisposing factors was different between patients with and without bowel angioedema (P > 0.05). The incidence of CM-associated bowel angioedema in group B was 1.9% (8/427) and 1.7% (8/458) for per-patient and per-examination analyses, respectively, and these rates were not significantly different between groups A and B (P = 0.346 and P = 0.370, respectively). The incidence of CM-associated bowel angioedema during CT was 1.7% to 3.3%, and none of the studied predisposing factors was associated with bowel angioedema.

  3. Hormones and arterial stiffness in patients with chronic kidney disease.

    PubMed

    Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

    2013-01-01

    Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population.

  4. Gene-environment interactions in geriatric depression.

    PubMed

    Lotrich, Francis E

    2011-06-01

    In older adults, several environmental challenges can potentially trigger the onset of an episode of major depression. Vulnerability to these challenges can be influenced by genetics. There is accumulating evidence for an interaction between stress and a serotonin transporter polymorphism, though there is also heterogeneity among studies. Other relevant genes include those encoding for the neuroendocrine stress axis, growth factors, and other monoaminergic systems. Each of these may interact with either predisposing traumas in early childhood or precipitating events later in life. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Ocular infections caused by Scedosporium apiospermum: A case series.

    PubMed

    Ramakrishnan, Seema; Mandlik, Kunal; Sathe, Tejashree Sanket; Gubert, Joseph; Krishnan, Thiruvengada; Baskaran, Prabu

    2018-01-01

    The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration.

  6. Aging and the Pathogenic Response to Burn

    PubMed Central

    Rani, Meenakshi; Schwacha, Martin G.

    2012-01-01

    Aging is an important and critical factor that contributes to the clinical outcome of burn patients. The very young and the elderly are more likely to succumb after major burn as compared to their adult counterparts. With the aging population, improved understanding of the mechanisms underlying age-associated complications after burns becomes even more demanding. It is widely accepted that elderly burn patients have significantly increased morbidity and mortality. Irrespective of the type of burn injury, the aged population shows slower recoveries and suffers more complications. Age-associated immune dysfunction, immunosenescence, may predispose the elderly burn patients to more infections, slower healing and/or to other complications. Furthermore, pre-existing, age-related medical conditions such as, pulmonary/cardiovascular dysfunctions and diabetes in the elderly are other important factors that contribute to their poorer outcomes after major burn. The present review describes the impact of aging on burn patients outcomes. PMID:22724078

  7. Factors associated with help-seeking behaviour among individuals with major depression: A systematic review

    PubMed Central

    Magaard, Julia Luise; Seeralan, Tharanya; Schulz, Holger; Brütt, Anna Levke

    2017-01-01

    Psychological models can help to understand why many people suffering from major depression do not seek help. Using the ‘Behavioral Model of Health Services Use’, this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed. PMID:28493904

  8. Factors associated with help-seeking behaviour among individuals with major depression: A systematic review.

    PubMed

    Magaard, Julia Luise; Seeralan, Tharanya; Schulz, Holger; Brütt, Anna Levke

    2017-01-01

    Psychological models can help to understand why many people suffering from major depression do not seek help. Using the 'Behavioral Model of Health Services Use', this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed.

  9. Detecting disease-predisposing variants: the haplotype method.

    PubMed Central

    Valdes, A M; Thomson, G

    1997-01-01

    For many HLA-associated diseases, multiple alleles-- and, in some cases, multiple loci--have been suggested as the causative agents. The haplotype method for identifying disease-predisposing amino acids in a genetic region is a stratification analysis. We show that, for each haplotype combination containing all the amino acid sites involved in the disease process, the relative frequencies of amino acid variants at sites not involved in disease but in linkage disequilibrium with the disease-predisposing sites are expected to be the same in patients and controls. The haplotype method is robust to mode of inheritance and penetrance of the disease and can be used to determine unequivocally whether all amino acid sites involved in the disease have not been identified. Using a resampling technique, we developed a statistical test that takes account of the nonindependence of the sites sampled. Further, when multiple sites in the genetic region are involved in disease, the test statistic gives a closer fit to the null expectation when some--compared with none--of the true predisposing factors are included in the haplotype analysis. Although the haplotype method cannot distinguish between very highly correlated sites in one population, ethnic comparisons may help identify the true predisposing factors. The haplotype method was applied to insulin-dependent diabetes mellitus (IDDM) HLA class II DQA1-DQB1 data from Caucasian, African, and Japanese populations. Our results indicate that the combination DQA1#52 (Arg predisposing) DQB1#57 (Asp protective), which has been proposed as an important IDDM agent, does not include all the predisposing elements. With rheumatoid arthritis HLA class II DRB1 data, the results were consistent with the shared-epitope hypothesis. PMID:9042931

  10. The factors that have correlation with student behavior to dispose liquid waste

    NASA Astrophysics Data System (ADS)

    Kusmawaningtyas, Rieneke; Darmajanti, Linda; Soesilo, Tri Edhi Budhi

    2017-03-01

    Students majoring in chemistry could produce toxic liquid waste in their laboratory practices. They are not allowed to dispose of hazardous laboratory liquid into the environment. The formulation of problem in this study is that not all students have good behavior to dispose liquid waste properly according to their type and chemical properties while it is expected that all students have good behavior to dispose liquid waste with the type and chemical properties in container vessel, even though all students are expected to have behavior to dispose waste in the container vessel with the support of the predisposing factors, enabling factors, and driving factors. The aim of this study is to analyze the type and chemical properties of liquid waste and the relationship between three factors forming behavior with student behavior. The relationship between three factors forming behavior with student behavior was analyzed by correlative analysis. Type and chemical properties known through observation and qualitative analysis. The results of this research is found that enabling factors and driving behavior have a weak relation with student behavior. Nevertheless, predisposing factors has no relation with student behavior. The result of analysis of waste laboratory are known that laboratory liquid waste contains Cu, Fe, and methylene blue which potentially pollute the environment. The findings show that although generally the laboratory use chemicals in small quantities, but the total quantity of laboratory liquid waste produced from all laboratories in some regions must be considered. Moreover, the impact of the big quantity of liquid waste to environment must be taken into account. Thus, it is recommended that students should raise awareness of the risks associated with laboratory liquid waste and, we should provide proper management for a laboratory and policy makers.

  11. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis

    PubMed Central

    2018-01-01

    Background Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen’s behavioural model. Methods Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Results Predisposing (OR = 0.89; 95% CI 0.81–0.97) and enabling (OR = 0.90; 95% CI 0.85–0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Conclusions Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services. PMID:29420660

  12. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

    PubMed

    Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

    2018-01-01

    Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

  13. Two necrotic enteritis predisposing factors, dietary fishmeal and Eimeria infection, induce large changes in the caecal microbiota of broiler chickens.

    PubMed

    Wu, Shu-Biao; Stanley, Dragana; Rodgers, Nicholas; Swick, Robert A; Moore, Robert J

    2014-03-14

    It is widely established that a high-protein fishmeal supplemented starter diet and Eimeria infection can predispose birds to the development of clinical necrotic enteritis symptoms following Clostridium perfringens infection. However, it has not been clearly established what changes these treatments cause to predispose birds to succumb to necrotic enteritis. We analysed caecal microbiota of 4 groups of broilers (n=12) using deep pyrosequencing of 16S rDNA amplicons: (1) control chicks fed a control diet, (2) Eimeria infected chicks fed control diet, (3) chicks fed fishmeal supplemented diet and lastly (4) both fishmeal fed and Eimeria infected chicks. We found that the high-protein fishmeal diet had a strong effect on the intestinal microbiota similar to the previously reported effect of C. perfringens infection. We noted major changes in the prevalence of various lactobacilli while the total culturable Lactobacillus counts remained stable. The Ruminococcaceae, Lachnospiraceae, unknown Clostridiales and Lactobacillaceae families were most affected by fishmeal with increases in a number of operational taxonomic units (OTUs) that had previously been linked to Crohn's disease and reductions in OTUs known to be butyrate producers. Eimeria induced very different changes in microbiota; Ruminococcaceae groups were reduced in number and three unknown Clostridium species were increased in abundance. Additionally, Eimeria did not significantly influence changes in pH, formic, propionic or isobutyric acid while fishmeal induced dramatic changes in all these measures. Both fishmeal feeding and Eimeria infection induced significant changes in the gut microbiota; these changes may play an important role in predisposing birds to necrotic enteritis. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Clinical course of ectopic pregnancy: A single-center experience.

    PubMed

    Ayaz, Aqueela; Emam, Sameh; Farooq, Mian Usman

    2013-01-01

    The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007). Out of total 7564 pregnancies, 44 (0.58%) patients were diagnosed as EP. Out of 44, 22 (50%) patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%), and 21 (48%) had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%), abdominal pain (39, 88.6%), and tenderness (38, 86%). Previous pelvic surgery (13, 29.5%), infertility treatment (11, 25%), and pelvic inflammatory disease (10, 22.7%) were the common predisposing factors. Twenty-five (57%) presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%). No mortality was observed. Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  15. Vulvovaginal Candidiasis in Aminu Kano Teaching Hospital, North-West Nigeria: Hospital-Based Epidemiological Study

    PubMed Central

    Ugwa, EA

    2015-01-01

    Background: Vulvovaginal candidiasis (VVC) remains a common problem worldwide and the role of douching as a predisposing factor is unclear. Aim: This study was undertaken to highlight the prevalence and predisposing factors of VVC in North-west Nigeria. Subjects and Methods: This was a prospective study done at Aminu Kano Teaching Hospital (AKTH), North-west. AKTH is a 500-bed tertiary hospital located in Kano, the most populous state in Nigeria. Ethical clearance was obtained. Three hundred patients with VVC were recruited from the gynecologic and general outpatients’ clinics of AKTH. Research structured questionnaires were used to obtain sociodemographic and clinical information. The data obtained were analyzed using SPSS version 16.0 statistical software (SPSS Inc., Chicago IL, USA). Frequency, mean and simple percentages were used to analyze data. Result: Candida albicans was the most frequent cause of the positive high vaginal swabs constituting 84.5% (316/374) while Proteus vulgaris was the least frequent cause constituting 0.53% (2/374). Fifty-three percent (143/270) of those with VVC were aged 26–35 years; the married were 80% (216/270) and those who were unmarried were 20% (54/270). Douching was the commonest predisposing factor occurring in 42.5% (115/270) of cases. Conclusion: VVC was the most prevalent cause of vaginosis in North-west Nigeria, and douching was the commonest predisposing factor. PMID:26229716

  16. Assessment of Factors Influencing Communication in Clinical Pharmacy.

    PubMed

    Yao, Dongning; Jiang, Liang; Huang, Yuankai; Chen, Lei; Wang, Yitao; Xi, Xiaoyu

    2018-01-01

    This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation-policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists' attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.

  17. Orbital cellulitis: clinical course and management challenges. the Lagos State University Teaching Hospital experience.

    PubMed

    Balogun, Bolanle G; Balogun, Modupe M; Adekoya, Bola J

    2012-01-01

    Orbital cellulitis is a devastating acute infection of orbital soft tissues located posterior to the orbital septum. It is both vision and life-threatening. It is an ocular emergency which most often present in childhood. This article reviewed cases presenting during the study period with the view of examining the pattern of presentation, clinical course and management challenges. A retrospective study was conducted on patients presenting with orbital cellulitis between January 2008 and June 2011. Socio-demographic data, entry and discharge visual acuity, presenting complaints, predisposing factors, duration of complaints, admission period and complications were extracted from clinical records and analyzed. Seventeen (17) patients presented with orbital cellulitis constituting 6.2% of ocular emergency admissions during the study period. Twelve (70.6%) were males. Thirteen (76.5%) were children. The major predisposing factors were upper respiratory tract infections, and facial and globe injuries in five (22.7%) cases respectively. Only five (29.4%), presented within three days of disease onset. Average duration of admission was 10.6 days. Complications during the course of disease were category 4 and 5 blindness in five (23.5%), orbital abscess four (23.5%), cavernous sinus thrombosis two (11.8%), contralateral preseptal cellulitis two (11.8%) and exposure keratopathy in one (5.9%). Orbital cellulitis has remained a disease with high ocular morbidity. The major management challenges were poor financial status of patients precluding necessary diagnostic laboratory and imaging studies. Early recognition, diagnosis and treatment are crucial to the preservation of vision and reduced occurrence of complications. The importance of record keeping is also highlighted.

  18. Expediting support for the pregnant mothers to obtain antenatal care at public health facilities in rural areas of Balochistan province, Pakistan

    PubMed Central

    Ghaffar, Abdul; Pongpanich, Sathirakorn; Ghaffar, Najma; Chapman, Robert Sedgwick; Mureed, Sheh

    2015-01-01

    Objectives: To identify, and compare relative importance of, factors associated with antenatal care (ANC) utilization in rural Balochistan, toward framing a policy to increase such utilization. Methods: This cross sectional study was conducted among 513 pregnant women in Jhal Magsi District, Balochistan, in 2011. A standardized interviewer-administered questionnaire was used. Predisposing, enabling, and reinforcing factors were evaluated with generalized linear models (Poisson distribution and log link). Results: Prevalence of any ANC was only 14.4%. Predisposing, enabling, and reinforcing factors were all important determinants of ANC utilization. Reinforcing factors were clearly most important, husband’s support for ANC was more important than support from other community members. Among predisposing factors, higher income, education, occupation, and better knowledge regarding benefits of ANC were positively and statistically significantly associated with ANC However increased number of children showed negative association. Complications free pregnancy showed positive significant association with ANC at public health facility among enabling factors. Conclusion: It is very important to increase antenatal care utilization in the study area and similar areas. Policy to achieve this should focus on enhancing support from the husband. PMID:26150867

  19. Differential Responses of Cecal Microbiota to Fishmeal, Eimeria and Clostridium perfringens in a Necrotic Enteritis Challenge Model in Chickens

    PubMed Central

    Rodgers, Nicholas; Swick, Robert A.; Moore, Robert J.

    2014-01-01

    Clostridium perfringens causes enteric diseases in animals and humans. In poultry, avian-specific C. perfringens strains cause necrotic enteritis, an economically significant poultry disease that costs the global industry over $2 billion annually in losses and control measures. With removal of antibiotic growth promoters in some countries this disease appears to be on the rise. In experimental conditions used to study disease pathogenesis and potential control measures, reproduction of the disease relies on the use of predisposing factors such as Eimeria infection and the use of high protein diets, indicating complex mechanisms involved in the onset of necrotic enteritis. The mechanisms by which the predisposing factors contribute to disease progression are not well understood but it has been suggested that they may cause perturbations in the microbiota within the gastrointestinal tract. We inspected changes in cecal microbiota and short chain fatty acids (SCFA) induced by Eimeria and fishmeal, in birds challenged or not challenged with C. perfringens. C. perfringens challenge in the absence of predisposing factors did not cause significant changes in either the alpha or beta diversity of the microbiota nor in concentrations of SCFA. Moreover, there was no C. perfringens detected in the cecal microbiota 2 days post-challenge without the presence of predisposing factors. In contrast, both fishmeal and Eimeria caused significant changes in microbiota, seen in both alpha and beta diversity and also enabled C. perfringens to establish itself post challenge. Eimeria had its strongest influence on intestinal microbiota and SCFA when combined with fishmeal. Out of 6 SCFAs measured, including butyric acid, none were significantly influenced by C. perfringens, but their levels were strongly modified following the use of both predisposing factors. There was little overlap in the changes caused following Eimeria and fishmeal treatments, possibly indicating multiple routes for progressing towards clinical symptoms of necrotic enteritis. PMID:25167074

  20. Isolated torsion of fallopian tube during pregnancy; report of two cases.

    PubMed

    Yalcin, O T; Hassa, H; Zeytinoglu, S; Isiksoy, S

    1997-08-01

    Isolated torsion of fallopian tube is very uncommon during pregnancy. Predisposing factors for torsion are hydrosalpinx, prior tubal operation, pelvic congestion, ovarian and paraovarian masses and trauma. Although the most important clinical symptom is abdominal pain in lower quadrants, the diagnosis is usually established during the operation performed for acute abdomen and salpingectomy is almost always necessary. Two cases of torsion of fallopian tube during pregnancy, one with hydrosalpinx, the other with paratubal cyst are presented and symptoms and predisposing factors are discussed.

  1. The relationship between neuroticism, major depressive disorder and comorbid disorders in Chinese women

    PubMed Central

    Xia, Jing; He, Qiang; Li, Yihan; Xie, Dong; Zhu, Suoyu; Chen, Jing; Shen, Yuan; Zhang, Ning; Wei, Yan; Chen, Chunfeng; Shen, Jianhua; Zhang, Yan; Gao, Chengge; Li, Youhui; Ding, Jihong; Shen, Wenwu; Wang, Qian; Cao, Meiyue; Liu, Tiebang; Zhang, Jinbei; Duan, Huijun; Bao, Cheng; Ma, Ping; Zhou, Cong; Luo, Yanfang; Zhang, Fengzhi; Liu, Ying; Li, Yi; Jin, Guixing; Zhang, Yutang; Liang, Wei; Chen, Yunchun; Zhao, Changyin; Li, Haiyan; Chen, Yiping; Shi, Shenxun; Kendler, Kenneth S.; Flint, Jonathan; Wang, Xumei

    2011-01-01

    Objective The personality trait of neuroticism is a risk factor for major depressive disorder (MDD), but this relationship has not been demonstrated in clinical samples from Asia. Methods We examined a large-scale clinical study of Chinese Han women with recurrent major depression and community-acquired controls. Results Elevated levels of neuroticism increased the risk for lifetime MDD (with an odds ratio of 1.37 per SD), contributed to the comorbidity of MDD with anxiety disorders, and predicted the onset and severity of MDD. Our findings largely replicate those obtained in clinical populations in Europe and US but differ in two ways: we did not find a relationship between melancholia and neuroticism; we found lower mean scores for neuroticism (3.6 in our community control sample). Limitations Our findings do not apply to MDD in community-acquired samples and may be limited to Han Chinese women. It is not possible to determine whether the association between neuroticism and MDD reflects a causal relationship. Conclusions Neuroticism acts as a risk factor for MDD in Chinese women, as it does in the West and may particularly predispose to comorbidity with anxiety disorders. Cultural factors may have an important effect on its measurement. PMID:21824661

  2. Ocular infections caused by Scedosporium apiospermum: A case series

    PubMed Central

    Ramakrishnan, Seema; Mandlik, Kunal; Sathe, Tejashree Sanket; Gubert, Joseph; Krishnan, Thiruvengada; Baskaran, Prabu

    2018-01-01

    The aim of our retrospective study is to report a case series of ocular infections caused by a rare fungus, Scedosporium apiospermum, in a South Indian population. Thirteen cases of culture-positive S. apiospermum infections diagnosed between January 2011 and March 2016 were included in this study. The parameters evaluated were predisposing factors, treatment and final clinical outcome. The most common mode of presentation was keratitis (84.6%) followed by sclerokeratitis (15.3%). The predisposing factors involved were unspecified foreign body injury (30.7%), organic matter injury (15.3%), uncontrolled diabetes (7.6%), and recent manual small-incision cataract surgery (7.6%). Five cases (38.46%) had no predisposing factor. Of the 11 keratitis cases, nine (69.2%) responded well to combination medical therapy while one case (7.6%) required therapeutic keratoplasty. One case was lost to follow-up. Both cases which presented with sclerokeratitis showed no response to medico-surgical treatment progressing to panophthalmitis and evisceration. PMID:29283143

  3. Extremely high frequency of autoimmune-predisposing alleles in medieval specimens*

    PubMed Central

    Witas, H.W.; Jędrychowska-Dańska, K.; Zawicki, P.

    2007-01-01

    The precise etiology and reasons for the increase in incidence of autoimmune disorders still remain unclear, and although both genetic and environmental factors have been proven to shape individual predisposition, it is not known which of the factors, if not both, is responsible for the boom observed during the last decades. In order to establish whether a higher frequency of autoimmune-predisposing alleles may explain this increase we took advantage of ancient DNA methodology to establish the genetic predisposition, conferred by cytotoxic T lymphocyte associated antigen-4 (CTLA4) +49A/G and human leukocyte antigens (HLA) DQB157, in population inhabiting Poland in the Middle Ages. After successful typing of 42 individuals from a 12th~14th’s century archeological burial site, we found that frequencies of the predisposing alleles in the medieval population were higher than they are at present, suggesting thus that the recently observed incidence increase results most probably from factors of other than genetic nature. PMID:17610332

  4. Splenic Abscess Associated with Endocarditis in a Patient on Hemodialysis: A Case Report

    PubMed Central

    Kim, Hyun Soo; Cho, Min Seok; Hwang, Seung Hwan; Ma, Seong Kwon; Kim, Soo Wan; Kim, Nam Ho

    2005-01-01

    Splenic abscess is an unusual condition usually seen in immunocompromised patients or associated with intravenous drug abuses. Several conditions including trauma, immunodeficiency, corticosteroid and/or immunosuppressive therapy and diabetes mellitus have been listed under the predisposing factors for a splenic abscess. Splenic abscess in a patient on hemodialysis is a rare but life-threatening condition if not corrected. We describe a case of splenic abscess with bacterial endocarditis on maintenance hemodialysis. He had staphylococcal septicemia secondary to bacterial endocarditis at the mitral valve from the dialysis accesssite infection. Although hematologic seeding from endocarditis has been the predisposing factor for splenic abscess, we postulate that access-site infections may predispose hemodialysis patients to splenic abscess. Splenic abscess may be considered as one of the causes when patients on hemodialysis develop unexplained fever. PMID:15832007

  5. Health care costs in the elderly in Germany: an analysis applying Andersen’s behavioral model of health care utilization

    PubMed Central

    2014-01-01

    Background To analyze the association of health care costs with predisposing, enabling, and need factors, as defined by Andersen’s behavioral model of health care utilization, in the German elderly population. Methods Using a cross-sectional design, cost data of 3,124 participants aged 57–84 years in the 8-year-follow-up of the ESTHER cohort study were analyzed. Health care utilization in a 3-month period was assessed retrospectively through an interview conducted by trained study physicians at respondents’ homes. Unit costs were applied to calculate health care costs from the societal perspective. Socio-demographic and health-related variables were categorized as predisposing, enabling, or need factors as defined by the Andersen model. Multimorbidity was measured by the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Mental health status was measured by the SF-12 mental component summary (MCS) score. Sector-specific costs were analyzed by means of multiple Tobit regression models. Results Mean total costs per respondent were 889 € for the 3-month period. The CIRS-G score and the SF-12 MCS score representing the need factor in the Andersen model were consistently associated with total, inpatient, outpatient and nursing costs. Among the predisposing factors, age was positively associated with outpatient costs, nursing costs, and total costs, and the BMI was associated with outpatient costs. Conclusions Multimorbidity and mental health status, both reflecting the need factor in the Andersen model, were the dominant predictors of health care costs. Predisposing and enabling factors had comparatively little impact on health care costs, possibly due to the characteristics of the German social health insurance system. Overall, the variables used in the Andersen model explained only little of the total variance in health care costs. PMID:24524754

  6. Health care costs in the elderly in Germany: an analysis applying Andersen's behavioral model of health care utilization.

    PubMed

    Heider, Dirk; Matschinger, Herbert; Müller, Heiko; Saum, Kai-Uwe; Quinzler, Renate; Haefeli, Walter Emil; Wild, Beate; Lehnert, Thomas; Brenner, Hermann; König, Hans-Helmut

    2014-02-14

    To analyze the association of health care costs with predisposing, enabling, and need factors, as defined by Andersen's behavioral model of health care utilization, in the German elderly population. Using a cross-sectional design, cost data of 3,124 participants aged 57-84 years in the 8-year-follow-up of the ESTHER cohort study were analyzed. Health care utilization in a 3-month period was assessed retrospectively through an interview conducted by trained study physicians at respondents' homes. Unit costs were applied to calculate health care costs from the societal perspective. Socio-demographic and health-related variables were categorized as predisposing, enabling, or need factors as defined by the Andersen model. Multimorbidity was measured by the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Mental health status was measured by the SF-12 mental component summary (MCS) score. Sector-specific costs were analyzed by means of multiple Tobit regression models. Mean total costs per respondent were 889 € for the 3-month period. The CIRS-G score and the SF-12 MCS score representing the need factor in the Andersen model were consistently associated with total, inpatient, outpatient and nursing costs. Among the predisposing factors, age was positively associated with outpatient costs, nursing costs, and total costs, and the BMI was associated with outpatient costs. Multimorbidity and mental health status, both reflecting the need factor in the Andersen model, were the dominant predictors of health care costs. Predisposing and enabling factors had comparatively little impact on health care costs, possibly due to the characteristics of the German social health insurance system. Overall, the variables used in the Andersen model explained only little of the total variance in health care costs.

  7. Micrococcus species-related peritonitis in patients receiving peritoneal dialysis.

    PubMed

    Kao, Chih-Chin; Chiang, Chih-Kang; Huang, Jenq-Wen

    2014-01-01

    Peritonitis is a major complication of peritoneal dialysis (PD) and remains the most common cause of PD failure. Micrococci are catalase-positive, coagulase-negative, and gram-positive cocci that are spherical, often found in tetrad, and belong to the family Micrococcaceae. Micrococcus species are commonly found in the environment, and it is now recognized that Micrococcus species can be opportunistic pathogens in immunocompromised patients. The only consistent predisposing factor for Micrococcus infection is an immunocompromised state. We report three cases of Micrococcus PD peritonitis. Improper practice of PD may have been the causative factor. Although Micrococcus species are low-virulence pathogens, infection could result in refractory peritonitis and subsequent PD failure. Intraperitoneal administration of vancomycin for at least 2 weeks is recommended for Micrococcus peritonitis.

  8. Perioperative recombinant human granulocyte colony-stimulating factor (Filgrastim) treatment prevents immunoinflammatory dysfunction associated with major surgery.

    PubMed

    Schneider, Christian; von Aulock, Sonja; Zedler, Siegfried; Schinkel, Christian; Hartung, Thomas; Faist, Eugen

    2004-01-01

    To examine the effects of perioperative rhG-CSF administration on immune function in patients subjected to major surgery. Severe trauma, such as major surgery, initiates acute immunodysfunction which predisposes the patient towards infectious complications. Sixty patients undergoing elective surgery received either recombinant human granulocyte colony-stimulating factor/rh G-CSF (Filgrastim) or a placebo perioperatively. At several time points before and after the surgical intervention immunofunctional parameters were assessed. RESULTS Leukocyte counts and serum levels of anti-inflammatory mediators (IL-1ra and TNF-R) were increased in Filgrastim-treated patients, while the post-operative acute phase response was attenuated. Monocyte deactivation (reduced TNF-alpha release and HLA-DR expression) and lymphocyte anergy (impaired mitogenic proliferation and reduced TH1 lymphokine release) were blunted and the incidence and severity of infectious complications were reduced. These results suggest that Filgrastim treatment reinforces innate immunity, enabling better prevention of infection. Thus, this unique combination of hematopoietic, anti-inflammatory and anti-infectious effects on the innate immune system warrants further study of clinical efficacy and sepsis prophylaxis.

  9. Perioperative Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) Treatment Prevents Immunoinflammatory Dysfunction Associated With Major Surgery

    PubMed Central

    Schneider, Christian; von Aulock, Sonja; Zedler, Siegfried; Schinkel, Christian; Hartung, Thomas; Faist, Eugen

    2004-01-01

    Objective: To examine the effects of perioperative rhG-CSF administration on immune function in patients subjected to major surgery. Summary Background Data: Severe trauma, such as major surgery, initiates acute immunodysfunction which predisposes the patient towards infectious complications. Methods: Sixty patients undergoing elective surgery received either recombinant human granulocyte colony-stimulating factor/rh G-CSF (Filgrastim) or a placebo perioperatively. At several time points before and after the surgical intervention immunofunctional parameters were assessed. Results: Leukocyte counts and serum levels of anti-inflammatory mediators (IL-1ra and TNF-R) were increased in Filgrastim-treated patients, while the post-operative acute phase response was attenuated. Monocyte deactivation (reduced TNF-α release and HLA-DR expression) and lymphocyte anergy (impaired mitogenic proliferation and reduced TH1 lymphokine release) were blunted and the incidence and severity of infectious complications were reduced. Conclusions: These results suggest that Filgrastim treatment reinforces innate immunity, enabling better prevention of infection. Thus, this unique combination of hematopoietic, anti-inflammatory and anti-infectious effects on the innate immune system warrants further study of clinical efficacy and sepsis prophylaxis. PMID:14685103

  10. Hypoglycemia induced by insulin as a triggering factor of cognitive deficit in diabetic children.

    PubMed

    Rodrigues Vilela, Vanessa; de Castro Ruiz Marques, Any; Schamber, Christiano Rodrigues; Bazotte, Roberto Barbosa

    2014-01-01

    This paper provides an overview of insulin-induced hypoglycemia as a triggering factor of cognitive deficit in children with type 1 diabetes mellitus. For this purpose, databases from 1961 to 2013 were used with the objective of detecting the primary publications that address the impact of hypoglycemia on cognitive performance of diabetic children. The results obtained from experimental animals were excluded. The majority of studies demonstrated that the cognitive deficit in diabetic children involves multiple factors including duration, intensity, severity, and frequency of hypoglycemia episodes. Additionally, age at the onset of type 1 diabetes also influences the cognitive performance, considering that early inception of the disease is a predisposing factor for severe hypoglycemia. Furthermore, the results suggest that there is a strong correlation between brain damage caused by hypoglycemia and cognitive deterioration. Therefore, a more cautious follow-up and education are needed to impede and treat hypoglycemia in children with diabetes mellitus.

  11. Determinants of psychology service utilization in a palliative care outpatient population.

    PubMed

    Azuero, Casey; Allen, Rebecca Sue; Kvale, Elizabeth; Azuero, Andres; Parmelee, Patricia

    2014-06-01

    Research has demonstrated that treating cancer patients' psychological and physical health leads to improved overall health. This may be especially true for palliative care patients facing serious illness. This study examines the proportion and determinants of psychology service utilization in an outpatient palliative care population. Data from an existing clinical database in an outpatient palliative clinic utilizing a collaborative care model to deliver psychology services were explored. This study was framed by Andersen's Behavioral Model of Health Service Use, which incorporates three main components: predisposing, enabling, and need factors to model health service utilization. The sample (N = 149) was majority middle aged, female, and White with a primary diagnosis of cancer. Cross-tabulations were conducted to determine how many patients who met screening criteria for depression or anxiety sought psychology services. Logistic regression analyses were conducted to assess for predisposing, enabling, and need factor determinants of psychology service utilization. Among patients who met criteria for moderate depression or anxiety, 50% did not access readily available psychology services. Enabling factors were the strongest determinant of psychology utilization. Factors associated with need for psychology services (i.e., emotional distress and psychological symptom burden) did not reach significance in determining psychology service use. This study extends current knowledge about psychology utilization to palliative care outpatients receiving care within a collaborative care model. Directions for future research include further investigation of care models that optimize enabling strategies to enhance access to these services, and examination of patient-reported barriers to receiving this care. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Identifying patients at high risk of tuberculosis recurrence.

    PubMed

    Sadikot, Ruxana T

    2016-12-01

    Several studies have been done in relation to recurrence of tuberculosis (TB) following completion of treatment. However, recurrence of TB is still a major problem from a public health perspective in high-burden countries, where no special attention is being given to this issue. Disease recurrence is an important indicator of the efficacy of antituberculosis treatment. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 25%. This variability is not only a reflection of regional epidemiology of recurrence but differences in the definitions used by the TB control programs. In addition to treatment failure related to medication adherence, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include: malnutrition; human immunodeficiency virus; substance abuse including tobacco use; comorbidity such as diabetes, renal failure and systemic diseases, especially immunosuppressive states; and environmental exposure such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being discovered. Information on temporal and geographical trends of TB cases as well as genotyping might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and defining host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence. Copyright © 2016.

  13. Patients at high risk of tuberculosis recurrence.

    PubMed

    Mirsaeidi, Mehdi; Sadikot, Ruxana T

    2018-01-01

    Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  14. Phospholipases D1 and D2 Suppress Appetite and Protect against Overweight.

    PubMed

    Trujillo Viera, Jonathan; El-Merahbi, Rabih; Nieswandt, Bernhard; Stegner, David; Sumara, Grzegorz

    2016-01-01

    Obesity is a major risk factor predisposing to the development of peripheral insulin resistance and type 2 diabetes (T2D). Elevated food intake and/or decreased energy expenditure promotes body weight gain and acquisition of adipose tissue. Number of studies implicated phospholipase D (PLD) enzymes and their product, phosphatidic acid (PA), in regulation of signaling cascades controlling energy intake, energy dissipation and metabolic homeostasis. However, the impact of PLD enzymes on regulation of metabolism has not been directly determined so far. In this study we utilized mice deficient for two major PLD isoforms, PLD1 and PLD2, to assess the impact of these enzymes on regulation of metabolic homeostasis. We showed that mice lacking PLD1 or PLD2 consume more food than corresponding control animals. Moreover, mice deficient for PLD2, but not PLD1, present reduced energy expenditure. In addition, deletion of either of the PLD enzymes resulted in development of elevated body weight and increased adipose tissue content in aged animals. Consistent with the fact that elevated content of adipose tissue predisposes to the development of hyperlipidemia and insulin resistance, characteristic for the pre-diabetic state, we observed that Pld1-/- and Pld2-/- mice present elevated free fatty acids (FFA) levels and are insulin as well as glucose intolerant. In conclusion, our data suggest that deficiency of PLD1 or PLD2 activity promotes development of overweight and diabetes.

  15. Pathology of fungal infections of the central nervous system: 17 years' experience from Southern India.

    PubMed

    Sundaram, C; Umabala, P; Laxmi, V; Purohit, A K; Prasad, V S S V; Panigrahi, M; Sahu, B P; Sarathi, M V; Kaul, S; Borghain, R; Meena, A K; Jayalakshmi, S S; Suvarna, A; Mohandas, S; Murthy, J M K

    2006-10-01

    To describe the pathology of central nervous system (CNS) fungal infections with particular reference to India. This was a retrospective study from 1988 to 2004 constituting 130 cases. The diagnosis was based on morphology of biopsy/autopsy material. These included aspergillosis (n=73), zygomycosis (n=40), cryptococcosis (n=2), rhodotorulosis (n=1), candidiasis (n=5), maduramycosis (n=1), pheohyphomycosis (n=3) and mixed infections (n=5). Predisposing risk factors were present in 49 (38%) patients only. The majority of the patients were immunocompetent. The commonest risk factor was diabetes mellitus, the commonest route of infection was from a contiguous site and the commonest pathology was granuloma. Culture positivity was seen in only 31%. Environmental factors in tropical countries such as India play a significant role in the pathogenesis of CNS fungal infections.

  16. Five years review of cases of adult tetanus managed at Gondar University Hospital, North West Ethiopia (Gondar, Sep. 2003-Aug. 2008).

    PubMed

    Tadesse, Abilo; Gebre-Selassie, Samuel

    2009-10-01

    Tetanus is a life threatening preventable infection relatively uncommon in the developed world but occurs frequently in developing countries with case fatality rate of 40-60%. We conducted the study as there is no recent review regarding adult tetanus in Ethiopia which looked at the predisposing factors, presenting features and case fatality rate. The study aims to evaluate clinical characteristics of adult tetanus as related to predisposing factors, presenting features and treatment outcome. This is a retrospective review of adult tetanus cases admitted to medical ward of Gondar University Hospital, North West Ethiopia, over a period of 5-years. A total of 29 adults were admitted with the diagnosis of generalized tetanus during the study period. There were more male then female patients (sex ratio 1.9:1) with rural dwellers constituting the majority. The mean age of patients was 35 +/- 14 yrs (range, 18-70 yrs. Majority of patients (72.4%) sustained acute injury preceding symptom onset, often on lower extremity. Three rural mothers, who denied history of trauma, developed puerperal tetanus with in 2 weeks of delivery, genital tract thought to be the portal of entry. Almost all patients, who had sustained acute injury, did not seek medical help for their wounds and missed the chance to receive prophylaxis for tetanus. Over all, 48.3% had severe, 37.9% moderate, and 13.8% mild form of tetanus at presentation. The most common clinical presentation was trismus (100%), followed by stiff neck and back (93.1%) and neck rigidity (86.2).Over all mortality rate was 41.4%. Respiratory failure requiring ventilatory support (66.7%) was the major cause of death. The study recommends a need for tetanus immunization in those who had acute injury and planning to educate individuals at risk to recognise symptoms early, and seek medical care to combat this fatal disease.

  17. Relationships between chronic obstructive pulmonary disease and lung cancer: biological insights

    PubMed Central

    Bustamante, Víctor; Curull, Víctor; Gea, Joaquim; López-Campos, José Luis; Muñoz, Xavier

    2016-01-01

    Lung cancer (LC) has become one of the leading causes of preventable death in the last few decades. Cigarette smoking (CS) stays as the main etiologic factor of LC despite that many other causes such as occupational exposures, air pollution, asbestos, or radiation have also been implicated. Patients with chronic obstructive pulmonary disease (COPD), which also represents a major cause of morbidity and mortality in developed countries, exhibit a significantly greater risk of LC. The study of the underlying biological mechanisms that may predispose patients with chronic respiratory diseases to a higher incidence of LC has also gained much attention in the last few years. The present review has been divided into three major sections in which different aspects have been addressed: (I) relevant etiologic agents of LC; (II) studies confirming the hypothesis that COPD patients are exposed to a greater risk of developing LC; and (III) evidence on the most relevant underlying biological mechanisms that support the links between COPD and LC. Several carcinogenic agents have been described in the last decades but CS remains to be the leading etiologic agent in most geographical regions in which the incidence of LC is very high. Growing evidence has put the line forward the implications of COPD and especially of emphysema in LC development. Hence, COPD represents a major risk factor of LC in patients. Different avenues of research have demonstrated the presence of relevant biological mechanisms that may predispose COPD patients to develop LC. Importantly, the so far identified biological mechanisms offer targets for the design of specific therapeutic strategies that will further the current treatment options for patients with LC. Prospective screening studies, in which patients with COPD should be followed up for several years will help identify biomarkers that may predict the risk of LC among these patients. PMID:27867578

  18. A novel unstable duplication upstream of HAS2 predisposes to a breed-defining skin phenotype and a periodic fever syndrome in Chinese Shar-Pei dogs.

    PubMed

    Olsson, Mia; Meadows, Jennifer R S; Truvé, Katarina; Rosengren Pielberg, Gerli; Puppo, Francesca; Mauceli, Evan; Quilez, Javier; Tonomura, Noriko; Zanna, Giordana; Docampo, Maria José; Bassols, Anna; Avery, Anne C; Karlsson, Elinor K; Thomas, Anne; Kastner, Daniel L; Bongcam-Rudloff, Erik; Webster, Matthew T; Sanchez, Armand; Hedhammar, Ake; Remmers, Elaine F; Andersson, Leif; Ferrer, Lluis; Tintle, Linda; Lindblad-Toh, Kerstin

    2011-03-01

    Hereditary periodic fever syndromes are characterized by recurrent episodes of fever and inflammation with no known pathogenic or autoimmune cause. In humans, several genes have been implicated in this group of diseases, but the majority of cases remain unexplained. A similar periodic fever syndrome is relatively frequent in the Chinese Shar-Pei breed of dogs. In the western world, Shar-Pei have been strongly selected for a distinctive thick and heavily folded skin. In this study, a mutation affecting both these traits was identified. Using genome-wide SNP analysis of Shar-Pei and other breeds, the strongest signal of a breed-specific selective sweep was located on chromosome 13. The same region also harbored the strongest genome-wide association (GWA) signal for susceptibility to the periodic fever syndrome (p(raw) = 2.3 × 10⁻⁶, p(genome) = 0.01). Dense targeted resequencing revealed two partially overlapping duplications, 14.3 Kb and 16.1 Kb in size, unique to Shar-Pei and upstream of the Hyaluronic Acid Synthase 2 (HAS2) gene. HAS2 encodes the rate-limiting enzyme synthesizing hyaluronan (HA), a major component of the skin. HA is up-regulated and accumulates in the thickened skin of Shar-Pei. A high copy number of the 16.1 Kb duplication was associated with an increased expression of HAS2 as well as the periodic fever syndrome (p < 0.0001). When fragmented, HA can act as a trigger of the innate immune system and stimulate sterile fever and inflammation. The strong selection for the skin phenotype therefore appears to enrich for a pleiotropic mutation predisposing these dogs to a periodic fever syndrome. The identification of HA as a major risk factor for this canine disease raises the potential of this glycosaminoglycan as a risk factor for human periodic fevers and as an important driver of chronic inflammation.

  19. A Novel Unstable Duplication Upstream of HAS2 Predisposes to a Breed-Defining Skin Phenotype and a Periodic Fever Syndrome in Chinese Shar-Pei Dogs

    PubMed Central

    Olsson, Mia; Mauceli, Evan; Quilez, Javier; Tonomura, Noriko; Zanna, Giordana; Docampo, Maria José; Bassols, Anna; Avery, Anne C.; Karlsson, Elinor K.; Thomas, Anne; Kastner, Daniel L.; Bongcam-Rudloff, Erik; Webster, Matthew T.; Sanchez, Armand; Hedhammar, Åke; Remmers, Elaine F.; Andersson, Leif; Ferrer, Lluis; Tintle, Linda; Lindblad-Toh, Kerstin

    2011-01-01

    Hereditary periodic fever syndromes are characterized by recurrent episodes of fever and inflammation with no known pathogenic or autoimmune cause. In humans, several genes have been implicated in this group of diseases, but the majority of cases remain unexplained. A similar periodic fever syndrome is relatively frequent in the Chinese Shar-Pei breed of dogs. In the western world, Shar-Pei have been strongly selected for a distinctive thick and heavily folded skin. In this study, a mutation affecting both these traits was identified. Using genome-wide SNP analysis of Shar-Pei and other breeds, the strongest signal of a breed-specific selective sweep was located on chromosome 13. The same region also harbored the strongest genome-wide association (GWA) signal for susceptibility to the periodic fever syndrome (praw = 2.3×10−6, pgenome = 0.01). Dense targeted resequencing revealed two partially overlapping duplications, 14.3 Kb and 16.1 Kb in size, unique to Shar-Pei and upstream of the Hyaluronic Acid Synthase 2 (HAS2) gene. HAS2 encodes the rate-limiting enzyme synthesizing hyaluronan (HA), a major component of the skin. HA is up-regulated and accumulates in the thickened skin of Shar-Pei. A high copy number of the 16.1 Kb duplication was associated with an increased expression of HAS2 as well as the periodic fever syndrome (p<0.0001). When fragmented, HA can act as a trigger of the innate immune system and stimulate sterile fever and inflammation. The strong selection for the skin phenotype therefore appears to enrich for a pleiotropic mutation predisposing these dogs to a periodic fever syndrome. The identification of HA as a major risk factor for this canine disease raises the potential of this glycosaminoglycan as a risk factor for human periodic fevers and as an important driver of chronic inflammation. PMID:21437276

  20. Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP.

    PubMed

    Chong, Charing Cn; Chiu, Philip Wy; Tan, Teresa; Teoh, Anthony Yb; Lee, Kit Fai; Ng, Enders Kwok Wai; Lai, Paul Bs; Lau, James Yw

    2016-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) for bile duct stone extraction has a major role in the treatment of cholangitis. It is well known that certain risk factors predispose to recurrence of such stones. The aims of this study were to evaluate the correlation between angulation of the common bile duct (CBD), right hepatic duct (RHD), and left hepatic duct (LHD) with recurrent cholangitic attacks and to elucidate other risk factors that may be associated with these attacks. This is retrospective study included 62 patients who had undergone therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stones. Their medical records were followed until May 1, 2009. The RHD, LHD, and CBD angulation and CBD diameter were measured on cholangiography prior to any endoscopic procedures. Among these 62 patients, 6 (9.7 %) had recurrence of cholangitis. Both angles of the RHD and the CBD were significantly smaller in the group with recurrence (P = 0.001, P = 0.004). A CBD angle ≤ 130(o) and RHD angle ≤ 125(o) were found to be significantly associated with an increased risk of recurrence (RR = 10.526, P = 0.033; RR = 24.97, P = 0.008) in multivariate analysis. Cholecystectomy was not a protective factor against recurrence of cholangitis (P = 0.615). Angulation of the CBD (≤ 130°) and RHD (≤ 125°) on ERCP are independent risk factors for recurrent cholangitis. Further prospective studies using these data may be warranted for a more accurate estimation and verification of the risk factors predisposing to recurrent cholangitis.

  1. Germline genetic variants in men with prostate cancer and one or more additional cancers.

    PubMed

    Pilié, Patrick G; Johnson, Anna M; Hanson, Kristen L; Dayno, Megan E; Kapron, Ashley L; Stoffel, Elena M; Cooney, Kathleen A

    2017-10-15

    Prostate cancer has a significant heritable component, and rare deleterious germline variants in certain genes can increase the risk of the disease. The aim of the current study was to describe the prevalence of pathogenic germline variants in cancer-predisposing genes in men with prostate cancer and at least 1 additional primary cancer. Using a multigene panel, the authors sequenced germline DNA from 102 men with prostate cancer and at least 1 additional primary cancer who also met ≥1 of the following criteria: 1) age ≤55 years at the time of diagnosis of the first malignancy; 2) rare tumor type or atypical presentation of a common tumor; and/or 3) ≥3 primary malignancies. Cancer family history and clinicopathologic data were independently reviewed by a clinical genetic counselor to determine whether the patient met established criteria for testing for a hereditary cancer syndrome. Sequencing identified approximately 3500 variants. Nine protein-truncating deleterious mutations were found across 6 genes, including BRCA2, ataxia telangiectasia mutated (ATM), mutL homolog 1 (MLH1), BRCA1 interacting protein C-terminal helicase 1 (BRIP1), partner and localizer of BRCA2 (PALB2), and fibroblast growth factor receptor 3 (FGFR3). Likely pathogenic missense variants were identified in checkpoint kinase 2 (CHEK2) and homeobox protein Hox-B13 (HOXB13). In total, 11 of 102 patients (10.8%) were found to have pathogenic or likely pathogenic mutations in cancer-predisposing genes. The majority of these men (64%) did not meet current clinical criteria for germline testing. Men with prostate cancer and at least 1 additional primary cancer are enriched for harboring a germline deleterious mutation in a cancer-predisposing gene that may impact cancer prognosis and treatment, but the majority do not meet current criteria for clinical genetic testing. Cancer 2017;123:3925-32. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. ApoE polymorphisms in narcolepsy

    PubMed Central

    Gencik, Martin; Dahmen, Norbert; Wieczorek, Stefan; Kasten, Meike; Gencikova, Alexandra; Epplen, Jorg T

    2001-01-01

    Background Narcolepsy is a common neuropsychiatric disorder characterized by increased daytime sleepiness, cataplexy and hypnagogic hallucinations. Deficiency of the hypocretin neurotransmitter system was shown to be involved in the pathogenesis of narcolepsy in animals and men. There are several hints that neurodegeneration of hypocretin producing neurons in the hypothalamus is the pathological correlate of narcolepsy. The ApoE4 allele is a major contributing factor to early-onset neuronal degeneration in Alzheimer disease and other neurodegenerative diseases as well. Methods To clarify whether the ApoE4 phenotype predisposes to narcolepsy or associates with an earlier disease onset, we have genotyped the ApoE gene in 103 patients with narcolepsy and 101 healthy controls. Results The frequency of the E4 allele of the ApoE gene was 11% in the patient and 15% in the control groups. Furthermore, the mean age of onset did not differ between the ApoE4+ and ApoE4- patient groups. Conclusion Our results exclude the ApoE4 allele as a major risk factor for narcolepsy. PMID:11560764

  3. The role of anxiety in vaginismus: a case-control study.

    PubMed

    Watts, Gayle; Nettle, Daniel

    2010-01-01

    Previous research suggests that anxiety may play a large role in the symptoms of vaginismus. We aimed to (i) determine the degree of self-reported general anxiety in women with vaginismus; and (ii) establish whether general anxiety is a consequence of the condition or a predisposing factor. Participants reported state and trait anxiety, five-factor personality scores, history of anxiety disorders, and their perceptions of their symptoms and history. We compared responses of 244 self-identified women with vaginismus with a control group of 101 women using an online questionnaire. The women with vaginismus were higher in trait anxiety and neuroticism, and lower in extraversion, than the controls. There was also a trend toward a greater prevalence of diagnosed anxiety disorders in the vaginismus group. Levels of state anxiety were high among the women with vaginismus, particularly when they felt unsupported by their partners or pressured to cure the condition. Levels of general anxiety are elevated among women with vaginismus and the data suggest that anxiety-proneness may be a predisposing factor for the condition. We conclude that although vaginismus is a multidimensional condition, it may have common predisposing factors with anxiety disorders.

  4. Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors

    PubMed Central

    Jabbari, Ali; Alijanpour, Ebrahim; Mir, Mehrafza; Bani hashem, Nadia; Rabiea, Seyed Mozaffar; Rupani, Mohammad Ali

    2013-01-01

    Post spinal puncture headache (PSPH) is a well known complication of spinal anesthesia. It occurs after spinal anesthesia induction due to dural and arachnoid puncture and has a significant effect on the patient’s postoperative well being. This manuscript is based on an observational study that runs on Babol University of Medical Sciences and review of literatures about current concepts about the incidence, risk factors and predisposing factors of post spinal puncture headache. The overall incidence of post-dural puncture headache after intentional dural puncture varies form 0.1-36%, while it is about 3.1% by atraumatic spinal needle 25G Whitacre. 25G Quincke needle with a medium bevel cutting is popular with widespread use and the incidence of PSPH is about 25%, but its incidence obtained 17.3% by spinal needle 25G Quincke in our observation. The association of predisposing factors like female, young age, pregnancy, low body mass index, multiple dural puncture, inexpert operators and past medical history of chronic headache, expose the patient to PSPH. The identification of factors that predict the likelihood of PSPH is important so that measures can be taken to minimize this painful complication resulting from spinal anesthesia. PMID:24009943

  5. Healthcare Utilization by Older Age Groups in Northern States of Peninsular Malaysia: The Role of Predisposing, Enabling and Need Factors.

    PubMed

    Samsudin, Shamzaeffa; Abdullah, Norehan

    2017-06-01

    Determining factors that affect healthcare utilization by the elderly is vital for the health system to be more responsive in providing care to this vulnerable group. The main objective of this paper is to identify the effect of the predisposing, enabling, and need factors on doctor visits and in-patient care for the elderly residing in the northern region of Malaysia. A multistage cluster sampling was used in selecting the sample for the study. A total of 1414 respondents aged 60 and over were interviewed face-to-face using a structured questionnaire. A probit model was used in estimating the utilization equations. At a significance level of 0.05, except for age, all predisposing and enabling factors were not statistically significant in affecting the doctor visits. On the other hand, being a male, smoker, medical insurance holder or had not actively involved in social interaction within the reference period increases the likelihood of being in-patient. Health-related variables remain the most significant factors that determine healthcare utilization, including both doctor visits and in-patient stays, in the area of study, which suggests that government policies to improve population health may influence the level of healthcare use in the future.

  6. Diagnosis and medical treatment of otitis externa in the dog and cat.

    PubMed

    Jacobson, L S

    2002-12-01

    Otitis externa is no longer viewed as an isolated disease of the ear canal, but is a syndrome that is often a reflection of underlying dermatological disease. Causes are classified as predisposing (increase the risk of otitis); primary (directly induce otitis), secondary (contribute to otitis only in an abnormal ear or in conjunction with predisposing factors) and perpetuating (result from inflammation and pathology in ear, prevent resolution of otitis). Common primary causes include foreign bodies, hypersensitivity (particularly atopy and food allergy), keratinisation disorders (most commonly primary idiopathic seborrhoea and hypothyroidism) and earmites, particularly in cats. A systematic diagnostic procedure is required to identify causes and contributing factors. This should include history, clinical examination, otoscopy and cytology in all cases and culture and sensitivity as well as otitis media assessment and biopsy in severe and recurrent cases. Ancillary tests may be required depending on the underlying cause. Treatment consists of identifying and addressing predisposing and primary factors; cleaning the ear canal; topical therapy; systemic therapy where necessary; client education; follow-up; and preventive and maintenance therapy as required.

  7. Assessing factors that may predispose Minnesota farms to wolf predation on cattle

    USGS Publications Warehouse

    Mech, L.D.; Harper, E.K.; Meier, T.J.; Paul, W.J.

    2000-01-01

    Wolf (Canis lupus) depredations on livestock cause considerable conflict and expense in Minnesota. Furthermore, claims are made that such depredations are fostered by the type of animal husbandry practiced. Thus, we tried to detect factors that might predispose farms in Minnesota to wolf depredations. We compared results of interviews with 41 cattle farmers experiencing chronic cattle losses to wolves (chronic farms) with results from 41 nearby matched farms with no wolf losses to determine farm characteristics or husbandry practices that differed and that therefore might have affected wolf depredations. We also used a Geographic Information System (GIS) to detect any habitat differences between the 2 types of farms. We found no differences between chronic and matched farms in the 11 farm characteristics and management practices that we surveyed, except that farms with chronic losses were larger, had more cattle, and had herds farther from human dwellings. Habitat types were the same around farms with and without losses. The role of proper carcass disposal as a possible factor predisposing farms to wolf depredations remains unclear

  8. Community-acquired adult Escherichia coli meningitis leading to diagnosis of unrecognized retropharyngeal abscess and cervical spondylodiscitis: a case report.

    PubMed

    Kohlmann, Rebekka; Nefedev, Andrey; Kaase, Martin; Gatermann, Sören G

    2015-12-12

    Escherichia coli is a rare cause of community-acquired meningitis in adults unless predisposing factors are present (e.g., previous penetrating cranio-cerebral injury or neurosurgery, immunosuppression, chronic alcoholism, history of cancer, diabetes mellitus, advanced age). We describe the case of a 53-year-old woman, resident in Germany, suffering from community-acquired bacterial meningitis caused by CTX-M-9 type extended spectrum β-lactamase producing Escherichia coli. Because typical predisposing factors were not apparent, pathogen identification resulted in expanded diagnostics to exclude a distant or contiguous primary focus. By magnetic resonance tomography, a previously unrecognized large retropharyngeal abscess with cervical spondylodiscitis was detected. In retrospect, the patient had complained about neck pain for a few weeks prior to meningitis onset, but the symptoms were interpreted as being related to a herniated disk. Meningitis and osteomyelitis resolved completely under surgical treatment and meropenem therapy. In case of adult Escherichia coli meningitis, underlying diseases should always be carefully excluded, especially if predisposing factors are not apparent.

  9. The Influence of Predisposing, Enabling and Need Factors on Condom Use in Ivory Coast

    ERIC Educational Resources Information Center

    Ngamini Ngui, Andre

    2010-01-01

    The main objective of this study was to identify key determinants of condom use in Ivory Coast. Data stem from Ivory Coast Demographic Health Survey (DHS) conducted by ORC Macro in 2005 among a representative sample of 9,686 persons aged 15 - 49. Following the behavioral model, we use logistic regression to assess the effect of predisposing,…

  10. A comparative analysis of North American adolescent and adult mass murderers.

    PubMed

    Meloy, J Reid; Hempel, Anthony G; Gray, B Thomas; Mohandie, Kris; Shiva, Andrew; Richards, Thomas C

    2004-01-01

    Thirty adult mass murderers and 34 adolescent mass murderers in North America are compared on both offender and offense variables to delineate similarities and differences. Findings indicate a plethora of psychiatric disturbances and odd/reclusive and acting-out personality traits. Predisposing factors include a fascination with weapons and war among many of the adolescents and the development of a "warrior mentality" in most of the adults. Precipitating factors indicate a major rejection or loss in the hours or days preceding the mass murder. Results are interpreted through the lens of threat assessment for targeted violence (Borum, Fein, Vossekuil, & Bergland 1999), recognizing that a fact-based, dynamic behavioral approach is most useful for mitigating risk of such an extremely low-base-rate violent crime. Copyright 2004 John Wiley & Sons, Ltd.

  11. Barriers and enablers to proper diabetic foot care amongst community dwellers in an Asian population: a qualitative study

    PubMed Central

    Cuttilan, Amit Nirmal; Pearce, Christopher J.

    2017-01-01

    Background Diabetic foot complications are common within Asian populations. They arise due to poor diabetic control and foot care. In this study, we aimed to identify the causes for proper and improper diabetic foot care. Methods A qualitative study consisting of key informant interviews with 17 healthcare professionals, including doctors and various allied health workers, was conducted. Participants included had at least five years of caring for diabetic foot patients either in public institutions or private clinics. Data collected was analyzed via thematic analysis. Results Diabetic patients were generally observed to have a mixture of proper and improper information and beliefs which eventually resulted in the extent of proper foot care. Factors which influenced the extent of proper and improper state of information and beliefs were classified into predisposing and precipitating factors. Predisposing factors were further categorised into modifiable factors (e.g., education level, socioeconomic status, social support) and non-modifiable factors (e.g., age, presence and severity of co-morbidities restricting ability to selfcare, past experiences). Precipitating factors were categorized into patient factors (e.g., degree of reception of information, presence of psychological barriers), provider factors (presence and degree of multi-disciplinary approach to care, presence of administrative inconveniences) and disease factors (presence of diabetic sensory neuropathy, complexity of disease process). Conclusions The extent of proper foot care amongst diabetic patients is influenced by numerous predisposing and precipitating factors. Further studies can look at further development of the described structure as well as quantitatively defining the various components and factors which make up the described system. PMID:28706922

  12. E-mental health care among young adults and help-seeking behaviors: a transversal study in a community sample.

    PubMed

    Younes, Nadia; Chollet, Aude; Menard, Estelle; Melchior, Maria

    2015-05-15

    The Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete. In a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care. Using data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen's behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents' income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not. Overall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03). E-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.

  13. Acute Intraoperative Pulmonary Aspiration

    PubMed Central

    Nason, Katie S.

    2015-01-01

    Synopsis Acute intraoperative aspiration is a potentially fatal complication with significant associated morbidity. Patients undergoing thoracic surgery are at increased risk for anesthesia-related aspiration, largely due to the predisposing conditions associated with this complication. Awareness of the risk factors, predisposing conditions, maneuvers to decrease risk and immediate management options by both the thoracic surgeon and the anesthesia team is imperative to reducing risk and optimizing patient outcomes associated with acute intraoperative pulmonary aspiration. Based on the root-cause analyses that many of the aspiration events can be traced back to provider factors, having an experienced anesthesiologist present for high-risk cases is also critical. PMID:26210926

  14. [Alexithymia--definition, causes and participation in the etiology of diseases].

    PubMed

    Orzechowska, Agata; Denys, Katarzyna; Gałecki, Piotr

    2014-08-01

    Alexithymia leads to an inability to recognize and identity feelings, use of language to describe the feelings and the inability to distinguish between emotions and bodily symptoms. Is treated as a stable personality trait, which along with other personality factors predispose to presence a variety of mental and physical diseases. Alexithymia is considered to be a personality trait which together with other environmental factors predispose to worsening of somatic diseases and may contribute to the emergence of mental disorders. The direction of this dependence is not exactly known for heterogeneity alexythymia etiology, and therefore requires further studies.

  15. [Tinnitus and temporomandibular joint: State of the art].

    PubMed

    Lina-Granade, G; Truy, E; Ionescu, E; Garnier, P; Thai Van, H

    2016-12-01

    Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Predictors of healthcare utilization among older Mexican Americans.

    PubMed

    Al Snih, Soham; Markides, Kyriakos S; Ray, Laura A; Freeman, Jean L; Ostir, Glenn V; Goodwin, James S

    2006-01-01

    To examine the effects of predisposing, enabling, and need factors on physician and hospital use among older Mexican Americans. A two-year prospective cohort study. Five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California. A population-based sample of 1987 non-institutionalized Mexican American men and women age > or =65 years. Physician and hospital utilization. Predictor variables included predisposing, enabling, and need factors. Ordinary least square and logistic regression analysis were used to model the effects of predictor factors specified in the Andersen model of health service use on physician and hospital use. After two years of follow-up, predisposing and enabling factors accounted for <5% of the variance in physician and hospital use. Need factors explained 21% of the variance in physician use and 7% of the variance in hospital use. Older age; being female; insurance coverage; having arthritis, diabetes, heart attack, hypertension, stroke, or cancer; and number of medications were factors associated with higher physician utilization. Subjects with arthritis, diabetes, hip fracture, high depressive symptoms, activities of daily living (ADL) disability, or high number of medications increased the odds of having any hospitalization. Subjects with diabetes, heart attack, hip fracture, ADL disabled, and high number of medications had a greater number of hospital nights than their counterparts. Older age, female sex, insurance coverage, and prevalent medical conditions are determinants of healthcare use among older Mexican Americans.

  17. Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases

    PubMed Central

    Bourcier, T; Thomas, F; Borderie, V; Chaumeil, C; Laroche, L

    2003-01-01

    Aim: To identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in current practice. Methods: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected. Results: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6% of cases. Contact lens wear was the main risk factor (50.3%). Trauma or a history of keratopathy was found in 15% and 21% of cases, respectively. An organism was identified in 201 eyes (68%). 83% of the infections involved Gram positive bacteria, 17% involved Gram negative bacteria, and 2% were polymicrobial. Gram negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). 99% of ulcers resolved with treatment, but only 60% of patients had visual acuity better than the level at admission, and 5% had very poor visual outcome. Conclusions: Contact lens wear is the most important risk factor. Most community acquired bacterial ulcers resolve with appropriate treatment. PMID:12812878

  18. [Cognitive and emotional alterations in chronic insomnia].

    PubMed

    Medrano-Martínez, Pablo; Ramos-Platón, María J

    2016-02-16

    Little is known about the cognitive and emotional alterations associated with chronic insomnia. After reviewing the aetiology and pathophysiology of chronic insomnia, taking into account the patient's vulnerability and its inheritability, this study reports on the knowledge currently held about the cognitive deficits and emotional alterations observed in patients with chronic insomnia. Most aetiological models include factors that predispose an individual to insomnia, as well as precipitating and maintaining it. Predisposing factors can be of a biological or psychosocial nature. One predisposing factor that plays an important role is the vulnerability to insomnia, which is related to a non-adaptive way of coping with stress (focused on the emotion rather than on the problem) and the internalisation of negative emotions, which favours a state of physiological, cognitive and emotional hyperactivation that disrupts sleep and may lead to insomnia. This vulnerability is largely hereditary. Two phenotypes, based on the objective duration of sleep, have been described, the difference between them being the severity of the disorder. Insomniacs with an objective sleep time below six hours present significant cognitive deficits. These become manifest in tasks that require a large number of cognitive resources, complex attention tasks, changes in the focus of attention, the process of consolidation of memory during sleep, and working memory. These data suggest the existence of a prefrontal dysfunction. Comorbidity between insomnia and anxiety-depression is high. The anxiety-depression triggered by the internalisation of emotions predisposes the individual to insomnia and this, in turn, intensifies the depression.

  19. Nipple Pain Incidence, the Predisposing Factors, the Recovery Period After Care Management, and the Exclusive Breastfeeding Outcome.

    PubMed

    Puapornpong, Pawin; Paritakul, Panwara; Suksamarnwong, Maysita; Srisuwan, Siriwan; Ketsuwan, Sukwadee

    2017-04-01

    Nipple pain is the most common complaint of breastfeeding mothers during the immediate postpartum period. Persistent nipple pain is associated with low breastfeeding rate at 6 months postpartum. To further explore the incidence of nipple pain, associated predisposing factors, time for recovery after management, and the impact on exclusive breastfeeding rates. Included in this study were 1,649 singleton, pregnant women who delivered and had their 1-week follow-up at the breastfeeding clinic during the period of January 2013 to December 2015. The mothers who experienced nipple pain were analyzed for the incidence, the predisposing factors, and the recovery period after care management. The breastfeeding outcome comparison of both, mothers with and without pain, was measured by the exclusive breastfeeding rate at the sixth week postpartum. The incidence of nipple pain was at 9.6% by day 7. A predisposing factor of nipple pain was primiparity (relative risk = 1.8, 95% confidence interval 1.3-2.5). The reasons for nipple pain were inappropriate positioning and latching (72.3%), tongue-tie (23.2%), and oversupply (4.4%). The recovery period after care management was 1-2 weeks. There were no statistically significant differences between the 6-week exclusive breastfeeding rates of the mothers with nipple pain with treatment and the mothers without nipple pain. Persistent nipple pain was a common problem. The active management, including early detection and treatment, would help the mothers recover within a 2-week period and there was no significant difference of exclusive breastfeeding rates between the mothers who had early care management and the mothers without nipple pain.

  20. Juvenile and adult-onset psychogenic non-epileptic seizures.

    PubMed

    Asadi-Pooya, Ali A; Emami, Mehrdad

    2013-09-01

    Psychogenic non-epileptic seizures (PNES) tend to begin in adolescence and young adulthood, although the seizures can occur in a wide range of ages. In the current study, we investigated the age of onset in patients with PNES and tried to determine the correlation between the age of onset and the demographic and clinical characteristics and factors potentially predisposing to PNES. In this cross-sectional study, all patients with a clinical diagnosis of PNES were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences from 2008 to 2012. We dichotomized the patients into two groups; those with age of onset below 18 years (juvenile), and those with age of onset at 18-55 years (adult-onset). We studied the demographic and clinical characteristics and factors potentially predisposing to PNES between these two groups. Statistical analyses were performed using Chi square and Fisher's Exact tests and Mann-Whitney U test. Fifty-seven patients with juvenile and 129 people with adult-onset PNES were studied. Demographic characteristics of these two groups were not different significantly. Seizure characteristics and semiology in these two groups were not significantly different either. However, factors potentially predisposing to PNES were significantly different between these two groups. History of being abused, academic failure, epilepsy or family history of epilepsy were more frequently observed in juvenile PNES, while medical comorbidities were more frequent among patients with adult-onset PNES. Age of onset of PNES is not correlated with the clinical manifestations; however, factors potentially predisposing to PNES are significantly different in patients with juvenile compared to those with adult-onset PNES. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Autoantibodies in dilated cardiomyopathy induce vascular endothelial growth factor expression in cardiomyocytes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Saygili, Erol, E-mail: erol.saygili@med.uni-duesseldorf.de; Noor-Ebad, Fawad; Schröder, Jörg W.

    2015-09-11

    Background: Autoantibodies have been identified as major predisposing factors for dilated cardiomyopathy (DCM). Patients with DCM show elevated serum levels of vascular endothelial growth factor (VEGF) whose source is unknown. Besides its well-investigated effects on angiogenesis, evidence is present that VEGF signaling is additionally involved in fibroblast proliferation and cardiomyocyte hypertrophy, hence in cardiac remodeling. Whether autoimmune effects in DCM impact cardiac VEGF signaling needs to be elucidated. Methods: Five DCM patients were treated by the immunoadsorption (IA) therapy on five consecutive days. The eluents from the IA columns were collected and prepared for cell culture. Cardiomyocytes from neonatal ratsmore » (NRCM) were incubated with increasing DCM-immunoglobulin-G (IgG) concentrations for 48 h. Polyclonal IgG (Venimmun N), which was used to restore IgG plasma levels in DCM patients after the IA therapy was additionally used for control cell culture purposes. Results: Elevated serum levels of VEGF decreased significantly after IA (Serum VEGF (ng/ml); DCM pre-IA: 45 ± 9.1 vs. DCM post–IA: 29 ± 6.7; P < 0.05). In cell culture, pretreatment of NRCM by DCM-IgG induced VEGF expression in a time and dose dependent manner. Biologically active VEGF that was secreted by NRCM significantly increased BNP mRNA levels in control cardiomyocytes and induced cell-proliferation of cultured cardiac fibroblast (Fibroblast proliferation; NRCM medium/HC-IgG: 1 ± 0.0 vs. NRCM medium/DCM-IgG 100 ng/ml: 5.6 ± 0.9; P < 0.05). Conclusion: The present study extends the knowledge about the possible link between autoimmune signaling in DCM and VEGF induction. Whether this observation plays a considerable role in cardiac remodeling during DCM development needs to be further elucidated. - Highlights: • Mechanisms of remodeling in dilated cardiomyopathy (DCM) are not fully understood. • Autoantibodies have been identified as major predisposing factors for DCM. • DCM patients show high serum levels of VEGF. • Recent data indicate that VEGF is involved in cardiac remodeling processes. • Whether autoimmune processes in DCM are involved in VEGF signaling are unclear.« less

  2. Are prostatic calculi independent predictive factors of lower urinary tract symptoms?

    PubMed

    Park, Sung-Woo; Nam, Jong-Kil; Lee, Sang-Don; Chung, Moon-Kee

    2010-03-01

    We determined the correlation between prostatic calculi and lower urinary tract symptoms (LUTS), as well as the predisposing factors of prostatic calculi. Of the 1 527 patients who presented at our clinic for LUTS, 802 underwent complete evaluations, including transrectal ultrasonography, voided bladder-3 specimen and international prostatic symptoms score (IPSS). A total of 335 patients with prostatic calculi and 467 patients without prostatic calculi were divided into calculi and no calculi groups, respectively. Predictive factors of severe LUTS and prostatic calculi were determined using uni/multivariate analysis. The overall IPSS score was 15.7 +/- 9.2 and 14.1 +/- 9.2 in the calculi and no calculi group, respectively (P = 0.013). The maximum flow rate was 12.1 +/- 6.9 and 14.2 +/- 8.2 mL s(-1) in the calculi and no calculi group, respectively (P = 0.003). On univariate analysis for predicting factors of severe LUTS, differences on age (P = 0.042), prostatic calculi (P = 0.048) and prostatitis (P = 0.018) were statistically significant. However, on multivariate analysis, no factor was significant. On multivariate analysis for predisposing factors of prostatic calculi, differences on age (P < 0.001) and prostate volume (P = 0.001) were significant. To our knowledge, patients who have prostatic calculi complain of more severe LUTS. However, prostatic calculi are not an independent predictive factor of severe LUTS. Therefore, men with prostatic calculi have more severe LUTS not only because of prostatic calculi but also because of age and other factors. In addition, old age and large prostate volume are independent predisposing factors for prostatic calculi.

  3. Incidence and predisposing factors of phlebitis in a surgery department.

    PubMed

    Rego Furtado, Luís Carlos do

    This paper reports on a study conducted to determine the incidence of phlebitis related to peripheral cannulae, and its predisposing factors in a general surgery department. Phlebitis is a serious health problem that affects a large proportion of hospitalized patients receiving intravenous therapy. A data collection tool was developed based on the previous literature and was completed between 15 October and 30 November 2010 in a general surgery department. All patients with peripheral cannulae who fulfilled the inclusion criteria, and who agreed to participate in the study where monitored. This was a quantitative study, which used descriptive, inferential, and correlational analysis. A total of 171 patients and 286 peripheral cannulae were monitored. The average incidence of phlebitis was 61.5%, and factors such as diabetes and tobacco consumption were identified as relevant to the development of phlebitis. Other elements identified as predisposing to the development of phlebitis include administration of potassium chloride, the dwell time of the peripheral cannula, and the anatomical location of the cannula. Phlebitis associated with peripheral cannulae is still a current problem requiring knowledgeable staff who can prevent, recognize and act appropriately in a timely manner to minimize its severity.

  4. Recurrent candidal intertrigo: challenges and solutions

    PubMed Central

    Metin, Ahmet; Dilek, Nursel; Bilgili, Serap Gunes

    2018-01-01

    Intertrigo is a common inflammatory dermatosis of opposing skin surfaces that can be caused by a variety of infectious agents, most notably candida, under the effect of mechanical and environmental factors. Symptoms such as pain and itching significantly decrease quality of life, leading to high morbidity. A multitude of predisposing factors, particularly obesity, diabetes mellitus, and immunosuppressive conditions facilitate both the occurrence and recurrence of the disease. The diagnosis of candidal intertrigo is usually based on clinical appearance. However, a range of laboratory studies from simple tests to advanced methods can be carried out to confirm the diagnosis. Such tests are especially useful in treatment-resistant or recurrent cases for establishing a differential diagnosis. The first and key step of management is identification and correction of predisposing factors. Patients should be encouraged to lose weight, followed up properly after endocrinologic treatment and intestinal colonization or periorificial infections should be medically managed, especially in recurrent and resistant cases. Medical treatment of candidal intertrigo usually requires topical administration of nystatin and azole group antifungals. In this context, it is also possible to use magistral remedies safely and effectively. In case of predisposing immunosuppressive conditions or generalized infections, novel systemic agents with higher potency may be required. PMID:29713190

  5. Association between alterations in global DNA methylation and predisposing factors in diabetes: a high pressure liquid chromatography based study.

    PubMed

    Maghbooli, Z; Hossein-Nezhad, A; Larijani, B; Pasalar, P; Keshtkar, A A

    2015-08-01

    The aim of this study was to investigate the relationship between inter-individual global DNA methylation and diabetes predisposing factors. The 5-methyl cytosine content was assessed by reverse phase high pressure liquid chromatography (RP-HPLC) of peripheral blood leukocytes obtained from 178 type 2 diabetes patients to determine individual global DNA methylation status. There was a positive significant correlation between diabetes duration and DNA methylation levels (P=0.002) with increasing levels of DNA methylation associated with age (P=0.047). There was no significant correlation between DNA methylation levels and HbA1c (P=0.15). No significant differences were observed between patients with and without diabetes predisposing factors including: hypertension (P=0.772), dyslipidemia (P=0.617), insulin resistance (homeostatic model assessment index) (P=0.156) and obesity (P=0.609). As such, the duration of diabetes (>10 years) was the most important predictor of global DNA methylation levels in diabetic patients after adjusting for age and sex (P=0.023). Our findings indicate that chronic hyperglycemic exposure plays an independent role in global DNA methylation levels in type 2 diabetes patients.

  6. Hypoglycemia Induced by Insulin as a Triggering Factor of Cognitive Deficit in Diabetic Children

    PubMed Central

    Rodrigues Vilela, Vanessa; de Castro Ruiz Marques, Any; Schamber, Christiano Rodrigues

    2014-01-01

    This paper provides an overview of insulin-induced hypoglycemia as a triggering factor of cognitive deficit in children with type 1 diabetes mellitus. For this purpose, databases from 1961 to 2013 were used with the objective of detecting the primary publications that address the impact of hypoglycemia on cognitive performance of diabetic children. The results obtained from experimental animals were excluded. The majority of studies demonstrated that the cognitive deficit in diabetic children involves multiple factors including duration, intensity, severity, and frequency of hypoglycemia episodes. Additionally, age at the onset of type 1 diabetes also influences the cognitive performance, considering that early inception of the disease is a predisposing factor for severe hypoglycemia. Furthermore, the results suggest that there is a strong correlation between brain damage caused by hypoglycemia and cognitive deterioration. Therefore, a more cautious follow-up and education are needed to impede and treat hypoglycemia in children with diabetes mellitus. PMID:24790575

  7. Factors Associated with Mental Health Service Utilization among Korean American Immigrants

    PubMed Central

    Park, So-Youn; Cho, Sunhee; Park, Yeddi; Bernstein, Kunsook S.; Shin, Jinah K.

    2014-01-01

    This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. PMID:23417654

  8. Cerebrospinal Fluid Leak at Percutaneous Exit of Ventricular Catheter as a Crucial Risk Factor for External Ventricular Drainage-Related Infection in Adult Neurosurgical Patients.

    PubMed

    Park, Jaechan; Choi, Yeon-Ju; Ohk, Boram; Chang, Hyun-Ha

    2018-01-01

    The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected. Four of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit. A prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Risk factors and epidemiological characteristics of new neonatal porcine diarrhoea syndrome in four Danish herds

    PubMed Central

    2014-01-01

    Background The epidemiology of New Neonatal Porcine Diarrhoea Syndrome (NNPDS) was studied in four selected herds. A total of 941 new born piglets in 86 litters were evaluated for five consecutive days. NNPDS is a newly emerged syndrome, characterized by diarrhoea within the first week of life, which is un-responsive to antibiotics and not associated with known pathogens. The aetiology behind the syndrome is unknown, and specific risk factors predisposing piglets to develop NNPDS also remain to be determined. The study evaluated sow and piglet-level risk factors for developing NNPDS and described the epidemiologic characteristics within four herds previously diagnosed with the syndrome. NNPDS was defined as diarrhoea at any time-point during the second to fifth day of life. Results NNPDS was observed in a total of 60% (range: 39%-89%) of first parity piglets and 36% (range: 19-65%) of piglets born by mature sows. In total of 26% of piglets had liquid faeces on the day of birth. Approximately half of these piglets developed NNPDS. In the majority of cases (50-70% of cases within herds) symptoms started on the second or third day of life. Piglets in Herd 1 had12.8 times higher probability of developing NNPDS than piglets in Herd 4. First parity piglets had a 4.1 higher probability of developing NNPDS than piglets born by mature sows. Birth weight and faecal consistency on the day of birth were minor risk factors, each significant within one herd. Conclusions The most important factors associated with NNPDS were herd of origin and sow-parity. The reason for one of the herds experiencing a considerably more severe outbreak than the others was not explained by factors addressed in this study. The epidemiological pattern of diarrhoea varied a lot between herds; however, in all herds first parity piglets seemed predisposed. This association may be explained by an infectious background of the syndrome, but further studies are needed to explain this association. PMID:25012922

  10. Age-associated Pro-inflammatory Remodeling and Functional Phenotype in the Heart and Large Arteries

    PubMed Central

    Wang, Mingyi; Shah, Ajay M

    2015-01-01

    The aging population is increasing dramatically. Aging–associated stress simultaneously drives proinflammatory remodeling, involving angiotensin II and other factors, in both the heart and large arteries. The structural remodeling and functional changes that occur with aging include cardiac and vascular wall stiffening, systolic hypertension and suboptimal ventricular-arterial coupling, features that are often clinically silent and thus termed a silent syndrome. These age-related effects are the result of responses initiated by cardiovascular proinflammatory cells. Local proinflammatory signals are coupled between the heart and arteries due to common mechanical and humoral messengers within a closed circulating system. Thus, targeting proinflammatory signaling molecules would be a promising approach to improve age-associated suboptimal ventricular-arterial coupling, a major predisposing factor for the pathogenesis of clinical cardiovascular events such as heart failure. PMID:25665458

  11. Colorectal Cancer and Alcohol Consumption—Populations to Molecules

    PubMed Central

    Rossi, Marco; Usman, Ahmad; Keshavarzian, Ali; Bishehsari, Faraz

    2018-01-01

    Colorectal cancer (CRC) is a major cause of morbidity and mortality, being the third most common cancer diagnosed in both men and women in the world. Several environmental and habitual factors have been associated with the CRC risk. Alcohol intake, a common and rising habit of modern society, is one of the major risk factors for development of CRC. Here, we will summarize the evidence linking alcohol with colon carcinogenesis and possible underlying mechanisms. Some epidemiologic studies suggest that even moderate drinking increases the CRC risk. Metabolism of alcohol involves ethanol conversion to its metabolites that could exert carcinogenic effects in the colon. Production of ethanol metabolites can be affected by the colon microbiota, another recently recognized mediating factor to colon carcinogenesis. The generation of acetaldehyde and alcohol’s other metabolites leads to activation of cancer promoting cascades, such as DNA-adduct formation, oxidative stress and lipid peroxidation, epigenetic alterations, epithelial barrier dysfunction, and immune modulatory effects. Not only does alcohol induce its toxic effect through carcinogenic metabolites, but alcoholics themselves are predisposed to a poor diet, low in folate and fiber, and circadian disruption, which could further augment alcohol-induced colon carcinogenesis. PMID:29385712

  12. Functional abdominal pain disorders in children.

    PubMed

    Rajindrajith, Shaman; Zeevenhooven, Judith; Devanarayana, Niranga Manjuri; Perera, Bonaventure Jayasiri Crispus; Benninga, Marc A

    2018-04-01

    Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on epidemiology, pathophysiology, risk factors related to pathophysiology, clinical evaluation and management of children with FAPDs. Expert commentary: FAPDs are a worldwide problem with a pooled prevalence of 13.5%. There are a number of predisposing factors and pathophysiological mechanisms including stressful events, child maltreatment, visceral hypersensitivity, altered gastrointestinal motility and change in intestinal microbiota. It is possible that the environmental risk factors intricately interact with genes through epigenetic mechanisms to contribute to the pathophysiology. The diagnosis mainly depends on clinical evaluation. Commonly used pharmacological interventions do not play a major role in relieving symptoms. Centrally directed, nonpharmacological interventions such as hypnotherapy and cognitive behavioral therapy have shown both short and long term efficacy in relieving pain in children with FAPDs. However, these interventions are time consuming and need specially trained staff and therefore, not currently available at grass root level. Clinicians and researchers should join hands in searching for more pragmatic and effective therapeutic modalities to improve overall care of children with FAPDs.

  13. Gaps in patient care practices to prevent hospital-acquired delirium.

    PubMed

    Alagiakrishnan, Kannayiram; Marrie, Thomas; Rolfson, Darryl; Coke, William; Camicioli, Richard; Duggan, D'Arcy; Launhardt, Bonnie; Fisher, Bruce; Gordon, Debbie; Hervas-Malo, Marilou; Magee, Bernice; Wiens, Cheryl

    2009-10-01

    To evaluate the current patient care practices that address the predisposing and precipitating factors contributing to the prevention of hospital-acquired delirium in the elderly. Prospective cohort (observational) study. Patients 65 years of age and older who were admitted to medical teaching units at the University of Alberta Hospital in Edmonton over a period of 7 months and who were at risk of delirium. Medical teaching units at the University of Alberta. Demographic data and information on predisposing factors for hospital-acquired delirium were obtained for all patients. Documented clinical practices that likely prevent common precipitants of delirium were also recorded. Of the 132 patients enrolled, 20 (15.2%) developed hospital-acquired delirium. At the time of admission several predisposing factors were not documented (eg, possible cognitive impairment 16 [12%], visual impairment 52 [39.4%], and functional status of activities of daily living 99 [75.0%]). Recorded precipitating factors included catheter use, screening for dehydration, and medications. Catheters were used in 35 (26.5%) patients, and fluid intake-and-output charting assessed dehydration in 57 (43.2%) patients. At the time of admission there was no documentation of hearing status in 69 (52.3%) patients and aspiration risk in 104 (78.8%) patients. After admission, reorientation measures were documented in only 16 (12.1%) patients. Although all patients had brief mental status evaluations performed once daily, this was not noted to occur twice daily (which would provide important information about fluctuation of mental status) and there was no formal attention span testing. In this study, hospital-acquired delirium was also associated with increased mortality (P < .004), increased length of stay (P < .007), and increased institutionalization (P < .027). Gaps were noted in patient care practices that might contribute to hospital-acquired delirium and also in measures to identify the development of delirium at an earlier stage. Effort should be made to educate health professionals to identify the predisposing and precipitating factors, and to screen for delirium. This might improve the prevention of delirium.

  14. Is valve choice a significant determinant of paravalular leak post-transcatheter aortic valve implantation? A systematic review and meta-analysis.

    PubMed

    O'Sullivan, Katie E; Gough, Aideen; Segurado, Ricardo; Barry, Mitchel; Sugrue, Declan; Hurley, John

    2014-05-01

    Paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) is associated with poor survival. The two main valve delivery systems used to date differ significantly in both structure and deployment technique. The primary objective of this study was to perform a systematic review and meta-analysis of studies identifying PVR in patients post-TAVI using Medtronic CoreValve (MCV) and Edward Sapien (ES) valves in order to identify whether a significant difference exists between valve types. The secondary objective was to identify additional factors predisposing to PVR to provide an overview of the other associated considerations. A systematic review and meta-analysis of the current literature to identify PVR rate in patients with MCV and ES valves was performed. We also sought to examine other factors predisposing to PVR. A total of 5910 patients were identified from 9 studies. PVR rates for MCV and ES were analysed. MCV was associated with a higher PVR rate of 15.75% [95% confidence interval (CI) 12.48-19.32] compared with ES 3.93% [95% CI 1.05-8.38]. We separately reviewed predisposing factors associated with PVR. A formal comparison of the MCV and ES valve leakage rates by mixed-effects meta-regression with a fixed-effect moderator variable for valve type (MCV or ES) suggested a statistically significant difference in leakage rate between the two valve types (P = 0.0002). Unfavourable anatomical and pathological factors as well as valve choice have an impact on rates of PVR. Additionally, certain anatomical features dictate valve choice. A direct comparison of all the predisposing factors at this time is not possible and will require prospective multivariate analysis. There is, however, a significant difference in the PVR rates between valves based on the published observational data available to date. The ES valve associated with a lower incidence of PVR overall; therefore, we conclude that valve choice is indeed a significant determinant of PVR post-TAVI.

  15. Overtime Work as a Predictor of Major Depressive Episode: A 5-Year Follow-Up of the Whitehall II Study

    PubMed Central

    Virtanen, Marianna; Stansfeld, Stephen A.; Fuhrer, Rebecca; Ferrie, Jane E.; Kivimäki, Mika

    2012-01-01

    Background The association between overtime work and depression is still unclear. This study examined the association between overtime work and the onset of a major depressive episode (MDE). Methodology/Principal Findings Prospective cohort study with a baseline examination of working hours, psychological morbidity (an indicator of baseline depression) and depression risk factors in 1991–1993 and a follow-up of major depressive episode in 1997–1999 (mean follow-up 5.8 years) among British civil servants (the Whitehall II study; 1626 men, 497 women, mean age 47 years at baseline). Onset of 12-month MDE was assessed by the Composite International Diagnostic Interview (CIDI) at follow-up. In prospective analysis of participants with no psychological morbidity at baseline, the odds ratio for a subsequent major depressive episode was 2.43 (95% confidence interval 1.11 to 5.30) times higher for those working 11+ hours a day compared to employees working 7–8 hours a day, when adjusted for socio-demographic factors at baseline. Further adjustment for chronic physical disease, smoking, alcohol use, job strain and work-related social support had little effect on this association (odds ratio 2.52; 95% confidence interval 1.12 to 5.65). Conclusions/Significance Data from middle-aged civil servants suggest that working long hours of overtime may predispose to major depressive episodes. PMID:22295106

  16. Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. VI. Unusual Events in Urolithiasis: 1. Long-Standing Urethral Stones without Underlying Anatomical Abnormalities in Male Children.

    PubMed

    Gadelkareem, Rabea A; Shahat, Ahmed A; Abdelhafez, Mohamed F; Moeen, Ahmed M; Ibrahim, Abdelrady S; Safwat, Ahmed S

    2018-06-06

    The study aimed to present our center's experience with long-standing urethral stones in male children with normal urethra. Retrospective search of our center data was done for the cases of long-standing urethral stones with normal urethra in male children during the period July 2001 - June 2016. Demographic and clinical data were studied. Of more than 54,000 urolithiasis procedures, 17 male children (0.031%) were operated for long-standing urethral stones with normal urethra. In 14 cases (82.4%), residence was rural and parental education levels were low or none. All children were regularly prompted voiding with a history of difficulty or dysuria. All the stones lodged in the posterior urethra with an approximate mean duration of 2 months. The mean stone size of 11.29 ± 3.88 mm and rough surfaces in 88.2% of cases represented the main predisposing factors. Major complications included rectal prolapse in 1 case and vesicoureteral reflux in 3 cases. Endoscopic push-back was followed by disintegration in 76.5% or cystolithotomy in 17.7%, while it failed in 1 case that was treated by cystolithotomy. Long-standing urethral stones in male children with normal urethra are very rare misdiagnoses. Stone topography and sociocultural factors predisposed to their lodgments and negligence. Endoscopic treatment is the best approach. © 2018 S. Karger AG, Basel.

  17. Management of Dentin Hypersensitivity by National Dental Practice-Based Research Network practitioners: results from a questionnaire administered prior to initiation of a clinical study on this topic.

    PubMed

    Kopycka-Kedzierawski, Dorota T; Meyerowitz, Cyril; Litaker, Mark S; Chonowski, Sidney; Heft, Marc W; Gordan, Valeria V; Yardic, Robin L; Madden, Theresa E; Reyes, Stephanie C; Gilbert, Gregg H

    2017-01-13

    Dentin hypersensitivity (DH) is a common problem encountered in clinical practice. The purpose of this study was to identify the management approaches for DH among United States dentists. One hundred eighty five National Dental Practice-Based Research Network clinicians completed a questionnaire regarding their preferred methods to diagnose and manage DH in the practice setting, and their beliefs about DH predisposing factors. Almost all dentists (99%) reported using more than one method to diagnose DH. Most frequently, they reported using spontaneous patient reports coupled with excluding other causes of oral pain by direct clinical examination (48%); followed by applying an air blast (26%), applying cold water (12%), and obtaining patient reports after dentist's query (6%). In managing DH, the most frequent first choice was desensitizing, over-the-counter (OTC), potassium nitrate toothpaste (48%), followed by fluorides (38%), and glutaraldehyde/HEMA (3%). A total of 86% of respondents reported using a combination of products when treating DH, most frequently using fluoride varnish and desensitizing OTC potassium nitrate toothpaste (70%). The most frequent predisposing factor leading to DH, as reported by the practitioners, was recessed gingiva (66%), followed by abrasion, erosion, abfraction/attrition lesions (59%) and bruxism (32%). The majority of network practitioners use multiple methods to diagnose and manage DH. Desensitizing OTC potassium nitrate toothpaste and fluoride formulations are the most widely used products to manage DH in dental practice setting.

  18. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    PubMed

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  19. Ovarian Cancer Stroma: Pathophysiology and the Roles in Cancer Development

    PubMed Central

    Furuya, Mitsuko

    2012-01-01

    Ovarian cancer represents one of the cancers with the worst prognostic in adult women. More than half of the patients who present with clinical signs such as abdominal bloating and a feeling of fullness already show advanced stages. The majority of ovarian cancers grow as cystic masses, and cancer cells easily spread into the pelvic cavity once the cysts rupture or leak. When the ovarian cancer cells disseminate into the peritoneal cavity, metastatic nests may grow in the cul-de-sac, and in more advanced stages, the peritoneal surfaces of the upper abdomen become the next largest soil for cancer progression. Ascites is also produced frequently in ovarian cancers, which facilitates distant metastasis. Clinicopathologic, epidemiologic and molecular studies on ovarian cancers have improved our understanding and therapeutic approaches, but still further efforts are required to reduce the risks in the patients who are predisposed to this lethal disease and the mortality of the patients in advanced stages. Among various molecules involved in ovarian carcinogenesis, special genes such as TP53, BRCA1 and BRCA2 have been well investigated. These genes are widely accepted as the predisposing factors that trigger malignant transformation of the epithelial cells of the ovary. In addition, adnexal inflammatory conditions such as chronic salpingitis and ovarian endometriosis have been great research interests in the context of carcinogenic background of ovarian cancers. In this review, I discuss the roles of stromal cells and inflammatory factors in the carcinogenesis and progression of ovarian cancers. PMID:24213462

  20. Epigenomics of idiopathic pulmonary fibrosis

    PubMed Central

    Yang, Ivana V

    2012-01-01

    Idiopathic pulmonary fibrosis (IPF) is a complex lung disease of unknown etiology. Development of IPF is influenced by both genetic and environmental factors. Gene-expression profiling studies have taught us quite a bit about the biology of this fatal disease, but epigenetic marks may be the missing link that connects the environmental exposure in genetically predisposed individuals to transcriptome changes associated with the development of IPF. This review will begin with an introduction to the disease, followed by brief summaries of studies of gene expression in IPF and epigenetic marks associated with exposures relevant to IPF. The majority of the discussion will focus on epigenetic studies conducted so far in IPF, the limitations, challenges and future directions in this field. PMID:22449190

  1. Epigenomics of idiopathic pulmonary fibrosis.

    PubMed

    Yang, Ivana V

    2012-04-01

    Idiopathic pulmonary fibrosis (IPF) is a complex lung disease of unknown etiology. Development of IPF is influenced by both genetic and environmental factors. Gene-expression profiling studies have taught us quite a bit about the biology of this fatal disease, but epigenetic marks may be the missing link that connects the environmental exposure in genetically predisposed individuals to transcriptome changes associated with the development of IPF. This review will begin with an introduction to the disease, followed by brief summaries of studies of gene expression in IPF and epigenetic marks associated with exposures relevant to IPF. The majority of the discussion will focus on epigenetic studies conducted so far in IPF, the limitations, challenges nd future directions in this field.

  2. Is Balamuthia mandrillaris a public health concern worldwide?

    PubMed

    Lorenzo-Morales, Jacob; Cabello-Vílchez, Alfonso Martín; Martín-Navarro, Carmen M; Martínez-Carretero, Enrique; Piñero, José E; Valladares, Basilio

    2013-10-01

    Balamuthia mandrillaris is an opportunistic, free-living amoeba that can cause skin lesions and the typically fatal Balamuthia amoebic encephalitis (BAE) both in immunocompromised and immunocompetent individuals. Available data for BAE cases indicate that this disease is difficult to detect because knowledge of predisposing factors is lacking, causing a challenge for diagnosing BAE. The number of reported BAE cases is increasing worldwide, and this is a major concern because little is known about the pathogen, no standardized detection tools are available, and most of the treatments are almost empirical. The recently reported cases, novel diagnostics tools, and successful therapeutic approaches against BAE infections are reviewed here. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. The prevalence of the Wernicke-Korsakoff syndrome in Sydney, Australia: a prospective necropsy study.

    PubMed Central

    Harper, C; Gold, J; Rodriguez, M; Perdices, M

    1989-01-01

    In a prospective necropsy study, the prevalence of the Wernicke-Korsakoff syndrome (WKS) in Sydney, Australia was 2.1% of adults over the age of 15 years. The population studied encompassed a wide spectrum of socio-economic and cultural backgrounds. Abuse of alcohol appeared to be the major predisposing factor to the development of the WKS in cases which were adequately documented. This high prevalence rate is in line with other clinical and pathological Australian studies and provides additional support for the idea of prevention of the WKS by the use of thiamin supplements in the Australian diet in flour, bread and perhaps alcoholic beverages. PMID:2784828

  4. Explaining use of food parenting practices: the importance of predisposing factors and parental cognitions.

    PubMed

    Gevers, Dorus Wm; van Assema, Patricia; de Vries, Nanne K; Kremers, Stef Pj

    2017-09-01

    The high energy intake from energy-dense foods among children in developed countries is undesirable. Improving food parenting practices has the potential to lower snack intakes among children. To inform the development of interventions, we aimed to predict food parenting practice patterns around snacking (i.e. 'high covert control and rewarding', 'low covert control and non-rewarding', 'high involvement and supportive' and 'low involvement and indulgent'). A cross-sectional survey was conducted. To predict the patterns of food parenting practices, multinomial logistic regression analyses were run with 888 parents. Predictors included predisposing factors (i.e. parents' and children's demographics and BMI, parents' personality, general parenting, and parenting practices used by their own parents) and parents' cognitions (i.e. perceived behaviour of other parents, subjective norms, attitudes, self-efficacy and outcome expectations). The Netherlands (October-November 2014). Dutch parents of children aged 4-12 years old. After backward elimination, nineteen factors had a statistically significant contribution to the model (Nagelkerke R 2=0·63). Overall, self-efficacy and outcome expectations were among the strongest explanatory factors. Considering the predisposing factors only, the general parenting factor nurturance most strongly predicted the food parenting clusters. Nurturance particularly distinguished highly involved parents from parents employing a pattern of low involvement. Parental cognitions and nurturance are important factors to explain the use of food parenting practices around snacking. The results suggest that intervention developers should attempt to increase self-efficacy and educate parents about what constitute effective and ineffective parenting practices. Promoting nurturance might be a prerequisite to achieve prolonged change.

  5. Antioxidant and anti-inflammatory medicinal plants have potential role in the treatment of cardiovascular disease: a review.

    PubMed

    Adegbola, Peter; Aderibigbe, Ifewumi; Hammed, Wasiu; Omotayo, Tolulope

    2017-01-01

    Cardiovascular disease is a compound name for clusters of disorders afflicting the heart and blood vessels; it is assuming an increasing role as a major cause of morbidity and mortality. Unhealthy practices such as smoking, high intake of saturated fat and cholesterol, diabetes and physical inactivity are predisposing factors. The risk factors cause alteration in vascular integrity, compromised membrane integrity, increase free radical generation and reduced endogenous antioxidant system resulting in oxidative stress. Substance with ability to maintain vascular integrity, prevent, or reduce radical formation are able to treat cardiovascular disease. Conventional drugs in use to this effect are with side effect and as alternative, medicinal plants are increasingly gaining acceptance from the public and medical professionals. Reports have shown that bioactive compounds in plants with antioxidant, anti-inflammatory, ability to protect vascular endothelium, prevent lipid oxidation, and augment endogenous antioxidant system are cardioprotective. Phenolics and flavonoids in medicinal plants have been widely reported to play these major roles. This study reviewed the role of bioactive compounds in medicinal plants using a wide range database search.

  6. Antioxidant and anti-inflammatory medicinal plants have potential role in the treatment of cardiovascular disease: a review

    PubMed Central

    Adegbola, Peter; Aderibigbe, Ifewumi; Hammed, Wasiu; Omotayo, Tolulope

    2017-01-01

    Cardiovascular disease is a compound name for clusters of disorders afflicting the heart and blood vessels; it is assuming an increasing role as a major cause of morbidity and mortality. Unhealthy practices such as smoking, high intake of saturated fat and cholesterol, diabetes and physical inactivity are predisposing factors. The risk factors cause alteration in vascular integrity, compromised membrane integrity, increase free radical generation and reduced endogenous antioxidant system resulting in oxidative stress. Substance with ability to maintain vascular integrity, prevent, or reduce radical formation are able to treat cardiovascular disease. Conventional drugs in use to this effect are with side effect and as alternative, medicinal plants are increasingly gaining acceptance from the public and medical professionals. Reports have shown that bioactive compounds in plants with antioxidant, anti-inflammatory, ability to protect vascular endothelium, prevent lipid oxidation, and augment endogenous antioxidant system are cardioprotective. Phenolics and flavonoids in medicinal plants have been widely reported to play these major roles. This study reviewed the role of bioactive compounds in medicinal plants using a wide range database search. PMID:28533927

  7. Dating violence and suicidal behavior in adolescents.

    PubMed

    Holmes, Kristin; Sher, Leo

    2013-01-01

    The aim of this paper is to assess the possible consequences of adolescent physical, emotional and sexual dating violence through a review of the literature on the topic. An electronic search of major biomedical bibliographic databases (Pubmed, ISI, PsycINFO) was used to retrieve articles providing information on the prevalence rates, risk factors, associated consequences and possible preventive measures for adolescent dating violence across different populations. Currently, there have been few longitudinal studies conducted to identify potential risk factors for entering a violent dating relationship in adolescence. Risky behaviors such as early sexual intercourse may predispose someone for victimization. Dating violence itself is also a predictor of future dating violence. Adolescent dating violence was associated with an increase in other violence-related behaviors, substance use, depression, poorer educational outcomes, posttraumatic stress, unhealthy weight control and risky sexual behavior. The association between adolescent dating violence and an increase in suicidal behavior is a major public health concern. Future research should focus on longitudinal studies so that a causal relationship between dating violence and suicidality may be better understood.

  8. Socioeconomic, demographic study on substance abuse among students of professional college in a southern town, Berhampur of Odisha state (India).

    PubMed

    Mohanty, Sachidananda; Tripathy, Radhamadhab; Palo, Subrat Kumar; Jena, Dhaneswari

    2013-11-01

    Currently there is an increasing trend of substance abuse in developing countries like India. This study attempted to identify the different predisposing factors, associated psycho-social and medical problems, prevalence and types of substance abuse in students. The study covered a cross-section of 720 students with an overall male to female ratio of 4.1:1. The majority of the sufferers were from middle socioeconomic class, aged between 15 and 19 years. Common substances of abuse were chewable tobacco and cannabis. The risk of abuse was more in hostellers hailing from broken families (62.5%). Friends had the highest influence (59%). Most of them (49.4%) tried multiple times to give up, but peer pressure (53%) compelled them to restart. In 60.8% cases the parents were completely unaware about this behavior. The commonly associated problems were psychological (34.3%) and medical (29.5%). Our study at the end points out major risk factors and their remedial measures to curb substance abuse. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  9. Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting.

    PubMed

    Ofori, Sandra N; Unachukwu, Chioma N

    2014-01-01

    Diabetes mellitus (DM) is a chronic, progressive metabolic disorder with several complications that affect virtually all the systems in the human body. Type 2 DM (T2DM) is a major risk factor for cardiovascular disease (CVD). The management of T2DM is multifactorial, taking into account other major modifiable risk factors, like obesity, physical inactivity, smoking, blood pressure, and dyslipidemia. A multidisciplinary team is essential to maximize the care of individuals with DM. DM self-management education and patient-centered care are the cornerstones of management in addition to effective lifestyle strategies and pharmacotherapy with individualization of glycemic goals. Robust evidence supports the effectiveness of this approach when implemented. Individuals with DM and their family members usually share a common lifestyle that, not only predisposes the non-DM members to developing DM but also, increases their collective risk for CVD. In treating DM, involvement of the entire family, not only improves the care of the DM individual but also, helps to prevent the risk of developing DM in the family members.

  10. Glomerular Diseases: Emerging Tests and Therapies for IgA Nephropathy

    PubMed Central

    Kiryluk, Krzysztof; Appel, Gerald B.

    2014-01-01

    Summary The last decade has seen major progress in understanding the pathogenesis as well as the prognosis and treatment of patients with IgA nephropathy (IgAN). Although the diagnostic criterion of a kidney biopsy demonstrating dominant or codominant IgA deposition remains unchanged, much more is known about the genetic and environmental factors predisposing to disease development and progression. These advances have led to the identification of novel diagnostic and prognostic markers. Among the most promising clinically are genetic profiling, quantification of galactose-deficient IgA1 levels, and measurement of anti-IgA1 immunoglobulins. While targeted treatment for IgAN remains elusive, there is mounting evidence for therapeutic interventions that alter the disease course. The appropriate validation and integration of these discoveries into clinical care represent a major challenge, but one that holds tremendous promise for refining prognostication, guiding therapy, and improving the lives of patients with IgAN. PMID:24071652

  11. Glomerular diseases: emerging tests and therapies for IgA nephropathy.

    PubMed

    Canetta, Pietro A; Kiryluk, Krzysztof; Appel, Gerald B

    2014-03-01

    The last decade has seen major progress in understanding the pathogenesis as well as the prognosis and treatment of patients with IgA nephropathy (IgAN). Although the diagnostic criterion of a kidney biopsy demonstrating dominant or codominant IgA deposition remains unchanged, much more is known about the genetic and environmental factors predisposing to disease development and progression. These advances have led to the identification of novel diagnostic and prognostic markers. Among the most promising clinically are genetic profiling, quantification of galactose-deficient IgA1 levels, and measurement of anti-IgA1 immunoglobulins. While targeted treatment for IgAN remains elusive, there is mounting evidence for therapeutic interventions that alter the disease course. The appropriate validation and integration of these discoveries into clinical care represent a major challenge, but one that holds tremendous promise for refining prognostication, guiding therapy, and improving the lives of patients with IgAN.

  12. Are prostatic calculi independent predictive factors of lower urinary tract symptoms?

    PubMed Central

    Park, Sung-Woo; Nam, Jong-Kil; Lee, Sang-Don; Chung, Moon-Kee

    2010-01-01

    We determined the correlation between prostatic calculi and lower urinary tract symptoms (LUTS), as well as the predisposing factors of prostatic calculi. Of the 1 527 patients who presented at our clinic for LUTS, 802 underwent complete evaluations, including transrectal ultrasonography, voided bladder-3 specimen and international prostatic symptoms score (IPSS). A total of 335 patients with prostatic calculi and 467 patients without prostatic calculi were divided into calculi and no calculi groups, respectively. Predictive factors of severe LUTS and prostatic calculi were determined using uni/multivariate analysis. The overall IPSS score was 15.7 ± 9.2 and 14.1 ± 9.2 in the calculi and no calculi group, respectively (P = 0.013). The maximum flow rate was 12.1 ± 6.9 and 14.2 ± 8.2 mL s−1 in the calculi and no calculi group, respectively (P = 0.003). On univariate analysis for predicting factors of severe LUTS, differences on age (P = 0.042), prostatic calculi (P = 0.048) and prostatitis (P = 0.018) were statistically significant. However, on multivariate analysis, no factor was significant. On multivariate analysis for predisposing factors of prostatic calculi, differences on age (P < 0.001) and prostate volume (P = 0.001) were significant. To our knowledge, patients who have prostatic calculi complain of more severe LUTS. However, prostatic calculi are not an independent predictive factor of severe LUTS. Therefore, men with prostatic calculi have more severe LUTS not only because of prostatic calculi but also because of age and other factors. In addition, old age and large prostate volume are independent predisposing factors for prostatic calculi. PMID:19966831

  13. Coexisting ankylosing spondylitis and rheumatoid arthritis: a case report with literature review.

    PubMed

    Guo, Ying-Ying; Yang, Li-Li; Cui, Hua-Dong; Zhao, Shuai; Zhang, Ning

    2011-10-01

    A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated. The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis. This patient was HLA-B27 and HLA-DR4 positive, and ankylosing spondylitis manifested before rheumatoid arthritis. After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby. One year later, she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis. We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis, and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.

  14. Restoring Psychology's Role in Peptic Ulcer

    PubMed Central

    Overmier, J Bruce; Murison, Robert

    2013-01-01

    This paper reviews the history of the transition from the belief that gastrointestinal ulcers are caused primarily by psychological factors to the current state of belief that they are caused primarily by infection and argues that neither is fully accurate. We argue that psychological factors play a significant role as predisposing to vulnerability, modulating of precipitation, and sustaining of gastric ulceration. We review data that challenge the assumption of a simple infectious disease model and adduce recent preclinical data that confirm the predisposing, modulatory, and sustaining roles for psychological factors. We note that others, too, are now challenging the adequacy of the contemporary simple bacterial infection model. We hope to replace the competition between psychology and medicine with cooperation in understanding and treating patients suffering gastric ulceration and ulcer. PMID:23457084

  15. Predisposition Factors in Anorexia Nervosa.

    ERIC Educational Resources Information Center

    Nagel, K. L.; Jones, Karen H.

    1992-01-01

    Reviews literature concerned with investigating psychiatric disturbances and genetic variables hypothesized as predisposing factors in etiology of anorexia nervosa. Gives particular emphasis to research which discusses association between anorexia nervosa and depression. Reviews psychopharmacological evidence and family genetics studies. Offers…

  16. Application of the PRECEDE model to understanding mental health promoting behaviors in Hong Kong.

    PubMed

    Mo, Phoenix K H; Mak, Winnie W S

    2008-08-01

    The burdens related to mental illness have been increasingly recognized in many countries. Nevertheless, research in positive mental health behaviors remains scarce. This study utilizes the Predisposing, Reinforcing, and Enabling Causes in Education Diagnosis and Evaluation (PRECEDE) model to identify factors associated with mental health promoting behaviors and to examine the effects of these behaviors on mental well-being and quality of life among 941 adults in Hong Kong. Structural equation modeling shows that sense of coherence (predisposing factor), social support (reinforcing factor), and daily hassles (enabling factor) are significantly related to mental health promoting behaviors, which are associated with mental well-being and quality of life. Results of bootstrap analyses confirm the mediating role of mental health promoting behaviors on well-being and quality of life. The study supports the application of the PRECEDE model in understanding mental health promoting behaviors and demonstrates its relationships with well-being and quality of life.

  17. Risk Factors for Heat-related Illness in U.S. Workers: An OSHA Case Series.

    PubMed

    Tustin, Aaron W; Cannon, Dawn L; Arbury, Sheila B; Thomas, Richard J; Hodgson, Michael J

    2018-05-30

    The aim of this study was to describe risk factors for heat-related illness (HRI) in U.S. workers. We reviewed a subset of HRI enforcement investigations conducted by the Occupational Safety and Health Administration (OSHA) from 2011 through 2016. We assessed characteristics of the workers, employers, and events. We stratified cases by severity to assess whether risk factors were more prevalent in fatal HRIs. We analyzed 38 investigations involving 66 HRIs. Many workers had predisposing medical conditions or used predisposing medications. Comorbidities were more prevalent in workers who died. Most (73%) fatal HRIs occurred during the first week on the job. Common clinical findings in heat stroke cases included multiorgan failure, muscle breakdown, and systemic inflammation. Severe HRI is more likely when personal susceptibilities coexist with work-related and environmental risk factors. Almost all HRIs occur when employers do not adhere to preventive guidelines.

  18. Factors Associated with HIV Viral Load in a Respondent Driven Sample in Los Angeles

    PubMed Central

    King, WD; Larkins, S; Hucks-Ortiz, C; Wang, J; Gorbach, P; Veniegas, R; Shoptaw, S

    2008-01-01

    This study used a modified version of the Behavioral Model for Vulnerable Populations to examine the predisposing, enabling, and need factors associated with detectable viral load (VL). HIV status was measured using saliva and confirmed by blood. Of 835 persons enrolled, 193 were HIV positive and provided VL counts. A multistage logistic regression demonstrated that the predisposing factors of homelessness and recent substance abuse, particularly methamphetamine abuse, had a negative association with VL. The negative association of homelessness was lessened with the introduction of enabling and need utilization factors in the model. In contrast, the negative association with recent substance abuse on VL was sustained in the final model. Provision of HIV care and medications attenuated the negative association of homelessness within this sample. Guided policy to address substance abuse among those who are HIV positive is needed to improve biological outcomes. PMID:18064555

  19. Risk factors for systemic reactions to bee venom in British beekeepers.

    PubMed

    Richter, Alex G; Nightingale, Peter; Huissoon, Aarnoud P; Krishna, Mamidipudi T

    2011-02-01

    There is a high incidence of systemic reactions (SRs) to bee stings in beekeepers, but the factors predisposing individuals to such responses are not well understood. To identify factors that predispose British beekeepers to SRs and to investigate how beekeepers access specialist services after SRs to bee venom. A link to an online survey was published in the bimonthly magazine and on the Web site of the British Beekeepers Association. The demographic results are presented using descriptive analysis, and a logistic regression model was used to determine risk factors for SRs. There were 852 responses to the questionnaire of which 63% were from male beekeepers; the most common age range was 51 to 60 years. Twenty-eight percent of all responders had experienced a large local reaction and 21% had experienced a SR. Factors that predisposed beekeepers to SRs included female sex, having a family member with bee venom allergy, more than 2 years of beekeeping before a SR, and premedication with an antihistamine before attending the hives. A total of 44% of beekeepers with SRs attended the emergency department because of their symptoms, 16.6% were reviewed by an allergy specialist, and only 18% carried an adrenaline autoinjector. Logistic regression analysis identified a number of novel factors to be associated with the development of SRs. Rates of attendance at the emergency department, allergy specialist review, and carriage of adrenaline were low, highlighting a need for education in the beekeeping community and among health care professionals. Copyright © 2011 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Cemental tear: To know what we have neglected in dental practice.

    PubMed

    Jeng, Po-Yuan; Luzi, Arlinda Luzi; Pitarch, Rocio Marco; Chang, Mei-Chi; Wu, Yu-Hsueh; Jeng, Jiiang-Huei

    2018-04-01

    Cemental tear is a special kind of root surface fracture, contributing to periodontal and periapical breakdown. However, it is a challenge for doctors to diagnose, resulting in delayed or improper treatment. We reviewed the predisposing factors, location, radiographic/clinical characteristics, diagnosis and treatments of cemental tears. From the literature, patients with cemental tear were mainly males, over 60 year-old. Possible predisposing factors include gender, age, tooth type, traumatic occlusal force and vital teeth. Cemental tears were common in upper and lower anterior teeth, single or multiple, and can be present in cervical, middle and apical third of roots. Morphology of cemental tears can be either piece-shaped or U-shaped. Clinically, cemental tear shows a unitary periodontal pocket and signs/symptoms mimicking localized periodontitis, apical periodontitis and vertical root fractures. Treatment of cemental tears include scaling, root planning, root canal treatment, periodontal/periapical surgery, guided tissue regeneration, bone grafting, and intentional replantation. Recurrence of cemental tear is possible especially when the fracture involves root apex. Extraction is recommended for teeth with poor prognosis. In conclusion, cemental tears can involve both periodontal and periapical area. Dentists should understand the predisposing factors and clinical features of cemental tears for early diagnosis/treatment to prevent bone loss/tooth extraction. Copyright © 2017. Published by Elsevier B.V.

  1. Assessing the significance of health information seeking in chronic condition management.

    PubMed

    Dean, Caress A; Geneus, Christian J; Rice, Shahida; Johns, Marquisha; Quasie-Woode, Delores; Broom, Kevin; Elder, Keith

    2017-08-01

    To examine the relationship between health information seeking and confidence in performing self-management activities, and to assess the influence of predisposing, enabling, and perceive need factors on confidence to perform self-management activities among adults with chronic conditions. The sample included 6724 adults from the 2007 Health Tracking Household Survey who were ≥18 years with a chronic condition. Binary logistic regression examined the relationship between health information seeking, predisposing, enabling, and perceive need factors and confidence in performing three self-management activities; prevent symptoms, tell doctor concerns, and know when to get medical care. Analyses indicated that 63.7% of adults sought health information. Rural residents who sought health information had 50% (95% CI: 0.28-0.89) lower odds of being confident to tell doctor concerns compared to urban residents who did not seek health information. The relationship between health information seeking and confidence to perform self-management varies by self-management activity. Rurality, education level, having a usual source of care, and perceived health status strongly predict confidence to perform self-management activities. Self-management strategies should incorporate health information seeking behavior that will enhance confidence to perform specific self-management activities, and should incorporate predisposing, enabling, and perceive need factors. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. A novel haplotype of spinocerebellar ataxia type 6 contributes to the highest prevalence in western Japan.

    PubMed

    Terasawa, Hideo; Oda, Masaya; Morino, Hiroyuki; Miyachi, Takafumi; Izumi, Yuishin; Maruyama, Hirofumi; Matsumoto, Masayasu; Kawakami, Hideshi

    2004-03-25

    The highest prevalence rate of spinocerebellar ataxia type 6 (SCA6) in the worldwide population is in the Chugoku and Kansai areas of Western Japan, but the reason of this geographic characteristics is unclear. We investigated the predisposing haplotypes and their geographic distribution. Genotyping of five microsatellite markers and three single nucleotide polymorphisms linked to the CACNA1A gene in 150 Japanese SCA6 patients from unrelated 118 families revealed three major haplotypes, carrying a pool of one common haplotype core. A founder chromosome was thought to have historically diverged into at least three types. One of the major haplotypes newly identified showed a strong geographical cluster around the Seto Inland Sea in the Chugoku and Kansai areas of Western Japan, whereas the others were widely distributed throughout Japan. The distribution of predisposing haplotypes contributes to the geographical differences in prevalence of SCA6.

  3. Suicidal Behaviour in Mood Disorders—Who, When, and Why?

    PubMed Central

    Isometsä, Erkki

    2014-01-01

    Objective: About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. Method: The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Results: Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Conclusion: Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts. PMID:24881160

  4. Suicidal behaviour in mood disorders--who, when, and why?

    PubMed

    Isometsä, Erkki

    2014-03-01

    About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive-aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.

  5. Diabetes and Associated Complications in the South Asian Population

    PubMed Central

    Shah, Arti; Kanaya, Alka M.

    2014-01-01

    The increasing prevalence of diabetes in South Asians has significant health and economic implications. South Asians are predisposed to the development of diabetes due to biologic and lifestyle factors. Furthermore, they experience significant morbidity and mortality from complications of diabetes, most notably coronary artery disease, cerebrovascular disease and chronic kidney disease. Therefore, understanding the pathophysiology and genetics of diabetes risk factors and its associated complications in South Asians is paramount to curbing the diabetes epidemic. With this understanding, the appropriate screening, preventative and therapeutic strategies can be implemented and further developed. In this review, we discuss in detail the biologic and lifestyle factors that predispose South Asians to diabetes and review the epidemiology and pathophysiology of microvascular and macrovascular complications of diabetes in South Asians. We also review the ongoing and completed diabetes prevention and management studies in South Asians. PMID:24643902

  6. Does omphalocele major undergo spontaneous closure?

    PubMed Central

    Emordi, Victor C.; Osifo, David O.

    2017-01-01

    Abstract The early surgical management of omphalocele major in Africa predisposes neonates to surgical complications which are often worsened by the presence of associated anomalies. Conservative management using available escharotics results in early skin cover by secondary wound healing. This delays the need for fascial closure and avoids neonatal surgical risks thus improving survival. We present a case of omphalocele major that underwent spontaneous closure during conservative management with honey dressing without surgical intervention. PMID:28928917

  7. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    PubMed Central

    Chu, Huikuan; Zhong, Likun; Li, Hai; Zhang, Xiujing; Zhang, Jingzhi; Hou, Xiaohua

    2014-01-01

    Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population (18.1%) and pediatric population (18.8%) were significantly higher than that in general population (8.2%). Prevalence of constipation defined by non-Rome criteria was higher than that by Rome criteria in general population. Prevalence rates of constipation were different for different geographical area. People with less education were predisposed to constipation. In pediatric population, prevalence of constipation was the lowest in children aged 2–6 years. Prevalence of constipation in ethnic minorities was higher than that in Han people. People with constipation were predisposed to FD, haemorrhoid, and GERD. Only 22.2% patients seek medical advice in general population. Conclusions. In China, prevalence of constipation was lower compared with most of other countries. The factors including female gender, diagnostic criteria, geographical area, age, educational class, and race seemed to have major effects on prevalence of constipation. PMID:25386187

  8. [Vascular trombosis of renal graft: 9 cases].

    PubMed

    Kaaroud, Hayet; Béji, Soumaya; Ben Hamida, Fethi; Rais, Lamia; Ben Abdallah, Taieb; El Younsi, Fethi; Ben Moussa, Fatma; Abderrahim, Ezzedine; Bardi, Rafika; Ayed, Khaled; Chebil, Mohamed; Kheder, Adel

    2008-04-01

    Allograft renal thrombosis can occur in 1 to 6% of cases. Many predisposing factors has been identified especially alteration of coagulation. We analyzed in this study frequency and predisposing factors of renal graft thrombosis. We report a retrospective study including 319 renal transplant recipients. Nine patients (2.8%) presented veinous graft thrombosis in 5 cases and arterial thombosis in 4 cases. There were 6 men and 3 women aged of 30.6 years meanly (10-56) which developed the thrombosis 6 days (1-48) after the transplantation. All patients were detransplanted after 16.2 days and 1 patient died. Thrombosis constitute an important cause of graft loss. A perfect surgical technic and prophylactic treatment in high risk patients are necessary to reduce this complication.

  9. The Impact of Healthcare Workers Job Environment on Their Mental-emotional Health. Coping Strategies: The Case of a Local General Hospital.

    PubMed

    Koinis, Aristotelis; Giannou, Vasiliki; Drantaki, Vasiliki; Angelaina, Sophia; Stratou, Elpida; Saridi, Maria

    2015-04-13

    Workplace stress can influence healthcare professionals' physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers' mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%). Our research protocol was first approved by the hospital's review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach's α=0.862). Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals' emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life - BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001) and quitting (t=-2.564, P=0.011) are predisposing factors. For the 'mental health and spirituality' regression model, positive re-assessment (t=5.528, P=0.000) and seeking social support (t=-1.991, P=0.048) are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0.000) is a predisposing factor. According to our findings, there was a notable lack of workplace stress management strategies, which the participants usually perceive as a lack of interest on behalf of the management regarding their emotional state. Some significant factors for lowering workplace stress were found to be the need to encourage and morally reward the staff and also to provide them with opportunities for further or continuous education.

  10. Gaps in patient care practices to prevent hospital-acquired delirium

    PubMed Central

    Alagiakrishnan, Kannayiram; Marrie, Thomas; Rolfson, Darryl; Coke, William; Camicioli, Richard; Duggan, D’Arcy; Launhardt, Bonnie; Fisher, Bruce; Gordon, Debbie; Hervas-Malo, Marilou; Magee, Bernice; Wiens, Cheryl

    2009-01-01

    ABSTRACT OBJECTIVE To evaluate the current patient care practices that address the predisposing and precipitating factors contributing to the prevention of hospital-acquired delirium in the elderly. DESIGN Prospective cohort (observational) study. PARTICIPANTS Patients 65 years of age and older who were admitted to medical teaching units at the University of Alberta Hospital in Edmonton over a period of 7 months and who were at risk of delirium. SETTING Medical teaching units at the University of Alberta. MAIN OUTCOME MEASURES Demographic data and information on predisposing factors for hospital-acquired delirium were obtained for all patients. Documented clinical practices that likely prevent common precipitants of delirium were also recorded. RESULTS Of the 132 patients enrolled, 20 (15.2%) developed hospital-acquired delirium. At the time of admission several predisposing factors were not documented (eg, possible cognitive impairment 16 [12%], visual impairment 52 [39.4%], and functional status of activities of daily living 99 [75.0%]). Recorded precipitating factors included catheter use, screening for dehydration, and medications. Catheters were used in 35 (26.5%) patients, and fluid intake-and-output charting assessed dehydration in 57 (43.2%) patients. At the time of admission there was no documentation of hearing status in 69 (52.3%) patients and aspiration risk in 104 (78.8%) patients. After admission, reorientation measures were documented in only 16 (12.1%) patients. Although all patients had brief mental status evaluations performed once daily, this was not noted to occur twice daily (which would provide important information about fluctuation of mental status) and there was no formal attention span testing. In this study, hospital-acquired delirium was also associated with increased mortality (P < .004), increased length of stay (P < .007), and increased institutionalization (P < .027). CONCLUSION Gaps were noted in patient care practices that might contribute to hospital-acquired delirium and also in measures to identify the development of delirium at an earlier stage. Effort should be made to educate health professionals to identify the predisposing and precipitating factors, and to screen for delirium. This might improve the prevention of delirium. PMID:19826141

  11. Assessment of HIV testing among young methamphetamine users in Muse, Northern Shan State, Myanmar

    PubMed Central

    2014-01-01

    Background Methamphetamine (MA) use has a strong correlation with risky sexual behaviors, and thus may be triggering the growing HIV epidemic in Myanmar. Although methamphetamine use is a serious public health concern, only a few studies have examined HIV testing among young drug users. This study aimed to examine how predisposing, enabling and need factors affect HIV testing among young MA users. Methods A cross-sectional study was conducted from January to March 2013 in Muse city in the Northern Shan State of Myanmar. Using a respondent-driven sampling method, 776 MA users aged 18-24 years were recruited. The main outcome of interest was whether participants had ever been tested for HIV. Descriptive statistics and multivariate logistic regression were applied in this study. Results Approximately 14.7% of young MA users had ever been tested for HIV. Significant positive predictors of HIV testing included predisposing factors such as being a female MA user, having had higher education, and currently living with one’s spouse/sexual partner. Significant enabling factors included being employed and having ever visited NGO clinics or met NGO workers. Significant need factors were having ever been diagnosed with an STI and having ever wanted to receive help to stop drug use. Conclusions Predisposing, enabling and need factors were significant contributors affecting uptake of HIV testing among young MA users. Integrating HIV testing into STI treatment programs, alongside general expansion of HIV testing services may be effective in increasing HIV testing uptake among young MA users. PMID:25042697

  12. Factors predisposing nursing home resident to inappropriate transfer to emergency department. The FINE study protocol.

    PubMed

    Perrin, Amélie; Tavassoli, Neda; Mathieu, Céline; Hermabessière, Sophie; Houles, Mathieu; McCambridge, Cécile; Magre, Elodie; Fernandez, Sophie; Caquelard, Anne; Charpentier, Sandrine; Lauque, Dominique; Azema, Olivier; Bismuth, Serge; Chicoulaa, Bruno; Oustric, Stéphane; Costa, Nadège; Molinier, Laurent; Vellas, Bruno; Bérard, Emilie; Rolland, Yves

    2017-09-01

    Each year, around one out of two nursing home (NH) residents are hospitalized in France, and about half to the emergency department (ED). These transfers are frequently inappropriate. This paper describes the protocol of the FINE study. The first aim of this study is to identify the factors associated with inappropriate transfers to ED. FINE is a case-control observational study. Sixteen hospitals participate. Inclusion period lasts 7 days per season in each center for a total period of inclusion of one year. All the NH residents admitted in ED during these periods are included. Data are collected in 4 times: before transfer in the NH, at the ED, in hospital wards in case of patient's hospitalization and at the patient's return to NH. The appropriateness of ED transfers (i.e. case versus control NH residents) is determined by a multidisciplinary team of experts. Our primary objective is to determine the factors predisposing NH residents to inappropriate transfer to ED. Our secondary objectives are to assess the cost of the transfers to ED; study the evolution of NH residents' functional status and the psychotropic and inappropriate drugs prescription between before and after the transfer; calculate the prevalence of potentially avoidable transfers to ED; and identify the factors predisposing NH residents to potentially avoidable transfer to ED. A better understanding of the determinant factors of inappropriate transfers to ED of NH residents may lead to proposals of recommendations of better practice in NH and would allow implementing quality improvement programs in the health organization.

  13. Chronic pancreatitis: diagnosis, classification, and new genetic developments.

    PubMed

    Etemad, B; Whitcomb, D C

    2001-02-01

    The utilization of recent advances in molecular and genomic technologies and progress in pancreatic imaging techniques provided remarkable insight into genetic, environmental, immunologic, and pathobiological factors leading to chronic pancreatitis. Translation of these advances into clinical practice demands a reassessment of current approaches to diagnosis, classification, and staging. We conclude that an adequate pancreatic biopsy must be the gold standard against which all diagnostic approaches are judged. Although computed tomography remains the initial test of choice for the diagnosis of chronic pancreatitis, the roles of endoscopic retrograde pancreatography, endoscopic ultrasonography, and magnetic resonance imaging are considered. Once chronic pancreatitis is diagnosed, proper classification becomes important. Major predisposing risk factors to chronic pancreatitis may be categorized as either (1) toxic-metabolic, (2) idiopathic, (3) genetic, (4) autoimmune, (5) recurrent and severe acute pancreatitis, or (6) obstructive (TIGAR-O system). After classification, staging of pancreatic function, injury, and fibrosis becomes the next major concern. Further research is needed to determine the clinical and natural history of chronic pancreatitis developing in the context of various risk factors. New methods are needed for early diagnosis of chronic pancreatitis, and new therapies are needed to determine whether interventions will delay or prevent the progression of the irreversible damage characterizing end-stage chronic pancreatitis.

  14. Factors predisposing to consecutive esotropia after surgery to correct intermittent exotropia.

    PubMed

    Jang, Jung Hyun; Park, Jung Min; Lee, Soo Jung

    2012-10-01

    To investigate the incidence of and factors predisposing to consecutive esotropia after intermittent exotropia surgery, and to prevent the onset of consecutive esotropia. We retrospectively surveyed 226 patients who had been followed up for more than 1 year after surgery for intermittent exotropia conducted between February 2005 and September 2010. Consecutive esotropia was defined as an esotropia of at least 10 prism diopters (PD) at distance or near at least once in 2 weeks after surgery. Presumed risk factors for consecutive esotropia were analyzed. Gender, age at surgery, average binocular spherical equivalent, anisometropia, high myopia, amblyopia, preoperative angle of deviation, vertical deviation, A-V pattern strabismus, exotropia type, type of surgery, stereopsis, and suppression were investigated to evaluate factors influencing the onset of consecutive esotropia. Consecutive esotropia occurred in 22 patients (9.7 %). Significant correlations with occurrence of the condition were found with high myopia (P = 0.013), amblyopia (P = 0.047), preoperative angle of deviation of 25-40 PD at distance (P = 0.016), deviation at distance - deviation at near > 10 PD (P = 0.041), lateral incomitance (P = 0.007), tenacious proximal convergence fusion type (P = 0.001), unilateral lateral rectus muscle recession and medial rectus muscle resection (P = 0.001). High myopia, amblyopia, and lateral incomitance were predisposing factors for consecutive esotropia. Furthermore, the preoperative angle of deviation at distance, differences between the angle of deviation at near and at distance, the type of intermittent exotropia, and the type of surgery affected the incidence of consecutive esotropia. More attention must be paid to patients with such factors.

  15. Dopamine D2 receptor-mediated neuroprotection in a G2019S Lrrk2 genetic model of Parkinson's disease.

    PubMed

    Tozzi, Alessandro; Tantucci, Michela; Marchi, Saverio; Mazzocchetti, Petra; Morari, Michele; Pinton, Paolo; Mancini, Andrea; Calabresi, Paolo

    2018-02-12

    Parkinson's disease (PD) is a neurodegenerative disorder in which genetic and environmental factors synergistically lead to loss of midbrain dopamine (DA) neurons. Mutation of leucine-rich repeated kinase2 (Lrrk2) genes is responsible for the majority of inherited familial cases of PD and can also be found in sporadic cases. The pathophysiological role of this kinase has to be fully understood yet. Hyperactivation of Lrrk2 kinase domain might represent a predisposing factor for both enhanced striatal glutamatergic release and mitochondrial vulnerability to environmental factors that are observed in PD. To investigate possible alterations of striatal susceptibility to mitochondrial dysfunction, we performed electrophysiological recordings from the nucleus striatum of a G2019S Lrrk2 mouse model of PD, as well as molecular and morphological analyses of G2019S Lrrk2-expressing SH-SY5Y neuroblastoma cells. In G2019S mice, we found reduced striatal DA levels, according to the hypothesis of alteration of dopaminergic transmission, and increased loss of field potential induced by the mitochondrial complex I inhibitor rotenone. This detrimental effect is reversed by the D2 DA receptor agonist quinpirole via the inhibition of the cAMP/PKA intracellular pathway. Analysis of mitochondrial functions in G2019S Lrrk2-expressing SH-SY5Y cells revealed strong rotenone-induced oxidative stress characterized by reduced Ca 2+ buffering capability and ATP synthesis, production of reactive oxygen species, and increased mitochondrial fragmentation. Importantly, quinpirole was able to prevent all these changes. We suggest that the G2019S-Lrrk2 mutation is a predisposing factor for enhanced striatal susceptibility to mitochondrial dysfunction induced by exposure to mitochondrial environmental toxins and that the D2 receptor stimulation is neuroprotective on mitochondrial function, via the inhibition of cAMP/PKA intracellular pathway. We suggest new possible neuroprotective strategies for patients carrying this genetic alteration based on drugs specifically targeting Lrrk2 kinase domain and mitochondrial functionality.

  16. Periprosthetic shoulder infection in the United States: incidence and economic burden.

    PubMed

    Padegimas, Eric M; Maltenfort, Mitchell; Ramsey, Matthew L; Williams, Gerald R; Parvizi, Javad; Namdari, Surena

    2015-05-01

    Periprosthetic joint infection (PJI) is a major cause of morbidity after shoulder arthroplasty. PJI epidemiology has not been well studied. We aimed to analyze the historical incidence, predisposing factors, and economic burden of PJI after shoulder arthroplasty in the United States. Primary shoulder arthroplasty patients were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes 81.80 (total shoulder arthroplasty), 81.81 (hemiarthroplasty), and 81.88 (reverse arthroplasty) in the Nationwide Inpatient Sample from 2002 to 2011. PJI was identified by codes 80.01 (arthrotomy for device removal) and 996.66 (prosthetic infection). Multivariate logistic regression analysis was used to identify predisposing factors for PJI. PJI rate was 0.98% from 2002 to 2011 and did not vary significantly. Comorbidities associated with PJI were weight loss/nutritional deficiency (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.53-4.51; P = .00047), drug abuse (OR, 2.38; 95% CI, 1.41-4.02; P = .0011), and anemia from blood loss (OR, 2.43; 95% CI, 1.50-3.93; P = .00031) or iron deficiency (OR, 2.05; 95% CI, 1.69-2.49; P < .0001). Demographic factors associated with PJI were younger age (OR, 1.020; 95% CI, 1.017-1.024; P < .0001) and male gender (OR, 1.961; 95% CI, 1.816-2.117; P < .0001). In 2011, median hospitalization costs for PJI were $17,163.57 compared with $16,132.68, $13,955.83, and $20,007.87 for total shoulder arthroplasty, hemiarthroplasty, and reverse arthroplasty, respectively. Increasing incidence of shoulder arthroplasty and a constant infection rate will result in greater overall PJI burden. Whereas hospitalization costs for PJI are comparable to those of primary arthroplasty, they are incurred after the original cost of shoulder arthroplasty. Certain identifiable patient variables correlate with higher PJI rates. Risk factor modification may decrease PJI incidence and help contain costs. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. Prevalence of venous thromboembolism at post-mortem in an African population: a cause for concern.

    PubMed

    Sotunmbi, P T; Idowu, A T; Akang, E E U; Aken'Ova, Y A

    2006-09-01

    Venous thromboembolism (VTE) remains a fatal complication and a frequent cause of death among patients hospitalized for remediable and often minor conditions. Various prevalence and associated risk factors of VTE have been documented in different parts of the world. It has been reported that the prevalence of VTE in Africans and Asians is not as pronounced as it is in the Caucasians. However, there is still a relative paucity of information about the prevalence of VTE and its associated risk factors in Nigeria, which is an African population. Data was collected retrospectively from records of post-mortem reports at the University College Hospital, Ibadan, Nigeria between January 1991 and December 1998. Of the 989 autopsies documented within the 8-year period, 29 autopsies confirmed VTE. This indicates a prevalence of 2.9%. Sixty five percent of the subjects were older than 40 years and male to female ratio was 2.6:1. Hence the condition is more prevalent in males than females. Malignancy was the commonest predisposing risk factor for VTE (37.9%). Other predisposing factors included immobility for more than 4 days (27.6%), neuromuscular paralysis (24.1%), septicaemia (20.7%), multiple trauma involving the pelvis, abdomen and head (17.2%), major surgery (13.8%), congestive cardiac failure (3.4%) and obesity (3.4%). This study highlights the need to have a closer look at this grave but preventable and treatable health condition. VTE is a preventable and treatable condition, especially where haematological services, intensive care management and good pre-emptive physiotherapy are available. Thus, mortality from this condition should be considered as a cause for concern even in a poorly funded health care delivery system such as in Africa. It is therefore recommended that appropriate physical and pharmacological methods of prophylaxis should be prescribed according to the degree of risk of VTE in individual patients.

  18. Diabetes and associated complications in the South Asian population.

    PubMed

    Shah, Arti; Kanaya, Alka M

    2014-05-01

    The rising prevalence of diabetes in South Asians has significant health and economic implications. South Asians are predisposed to the development of diabetes due to biologic causes which are exacerbated by lifestyle and environmental factors. Furthermore, they experience significant morbidity and mortality from complications of diabetes, most notably coronary artery disease, cerebrovascular disease, and chronic kidney disease. Therefore, understanding the pathophysiology and genetics of diabetes risk factors and its associated complications in South Asians is paramount to curbing the diabetes epidemic. With this understanding, the appropriate screening, preventative and therapeutic strategies can be implemented and further developed. In this review, we discuss in detail the biologic and lifestyle factors that predispose South Asians to diabetes and review the epidemiology and pathophysiology of microvascular and macrovascular complications of diabetes in South Asians. We also review the ongoing and completed diabetes prevention and management studies in South Asians.

  19. A practical approach to the assessment of psychosocial and psychiatric comorbidity in the dermatology patient.

    PubMed

    Gupta, Madhulika A; Gupta, Aditya K

    2013-01-01

    It is well recognized that the clinical course of many dermatologic disorders is the result of a complex and sometimes reciprocal interaction between biological, psychiatric/psychological, and social factors that can have a predisposing, precipitating, and/or perpetuating role for the dermatologic disorder. Assessment of psychiatric and psychosocial comorbidity, which can be present in up to 30% of dermatology patients, is an important component of the overall clinical evaluation of the patient. This paper discusses a practical approach to the assessment of psychosocial and psychiatric factors, including suicide risk and parasuicidal behaviors in the dermatology patient. The approach further classifies these factors as predisposing, precipitating, and/or perpetuating, in order to aid the clinician with the possible secondary and tertiary prevention of some dermatologic disorders by management of their psychosocial and psychiatric comorbidity. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. FTO gene variant modulates the neural correlates of visual food perception.

    PubMed

    Kühn, Anne B; Feis, Delia-Lisa; Schilbach, Leonhard; Kracht, Lutz; Hess, Martin E; Mauer, Jan; Brüning, Jens C; Tittgemeyer, Marc

    2016-03-01

    Variations in the fat mass and obesity associated (FTO) gene are currently the strongest known genetic factor predisposing humans to non-monogenic obesity. Recent experiments have linked these variants to a broad spectrum of behavioural alterations, including food choice and substance abuse. Yet, the underlying neurobiological mechanisms by which these genetic variations influence body weight remain elusive. Here, we explore the brain structural substrate of the obesity-predisposing rs9939609 T/A variant of the FTO gene in non-obese subjects by means of multivariate classification and use fMRI to investigate genotype-specific differences in neural food-cue reactivity by analysing correlates of a visual food perception task. Our findings demonstrate that MRI-derived measures of morphology along middle and posterior fusiform gyrus (FFG) are highly predictive for FTO at-risk allele carriers, who also show enhanced neural responses elicited by food cues in the same posterior FFG area. In brief, these findings provide first-time evidence for FTO-specific differences in both brain structure and function already in non-obese individuals, thereby contributing to a mechanistic understanding of why FTO is a predisposing factor for obesity. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. The epidemiology of bovine respiratory disease: What is the evidence for predisposing factors?

    PubMed Central

    Taylor, Jared D.; Fulton, Robert W.; Lehenbauer, Terry W.; Step, Douglas L.; Confer, Anthony W.

    2010-01-01

    Bovine respiratory disease (BRD) is the most costly disease of beef cattle in North America. It is multi-factorial, with a variety of physical and physiological stressors combining to predispose cattle to pneumonia. However, efforts to discern which factors are most important have frequently failed to establish definitive answers. Calves are at highest risk shortly after transport. Risk factors include purchasing from sale barns and commingling. It is unclear whether or not these practices increase susceptibility, increase exposure, or are proxies for poor management. Lighter-weight calves appear to be at greater risk, although this has not been consistent. Persistent infection (PI) with bovine virus diarrhea virus increases BRD occurrence, but it is unclear if PI calves affect other cattle in the feedlot. The complexity of BRD has made it difficult to define involvement of individual factors. Stressors may play a role as “necessary but not sufficient” components, requiring additive effects to cause disease. PMID:21197200

  2. The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study.

    PubMed

    Garthus-Niegel, Susan; von Soest, Tilmann; Vollrath, Margarete E; Eberhard-Gran, Malin

    2013-02-01

    The aim of this prospective study was to examine the etiology of post-traumatic stress symptoms following childbirth within a transactional framework of stress. Participants were women (N = 1,499) from the Akershus Birth Cohort. These women were followed from pregnancy to 8 weeks postpartum. We modeled predisposing factors (e.g., fear of childbirth) and precipitating factors (subjective and objective birth experiences) as predictors of post-traumatic stress symptoms. Post-traumatic stress symptoms were measured by means of the Impact of Event Scale, objective birth experiences by means of birth journals, and subjective birth experiences by means of three questions. A structural equation model showed that subjective birth experiences had the highest association with post-traumatic stress symptoms. Moreover, they mediated the effect of predisposing factors and objective birth experiences. The results suggest that women's subjective birth experiences are the most important factor in the development of post-traumatic stress symptoms following childbirth.

  3. Urinary Tract Infection among Renal Transplant Recipients in Yemen

    PubMed Central

    Gondos, Adnan S.; Al-Moyed, Khaled A.; Al-Robasi, Abdul Baki A.; Al-Shamahy, Hassan A.; Alyousefi, Naelah A.

    2015-01-01

    Urinary tract infection (UTI) is the most common complication following kidney transplantation (KT), which could result in losing the graft. This study aims to identify the prevalence of bacterial UTI among KT recipients in Yemen and to determine the predisposing factors associated with post renal transplantation UTI. A cross sectional study included of 150 patients, who underwent KT was conducted between June 2010 and January 2011. A Morning mid-stream urine specimen was collected for culture and antibiotic susceptibility test from each recipient. Bacterial UTI was found in 50 patients (33.3%). The prevalence among females 40.3% was higher than males 29%. The UTI was higher in the age group between 41–50 years with a percentage of 28% and this result was statistically significant. Predisposing factors as diabetes mellitus, vesicoureteral reflux, neurogenic bladder and polycystic kidney showed significant association. High relative risks were found for polycystic kidney = 13.5 and neurogenic bladder = 13.5. The most prevalent bacteria to cause UTI was Escherichia coli represent 44%, followed by Staphylococcus saprophyticus 34%. Amikacin was the most effective antibiotic against gram-negative isolates while Ciprofloxacin was the most effective antibiotic against Staphylococcus saprophyticus. In conclusion, there is high prevalence of bacterial UTI among KT recipients in Yemen. Diabetes mellitus, vesicoureteral reflux, neurogenic bladder, polycystic kidney and calculi were the main predisposing factors. PMID:26657128

  4. Evolving Use of Natriuretic Peptides as Part of Strategies for Heart Failure Prevention.

    PubMed

    McDonald, Ken; Wilkinson, Mark

    2017-01-01

    Heart failure (HF) remains one of the major cardiovascular challenges to the Western world. Once established, HF is characterized by compromised life expectancy and quality of life with considerable dependence on hospital care for episodic clinical deterioration. Much is understood about the risk factors that predispose to the development of HF. With such a broad range of factors, it is clear that there is a large population at risk, potentially in excess of 25% of the adult population. Therein lies the major challenge at the outset of our efforts to prevent HF. With such a large population at risk, how do we develop an effective prevention strategy? HF prevention requires a multimodal approach. In this review, we focus primarily on the role of natriuretic peptide (NP) as a tool in a prevention strategy. Prevention of HF is a major public health challenge, underlined by the concerning epidemiological trends, the associated costs, and the continued difficulty to find effective therapies for the growing number of patients with preserved systolic function HF. Population-based approaches focusing on lifestyle and risk factor control have made some impact but not to a satisfactory level and also tend to result in a uniform approach across a population with different risk profiles. Individualizing risk is therefore required, with emerging data indicating that NP-guided risk stratification and intervention can reduce downstream incident HF and other cardiovascular events. © 2016 American Association for Clinical Chemistry.

  5. Neurosarcoidosis

    MedlinePlus

    ... and fund research into the disease mechanisms of sarcoidosis, predisposing factors, genetic underpinnings, and the potential for ... better ways to diagnose, treat, and ultimately cure sarcoidosis and neurosarcardoisis. Information from the National Library of ...

  6. Immunoevasive Aspergillus virulence factors.

    PubMed

    Chotirmall, Sanjay H; Mirkovic, Bojana; Lavelle, Gillian M; McElvaney, Noel G

    2014-12-01

    Individuals with structural lung disease or defective immunity are predisposed to Aspergillus-associated disease. Manifestations range from allergic to cavitary or angio-invasive syndromes. Despite daily spore inhalation, immunocompetence facilitates clearance through initiation of innate and adaptive host responses. These include mechanical barriers, phagocyte activation, antimicrobial peptide release and pattern recognition receptor activation. Adaptive responses include Th1 and Th2 approaches. Understanding Aspergillus virulence mechanisms remains critical to the development of effective research and treatment strategies to counteract the fungi. Major virulence factors relate to fungal structure, protease release and allergens; however, mechanisms utilized to evade immune recognition continue to be important in establishing infection. These include the fungal rodlet layer, dihydroxynaphthalene-melanin, detoxifying systems for reactive oxygen species and toxin release. One major immunoevasive toxin, gliotoxin, plays a key role in mediating Aspergillus-associated colonization in the context of cystic fibrosis. Here, it down-regulates vitamin D receptor expression which following itraconazole therapy is rescued concurrent with decreased Th2 cytokine (IL-5 and IL-13) concentrations in the CF airway. This review focuses on the interaction between Aspergillus pathogenic mechanisms, host immune responses and the immunoevasive strategies employed by the organism during disease states such as that observed in cystic fibrosis.

  7. A survey of diabetes prevalence in zoo-housed primates.

    PubMed

    Kuhar, C W; Fuller, G A; Dennis, P M

    2013-01-01

    In humans, type II diabetes mellitus is a condition in which the pancreas is capable of producing insulin but cells do not appropriately respond to insulin with an uptake of glucose. While multiple factors are associated with type II diabetes in humans, a high calorie diet and limited exercise are significant risk factors for the development of this disease. Zoo primates, with relatively high caloric density diets and sedentary lifestyles, may experience similar conditions that could predispose them to the development of diabetes. We surveyed all Association of Zoos and Aquariums (AZA) facilities with primates in their collections to determine the prevalence of diabetes, diagnosis and treatment methods, and treatment outcomes. Nearly 30% of responding institutions reported at least one diabetic primate in their current collection. Although the majority of reported cases were in Old World Monkeys (51%), all major taxonomic groups were represented. Females represented nearly 80% of the diagnosed cases. A wide variety of diagnosing, monitoring, and treatment techniques were reported. It is clear from these results diabetes should be considered prominently in decisions relating to diet, weight and activity levels in zoo-housed primates, as well as discussions surrounding animal health and welfare. © 2012 Wiley Periodicals, Inc.

  8. Extra-hepatic hepatocellular carcinoma presenting as obstructive jaundice.

    PubMed

    Batsis, J A; Halfdanarson, T R; Pitot, H

    2006-10-01

    Hepatocellular carcinoma is a neoplasm with a uniformly poor prognosis. Risk factors for its development include chronic hepatitis B or C infection, haemochromatosis and alpha-1-antitrypsin deficiency, but individuals with any type of chronic liver disease are predisposed. The incidence is significantly higher in Asia and Africa although it has been noted to be increasing in the United States. We present a patient with notable atypical clinical features for hepatocellular carcinoma. The patient had neither predisposing risk factors nor a primary liver lesion causing obstructive jaundice. After multiple tissue specimens were obtained, the final pathological diagnosis was established. Hepatocellular carcinoma generally requires a surgical cure, but patients who are icteric often portend poorer prognoses. For those at high risk, screening may be indicated to identify early curative treatment.

  9. Identifying the "Truly Disadvantaged": A Comprehensive Biosocial Approach

    ERIC Educational Resources Information Center

    Barnes, J. C.; Beaver, Kevin M.; Connolly, Eric J.; Schwartz, Joseph A.

    2016-01-01

    There has been significant interest in examining the developmental factors that predispose individuals to chronic criminal offending. This body of research has identified some social-environmental risk factors as potentially important. At the same time, the research producing these results has generally failed to employ genetically sensitive…

  10. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes.

    PubMed

    Saw, Jacqueline; Aymong, Eve; Sedlak, Tara; Buller, Christopher E; Starovoytov, Andrew; Ricci, Donald; Robinson, Simon; Vuurmans, Tycho; Gao, Min; Humphries, Karin; Mancini, G B John

    2014-10-01

    Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is underdiagnosed and an important cause of myocardial infarction in young women. The frequency of predisposing and precipitating conditions and cardiovascular outcomes remains poorly described. Patients with NA-SCAD prospectively evaluated (retrospectively or prospectively identified) at Vancouver General Hospital were included. Angiographic SCAD diagnosis was confirmed by 2 experienced interventional cardiologists and categorized as type 1 (multiple lumen), 2 (diffuse stenosis), or 3 (mimic atherosclerosis). Fibromuscular dysplasia screening of renal, iliac, and cerebrovascular arteries were performed with angiography or computed tomographic angiography/MR angiography. Baseline, predisposing and precipitating conditions, angiographic, revascularization, in-hospital, and long-term events were recorded. We prospectively evaluated 168 patients with NA-SCAD. Average age was 52.1±9.2 years, 92.3% were women (62.3% postmenopausal). All presented with myocardial infarction. ECG showed ST-segment elevation in 26.1%, and 3.6% had ventricular tachycardia/ventricular fibrillation arrest. Fibromuscular dysplasia was diagnosed in 72.0%. Precipitating emotional or physical stress was reported in 56.5%. Majority had type 2 angiographic SCAD (67.0%), only 29.1% had type 1, and 3.9% had type 3. The majority (134/168) were initially treated conservatively. Overall, 6 of 168 patients had coronary artery bypass surgery and 33 of 168 had percutaneous coronary intervention in-hospital. Of those treated conservatively (n=134), 3 required revascularization for SCAD extension, and all 79 who had repeat angiogram ≥26 days later had spontaneous healing. Two-year major adverse cardiac events were 16.9% (retrospectively identified group) and 10.4% (prospectively identified group). Recurrent SCAD occurred in 13.1%. Majority of patients with NA-SCAD had fibromuscular dysplasia and type 2 angiographic SCAD. Conservative therapy was associated with spontaneous healing. NA-SCAD survivors are at risk for recurrent cardiovascular events, including recurrent SCAD. © 2014 American Heart Association, Inc.

  11. Sudden aspen decline in southwest Colorado: Site and stand factors and a hypothesis on etiology

    Treesearch

    Jim Worrall; Leanne Egeland; Tom Eager; Roy Mask; Erik Johnson; Phil Kemp; Wayne Shepperd

    2008-01-01

    An initial assessment of rapid dieback and mortality of aspen in southwest Colorado suggests that it represents a decline disease incited by acute, warm drought. Predisposing factors include low elevation, south and southwest aspects, droughty soils, open stands, and physiological maturity. Contributing factors include Cytospora canker, two bark beetles, poplar borer,...

  12. Modeling the effects of harvest alternatives on mitigating oak decline in a Central Hardwood Forest landscape

    Treesearch

    Wen J. Wang; Hong S. He; Martin A. Spetich; Stephen R. Shifley; Frank R. III Thompson; Jacob S. Fraser

    2013-01-01

    Oak decline is a process induced by complex interactions of predisposing factors, inciting factors, and contributing factors operating at tree, stand, and landscape scales. It has greatly altered species composition and stand structure in affected areas. Thinning, clearcutting, and group selection are widely adopted harvest alternatives for reducing forest...

  13. Association study between the dopamine D4 receptor gene and schizophrenia

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Petronis, A.; Macciardi, F.; Athanassiades, A.

    The dopamine D4 receptor is of major interest in schizophrenia research due to its high affinity for the atypical neuroleptic clozapine and a high degree of variability in the receptor gene (DRD4). Although several genetic linkage analyses performed on schizophrenia multiplex families from different regions of the world have either excluded or failed to prove that DRD4 is a major genetic factor for the development of schizophrenia, analyses for moderate predisposing effects are still of significant interest. We performed a study examining differences in allele frequencies of 4 different DRD4 polymorphisms in schizophrenia patients and age, sex, and ethnic originmore » matched controls. None of these 4 polymorphisms showed evidence for genetic association with schizophrenia, although a trend towards excess of the allele with 7 repeats in the (48){sub n} bp exon III polymorphism was observed. Complexities in the DRD4 genetic investigation and further analytic approaches are discussed. 18 refs., 2 tabs.« less

  14. Linkage analyses of chromosome 6 loci, including HLA, in familial aggregations of Crohn disease

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hugot, J.P.; Laurent-Puig, P.; Gower-Rousseau, C.

    1994-08-15

    Segregation analyses of familial aggregations of Crohn disease have provided consistent results pointing to the involvement of a predisposing gene with a recessive mode of inheritance. Although extensively investigated, the role played by human leucocyte antigen (HLA) genes in this inflammatory bowel disease remains elusive and the major histocompatibility complex is a candidate region for the mapping of the Crohn disease susceptibility gene. A total of 25 families with multiple cases of Crohn disease was genotyped for HLA DRB1 and for 16 highly polymorphic loci evenly distributed on chromosome 6. The data were subjected to linkage analysis using the lodmore » score method. Neither individual nor combined lod scores for any family and for any locus tested reached values suggesting linkage or genetic heterogeneity. The Crohn disease predisposing locus was excluded from the whole chromosome 6 with lod scores less than -2. It was excluded from the major histocompatibility complex and from 91% of the chromosome 6 genetic map with lod scores less than -4. The major recessive gene involved in genetic predisposition to Crohn disease does not reside on the major histocompatibility complex nor on any locus mapping to chromosome 6. 37 refs., 2 figs., 2 tabs.« less

  15. The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural Region

    PubMed Central

    Arcury, Thomas A; Gesler, Wilbert M; Preisser, John S; Sherman, Jill; Spencer, John; Perin, Jamie

    2005-01-01

    Objective This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. Data Sources A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. Study Design This cross-sectional study used a three-stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check-up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization. Data Collection Methods Respondents answered standard survey questions. They located places in which they engaged health related and normal day-to-day activities; these data were entered into a geographic information system for analysis. Principal Findings Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis. In the multivariate model, having a driver's license and distance for regular care remained significant, as did several predisposing (age, gender, ethnicity), enabling (household income), and need (physical and mental health measures, number of conditions). Geographic measures, as predisposing and enabling factors, were related to regular check-up and chronic care, but not to acute care visits. Conclusions These results show the importance of geographic and spatial behavior factors in rural health care utilization. They also indicate continuing inequity in rural health care utilization that must be addressed in public policy. PMID:15663706

  16. Delirium after cardiac surgery: incidence and risk factors†

    PubMed Central

    Smulter, Nina; Lingehall, Helena Claesson; Gustafson, Yngve; Olofsson, Birgitta; Engström, Karl Gunnar

    2013-01-01

    OBJECTIVES Delirium after cardiac surgery is a problem with consequences for patients and healthcare. Preventive strategies from known risk factors may reduce the incidence and severity of delirium. The present aim was to explore risk factors behind delirium in older patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS Patients (≥70 years) scheduled for routine cardiac surgery were included (n = 142). The patients were assessed and monitored pre-/postoperatively, and delirium was diagnosed from repeated assessments with the Mini-Mental State Examination and the Organic Brain Syndrome Scale, using the DSM-IV-TR criteria. Variables were analysed by uni-/multivariable logistic regression, including both preoperative variables (predisposing) and those extracted during surgery and in the early postoperative period (precipitating). RESULTS Delirium was diagnosed in 78 patients (54.9%). Delirium was independently associated with both predisposing and precipitating factors (P-value, odds ratio, upper/lower confidence interval): age (0.036, 1.1, 1.0/1.2), diabetes (0.032, 3.5, 1.1/11.0), gastritis/ulcer problems (0.050, 4.0, 1.0/16.1), volume load during operation (0.001, 2.8, 1.5/5.1), ventilator time in ICU (0.042, 1.2, 1.0/1.4), highest temperature recorded in ICU (0.044, 2.2, 1.0/4.8) and sodium concentration in ICU (0.038, 1.2, 1.0/1.4). CONCLUSIONS Delirium was common among older patients undergoing cardiac surgery. Both predisposing and precipitating factors contributed to delirium. When combined, the predictive strength of the model improved. Preventive strategies may be considered, in particular among the precipitating factors. Of interest, delirium was strongly associated with an increased volume load during surgery. PMID:23887126

  17. Does a PBL-based medical curriculum predispose training in specific career paths? A systematic review of the literature.

    PubMed

    Tsigarides, Jordan; Wingfield, Laura R; Kulendran, Myutan

    2017-01-07

    North American medical schools have used problem-based learning (PBL) structured medical education for more than 60 years. However, it has only recently been introduced in other medical schools outside of North America. Since its inception, there has been the debate on whether the PBL learning process predisposes students to select certain career paths. To review available evidence to determine the predisposition of specific career paths when undertaking a PBL-based medical curriculum. The career path trajectory was determined as measured by official Matching Programs, self-reported questionnaires and surveys, and formally defined career development milestones. A systematic literature review was performed. PubMed, Medline, Cochrane and ERIC databases were analysed in addition to reference lists for appropriate inclusion. Eleven studies fitting the inclusion criteria were identified. The majority of studies showed that PBL did not predispose a student to a career in a specific speciality (n = 7 out of 11 studies, 64%). However, three studies reported a significantly increased number of PBL graduates working in primary care compared to those from a non-PBL curriculum. PBL has been shown not to predispose medical students to a career in General Practice or any other speciality. Furthermore, a greater number of similar studies are required before a definitive conclusion can be made in the future.

  18. The Recovering Female Alcoholic: A Family Affair.

    ERIC Educational Resources Information Center

    Rolls, Judith A.

    To ensure a positive prognosis, the recovering female alcoholic requires family therapy as an adjunct to her regular treatment program. Research indicates that the characteristics affecting a person's ability to secure and use treatment include (1) predisposing factors; (2) attitudes toward alcohol and health care; (3) personal enabling factors;…

  19. Factors Associated with Living in Developmental Centers in California

    ERIC Educational Resources Information Center

    Harrington, Charlene; Kang, Taewoon; Chang, Jamie

    2009-01-01

    This study examined need, predisposing, market, and regional factors that predicted the likelihood of individuals with developmental disabilities living in state developmental centers (DCs) compared with living at home, in community care, or in intermediate care (ICFs) and other facilities. Secondary data analysis using logistic regression models…

  20. Student Success Factors in Graduate Psychology Professional Programs

    ERIC Educational Resources Information Center

    Newhouse, Noelle K.; Cerniak, Jessica

    2016-01-01

    Research examining factors contributing to online students' success typically focuses on a single point in time or completion of a single course, as well as individual difference variables, such as learning style or motivation, that may predispose a student to succeed. However, research concerning longer term online student outcomes, such as…

  1. A magnetic resonance imaging study of abnormalities of the patella and patellar tendon that predispose children to acute patellofemoral dislocation.

    PubMed

    Yılmaz, Barış; Çiçek, Esin Derin; Şirin, Evrim; Özdemir, Güzelali; Karakuş, Özgün; Muratlı, Hasan Hilmi

    This study compared 20 children hospitalised with acute patellofemoral dislocation with an age-matched healthy control group with no history of knee problems or patellar dislocation. The following morphological parameters were significantly different between the groups: the mean patellar width and length, mean sulcus depth, mean patellar tendon width and total patellar volume. The magnetic resonance imaging findings of this study suggested that structurally smaller than normal patella and patellar tendon volumes are predisposing factors for acute patellofemoral dislocation. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Cleared for the visual approach: Human factor problems in air carrier operations

    NASA Technical Reports Server (NTRS)

    Monan, W. P.

    1983-01-01

    The study described herein, a set of 353 ASRS reports of unique aviation occurrences significantly involving visual approaches was examined to identify hazards and pitfalls embedded in the visual approach procedure and to consider operational practices that might help avoid future mishaps. Analysis of the report set identified nine aspects of the visual approach procedure that appeared to be predisposing conditions for inducing or exacerbating the effects of operational errors by flight crew members or controllers. Predisposing conditions, errors, and operational consequences of the errors are discussed. In a summary, operational policies that might mitigate the problems are examined.

  3. Booker T. Washington and the Secret of Hypertension in African Americans.

    PubMed

    Mackowiak, Philip A

    2016-10-01

    Booker T. Washington rose from slavery to become one of the most admired Americans of his time. He died of long-standing malignant hypertension on November 14, 1915. At that time the medical profession was just beginning to recognize the importance of hypertension as a risk factor for cardiovascular disease. In spite of intensive research fueled by ongoing speculation, why Washington might have been predisposed to the ravages of hypertension, and African Americans continue to be so predisposed, is a secret yet to be told. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  4. Epigenomics.

    PubMed

    Gomase, Virendra S; Tagore, Somnath

    2008-03-01

    'Epigenomics' can be termed as the study of the effects of chromatin structure, including the higher order of chromatin folding and attachment to the nuclear matrix, packaging of DNA around nucleosomes, covalent modifications of histone tails and DNA methylation. This has evolved to include any process that alters gene activity without changing the DNA sequence, and leads to modifications that can be transmitted to daughter cells. It also leads to a better knowledge of the changes in the regulation of genes and genomes that occur in major psychosis. It may also aid in understanding why the same gene sequence may predispose an individual to schizophrenia or bipolar disorder and in other cases does not, and elucidate the molecular mechanisms of how harmful; environmental factors interact with the genome. Results from the work may further lead to new diagnostics and effective therapies.

  5. SYN2 is an autism predisposing gene: loss-of-function mutations alter synaptic vesicle cycling and axon outgrowth

    PubMed Central

    Corradi, Anna; Fadda, Manuela; Piton, Amélie; Patry, Lysanne; Marte, Antonella; Rossi, Pia; Cadieux-Dion, Maxime; Gauthier, Julie; Lapointe, Line; Mottron, Laurent; Valtorta, Flavia; Rouleau, Guy A.; Fassio, Anna; Benfenati, Fabio; Cossette, Patrick

    2014-01-01

    An increasing number of genes predisposing to autism spectrum disorders (ASDs) has been identified, many of which are implicated in synaptic function. This ‘synaptic autism pathway’ notably includes disruption of SYN1 that is associated with epilepsy, autism and abnormal behavior in both human and mice models. Synapsins constitute a multigene family of neuron-specific phosphoproteins (SYN1-3) present in the majority of synapses where they are implicated in the regulation of neurotransmitter release and synaptogenesis. Synapsins I and II, the major Syn isoforms in the adult brain, display partially overlapping functions and defects in both isoforms are associated with epilepsy and autistic-like behavior in mice. In this study, we show that nonsense (A94fs199X) and missense (Y236S and G464R) mutations in SYN2 are associated with ASD in humans. The phenotype is apparent in males. Female carriers of SYN2 mutations are unaffected, suggesting that SYN2 is another example of autosomal sex-limited expression in ASD. When expressed in SYN2  knockout neurons, wild-type human Syn II fully rescues the SYN2 knockout phenotype, whereas the nonsense mutant is not expressed and the missense mutants are virtually unable to modify the SYN2 knockout phenotype. These results identify for the first time SYN2  as a novel predisposing gene for ASD and strengthen the hypothesis that a disturbance of synaptic homeostasis underlies ASD. PMID:23956174

  6. A Parallel Genetic Algorithm to Discover Patterns in Genetic Markers that Indicate Predisposition to Multifactorial Disease

    PubMed Central

    Rausch, Tobias; Thomas, Alun; Camp, Nicola J.; Cannon-Albright, Lisa A.; Facelli, Julio C.

    2008-01-01

    This paper describes a novel algorithm to analyze genetic linkage data using pattern recognition techniques and genetic algorithms (GA). The method allows a search for regions of the chromosome that may contain genetic variations that jointly predispose individuals for a particular disease. The method uses correlation analysis, filtering theory and genetic algorithms (GA) to achieve this goal. Because current genome scans use from hundreds to hundreds of thousands of markers, two versions of the method have been implemented. The first is an exhaustive analysis version that can be used to visualize, explore, and analyze small genetic data sets for two marker correlations; the second is a GA version, which uses a parallel implementation allowing searches of higher-order correlations in large data sets. Results on simulated data sets indicate that the method can be informative in the identification of major disease loci and gene-gene interactions in genome-wide linkage data and that further exploration of these techniques is justified. The results presented for both variants of the method show that it can help genetic epidemiologists to identify promising combinations of genetic factors that might predispose to complex disorders. In particular, the correlation analysis of IBD expression patterns might hint to possible gene-gene interactions and the filtering might be a fruitful approach to distinguish true correlation signals from noise. PMID:18547558

  7. Comparative leaf proteomics of drought-tolerant and -susceptible peanut in response to water stress

    USDA-ARS?s Scientific Manuscript database

    Water stress (WS) predisposes peanut plants to fungal infection resulting in pre-harvest aflatoxin contamination. Major changes during water stress including oxidative stress, lead to destruction of photosynthetic apparatus and other macromolecules within cells. Two peanut cultivars with diverse dro...

  8. Crash-type manual for pedestrians

    DOT National Transportation Integrated Search

    1996-01-01

    Bicyclists or pedestrians are involved in approximately one out of six highway fatalities each year. This research was conducted in order to better understand the precipitating actions, predisposing factors and characteristic populations involved. So...

  9. Runaway Children in America: A Review of the Literature.

    ERIC Educational Resources Information Center

    Burke, William H.; Burkhead, E. Jane

    1989-01-01

    The paper reviews the literature regarding runaway children, defines runaway youth, and discusses predisposing factors. Suggestions are offered for further research on the etiology and treatment of runaway behavior. (JDD)

  10. Factors associated with workplace violence in paramedics.

    PubMed

    Koritsas, Stella; Boyle, Malcolm; Coles, Jan

    2009-01-01

    The majority of research that has explored workplace violence has focused on establishing the prevalence of violence in different settings. In general, there is a paucity of research that explores factors that may predict or increase the risk of experiencing violence in the workplace. The aim of this research was to determine predictors of violence for paramedics. A questionnaire was developed that focused on paramedics' experiences with six forms of violence: verbal abuse, property damage/theft, intimidation, physical abuse, sexual harassment, and sexual assault. The questionnaire was distributed randomly to paramedics throughout rural Victoria and metropolitan South Australia, and completed and returned anonymously. Predictors emerged for verbal abuse, intimidation, sexual harassment, and sexual abuse. Specifically, gender was the only predictor of intimidation, sexual harassment, and sexual assault. Paramedic qualifications, how they responded to a call-out, and hours per week in direct patient contact emerged as a predictor of verbal abuse. Certain factors predict or predispose paramedics to workplace violence. The need for workplace violence education and training is imperative for the prevention of violence, as well as for its management.

  11. Detection of Streptococcus mutans Genomic DNA in Human DNA Samples Extracted from Saliva and Blood

    PubMed Central

    Vieira, Alexandre R.; Deeley, Kathleen B.; Callahan, Nicholas F.; Noel, Jacqueline B.; Anjomshoaa, Ida; Carricato, Wendy M.; Schulhof, Louise P.; DeSensi, Rebecca S.; Gandhi, Pooja; Resick, Judith M.; Brandon, Carla A.; Rozhon, Christopher; Patir, Asli; Yildirim, Mine; Poletta, Fernando A.; Mereb, Juan C.; Letra, Ariadne; Menezes, Renato; Wendell, Steven; Lopez-Camelo, Jorge S.; Castilla, Eduardo E.; Orioli, Iêda M.; Seymen, Figen; Weyant, Robert J.; Crout, Richard; McNeil, Daniel W.; Modesto, Adriana; Marazita, Mary L.

    2011-01-01

    Caries is a multifactorial disease, and studies aiming to unravel the factors modulating its etiology must consider all known predisposing factors. One major factor is bacterial colonization, and Streptococcus mutans is the main microorganism associated with the initiation of the disease. In our studies, we have access to DNA samples extracted from human saliva and blood. In this report, we tested a real-time PCR assay developed to detect copies of genomic DNA from Streptococcus mutans in 1,424 DNA samples from humans. Our results suggest that we can determine the presence of genomic DNA copies of Streptococcus mutans in both DNA samples from caries-free and caries-affected individuals. However, we were not able to detect the presence of genomic DNA copies of Streptococcus mutans in any DNA samples extracted from peripheral blood, which suggests the assay may not be sensitive enough for this goal. Values of the threshold cycle of the real-time PCR reaction correlate with higher levels of caries experience in children, but this correlation could not be detected for adults. PMID:21731912

  12. Tuberculosis of the ear, a professional disease?

    PubMed

    Sens, Patrícia Maria; Almeida, Clemente I R; Valle, Lupércio O do; Costa, Luís H C; Angeli, Miguel L S

    2008-01-01

    Tuberculosis is a rare cause of chronic suppurative otitis media and mastoiditis; the predisposing factors of this association, however, are not commonly described. There has been an alarming increase in the incidence of tuberculosis in Brazil, including tuberculous otitis media. These patients typically present multiple perforations of the tympanic membrane, an ear discharge, and progressive hearing loss. This diagnosis should be taken into account in patients that do not respond to routine therapy for fungal external otitis or bacterial otitis media. In this retrospective study, the authors describe four cases of patients with tuberculous otitis media. This sample consisted of two physicians, a chemical engineer and an underage child in whose family there were cases of active tuberculosis. Predisposing factors for tuberculous otitis were contact with family members that had tuberculosis, professional contact with patients and exposure to pathogenic microorganisms in airways.

  13. Necrotizing Sialometaplasia of the Hard Palate in a Patient Treated with Topical Nonsteroidal Anti-Inflammatory Drug.

    PubMed

    Gatti, Alessandro; Broccardo, Emanuele; Poglio, Giuseppe; Benech, Arnaldo

    2016-01-01

    Necrotizing sialometaplasia is a rare, benign, self-limiting, necrotizing process involving the minor salivary glands, mainly the mucoserous glands of the hard palate. It is thought to be the result of an ischemic event of the vasculature supplying the salivary gland lobules. Some predisposing factors such as smoking, use of alcohol, denture wearing, recent surgery, traumatic injuries, respiratory infections, systemic diseases bulimia, and anorexia have been described. Herein we present a case of necrotizing sialometaplasia of the hard palate in a patient without known predisposing factors, in our opinion, resulting from the use of topical anti-inflammatory drug. After diagnosis, the patient underwent treatment with chlorhexidine gluconate and a full palatal acrylic guard to protect the exposed bone from food residues during meals. After the sixth week the lesion regressed.

  14. Bronchopulmonary Actinomycosis Associated With Hiatal Hernia

    PubMed Central

    Andreani, Alessandro; Cavazza, Alberto; Marchioni, Alessandro; Richeldi, Luca; Paci, Massimiliano; Rossi, Giulio

    2009-01-01

    OBJECTIVES: To describe clinicoradiologic and histopathologic features of bronchopulmonary actinomycosis and to determine whether hiatal hernia (HH) is a potential predisposing factor for bronchopulmonary actinomycosis. PATIENTS AND METHODS: We reviewed the medical charts of 10 patients who had bronchopulmonary actinomycosis between November 1, 2002, and January 31, 2008. Complete clinical data, radiologic studies (chest radiographs and computed tomographic scans), and histopathologic features were assessed to investigate clinical manifestations and predisposing factors related to bronchopulmonary actinomycosis. RESULTS: The series consisted of 6 men and 4 women, with a mean age of 63.5 years; 8 of the patients were smokers. Cough and fever were the most common symptoms. Chest imaging showed mass-like consolidation in 4 patients, bronchial thickening or lung atelectasis with pleural thickening in 2 patients each, and perihilar irregular mass or multiple bilateral nodules in 1 patient each. Primary or metastatic lung cancer was suspected clinically in 8 of the 10 patients. Foreign body-related endobronchial actinomycosis was diagnosed in 6 patients, 5 of whom had HH; only 1 had gastroesophageal reflux-related symptoms. Because of bronchial obstruction, rigid bronchoscopy was performed in 3 patients, lobectomy in 2, and atypical resection in 1. Antibiotic therapy with amoxicillin was given to all patients, with resolution of actinomycosis. CONCLUSION: Bronchopulmonary actinomycosis is a rare condition that mimics pulmonary malignancy on clinical and radiologic grounds. Diagnosis relies on an accurate patient history and histopathologic examination. Although further confirmation is required, esophageal HH appears to be a potential predisposing factor. PMID:19181645

  15. Evaluation of brine disposal from the Bryan Mound site of the Strategic Petroleum Reserve Program. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hann, R.W. Jr.; Randall, R.E.

    1980-12-01

    The purpose of this report is to describe the environmental conditions found by the principal investigators during the predisposal study conducted from September 1977 through February 1980 prior to the start of brine discharge in March 1980. The major areas of investigation are physical oceanography, analysis of the discharge plume, water and sediment quality, nekton, benthos, phytoplankton, zooplankton, and data management. Volume 1 describes the results of the predisposal study, and it is divided into eight chapters entitled: Physical Oceanography, Analsyis of the Discharge Plume, Water and Sediment Quality, Nekton, Benthos, Zooplankton, Phytoplankton, and Data Management. Volume 2 consists ofmore » appendices which contain additional supporting data in the form of figures and tables.« less

  16. Evaluation of brine disposal from the Bryan Mound site of the Strategic Petroleum Reserve Program. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hann, R.W. Jr.; Randall, R.E.

    1980-12-01

    The purpose of this report is to describe the environmental conditions found by the principal investigators during the predisposal study conducted from September 1977 through February 1980 prior to the start of brine discharge in March 1980. The major areas of investigation are physical oceanography, analysis of the discharge plume, water and sediment quality, nekton, benthos, phytoplankton, zooplankton, and data management. Volume 1 describes the results of the predisposal study, and it is divided into eight chapters entitled: Physical Oceanography, Analysis of the Discharge Plume, Water and Sediment Quality, Nekton, Benthos, Zooplankton, Phytoplankton, and Data Management. Volume 2 consists ofmore » appendices which contain additional supporting data in the form of figures and tables.« less

  17. Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

    PubMed

    Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

    2016-08-23

    Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

  18. Hand infections following penetrating fish fins or bones injuries (FFBI): a large, hospital based, retrospective study.

    PubMed

    Imberg, R; Potasman, I; Weissman, Y; Grupper, M

    2008-12-01

    The incidence of hand infections caused by penetrating fish fins or bones injuries (FFBI) is likely to increase following worldwide constant growth of fishery production and consumption. Because data on these infections are scarce, the purposes of this study were to describe their clinical characteristics and disease course, and to analyze risk factors for a complicated disease course. We studied retrospectively all cases of hospitalized patients with hand infections following FFBI over the years 1999-2006 in a single medical center. Demographic data, underlying diseases, clinical characteristics and disease course were analyzed for each case. Univariate and multivariate analysis were used for analyzing risk factors for a complicated hospitalization course. There were 122 separate episodes of hand infections following FFBI among 116 patients, with a mean age (+/- SD) of 52 +/- 19.7. The majority of cases were women (51.6%), and they arrived significantly later to the hospital after injury. Predisposing conditions (diabetes mellitus, liver disease, rheumatologic disorder, malignancy or chronic steroid treatment) were present in 25% of cases. Most of the cases presented with cellulitis. Cultures of either blood or wound were obtained in approximately 1/3 of cases, and 40% of them yielded an isolate. Ceftazidime and doxycycline were administered to 68.8% and 96.7% of cases, respectively. Surgical debridement was performed in 34.4% of cases, but there was no case of death or limb amputation. The presence of fever (p = 0.0005) and a predisposing condition (p = 0.035) were independently correlated with a complicated hospitalization course. The overall prognosis in this largest cohort of hand infections following FFBI was favorable, but immune dysfunction carried a complicated course.

  19. Impact of timing of sex education on teenage pregnancy in Nigeria: cross-sectional survey of secondary school students.

    PubMed

    Ochiogu, Ifeoma N; Miettola, Juhani; Ilika, Amobi L; Vaskilampi, Tuula

    2011-06-01

    The objective of this study was to explore whether the time at which sex education was provided had any impact on reported cases of unintended pregnancies. A cross-sectional survey of secondary school students and their teachers was conducted using self-administered questionnaires. The participants were 1,234 students aged 14-17 years and 46 teachers in 5 secondary schools in South Eastern Nigeria. The outcome measures were reported pregnancies within the last 3 years by type of school and class level; class level at the time of receiving sex education at school; and age at the time of receiving sex education at home. In all schools, sex education was provided at all the junior and senior secondary school levels (JSS and SSS, respectively). Overall, reported cases of unintended pregnancies were highest among the junior students. In the private schools, four in ten teachers reported pregnancies among JSS 3 students. Almost four in ten teachers in public schools reported pregnancies among JSS 2 students. Of all the students, about three in ten reported pregnancies among JSS 2 and 3 students respectively. At home, sex education was provided at the mean age of 16 years (SD ± 2.2). All participants cited financial need and marital promise as major predisposing factors. About four in ten students did not use contraceptives during their first sexual experience. This study highlights the need to introduce sex education much earlier, possibly before the JSS levels. At home, sex education may have greater impact if provided before the age of 14 years. Efforts should be made to address the factors predisposing to teenage pregnancy.

  20. Results of Cervical Cancer Screening in the Rural Population of Lucknow West, India, through a Camp Approach.

    PubMed

    Misra, Jata S; Srivastava, Anand N; Gupta, Hem P

    2018-06-13

    Cytological screening was carried out in rural women of Lucknow West, India, through a camp approach to detect cervical cancer in its preinvasive phase and to see whether the primitive living conditions in the villages have any effect on the incidence of precancer and carcinoma of the cervix and the associated predisposing factors of cervical carcinogenesis. During a span of 4 years (May 2013 to March 2017), a total of 135 camps were organized under the auspice of Era's Lucknow Medical College and Hospital (Lucknow, India). Only 4,269 (31.2%) out of 13,500 women who were motivated and counseled attended the camp and 2,369 (55.1%) of them underwent a Pap smear examination. The incidence of squamous intraepithelial lesions of the cervix (SIL) was found to be very high (18.2%) in the 2,369 women who were screened, but the majority of them were of a low grade. The SIL incidence was very high for all predisposing factors like gynaecological symptoms, age, and clinical lesions of the cervix. However, the SIL rate showed a rise with increasing parity. Candida albicans was more common in rural women (4.7%) than Trichomonas vaginalis (1.1%), and a low incidence of viral sexually transmitted diseases (STD) was seen. Organizing camps in the villages through proper counseling and motivation may help in the screening of larger numbers of women for early detection of cervical cancer, the adequate treatment of which will check the progression of the disease and thus minimize the incidence of carcinoma of the cervix and its associated mortality in the rural population of India. © 2018 S. Karger AG, Basel.

  1. Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics.

    PubMed

    Mohan, Anand; Podin, Yuwana; Tai, Nickson; Chieng, Chae-Hee; Rigas, Vanessa; Machunter, Barbara; Mayo, Mark; Wong, Desiree; Chien, Su-Lin; Tan, Lee-See; Goh, Charles; Bantin, Reginal; Mijen, Alexander; Chua, Wen-Yi; Hii, King-Ching; Wong, See-Chang; Ngian, Hie-Ung; Wong, Jin-Shyan; Hashim, Jamilah; Currie, Bart J; Ooi, Mong-How

    2017-06-01

    Melioidosis is a serious, and potentially fatal community-acquired infection endemic to northern Australia and Southeast Asia, including Sarawak, Malaysia. The disease, caused by the usually intrinsically aminoglycoside-resistant Burkholderia pseudomallei, most commonly affects adults with predisposing risk factors. There are limited data on pediatric melioidosis in Sarawak. A part prospective, part retrospective study of children aged <15 years with culture-confirmed melioidosis was conducted in the 3 major public hospitals in Central Sarawak between 2009 and 2014. We examined epidemiological, clinical and microbiological characteristics. Forty-two patients were recruited during the 6-year study period. The overall annual incidence was estimated to be 4.1 per 100,000 children <15 years, with marked variation between districts. No children had pre-existing medical conditions. Twenty-three (55%) had disseminated disease, 10 (43%) of whom died. The commonest site of infection was the lungs, which occurred in 21 (50%) children. Other important sites of infection included lymph nodes, spleen, joints and lacrimal glands. Seven (17%) children had bacteremia with no overt focus of infection. Delays in diagnosis and in melioidosis-appropriate antibiotic treatment were observed in nearly 90% of children. Of the clinical isolates tested, 35/36 (97%) were susceptible to gentamicin. Of these, all 11 isolates that were genotyped were of a single multi-locus sequence type, ST881, and possessed the putative B. pseudomallei virulence determinants bimABp, fhaB3, and the YLF gene cluster. Central Sarawak has a very high incidence of pediatric melioidosis, caused predominantly by gentamicin-susceptible B. pseudomallei strains. Children frequently presented with disseminated disease and had an alarmingly high death rate, despite the absence of any apparent predisposing risk factor.

  2. Pediatric melioidosis in Sarawak, Malaysia: Epidemiological, clinical and microbiological characteristics

    PubMed Central

    Podin, Yuwana; Tai, Nickson; Chieng, Chae-Hee; Rigas, Vanessa; Machunter, Barbara; Mayo, Mark; Wong, Desiree; Chien, Su-Lin; Tan, Lee-See; Goh, Charles; Bantin, Reginal; Mijen, Alexander; Chua, Wen-Yi; Hii, King-Ching; Wong, See-Chang; Ngian, Hie-Ung; Wong, Jin-Shyan; Hashim, Jamilah; Currie, Bart J.; Ooi, Mong-How

    2017-01-01

    Background Melioidosis is a serious, and potentially fatal community-acquired infection endemic to northern Australia and Southeast Asia, including Sarawak, Malaysia. The disease, caused by the usually intrinsically aminoglycoside-resistant Burkholderia pseudomallei, most commonly affects adults with predisposing risk factors. There are limited data on pediatric melioidosis in Sarawak. Methods A part prospective, part retrospective study of children aged <15 years with culture-confirmed melioidosis was conducted in the 3 major public hospitals in Central Sarawak between 2009 and 2014. We examined epidemiological, clinical and microbiological characteristics. Findings Forty-two patients were recruited during the 6-year study period. The overall annual incidence was estimated to be 4.1 per 100,000 children <15 years, with marked variation between districts. No children had pre-existing medical conditions. Twenty-three (55%) had disseminated disease, 10 (43%) of whom died. The commonest site of infection was the lungs, which occurred in 21 (50%) children. Other important sites of infection included lymph nodes, spleen, joints and lacrimal glands. Seven (17%) children had bacteremia with no overt focus of infection. Delays in diagnosis and in melioidosis-appropriate antibiotic treatment were observed in nearly 90% of children. Of the clinical isolates tested, 35/36 (97%) were susceptible to gentamicin. Of these, all 11 isolates that were genotyped were of a single multi-locus sequence type, ST881, and possessed the putative B. pseudomallei virulence determinants bimABp, fhaB3, and the YLF gene cluster. Conclusions Central Sarawak has a very high incidence of pediatric melioidosis, caused predominantly by gentamicin-susceptible B. pseudomallei strains. Children frequently presented with disseminated disease and had an alarmingly high death rate, despite the absence of any apparent predisposing risk factor. PMID:28599008

  3. Salivary fistula: Blue dye testing as part of an algorithm for early diagnosis

    PubMed Central

    Kiong, Kimberley L.; Tan, Ngian Chye; Skanthakumar, Thakshayeni; Teo, Constance E.H.; Soo, Khee Chee; Tan, Hiang Khoon; Roche, Elizabeth; Yee, Kaisin

    2017-01-01

    Objective Orocutaneous and pharyngocutaneous fistula (OPCF) is a debilitating complication of head and neck surgery for squamous cell carcinoma (SCC), resulting in delayed adjuvant treatment and prolonged hospitalization. As yet, there is no established test that can help in prompt and accurate diagnosis of OPCF. This study aims to determine the accuracy of bedside blue dye testing and its role as part of an algorithm for early diagnosis. We also analyze the risk factors predisposing to OPCF. Study Design Retrospective cohort study from 2012 to 2014. Methods Patients with head and neck SCC who underwent major resection and reconstruction, at risk of OPCF, were included. Results of blue‐dye and video‐fluoroscopic swallow‐studies (VFSS) testing for OPCF were recorded. For the patients that were noted to develop OPCF, the length of time to diagnosis of fistula and subsequent mode of management were examined. Results Of the 93 patients in this study, 25 (26.9%) developed OPCF. Advanced T‐classification (T3/T4) was the only significant predisposing risk factor (p = 0.013). The sensitivity and specificity of the bedside blue dye testing was found to be 36.4% and 100%, respectively. The test positive patients were diagnosed with OPCF at a median of postoperative day (POD) 9.5 as compared to POD 13 for the test negative patients (p = 0.001). Early diagnosis was associated with faster fistula resolution with treatment. Conclusion Blue dye testing is a simple bedside test that can assist in the early diagnosis of OPCF in patients, allowing treatment to be instituted earlier with improved outcomes. Level of Evidence 3 PMID:29299509

  4. A content analysis of precede-proceed constructs in stress management mobile apps

    PubMed Central

    Wilkinson, Jessica; West, Joshua H.; Bernhardt, Jay M.

    2016-01-01

    Background The emergence of Apple’s iPhone provides a platform for freelance developers to design third party apps, which greatly expands the functionality and utility of mobile devices for stress management. This study provides a basic overview of the stress management apps under the health and fitness category of the Apple App store and appraises each app’s potential for influencing behavior change. Methods Data for this study came from a content analysis of health and fitness app descriptions available in the App Store on iTunes. Trained research assistants used the Precede-Proceed Model (PPM) as a framework to guide the coding of paid stress management apps and to evaluate each app’s potential for effecting health behavior change. Results Most apps were rated as being plausible (96.9%) and intending to address stress management (98.5%), but only 63.3% were rated as recommendable to others for their use. Reinforcing apps were less common than predisposing and enabling apps. Less than one percent (0.39%) of apps included all three factors (predisposing, enabling and reinforcing). Conclusions Practitioners should be cautious when promoting the use of stress management apps, as most provide only health-related information (predisposing) or suggestions for enabling behavior, but almost none include all three theoretical factors recommended for behavior change. PMID:28293583

  5. An overview of structure, mechanical properties, and treatment for age-related tendinopathy.

    PubMed

    Zhou, B; Zhou, Y; Tang, K

    2014-04-01

    Tendons transfer tensile loads from muscle to bone, which enable joint motions and stabilize joints. Tendons sustain large mechanical loads in vivo and as a result, tendons were frequently injured. Aging has been confirmed as a predisposing factor of tendinopathy and bad recovery quality following tendon repair. Current treatment methods are generally not effective and involve either symptomatic relief with non-steroidal antiinflammatory drugs and physical therapy or surgery when conservative treatments failed. The limitation in treatment options is due to our incomplete knowledge of age-related tendinopathy. Studies over the past decades have uncovered a number of important mechanical and cellular changes of aging tendon. However, the basis of aging as a major risk factor for tendon injury and impaired tendon healing remained poorly understood. The objectives of this review are to provide an overview of the current knowledge about the aging-associated changes of structure, mechanical properties and treatment in tendon and highlight causes and therapies for age-related tendinopathy.

  6. Increased calcium deposits and decreased Ca2+ -ATPase in erythrocytes of ascitic broiler chickens.

    PubMed

    Li, Kai; Zhao, Lihong; Geng, Guangrui; Ma, Liqin; Dong, Shishan; Xu, Tong; Wang, Jianlin; Wang, Huiyu; Tian, Yong; Qiao, Jian

    2011-06-01

    The decrease of erythrocyte deformability may be one of the predisposing factors for pulmonary hypertension and ascites in broiler chickens. In mammals, the cytoplasmic calcium is a major regulator of erythrocyte deformability. In this study, the erythrocyte deformability was measured, and the precise locations of Ca2+ and Ca2+ -ATPase in the erythrocytes were investigated in chickens with ascites syndrome induced by low ambient temperature. The results showed that ascitic broilers had higher filtration index of erythrocyte compared with control groups, indicating a decrease in erythrocyte deformability in ascitic broilers. The more calcium deposits were observed in the erythrocytes of ascitic broilers compared with those of the age-matched control birds. The Ca2+ -ATPase reactive grains were significantly decreased on the erythrocyte membranes of ascitic broilers. Our data suggest that accumulation of intracellular calcium and inhibition of Ca2+ -ATPase might be important factors for the reduced deformability of the erythrocytes of ascitic broilers. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. Glial contributions to visceral pain: implications for disease etiology and the female predominance of persistent pain

    PubMed Central

    Dodds, K N; Beckett, E A H; Evans, S F; Grace, P M; Watkins, L R; Hutchinson, M R

    2016-01-01

    In the central nervous system, bidirectional signaling between glial cells and neurons (‘neuroimmune communication') facilitates the development of persistent pain. Spinal glia can contribute to heightened pain states by a prolonged release of neurokine signals that sensitize adjacent centrally projecting neurons. Although many persistent pain conditions are disproportionately common in females, whether specific neuroimmune mechanisms lead to this increased susceptibility remains unclear. This review summarizes the major known contributions of glia and neuroimmune interactions in pain, which has been determined principally in male rodents and in the context of somatic pain conditions. It is then postulated that studying neuroimmune interactions involved in pain attributed to visceral diseases common to females may offer a more suitable avenue for investigating unique mechanisms involved in female pain. Further, we discuss the potential for primed spinal glia and subsequent neurogenic inflammation as a contributing factor in the development of peripheral inflammation, therefore, representing a predisposing factor for females in developing a high percentage of such persistent pain conditions. PMID:27622932

  8. Recent developments in the pathophysiology of irritable bowel syndrome

    PubMed Central

    El-Salhy, Magdy

    2015-01-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, the pathophysiology of which is not completely known, although it has been shown that genetic/social learning factors, diet, intestinal microbiota, intestinal low-grade inflammation, and abnormal gastrointestinal endocrine cells play a major role. Studies of familial aggregation and on twins have confirmed the heritability of IBS. However, the proposed IBS risk genes are thus far nonvalidated hits rather than true predisposing factors. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, with the effect exerted by diet seemingly caused by intake of poorly absorbed carbohydrates and fiber. Obesity is a possible comorbidity of IBS. Differences in the microbiota between IBS patients and healthy controls have been reported, but the association between IBS symptoms and specific bacterial species is uncertain. Low-grade inflammation appears to play a role in the pathophysiology of a major subset of IBS, namely postinfectious IBS. The density of intestinal endocrine cells is reduced in patients with IBS, possibly as a result of genetic factors, diet, intestinal microbiota, and low-grade inflammation interfering with the regulatory signals controlling the intestinal stem-cell clonogenic and differentiation activities. Furthermore, there is speculation that this decreased number of endocrine cells is responsible for the visceral hypersensitivity, disturbed gastrointestinal motility, and abnormal gut secretion seen in IBS patients. PMID:26167065

  9. Upper respiratory tract disease in captive orangutans (Pongo sp.): prevalence in 20 European zoos and predisposing factors.

    PubMed

    Zimmermann, N; Pirovino, M; Zingg, R; Clauss, M; Kaup, F J; Heistermann, M; Hatt, J M; Steinmetz, H W

    2011-12-01

    Upper respiratory tract disease (URTD) is a significant cause of morbidity in captive orangutans (Pongo abelii, Pongo pygmaeus), and the pathogenesis is often unknown.  The prevalence of respiratory disease in captive European orangutans (201 animals; 20 zoos) and possible predisposing factors were investigated. Bornean orangutans (P. pygmaeus) showed chronic respiratory signs significantly more often (13.8%) than Sumatran (P. abelii; 3.6%), and males (15.8%) were more often afflicted than females (3.9%). Hand-reared animals (21%) developed air sacculitis more often than parent-reared animals (5%). Diseased animals were more often genetically related to animals with respiratory diseases (93%) than to healthy animals (54%). None of the environmental conditions investigated had a significant effect on disease prevalence. Results suggest a higher importance of individual factors for the development of URTD than environmental conditions. Bornean, male and hand-reared orangutans and animals related to diseased animals need increased medical surveillance for early detection of respiratory disease. © 2011 University of Zurich.

  10. Frequency, character and predisposing factor of headache among students of medical college of Karachi.

    PubMed

    Noor, Tooba; Sajjad, Ali; Asma, Anoosha

    2016-02-01

    To evaluate the frequency, predisposing factors and symptomatology of headache among medical students. The cross-sectional study was conducted from September to December 2013 and comprised students of two medical colleges of Karachi. International Classification of Headache Disorder-II criterion was used to diagnose and classify headache. SPSS 17 was used for statistical analysis. Of the 413 medical students studies, 326(79%) had tension type headache, and 87 (21%) had migraine. Headache was more frequent among females than males, with a ratio of 6.5:1. Both types of headache were significantly associated with self-reported disturbed sleep pattern, stress and various triggering factors (p<0.05 each). Both types greatly influenced individual's daily life with significant association with avoiding academics, extra-curricular activities, family and friends (p<0.05 each). High self-medication rate of 400(96.9%) was observed. The prevalence of headache among medical students was high with female predominance. Infrequent consultation needs to be addressed through awareness programmes.

  11. Androgen-induced cerebral venous sinus thrombosis in a young body builder: case report

    PubMed Central

    Sahraian, Mohammad Ali; Mottamedi, Mahmood; Azimi, Amir Reza; Moghimi, Babak

    2004-01-01

    Background Cerebral venous sinus thrombosis is an infrequent disease with a variety of causes. Pregnancy, puerperium, contraceptive pills and intracranial infections are the most common causes. The patient may present with headache, focal neurological deficits and seizures. The clinical outcome is highly variable and treatment with heparin is advised. Case presentation The patient is a 22 year old male who presented with headache, repeated vomiting and papilledema. He was a bodybuilder doing exercise since 5 years ago, who had used nandrolone decaonoate 25 milligrams intramuscularly during the previous 5 months. Brain MRI and MRV showed superior sagital and transverse sinus thrombosis and extensive investigations did not reveal any known cause. Conclusions We suggested that androgen was the predisposing factor in our patient. Androgens may increase coagulation factors or platelet activity and cause arterial or venous thrombosis. As athletes may hide using androgens it should be considered as a predisposing factor for thrombotic events in such patients. PMID:15579201

  12. Factors Related to Successful Transition Planning for Adolescents on the Autism Spectrum

    ERIC Educational Resources Information Center

    Hatfield, Megan; Ciccarelli, Marina; Falkmer, Torbjörn; Falkmer, Marita

    2018-01-01

    Adolescents on the autism spectrum often have difficulties with the transition from high school to post-school activities. Despite this, little is known about the transition planning processes for this group. This study explored predisposing, reinforcing and enabling factors related to the transition planning processes for adolescents on the…

  13. [Adverse childhood experiences and their association to personality styles in a nonmelancholic depressive sample].

    PubMed

    Farar, Johannes; Schüssler, Gerhard

    2011-01-01

    Do some life story patterns exist, which are associated with depression? Can some life story factors be identified, which influence or determine a special kind of personality, predisposing to depression? Retrospective, cross sectional study with nonexperimental character, using a number of 60 nonmelancholic depressed patients. First, they were asked to give an interview on their life story. Then, they were asked to fill in questionnaires about personality, parental style of raising, clinical symptoms and personality disorders. Significant correlations could be found between parental style of raising, a family history affected by depression, a dysfunctional household, the family composition, negative school experience and all investigated styles of personality. Further, clusters of personality, clusters of parental style of raising and clusters of specific life story factors could be detected. Results show a strong relation between life story factors and personality styles, predisposing to depression and emphasize the importance of considering personality, when exploring special life story factors. Vice versa, actual personality styles can point to different patterns of life story and thus, show the relevance for the diagnostic and therapeutic process.

  14. Predictive factors and management of rectal bleeding side effects following prostate cancer brachytherapy.

    PubMed

    Price, Jeremy G; Stone, Nelson N; Stock, Richard G

    2013-08-01

    To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥ grade 2 proctitis. A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, and treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. Actuarial risk of ≥ grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following BT. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Predictive Factors and Management of Rectal Bleeding Side Effects Following Prostate Cancer Brachytherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Price, Jeremy G.; Stone, Nelson N.; Stock, Richard G., E-mail: Richard.Stock@mountsinai.org

    2013-08-01

    Purpose: To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥grade 2 proctitis. Methods and Materials: A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, andmore » treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. Results: Actuarial risk of ≥grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. Conclusions: Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following BT.« less

  16. Caveolin-1 deficiency may predispose African Americans to systemic sclerosis-related interstitial lung disease.

    PubMed

    Reese, Charles; Perry, Beth; Heywood, Jonathan; Bonner, Michael; Visconti, Richard P; Lee, Rebecca; Hatfield, Corey M; Silver, Richard M; Hoffman, Stanley; Tourkina, Elena

    2014-07-01

    Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis (SSc; scleroderma). Although SSc-related ILD is more common and severe in African Americans than in Caucasians, little is known about factors underlying this significant health disparity. The aim of this study was to examine the role that low expression of caveolin-1 might play in susceptibility to ILD among African Americans. Assays of monocyte migration toward stromal cell-derived factor 1 (SDF-1) were performed using monocytes from Caucasian and African American healthy donors and patients with SSc. For fibrocyte differentiation studies, total peripheral blood mononuclear cells were incubated on fibronectin-coated plates. Protein expression was evaluated by immunohistochemistry and Western blotting. Monocytes from healthy African American donors and those from patients with SSc had low caveolin-1 levels, enhanced migration toward the CXCR4 ligand SDF-1, and enhanced differentiation to fibrocytes. Enhanced migration and differentiation of monocytes from African Americans and patients with SSc appeared to be attributable to the lack of caveolin-1, because restoring caveolin-1 function using a caveolin-1 scaffolding domain peptide inhibited these processes. Although they differed from monocytes from Caucasians, monocytes from both African Americans and patients with SSc were not identical, because SSc monocytes showed major increases from baseline in ERK, JNK, p38, and Smad2/3 activation, while monocytes from African Americans showed only limited ERK activation and no activation of JNK, p38, or Smad2/3. In contrast, SDF-1 exposure caused no additional ERK activation in SSc monocytes but did cause significant additional activation in monocytes from African Americans. African Americans may be predisposed to SSc-related ILD due to low baseline caveolin-1 levels in their monocytes, potentially affecting signaling, migration, and fibrocyte differentiation. The monocytes of African Americans may lack caveolin-1 due to high levels of transforming growth factor β in their blood. Copyright © 2014 by the American College of Rheumatology.

  17. Caveolin-1 Deficiency May Predispose African Americans to Systemic Sclerosis–Related Interstitial Lung Disease

    PubMed Central

    Reese, Charles; Perry, Beth; Heywood, Jonathan; Bonner, Michael; Visconti, Richard P.; Lee, Rebecca; Hatfield, Corey M.; Silver, Richard M.; Hoffman, Stanley; Tourkina, Elena

    2014-01-01

    Objective Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis (SSc; scleroderma). Although SSc-related ILD is more common and severe in African Americans than in Caucasians, little is known about factors underlying this significant health disparity. The aim of this study was to examine the role that low expression of caveolin-1 might play in susceptibility to ILD among African Americans. Methods Assays of monocyte migration toward stromal cell–derived factor 1 (SDF-1) were performed using monocytes from Caucasian and African American healthy donors and patients with SSc. For fibrocyte differentiation studies, total peripheral blood mono-nuclear cells were incubated on fibronectin-coated plates. Protein expression was evaluated by immuno-histochemistry and Western blotting. Results Monocytes from healthy African American donors and those from patients with SSc had low caveolin-1 levels, enhanced migration toward the CXCR4 ligand SDF-1, and enhanced differentiation to fibrocytes. Enhanced migration and differentiation of monocytes from African Americans and patients with SSc appeared to be attributable to the lack of caveolin-1, because restoring caveolin-1 function using a caveolin-1 scaffolding domain peptide inhibited these processes. Although they differed from monocytes from Caucasians, monocytes from both African Americans and patients with SSc were not identical, because SSc monocytes showed major increases from baseline in ERK, JNK, p38, and Smad2/3 activation, while monocytes from African Americans showed only limited ERK activation and no activation of JNK, p38, or Smad2/3. In contrast, SDF-1 exposure caused no additional ERK activation in SSc monocytes but did cause significant additional activation in monocytes from African Americans. Conclusion African Americans may be predisposed to SSc-related ILD due to low baseline caveolin-1 levels in their monocytes, potentially affecting signaling, migration, and fibrocyte differentiation. The monocytes of African Americans may lack caveolin-1 due to high levels of transforming growth factor β in their blood. PMID:24578173

  18. Different risk factors related to adenovirus- or BK virus-associated hemorrhagic cystitis following allogeneic stem cell transplantation.

    PubMed

    Mori, Yasuo; Miyamoto, Toshihiro; Kato, Koji; Kamezaki, Kenjiro; Kuriyama, Takuro; Oku, Seido; Takenaka, Katsuto; Iwasaki, Hiromi; Harada, Naoki; Shiratsuchi, Motoaki; Abe, Yasunobu; Nagafuji, Koji; Teshima, Takanori; Akashi, Koichi

    2012-03-01

    Virus-associated hemorrhagic cystitis (HC) is a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HSCT). Although numerous studies have attempted to identify factors that predispose patients to viral HC, its causes remain controversial. We analyzed retrospectively the results of 266 allogeneic HSCTs to identify factors associated with HC. Of this group, 42 patients (15.8%) were diagnosed with viral HC, because of either adenovirus (ADV; n = 26; 9.8%) or BK virus (BKV; n = 16; 6.0%). ADV-HC was frequently associated with T cell purging, and was less common in patients with acute graft-versus-host-disease (GVHD). Conversely, BKV-HC was more frequently observed in patients with excessive immune reactions such as GVHD, preengraftment immune reaction, and hemophagocytic syndrome. These observations indicate that ADV- and BKV-HC may differ significantly in their risk factors and pathogenesis. Profound immune deficiency is more likely to be associated with ADV-HC, whereas immune hyperactivity might play a key role in BKV-HC. Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  19. Gut Microbiota: A Contributing Factor to Obesity

    PubMed Central

    Harakeh, Steve M.; Khan, Imran; Kumosani, Taha; Barbour, Elie; Almasaudi, Saad B.; Bahijri, Suhad M.; Alfadul, Sulaiman M.; Ajabnoor, Ghada M. A.; Azhar, Esam I.

    2016-01-01

    Obesity, a global epidemic of the modern era, is a risk factor for cardiovascular diseases (CVD) and diabetes. The pervasiveness of obesity and overweight in both developed as well as developing populations is on the rise and placing a huge burden on health and economic resources. Consequently, research to control this emerging epidemic is of utmost importance. Recently, host interactions with their resident gut microbiota (GM) have been reported to be involved in the pathogenesis of many metabolic diseases, including obesity, diabetes, and CVD. Around 1014 microorganisms reside within the lower human intestine and many of these 1014 microorganisms have developed mutualistic or commensal associations with the host and actively involved in many physiological processes of the host. However, dysbiosis (altered gut microbial composition) with other predisposing genetic and environmental factors, may contribute to host metabolic disorders resulting in many ailments. Therefore, delineating the role of GM as a contributing factor to obesity is the main objective of this review. Obesity research, as a field is expanding rapidly due to major advances in nutrigenomics, metabolomics, RNA silencing, epigenetics, and other disciplines that may result in the emergence of new technologies and methods to better interpret causal relationships between microbiota and obesity. PMID:27625997

  20. A Clinical Update on Delirium: From Early Recognition to Effective Management

    PubMed Central

    Cerejeira, Joaquim; Mukaetova-Ladinska, Elizabeta B.

    2011-01-01

    Delirium is a neuropsychiatric syndrome characterized by altered consciousness and attention with cognitive, emotional and behavioural symptoms. It is particularly frequent in elderly people with medical or surgical conditions and is associated with adverse outcomes. Predisposing factors render the subject more vulnerable to a congregation of precipitating factors which potentially affect brain function and induce an imbalance in all the major neurotransmitter systems. Early diagnosis of delirium is crucial to improve the prognosis of patients requiring the identification of subtle and fluctuating signs. Increased awareness of clinical staff, particularly nurses, and routine screening of cognitive function with standardized instruments, can be decisive to increase detection rates of delirium. General measures to prevent delirium include the implementation of protocols to systematically identify and minimize all risk factors present in a particular clinical setting. As soon as delirium is recognized, prompt removal of precipitating factors is warranted together with environmental changes and early mobilization of patients. Low doses of haloperidol or olanzapine can be used for brief periods, for the behavioural control of delirium. All of these measures are a part of the multicomponent strategy for prevention and treatment of delirium, in which the nursing care plays a vital role. PMID:21994844

  1. Age, Predisposing Diseases, and Ultrasonographic Findings in Determining Clinical Outcome of Acute Acalculous Inflammatory Gallbladder Diseases in Children

    PubMed Central

    2016-01-01

    We evaluated clinical factors such as age, gender, predisposing diseases and ultrasonographic findings that determine clinical outcome of acute acalculous inflammatory gallbladder diseases in children. The patients were divided into the four age groups. From March 2004 through February 2014, clinical data from 131 children diagnosed as acute acalculous inflammatory gallbladder disease by ultrasonography were retrospectively reviewed. Systemic infectious diseases were the most common etiology of acute inflammatory gallbladder disease in children and were identified in 50 patients (38.2%). Kawasaki disease was the most common predisposing disease (28 patients, 21.4%). The incidence was highest in infancy and lowest in adolescence. The age groups were associated with different predisposing diseases; noninfectious systemic disease was the most common etiology in infancy and early childhood, whereas systemic infectious disease was the most common in middle childhood and adolescence (P = 0.001). Gallbladder wall thickening was more commonly found in malignancy (100%) and systemic infection (94.0%) (P = 0.002), whereas gallbladder distension was more frequent in noninfectious systemic diseases (60%) (P = 0.000). Ascites seen on ultrasonography was associated with a worse clinical course compared with no ascites (77.9% vs. 37.7%, P = 0.030), and the duration of hospitalization was longer in patients with ascites (11.6 ± 10.7 vs. 8.0 ± 6.6 days, P = 0.020). In conclusion, consideration of age and predisposing disease in addition to ultrasonographic gallbladder findings in children suspected of acute acalculous inflammatory gallbladder disease might result in better outcomes. PMID:27550491

  2. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan.

    PubMed

    Nasir, Elwalid Fadul; Astrøm, Anne Nordrehaug; David, Jamil; Ali, Raouf Wahab

    2009-11-16

    HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.

  3. Clinical outcome in 94 cases of dermal haemangiosarcoma in dogs treated with surgical excision: 1993-2007*.

    PubMed

    Szivek, A; Burns, R E; Gericota, B; Affolter, V K; Kent, M S; Rodriguez, C O; Skorupski, K A

    2012-03-01

    Canine dermal haemangiosarcoma (HSA) is believed to have a better prognosis compared to HSA in other organs, but outcome has only been reported in a small number of dogs. The purpose of this study was to assess outcome and prognostic factors in a larger cohort of dogs with dermal HSA. Clinical data was collected retrospectively for 94 dogs and histopathology was reviewed in 53 dogs. Median overall survival time was 987 days. Dogs of predisposed breed with ventral location and histologic solar changes had longer survivals. Loco-regional recurrence occurred in 72/94 (77%) dogs. Predisposed breeds with ventral location and multiple masses were more likely to develop recurrence. Non-predisposed breeds with invasive tumours were more likely to develop metastasis. Results suggest that dogs with solar-induced dermal HSA may have high recurrence rates, but prolonged survivals. Dogs with non-solar tumours may be at increased risk for metastasis and shorter survival. © 2011 Blackwell Publishing Ltd.

  4. Dietary copper: a novel predisposing factor for oral submucous fibrosis?

    PubMed

    Arakeri, Gururaj; Brennan, Peter A

    2013-03-01

    Oral submucous fibrosis (OSMF) is known devastating disorder commonly seen in South Asian developing countries. It is directly linked to areca nut chewing and the contents of areca are subjected to multitude of investigations. Among all the contents of areca nut, the copper element has been extensively studied. Most of the published studies have validated its association with OSMF because of its local action. In this paper we postulate a novel biological pathway through which copper is thought to predispose oral mucosa to OSMF. The hypothesis is instructive in explaining various unexplored aspects of the disease. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Bilateral breast abscess: a rare complication of enteric fever.

    PubMed

    Singh, S; Pandya, Y; Rathod, J; Trivedi, S

    2009-01-01

    Breast abscess is usually caused by Staphylococcus aureus in pregnant or lactating females. Salmonella spp. is occasionally associated with abscess formation in various organs, but breast abscess is a very rare complication. In enteric fever dissemination to multiple organ systems following bacteraemia can lead to localized abscess. We report a case of bilateral breast abscess due to Salmonella Typhi in an unmarried 35-year-old female without any predisposing conditions. She presented with fever and painful swelling of both the breasts. S. typhi was isolated from both breasts. Such rare cause must be suspected in females without any evident predisposing factors for effective management.

  6. Gingival recession: its causes and types, and the importance of orthodontic treatment

    PubMed Central

    Jati, Ana Suzy; Furquim, Laurindo Zanco; Consolaro, Alberto

    2016-01-01

    abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature. PMID:27409650

  7. The stress and migraine interaction.

    PubMed

    Sauro, Khara M; Becker, Werner J

    2009-10-01

    There are several ways in which stress may interact with migraine in those predisposed to migraine attacks. These interactions may result from biochemical changes related to the physiological stress response, as, for example, the release of corticotrophin releasing hormone, or from changes induced by the psychological response to stressors. Stress is the factor listed most often by migraine sufferers as a trigger for their attacks, but in addition there is evidence that stress can help initiate migraine in those predisposed to the disorder, and may also contribute to migraine chronification. Migraine attacks themselves can act as a stressor, thereby potentially leading to a vicious circle of increasing migraine frequency. Since the important factor in the stress-migraine interaction is likely the individual's responses to stressors, rather than the stressors themselves, the acquisition of effective stress management skills has the potential to reduce the impact of stressors on those with migraine.

  8. Right-sided infective endocarditis: recent epidemiologic changes

    PubMed Central

    Yuan, Shi-Min

    2014-01-01

    Background: Infective endocarditis (IE) has been increasingly reported, however, little is available regarding recent development of right-sided IE. Methods: Right-sided IE was comprehensively analyzed based on recent 5⅓-year literature. Results: Portal of entry, implanted foreign material, and repaired congenital heart defects were the main predisposing risk factors. Vegetation size on the right-sided valves was much smaller than those beyond the valves. Multiple logistic regression analysis revealed that predisposing risk factors, and vegetation size and locations were independent predictive risks of patients’ survival. Conclusions: Changes of right-sided IE in the past 5⅓ years included younger patient age, and increased vegetation size, but still prominent Staphylococcus aureus infections. Complication spectrum has changed into more valve insufficiency, more embolic events, reduced abscess formation, and considerably decreased valve perforations. With effective antibiotic regimens, prognoses of the patients seemed to be better than before. PMID:24482708

  9. [Pathogenesis of adhesions formation after intraabdominal operations].

    PubMed

    Voskanian, S É; Kyzlasov, P S

    2011-01-01

    The article describes the pathogenesis of adhesions formation after intraabdominal operations. Described predisposing factors leading of which is mechanical trauma, resulting from the use of surgical instruments, rough manipulations during surgery, damage to the mesothelium by dry gauze etc, which cause the adhesions. The pathogenesis of adhesions formation after intraabdominal surgery is presented in outline form, which described the changes occurring in the body starting with combination of predisposing factors and ending with the development of adhesions with blood vessels by 7-12 days after surgery. At the genetic level predisposition to adhesions formation and development of adhesive disease is treated as a manifestation of rapid acetylation phenotype, in which the intensity of fibrin formation exceeds normal rate of its catabolism. Thus, according to modem concepts, adhesive disease is a separate nosologic unit that dictates the necessity of its detailed study, development and introduction new universal methods of preventing the adhesions formation after intraabdominal operations.

  10. Subclinical mastitis in dairy animals: incidence, economics, and predisposing factors.

    PubMed

    Sinha, Mukesh Kr; Thombare, N N; Mondal, Biswajit

    2014-01-01

    A study was conducted to assess the incidence and economics of subclinical form of bovine mastitis in Central Region of India. Daily milk records of 187 animals during three seasons were collected and subjected to analysis. The economic loss due to reduction in yield, clinical expenses, and additional resources used were quantified and aggregated. The losses due to mastitis in monetary terms were estimated to be INR1390 per lactation, among which around 49% was owing to loss of value from milk and 37% on account of veterinary expenses. Higher losses were observed in crossbred cows due to their high production potential that was affected during mastitis period. The cost of treating an animal was estimated to be INR509 which includes cost of medicine (31.10%) and services (5.47%). Inadequate sanitation, hygiene, and veterinary services were the main predisposing factors for incidence and spread of mastitis as perceived by the respondents.

  11. Acute respiratory distress syndrome.

    PubMed

    Confalonieri, Marco; Salton, Francesco; Fabiano, Francesco

    2017-06-30

    Since its first description, the acute respiratory distress syndrome (ARDS) has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foster geographic variability and contrasting outcome data. A large international multicentre prospective cohort study including 50 countries across five continents reported that ARDS is underdiagnosed, and there is potential for improvement in its management. Furthermore, epidemiological data from low-income countries suggest that a revision of the current definition of ARDS is needed in order to improve its recognition and global clinical outcome. In addition to the well-known risk-factors for ARDS, exposure to high ozone levels and low vitamin D plasma concentrations were found to be predisposing circumstances. Drug-based preventive strategies remain a major challenge, since two recent trials on aspirin and statins failed to reduce the incidence in at-risk patients. A new disease-modifying therapy is awaited: some recent studies promised to improve the prognosis of ARDS, but mortality and disabling complications are still high in survivors in intensive care. Copyright ©ERS 2017.

  12. Phosphate toxicity and vascular mineralization.

    PubMed

    Razzaque, Mohammed S

    2013-01-01

    Vascular calcification or mineralization is a major complication seen in patients with advanced stages of chronic kidney disease (CKD), and it is associated with markedly increased morbidity and mortality. Most of the CKD-related vascular mineralization is attributable to abnormal mineral ion metabolism. Elevated serum calcium and phosphate levels, along with increased calcium-phosphorus byproduct, and the use of active vitamin D metabolites are thought to be the predisposing factors for developing vascular mineralization in patients with CKD. Recent experimental studies have shown that vascular mineralization can be suppressed by reducing serum phosphate levels, even in the presence of extremely high serum calcium and 1,25-dihydroxyvitamin D levels, indicating that reducing 'phosphate toxicity' should be the important therapeutic priority in CKD patients for minimizing the risk of developing vascular mineralization and the disease progression. Copyright © 2013 S. Karger AG, Basel.

  13. Managing comorbidities in idiopathic pulmonary fibrosis

    PubMed Central

    Fulton, Blair G; Ryerson, Christopher J

    2015-01-01

    Major risk factors for idiopathic pulmonary fibrosis (IPF) include older age and a history of smoking, which predispose to several pulmonary and extra-pulmonary diseases. IPF can be associated with additional comorbidities through other mechanisms as either a cause or a consequence of these diseases. We review the literature regarding the management of common pulmonary and extra-pulmonary comorbidities, including chronic obstructive pulmonary disease, lung cancer, pulmonary hypertension, venous thromboembolism, sleep-disordered breathing, gastroesophageal reflux disease, coronary artery disease, depression and anxiety, and deconditioning. Recent studies have provided some guidance on the management of these diseases in IPF; however, most treatment recommendations are extrapolated from studies of non-IPF patients. Additional studies are required to more accurately determine the clinical features of these comorbidities in patients with IPF and to evaluate conventional treatments and management strategies that are beneficial in non-IPF populations. PMID:26451121

  14. Diabetic Ketoacidosis—A Review of Cases at a University Medical Center

    PubMed Central

    Kiraly, John F.; Becker, Charles E.; Williams, Hibbard E.

    1970-01-01

    Twenty-five cases of diabetic ketoacidosis were studied retrospectively with respect to clinical characteristics and results of therapy. In this series (as with all 88 patients admitted in the last five years with a diagnosis of diabetic ketoacidosis) there were no deaths. Infection was found to be the most common precipitating event, documented by physical findings and cultures in one-third of these cases. In about two-thirds of the cases, electrocardiograms which were read as abnormal on admission reverted to normal after therapy. In all patients serum potassium levels decreased from admission values; one patient became symptomatically hypokalemic. Low serum potassium levels on admission and early vigorous bicarbonate therapy are emphasized as major predisposing factors of symptomatic hypokalemia. None of the patients had overt hyperosmolar coma, lactic acidosis or cerebral edema during therapy. PMID:4985288

  15. Exploitation of children and young people through prostitution.

    PubMed

    Walker, Karen Elizabeth

    2002-09-01

    The numbers of children in contemporary society involved in prostitution is still largely unknown. However, there are multiple factors which leave children vulnerable and involved in prostitution. This article aims to explore the historical context of child prostitution, factors which may predispose an adolescent engaging in prostitution, and the role that professionals within the healthcare settings can offer.

  16. Correlates of Geriatric Loneliness in Philippine Nursing Homes: A Multiple Regression Model

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Maravilla, Katrina N.; Maravilla, Veniza Anne M.; Marfil, Jomille D. V.; Marinas, Janine Angelica R.; Marquez, Jorelle Michael B.

    2012-01-01

    Numerous studies have been conducted worldwide about loneliness in older adults living in nursing homes and the factors associated with it. However, only a few studies have focused on social factors that may predispose these older adults to experience loneliness. The purpose of this study was to examine the interplay between and among loneliness,…

  17. Risk Factors for Low Bone Mineral Density in Individuals Residing in a Facility for the People with Intellectual Disability

    ERIC Educational Resources Information Center

    Jaffe, J. S.; Timell, A. M.; Elolia, R.; Thatcher, S. S.

    2005-01-01

    Background: Individuals with intellectual disability (ID) are known to have a high prevalence of both low bone mineral density (BMD) and fractures with significant attendant morbidity. Effective strategies aimed at reducing fractures will be facilitated by the identification of predisposing risk factors. Methods: Bone mineral density was measured…

  18. Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

    PubMed

    Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

    2016-11-01

    Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit. The block of enabling factors was the strongest predictor of hospitalization following an ED visit compared to predisposing and need factors. Our findings also provide evidence of disparities in hospitalization of the uninsured and racial and ethnic minority patients with ED visits for behavioral health conditions. Thus, improved access to community-based behavioral health services and an increased capacity for inpatient psychiatric hospitals for treating indigent patients may be needed to improve the efficiency of ED services in our region for patients with behavioral health conditions. Among need factors, a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, an impulse control disorder, or dementia as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization following an ED visit, also suggesting an opportunity for improving the efficiency of ED care through the provision of psychiatric services to stabilize and treat patients with serious mental illness. © 2016 by the Society for Academic Emergency Medicine.

  19. Human natural killer cells prevent infectious mononucleosis features by targeting lytic Epstein-Barr virus infection

    PubMed Central

    Chijioke, Obinna; Müller, Anne; Feederle, Regina; Barros, Mario Henrique M.; Krieg, Carsten; Emmel, Vanessa; Marcenaro, Emanuela; Leung, Carol S.; Antsiferova, Olga; Landtwing, Vanessa; Bossart, Walter; Moretta, Alessandro; Hassan, Rocio; Boyman, Onur; Niedobitek, Gerald; Delecluse, Henri-Jacques; Capaul, Riccarda; Münz, Christian

    2014-01-01

    SUMMARY Primary infection with the human oncogenic Epstein Barr virus (EBV) can result in infectious mononucleosis (IM), a self-limiting disease caused by massive lymphocyte expansion, which predisposes for the development of distinct EBV-associated lymphomas. It remains unclear why some individuals experience this symptomatic primary EBV infection, while the majority acquires the virus asymptomatically. Using a mouse model with reconstituted human immune system components, we show here that depletion of human natural killer (NK) cells enhances IM symptoms and promotes EBV-associated tumorigenesis, mainly due to loss of immune control over lytic EBV infection. These data suggest that failure of innate immune control by human NK cells augments symptomatic lytic EBV infection, which drives lymphocyte expansion and predisposes for EBV-associated malignancies. PMID:24360958

  20. Anaerobic infections in surgical wards: a two year study

    PubMed Central

    Ananth-Shenoy, Padmaja; Vishwanath, Shashidhar; Targain, Ryumzook; Shetty, Seema; Sunil-Rodrigues, Gabriel; Mukhopadhyay, Chiranjay; Chawla, Kiran

    2016-01-01

    Background and Objectives: Anaerobic bacteria are recognized as important pathogens in surgical infections. However, they are the most overlooked microorganisms by the clinic and the laboratory because of the tedious culture techniques with longer turn-around times. The study was aimed to analyze the frequency of anaerobic bacterial surgical infections and their predisposing factors. Materials and Methods: A retrospective study was conducted over a period of two years including patients with surgical infections. The specimens were processed by Gram staining, aerobic and anaerobic culture. The anaerobic bacteria were isolated using standard procedures. The predisposing factors and clinical presentation were studied in these patients. Results: A total of 261 specimens were received from patients with diverse infections from surgical wards. Ninety-one anaerobes were isolated from 64 (24.5%) surgical patients with a predominance of Gram-negative bacilli (37.4%). Anaerobic bacteria as monomicrobial isolates were seen in 21.9% isolates. Anaerobic bacterial isolation along with aerobic bacteria was seen in 71.9% of patients and polymicrobial anaerobic growth was detected in 6.3% of patients. Diabetes mellitus (28, 43.8%) was found to be the most frequent predisposing factor. Bacteroides fragilis group (20.9%) were the most frequent anaerobic Gram-negative bacilli followed by Prevotella spp. (12.1%). Peptostreptococcus anaerobius was the predominant anaerobic cocci isolated (14.3%). Necrotizing fascitis (34.4%) was the most common clinical presentation with anaerobic etiology followed by deep seated abscesses (23.4%). Conclusion: Anaerobic bacteria were isolated from a significant proportion of surgical infections. To avoid therapeutic failures, anaerobic bacteria in surgical infections need to be recognized by surgeons and laboratorians. PMID:27928485

  1. Facilitating Soldier Receipt of Needed Mental Health Treatment

    DTIC Science & Technology

    2013-11-01

    an intelligent lay audience can understand (Scientific American style ). In addition to the publications and presentations developed based on the...only thing was my parents , with like the 4 13 meds and stuff. Just that whole stigma. Discharge from Army ’Cause I did not want them to try to...predis- posing, enabling, and need factors (Andersen & Newman , 1973). Predisposing factors are pre- existing factors that contribute to an individu

  2. Genetics and risk factors for basal cell carcinoma.

    PubMed

    Madan, V; Hoban, P; Strange, R C; Fryer, A A; Lear, J T

    2006-05-01

    Nonmelanoma skin cancer (NMSC) is the commonest cancer in whites and its incidence is increasing worldwide. The prevalence of this cancer is predicted to equal that of all others combined and it was estimated that there were over 2 million cases diagnosed in the U.S.A. in 2004. Patients exhibit marked differences in clinical phenotype with variations in tumour numbers, rate of tumour accrual, site and histological subtype. Furthermore, patients are at increased risk of other cutaneous and noncutaneous cancers. The factors accounting for this variation are complex and still not completely understood. Clearly, ultraviolet light (UV) exposure is a major influence but its relationship to clinical phenotype is not yet clear. In addition, immunosuppression is a significant risk factor. Our group has identified high-risk groups for the development of further basal cell carcinoma (BCC), namely patients with truncal BCC and those presenting with tumour clusters. This presentation will concentrate on these clinical subgroups as well as immunosuppressed patients. These groups represent significant management challenges and are areas where novel, nonsurgical treatment options may make a significant clinical impact in patient care. The risk factors predisposing to these clinical phenotypes will be discussed, including genetic factors and UV exposure. Potential clinical applications, including predictive indices, will be considered.

  3. The increasing importance of environmental conditions in amyotrophic lateral sclerosis

    NASA Astrophysics Data System (ADS)

    Riancho, Javier; Bosque-Varela, Pilar; Perez-Pereda, Sara; Povedano, Mónica; de Munaín, Adolfo López; Santurtun, Ana

    2018-04-01

    Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative disease affecting motor neurons (MNs). Although a small percentage of ALS has a familial origin, the vast majority of cases are sporadic in which genetic factors and environment interact with each other leading to disease onset in genetically predisposed individuals. In the current model of the disease, each individual has a determined genetic load, some degree of cell degeneration related to age and several risky environmental exposures. In this scenario, MN degeneration would occur when the sum of these factors reach a certain threshold. To date, an extensive list of environmental factors has been associated to ALS, including different categories, such as exposure to heavy metals and other toxicants, cyanotoxins or infectious agents. In addition, in recent years, lifestyle and other demographic parameters are gaining relevance in the genesis of the disease. Among them, physical activity, nutrition, body mass index, cardiovascular risk factors, autoimmune diseases and cancer are some of the conditions which have been related to the disease. In this review, we will discuss the potential mechanisms of environmental conditions in motor neuron degeneration. Understanding the role of each one of these factors as well as their interactions appears as a crucial step in order to develop new preventive, diagnostic and therapeutic approaches for ALS patients.

  4. Predictors of Adolescent Health Care Utilization

    ERIC Educational Resources Information Center

    Vingilis, Evelyn; Wade, Terrance; Seeley, Jane

    2007-01-01

    This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…

  5. Assessment of the predisposing factors for shallow landslides activation in terraced areas: the case of the Rupinaro catchment, Liguria (northwestern Italy).

    NASA Astrophysics Data System (ADS)

    Cignetti, Martina; Godone, Danilo; Giordan, Daniele

    2017-04-01

    The shallow landslides occurrence is strongly correlated with climatic conditions and environmental settings. In the Liguria region (northwestern Italy), the landscape presents an ancient human intervention represented by terraces and, in the last century, by a general overbuilding, both in the few flat areas and in the steep slope hinterland. From the twentieth century, the progressive abandonment of agriculture generated a lack of maintenance of terraced areas, which associated to the urban and the road net development, supported the slope susceptibility to instability. This makes the assessment of the predisposing factors for shallow landslides a multidisciplinary task, combining natural and man-made issues. In this work, we try to define all the main predisposing factors of the Rupinaro catchment (southeast Liguria). We operate starting from a high-resolution Digital Terrain Model (DTM) supplied by an airborne LiDAR survey carried out after the autumn 2014 rainfall events. From this DTM, we mapped a total amount of 96 landslides in the study area. Then, we implemented a classification methodology based on a simple parametric score. In GIS environment we overlaid several layers: i) lithological and hydrogeological map, ii) slope iii) aspect, iv) the land use information, available by the CORINE land cover, and iv) the presence of terraces. Each spatial data was than reclassified according a numerical code. The sum, by raster math, of these factors provided an overall score raster for the entire basin. This method allows the characterization of the entire watershed, gathering all the predisposing factors for the shallow landslides activation. A categorization of the landslides area mapped from the DTM and stored in a vector layer has been made. In particular, we estimated the most frequent code within each landslide polygon, obtaining a representative data of the most influential factors that triggered shallow landslides. The results showed the prevalent occurrence of shallow landslides in correspondence of terraced areas, cultivated by olive grove, with an impervious bedrock, and presenting gently slope and variable exposure from east/west to south. Our approach focuses on the interaction of landslides susceptibility and the land use modifications over time, with more attention over maintenance level of terraces. This methodology represents a starting point for the correct assessment of shallow landslides occurrence factors, capable to generate a susceptibility map of the entire basin, taking in account of the characteristic features of this extremely man-made territory. In order to assess the spatial connectivity of the basin and in addition to highlight the road network and the terraces role in the shallow landslides occurrence, a future comparison of the obtained data with hydrological indexes is planned.

  6. Promoting physical activity in the workplace: A systematic meta-review

    PubMed Central

    Jirathananuwat, Areeya; Pongpirul, Krit

    2017-01-01

    Introduction: Physically active (PA) people have a lower risk of various diseases, compared to those with sedentary lifestyles. Evidence on the effects of PA promoting programs in the workplace is large, and several systematic reviews (SR) and/or meta-analyses (MA) have been published. However, they have failed to consider factors that could influence interventions. This paper aimed to classify and describe interventions to promote PA in the workplace based on evidence from SR/MA. Method: A literature search for SR/MA was done using PubMed, Web of Science, and Science Direct (January 2006-February 2015). Quality assessment of SR/MA was performed using AMSTAR. The PRECEDE-PROCEED model was used for classifying the interventions into predisposing, enabling, reinforcing, environment, and policy domains of focus. Results: Eleven SR/MA included 220 primary studies, of which 139 (63%) were randomized controlled trials. Of 48 interventions identified, 22 (46%) and 17 (35%) focused on predisposing or enabling employees to have more PA, respectively. Of the 22 predisposing factors, 6 were information delivery, 5 were self-motivation, and 11 were program training. The enabling approaches were 12 instrument resources and 5 health service facilities. The reinforcing approaches were 4 incentive and 3 social support. The remaining interventions focused on the environmental development and policy regulation. Conclusions: This systematic meta-review classified interventions using appropriate framework and described the intervention pattern. PMID:28740029

  7. Promoting physical activity in the workplace: A systematic meta-review.

    PubMed

    Jirathananuwat, Areeya; Pongpirul, Krit

    2017-09-28

    Physically active (PA) people have a lower risk of various diseases, compared to those with sedentary lifestyles. Evidence on the effects of PA promoting programs in the workplace is large, and several systematic reviews (SR) and/or meta-analyses (MA) have been published. However, they have failed to consider factors that could influence interventions. This paper aimed to classify and describe interventions to promote PA in the workplace based on evidence from SR/MA. A literature search for SR/MA was done using PubMed, Web of Science, and Science Direct (January 2006-February 2015). Quality assessment of SR/MA was performed using AMSTAR. The PRECEDE-PROCEED model was used for classifying the interventions into predisposing, enabling, reinforcing, environment, and policy domains of focus. Eleven SR/MA included 220 primary studies, of which 139 (63%) were randomized controlled trials. Of 48 interventions identified, 22 (46%) and 17 (35%) focused on predisposing or enabling employees to have more PA, respectively. Of the 22 predisposing factors, 6 were information delivery, 5 were self-motivation, and 11 were program training. The enabling approaches were 12 instrument resources and 5 health service facilities. The reinforcing approaches were 4 incentive and 3 social support. The remaining interventions focused on the environmental development and policy regulation. This systematic meta-review classified interventions using appropriate framework and described the intervention pattern.

  8. Cigarette Smoke Attenuates the Nasal Host Response to Streptococcus pneumoniae and Predisposes to Invasive Pneumococcal Disease in Mice

    PubMed Central

    Shen, Pamela; Morissette, Mathieu C.; Vanderstocken, Gilles; Gao, Yang; Hassan, Muhammad; Roos, Abraham; Thayaparan, Danya; Merlano, Maria; Dorrington, Michael G.; Nikota, Jake K.; Bauer, Carla M. T.; Kwiecien, Jacek M.; Labiris, Renee; Bowdish, Dawn M. E.; Stevenson, Christopher S.

    2016-01-01

    Streptococcus pneumoniae is a leading cause of invasive bacterial infections, with nasal colonization an important first step in disease. While cigarette smoking is a strong risk factor for invasive pneumococcal disease, the underlying mechanisms remain unknown. This is partly due to a lack of clinically relevant animal models investigating nasal pneumococcal colonization in the context of cigarette smoke exposure. We present a model of nasal pneumococcal colonization in cigarette smoke-exposed mice and document, for the first time, that cigarette smoke predisposes to invasive pneumococcal infection and mortality in an animal model. Cigarette smoke increased the risk of bacteremia and meningitis without prior lung infection. Mechanistically, deficiency in interleukin 1α (IL-1α) or platelet-activating factor receptor (PAFR), an important host receptor thought to bind and facilitate pneumococcal invasiveness, did not rescue cigarette smoke-exposed mice from invasive pneumococcal disease. Importantly, we observed cigarette smoke to attenuate nasal inflammatory mediator expression, particularly that of neutrophil-recruiting chemokines, normally elicited by pneumococcal colonization. Smoking cessation during nasal pneumococcal colonization rescued nasal neutrophil recruitment and prevented invasive disease in mice. We propose that cigarette smoke predisposes to invasive pneumococcal disease by suppressing inflammatory processes of the upper respiratory tract. Given that smoking prevalence remains high worldwide, these findings are relevant to the continued efforts to reduce the invasive pneumococcal disease burden. PMID:26930709

  9. [The comorbidity of major depressive disorder, dysthymic disorder and anxiety disorders with migraine].

    PubMed

    Cardona-Castrillon, G P; Isaza, R; Zapata-Soto, A P; Franco, J G; Gonzalez-Berrio, C; Tamayo-Diaz, C P

    Since migraine was first reported it has been associated with psychiatric disorders. This association has clinical repercussions and common genetic, environmental and psychological predisposing factors have been suggested. To determine the prevalence of anxiety disorders, major depressive disorder and dysthymic disorder as conditions that are comorbid to migraine in patients visiting due to headaches at the Pablo Tobon Uribe Hospital (Medellin, Colombia). We conducted a cross-sectional analytical study that evaluated all patients aged between 18 and 65 years with migraine according to the International Headache Society criteria who visited during a one-year period. Psychiatric disorders were diagnosed using the Hospital Anxiety and Depression Scale, followed by a semi-structured interview according to criteria in the Diagnostic and Statistical Manual of Mental Disorders IV, Text Revision. A total of 89 patients with migraine were evaluated. The frequency of migraine with aura was 35.9% and that of migraine without aura was 25.8%. The prevalence of major depressive disorder was 21.3%; that of dysthymic disorder was 4.5%; generalised anxiety disorder was 14.6%; social phobia was 6.7%; specific phobia was 5.6%; panic disorder was 5.6%; post-traumatic stress was 4.5% and obsessive-compulsive disorder was 2.2%. Seventeen people (19.1%) had two mental disorders. Prevalence of the mental disorders evaluated in this group of patients was found to be high. This work suggests the need to evaluate possible common risk and aetiological factors, as well as multidisciplinary treatments for these comorbid states.

  10. A Multivariate Test of an Expanded Andersen Health Care Utilization Model for Complementary and Alternative Medicine (CAM) Use in African Americans

    PubMed Central

    Barner, Jamie; Bohman, Tom; Richards, Kristin

    2009-01-01

    Abstract Objectives The objectives of this study were (1) to determine which Andersen Model variables [predisposing, enabling, and need (PEN)] are related to complementary and alternative medicine (CAM) use by African Americans in the past 12 months; and (2) to determine whether the addition of disease states to the Model will explain significant variation in CAM use in the past 12 months. Design The 2002 National Health Interview Survey was used with 4256 African American adults (n = 23,828,268 weighted) selected as the study population. The dependent variable, CAM Past 12 Months, represented participants' use of at least 1 of 17 CAM modalities during the past 12 months. The Andersen Model variables [predisposing (e.g., age); enabling (e.g., insurance); and need (e.g., medical conditions)] and prevalent disease states (≥10%) comprised the independent variables. Logistic regression analyses, incorporating the sampling weights, were employed. Results Among predisposing factors, CAM use was associated with middle-aged to older, more educated, and female African Americans. Region (Northeast less likely than South) was the only significant enabling factor. Need factors had the most frequent relationships, with more medical conditions, more physician visits, better health status, prescription and over-the-counter medication use, more frequent exercise, and having activities of daily living limitations being associated with CAM use. After adjusting for PEN factors, the disease states of pain/aching joints, recurring pain, and migraine were related to CAM use. Conclusions African American CAM users are middle-aged to older, female, educated, and have more medical conditions (especially pain-related). Users report higher utilization of “traditional” care (e.g., physician visits), indicating that CAM is likely a complement to conventional treatment in this population. Health care providers should use these factors as prompts for inquiring about CAM use in African American patients. PMID:19678783

  11. A multivariate test of an expanded Andersen Health Care utilization model for complementary and alternative medicine (CAM) use in African Americans.

    PubMed

    Brown, Carolyn; Barner, Jamie; Bohman, Tom; Richards, Kristin

    2009-08-01

    The objectives of this study were (1) to determine which Andersen Model variables [predisposing, enabling, and need (PEN)] are related to complementary and alternative medicine (CAM) use by African Americans in the past 12 months; and (2) to determine whether the addition of disease states to the Model will explain significant variation in CAM use in the past 12 months. The 2002 National Health Interview Survey was used with 4256 African American adults (n = 23,828,268 weighted) selected as the study population. The dependent variable, CAM Past 12 Months, represented participants' use of at least 1 of 17 CAM modalities during the past 12 months. The Andersen Model variables [predisposing (e.g., age); enabling (e.g., insurance); and need (e.g., medical conditions)] and prevalent disease states (> or =10%) comprised the independent variables. Logistic regression analyses, incorporating the sampling weights, were employed. Among predisposing factors, CAM use was associated with middle-aged to older, more educated, and female African Americans. Region (Northeast less likely than South) was the only significant enabling factor. Need factors had the most frequent relationships, with more medical conditions, more physician visits, better health status, prescription and over-the-counter medication use, more frequent exercise, and having activities of daily living limitations being associated with CAM use. After adjusting for PEN factors, the disease states of pain/aching joints, recurring pain, and migraine were related to CAM use. African American CAM users are middle-aged to older, female, educated, and have more medical conditions (especially pain-related). Users report higher utilization of "traditional" care (e.g., physician visits), indicating that CAM is likely a complement to conventional treatment in this population. Health care providers should use these factors as prompts for inquiring about CAM use in African American patients.

  12. Predisposing characteristics, enabling resources and need as predictors of utilization and clinical outcomes for veterans receiving mental health services.

    PubMed

    Fasoli, DiJon R; Glickman, Mark E; Eisen, Susan V

    2010-04-01

    Though demand for mental health services (MHS) among US veterans is increasing, MHS utilization per veteran is decreasing. With health and social service needs competing for limited resources, it is important to understand the association between patient factors, MHS utilization, and clinical outcomes. We use a framework based on Andersen's behavioral model of health service utilization to examine predisposing characteristics, enabling resources, and clinical need as predictors of MHS utilization and clinical outcomes. This was a prospective observational study of veterans receiving inpatient or outpatient MHS through Veterans Administration programs. Clinician ratings (Global Assessment of Functioning [GAF]) and self-report assessments (Behavior and Symptom Identification Scale-24) were completed for 421 veterans at enrollment and 3 months later. Linear and logistic regression analyses were conducted to examine: (1) predisposing characteristics, enabling resources, and need as predictors of MHS inpatient, residential, and outpatient utilization and (2) the association between individual characteristics, utilization, and clinical outcomes. Being older, female, having greater clinical need, lack of enabling resources (employment, stable housing, and social support), and easy access to treatment significantly predicted greater MHS utilization at 3-month follow-up. Less clinical need and no inpatient psychiatric hospitalization predicted better GAF and Behavior and Symptom Identification Scale-24 scores. White race and residential treatment also predicted better GAF scores. Neither enabling resources, nor number of outpatient mental health visits predicted clinical outcomes. This application of Andersen's behavioral model of health service utilization confirmed associations between some predisposing characteristics, need, and enabling resources on MHS utilization but only predisposing characteristics, need, and utilization were associated with clinical outcomes.

  13. Choroidal neovascularisation triggered multiple evanescent white dot syndrome (MEWDS) in predisposed eyes.

    PubMed

    Mathis, Thibaud; Delaunay, Benoit; Cahuzac, Armelle; Vasseur, Vivien; Mauget-Faÿsse, Martine; Kodjikian, Laurent

    2017-09-28

    Multiple evanescent white dot syndrome (MEWDS) is an inflammatory disease that can be associated with choroidalneovascularisation (CNV). However, few studies in the literature have described the occurrence of MEWDS in association with CNV. This paper discusses whether CNV can trigger MEWDS in a predisposed eye. A retrospective multicentric case series of six eyes in six patients with acute onset of MEWDS and evidence of previous CNV was conducted between January 2015 and January 2017. All patients underwent ophthalmic examination including multimodal imaging at baseline and during follow-up. The mean age was 32.2±12.2 years. The majority of patients were women (5/1). In each case, MEWDS was diagnosed during a recurrence or occurrence of CNV secondary to choriocapillaritis, central serous chorioretinopathy or atrophic scar, presumably due to congenital toxoplasmosis. All patients were treated with intravitreal injections of antivascular endothelial growth factor (anti-VEGF) with good anatomical and functional responses (mean gain of 0.3±0.31 logMAR). The mean duration of follow-up was 13.5±10.65 months. This study highlights a sequence in the development of MEWDS, following the occurrence or recurrence of CNV. CNV may trigger MEWDS, possibly due to the proinflammatory environment created by the retinal tissue surrounding the CNV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Environmental and geomagnetic factors in relation to self-destructive ideation and behaviour

    NASA Astrophysics Data System (ADS)

    Bergiannaki, J. D.; Psarros, C.; Nastos, P. Th.; Paparigopoulos, T.; Paliatsos, A. G.; Tritakis, V. P.; Stefanis, C. N.

    2001-09-01

    Besides the individual factors such as the reaction to conflicts, several exogenous factors environmental and social may exert a pathogenic influence on suicidal behavior, suicide attempts and complete suicide on predisposed individuals. In the turn of the century many reports accord for the seasonality of suicides, which seems to have a bimodal distribution with a major peak around the spring-summer (April-May) and a second minor in autumn. On the other hand, the seasonal variation of environmental factors (daylight, sunlight duration, weather, temperature, air pressure, humidity, geomagnetism, solar activity, etc), of biological factors (melatonin, serotonin, serotonin precursors, etc) as also of sociological factors (ethnic events, major holidays, weekends etc) possibly influences the seasonal pattern of self-destructive behavior. Bimodal seasonal variation is also reported for biochemical parameters (L-tryptophan, serotonin, endorphin I fraction) that matches seasonal pattern in the prevalence of violent suicide in the total population and also in the incidence of the affective disorders. The aim of this study is to investigate the relation of environmental factors expressed by the Discomfort Index (DI) and geomagnetic factors expressed by the geomagnetic field Index DST in relation to suicidal behavior. The total number (4803) of patients recorded in the Ambulance of a Phychiatric Hospital (Eginition) throughout 1994 was used along with the records of 2750 patients of the year 1989. The Index DI is a function of dry and wet-bulb temperature. DST is probably one of the geomagnetic indices that expresses and monitors with the greatest accuracy the equatorial ring current variations. Our results show that there is a seasonal variation of suicidal behavior (Fourier analysis) with a major peak during summer (July) and a minor one during spring. A difference in the occurrence of the peaks was observed among genders. A relation of self-destructive behavior and the daily changes of the geomagnetic index DST was found. This was significant with a latency of three days. As reported in the literature, serotonin, which is involved in the presence of suicide, was found to be magnetosensitive with a latency of three days. The contextual influence of the above factors in suicidal behavior will be discussed.

  15. An Overview on Mycotoxin Contamination of Foods in Africa

    PubMed Central

    DARWISH, Wageh Sobhy; IKENAKA, Yoshinori; NAKAYAMA, Shouta M.M.; ISHIZUKA, Mayumi

    2014-01-01

    ABSTRACT Mycotoxins are fungal secondary metabolites that contaminate various feedstuffs and agricultural crops. The contamination of food by mycotoxins can occur before production, during storage, processing, transportation or marketing of the food products. High temperature, moisture content and water activity are among the predisposing factors that facilitate the production of mycotoxins in food. Aflatoxins, ochratoxins, fumonisins, deoxynivalenol and zearalenone are all considered the major mycotoxins produced in food and feedstuffs. In Africa, mycotoxin contamination is considered to be a major problem with implications that affect human and animal health and economy. Aflatoxin-related hepatic diseases are reported in many African countries. Ochratoxin and fumonisin toxicity in humans and animals is widespread in Africa. The available, updated information on the incidence of mycotoxin contamination, decontamination and its public health importance in Africa is lacking. The aim of this review is to highlight, update and discuss the available information on the incidence of mycotoxins in African countries. The public health implications and the recommended strategies for control of mycotoxins in food and agricultural crops are also discussed. PMID:24572628

  16. Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

    PubMed

    Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid

    2017-04-01

    Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The analysis sheds further light on predisposing, need and enabling factors as predictors of non-drug psychotherapeutic/psychiatric treatment in children and adolescents with mental or behavioural health disorders in Germany. More research is needed to further understand the factors promoting the gap between the need and utilization of mental health care.

  17. Alcoholism and Suicide.

    ERIC Educational Resources Information Center

    Roy, Alec; Linnoila, Markku

    1986-01-01

    Reviews knowledge about suicide in alcoholism: how commonly suicide among alcoholics occurs; which alcoholics commit suicide and why; suicide among alcoholic women and alcoholic physicians; possible predisposing biological factors; possible linkages with depression, adverse life events, and personality disorder; and future research and directions.…

  18. HPV literacy and its link to initiation and completion of HPV vaccine among young adults in Minnesota.

    PubMed

    Lee, H Y; Lee, J; Henning-Smith, C; Choi, J

    2017-11-01

    This study identifies whether, and how, human papillomavirus (HPV) literacy and predisposing, enabling, and need factors are associated with HPV vaccine initiation and completion among young adults in Minnesota. Cross-sectional survey design. Using a sample of 170 young adults (aged 18-26 years), we used logistic regression models to identify factors associated with HPV vaccination initiation and completion, including HPV literacy, adjusting for relevant predisposing, enabling, and need factors. Consistent with national estimates, we found relatively low rates of HPV vaccination initiation (46%) and completion (36%). Better HPV literacy was significantly associated with higher rates of both initiation and completion, as was being female and having an annual check-up. Being married/partnered was significantly associated with lower odds of HPV vaccination. Public health programs, policy-makers, and healthcare providers can use these results to increase HPV vaccination rates by making concerted efforts to improve HPV vaccination literacy through individual and public education campaigns and by improving access to annual check-ups. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. Factors predisposing to early childhood caries (ECC) in children of pre-school age in the city of Zagreb, Croatia.

    PubMed

    Lulić-Dukić, O; Jurić, H; Dukić, W; Glavina, D

    2001-06-01

    The aim of this study was to investigate factors predisposing to early childhood caries (ECC) in pre-school children in the city of Zagreb, Croatia. The investigation was carried out on the sample of 145 children (77 boys and 68 girls) aged between 2 and 5 years, including clinical examination of dental status and survey on the habits among the parents. The overall prevalence of ECC was 30%: in girls it was 25%, and in boys 48%. The study on the risk factors was designed as a classic case-control study. The mean value of dmfs index among the cases amounted to 8.6, in comparison to 5.2 in the control group (p<0.05). Bottle-feeding did not represent a significant risk, but night consumption of sweet beverages after first 24 months and the lack of introduction of teeth-brushing habit after first 24 months did (p < 0.001 for both predictors). The study revealed the importance of early introduction of teeth-brushing and giving up the nightly consumption of sweet beverages in prevention of ECC.

  20. Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

    PubMed

    Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

    2012-10-01

    This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

  1. Help-seeking behaviors for serious psychological distress among individuals with diabetes mellitus: The California Health Interview Survey, 2011-2012.

    PubMed

    Shin, Jinah K; Poltavskiy, Eduard; Kim, Tae Nyun; Hasan, Abdullah; Bang, Heejung

    2017-02-01

    To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD). The analysis was conducted with the California Health Interview Survey (CHIS) 2011-2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen's Health Care Utilization Model. The prevalence of DM and SPD were 10.9% and 3.4%, respectively, among participants in the survey. The participants with DM were more likely to experience SPD than those without DM (OR 1.46, 95% CI=1.11-1.91, p=0.006). Participants with combined DM and SPD, the most underserved, were less likely to perceive the need for mental health services and less likely to seek help, compared to those with only SPD. Need factors (SPD status and perceived need) were significantly associated with help-seeking behaviors for mental health, along with predisposing factors (age, gender, obesity, race, and employment), and enabling factors (insurance, English proficiency). Perceptions about need for seeking help seem to play an important role in receiving mental health services in addition to other predisposing or enabling factors. Identification of these factors may improve clinical outcomes related to DM and SPD. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  2. Using Online Respondent Driven Sampling for Vietnamese Youths' Alcohol Use and Associated Risk Factors

    PubMed Central

    Zhang, Melvyn W. B.; Tran, Bach Xuan; Le, Huong Thi; Long, Nguyen Hoang; Le, Huong Thi; Hinh, Nguyen Duc; Tho, Tran Dinh; Le, Bao Nguyen; Thuc, Vu Thi Minh; Ngo, Chau; Tu, Nguyen Huu; Latkin, Carl A.; Ho, Roger CM

    2017-01-01

    Objectives The average alcohol consumption per capita among Vietnamese adults has consistently increased. Although alcohol-related disorders have been extensively studied, there is a paucity of research shedding light on this issue among Internet users. The study aimed to examine the severity of alcohol-related disorders and other associated factors that might predispose individuals towards alcohol usage in a sample of youths recruited online. Methods An online cross-sectional study was conducted with 1,080 Vietnamese youths. A standardized questionnaire was used. Respondent-driven sampling was applied to recruit participants. Multivariate logistic and Tobit regressions were utilized to identify the associated factors. Results About 59.5% of the males and 12.7% of the total youths declared that they were actively using alcohol. From the total sample, a cumulative total of 32.3% of the participants were drinking alcohol, with 21.8% and 25.0% of the participants being classified as drinking hazardously and binge drinkers, respectively. The majority of the participants (60.7%) were in the pre-contemplative stage. Conclusions A high prevalence of hazardous drinking was recognized among online Vietnamese youths. In addition, we found relationships between alcohol use disorder and other addictive disorders, such as tobacco smoking and water-pipe usage. Our results highlighted that the majority of the individuals are not receptive to the idea of changing their alcohol habits, and this would imply that there ought to be more government effort towards the implementation of effective alcohol control policies. PMID:28523209

  3. The patellofemoral joint: from dysplasia to dislocation

    PubMed Central

    Zaffagnini, Stefano; Grassi, Alberto; Zocco, Gianluca; Rosa, Michele Attilo; Signorelli, Cecilia; Muccioli, Giulio Maria Marcheggiani

    2017-01-01

    Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors. The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators. Therefore, a comprehensive evaluation of all the radiographic, MRI and CT parameters can help the clinician to assess patients with primary and recurrent patellar dislocation and guide management. Patellofemoral dysplasia still represents an extremely challenging condition to manage. Its controversial aetiology and its complex biomechanical behaviour continue to pose more questions than answers to the research community, which reflects the lack of universally accepted guidelines for the correct treatment. However, due to the complexity of this condition, an extremely personalised approach should be reserved for each patient, in considering and addressing the anatomical abnormalities responsible for the symptoms. Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160081. Originally published online at www.efortopenreviews.org PMID:28630757

  4. Management of asthma: the essentials of good clinical practice.

    PubMed

    Aït-Khaled, N; Enarson, D A

    2006-02-01

    Asthma is a condition that affects all countries worldwide. It is a chronic, disabling condition that diminishes the quality of life and the economic prosperity of those who live with it. The majority of persons living with asthma are from developing countries. Asthma management necessitates long-term treatment that is expensive, making it less accessible to poor people. The cost of medications is the key factor preventing people living with asthma from having access to care that has the potential to relieve their suffering, improve their quality of life and enhance their economic status. Asthma is a disease caused by environmental exposures. Genetic factors predispose certain people to developing asthma once they are exposed to the causative agents, and certain factors can trigger symptomatic episodes of asthma in those who have already developed the disease. Certain clinical characteristics differentiate asthma from other chronic lung conditions. The most important of these is that the symptoms and functional disability caused by asthma vary from one occasion to another. In those with less severe asthma, they may be present on some occasions and not others; in those with more severe asthma, their degree of severity varies from one time to another.

  5. Epidemiology, Etiology, Diagnosis, and Management of Placenta Accreta

    PubMed Central

    Garmi, Gali; Salim, Raed

    2012-01-01

    Placenta accreta is a severe pregnancy complication and is currently the most common indication for peripartum hysterectomy. It is becoming an increasingly common complication mainly due to the increasing rate of cesarean delivery. Main risk factor for placenta accreta is a previous cesarean delivery particularly when accompanied with a coexisting placenta previa. Antenatal diagnosis seems to be a key factor in optimizing maternal outcome. Diagnosis can be achieved by ultrasound in the majority of cases. Women with placenta accreta are usually delivered by a cesarean section. In order to avoid an emergency cesarean and to minimize complications of prematurity it is acceptable to schedule cesarean at 34 to 35 weeks. A multidisciplinary team approach and delivery at a center with adequate resources, including those for massive transfusion are both essential to reduce neonatal and maternal morbidity and mortality. The optimal management after delivery of the neonate is vague since randomized controlled trials and large cohort studies are lacking. Cesarean hysterectomy is probably the preferable treatment. In carefully selected cases, when fertility is desired, conservative management may be considered with caution. The current review discusses the epidemiology, predisposing factors, pathogenesis, diagnostic methods, clinical implications and management options of this condition. PMID:22645616

  6. Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

    PubMed

    Ndukwu, C I; Egbuonu, I; Ulasi, T O; Ebenebe, J C

    2013-01-01

    Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

  7. The Pathogenesis of Staphylococcus aureus Eye Infections

    PubMed Central

    2018-01-01

    Staphylococcus aureus is a major pathogen of the eye able to infect the tear duct, eyelid, conjunctiva, cornea, anterior and posterior chambers, and the vitreous chamber. Of these infections, those involving the cornea (keratitis) or the inner chambers of the eye (endophthalmitis) are the most threatening because of their potential to cause a loss in visual acuity or even blindness. Each of these ocular sites is protected by the constitutive expression of a variety of antimicrobial factors and these defenses are augmented by a protective host response to the organism. Such infections often involve a predisposing factor that weakens the defenses, such as the use of contact lenses prior to the development of bacterial keratitis or, for endophthalmitis, the trauma caused by cataract surgery or intravitreal injection. The structural carbohydrates of the bacterial surface induce an inflammatory response able to reduce the bacterial load, but contribute to the tissue damage. A variety of bacterial secreted proteins including alpha-toxin, beta-toxin, gamma-toxin, Panton-Valentine leukocidin and other two-component leukocidins mediate tissue damage and contribute to the induction of the inflammatory response. Quantitative animal models of keratitis and endophthalmitis have provided insights into the S. aureus virulence and host factors active in limiting such infections. PMID:29320451

  8. [Breast cancer genetics. BRCA1 and BRCA2: the main genes for disease predisposition].

    PubMed

    Ruiz-Flores, P; Calderón-Garcidueñas, A L; Barrera-Saldaña, H A

    2001-01-01

    Breast cancer is among the most common world cancers. In Mexico this neoplasm has been progressively increasing since 1990 and is expected to continue. The risk factors for this disease are age, some reproductive factors, ionizing radiation, contraceptives, obesity and high fat diets, among other factors. The main risk factor for BC is a positive family history. Several families, in which clustering but no mendelian inheritance exists, the BC is due probably to mutations in low penetrance genes and/or environmental factors. In families with autosomal dominant trait, the BRCA1 and BRCA2 genes are frequently mutated. These genes are the two main BC susceptibility genes. BRCA1 predispose to BC and ovarian cancer, while BRCA2 mutations predispose to BC in men and women. Both are long genes, tumor suppressors, functioning in a cell cycle dependent manner, and it is believed that both switch on the transcription of several genes, and participate in DNA repair. The mutations profile of these genes is known in developed countries, while in Latin America their search has just began. A multidisciplinary group most be responsible of the clinical management of patients with mutations in BRCA1 and BRCA2, and the risk assignment and Genetic counseling most be done carefully.

  9. Human natural killer cells prevent infectious mononucleosis features by targeting lytic Epstein-Barr virus infection.

    PubMed

    Chijioke, Obinna; Müller, Anne; Feederle, Regina; Barros, Mario Henrique M; Krieg, Carsten; Emmel, Vanessa; Marcenaro, Emanuela; Leung, Carol S; Antsiferova, Olga; Landtwing, Vanessa; Bossart, Walter; Moretta, Alessandro; Hassan, Rocio; Boyman, Onur; Niedobitek, Gerald; Delecluse, Henri-Jacques; Capaul, Riccarda; Münz, Christian

    2013-12-26

    Primary infection with the human oncogenic Epstein-Barr virus (EBV) can result in infectious mononucleosis (IM), a self-limiting disease caused by massive lymphocyte expansion that predisposes for the development of distinct EBV-associated lymphomas. Why some individuals experience this symptomatic primary EBV infection, whereas the majority acquires the virus asymptomatically, remains unclear. Using a mouse model with reconstituted human immune system components, we show that depletion of human natural killer (NK) cells enhances IM symptoms and promotes EBV-associated tumorigenesis mainly because of a loss of immune control over lytic EBV infection. These data suggest that failure of innate immune control by human NK cells augments symptomatic lytic EBV infection, which drives lymphocyte expansion and predisposes for EBV-associated malignancies. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Gene-Environment Interactions Controlling Energy and Glucose Homeostasis and the Developmental Origins of Obesity

    PubMed Central

    Bouret, Sebastien; Levin, Barry E.; Ozanne, Susan E.

    2015-01-01

    Obesity and type 2 diabetes mellitus (T2DM) often occur together and affect a growing number of individuals in both the developed and developing worlds. Both are associated with a number of other serious illnesses that lead to increased rates of mortality. There is likely a polygenic mode of inheritance underlying both disorders, but it has become increasingly clear that the pre- and postnatal environments play critical roles in pushing predisposed individuals over the edge into a disease state. This review focuses on the many genetic and environmental variables that interact to cause predisposed individuals to become obese and diabetic. The brain and its interactions with the external and internal environment are a major focus given the prominent role these interactions play in the regulation of energy and glucose homeostasis in health and disease. PMID:25540138

  11. Ulcerative Vaginitis Due to Torulopsis Glabrata: A Case Report

    PubMed Central

    Clark, John F. J.; Faggett, Timothy; Peters, Barbara; Sampson, Calvin C.

    1978-01-01

    A patient with ulcerative vaginitis is presented. The differential diagnosis included malignant ulcer, chancroid, and granuloma venereum. Torulopsis glabrata vaginitis, which was subsequently proven, responded successfully to clotrimazole suppositories. Predisposing and related factors and isolation and identification procedures are discussed. PMID:569709

  12. Fournier's gangrene: non-clostridial gas gangrene of the perineum and diabetes mellitus.

    PubMed Central

    Lamerton, A J

    1986-01-01

    Three successfully managed cases of Fournier's gangrene, all with diabetes, are reported. A simple bacteriological classification is offered and the importance of diabetes mellitus as a predisposing factor is stressed. Images Figure 1. Figure 2. Figure 3. PMID:3701767

  13. Evaluation of Genetic Susceptibility to Childhood Allergy and Asthma in an African American Urban Population

    EPA Science Inventory

    Background: Asthma and allergy represent complex phenotypes, which disproportionately burden ethnic minorities in the United States. Strong evidence for genomic factors predisposing subjects to asthma/allergy is available. However, methods to utilize this information to identify ...

  14. Headache and Decompression Sickness: Type I or Type II?

    DTIC Science & Technology

    2001-06-01

    criteria for Type I instead of Type II DCS. This includes no clear alternative diagnosis, a localized headache along the suture, and no nerologic findings...page survey. Here, demographic information, exposure data, predisposing factors, symptom onset, symptoms and signs, diagnosis, disease progression

  15. Infective endocarditis in the Western Cape Province of South Africa: a three-year prospective study.

    PubMed

    Koegelenberg, C F N; Doubell, A F; Orth, H; Reuter, H

    2003-03-01

    The last 50 years have seen major changes in the epidemiology of infective endocarditis (IE). To evaluate local patient characteristics, risk factors, clinical sequelae, microbiology, morbidity and mortality in patients with definite IE. Prospective observational study. Over a three-year period, patients referred with probable IE were prospectively enrolled. All received a standardized diagnostic evaluation. Epidemiological data were documented; underlying risk factors for IE were sought. Initial evaluation and follow-up (to 6 months) included the documentation of vascular or immunological phenomena, morbidity and mortality. Of 92 patients referred with probable IE, 47 had definite IE. These patients had a mean age of 37.7 years with a male predominance (1.6:1). Rheumatic heart disease was present in 36 (76.6%). Eight had prosthetic valves. Three had congenital heart disease, mitral valve prolapse or multiple central intravascular catheters, respectively. All denied the use of intravenous recreational drugs and only one tested seropositive for HIV. Renal involvement (59.6%) and clubbing (29.8%) were commonly observed. The 6-month mortality rate was 35.6%, while 44.7% needed valvular replacement. An aetiological diagnosis was made in 21, with viridans streptococci the most common isolate. Infective endocarditis in the Western Cape of South Africa is a disease of younger adults, with a male predominance. Rheumatic heart disease is the major predisposing factor. Degenerative heart disease and intravenous drug abuse are not important risk factors. Our data do not support the notion that HIV infection is an independent risk factor for IE. Local mortality rates are much higher than recent international figures, as is the proportion of 'culture-negative' IE.

  16. A systematic review exploring the relationship between infection and sudden unexpected death between 2000 and 2016: A forensic perspective.

    PubMed

    Kruger, Mia M; Martin, Lorna J; Maistry, Sairita; Heathfield, Laura J

    2018-05-21

    Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur. In addition, there are many risk factors associated with sudden death due to infection, which differ between infants and older individuals. However, it is unclear which pathogens and risk factors are most frequently associated with sudden death due to infection. Therefore a systematic review of articles and case reports published between 1 January 2000 and 30 June 2016 was undertaken in order to (1) explore the relationship between pathogens and their causative role and (2) identify the relationship between predisposing and/or risk factors associated with sudden death due to infection. Major databases were searched and after critical appraisal 143 articles were identified. It was found that respiratory infections and deaths involving bacterial pathogens were most commonly associated with these deaths. In addition the most common risk factors in infants were exposure to tobacco smoke and co-sleeping. In adults the most common risk factors were co-morbid conditions and illnesses. This information aids in a better understanding of these deaths and highlights the need for more research in this field, particularly in developing countries. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Prevalence of positive coeliac disease serology and HLA risk genotypes in a multiethnic population of adults in Canada: a cross-sectional study

    PubMed Central

    Jamnik, Joseph; Villa, Christopher R; Dhir, Sirbarinder Bryn; Jenkins, David J A; El-Sohemy, Ahmed

    2017-01-01

    Objectives Coeliac disease (CD) is a complex autoimmune disorder with known genetic risk factors. Approximately 1% of individuals of European ancestry have CD, but the prevalence among different ethnicities living in Canada remains unknown. The objective of the present study was to determine the prevalence of positive CD serology in a population of Canadian adults living in Toronto, and to determine whether the prevalence of CD seropositivity and predisposing human leucocyte antigen (HLA)-DQ2/DQ8 risk genotypes differ between major ethnocultural groups. Design Cross-sectional screening study of participants from the Toronto Nutrigenomics and Health and the Toronto Healthy Diet studies. Setting University campus and households across Toronto, Canada. Participants: free-living Adults (n=2832) of diverse ethnocultural backgrounds. Main outcome measures Prevalence of positive CD serology was determined by screening for antitissue transglutaminase antibodies in individuals with predisposing HLA-DQ2/DQ8 genotypes. HLA genotypes were determined using six single nucleotide polymorphisms in the HLA gene region. Results Of the 2832 individuals screened, a total of 25 (0.88%; 95% CI 0.57% to 1.30%) were determined to have positive CD serology. The majority of seropositive CD cases were undiagnosed (87%). Prevalence was highest among Caucasians (1.48%; 95% CI 0.93% to 2.23%), and similar in those of ‘Other’ (0.74%; 95% CI 0.09% to 2.63%) or ‘Unknown’ (0.43; 95% CI 0.01% to 2.36%) ethnicity. No cases of positive CD serology were identified among East Asian or South Asian individuals. East Asians had a lower prevalence of HLA risk genotypes than Caucasians and South Asians (p<0.005). Conclusions The prevalence of positive CD serology among Canadian adults living in Toronto is likely ~1%, with 87% of cases being undiagnosed. These findings suggest the need for better screening in high genetic risk groups. Trial registration number NCT00516620; Post-results.

  18. Transcriptome association analysis identifies miR-375 as a major determinant of variable acetaminophen glucuronidation by human liver.

    PubMed

    Papageorgiou, Ioannis; Freytsis, Marina; Court, Michael H

    2016-10-01

    Acetaminophen is the leading cause of acute liver failure (ALF) in many countries including the United States. Hepatic glucuronidation by UDP-glucuronosyltransferase (UGT) 1A subfamily enzymes is the major route of acetaminophen elimination. Reduced glucuronidation may predispose some individuals to acetaminophen-induced ALF, but mechanisms underlying reduced glucuronidation are poorly understood. We hypothesized that specific microRNAs (miRNAs) may reduce UGT1A activity by direct effects on the UGT1A 3'-UTR shared by all UGT1A enzyme transcripts, or by indirect effects on transcription factors regulating UGT1A expression. We performed an unbiased miRNA whole transcriptome association analysis using a bank of human livers with known acetaminophen glucuronidation activities. Of 754 miRNAs evaluated, 9 miRNAs were identified that were significantly overexpressed (p<0.05; >2-fold) in livers with low acetaminophen glucuronidation activities compared with those with high activities. miR-375 showed the highest difference (>10-fold), and was chosen for further mechanistic validation. We demonstrated using in silico analysis and luciferase reporter assays that miR-375 has a unique functional binding site in the 3'-UTR of the aryl hydrocarbon receptor (AhR) gene. Furthermore overexpression of miR-375 in LS180 cells demonstrated significant repression of endogenous AhR protein (by 40%) and mRNA (by 10%), as well as enzyme activity and/or mRNA of AhR regulated enzymes including UGT1A1, UGT1A6, and CYP1A2, without affecting UGT2B7, which is not regulated by AhR. Thus miR-375 is identified as a novel repressor of UGT1A-mediated hepatic acetaminophen glucuronidation through reduced AhR expression, which could predispose some individuals to increased risk for acetaminophen-induced ALF. Published by Elsevier Inc.

  19. Prevention of childbirth injuries to the pelvic floor.

    PubMed

    Heit, M; Mudd, K; Culligan, P

    2001-08-01

    The majority of childbirth injuries to the pelvic floor occur after the first vaginal delivery. Cesarean sections performed after the onset of labor may not protect the pelvic floor. Elective cesarean section is the only true primary prevention strategy for childbirth injuries to the pelvic floor. Alternative primary prevention strategies include elective cesarean section for women with nonmodifiable risks for childbirth injuries to the pelvic floor, antepartum pelvic floor exercises, or intrapartum pudendal nerve monitoring. Secondary prevention strategies must focus on modifying obstetric practices that predispose women to pelvic floor injury. These factors are best delineated for anal incontinence and include restrictive use of episiotomy, mediolateral episiotomy when necessary, spontaneous over forceps-assisted vaginal delivery, vacuum extraction over forceps delivery, and antepartum perineal massage. Finally, tertiary prevention strategies should address the mode of delivery made for women with childbirth injuries to the pelvic floor who desire future fertility.

  20. Pituitary apoplexy: pathophysiology, diagnosis and management.

    PubMed

    Glezer, Andrea; Bronstein, Marcello D

    2015-06-01

    Pituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to ischemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5th decade of life, predominantly in males and in previously unknown clinically non-functioning pituitary adenomas. There are some predisposing factors as arterial hypertension, anticoagulant therapy and major surgery. Clinical picture comprises headache, visual impairment, cranial nerve palsies and hypopituitarism. Most cases improve with both surgical and expectant management and the best approach in the acute phase is still controversial. Surgery, usually by transsphenoidal route, is indicated if consciousness and/or vision are impaired, despite glucocorticoid replacement and electrolyte support. Pituitary function is impaired in most patients before apoplexy and ACTH deficiency is common, which makes glucocorticoid replacement needed in most cases. Pituitary deficiencies, once established, usually do not recover, regardless the treatment. Sellar imaging and endocrinological function must be periodic reevaluated.

  1. Barriers to the use of genetic information for the development of new epilepsy treatments.

    PubMed

    Ferraro, Thomas N

    2016-01-01

    Genetic analysis is providing new information on the biological basis of epilepsy at a rapid pace; this article identifies factors acting as major barriers to use of these data for therapy development. Disease heterogeneity is a primary obstacle since so many genes can cause or predispose to epilepsy and the clinical presentation of epilepsy is so diverse, thus making it difficult to define the most therapeutically relevant targets. Further, many epilepsy genes affect brain development, an observation that represents a barrier unto itself given the challenge of reversing or preventing genetically mediated alterations of brain pathway formation. Finally, the lack of appropriate models for testing new therapies is also recognized as a fundamental limitation. Overcoming these barriers will be aided by full characterization of the genetic landscape of epilepsy, elucidation of key pathway points for therapeutic intervention and creation of unique experimental models to validate results.

  2. Predictors of students' adjustment during transition to university in Spain.

    PubMed

    Páramo Fernández, María F; Araújo, Alexandra M; Tinajero Vacas, Carolina; Almeida, Leandro S; Rodríguez González, María S

    2017-02-01

    Adjustment to university is a major life transition that not all emerging adults manage successfully. The Student University Adjustment Questionnaire is the instrument most commonly used to evaluate this multidimensional construct. Research in Spain on the predisposing factors for successful adjustment to university in emerging adults is scarce relative to the large number of studies carried out in North America. The objective of the present study was to analyze the association between students’ gender, family background, pre-university achievement and adjustment to university. Participants were 300 Spanish first-year students (198 women and 102 men) of mean age 18.02 years. Pre-university achievement was the only significant predictor of academic, social and institutional adjustment. Gender directly affected personal-emotional adjustment and indirectly affected academic adjustment mediated by entry grade. Students’ entry characteristics predict adjustment to university in the first year. These findings have important theoretical and practical implications.

  3. Whole-genome sequence of Schistosoma haematobium.

    PubMed

    Young, Neil D; Jex, Aaron R; Li, Bo; Liu, Shiping; Yang, Linfeng; Xiong, Zijun; Li, Yingrui; Cantacessi, Cinzia; Hall, Ross S; Xu, Xun; Chen, Fangyuan; Wu, Xuan; Zerlotini, Adhemar; Oliveira, Guilherme; Hofmann, Andreas; Zhang, Guojie; Fang, Xiaodong; Kang, Yi; Campbell, Bronwyn E; Loukas, Alex; Ranganathan, Shoba; Rollinson, David; Rinaldi, Gabriel; Brindley, Paul J; Yang, Huanming; Wang, Jun; Wang, Jian; Gasser, Robin B

    2012-01-15

    Schistosomiasis is a neglected tropical disease caused by blood flukes (genus Schistosoma; schistosomes) and affecting 200 million people worldwide. No vaccines are available, and treatment relies on one drug, praziquantel. Schistosoma haematobium has come into the spotlight as a major cause of urogenital disease, as an agent linked to bladder cancer and as a predisposing factor for HIV/AIDS. The parasite is transmitted to humans from freshwater snails. Worms dwell in blood vessels and release eggs that become embedded in the bladder wall to elicit chronic immune-mediated disease and induce squamous cell carcinoma. Here we sequenced the 385-Mb genome of S. haematobium using Illumina-based technology at 74-fold coverage and compared it to sequences from related parasites. We included genome annotation based on function, gene ontology, networking and pathway mapping. This genome now provides an unprecedented resource for many fundamental research areas and shows great promise for the design of new disease interventions.

  4. Periodontal microbiology in Latin America.

    PubMed

    Contreras, Adolfo; Moreno, Sandra M; Jaramillo, Adriana; Pelaez, Melissa; Duque, Andres; Botero, Javier E; Slots, Jørgen

    2015-02-01

    This review article describes the microbiota associated with periodontal disease in Latin America. This vast territory includes 22 nations, which show great ethnic diversity, with large groups of White people, Black people, Mestizo people and Native people. Widespread poverty and limited access to education and health-care services, including periodontal care, are prominent predisposing factors for destructive periodontal disease in Latin America. Black people and Mestizo people seem to have particularly severe periodontal disease and are frequently colonized by the major periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The 'red complex' bacterial pathogens and A. actinomycetemcomitans predominate in chronic and aggressive periodontitis, but gram-negative enteric rods and herpesviruses can also play important periodontopathic roles in Latin America. The key to minimizing the risk of periodontal disease is control of the pathogens, and new low-cost periodontal treatments deserve serious consideration in Latin America. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Impaired postprandial tissue regulation of blood flow in insulin resistance: a determinant of cardiovascular risk?

    PubMed

    Summers, L K; Samra, J S; Frayn, K N

    1999-11-01

    The insulin resistant state is a major risk factor for coronary artery disease. This increased risk is likely to be due to associated lipid and coagulation abnormalities rather than just abnormalities in glucose metabolism or hyperinsulinaemia alone. Exaggerated postprandial lipaemia is a well-recognised associate of insulin resistance and postprandial hypertriglyceridaemia is particularly important in the development of coronary atheroma. It seems likely that insulin is one of the hormonal regulators of adipose tissue and skeletal muscle blood flow. The reduced blood flow and blunting of the postprandial rise of peripheral blood flow in insulin resistance may decrease chylomicron-triglyceride delivery to muscle in subjects with insulin resistance. This, in turn, will lead to increased production of atherogenic particles. We propose that impaired postprandial vasodilation, already recognised as a key feature of glucose intolerance, is also the cause of impaired lipid metabolism in insulin resistant subjects and predisposes them to cardiovascular disease.

  6. Efficacy of dietary behavior modification for preserving cardiovascular health and longevity.

    PubMed

    Pryde, Moira McAllister; Kannel, William Bernard

    2010-12-28

    Cardiovascular disease (CVD) and its predisposing risk factors are major lifestyle and behavioral determinants of longevity. Dietary lifestyle choices such as a heart healthy diet, regular exercise, a lean weight, moderate alcohol consumption, and smoking cessation have been shown to substantially reduce CVD and increase longevity. Recent research has shown that men and women who adhere to this lifestyle can substantially reduce their risk of coronary heart disease (CHD). The preventive benefits of maintaining a healthy lifestyle exceed those reported for using medication and procedures. Among the modifiable preventive measures, diet is of paramount importance, and recent data suggest some misconceptions and uncertainties that require reconsideration. These include commonly accepted recommendations about polyunsaturated fat intake, processed meat consumption, fish choices and preparation, transfatty acids, low carbohydrate diets, egg consumption, coffee, added sugar, soft drink beverages, glycemic load, chocolate, orange juice, nut consumption, vitamin D supplements, food portion size, and alcohol.

  7. Highlights Regarding Host Predisposing Factors to Recurrent Vulvovaginal Candidiasis: Chronic Stress and Reduced Antioxidant Capacity.

    PubMed

    Akimoto-Gunther, Luciene; Bonfim-Mendonça, Patrícia de Souza; Takahachi, Gisele; Irie, Mary Mayumi T; Miyamoto, Sônia; Consolaro, Márcia Edilaine Lopes; Svidzinsk, Terezinha I Estivalet

    2016-01-01

    We studied host factors that could predispose women to develop recurrent vulvovaginal candidiasis (RVVC), including glycemia, insulin resistance, chronic stress, antioxidant capacity, overall immune status, local inflammation and vaginal microbiota. The presence of yeasts in vaginal culture was screened in 277 women, with or without signs and symptoms of VVC and RVVC. The presence of an inflammatory process and microbiota were analyzed through vaginal bacterioscopy and cervical-vaginal cytology, respectively. Fasting-blood samples were collected by standard venipuncture for biochemical analyses. Flow cytometry was employed to obtain the T helper/T cytotoxic lymphocyte ratio, and insulin resistance was assessed by the HOMA index (HI). Yeasts were isolated from 71 (26%) women: 23 (32.4%) with a positive culture but without symptoms (COL), 22 (31%) in an acute episode (VVC), and 26 (36.6%) with RVVC. C. albicans was the main yeast isolated in all clinical profiles. The control group (negative culture) comprised 206 women. Diabetes mellitus and insulin resistance were more associated with the positive-culture groups (COL, VVC and RVVC) than with negative ones. The RVVC group showed lower mean levels of cortisol than the control group and lower antioxidant capacity than all other groups. The T Helper/T cytotoxic lymphocyte ratio was similar in all groups. The RVVC group showed a similar level of vaginal inflammation to the control group, and lower than in the COL and VVC groups. Only the CVV group showed a reduction in vaginal lactobacillus microbiota. Our data suggest that both chronic stress (decreased early-morning cortisol levels) and reduced antioxidant capacity can be host predisposing factors to RVVC.

  8. Highlights Regarding Host Predisposing Factors to Recurrent Vulvovaginal Candidiasis: Chronic Stress and Reduced Antioxidant Capacity

    PubMed Central

    Akimoto-Gunther, Luciene; Bonfim-Mendonça, Patrícia de Souza; Takahachi, Gisele; Irie, Mary Mayumi T.; Miyamoto, Sônia; Consolaro, Márcia Edilaine Lopes; Svidzinsk, Terezinha I. Estivalet

    2016-01-01

    We studied host factors that could predispose women to develop recurrent vulvovaginal candidiasis (RVVC), including glycemia, insulin resistance, chronic stress, antioxidant capacity, overall immune status, local inflammation and vaginal microbiota. The presence of yeasts in vaginal culture was screened in 277 women, with or without signs and symptoms of VVC and RVVC. The presence of an inflammatory process and microbiota were analyzed through vaginal bacterioscopy and cervical-vaginal cytology, respectively. Fasting-blood samples were collected by standard venipuncture for biochemical analyses. Flow cytometry was employed to obtain the T helper/T cytotoxic lymphocyte ratio, and insulin resistance was assessed by the HOMA index (HI). Yeasts were isolated from 71 (26%) women: 23 (32.4%) with a positive culture but without symptoms (COL), 22 (31%) in an acute episode (VVC), and 26 (36.6%) with RVVC. C. albicans was the main yeast isolated in all clinical profiles. The control group (negative culture) comprised 206 women. Diabetes mellitus and insulin resistance were more associated with the positive-culture groups (COL, VVC and RVVC) than with negative ones. The RVVC group showed lower mean levels of cortisol than the control group and lower antioxidant capacity than all other groups. The T Helper/T cytotoxic lymphocyte ratio was similar in all groups. The RVVC group showed a similar level of vaginal inflammation to the control group, and lower than in the COL and VVC groups. Only the CVV group showed a reduction in vaginal lactobacillus microbiota. Our data suggest that both chronic stress (decreased early-morning cortisol levels) and reduced antioxidant capacity can be host predisposing factors to RVVC. PMID:27415762

  9. N-acetyltransferase 2 (NAT2) gene polymorphism as a predisposing factor for phenytoin intoxication in tuberculous meningitis or tuberculoma patients having seizures - A pilot study.

    PubMed

    Adole, Prashant S; Kharbanda, Parampreet S; Sharma, Sadhna

    2016-05-01

    Simultaneous administration of phenytoin and isoniazid (INH) in tuberculous meningitis (TBM) or tuberculoma patients with seizures results in higher plasma phenytoin level and thus phenytoin intoxication. N-acetyltransferase 2 (NAT2) enzyme catalyses two acetylation reactions in INH metabolism and NAT2 gene polymorphism leads to slow and rapid acetylators. The present study was aimed to evaluate the effect of allelic variants of N-acetyltransferase 2 (NAT2) gene as a predisposing factor for phenytoin toxicity in patients with TBM or tuberculoma having seizures, and taking INH and phenytoin simultaneously. Sixty patients with TBM or tuberculoma with seizures and taking INH and phenytoin simultaneously for a minimum period of seven days were included in study. Plasma phenytoin was measured by high performance liquid chromatography. NAT2 gene polymorphism was studied using restriction fragment length polymorphism and allele specific PCR. The patients were grouped into those having phenytoin intoxication and those with normal phenytoin level, and also classified as rapid or slow acetylators by NAT2 genotyping. Genotypic analysis showed that of the seven SNPs (single nucleotide polymorphisms) of NAT2 gene studied, six mutations were found to be associated with phenytoin intoxication. For rs1041983 (C282T), rs1799929 (C481T), rs1799931 (G857A), rs1799930 (G590A), rs1208 (A803G) and rs1801280 (T341C) allelic variants, the proportion of homozygous mutant was higher in phenytoin intoxicated group than in phenytoin non-intoxicated group. Homozygous mutant allele of NAT2 gene at 481site may act as a predisposing factor for phenytoin intoxication among TBM or tuberculoma patients having seizures.

  10. A rare cause of gastrointestinal phytobezoars: diospyros lotus

    PubMed Central

    2012-01-01

    Aim Diospyros Lotus (“Wild Date Palm of Trabzon or Persimmon”), which has been proven to cause phytobezoars, is a widely consumed fruit in the Black Sea and Northeast Anatolia regions of Turkey. The aim of the present study was to investigate the effects of Diospyros Lotus together with other predisposing factors, on the development of gastrointestinal phytobezoars and to discuss the treatment results in comparison to the literature. Material and method The records of 13 patients, who had been admitted to the General Surgery Clinic of Düzce Atatürk State Hospital between August 2008 and August 2011, were retrospectively reviewed. Demographic characteristics, predisposing factors, clinical and radiological findings, diagnostic and therapeutic methods, and the outcomes of the patients were recorded from the patient files. Written informed consent was obtained from each patient for publication of this research article and accompanying images. Results All the patients had a history of consuming Diospyros Lotus. Of the patients, 30,7% had a history of previous gastric surgery, 30,7% had diabetes mellitus and 23% had dental implants. None of the patients had hypothyroidism, which is another predisposing factor for phytobezoars. The phytobezoars were located in the stomach alone in 23% of the patients, whereas 15,3% was detected in the jejunum and stomach, 15,3% was detected in the jejunum alone, and 46,1% was detected in the ileum alone. All patients were treated with surgery, and there were no deaths. Conclusion Gastric phytobezoars are rare. Preventive measures have particular importance in the management of this condition, which is difficult to treat. For this purpose, excessive consumption of herbal nutrients containing a high amount of indigestible fibers such as Diospyros Lotus should be avoided in patients with a history of gastrointestinal surgery or poor oral and dental health. PMID:22721161

  11. N-acetyltransferase 2 (NAT2) gene polymorphism as a predisposing factor for phenytoin intoxication in tuberculous meningitis or tuberculoma patients having seizures - A pilot study

    PubMed Central

    Adole, Prashant S.; Kharbanda, Parampreet S.; Sharma, Sadhna

    2016-01-01

    Background & objectives: Simultaneous administration of phenytoin and isoniazid (INH) in tuberculous meningitis (TBM) or tuberculoma patients with seizures results in higher plasma phenytoin level and thus phenytoin intoxication. N-acetyltransferase 2 (NAT2) enzyme catalyses two acetylation reactions in INH metabolism and NAT2 gene polymorphism leads to slow and rapid acetylators. The present study was aimed to evaluate the effect of allelic variants of N-acetyltransferase 2 (NAT2) gene as a predisposing factor for phenytoin toxicity in patients with TBM or tuberculoma having seizures, and taking INH and phenytoin simultaneously. Methods: Sixty patients with TBM or tuberculoma with seizures and taking INH and phenytoin simultaneously for a minimum period of seven days were included in study. Plasma phenytoin was measured by high performance liquid chromatography. NAT2 gene polymorphism was studied using restriction fragment length polymorphism and allele specific PCR. Results: The patients were grouped into those having phenytoin intoxication and those with normal phenytoin level, and also classified as rapid or slow acetylators by NAT2 genotyping. Genotypic analysis showed that of the seven SNPs (single nucleotide polymorphisms) of NAT2 gene studied, six mutations were found to be associated with phenytoin intoxication. For rs1041983 (C282T), rs1799929 (C481T), rs1799931 (G857A), rs1799930 (G590A), rs1208 (A803G) and rs1801280 (T341C) allelic variants, the proportion of homozygous mutant was higher in phenytoin intoxicated group than in phenytoin non-intoxicated group. Interpretation & conclusions: Homozygous mutant allele of NAT2 gene at 481site may act as a predisposing factor for phenytoin intoxication among TBM or tuberculoma patients having seizures. PMID:27488001

  12. Prevalence of high altitude pulmonary hypertension among the natives of Spiti Valley--a high altitude region in Himachal Pradesh, India.

    PubMed

    Negi, Prakash Chand; Marwaha, Rajeev; Asotra, Sanjeev; Kandoria, Arvind; Ganju, Neeraj; Sharma, Rajesh; Kumar, Ravi V; Bhardwaj, Rajeev

    2014-12-01

    The study aimed to determine the prevalence of high altitude pulmonary hypertension (HAPH) and its predisposing factors among natives of Spiti Valley. A cross-sectional survey study was done on the permanent natives of Spiti Valley residing at an altitude of 3000 m to 4200 m. Demographic characteristics, health behavior, anthropometrics, and blood pressure were recorded. Investigations included recording of 12 lead electrocardiogram (ECG), SaO2 with pulse oximeter, spirometry and echocardiography study, and measurement of Hb levels using the cynmethhemoglobin method. HAPH was diagnosed using criteria; tricuspid regurgitation (TR) gradient of ≥46 mmHg. ECG evidence of RV overload on 12 lead ECG was documented based on presence of 2 out of 3 criteria; R>S in V1, right axis deviation or RV strain, T wave inversion in V1 and V2. Data of 1087 subjects were analyzed who were free of cardiorespiratory diseases to determine the prevalence of HAPH and its predisposing factors. HAPH was recorded in 3.23% (95% C.I. of 0.9-8.1%) and ECG evidence of right ventricular (RV) overload was 1.5% in the study population. Prevalence of HAPH was not different in men and women 2.63% vs. 3.54% p<0.2. Age (Z statistics of 3.4 p<0.0006), hypoxemia (Z statistics of 2.9 p<0.002), and erythrocythemia (Z statistics of 4.7 p<0.003) were independently associated with HAPH. Altitude of residence was not found to be significantly associated with HAPH, although there was a trend of increasing prevalence with increasing altitude. It can be concluded that HAPH is prevalent in 3.23% of natives of Spiti Valley. Increasing age, erythrocythemia and hypoxemia are independent predisposing factors.

  13. Preconception gynecological risk factors of postpartum depression among Japanese women: The Japan Environment and Children's Study (JECS).

    PubMed

    Muchanga, Sifa Marie Joelle; Yasumitsu-Lovell, Kahoko; Eitoku, Masamitsu; Mbelambela, Etongola Papy; Ninomiya, Hitoshi; Komori, Kaori; Tozin, Rahma; Maeda, Nagamasa; Fujieda, Mikiya; Suganuma, Narufumi

    2017-08-01

    Postpartum depression is one of the major causes of disability among women who are on their childbearing years. Identifying people at risk of postpartum depression may improve its management. The objective of this study was to determine the probable association between postpartum depression and some preconception gynecological morbidities. Data from a nationwide birth cohort study, the Japan Environment and Children's study (JECS), up to one month of postpartum were analyzed. To assess postpartum depression, the Edinburgh Postnatal Depression Scale (EPDS) was used; 11 preconception gynecological morbidities were considered as risk factors. Covariates included psychiatric illness history, psychosocial factors, some pregnancy adverse outcomes, birth outcomes, socio-demographic and health behavioral factors. Except for the prevalence of previous miscarriage, leiomyoma and polycystic ovarian syndrome, depressive women had more gynecological morbidities compared to non-depressive ones. In logistic regression model, endometriosis (OR, 1.27; 95%CI: 1.15-1.41), dysmenorrhea (OR, 1.13; 95%CI: 1.06-1.21) and abnormal uterine bleeding (OR, 1.21; 95%CI: 1.15-1.29) were associated with postpartum depression. CONCLUSION: Women with endometriosis and menstrual problems were at risk of developing postpartum depression. This study suggests a perinatal mental health screening for predisposed women. Copyright © 2017. Published by Elsevier B.V.

  14. Are genetic variants in the platelet-derived growth factor [beta] gene associated with chronic pancreatitis?

    PubMed

    Muddana, Venkata; Park, James; Lamb, Janette; Yadav, Dhiraj; Papachristou, Georgios I; Hawes, Robert H; Brand, Randall; Slivka, Adam; Whitcomb, David C

    2010-11-01

    Platelet-derived growth factor [beta] (PDGF-[beta]) is a major signal in proliferation and matrix synthesis through activated pancreatic stellate cells, leading to fibrosis of the pancreas. Recurrent acute pancreatitis (RAP) seems to predispose to chronic pancreatitis (CP) in some patients but not others. We tested the hypothesis that 2 known PDGF-[beta] polymorphisms are associated with progression from RAP to CP. We also tested the hypothesis that PDGF-[beta] polymorphisms in combination with environmental risk factors such as alcohol and smoking are associated with CP. Three hundred eighty-two patients with CP (n = 176) and RAP (n = 206) and 251 controls were evaluated. Platelet-derived growth factor [beta] polymorphisms +286 A/G (rs#1800818) seen in 5'-UTR and +1135 A/C (rs#1800817) in first intron were genotyped using single-nucleotide polymorphism polymerase chain reaction approach and confirmed by DNA sequencing. The genotypic frequencies for PDGF-[beta] polymorphisms in positions +286 and +1135 were found to be similar in controls and patients with RAP and CP. There was no difference in genotypic frequencies among RAP, CP, and controls in subjects in the alcohol and smoking subgroups. Known variations in the PDGF-[beta] gene do not have a significant effect on promoting or preventing fibrogenesis in pancreatitis. Further evaluation of this important pathway is warranted.

  15. Soil transmitted Helminthiasis and associated risk factors among elementary school children in ambo town, western Ethiopia.

    PubMed

    Samuel, Fikreslasie; Demsew, Asalif; Alem, Yonas; Hailesilassie, Yonas

    2017-10-10

    Soil-transmitted helminths (STHs) are widespread in underdeveloped countries. In Ethiopia, the prevalence and distribution of helminth infection varies by different exposing risk factors. We therefore investigated the prevalence of and risk factors of STHs infection in school children living in Ambo town, west Shoa Ethiopia. In 2014/15, among 375 school children planed to be included in this study, only 321 school children were recruited in the study. Data onto school children from different schools were collected, including stool samples for qualitative STHs analysis. Questionnaire data on various demographic, housing and lifestyle variables were also available. Prevalence of any STHs infection was 12.6%. The respective prevalence of major soil-transmitted helminths is Ascaris (7.8%), Hookworm (2.8%) and Trichuris (2.2%). This study result shows STHs prevalence varies regards to age, sex, latrine use, family size and nail trimming. The results of the present study indicated that the percentage of positive finding for STHs in Ambo area is low. Besides, Large Family size, not nail trimming and unavailability of improved latrine were identified as predisposing factor for STHs infections. All school children enrolled and not enrolled in this study should be treated twice a year until the prevalence falls below the level of public health importance.

  16. [Factors associated with road accidents in the city of Lubumbashi].

    PubMed

    Kandolo, Simon Ilunga; Matungulu, Charles Matungulu; Mukanya, Pascal Kimba; Umba, Irène Kabange; Kabamba, Julie Ndayi; Numbi, Oscar Luboya; Ilunga, Benjamin Kabyla; Kaj, Françoise Malonga; Lubaba, Célestin Banza; Ngongo, Ghislain Mashini

    2014-01-01

    We conducted a retrospective non-comparative cross-sectional study in Lubumbashi on factors associated with road accidents. To contribute to the reduction of morbidity and mortality related to road accidents based on a better understanding of this phenomenon in the city of Lubumbashi, to assess the frequency and the growth of road accidents in the city of Lubumbashi and to determine the factors predisposing to these accidents. This non-controlled retrospective cross-sectional descriptive study covered the period from 1st January to 31st December 2008, and included all cases of vehicles registered by the police department after an accident. A total of 1,915 road traffic were reported, mostly caused by public transport vehicles (59%) driven by young adult males (89% of cases) with a mean age of 28 years. The main cause was speeding combined with other factors (34% of cases). The majority of these accidents occurred in the city of Lubumbashi (52.9% of cases) between 6:00 a.m. and 6:00 p.m. (74% of cases). Transit vehicles were exposed to a greater risk of road accidents (59%). There is an urgent need for accurate information on the rules of the road for drivers and road users to reduce the mortality and morbidity due to road accidents.

  17. Menstrual dysfunction in female athletes. A review for clinicians.

    PubMed

    Noakes, T D; van Gend, M

    1988-03-19

    A critical review of factors considered to cause menstrual dysfunction is women athletes with no overt organic cause for the abnormality is presented. Evidence suggests that although regular exercise can produce a specific change in hypothalamic-pituitary function, in particular reduced pulsatile luteinising hormone secretion, this is not associated with amenorrhoea or oligomenorrhoea in the majority of female athletes, most of whom continue to menstruate cyclically. Thus additional factors must be operative. It seems probable that severe menstrual dysfunction occurs in a specific predisposed subset of women athletes who have a particular personality type or body build and are attracted to a lifestyle including regular vigorous exercise. The biochemical basis may be related to hypothalamic, pituitary or even ovarian dysfunction possibly due to elevated levels of anti-reproductive hormones, including beta-endorphins, dopamine, prolactin and catechol oestrogens, induced by exercise; dopamine appears the most likely candidate. Chronic hypo-oestrogenic or eu-oestrogenic amenorrhoea or oligomenorrhoea may not be benign and should probably be treated in order to reduce the risk of osteoporosis or endometrial hyperplasia and adenocarcinoma.

  18. Phenotypes and enviromental factors: their influence in PCOS.

    PubMed

    Diamanti-Kandarakis, Evanthia; Christakou, Charikleia; Marinakis, Evangelos

    2012-01-01

    Polycystic ovary syndrome (PCOS) is a complex syndrome of unclear etiopathogenesis characterized by heterogeneity in phenotypic manifestations. The clinical phenotype of PCOS includes reproductive and hormonal aberrations, namely anovulation and hyperandrogenism, which coexist with metabolic disturbances. Reflecting the crosstalk between the reproductive system and metabolic tissues, obesity not only deteriorates the metabolic profile but also aggravates ovulatory dysfunction and hyperandrogenism. Although the pathogenesis of PCOS remains unclear, the syndrome appears to involve environmental and genetic components. Starting from early life and extending throughout lifecycle, environmental insults may affect susceptible women who finally demonstrate the clinical phenotype of PCOS. Diet emerges as the major environmental determinant of PCOS. Overnutrition leading to obesity is widely recognized to have an aggravating impact, while another detrimental dietary factor may be the high content of food in advanced glycated end products (AGEs). Environmental exposure to industrial products, particularly Bisphenol A (BPA), may also exacerbate the clinical course of PCOS. AGEs and BPA may act as endocrine disruptors in the pathogenesis of the syndrome. PCOS appears to mirror the harmful influence of the modern environment on the reproductive and metabolic balance of inherently predisposed individuals.

  19. Lupus erythematosus revisited.

    PubMed

    Kuhn, Annegret; Wenzel, Joerg; Bijl, Marc

    2016-01-01

    Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity. The exact pathomechanisms and interactions resulting in the inflammatory and immunological processes of this heterogeneous disease remain elusive. Approaches in the understanding of the pathomechanisms revealed that the clinical expression of LE is predisposed by susceptibility genes and that various environmental factors are responsible for an abnormal immune response. Several studies demonstrated that ultraviolet (UV) light is one of the major factors in the pathogenesis of the disease. Standardized photoprovocation in patients with LE has been shown to be a safe and efficient model for evaluating the underlying pathomechanisms which lead to the production of autoantibodies and immune complexes. In particular, interferons were defined as important players in the early activation of the immune system and were observed to play a specific role in the immunological interface between the innate and the adaptive immune system. Abnormalities or disturbances in the different processes of cell death, such as apoptosis or necrosis, have also been recognized as crucial in the pathogenesis of LE. Although each process is different and characterized by unique features, the processes are interrelated and result in a complex disease.

  20. Molecular genetics of human obesity: A comprehensive review.

    PubMed

    Singh, Rajan Kumar; Kumar, Permendra; Mahalingam, Kulandaivelu

    2017-02-01

    Obesity and its related health complications is a major problem worldwide. Hypothalamus and their signalling molecules play a critical role in the intervening and coordination with energy balance and homeostasis. Genetic factors play a crucial role in determining an individual's predisposition to the weight gain and being obese. In the past few years, several genetic variants were identified as monogenic forms of human obesity having success over common polygenic forms. In the context of molecular genetics, genome-wide association studies (GWAS) approach and their findings signified a number of genetic variants predisposing to obesity. However, the last couple of years, it has also been noticed that alterations in the environmental and epigenetic factors are one of the key causes of obesity. Hence, this review might be helpful in the current scenario of molecular genetics of human obesity, obesity-related health complications (ORHC), and energy homeostasis. Future work based on the clinical discoveries may play a role in the molecular dissection of genetic approaches to find more obesity-susceptible gene loci. Copyright © 2016 Académie des sciences. Published by Elsevier Masson SAS. All rights reserved.

  1. Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

    PubMed Central

    Amin, Noha; Doupis, John

    2016-01-01

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

  2. Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

    ERIC Educational Resources Information Center

    Espejo, Emmanuel Peter; Hammen, Constance; Brennan, Patricia A.

    2012-01-01

    The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents…

  3. Host and environmental factors affect pulmonary responses measured in bronchoalveolar lavage

    EPA Science Inventory

    Abstract Obesity is considered a chronic low-grade inflammatory state which may predispose individuals to lung disease. Measures of obesity can be associated with changes in adipokine levels, cytokine concentrations, and indices of iron homeostasis in the serum. To test for an...

  4. Stigma, help-seeking attitudes, and use of psychotherapy in veterans with diagnoses of posttraumatic stress disorder.

    PubMed

    Rosen, Craig S; Greenbaum, Mark A; Fitt, Julie E; Laffaye, Charlene; Norris, Virginia A; Kimerling, Rachel

    2011-11-01

    Survey and medical record data from 482 Veterans Affairs (VA) patients who recently received diagnoses of posttraumatic stress disorder (PTSD) were examined to determine need and predisposing factors associated with utilization of psychotherapy and counseling. More than half (58%) of participants initiated VA psychotherapy for PTSD within a year of diagnosis. Of those, one third completed eight or more sessions. Roughly two thirds of participants initiated counseling at a Vet Center. Initiating PTSD psychotherapy was associated with greater impairment but not with stigma, concerns about fitting in, or satisfaction with care. The use of Vet Center counseling was associated with desire for help, concerns about fitting in, and satisfaction with care. Unexpectedly, veterans with greater stigma concerns completed more psychotherapy visits and Vet Center counseling. Negative attitudes about mental health treatment did not seem to be substantial barriers to engaging in psychotherapy among these VA patients. Future research should consider enabling treatment system factors in addition to predisposing patient characteristics.

  5. Transverse colon volvulus in neurologicaly imparied patient as an emergency surgical condition: A case report.

    PubMed

    Miličković, Maja; Savić, Đorđe; Stanković, Nikola; Vukadin, Miroslav; Božić, Dejana

    2017-01-01

    Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and congenital megacolon. We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Chronic constipation in neurologicaly impaired patient was a risk factor predisposing to volvulus. The patient was admitted to the hospital with enormous abdominal distension and acute respiratory insufficiency. A boy was emergently taken to the operating room for exploratory laparotomy. During the surgery, a 360º clockwise volvulus of the transverse colon was found. After reduction of volvulus, an enormous transverse colon was resected and colostomy was formed. In the postoperative period, despite the good functioning of stoma and intraabdominal normotension, numerous and long lasting respiratory problems developed. The patient was discharged from our institution after 8 months. Though very rare in pediatric group, the possibility of a transverse colon volvulus must be considered in the differential diagnosis of acute large bowel obstruction.

  6. Depression, anxiety, and the cardiovascular system: the cardiologist's perspective.

    PubMed

    Sheps, D S; Sheffield, D

    2001-01-01

    Up to one fifth of patients with cardiovascular disease, including those who have experienced a myocardial infarction, may have concomitant major depression. Studies have suggested that the relative risk of major depression with cardiovascular disease ranges from 1.5 to 4.5. Further information is required to establish a dose-response relationship between depression and coronary artery disease (CAD); however, such a relationship has been shown between anxiety and CAD. Development of a conceptual model of the pathophysiologic actions of stress in CAD will assist in the understanding of this relationship. In patients with angiographic evidence of CAD, the presence of major depressive disorder was the best single predictor of cardiac events during the 12 months following diagnosis. Significantly, 6-month cumulative mortality following diagnosis of myocardial infarction has been shown to be higher in depressed patients than in nondepressed patients. A decrease in heart rate variability may mediate the deleterious effect of depression on post-myocardial infarction prognosis. Other factors such as mental stress and altered platelet function may also predispose depressed patients to a heightened risk of cardiac events. With an increased understanding of the relationship between depression and heightened risk of cardiovascular mortality, it is necessary to assess current overall treatment for cardiac patients.

  7. Delayed celiac disease diagnosis predisposes to reduced quality of life and incremental use of health care services and medicines: A prospective nationwide study

    PubMed Central

    Fuchs, Valma; Kurppa, Kalle; Huhtala, Heini; Mäki, Markku; Kekkonen, Leila; Kaukinen, Katri

    2018-01-01

    Background Celiac disease is challenging to recognize, predisposing to long diagnostic delay. Currently, associated factors and significance of the delay remain obscure. Objective The objective of this article is to investigate associated sociodemographic risk factors and health consequences of diagnostic delay in celiac disease. Methods Altogether 611 patients were surveyed at diagnosis and after one year on a gluten-free diet regarding sociodemographic variables, well-being and use of medicines and health care services. Quality of life was measured by a validated Psychological General Well-Being (PGWB) questionnaire. The results were compared between patients with and without delayed (≥3 years) diagnosis. Results A total of 332 (54%) individuals reported a delay of ≥3 years. Associated with the delay were being a student or homemaker, but not gender, marital or occupational status, site of diagnosis or place of residence. Patients with the delay also had decreased self-perceived health and poorer PGWB scores compared to those without delay; in anxiety and general health this was seen even on a gluten-free diet. Days of sickness and doctor visits as well as use of drugs for dyspepsia and antidepressants were increased in the delay group both before and after diagnosis. Conclusion A delay in celiac disease diagnosis predisposes to reduced well-being and incremental use of medicines and health care services, both before diagnosis and one year after diagnosis. PMID:29881612

  8. Pediatric stroke: clinical characteristics, acute care utilization patterns, and mortality.

    PubMed

    Statler, Kimberly D; Dong, Li; Nielsen, Denise M; Bratton, Susan L

    2011-04-01

    Acute care utilization patterns are not well described but may help inform care coordination and treatment for pediatric stroke. The Kids Inpatient Database was queried to describe demographics and clinical characteristics of children with stroke, compare acute care utilization for hemorrhagic vs. ischemic stroke and Children's vs. non-Children's Hospitals, and identify factors associated with aggressive care and in-hospital mortality. Using a retrospective cohort of children hospitalized with stroke, demographics, predisposing conditions, and intensive (mechanical ventilation, advanced monitoring, and blood product administration) or aggressive (pharmacological therapy and/or invasive interventions) care were compared by stroke and hospital types. Factors associated with aggressive care or in-hospital mortality were explored using logistic regression. Hemorrhagic stroke comprised 43% of stroke discharges, was more common in younger children, and carried greater mortality. Ischemic stroke was more common in older children and more frequently associated with a predisposing condition. Rates of intensive and aggressive care were low (30% and 15%), similar by stroke type, and greater at Children's Hospitals. Older age, hemorrhagic stroke, predisposing condition, and treatment at a Children's Hospital were associated with aggressive care. Hemorrhagic stroke and aggressive care were associated with in-hospital mortality. Acute care utilization is similar by stroke type but both intensive and aggressive care are more common at Children's Hospitals. Mortality remains relatively high after pediatric stroke. Widespread implementation of treatment guidelines improved outcomes in adult stroke. Adoption of recently published treatment recommendations for pediatric stroke may help standardize care and improve outcomes.

  9. Trends in management of gallbladder disorders in children.

    PubMed

    Lugo-Vicente, H L

    1997-07-01

    Gallbladder disorders have been recognized with increasing frequency in pediatric patients. This study aimed to identify recent trends in management and compare the effectiveness of laparoscopic (LC) over open cholecystectomy (OC) by a retrospective chart analysis of all cholecystectomies from 1990 through 1995. Information obtained included demographics, symptoms, predisposing conditions, associated illnesses, family history, imaging studies, type of cholecystectomy, complications, operative time, pain medication, diet recommencement, pathologic findings, and length of hospital stay. The type of cholecystectomy (OC vs. LC) was compared with the clinical variables using standard statistics. Eighty-three patients between 21 months and 18 years of age were identified; their mean age was 14.8 years. Females (76%) with classic biliary symptoms predominated;12% of the patients developed gallstone pancreatitis and 7% jaundice. Abnormal liver chemistry values, obesity, and elevated triglyceride levels comprised the most significant predisposing factors. Indications for surgery were cholelithiasis in 71 patients (86%), gallbladder dyskinesia in 10 (12%), and sludge/polyp in 2. Fifty-nine cholecystectomies (71%) were done laparoscopically and 24 (29%) open. Choledocholithiasis in 6 children (7%) was managed by open extraction with t-tube placement or endoscopic papillotomy followed by LC. No major ductal complication was identified. The predominant pathologic finding was chronic cholecystitis, including the subgroup with biliary dyskinesia. Statistical comparison showed that LC is superior to OC in regard to length of stay, diet resumption, use of pain medication, operating time, and cosmetic results. It is concluded that a contemporary diet, obesity, and abnormal liver chemistry are the main predisposing conditions of gallbladder disease in children in this decade. Females in their teenage years with typical symptoms continue to be the most commonly affected group. Persistent biliary symptoms associated with low gallbladder ejection fractions during hepatobiliary cholecystokinin-stimulated scans can be caused by dyskinesia. The method of choice to remove the diseased gallbladder in children is LC, which is safe, efficient, and superior to the conventional method. Common duct stones can be managed by simultaneous endoscopic papillotomy. The costs of LC are reduced by employing reusable equipment and selective cholangiographic indications.

  10. The Predisposing Factors between Dental Caries and Deviations from Normal Weight.

    PubMed

    Chopra, Amandeep; Rao, Nanak Chand; Gupta, Nidhi; Vashisth, Shelja; Lakhanpal, Manav

    2015-04-01

    Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors. So it's important to understand any relationship between dental state and body weight if either is to be managed appropriately. The study was done to find out the correlation between body mass index (BMI), diet, and dental caries among 12-15-year-old schoolgoing children in Panchkula District. A multistage sample of 12-15-year-old school children (n = 810) in Panchkula district, Haryana was considered. Child demographic details and diet history for 5 days was recorded. Data regarding dental caries status was collected using World Health Organization (1997) format. BMI was calculated and categorized according to the World Health Organization classification system for BMI. The data were subjected to statistical analysis using chi-square test and binomial regression developed using the Statistical Package for Social Sciences (SPSS) 20.0. The mean Decayed Missing Filled Teeth (DMFT) score was found to be 1.72 with decayed, missing, and filled teeth to be 1.22, 0.04, and 0.44, respectively. When the sample was assessed based on type of diet, it was found that vegetarians had higher mean DMFT (1.72) as compared to children having mixed diet. Overweight children had highest DMFT (3.21) which was followed by underweight (2.31) and obese children (2.23). Binomial regression revealed that females were 1.293 times at risk of developing caries as compared to males. Fair and poor Simplified-Oral Hygiene Index (OHI-S) showed 3.920 and 4.297 times risk of developing caries as compared to good oral hygiene, respectively. Upper high socioeconomic status (SES) is at most risk of developing caries. Underweight, overweight, and obese are at 2.7, 2.5, and 3 times risk of developing caries as compared to children with normal BMI, respectively. Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors such as diet, SES, lifestyle and other environmental factors.

  11. Patient-physician trust: an exploratory study.

    PubMed

    Thom, D H; Campbell, B

    1997-02-01

    Patients' trust in their physicians has recently become a focus of concern, largely owing to the rise of managed care, yet the subject remains largely unstudied. We undertook a qualitative research study of patients' self-reported experiences with trust in a physician to gain further understanding of the components of trust in the context of the patient-physician relationship. Twenty-nine patients participants, aged 26 to 72, were recruited from three diverse practice sites. Four focus groups, each lasting 1.5 to 2 hours, were conducted to explore patients' experiences with trust. Focus groups were audio-recorded, transcribed, and coded by four readers, using principles of grounded theory. The resulting consensus codes were grouped into seven categories of physician behavior, two of which related primarily to technical competence (thoroughness in evaluation and providing appropriate and effective treatment) and five of which were interpersonal (understanding patient's individual experience, expressing caring, communicating clearly and completely, building partnership/sharing power and honesty/respect for patient). Two additional categories were predisposing factors and structural/staffing factors. Each major category had multiple subcategories. Specific examples from each major category are provided. These nine categories of physician behavior encompassed the trust experiences related by the 29 patients. These categories and the specific examples provided by patients provide insights into the process of trust formation and suggest ways in which physicians could be more effective in building and maintaining trust.

  12. Gene-environment interaction in major depression: focus on experience-dependent biological systems.

    PubMed

    Lopizzo, Nicola; Bocchio Chiavetto, Luisella; Cattane, Nadia; Plazzotta, Giona; Tarazi, Frank I; Pariante, Carmine M; Riva, Marco A; Cattaneo, Annamaria

    2015-01-01

    Major depressive disorder (MDD) is a multifactorial and polygenic disorder, where multiple and partially overlapping sets of susceptibility genes interact each other and with the environment, predisposing individuals to the development of the illness. Thus, MDD results from a complex interplay of vulnerability genes and environmental factors that act cumulatively throughout individual's lifetime. Among these environmental factors, stressful life experiences, especially those occurring early in life, have been suggested to exert a crucial impact on brain development, leading to permanent functional changes that may contribute to lifelong risk for mental health outcomes. In this review, we will discuss how genetic variants (polymorphisms, SNPs) within genes operating in neurobiological systems that mediate stress response and synaptic plasticity, can impact, by themselves, the vulnerability risk for MDD; we will also consider how this MDD risk can be further modulated when gene × environment interaction is taken into account. Finally, we will discuss the role of epigenetic mechanisms, and in particular of DNA methylation and miRNAs expression changes, in mediating the effect of the stress on the vulnerability risk to develop MDD. Taken together, we aim to underlie the role of genetic and epigenetic processes involved in stress- and neuroplasticity-related biological systems on the development of MDD after exposure to early life stress, thereby building the basis for future research and clinical interventions.

  13. Familial Contributions to the Etiology and Course of Anorexia Nervosa and Bulimia.

    ERIC Educational Resources Information Center

    Strober, Michael; Humphrey, Laura Lynn

    1987-01-01

    Discusses familial influences in anorexia nervosa and bulimia. Reviews descriptions of family interaction, familial correlates of course and phenomenology of symptoms, and studies of familial transmission. Concludes that certain personality factors, possibly genetically determined, predispose the individual to greater sensitivity and vulnerability…

  14. Depression: What Every Woman Should Know.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHHS), Bethesda, MD.

    This publication, written in English, explains why women are at greater risk for depression than men. Types of depressive illnesses are explained along with the symptoms. It states that some women are predisposed genetically to depression but biochemical, environmental, psychological, and social factors also contribute to its occurrence.…

  15. Bovine colostrum improves intestinal function following formula-induced gut inflammation in preterm pigs

    USDA-ARS?s Scientific Manuscript database

    Only few hours of formula feeding may induce proinflammatory responses and predispose to necrotizing enterocolitis (NEC) in preterm pigs. We hypothesized that bovine colostrum, rich in bioactive factors, would improve intestinal function in preterm pigs following an initial exposure to formula feedi...

  16. Heroin Addict Relationships with Parents During Childhood and Early Adolescent Years

    ERIC Educational Resources Information Center

    Baer, Daniel J.; Corrado, James J.

    1974-01-01

    The antecedents of drug addiction were studied in addicts and nonusers. Results suggest that the early life histories of individuals may be important predisposing factors, particularly if the life history includes and unhappy childhood, harsh physical punishment, or lack of parental concern. (ST)

  17. Gene-environment interactions controlling energy and glucose homeostasis and the developmental origins of obesity.

    PubMed

    Bouret, Sebastien; Levin, Barry E; Ozanne, Susan E

    2015-01-01

    Obesity and type 2 diabetes mellitus (T2DM) often occur together and affect a growing number of individuals in both the developed and developing worlds. Both are associated with a number of other serious illnesses that lead to increased rates of mortality. There is likely a polygenic mode of inheritance underlying both disorders, but it has become increasingly clear that the pre- and postnatal environments play critical roles in pushing predisposed individuals over the edge into a disease state. This review focuses on the many genetic and environmental variables that interact to cause predisposed individuals to become obese and diabetic. The brain and its interactions with the external and internal environment are a major focus given the prominent role these interactions play in the regulation of energy and glucose homeostasis in health and disease. Copyright © 2015 the American Physiological Society.

  18. Potential roles of high salt intake and maternal malnutrition in the development of hypertension in disadvantaged populations.

    PubMed

    Thrift, Amanda G; Srikanth, Velandai; Fitzgerald, Sharyn M; Kalyanram, Kartik; Kartik, Kamakshi; Hoppe, Chantal C; Walker, Karen Z; Evans, Roger G

    2010-02-01

    1. It has been argued that all major risk factors for cardiovascular disease have been identified. Yet, epidemiological studies undertaken to identify risk factors have largely focused on populations in developed nations or on the urban or relatively affluent rural populations of developing countries. Poor rural populations are seldom studied. 2. Somewhat different risk factors may operate in poor rural populations. Evidence for this is provided by the finding that, in disadvantaged rural India, the prevalence of hypertension is greater than would be expected based on established risk factors in these populations. One risk factor to be considered is a poor intrauterine environment. 3. In animals, maternal macro- and micronutrient malnutrition can lead to reduced nephron endowment. Nephron deficiency, in turn, can render blood pressure salt sensitive. The combination of nephron deficiency and excessive salt intake will predispose to hypertension. 4. Human malnutrition may have similar effects, particularly in regions of the world where malnutrition is endemic and where women are disadvantaged by existing social practices. 5. Moreover, high salt intake is endemic in many parts of Asia, including India. Therefore, we propose that maternal malnutrition (leading to reduced nephron endowment), when combined with excessive salt intake postnatally, will account, at least in part, for the unexpectedly high prevalence of hypertension in disadvantaged rural communities in India and elsewhere.

  19. Depression and smoking: a 5-year prospective study of patients with major depressive disorder.

    PubMed

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Ketokivi, Mikko; Isometsä, Erkki T

    2013-06-01

    Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation. In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20-59 years at were followed from baseline to 6 months, 18 months, and 5 years. We investigated course of depression, smoking, and comorbid alcohol-use disorders among the 214 patients (79.6% of 269) participating at least three time points; differences between smoking versus nonsmoking patients, and covariation of MDD, smoking, and alcohol-use disorders. Overall, 31.3% of the patients smoked regularly, 41.1% intermittently, and 27.6% never. Smokers were younger, had more alcohol-use disorders and Cluster B and C personality disorder symptoms, a higher frequency of lifetime suicide attempts, higher neuroticism, smaller social networks, and lower perceived social support than never smokers. Smoking and depression had limited longitudinal covariation. Depression, smoking, and alcohol-use disorders all exhibited strong autoregressive tendencies. Among adult psychiatric MDD patients, smoking is strongly associated with substance-use and personality disorders, which may confound research on the impact of smoking. Rather than depression or smoking covarying or predicting each other, depression, smoking, and alcohol-use disorders each have strong autoregressive tendencies. These findings are more consistent with common factors causing their association than either of the conditions strongly predisposing to the other. © 2013 Wiley Periodicals, Inc.

  20. Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism

    NASA Astrophysics Data System (ADS)

    Törő, Klára; Pongrácz, Rita; Bartholy, Judit; Váradi-T, Aletta; Marcsa, Boglárka; Szilágyi, Brigitta; Lovas, Attila; Dunay, György; Sótonyi, Péter

    2016-03-01

    The objective of the present study was to identify risk factors among epidemiological factors and meteorological conditions in connection with fatal pulmonary embolism. Information was collected from forensic autopsy records in sudden unexpected death cases where pulmonary embolism was the exact cause of death between 2001 and 2010 in Budapest. Meteorological parameters were detected during the investigated period. Gender, age, manner of death, cause of death, place of death, post-mortem pathomorphological changes and daily meteorological conditions (i.e. daily mean temperature and atmospheric pressure) were examined. We detected that the number of registered pulmonary embolism (No 467, 211 male) follows power law in time regardless of the manner of death. We first described that the number of registered fatal pulmonary embolism up to the nth day can be expressed as Y( n) = α ṡ n β where Y denotes the number of fatal pulmonary embolisms up to the nth day and α > 0 and β > 1 are model parameters. We found that there is a definite link between the cold temperature and the increasing incidence of fatal pulmonary embolism. Cold temperature and the change of air pressure appear to be predisposing factors for fatal pulmonary embolism. Meteorological parameters should have provided additional information about the predisposing factors of thromboembolism.

  1. Plantar pressures in children with and without sever's disease.

    PubMed

    Becerro de Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Rodríguez Sanz, David; Prados Frutos, Juan Carlos; Salvadores Fuentes, Paloma; Chicharro, José López

    2011-01-01

    a case-control study was conducted to compare static plantar pressures and distribution of body weight across the two lower limbs, as well as the prevalence of gastrocnemius soleus equinus, in children with and without calcaneal apophysitis (Sever's disease). the participants were 54 boys enrolled in a soccer academy, of which eight were lost to follow-up. Twenty-two boys with unilateral Sever's disease comprised the Sever's disease group and 24 healthy boys constituted a control group. Plantar pressure data were collected using pedobarography, and gastrocnemius soleus equinus was assessed. peak pressure and percentage of body weight supported were significantly higher in the symptomatic feet of the Sever's disease group than in the asymptomatic feet of the Sever's disease group and the control group. Every child in the Sever's disease group had bilateral gastrocnemius equinus, while nearly all children in the control group had no equinus. high plantar foot pressures are associated with Sever's disease, although it is unclear whether they are a predisposing factor or a result of the condition. Gastrocnemius equinus may be a predisposing factor for Sever's disease. Further research is needed to identify other factors involved in the disease and to better understand the factors that contribute to abnormal distribution of body weight in the lower limbs.

  2. Evening primrose oil or forskolin ameliorates celecoxib-enhanced upregulation of tissue factor expression in mice subjected to lipopolysaccharide-induced endotoxemia.

    PubMed

    Mosaad, Sarah M; Zaitone, Sawsan A; Ahmed, Amal A M; Abo-Elmatty, Dina M; El-Baz, Amani A; Moustafa, Yasser M

    2017-05-01

    Celecoxib, a selective cyclooxygenase-2 inhibitor, produces thrombotic events in patients predisposed to cardiovascular risk factors. One theory reported an increase in endothelial expression of tissue factor (TF) as a predisposing factor. This work explored the effect of evening primrose oil (EPO), a source of prostaglandin E1, and forskolin (a cyclic adenosine monophosphate stimulator) against the prothrombotic effect of celecoxib in mice. Lipopolysaccharide mouse model of endotoxemia was used to induce an upregulation of TF activity. Male mice received celecoxib (25 mg/kg), celecoxib plus EPO, or celecoxib plus forskolin for 4 weeks and then subjected to a prothrombotic challenge in the form of an intraperitoneal injection of lipopolysaccharide. Results showed an increase in plasma TF activity, endothelial TF expression, and thrombin-antithrombin (TAT) but lower antithrombin III (ATIII) level in mice that received celecoxib in comparison to those that received the vehicle. Adding EPO or forskolin to celecoxib regimen significantly decreased the prothrombotic effect of celecoxib. A positive correlation (r = 0.8501) was found between TF activity and TAT. Co-administration of EPO or forskolin decreased the activity of TF and mitigated the prothrombotic effect of celecoxib. Therefore, these combinations may have the utility to abrogate the prothrombotic adverse effect of celecoxib in clinical setting.

  3. Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant.

    PubMed

    Williams, L A; Evans, S F; Newnham, J P

    1997-06-28

    To determine the demographic, environmental, and medical factors that influence the relative weights of the newborn infant and the placenta and compare this ratio with other factors known to predispose to adult ill health. Prospective cohort study. The tertiary referral centre for perinatal care in Perth, Western Australia. 2507 pregnant women who delivered a single live infant at term. Placental weight, birth weight, and the ratio of placental weight to birth weight. By multiple regression analysis the placental weight to birthweight ratio was significantly and positively associated with gestational age, female sex, Asian parentage, increasing maternal body mass index, increased maternal weight at booking, lower socioeconomic status, maternal anaemia, and increasing number of cigarettes smoked daily. There were no consistent relations between the placental weight to birthweight ratio and measures of newborn size. The ratio of placental weight to birth weight is not an accurate marker of fetal growth. In its role as a predictor of adult disease the ratio may be acting as a surrogate for other factors which are already known to influence health and may act before or after birth. Determining the role that relative growth rates of the fetus and placenta have in predisposing to adult disease requires prospective study to account for the many confounding variables which complicate this hypothesis.

  4. The impact of nutritional deficit on mortality of in-patients with pulmonary tuberculosis.

    PubMed

    Kim, H-J; Lee, C-H; Shin, S; Lee, J H; Kim, Y W; Chung, H S; Han, S K; Shim, Y-S; Kim, D K

    2010-01-01

    A metropolitan governmental medical centre, Seoul, Republic of Korea. To elucidate the impact of the nutritional deficit assessed by the Nutritional Risk Score (NRS) on the outcomes of in-patients with pulmonary tuberculosis (PTB). All hospitalised patients with microbiologically confirmed PTB were enrolled. A four-point NRS included low body mass index (<18.5 kg/m(2)), hypoalbuminaemia (<30.0 g/l), hypocholesterolaemia (<2.33 mmol/l) and severe lymphocytopaenia (<7 x 10(5) cells/l). The primary outcome was overall in-hospital mortality. The degree of radiographical resolution after anti-tuberculosis treatment was also evaluated. In a total of 156 patients, the male to female ratio was 1.6:1. The overall mortality was 13.5% and tuberculosis-specific fatality was 3.9%. Predisposing factors and high NRS (> or = 3 points) were independent risk factors for in-hospital death after adjusting for the severity of PTB. High NRS (OR = 16.8, P < 0.001) and predisposing factors (OR = 5.4, P = 0.032) were independent risk factors for 30-day survival. The NRS was not associated with radiographic improvement. Regardless of disease severity, the high NRS was a significant negative predictor among in-patients with PTB; this finding should therefore be considered in the management of PTB despite the current era of effective anti-tuberculosis chemotherapy.

  5. [Clinical-psychological components in the consideration of functional dysphonia--a review].

    PubMed

    Kiese-Himmel, C

    2015-03-01

    The etiopathogenesis of functional dysphonia is complex; it is not sufficient to look solely at vocal behavior aspects. The predisposing basis for functional dysphonia can lie in the constitution of an individual, his/her professional speaking and speech behavior and/or may be personality-based. (Prolonged) psychosocial stress, vocal overstressing, unfavorable speaking habits, infection of the upper respiratory tract, inflammatory processes in the larynx, emotional life events and COSO events are considered as possible triggers. The interaction of predisposed and causal factors is unknown. Stress, overall fatigue, anxiety, depression and/or certain personality traits (which complicate or hamper coping) are considered as perpetuating factors. In any case, overlaps between voice symptoms and reactive psychic as well as social problems have to be kept in mind (e. g. the burden of suffering, depressive processing, speaking anxiety, socially withdrawal). Because the association of multiple psychosocial factors with functional dysphonia is not distinct--such are always existent in organ medically unexplained symptoms--functional dysphonia has to be diagnostically differentiated. For the purpose of the article, a psycho-diagnostic path following the ICD-10 chapter V along general lines is presented. Until now, it is unknown which psychosocial factors discriminate a psychogenic dysphonia from muscle tension dysphonia. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

    PubMed Central

    Espejo, Emmanuel P.; Hammen, Constance; Brennan, Patricia A.

    2012-01-01

    The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents who were administered diagnostic and life stress interviews at ages 15 and 20. Participants’ appraisals of the negative impact of LEs reported at age 15 were statistically adjusted using investigator-based ratings to control for objective differences across LEs. Higher appraisals of the negative impact of LEs were associated with both past and current depressive and anxiety disorders at age 15 and predicted subsequent first onsets of depressive and anxiety disorders occurring between ages 15 and 20. In addition, appraisals of the negative impact of LEs were particularly elevated among those experiencing both a depressive and anxiety disorder over the course of the study. The findings suggest that systematically elevated appraisals of the negative impact of LEs is a predisposing factor for depression and anxiety disorders and may represent a specific risk factor for co-morbid depression and anxiety in mid-adolescence and early adulthood. Keywords: depression; anxiety; stress appraisals; prospective study; PMID:21845380

  7. Human susceptibility to legionnaires' disease.

    PubMed

    Berrington, William R; Hawn, Thomas R

    2013-01-01

    Legionella pneumophila is a facultative intracellular pathogen that is an important cause of pneumonia. Although host factors that may predispose to acquisition of Legionnaire's Disease (LD) include comorbid illnesses (e.g., diabetes, chronic lung disease), age, male sex, and smoking, many individuals have no identifiable risk factors. Some studies suggest that genetic factors may enhance susceptibility to LD. In this chapter we discuss current techniques and scientific methods to identify genetic susceptibility factors. These genetic studies provide insight into the human immune response to intracellular pathogens and may improve strategies for treatment and vaccine development.

  8. Complex Landscape of Germline Variants in Brazilian Patients With Hereditary and Early Onset Breast Cancer.

    PubMed

    Torrezan, Giovana T; de Almeida, Fernanda G Dos Santos R; Figueiredo, Márcia C P; Barros, Bruna D de Figueiredo; de Paula, Cláudia A A; Valieris, Renan; de Souza, Jorge E S; Ramalho, Rodrigo F; da Silva, Felipe C C; Ferreira, Elisa N; de Nóbrega, Amanda F; Felicio, Paula S; Achatz, Maria I; de Souza, Sandro J; Palmero, Edenir I; Carraro, Dirce M

    2018-01-01

    Pathogenic variants in known breast cancer (BC) predisposing genes explain only about 30% of Hereditary Breast Cancer (HBC) cases, whereas the underlying genetic factors for most families remain unknown. Here, we used whole-exome sequencing (WES) to identify genetic variants associated to HBC in 17 patients of Brazil with familial BC and negative for causal variants in major BC risk genes ( BRCA1/2, TP53 , and CHEK2 c.1100delC). First, we searched for rare variants in 27 known HBC genes and identified two patients harboring truncating pathogenic variants in ATM and BARD1 . For the remaining 15 negative patients, we found a substantial vast number of rare genetic variants. Thus, for selecting the most promising variants we used functional-based variant prioritization, followed by NGS validation, analysis in a control group, cosegregation analysis in one family and comparison with previous WES studies, shrinking our list to 23 novel BC candidate genes, which were evaluated in an independent cohort of 42 high-risk BC patients. Rare and possibly damaging variants were identified in 12 candidate genes in this cohort, including variants in DNA repair genes ( ERCC1 and SXL4 ) and other cancer-related genes ( NOTCH2, ERBB2, MST1R , and RAF1 ). Overall, this is the first WES study applied for identifying novel genes associated to HBC in Brazilian patients, in which we provide a set of putative BC predisposing genes. We also underpin the value of using WES for assessing the complex landscape of HBC susceptibility, especially in less characterized populations.

  9. Cigarette Smoking Accelerated Brain Aging and Induced Pre-Alzheimer-Like Neuropathology in Rats

    PubMed Central

    Ho, Yuen-Shan; Yang, Xifei; Yeung, Sze-Chun; Chiu, Kin; Lau, Chi-Fai; Tsang, Andrea Wing-Ting; Mak, Judith Choi-Wo; Chang, Raymond Chuen-Chung

    2012-01-01

    Cigarette smoking has been proposed as a major risk factor for aging-related pathological changes and Alzheimer's disease (AD). To date, little is known for how smoking can predispose our brains to dementia or cognitive impairment. This study aimed to investigate the cigarette smoke-induced pathological changes in brains. Male Sprague-Dawley (SD) rats were exposed to either sham air or 4% cigarette smoke 1 hour per day for 8 weeks in a ventilated smoking chamber to mimic the situation of chronic passive smoking. We found that the levels of oxidative stress were significantly increased in the hippocampus of the smoking group. Smoking also affected the synapse through reducing the expression of pre-synaptic proteins including synaptophysin and synapsin-1, while there were no changes in the expression of postsynaptic protein PSD95. Decreased levels of acetylated-tubulin and increased levels of phosphorylated-tau at 231, 205 and 404 epitopes were also observed in the hippocampus of the smoking rats. These results suggested that axonal transport machinery might be impaired, and the stability of cytoskeleton might be affected by smoking. Moreover, smoking affected amyloid precursor protein (APP) processing by increasing the production of sAPPβ and accumulation of β–amyloid peptide in the CA3 and dentate gyrus region. In summary, our data suggested that chronic cigarette smoking could induce synaptic changes and other neuropathological alterations. These changes might serve as evidence of early phases of neurodegeneration and may explain why smoking can predispose brains to AD and dementia. PMID:22606286

  10. Personality disorders and suicide attempts in unipolar and bipolar mood disorders.

    PubMed

    Jylhä, Pekka; Rosenström, Tom; Mantere, Outi; Suominen, Kirsi; Melartin, Tarja; Vuorilehto, Maria; Holma, Mikael; Riihimäki, Kirsi; Oquendo, Maria A; Keltikangas-Järvinen, Liisa; Isometsä, Erkki T

    2016-01-15

    Comorbid personality disorders may predispose patients with mood disorders to suicide attempts (SAs), but factors mediating this effect are not well known. Altogether 597 patients from three prospective cohort studies (Vantaa Depression Study, Jorvi Bipolar Study, and Vantaa Primary Care Depression Study) were interviewed at baseline, at 18 months, and in VDS and PC-VDS at 5 years. Personality disorders (PDs) at baseline, number of previous SAs, life-charted time spent in major depressive episodes (MDEs), and precise timing of SAs during follow-up were determined and investigated. Overall, 219 (36.7%) patients had a total of 718 lifetime SAs; 88 (14.7%) patients had 242 SAs during the prospective follow-up. Having any PD diagnosis increased the SA rate, both lifetime and prospectively evaluated, by 90% and 102%, respectively. All PD clusters increased the rate of new SAs, although cluster C PDs more than the others. After adjusting for time spent in MDEs, only cluster C further increased the SA rate (by 52%). Mediation analyses of PD effects on prospectively ascertained SAs indicated significant mediated effects through time at risk in MDEs, but also some direct effects. Findings generalizable only to patients with mood disorders. Among mood disorder patients, comorbid PDs increase the risk of SAs to approximately two-fold. The excess risk is mostly due to patients with comorbid PDs spending more time in depressive episodes than those without. Consequently, risk appears highest for PDs that most predispose to chronicity and recurrences. However, also direct risk-modifying effects of PDs exist. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

    PubMed

    García-Aparicio, Luis; Blázquez-Gómez, Eva; de Haro, Irene; Garcia-Smith, Natalie; Bejarano, Miguel; Martin, Oriol; Rodo, Joan

    2015-12-01

    To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

  12. Risk factors in the mother-child relationship that predispose to the development of early childhood caries.

    PubMed

    Moimaz, S A S; Garbin, A J Í; Lima, A M C; Lolli, L F; Saliba, O; Garbin, C A S

    2014-08-01

    This study focused on the risk factors in mother-child relationship that predispose babies to the development of dental caries. A prospective cohort study with 80 mother-child pairs was conducted. The mothers responded at 12, 18 and 30 months after their children's birth, to questions about variables related to diet, sucking habits, and oral care. Children were clinically examined to verify caries lesions (white spot lesions or cavitation). Data were analysed using Chi squared or Fisher's exact tests. The significance level was set at 5%. Of the total, 3.75% showed cavitated lesions after 18 months; 6.25 and 45% had spot white lesions, respectively, at 18 and 30 months. The cariogenic diet was high at 12 (63.75%) and 30 (88.75%) months. Good oral hygiene was present in a minority of children at 12 months (46.25%), but increased at 30 months (65%), helping to prevent cavities and white spot lesions over this period (p = 0.0005). The variables of the blocks sucking habits and diet were not associated with caries. The lack of oral care in children was a risk factor for dental caries development.

  13. Cystic fibrosis liver disease - from diagnosis to risk factors.

    PubMed

    Ciucă, Ioana Mihaiela; Pop, Liviu; Tămaş, Liviu; Tăban, Sorina

    2014-01-01

    Cystic fibrosis (CF) is the most frequent monogenic genetic disease, autosomal recessive transmitted, characterized by an impressive clinical polymorphism and appreciative fatal prospective. Liver disease is the second non-pulmonary cause of death in cystic fibrosis, which, with increasing life expectancy, became an important management problem. Predisposing factors like male gender, pancreatic insufficiency, meconium ileus and severe mutation are incriminated to influence the occurrence of cystic fibrosis associated liver disease (CFLD). Our study included 174 patients with CF, monitored in the National Cystic Fibrosis Centre, Timisoara, Romania. They were routinely followed-up by clinical assessment, liver biochemical tests, ultrasound examinations and other methods like transient elastography, biopsy, in selected cases. Sixty-six patients, with median age at diagnosis 4.33 years, diagnosed with CFLD, without significant gender gap. CFLD was frequent in patients aged over eight years, with meconium ileus history, carriers of severe mutations (p=0.002). Pancreatic insufficiency, although present in 75% of patients with CFLD was not confirmed as risk factor, not male gender, in our study. CF children older than eight years, carriers of a severe genotype, with a positive history of meconium ileus, were more likely predisposed to CFLD.

  14. Factors associated to acceptable treatment adherence among children with chronic kidney disease in Guatemala

    PubMed Central

    Cerón, Alejandro; Méndez-Alburez, Luis Pablo; Lou-Meda, Randall

    2017-01-01

    Pediatric patients with Chronic Kidney Disease face several barriers to medication adherence that, if addressed, may improve clinical care outcomes. A cross sectional questionnaire was administered in the Foundation for Children with Kidney Disease (FUNDANIER, Guatemala City) from September of 2015 to April of 2016 to identify the predisposing factors, enabling factors and need factors related to medication adherence. Sample size was calculated using simple random sampling with a confidence level of 95%, confidence interval of 0.05 and a proportion of 87%. A total of 103 participants responded to the questionnaire (calculated sample size was 96). Independent variables were defined and described, and the bivariate relationship to dependent variables was determined using Odds Ratio. Multivariate analysis was carried out using logistic regression. The mean adherence of study population was 78% (SD 0.08, max = 96%, min = 55%). The mean adherence in transplant patients was 82% (SD 7.8, max 96%, min 63%), and the mean adherence in dialysis patients was 76% (SD 7.8 max 90%, min 55%). Adherence was positively associated to the mother’s educational level and to higher monthly household income. Together predisposing, enabling and need factors illustrate the complexities surrounding adherence in this pediatric CKD population. Public policy strategies aimed at improving access to comprehensive treatment regimens may facilitate treatment access, alleviating economic strain on caregivers and may improve adherence outcomes. PMID:29036228

  15. Repeated addiction treatment use in Sweden: a National Register Database study.

    PubMed

    Grahn, Robert; Chassler, Deborah; Lundgren, Lena

    2014-11-01

    Sweden has a free, universal addiction treatment system, yet few studies exist examining utilization of treatment in this country. This study identified predisposing, enabling, and need factors associated with history of number of voluntary addiction treatment episodes for a national sample of 12,009 individuals assessed for an alcohol and/or drug use disorder in Sweden. On average, people reported 4.3 prior treatment episodes. Linear regression methods identified that predisposing factors such as older age and being male were associated with more voluntary addiction treatment episodes compared to younger and female clients; a higher Addiction Severity Index (ASI) employment score (an enabling factor) was associated with more voluntary addiction treatment episodes; and need factors including a history of inpatient mental health treatment, a higher ASI psychiatric score, a higher ASI alcohol score, higher levels of illicit drug use, more compulsory addiction treatment episodes, a lower ASI legal score, and a history of criminal justice involvement were all associated with more voluntary addiction treatment episodes compared to their counterparts.. There were no differences in the number of treatment episodes by education or immigrant status. (1) Need is a key factor associated with more treatment use. (2) Further studies are needed to identify gender differences in access/use of treatment. (3) Given multiple treatment histories, Swedish addiction treatment policy should reflect a chronic care model rather than an acute care model.

  16. Factors associated to acceptable treatment adherence among children with chronic kidney disease in Guatemala.

    PubMed

    Ramay, Brooke M; Cerón, Alejandro; Méndez-Alburez, Luis Pablo; Lou-Meda, Randall

    2017-01-01

    Pediatric patients with Chronic Kidney Disease face several barriers to medication adherence that, if addressed, may improve clinical care outcomes. A cross sectional questionnaire was administered in the Foundation for Children with Kidney Disease (FUNDANIER, Guatemala City) from September of 2015 to April of 2016 to identify the predisposing factors, enabling factors and need factors related to medication adherence. Sample size was calculated using simple random sampling with a confidence level of 95%, confidence interval of 0.05 and a proportion of 87%. A total of 103 participants responded to the questionnaire (calculated sample size was 96). Independent variables were defined and described, and the bivariate relationship to dependent variables was determined using Odds Ratio. Multivariate analysis was carried out using logistic regression. The mean adherence of study population was 78% (SD 0.08, max = 96%, min = 55%). The mean adherence in transplant patients was 82% (SD 7.8, max 96%, min 63%), and the mean adherence in dialysis patients was 76% (SD 7.8 max 90%, min 55%). Adherence was positively associated to the mother's educational level and to higher monthly household income. Together predisposing, enabling and need factors illustrate the complexities surrounding adherence in this pediatric CKD population. Public policy strategies aimed at improving access to comprehensive treatment regimens may facilitate treatment access, alleviating economic strain on caregivers and may improve adherence outcomes.

  17. Predictive Factors of Regular Physical Activity among Middle-Aged Women in the West of Iran, Hamadan: Application of PRECEDE Model.

    PubMed

    Emdadi, Shohreh; Hazavehie, Seyed Mohammad Mehdi; Soltanian, Alireza; Bashirian, Saeed; Heidari Moghadam, Rashid

    2015-01-01

    Regular physical activity is important for midlife women. Models and theories help better understanding this behavior among middle-aged women and better planning for change behavior in target group. This study aimed to investigate predictive factors of regular physical activity among middle-aged women based on PRECEDE model as a theoretical framework. This descriptive-analytical study was performed on 866 middle-aged women of Hamadan City western Iran, recruited with a proportional stratified sampling method in 2015. The participants completed a self-administered questionnaire including questions on demographic characteristics and PRECEDE model constructs and IPAQ questionnaire. Data were then analyzed by SPSS-16 and AMOS-16 using the Pearson correlation test and the pathway analysis method. Overall, 57% of middle-aged women were inactive (light level) or not sufficiently active. With SEM (Structural Equation Modeling) analysis, knowledge b=0.84, P<0.001, attitude b=0.799, P<0.001, self-efficacy b=0.633, P<0.001 as predisposing factor and social support as reinforcing factor b=0.2, P<0.001 were the most important predictors for physical activity among middle-aged women in Hamadan. The framework of the PRECEDE model is useful in understanding regular physical activity among middle-aged women. Furthermore, results showed the importance of predisposing and reinforcing factors when planning educational interventions.

  18. The High Affinity Iron Permease is a Key Virulence Factor Required for Rhizopus oryzae Pathogenesis

    USDA-ARS?s Scientific Manuscript database

    Rhizopus oryzae is the most common cause of mucormycosis, an angioinvasive fungal infection that causes a >/=50% mortality rate despite first-line therapy. Clinical and animal model data clearly demonstrate that the presence of elevated available serum iron predisposes the host to mucormycosis. Th...

  19. Predisposition for Burnout among First-Year Teachers.

    ERIC Educational Resources Information Center

    Hall, Bruce W.; And Others

    1988-01-01

    Findings from a study of 224 first-year teachers suggest: (1) burnout begins during the first year; (2) high-school teachers are more predisposed to burnout; (3) quality teacher preparation, particularly in student discipline, may promote resistance to burnout; (4) burnout is a reflection of emotional and motivational factors rather than academic…

  20. Short-Term Exercise and Prostate Cancer Prevention in African American Men

    DTIC Science & Technology

    2007-04-01

    sedentary lifestyle may predispose African-African men to prostate cancer by affecting levels of serum factors that potentate the growth of the...whites of similar age. It has been suggested that a high fat diet and sedentary lifestyle may possibly cause the increased incidence of prostate

  1. Application of the PRECEDE Model to Understanding Mental Health Promoting Behaviors in Hong Kong

    ERIC Educational Resources Information Center

    Mo, Phoenix K. H.; Mak, Winnie W. S.

    2008-01-01

    The burdens related to mental illness have been increasingly recognized in many countries. Nevertheless, research in positive mental health behaviors remains scarce. This study utilizes the Predisposing, Reinforcing, and Enabling Causes in Education Diagnosis and Evaluation (PRECEDE) model to identify factors associated with mental health…

  2. Yogurt, immune function and infectious disease: can yogurt be used to protect the elderly against infections?

    USDA-ARS?s Scientific Manuscript database

    Systemic low-grade inflammation and immunosenescence occurs with aging, predisposing the elderly to myriad risk factors for infectious and chronic disease. Respiratory infections such as influenza and pneumonia are a leading cause of mortality in the elderly, and therefore of significant public hea...

  3. Preventing Dance Injuries: An Interdisciplinary Perspective.

    ERIC Educational Resources Information Center

    Solomon, Ruth, Ed.; And Others

    This book on the interdisciplinary nature of dance medicine as an emerging field of inquiry contains the following chapters: (1) "A Comparison of Patterns of Injury in Ballet, Modern, and Aerobic Dance" (Marie Schafle, And Others); (2) "Pronation as a Predisposing Factor in Overuse Injuries" (Steven R. Kravitz); (3) "Some…

  4. Predicting Physical Activity in 10-12 Year Old Children: A Social Ecological Approach

    ERIC Educational Resources Information Center

    Zhang, Tao; Thomas, Katherine; Weiller, Karen H.

    2015-01-01

    The purpose of this study was to investigate the associations among predisposing (perceived competence and enjoyment), reinforcing (social environments), enabling factors (motor skills, fitness, physical environments) and physical activity among 288 children, and to identify the age and gender differences among participants. The children completed…

  5. A Cluster Analytic Study of Osteoprotective Behavior in Undergraduates

    ERIC Educational Resources Information Center

    Sharp, Katherine; Thombs, Dennis L.

    2003-01-01

    Objective: To derive an empirical taxonomy of osteoprotective stages using the Precaution Adoption Process Model (PAPM) and to identify the predisposing factors associated with each stage. Methods: An anonymous survey was completed by 504 undergraduates at a Midwestern public university. Results: Cluster analytic findings indicate that only 2…

  6. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis.

    PubMed

    Ajmera, Mayank; Raval, Amit D; Shen, Chan; Sambamoorthi, Usha

    2014-01-01

    To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD) among elderly individuals with chronic obstructive pulmonary disease (COPD) and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009) of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001]) expenditures than did those with COPD/no GERD. Ordinary least squares regression revealed that individuals with COPD/GERD had 36.3% (P<0.001) higher expenditures than did those with COPD/no GERD. Overall, 30.9% to 43.6% of the differences in average health care expenditures were explained by differences in predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors between the two groups. Need factors explained up to 41% of the differences in average health care expenditures between the two groups. Among elderly Medicare beneficiaries with COPD, the presence of GERD was associated with higher expenditures. Need factors primarily contributed to the differences in average health care expenditures, suggesting that the comanagement of chronic conditions may reduce excess health care expenditures associated with GERD.

  7. The Status of Secondary School Science Laboratory Activities for Quality Education in Case of Wolaita Zone, Southern Ethiopia

    ERIC Educational Resources Information Center

    Zengele, Ashebir Gogile; Alemayehu, Bereket

    2016-01-01

    A high quality science education in primary and secondary schools contributes to developing scientific literacy and would be expected to predispose students to study the enabling sciences at university. The major purpose of this study was to assess the practice and problems in science laboratory activities in the secondary school of Wolaita Zone,…

  8. Formal Home Care Utilization Patterns by Rural–Urban Community Residence

    PubMed Central

    Spector, William; Van Nostrand, Joan

    2009-01-01

    Background We examined formal home care utilization among civilian adults across metro and nonmetro residential categories before and after adjustment for predisposing, enabling, and need variables. Methods Two years of the Medical Expenditure Panel Survey (MEPS) were combined to produce a nationally representative sample of adults who resided in the community for a calendar year. We established 6 rural–urban categories based upon Urban Influence Codes and examined 2 dependent variables: (a) likelihood of using any formal home care and (b) number of provider days received by users. The Area Resource File provided county-level information. Logistic and negative binomial regression analyses were employed, with adjustments for the MEPS complex sampling design and the combined years. Results Under controls for predisposing, enabling, and need variables, differences in likelihood of any formal home care use disappear, but differences in number of provider days received by users emerged, with fewer provider days in remote areas than in metro and several other nonmetro types. Conclusions It is important to fully account for predisposing, enabling, and need factors when assessing rural and urban home care utilization patterns. The limited provider days in remote counties under controls suggest a possible access problem for adults in these areas. PMID:19196690

  9. Campylobacteriosis in dogs and cats: a review.

    PubMed

    Acke, E

    2018-05-13

    Campylobacter species are commonly isolated from faecal samples collected from dogs and cats with the most prevalent species being C. upsaliensis, C. helveticus, and C. jejuni. Although the majority of dogs and cats are subclinically infected, some will develop mild to moderate enteritis. Immature animals, animals from intensive housing backgrounds, and animals with concurrent disease are especially predisposed to infection and the development of clinical signs. Bacterial culture methods applied in diagnostic laboratories remain biased to C. jejuni and C. coli detection, but molecular methods to diagnose Campylobacter spp. infections in dogs and cats have become widely available and can aid rapid and accurate diagnosis. Multilocus sequence typing has also been developed for subtyping different strains and has been used in epidemiological investigations. In the majority of cases, clinical signs are self-limiting and antimicrobial treatment is not warranted. Campylobacter spp. isolated from dogs and cats have shown resistance to commonly used antimicrobials, so antimicrobial therapy should only be administered where this is justified. Contact with dogs and cats is a recognised risk factor for human campylobacteriosis, thus people living or working in close contact with cats and dogs should be made aware of the zoonotic organisms these animals can shed.

  10. Implications of DSM-5 for Health Care Organizations and Mental Health Policy.

    PubMed

    Castillo, Richard J; Guo, Kristina L

    2016-01-01

    The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.

  11. Clinical and Demographic Characteristics of Women with Intrauterine Adhesion in Abuja, Nigeria

    PubMed Central

    Efetie, Efena R.; Umezulike, Augustine C.; Okafor, Ugochukwu V.

    2012-01-01

    Objective. Infertility menstrual abnormalities continue to constitute a significant bulk of gynecological consultation in Africa. Both of these problems are sometimes traced to intrauterine adhesions which are preventable in the majority of cases. Study Design. A retrospective analysis of intrauterine adhesions at the National Hospital Abuja, Nigeria, was carried out, covering the period from 1st September 1999 to 1st September 2004. A total of 72 cases were analyzed. Statical analysis was done using X 2. Results. The incidence of intrauterine adhesions was 1.73% of new patients. Mean age ± SD was 29.97 ± 4.82 years. Patients who were Para 0 to 1 constituted 81.9% of the total. Intrauterine adhesions significantly (P < 0.02) occurred in nulliparae. The majority (68%) were educated only up to secondary level which was significant (P < 0.05). Menstrual abnormalities were present in 90.3%. The commonest predisposing factor identified was a history of dilatation and curettage or uterine evacuation. Conclusion. Intrauterine adhesions are associated with lower educational status and low parity. Increasing educational targets nationally, poverty alleviation, nationwide retraining in manual vacuum aspiration, and wider application of this technique are recommended. PMID:22190953

  12. Recurrent posttraumatic meningitis due to nontypable Haemophilus influenzae: case report and review of the literature.

    PubMed

    Kunze, W; Müller, L; Kilian, M; Schuhmann, M U; Baumann, L; Handrick, W

    2008-02-01

    We report a case of relapsing Haemophilus influenzae meningitis in a boy at the age of nearly 3 years and 4.2 years who had been successfully vaccinated against H. influenzae serotype b (Hib). The pathogen was a nonencapsulated (nontypable) H. influenzae strain of biotypes III and VI, respectively. A rhinobasal impalement injury with development of a posttraumatic encephalocele is considered to be the predisposing condition. Review of the literature reveals that in patients systemically infected by nonencapsulated H. influenzae strains predisposing factors such as cerebrospinal fluid-shunts, implants and traumas are often found. To obtain further information on potential new disease patterns H. influenzae isolates from cerebrospinal fluid should be examined for capsule production and, if relevant, further characterized by capsular typing.

  13. Helminth control as an entry point for health-promoting schools in KwaZulu-Natal.

    PubMed

    Taylor, M; Coovadia, H M; Kvalsvig, J D; Jinabhai, C C; Reddy, P

    1999-03-01

    To use a health promotion model to investigate the risk factors (predisposing, enabling and reinforcing) for geohelminth and schistosomiasis infections, in order to develop and implement effective intervention strategies. Phase 1: Qualitative study using focus group discussions (FGDs) with parents, pupils and teachers; and interviews with health workers. Phase 2: Quantitative study using a semi-structured questionnaire to investigate whether the determinants identified in phase 1 were generalisable. Rural primary schools in Vulamehlo magisterial district, southern KwaZulu-Natal. Qualitative study: 9 schools with 179 pupils, 93 parents and 82 teachers; and local clinics (4 fixed, 1 mobile), with 7 professional nurses. Quantitative study: 2 other schools, with 730 pupils. Predisposing factors: Respondents were familiar with symptoms, but did not know the cause or mode of transmission of helminth infections. Many respondents perceived food to be the cause of geohelminth infection and swimming in the river to be the cause of schistosomiasis. Although 649 (88.9%) pupils had toilets at home and at school, only 218 (29.9%) were motivated to 'always' use the toilet for faecal disposal (rural communities previously did not have toilets). Six hundred and seventy-eight pupils (92.9%) understood that it was necessary to wash their hands after using the toilet, but many schools lacked water. Personal cleanliness was a problem despite the emphasis on hygiene by health workers and teachers. Few pupils admitted to eating soil, but it was agreed that geophagia affected young children between the ages of 8 months and 6 years. Enabling factors (positive/negative): Barriers to health promotion frequently included inadequate toilet facilities at school and home, and river-water contact resulting from a lack of clean water. A dearth of recreational facilities resulted in children swimming and playing in the river. Positive factors were the health-seeking behaviour of the majority of the target group, who identified helminth infections as a health problem and sought treatment. Parents and pupils in the FGDs unanimously supported health education and 655 (89.8%) questionnaire respondents indicated that they wished to learn how to avoid helminth infections. Although the Government strategy is to provide clean water and adequate sanitation, provision of services does not necessarily ensure usage. A comprehensive approach to health promotion is required and the complementary development of the 'health-promoting school' would support, reinforce and sustain a helminth control programme.

  14. Unplanned extubations in an intensive care unit: Findings from a critical incident technique.

    PubMed

    Danielis, Matteo; Chiaruttini, Simona; Palese, Alvisa

    2018-05-15

    Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. To gain a greater understanding of the antecedents of unplanned extubations. A qualitative study design involving the critical-incident technique. A total of 10 registered nurses who reported one or more episodes of unplanned extubations were involved in an in-depth interview. According to the nurses' experience, episodes of unplanned extubations are determined by predisposing, precipitating and mediating factors. The predisposing factors have been recognised in the (a) weaning programme (expected/unexpected decreased sedation) and in the (b) patient factors (increased needs due to discomfort, restlessness and desire to communicate). The precipitating factors have been divided into (a) organisational (failures in multi-professional communication), (b) environmental (excessive environmental chaos and barriers preventing direct surveillance) and (c) nursing care factors (ensuring privacy by creating barriers, avoiding disturbing other patients and poor nurse-to-patient ratio). Among the mediating factors, which are affected by the precipitating factors, decreased surveillance and mechanical restraints' use have been identified. Identifying risk factors of unplanned extubation, specifically those that are modifiable, such as increasing interprofessional communication, reducing excessive environment chaos, implementing strategies aimed at overcoming barriers threatening direct surveillance and ensuring appropriate nurse-to-patient ratio, can prevent the occurrence of these events. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Exploring differences in healthcare utilization of prisoners in the Canton of Vaud, Switzerland

    PubMed Central

    Moschetti, Karine; Zabrodina, Véra; Stadelmann, Pierre; Wangmo, Tenzin; Holly, Alberto; Wasserfallen, Jean-Blaise; Elger, Bernice S.; Gravier, Bruno

    2017-01-01

    Prison healthcare is an important public health concern given the increasing healthcare needs of a growing and aging prison population, which accumulates vulnerability factors and suffers from higher disease prevalence than the general population. This study identifies the key factors associated with outpatient general practitioner (GP), nursing or psychiatric healthcare utilization (HCU) within prisons. Cross-sectional data systematically collected by the prison medical staff were obtained for a sample of 1664 adult prisoners of the Canton of Vaud, Switzerland, for the year 2011. They contain detailed information on demographics (predisposing factors), diagnosed chronic somatic and psychiatric disorders (needs factors), as well as prison stay characteristics (contextual factors). For GP, nurse and psychiatric care, two-part regressions are used to model separately the probability and the volume of HCU. Predisposing factors are generally not associated with the probability to use healthcare services after controlling for needs factors. However, female inmates use higher volumes of care, and the volume of GP consultations increases with age. Chronic somatic and psychiatric conditions are the most important predictors of the probability of HCU, but associations with volumes differ in their magnitude and significance across disease groups. Infectious, musculoskeletal, nervous and circulatory diseases actively mobilize GP and nursing staff. Schizophrenia, illicit drug and pharmaceuticals abuse are strongly positively associated with psychiatric and nurse HCU. The occupancy rate displays positive associations among contextual factors. Prison healthcare systems face increasingly complex organizational, budgetary and ethical challenges. This study provides relevant insights into the HCU patterns of a marginalized and understudied population. PMID:29084290

  16. [Chronic insomnia: treatment methods based on the current "3P" model of insomnia].

    PubMed

    Poluektov, M G; Pchelina, P V

    2015-01-01

    Authors consider one of the popular models of the pathogenesis of chronic insomnia--"3P" model. It explains the origin and course of insomnia on the basis of interaction of three factors: predisposing, precipitating and perpetuating. The role of each group of factors and its connection to the cerebral hyperarousal state is discussed. Different variants of cognitive-behavioral therapy and pharmacological treatment of chronic insomnia are described.

  17. Why is the thyroid so prone to autoimmune disease?

    PubMed

    Saranac, L; Zivanovic, S; Bjelakovic, B; Stamenkovic, H; Novak, M; Kamenov, B

    2011-01-01

    The thyroid gland plays a major role in the human body; it produces the hormones necessary for appropriate energy levels and an active life. These hormones have a critical impact on early brain development and somatic growth. At the same time, the thyroid is highly vulnerable to autoimmune thyroid diseases (AITDs). They arise due to the complex interplay of genetic, environmental, and endogenous factors, and the specific combination is required to initiate thyroid autoimmunity. When the thyroid cell becomes the target of autoimmunity, it interacts with the immune system and appears to affect disease progression. It can produce different growth factors, adhesion molecules, and a large array of cytokines. Preventable environmental factors, including high iodine intake, selenium deficiency, and pollutants such as tobacco smoke, as well as infectious diseases and certain drugs, have been implicated in the development of AITDs in genetically predisposed individuals. The susceptibility of the thyroid to AITDs may come from the complexity of hormonal synthesis, peculiar oligoelement requirements, and specific capabilities of the thyroid cell's defense system. An improved understanding of this interplay could yield novel treatment pathways, some of which might be as simple as identifying the need to avoid smoking or to control the intake of some nutrients. Copyright © 2011 S. Karger AG, Basel.

  18. The role of epigenetics in cardiovascular health and ageing: A focus on physical activity and nutrition.

    PubMed

    Wallace, Robert G; Twomey, Laura C; Custaud, Marc-Antoine; Turner, Jonathan D; Moyna, Niall; Cummins, Philip M; Murphy, Ronan P

    2017-11-16

    The cardiovascular system is responsible for transport of blood and nutrients to tissues, and is pivotal to the physiological health and longevity. Epigenetic modification is a natural, age-associated process resulting in highly contextualised gene expression with clear implications for cell differentiation and disease onset. Biological/epigenetic age is independent of chronological age, constituting a highly reflective snapshot of an individual's overall health. Accelerated vascular ageing is of major concern, effectively lowering disease threshold. Age-related chronic illness involves a complex interplay between many biological processes and is modulated by non-modifiable and modifiable risk factors. These alter the static genome by a number of epigenetic mechanisms, which change gene expression in an age and lifestyle dependent manner. This 'epigenetic drift' impacts health and contributes to the etiology of chronic illness. Lifestyle factors may cause acceleration of this epigenetic "clock", pre-disposing individuals to cardiovascular disease. Nutrition and physical activity are modifiable lifestyle choices, synergistically contributing to cardiovascular health. They represent a powerful potential epigenetic intervention point for effective cardiovascular protective and management strategies. Thus, together with traditional risk factors, monitoring the epigenetic signature of ageing may prove beneficial for tailoring lifestyle to fit biology - supporting the increasingly popular concept of "ageing well". Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Polygenic risk for psychiatric disorders correlates with executive function in typical development.

    PubMed

    Schork, A J; Brown, T T; Hagler, D J; Thompson, W K; Chen, C-H; Dale, A M; Jernigan, T L; Akshoomoff, N

    2018-04-16

    Executive functions are a diverse and critical suite of cognitive abilities that are often disrupted in individuals with psychiatric disorders. Despite their moderate to high heritability, little is known about the molecular genetic factors that contribute to variability in executive functions and how these factors may be related to those that predispose to psychiatric disorders. We examined the relationship between polygenic risk scores built from large genome-wide association studies of psychiatric disorders and executive functioning in typically developing children. In our discovery sample (N = 417), consistent with previous reports on general cognitive abilities, polygenic risk for autism spectrum disorder was associated with better performance on the Dimensional Change Card Sort test from the NIH Cognition Toolbox, with the largest effect in the youngest children. Polygenic risk for major depressive disorder was associated with poorer performance on the Flanker test in the same sample. This second association replicated for performance on the Penn Conditional Exclusion Test in an independent cohort (N = 3681). Our results suggest that the molecular genetic factors contributing to variability in executive function during typical development are at least partially overlapping with those associated with psychiatric disorders, although larger studies and further replication are needed. © 2018 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

  20. Type 4 cardiorenal syndrome.

    PubMed

    Pinheiro da Silva, Ana Luísa; Vaz da Silva, Manuel Joaquim

    2016-11-01

    The Acute Dialysis Quality Initiative consensus conference proposed a classification of cardiorenal syndrome (CRS), aiming for a better delineation of each subtype. Although the exact pathophysiology of type 4 CRS is not completely understood, the mechanisms involved are probably multifactorial. There is growing evidence that oxidative stress is a major connector in the development and progression of type 4 CRS. Giving its complexity, poor prognosis and increasing incidence, type 4 CRS is becoming a significant public health problem. Patients with chronic kidney disease are particularly predisposed to cardiac dysfunction, due to the high prevalence of traditional cardiovascular risk factors in this population, but the contribution of risk factors specific to chronic kidney disease should also be taken into account. Much remains to be elucidated about type 4 CRS: despite progress over the last decade, there are still significant questions regarding its pathophysiology and there is as yet no specific therapy. A better understanding of the mechanisms involved may provide potential targets for intervention. The present review will provide a brief description of the definition, epidemiology, diagnosis, prognosis, biomarkers and management strategies of type 4 CRS, and the pathophysiological mechanisms and risk factors presumably involved in its development will be particularly highlighted. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Managing animal disease risk in Australia: the impact of climate change.

    PubMed

    Black, P F; Murray, J G; Nunn, M J

    2008-08-01

    Climate change is one of a number of factors that are likely to affect the future of Australian agriculture, animal production and animal health, particularly when associated with other factors such as environmental degradation, intensive animal production, an increasing human population, and expanding urbanisation. Notwithstanding the harshness and variability of Australia's climate, significant livestock industries have been developed, with the majority of products from such industries exported throughout the world. A critical factor in achieving market access has been an enviable animal health status, which is underpinned by first class animal health services with a strong legislative basis, well-trained staff, engagement of industry, effective surveillance, good scientific and laboratory support, effective emergency management procedures, a sound quarantine system, and strong political support. However, enhancements still need to be made to Australia's animal health system, for example: re-defining the science-policy interface; refining foresight, risk analysis, surveillance, diagnostics, and emergency management; improving approaches to education, training, technology transfer, communications and awareness; and engaging more with the international community in areas such as capacity building, the development of veterinary services, and disease response systems. A 'one health' approach will be adopted to bring together skills in the fields of animal, public, wildlife and environmental health. These initiatives, if managed correctly, will minimise the risks resulting from global warming and other factors predisposing to disease.

  2. Temporal changes and risk factors for foot-pad dermatitis in Danish broilers.

    PubMed

    Kyvsgaard, Niels Chr; Jensen, Henrik Bang; Ambrosen, Thorkil; Toft, Nils

    2013-01-01

    Foot-pad dermatitis is a major welfare concern of broilers caused by ammonia irritation from the bedding material. In Denmark, an action plan to control the condition was implemented in 2002 with monitoring through a foot scoring system at slaughter and with predefined limits that trigger sanctions. The objective of the present study was to study time trends and to identify predisposing factors on the flock lesion scores. The analysis was carried out on a database created by merging abattoir lesion data with antemortem evaluation data, and the flock productivity database managed by the farmers' association. The database had a record for each flock and variables containing information on both flock foot-pad scores and a range of management factors. We observed a dramatic decline in flock lesion scores between the years 2002 and 2005 followed by a minimal decline hereafter. Mean flock lesion scores differed between abattoirs, and subsequent analysis was performed in a mixed effect model where abattoir was considered a random effect. The analysis showed that flock lesion scores increased when the litter quality was evaluated as poor during the on-site antemortem evaluation. Other significant risk factors were winter season as opposed to summer, low daily weight gain, straw as bedding material in contrast to wood shavings and sphagnum peat, and high age at slaughter. Stocking density was only weakly associated with flock lesion scores.

  3. A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

    PubMed

    Martínez-Torres, Javier; Correa-Bautista, Jorge Enrique; González-Ruíz, Katherine; Vivas, Andrés; Triana-Reina, Héctor Reynaldo; Prieto-Benavidez, Daniel Humberto; Carrillo, Hugo Alejandro; Ramos-Sepúlveda, Jeison Alexander; Villa-González, Emilio; García-Hermoso, Antonio; Ramírez-Vélez, Robinson

    2017-02-27

    Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

  4. A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study

    PubMed Central

    Martínez-Torres, Javier; Correa-Bautista, Jorge Enrique; González-Ruíz, Katherine; Vivas, Andrés; Triana-Reina, Héctor Reynaldo; Prieto-Benavidez, Daniel Humberto; Carrillo, Hugo Alejandro; Ramos-Sepúlveda, Jeison Alexander; Villa-González, Emilio; García-Hermoso, Antonio; Ramírez-Vélez, Robinson

    2017-01-01

    Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors. PMID:28264459

  5. Correspondence between Physiological and Self-Report Measures of Emotion Dysregulation: A Longitudinal Investigation of Youth with and without Psychopathology

    ERIC Educational Resources Information Center

    Vasilev, Christina A.; Crowell, Sheila E.; Beauchaine, Theodore P.; Mead, Hilary K.; Gatzke-Kopp, Lisa M.

    2009-01-01

    Background: Several theoretical perspectives suggest that emotion dysregulation is a predisposing risk factor for many psychiatric disorders. Yet despite a rapidly evolving literature, difficulties with emotion regulation (ER) are often measured inconsistently across studies, with little regard to whether different approaches capture the same…

  6. Vitamin D status is note related to development of atrial fibrillation in the community

    USDA-ARS?s Scientific Manuscript database

    Atrial fibrillation (AF) is common and is an important cause of cardiovascular morbidity and mortality. Vitamin D is an emerging risk factor in cardiovascular disease, and vitamin D status is modifiable. Thus, we sought to investigate whether vitamin D status predisposed to the development of AF in ...

  7. Nitrogen excess in North American ecosystems: predisposing factors, ecosystem responses, and management strategies

    Treesearch

    Mark E. Fenn; Mark A. Poth; John D. Aber; Jill S. Baron; Bernard T. Bormann; Dale W. Johnson; A. Dennis Lemly; Steven G. McNulty; Douglas F. Ryan; Robert Stottlemyer

    1998-01-01

    Most forests in North America remain nitrogen limited, although recent studies have identified forested areas that exhibit symptoms of N excess, analogous to overfertilization of arable land. Nitrogen excess in watersheds is detrimental because of disruptions in plantlsoil nutrient relations, increased soil acidification and aluminum mobility, increased emissions of...

  8. Nitrogen Excess in North American Ecosystems: Predisposing Factors, Ecosystem Responses, and Management Strategies

    Treesearch

    Mark E. Fenn; Mark A. Poth; John D. Aber; Jill S. Baron; Bernard T. Bormann; Dale W. Johnson; A. Dennis Lemly; Steven G. McNulty; Douglas F. Ryan; Robert Stottlemyer

    1998-01-01

    Most forests in North America remain nitrogen limited, although recent studies have identified forested areas that exhibit symptoms of N excess, analogous to overfertilization of arable land. Nitrogen excess in watersheds is detrimental because of disruptions in plant/soil nutrient relations, increased soil acidification and aluminum mobility, increased emissions of...

  9. Correlates of Examination Malpractice among Secondary School Students in Oyo State, Nigeria

    ERIC Educational Resources Information Center

    Animasahun, R. A.; Ogunniran, J. O.

    2014-01-01

    The purpose of this study is to investigate the correlates of examination malpractice among secondary school students in Oyo State, Nigeria. The instrument used for the study was tagged Predisposing Factors towards Examination Malpractice Questionnaire (PFTEMQ). The instrument was administered to 300 students randomly selected from 20 multi staged…

  10. Identification of Proteins Required for Repair of Double-Strand Chromosome Breaks, a Predisposing Factor in Breast Cancer

    DTIC Science & Technology

    2001-06-01

    enzymatic apparatus needed to initiate DNA replication on recombination intermediates. Escherichia coli PriA protein was found to play a critical function in...the transition from recombination to DNA replication . PriA specifically binds to forked DNA structures created by recombination or replication fork

  11. The Association of Birth Complications and Externalizing Behavior in Early Adolescents: Direct and Mediating Effects

    ERIC Educational Resources Information Center

    Liu, Jianghong; Raine, Adrian; Wuerker, Anne; Venables, Peter H.; Mednick, Sarnoff

    2009-01-01

    Prior studies have shown that birth complications interact with psychosocial risk factors in predisposing to increased externalizing behavior in childhood and criminal behavior in adulthood. However, little is known about the direct relationship between birth complications and externalizing behavior. Furthermore, the mechanism by which the birth…

  12. Climatic and weather factors affecting fire occurrence and behavior

    Treesearch

    Randall P. Benson; John O. Roads; David R. Weise

    2009-01-01

    Weather and climate have a profound influence on wildland fire ignition potential, fire behavior, and fire severity. Local weather and climate are affected by large-scale patterns of winds over the hemispheres that predispose wildland fuels to fire. The characteristics of wildland fuels, especially the moisture content, ultimately determine fire behavior and the impact...

  13. Sleep Correlates of Pervasive Developmental Disorders: A Review of the Literature

    ERIC Educational Resources Information Center

    Hollway, Jill A.; Aman, Michael G.

    2011-01-01

    Sleep disturbance is a significant problem in the general pediatric population, and it occurs even more frequently in children with pervasive developmental disorders (PDDs). Much time and energy have been spent examining the characteristics that predispose children to insomnia and it is likely that equivalent factors influence sleep in PDDs.…

  14. Bacterial reproductive pathogens of cats and dogs.

    PubMed

    Graham, Elizabeth M; Taylor, David J

    2012-05-01

    With the notable exception of Brucella canis, exogenous bacterial pathogens are uncommon causes of reproductive disease in cats and dogs. Most bacterial reproductive infections are endogenous, and predisposing factors for infection are important. This article reviews the etiology, pathogenesis, clinical presentation, diagnosis, treatment, and public health significance of bacterial reproductive pathogens in cats and dogs.

  15. Antisocial Behavior in Youth: Causes, Consequences and Interventions.

    ERIC Educational Resources Information Center

    Moseley, Stephanie

    This paper examines the roots of youth violence in U.S. society and the specific risk factors that predispose children to use violence. Using surveys of the literature, interviews with researchers, and an observation of an intervention, the report describes a highly successful school-based program of identification and intervention for high-risk…

  16. Predisposing, Reinforcing and Enabling Predictors of Middle School Children's After-School Physical Activity Participation

    ERIC Educational Resources Information Center

    King, Kristi M.; Ogletree, Roberta J.; Fetro, Joyce V.; Brown, Stephen L.; Partridge, Julie A.

    2011-01-01

    Children's participation in after-school physical activity can attenuate the overweight and obesity rates among rural, low socioeconomic status (SES) children. Children's individual determination, as well as social and environmental factors, can influence their behaviors. Purpose: The purposes of this study were to determine if a difference…

  17. Predisposing Risk Factors for Non-Contact ACL Injuries in Military Subjects

    DTIC Science & Technology

    2011-01-01

    with activity: epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med 35:1635–1642 21. Nicholas JA (1970...Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch steno - sis. Am J Sports Med 16:449–454 27. Uhorchak JM, Scoville CR

  18. On insomnia analysis using methods of artificial intelligence

    NASA Astrophysics Data System (ADS)

    Wasiewicz, P.; Skalski, M.

    2011-10-01

    Insomnia generally is defined as a subjective report of difficulty falling sleep, difficulty staying asleep, early awakening, or nonrestorative sleep. It is one of the most common health complaints among the general population. in this paper we try to find relationships between different insomnia cases and predisposing, precipitating, and perpetuating factors following by pharmacological treatment.

  19. Updated assessment of the critical environmental factors involved in the prevention of allergic disease

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Green, A.R.

    1979-06-01

    The effects of climate, as well as outdoor and indoor pollution, on allergic respiratory symptoms are herein explored. Also, measures utilized in modifying the susceptible individual's milieu are examined. Finally, the potential for ameliorating or preventing the development of allergies in genetically predisposed children is discussed.

  20. Depresion: Lo Que Toda Mujer Debe Saber (Depression: What Every Woman Should Know).

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHHS), Bethesda, MD.

    This publication, written in Spanish, explains why women are at greater risk for depression than men. Types of depressive illnesses are explained along with the symptoms. It states that some women are predisposed genetically to depression but biochemical, environmental, psychological, and social factors also often contribute to its occurrence.…

  1. Epidemiological aspects of ageing.

    PubMed Central

    Khaw, K T

    1997-01-01

    A major societal challenge is to improve quality of life and prevent or reduce disability and dependency in an ageing population. Increasing age is associated with increasing risk of disability and loss of independence, due to functional impairments such as loss of mobility, hearing and vision; a major issue must be how far disability can be prevented. Ageing is associated with loss of bone tissue, reduction in muscle mass, reduced respiratory function, decline in cognitive function, rise in blood pressure and macular degeneration which predispose to disabling conditions such as osteoporosis, heart disease, dementia and blindness. However, there are considerable variations in different communities in terms of the rate of age-related decline. Large geographic and secular variations in the age-adjusted incidence of major chronic diseases such as stroke, hip fracture, coronary heart disease, cancer, visual loss from cataract, glaucoma and macular degeneration suggest strong environmental determinants in diet, physical activity and smoking habit. The evidence suggests that a substantial proportion of chronic disabling conditions associated with ageing are preventable, or at least postponable and not an inevitable accompaniment of growing old. Postponement or prevention of these conditions may not only increase longevity, but, more importantly, reduce the period of illnesses such that the majority of older persons may live high-quality lives, free of disability, until very shortly before death. We need to understand better the factors influencing the onset of age-related disability in the population, so that we have appropriate strategies to maintain optimal health in an ageing population. PMID:9460067

  2. Epidemiological aspects of ageing.

    PubMed

    Khaw, K T

    1997-12-29

    A major societal challenge is to improve quality of life and prevent or reduce disability and dependency in an ageing population. Increasing age is associated with increasing risk of disability and loss of independence, due to functional impairments such as loss of mobility, hearing and vision; a major issue must be how far disability can be prevented. Ageing is associated with loss of bone tissue, reduction in muscle mass, reduced respiratory function, decline in cognitive function, rise in blood pressure and macular degeneration which predispose to disabling conditions such as osteoporosis, heart disease, dementia and blindness. However, there are considerable variations in different communities in terms of the rate of age-related decline. Large geographic and secular variations in the age-adjusted incidence of major chronic diseases such as stroke, hip fracture, coronary heart disease, cancer, visual loss from cataract, glaucoma and macular degeneration suggest strong environmental determinants in diet, physical activity and smoking habit. The evidence suggests that a substantial proportion of chronic disabling conditions associated with ageing are preventable, or at least postponable and not an inevitable accompaniment of growing old. Postponement or prevention of these conditions may not only increase longevity, but, more importantly, reduce the period of illnesses such that the majority of older persons may live high-quality lives, free of disability, until very shortly before death. We need to understand better the factors influencing the onset of age-related disability in the population, so that we have appropriate strategies to maintain optimal health in an ageing population.

  3. Childhood CT scans and cancer risk: impact of predisposing factors for cancer on the risk estimates.

    PubMed

    Journy, N; Roué, T; Cardis, E; Le Pointe, H Ducou; Brisse, H; Chateil, J-F; Laurier, D; Bernier, M-O

    2016-03-01

    To investigate the role of cancer predisposing factors (PFs) on the associations between paediatric computed tomography (CT) scan exposures and subsequent risk of central nervous system (CNS) tumours and leukaemia. A cohort of children who underwent a CT scan in 2000-2010 in 23 French radiology departments was linked with the national childhood cancers registry and national vital status registry; information on PFs was retrieved through hospital discharge databases. In children without PF, hazard ratios of 1.07 (95% CI 0.99-1.10) for CNS tumours (15 cases) and 1.16 (95% CI 0.77-1.27) for leukaemia (12 cases) were estimated for each 10 mGy increment in CT x-rays organ doses. These estimates were similar to those obtained in the whole cohort. In children with PFs, no positive dose-risk association was observed, possibly related to earlier non-cancer mortality in this group. Our results suggest a modifying effect of PFs on CT-related cancer risks, but need to be confirmed by longer follow-up and other studies.

  4. Alcohol and the Intestine

    PubMed Central

    Patel, Sheena; Behara, Rama; Swanson, Garth R.; Forsyth, Christopher B.; Voigt, Robin M.; Keshavarzian, Ali

    2015-01-01

    Alcohol abuse is a significant contributor to the global burden of disease and can lead to tissue damage and organ dysfunction in a subset of alcoholics. However, a subset of alcoholics without any of these predisposing factors can develop alcohol-mediated organ injury. The gastrointestinal tract (GI) could be an important source of inflammation in alcohol-mediated organ damage. The purpose of review was to evaluate mechanisms of alcohol-induced endotoxemia (including dysbiosis and gut leakiness), and highlight the predisposing factors for alcohol-induced dysbiosis and gut leakiness to endotoxins. Barriers, including immunologic, physical, and biochemical can regulate the passage of toxins into the portal and systemic circulation. In addition, a host of environmental interactions including those influenced by circadian rhythms can impact alcohol-induced organ pathology. There appears to be a role for therapeutic measures to mitigate alcohol-induced organ damage by normalizing intestinal dysbiosis and/or improving intestinal barrier integrity. Ultimately, the inflammatory process that drives progression into organ damage from alcohol appears to be multifactorial. Understanding the role of the intestine in the pathogenesis of alcoholic liver disease can pose further avenues for pathogenic and treatment approaches. PMID:26501334

  5. Clinical study of 200 patients with recurrent aphthous stomatitis.

    PubMed

    Rodríguez-Archilla, Alberto; Raissouni, Tarik

    2018-01-01

    Recurrent aphthous stomatitis (RAS) affects approximately 20% of the general population. Its etiology is still unknown. To analyze this entity's clinical features. Data such as age, gender, family history of RAS, age at first episode onset, prodromal symptoms, number, size, morphology and localization of lesions, RAS clinical form, annual rate of recurrence, predisposing factors, symptoms and time for symptoms and lesions disappearance were assessed in 200 patients with RAS. Patients had RAS minor forms. Main clinical characteristics were family history of RAS (89%), first episode at ≥ 10 years of age (69%), prodromal symptoms (66%), one lesion per episode (63%), < 0.5 cm lesions (64%), rounded morphology (55%), localization at the tongue (27%), 3 recurrent episodes per year (36%), stress as predisposing factor (34%), symptom disappearance in 2 days (54%) and healing of lesions in 8 days (40%). Even when RAS is a common disorder of the oral mucosa, there is no curative treatment available. Therapeutic measures seek to reduce the pain and size of lesions, accelerate the time of recovery and decrease the rate of relapses. Copyright: © 2018 SecretarÍa de Salud.

  6. Risky cannabis use is associated with alexithymia, frontal lobe dysfunction, and impulsivity in young adult cannabis users.

    PubMed

    Lyvers, Michael; Jamieson, Reuben; Thorberg, Fred Arne

    2013-01-01

    Risky or problematic alcohol use by young adults has been found to be associated with factors such as alexithymia, frontal lobe dysfunction, reward sensitivity, and impulsivity. One interpretation is that these factors reflect inherent traits that predispose to risky substance use in general, a notion examined in the present study. Alexithymia, everyday frontal lobe functioning, sensitivity to reward and punishment, and impulsivity were examined in 138 young adult cannabis users who were divided into Low Risk (n = 99) and Risky (n = 39) users according to their Cannabis Use Disorder Identification Test (CUDIT) scores. Risky cannabis use was significantly positively associated with alexithymia, multiple signs of frontal lobe dysfunction in everyday life, and impulsivity. A broader pattern of dysfunction was indicated for risky cannabis use than for risky alcohol use in this sample. Findings are interpreted as likely reflecting not only inherent traits that predispose to risky substance use in general, but also perhaps residual effects of recent heavy cannabis use in the Risky user group. Longitudinal research is needed to disentangle these competing possibilities.

  7. Seborrheic dermatitis: predisposing factors and ITS2 secondary structure for Malassezia phylogenic analysis.

    PubMed

    Amado, Yulien; Patiño-Uzcátegui, Anelvi; Cepero de García, Maria C; Tabima, Javier; Motta, Adriana; Cárdenas, Martha; Bernal, Adriana; Restrepo, Silvia; Celis, Adriana

    2013-11-01

    Seborrheic dermatitis (SD) is a chronic, widespread skin condition, which is considered a multifactorial disease influenced, in part, by Malassezia spp. opportunistic activities, as well as various endogenous and exogenous factors. Malassezia species are lipophilic, lipid-dependent yeasts that are members of the normal mycobiota of the human skin. Their isolation from SD lesions varies around the world and the study of the relationship among factors such as gender, age, immunosuppressive condition of the patient and SD development, can lead to a better understanding of this disease. To elucidate the association of age and gender with the development of SD and to precisely determine the Malassezia species involved in the disease, samples were obtained from 134 individuals, including individuals without lesions, human immunodeficiency virus positive patients, individuals with seborrheic dermatitis, and HIV patients with seborrheic dermatitis. Malassezia spp. were identified by phenotypic and genotypic methods and a phylogenetic analysis was performed using Bayesian inference. This study revealed that age and gender are not predisposing factors for SD development, and that the most frequent species of Malassezia related to SD development among the Colombian population is M. restricta. We also report the isolation of M. yamatoensis for the first time in Colombia, and propose an ITS2 secondary structure from Malassezia taxa that can be used for precise identification and to establish more robust phylogenetic relationships.

  8. Health behavior and perceptions among African American women with metabolic syndrome.

    PubMed

    Malayala, Srikrishna Varun; Raza, Ambreen

    2016-01-01

    Metabolic syndrome is a cluster of different risk factors (abdominal obesity, insulin resistance, high blood pressure, and high cholesterol) that predispose to the development of cardiovascular diseases. African American women (AAW) are easily predisposed to metabolic syndrome due to higher levels of insulin resistance. Various sociodemographic factors further contribute to higher prevalence. This study evaluates the current prevalence of metabolic syndrome in AAW and identifies the related sociodemographic risk factors. The study utilized 2007-11 National Health and Nutrition Examination Survey (NHANES) data sets from the Centers for Disease Control (CDC). The sample was divided into two groups: AAW with and without metabolic syndrome. Sociodemographic, physical examination, laboratory parameters, and health perceptions were compared between the two groups. Out of the available sample of 30,442 individuals, 1918 (6.4%) met the inclusion criteria (AAW, age>20, non-pregnant women). The prevalence of metabolic syndrome was 47%. Older age, lower education level, low socioeconomic status, unmarried status, low physical activity level, and smoking were associated with higher prevalence of metabolic syndrome (p<0.001). The prevalence of borderline hypertension, hypertension, diabetes, stroke, and cardiovascular diseases was significantly higher in AAW with metabolic syndrome (p<0.001). In spite of the focus on prevention of cardiovascular risk factors and elimination of ethnic and gender disparities, metabolic syndrome is still widely prevalent in AAW and poses a threat to the goals of Healthy People 2020.

  9. Is There a Genetic Predisposition to Anterior Cruciate Ligament Tear? A Systematic Review.

    PubMed

    John, Rakesh; Dhillon, Mandeep Singh; Sharma, Siddhartha; Prabhakar, Sharad; Bhandari, Mohit

    2016-12-01

    Injuries to the anterior cruciate ligament (ACL) are among the most common knee ligament injuries and frequently warrant reconstruction. The etiopathogenesis of these injuries has focused mainly on mechanism of trauma, patient sex, and anatomic factors as predisposing causes. Several genetic factors that could predispose to an ACL tear have recently been reported. This systematic review summarizes the current evidence for a genetic predisposition to ACL tears. The principal research question was to identify genetic factors, based on the available literature, that could predispose an individual to an ACL tear. Systematic review. The PubMed, EMBASE, Cochrane, and HuGE databases were searched; the search was run from the period of inception until June 21, 2015. A secondary search was performed by screening the references of full-text articles obtained and by manually searching selected journals. Articles were screened with prespecified inclusion criteria. The quality of studies included in the review was assessed for risk of bias by 2 reviewers using the Newcastle-Ottawa Scale. A total of 994 records were identified by the search, out of which 17 studies (16 case-control studies and 1 cross-sectional study) were included in the final review. Two studies observed a familial predisposition to an ACL tear. Fourteen studies looked at specific gene polymorphisms in 20 genes, from which different polymorphisms in 10 genes were positively associated with an ACL tear. In addition to these polymorphisms, 8 haplotypes were associated with ACL tear. One study looked at gene expression analysis. Although specific gene polymorphisms and haplotypes have been identified, it is difficult to come to a conclusion on the basis of the existing literature. Several sources of bias have been identified in these studies, and the results cannot be extrapolated to the general population. More studies are needed in larger populations of different ethnicities. Gene-gene interactions and gene expression studies in the future may delineate the exact role of these gene polymorphisms in ACL tears. © 2016 The Author(s).

  10. An Exertional Heat Stroke Survivor's Return to Running: An Integrated Approach on the Treatment, Recovery, and Return to Activity.

    PubMed

    Adams, William M; Hosokawa, Yuri; Huggins, Robert A; Mazerolle, Stephanie M; Casa, Douglas J

    2016-08-01

    Evidence-based best practices for the recognition and treatment of exertional heat stroke (EHS) indicate that rectal thermometry and immediate, aggressive cooling via cold-water immersion ensure survival from this medical condition. However, little is known about the recovery, medical follow-up, and return to activity after an athlete has suffered EHS. To highlight the transfer of evidenced-based research into clinical practice by chronicling the treatment, recovery, and return to activity of a runner who suffered an EHS during a warm-weather road race. Case study. Warm-weather road race. 53-y-old recreationally active man. A runner's treatment, recovery, and return to activity from EHS and 2014 Falmouth Road Race performance. Runner's perceptions and experiences with EHS, body temperature, heart rate, hydration status, exercise intensity. The runner successfully completed the 2014 Falmouth Road Race without incident of EHS. Four dominant themes emerged from the data: predisposing factors, ideal treatment, lack of medical follow-up, and patient education. The first theme identified 3 predisposing factors that contributed to the runner's EHS: hydration, sleep loss, and lack of heat acclimatization. The runner received ideal treatment using evidence-based best practices. A lack of long-term medical care following the EHS with no guidance on the runner's return to full activity was observed. The runner knew very little about EHS before the 2013 race, which drove him to seek knowledge as to why he suffered EHS. Using this newly learned information, he successfully completed the 2014 Falmouth Road Race without incident. This case supports prior literature examining the factors that predispose individuals to EHS. Although evidence-based best practices regarding prompt recognition and treatment of EHS ensure survival, this case highlights the lack of medical follow-up and physician-guided return to activity after EHS.

  11. Lung Infarction Following Pulmonary Embolism: A Comparative Study on Clinical Conditions and CT Findings to Identify Predisposing Factors.

    PubMed

    Kirchner, J; Obermann, A; Stückradt, S; Tüshaus, C; Goltz, J; Liermann, D; Kickuth, R

    2015-06-01

    The aim of this study was to identify factors predisposing to lung infarction in patients with pulmonary embolism (PE). We performed a retrospective analysis on 154 patients with the final diagnosis of PE being examined between January 2009 and December 2012 by means of a Toshiba Aquilion 64 CT scanner. The severity of clinical symptoms was defined by means of a clinical index with 4 classes. The pulmonary clot load was quantified using a modified severity index of PE as proposed by Miller. We correlated several potential predictors of pulmonary infarction such as demographic data, pulmonary clot burden, distance of total vascular obstruction and pleura, the presence of cardiac congestion, signs of chronic bronchitis or emphysema with the occurrence of pulmonary infarction. Computed tomography revealed 78 areas of pulmonary infarction in 45/154 (29.2 %) patients. The presence of infarction was significantly higher in the right lung than in the left lung (p < 0.001). We found no correlation between pulmonary infarction and the presence of accompanying malignant diseases (r = -0.069), signs of chronic bronchitis (r = -0.109), cardiac congestion (r = -0.076), the quantified clot burden score (r = 0.176), and the severity of symptoms (r = -0.024). Only a very weak negative correlation between the presence of infarction and age (r = -0.199) was seen. However, we could demonstrate a moderate negative correlation between the distance of total vascular occlusion and the occurrence of infarction (r = -0.504). Neither cardiac congestion nor the degree of pulmonary vascular obstruction are main factors predisposing to pulmonary infarction in patients with PE. It seems that a peripheral total vascular obstruction more often results in infarction than even massive central clot burden. © Georg Thieme Verlag KG Stuttgart · New York.

  12. JAK2 haplotype is a major risk factor for the development of myeloproliferative neoplasms

    PubMed Central

    Jones, Amy V; Chase, Andrew; Silver, Richard T; Oscier, David; Zoi, Katerina; Wang, Y Lynn; Cario, Holger; Pahl, Heike L; Collins, Andrew; Reiter, Andreas; Grand, Francis; Cross, Nicholas C P

    2014-01-01

    Chronic myeloproliferative neoplasms (MPNs) are a group of related conditions characterized by the overproduction of cells from one or more myeloid lineages. More than 95% of cases of polycythemia vera, and roughly half of essential thrombocythemia and primary myelofibrosis acquire a unique somatic 1849G>T JAK2 mutation (encoding V617F) that is believed to be a critical driver of excess proliferation1–4. We report here that JAK2V617F-associated disease is strongly associated with a specific constitutional JAK2 haplotype, designated 46/1, in all three disease entities compared to healthy controls (polycythemia vera, n = 192, P = 2.9 × 10−16; essential thrombocythemia, n = 78, P = 8.2 × 10−9 and myelofibrosis, n = 41, P = 8.0 × 10−5). Furthermore, JAK2V617F specifically arises on the 46/1 allele in most cases. The 46/1 JAK2 haplotype thus predisposes to the development of JAK2V617F-associated MPNs (OR = 3.7; 95% CI = 3.1–4.3) and provides a model whereby a constitutional genetic factor is associated with an increased risk of acquiring a specific somatic mutation. PMID:19287382

  13. Reduced expression of fumarate hydratase in clear cell renal cancer mediates HIF-2α accumulation and promotes migration and invasion.

    PubMed

    Sudarshan, Sunil; Shanmugasundaram, Karthigayan; Naylor, Susan L; Lin, Shu; Livi, Carolina B; O'Neill, Christine F; Parekh, Dipen J; Yeh, I-Tien; Sun, Lu-Zhe; Block, Karen

    2011-01-01

    Germline mutations of FH, the gene that encodes for the tricarboxylic acid TCA (TCA) cycle enzyme fumarate hydratase, are associated with an inherited form of cancer referred to as Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC). Individuals with HLRCC are predisposed to the development of highly malignant and lethal renal cell carcinoma (RCC). The mechanisms of tumorigenesis proposed have largely focused on the biochemical consequences of loss of FH enzymatic activity. While loss of the tumor suppressor gene von Hippel Lindau (VHL) is thought to be an initiating event for the majority of RCCs, a role for FH in sporadic renal cancer has not been explored. Here we report that FH mRNA and protein expression are reduced in clear cell renal cancer, the most common histologic variant of kidney cancer. Moreover, we demonstrate that reduced FH leads to the accumulation of hypoxia inducible factor- 2α (HIF-2α), a transcription factor known to promote renal carcinogenesis. Finally, we demonstrate that overexpression of FH in renal cancer cells inhibits cellular migration and invasion. These data provide novel insights into the tumor suppressor functions of FH in sporadic kidney cancer.

  14. Coronary artery disease: new insights into the pathophysiology, prevalence, and early detection of a monster menace.

    PubMed

    Slater, James; Rill, Velisar

    2004-04-01

    Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the United States and other industrialized countries. In the undeveloped world a similar epidemic is brewing. A new pathophysiologic paradigm has emerged, which assigns the mediators of inflammation a much larger role in the disease process. This paradigm has helped explain the unpredictable nature of many adverse consequences of CAD. The long latent phase of the disease, and often sudden initial presentation, make efforts at early detection extremely important. Considerable work has been devoted to identify, as well as influence, predisposing risk factors for developing arteriosclerosis. Novel markers of inflammation, like C-reactive protein, have been identified and compared to traditional risk factors. In addition, new imaging modalities introduce the possibility of screening for subclinical disease. Electron beam and multidetector computed tomography (CT) scanners, as well as other techniques, are emerging as powerful tools to detect early disease presence and allow intervention to take place before major clinical events occur. Advances in our understanding of the pathophysiology of CAD, and our ability to image the stages of silent disease will go hand in hand to revolutionize our approach to prevention and treatment of this deadly malady.

  15. Coronary artery disease: new insights into the pathophysiology, prevalence and early detection of a monster menace.

    PubMed

    Slater, James; Rill, Velisar

    2003-04-01

    Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the United States and industrialized countries. In the undeveloped world a similar epidemic is brewing. A new pathophysiologic paradigm has emerged, which assigns the mediators of inflammation a much larger role in the disease process. This paradigm has helped explain the unpredictable nature of many adverse consequences of CAD. The long latent phase of the disease and often sudden initial presentation make efforts at early detection extremely important. Considerable work has been devoted to identify as well as influence predisposing risk factors for developing arteriosclerosis. Novel markers of inflammation, like C-reactive protein, have been identified and compared to traditional risk factors. In addition, new imaging modalities introduce the possibility of screening for sub-clinical disease. Electron-beam and spiral CT scanners, as well as other techniques, are emerging as powerful tools to detect early disease presence and allow intervention to take place before major clinical events occur. Advances in our understanding of the pathophysiology and our ability to image the stages of silent disease will go hand in hand to revolutionize our approach to prevention and treatment of this deadly disease.

  16. Demographic, maternal, and infant health correlates of post-partum depression in Jordan.

    PubMed

    Safadi, Reema R; Abushaikha, Lubna A; Ahmad, Muayyad M

    2016-09-01

    This cross-sectional correlational study examined post-partum depression and its relationship with demographic, maternal, and infant health problems in urban Jordanian women. Participants (n = 315) were selected from five maternal child healthcare centers and one major hospital in Amman, Jordan. Patient Health Questionnaire-9 was used to measure post-partum depression within 12 weeks of birth. A number of socio-demographic and health problems were examined for an association with post-partum depression. Results showed that 25% of post-partum women suffered moderate to severe depression and 50% of the sample had mild depression. None of the socio-demographic variables (age, education, employment, income) were significantly related to post-partum depression; however, two obstetric/infant variables (mode of birth and breastfeeding), were significantly associated with post-partum depression. There was a significant association between post-partum depression and 15 health problems of obstetric, gynecologic (i.e. episiotomy pain, infection), and general health conditions (i.e. fatigue, headache). Nurses and midwives need to emphasize post-partum depression screening, follow-up, and proper management of maternal and infant health factors predisposing to post-partum depression rather than merely focusing on women's inherent demographic factors. © 2015 Wiley Publishing Asia Pty Ltd.

  17. A Multi-Breed Genome-Wide Association Analysis for Canine Hypothyroidism Identifies a Shared Major Risk Locus on CFA12.

    PubMed

    Bianchi, Matteo; Dahlgren, Stina; Massey, Jonathan; Dietschi, Elisabeth; Kierczak, Marcin; Lund-Ziener, Martine; Sundberg, Katarina; Thoresen, Stein Istre; Kämpe, Olle; Andersson, Göran; Ollier, William E R; Hedhammar, Åke; Leeb, Tosso; Lindblad-Toh, Kerstin; Kennedy, Lorna J; Lingaas, Frode; Rosengren Pielberg, Gerli

    2015-01-01

    Hypothyroidism is a complex clinical condition found in both humans and dogs, thought to be caused by a combination of genetic and environmental factors. In this study we present a multi-breed analysis of predisposing genetic risk factors for hypothyroidism in dogs using three high-risk breeds--the Gordon Setter, Hovawart and the Rhodesian Ridgeback. Using a genome-wide association approach and meta-analysis, we identified a major hypothyroidism risk locus shared by these breeds on chromosome 12 (p = 2.1x10(-11)). Further characterisation of the candidate region revealed a shared ~167 kb risk haplotype (4,915,018-5,081,823 bp), tagged by two SNPs in almost complete linkage disequilibrium. This breed-shared risk haplotype includes three genes (LHFPL5, SRPK1 and SLC26A8) and does not extend to the dog leukocyte antigen (DLA) class II gene cluster located in the vicinity. These three genes have not been identified as candidate genes for hypothyroid disease previously, but have functions that could potentially contribute to the development of the disease. Our results implicate the potential involvement of novel genes and pathways for the development of canine hypothyroidism, raising new possibilities for screening, breeding programmes and treatments in dogs. This study may also contribute to our understanding of the genetic etiology of human hypothyroid disease, which is one of the most common endocrine disorders in humans.

  18. A Multi-Breed Genome-Wide Association Analysis for Canine Hypothyroidism Identifies a Shared Major Risk Locus on CFA12

    PubMed Central

    Massey, Jonathan; Dietschi, Elisabeth; Kierczak, Marcin; Lund-Ziener, Martine; Sundberg, Katarina; Thoresen, Stein Istre; Kämpe, Olle; Andersson, Göran; Ollier, William E. R.; Hedhammar, Åke; Leeb, Tosso; Lindblad-Toh, Kerstin; Kennedy, Lorna J.; Lingaas, Frode; Rosengren Pielberg, Gerli

    2015-01-01

    Hypothyroidism is a complex clinical condition found in both humans and dogs, thought to be caused by a combination of genetic and environmental factors. In this study we present a multi-breed analysis of predisposing genetic risk factors for hypothyroidism in dogs using three high-risk breeds—the Gordon Setter, Hovawart and the Rhodesian Ridgeback. Using a genome-wide association approach and meta-analysis, we identified a major hypothyroidism risk locus shared by these breeds on chromosome 12 (p = 2.1x10-11). Further characterisation of the candidate region revealed a shared ~167 kb risk haplotype (4,915,018–5,081,823 bp), tagged by two SNPs in almost complete linkage disequilibrium. This breed-shared risk haplotype includes three genes (LHFPL5, SRPK1 and SLC26A8) and does not extend to the dog leukocyte antigen (DLA) class II gene cluster located in the vicinity. These three genes have not been identified as candidate genes for hypothyroid disease previously, but have functions that could potentially contribute to the development of the disease. Our results implicate the potential involvement of novel genes and pathways for the development of canine hypothyroidism, raising new possibilities for screening, breeding programmes and treatments in dogs. This study may also contribute to our understanding of the genetic etiology of human hypothyroid disease, which is one of the most common endocrine disorders in humans. PMID:26261983

  19. Mucocutaneous candidiasis in a mandrill (Mandrillus sphinx).

    PubMed

    Zöller, M; Silinski, S; Ludwig, C; Weig, M; Mätz-Rensing, K; Kaup, F-J

    2012-01-01

    An adult male mandrill (Mandrillus sphinx) suffered from chronic ulceration of the facial and gluteal skin and the oral and nasal mucosa. The ulcers were resistant to therapy and led to deterioration in the general condition of the animal. Microscopical examination revealed a severe, chronic, multifocal, granulomatous and eosinophilic dermatitis and panniculitis. There was also stomatitis and rhinitis with numerous intralesional fungal elements. These organisms were identified by immunohistochemistry, transmission electron microscopy, polymerase chain reaction and fungal culture as Candida albicans. Species identification was confirmed by MALDI-TOF mass spectrometry. A specific predisposing immunosuppressive factor for the deep chronic mucocutaneous candidiasis was not identified; however, social stress and/or a primary defect in cell-mediated immunity could not be excluded as possible causes for a predisposing immunodeficiency in the animal. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Clinics in diagnostic imaging (163). Transient lateral patellar dislocation with trochlear dysplasia

    PubMed Central

    Zhang, Junwei; Lee, Chin Hwee

    2015-01-01

    A 14-year-old girl presented with left knee pain and swelling after an injury. Magnetic resonance (MR) imaging showed a transient lateral patellar dislocation with patellar osteochondral fracture, medial patellofemoral ligament tear and underlying femoral trochlear dysplasia. Open reduction and internal fixation of the osteochondral fracture, plication of the medial patellar retinaculum and lateral release were performed. As lateral patellar dislocation is often clinically unsuspected, an understanding of its characteristic imaging features is important in making the diagnosis. Knowledge of the various predisposing factors for patellar instability may also influence the choice of surgical management. We also discuss signs of acute injury and chronic instability observed on MR imaging, and the imaging features of anatomical variants that predispose an individual to lateral patellar dislocation. Treatment options and postsurgical imaging appearances are also briefly described. PMID:26512145

  1. Correlation of worldwide incidence of type 1 diabetes (DiaMond) with prevalence of asthma and atopic eczema (ISAAC).

    PubMed

    Fsadni, Peter; Fsadni, Claudia; Fava, Stephen; Montefort, Stephen

    2012-01-01

    Environmental factors play a role in pathogenesis of both type 1 diabetes and atopic disease but they remain incompletely understood. T cell-mediated responses primarily of the T helper type 1 (Th1) are involved in type 1 diabetes while T helper type 2 (Th2) responses favour allergic disease. This TH 1/TH 2 paradigm is currently the source of much controversy in various studies. The aim of the study was to compare the reported country incidence of type 1 diabetes with the prevalence of atopic disease. The prevalence of wheeze, rhinitis, rhinoconjunctivitis and atopic eczema in the preceding 12 months in the 13- to 14-year-old age group was taken from The International Study of Asthma and Allergies in Childhood phase 1 study. These were compared to the age specific incidence of type 1 diabetes in children per 100 000 per year obtained from the Diabetes Mondiale Project Group study from those countries participating in both studies. Data collected from these 31 countries together with latitude was analysed using a Pearson correlation and significance analysis. A multiple regression analysis determined the confounding effect of latitude. The incidence of type 1 diabetes was found to have a positive correlation with both wheezing (P = 0.009) and atopic eczema (P < 0.01). There was a no correlation between the incidence of type 1 diabetes and the prevalance of rhinitis (r = 0.02, P = 0.88) or of rhinoconjunctivitis (r = 0.026, P = 0.88). Latitude correlated negatively with type 1 diabetes and positively with rhinitis and rhinoconjnctuvits; it was not significantly correlated with wheeze or eczema. Regression analysis showed that latitude is a significant confounding factor in the correlation of rhinitis (P value < 0.0008) and rhinoconjunctivitis (P value < 0.0003) with diabetes. The study suggests that common environmental and/or genetic factors predispose to type 1 diabetes, wheezing and atopic eczema while factors predisposing to rhinitis and rhinoconjunctivitis appear to be distinct from those predisposing to type 1 diabetes. © 2011 Blackwell Publishing Ltd.

  2. Application of the nonlinear Blinder-Oaxaca decomposition to study racial/ethnic disparities in antiobesity medication use in the United States.

    PubMed

    Mehta, Hemalkumar B; Rajan, Suja S; Aparasu, Rajender R; Johnson, Michael L

    2013-01-01

    The nonlinear Blinder-Oaxaca (BO) decomposition method is gaining popularity in health services research because of its ability to explain disparity issues. The present study demonstrates the use of this method for categorical variables by addressing antiobesity medication use disparity. To examine racial/ethnic disparity in antiobesity medication use and to quantify the observed factor contribution behind the disparity using the nonlinear BO decomposition. Medical Expenditure Panel Survey data, 2002-2007, were used in this retrospective cross-sectional study. Adults with body mass index (BMI) >30, or BMI ≥27 and comorbidities such as hypertension, cardiovascular diseases, diabetes, or hyperlipidemia were included in the cohort (N=65,886,625). Multivariable logistic regression was performed to examine racial/ethnic disparity in antiobesity medication use controlling for predisposing, enabling, and need factors. The nonlinear BO decomposition was used to identify the contribution of each predisposing, enabling, and need factors in explaining the racial/ethnic disparity and to estimate the residual unexplained disparity. Non-Hispanic Blacks were 46% (odds ratio [OR]: 0.54; 95% confidence interval [CI]: 0.35-0.83) less likely to use antiobesity drugs compared with non-Hispanic Whites, whereas no difference was observed between Hispanics and non-Hispanic Whites. A 0.22 percentage point of disparity existed between non-Hispanic Whites and Blacks. The nonlinear BO decomposition estimated a decomposition coefficient of -0.0013 indicating that the observed disparity would have been 58% higher (-0.0013/0.0022) if non-Hispanic Blacks had similar observed characteristics as non-Hispanic Whites. Age, gender, marital status, region, and BMI were significant factors in the decomposition model; only marital status explained the racial/ethnic disparity among all observed characteristics. The study revealed that differences in the predisposing, enabling, and need characteristics (except marital status) did not successfully explain the racial/ethnic disparity in antiobesity medication use. Further studies examining racial/ethnic differences in individual beliefs, behavioral patterns, and provider prescription patterns are vital to understand these disparities. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. A clinical characteristic analysis of pregnancy-associated intracranial haemorrhage in China.

    PubMed

    Liang, Zhu-Wei; Lin, Li; Gao, Wan-Li; Feng, Li-Min

    2015-03-30

    Intracerebral haemorrhage (ICH) occurring during pregnancy and the puerperium is an infrequent but severe complication with a high mortality and poor prognosis. Until recently, previous studies have mainly focused on the effect of different treatments on prognosis. However, few studies have provided solid evidence to clarify the key predisposing factors affecting the prognosis of ICH. In the present study, based on a unique sample with a high ICH incidence and mortality rate, we described the main clinical characteristics of ICH patients and found that the prognosis of patients who underwent surgical intervention was not better than that of patients who received other treatment modalities. However, pre-eclampsia patients had higher maternal and neonatal mortality rates than other aetiology groups. Furthermore, univariate regression analysis identified onset to diagnosis time (O-D time) and pre-eclampsia as the only factors showing independent correlation with poor maternal outcomes (modified Rankin Scale, mRS ≥ 3), and only O-D time was identified as a predictor of maternal mortality. These results revealed that the aetiology of ICH and O-D time might be crucial predisposing factors to prognosis, especially for patients with pre-eclampsia. The study highlighted a novel direction to effectively improve the prognosis of pregnancy-associated ICH.

  4. HLA-DRB1 alleles and juvenile idiopathic arthritis: Diagnostic clues emerging from a meta-analysis.

    PubMed

    De Silvestri, Annalisa; Capittini, Cristina; Poddighe, Dimitri; Marseglia, Gian Luigi; Mascaretti, Luca; Bevilacqua, Elena; Scotti, Valeria; Rebuffi, Chiara; Pasi, Annamaria; Martinetti, Miryam; Tinelli, Carmine

    2017-12-01

    Juvenile Idiopathic Arthritis (JIA) is characterized with a variable pattern of articular involvement and systemic symptoms and, thus, it has been classified in several subtypes. Genetic predisposition to JIA is mainly due to HLA class II molecules (HLA-DRB1, HLA-DPB1), although HLA class I molecules and non-HLA genes have been implicated, too. Here, we carried out a meta-analysis including selected studies designed to assess HLA genetic background of JIA patients, compared to healthy controls; particularly, we focused our attention on HLA-DRB1. In summary, our meta-analysis showed four main findings regarding HLA-DRB1 locus as a genetic factor of JIA: i) HLA-DRB1*08 is a strong factor predisposing to JIA, both for oligo-articular and poly-articular forms (oJIA>pJIA); ii) HLA-DRB1*01 and HLA-DRB1*04 may be involved in the genetic predisposition of Rheumatoid Factor (RF) positive forms of JIA; iii) HLA-DRB1*11 was confirmed to be predisposing to oligo-articular JIA; iv) HLA-DRB1*04 was confirmed to have a role in systemic JIA. Importantly, RF positivity seems to select the JIA clinical subset with the strongest immunogenetic similarities with adult rheumatoid arthritis. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. A family report of Crohn's disease in three children immigrating from Albania to Greece and review of the literature.

    PubMed

    Katsanos, Konstantinos H; Karetsos, Vasileios; Tsianos, Epameinondas V

    2010-11-01

    Cases of immigrant families affected by IBD have rarely been reported and seem to be of exceptional interest towards a better understanding of disease aetiopathogenesis. The first case of Crohn's disease in a family of immigrants from Albania to Greece with three offspring is described herein. A family with three children, one 22 year-old male and two 18-year-old twin females immigrated from southern Albania to northwest Greece ten years ago. The whole family lived in the same house and had no previous history of bowel or other chronic diseases. Two years ago the boy complained of diarrhoea, perianal pain and loss of weight. Subsequent investigation revealed ileal and perianal Crohn's disease. One year after Crohn's disease was diagnosed in the boy, one of the twins was diagnosed with ileal Crohn's disease. Six months afterwards, the second twin underwent emergency appendectomy due to acute appendicitis; four months later she was diagnosed with ileal Crohn's disease. Genetically predisposed individuals seem to be vulnerable to a continuous pressure of a still unknown environmental factor(s). In addition, lifestyle modification seems to represent a predisposing factor toward inflammatory bowel disease in immigrants. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  6. Predisposing factors to phlebitis in patients with peripheral intravenous catheters: a descriptive study.

    PubMed

    Uslusoy, Esin; Mete, Samiye

    2008-04-01

    The purpose of this study was to investigate the predisposing factors in the development of phlebitis in peripheral intravenous (IV) catheterization sites in patients treated with a variety of IV infusion solutions and drugs. Systematic observation of 568 IV sites inserted for fluid infusion and drug administration in 355 patients in the Department of General Surgery of a University Hospital in Turkey. A data collection tool was based on standards established by the Infusion Nurses Society. Patients' infusion sites were monitored every 24 h during treatment and for 48 h after discontinuation of the IV. In contrast to the usual findings in the literature, the authors found that infusion through an infusion pump and insertion of catheters in the veins around the elbow increased the risk of phlebitis. Also, the number of times infusions were started led to an increased rate of phlebitis. However, conflicting results were obtained about the relation between phlebitis, gender, and catheter size. Phlebitis causes sepsis, pain, additional diagnostic investigations, and treatments, and may lead to increased duration of hospitalization, patient's stress level, and financial burden, as well as increasing staff workload. Advanced practice nurses need to be aware of the factors that increase the likelihood of phlebitis and take appropriate measures to prevent it.

  7. Hip fractures in a developing country: osteoporosis frequency, predisposing factors and treatment costs.

    PubMed

    Tanriover, Mine Durusu; Oz, S Gul; Tanriover, Altug; Kilicarslan, Alpaslan; Turkmen, Ercan; Guven, Gulay Sain; Saracbasi, Osman; Tokgozoglu, Mazhar; Sozen, Tumay

    2010-01-01

    Hip fractures are a burden to both society and the individual. The aim of this study was to describe the frequency of osteoporosis and the in-hospital treatment costs of patients with hip fractures admitted to Hacettepe University Faculty of Medicine Hospital. Patients with a hip fracture who were admitted to the Orthopedics and Traumatology wards between April 2003 and December 2006 were interviewed and 50 of them were enrolled prospectively in the study protocol. Patient characteristics, predisposing factors for fractures and hospital costs were recorded as well as laboratory test results and bone mineral density measurements. The mean age was 74.2 years and 72% of the patients were women. Sixty-four percent of them presented with an intertrochanteric fracture. The patient population was significantly debilitated with a high prevalence of vitamin D insufficiency and secondary hyperparathyroidism. No association was shown with T scores and dietary habits and lifestyle characteristics of patients. In 34% of patients in whom measurements were available, no osteoporosis could be documented. The mean hospital expenditure was $5983. Factors affecting the total cost were age and functional status of the patient and the duration of hospital stay, independent of the type of fracture and surgical procedure used. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  8. Intraurban Differences in the Use of Ambulatory Health Services in a Large Brazilian City

    PubMed Central

    Lima-Costa, Maria Fernanda; Proietti, Fernando Augusto; Cesar, Cibele C.; Macinko, James

    2010-01-01

    A major goal of health systems is to reduce inequities in access to services, that is, to ensure that health care is provided based on health needs rather than social or economic factors. This study aims to identify the determinants of health services utilization among adults in a large Brazilian city and intraurban disparities in health care use. We combine household survey data with census-derived classification of social vulnerability of each household’s census tract. The dependent variable was utilization of physician services in the prior 12 months, and the independent variables included predisposing factors, health needs, enabling factors, and context. Prevalence ratios and 95% confidence intervals were estimated by the Hurdle regression model, which combined Poisson regression analysis of factors associated with any doctor visits (dichotomous variable) and zero-truncated negative binomial regression for the analysis of factors associated with the number of visits among those who had at least one. Results indicate that the use of health services was greater among women and increased with age, and was determined primarily by health needs and whether the individual had a regular doctor, even among those living in areas of the city with the worst socio-environmental indicators. The experience of Belo Horizonte may have implications for other world cities, particularly in the development and use of a comprehensive index to identify populations at risk and in order to guide expansion of primary health care services as a means of enhancing equity in health. PMID:21104332

  9. Protein biomarkers in vernix with potential to predict the development of atopic eczema in early childhood

    PubMed Central

    Holm, T; Rutishauser, D; Kai-Larsen, Y; Lyutvinskiy, Y; Stenius, F; Zubarev, R A; Agerberth, B; Alm, J; Scheynius, A

    2014-01-01

    Background Atopic eczema (AE) is a chronic inflammatory skin disease, which has increased in prevalence. Evidence points toward lifestyle as a major risk factor. AE is often the first symptom early in life later followed by food allergy, asthma, and allergic rhinitis. Thus, there is a great need to find early, preferentially noninvasive, biomarkers to identify individuals that are predisposed to AE with the goal to prevent disease development. Objective To investigate whether the protein abundances in vernix can predict later development of AE. Methods Vernix collected at birth from 34 newborns within the Assessment of Lifestyle and Allergic Disease During INfancy (ALADDIN) birth cohort was included in the study. At 2 years of age, 18 children had developed AE. Vernix proteins were identified and quantified with liquid chromatography coupled to tandem mass spectrometry. Results We identified and quantified 203 proteins in all vernix samples. An orthogonal projections to latent structures-discriminant analysis (OPLS-DA) model was found with R2 = 0.85, Q2 = 0.39, and discrimination power between the AE and healthy group of 73.5%. Polyubiquitin-C and calmodulin-like protein 5 showed strong negative correlation to the AE group, with a correlation coefficient of 0.73 and 0.68, respectively, and a P-value of 8.2 E-7 and 1.8 E-5, respectively. For these two proteins, the OPLS-DA model showed a prediction accuracy of 91.2%. Conclusion The protein abundances in vernix, and particularly that of polyubiquitin-C and calmodulin-like protein 5, are promising candidates as biomarkers for the identification of newborns predisposed to develop AE. PMID:24205894

  10. Oral Candidal Carriage in Subjects with Pure Vegetarian and Mixed Dietary Habits

    PubMed Central

    Patil, Shankargouda; Rao, Roopa S; Sanketh, D.S.; Sarode, Sachin; Sarode, Gargi

    2017-01-01

    Introduction Candida albicans being a part of the normal oral microbial flora is one of the most commonly isolated species from the oral cavity. Recent studies have shown a steady rise in the number of non C. albicans species, which are relatively resistant to common antifungal agents and are being recognized as potential pathogens. It is vital to ascertain the predisposing factors leading to such a shift in the oral candidal flora. Aim To estimate the prevalence of candidal species among vegetarians and non-vegetarians. Materials and Methods Clinical data including age, gender, and diet preference of 238 participants were noted. Participants with a history of systemic disorders, oral prosthesis, salivary gland disorders and habits such as smoking, alcoholism, and tobacco usage were excluded from the study. The participants were asked to gargle a 10 ml solution of phosphate buffered saline for one minute before depositing the same in a sterile container. The samples were cultured using Hicrome agar media. Data analysis was carried out using Statistical Package for Social Sciences (SPSS software) version 10.5 and differences between individual groups were tested by Chi-square test. Results Among 238 samples, 127 (53.3%) samples were positive for Candida. The candidal prevalence in vegetarians (68.5%) was higher than non-vegetarians (40.7%). C. albicans was the most common species to be isolated in both vegetarians (35.1%) and non-vegetarians (39.2%). Candida glabrata and Candida tropicalis showed a higher prevalence in vegetarians (30.5% and 10.1%, respectively) in comparison to non-vegetarians (8.4% and 2.3%, respectively). Candida krusei was isolated only from vegetarians (4.6%). Conclusion Results indicate that diet plays a major role in oral candidal prevalence and species specificity which in turn may predispose the vegetarians toward these pathogenic organisms. PMID:28893036

  11. Oral Candidal Carriage in Subjects with Pure Vegetarian and Mixed Dietary Habits.

    PubMed

    Patil, Shankargouda; Rao, Roopa S; Raj, A Thirumal; Sanketh, D S; Sarode, Sachin; Sarode, Gargi

    2017-07-01

    Candida albicans being a part of the normal oral microbial flora is one of the most commonly isolated species from the oral cavity. Recent studies have shown a steady rise in the number of non C. albicans species, which are relatively resistant to common antifungal agents and are being recognized as potential pathogens. It is vital to ascertain the predisposing factors leading to such a shift in the oral candidal flora. To estimate the prevalence of candidal species among vegetarians and non-vegetarians. Clinical data including age, gender, and diet preference of 238 participants were noted. Participants with a history of systemic disorders, oral prosthesis, salivary gland disorders and habits such as smoking, alcoholism, and tobacco usage were excluded from the study. The participants were asked to gargle a 10 ml solution of phosphate buffered saline for one minute before depositing the same in a sterile container. The samples were cultured using Hicrome agar media. Data analysis was carried out using Statistical Package for Social Sciences (SPSS software) version 10.5 and differences between individual groups were tested by Chi-square test. Among 238 samples, 127 (53.3%) samples were positive for Candida . The candidal prevalence in vegetarians (68.5%) was higher than non-vegetarians (40.7%). C. albicans was the most common species to be isolated in both vegetarians (35.1%) and non-vegetarians (39.2%). Candida glabrata and Candida tropicalis showed a higher prevalence in vegetarians (30.5% and 10.1%, respectively) in comparison to non-vegetarians (8.4% and 2.3%, respectively). Candida krusei was isolated only from vegetarians (4.6%). Results indicate that diet plays a major role in oral candidal prevalence and species specificity which in turn may predispose the vegetarians toward these pathogenic organisms.

  12. Association of IRF5 polymorphisms with activation of the interferon α pathway

    PubMed Central

    Rullo, Ornella J; Woo, Jennifer M P; Wu, Hui; Hoftman, Alice D C; Maranian, Paul; Brahn, Brittany A; McCurdy, Deborah; Cantor, Rita M; Tsao, Betty P

    2011-01-01

    Objective The genetic association of interferon regulatory factor 5 (IRF5) with systemic lupus erythematosus (SLE) susceptibility has been convincingly established. To gain understanding of the effect of IRF5 variation in individuals without SLE, a study was undertaken to examine whether such genetic variation predisposes to activation of the interferon α (IFNα) pathway. Methods Using a computer simulated approach, 14 single nucleotide polymorphisms (SNPs) and haplotypes of IRF5 were tested for association with mRNA expression levels of IRF5, IFNα and IFN-inducible genes and chemokines in lymphoblastoid cell lines (LCLs) from individuals of European (CEU), Han Chinese (CHB), Japanese (JPT) and Yoruba Nigerian (YRI) backgrounds. IFN-inducible gene expression was assessed in LCLs from children with SLE in the presence and absence of IFNα stimulation. Results The major alleles of IRF5 rs13242262 and rs2280714 were associated with increased IRF5 mRNA expression levels in the CEU, CHB+JPT and YRI samples. The minor allele of IRF5 rs10488631 was associated with increased IRF5, IFNα and IFN-inducible chemokine expression in CEU (pc=0.0005, 0.01 and 0.04, respectively). A haplotype containing these risk alleles of rs13242262, rs10488631 and rs2280714 was associated with increased IRF5, IFNα and IFN-inducible chemokine expression in CEU LCLs. In vitro studies showed specific activation of IFN-inducible genes in LCLs by IFNα. Conclusions SNPs of IRF5 in healthy individuals of a number of ethnic groups were associated with increased mRNA expression of IRF5. In European-derived individuals, an IRF5 haplotype was associated with increased IRF5, IFNα and IFN-inducible chemokine expression. Identifying individuals genetically predisposed to increased IFN-inducible gene and chemokine expression may allow early detection of risk for SLE. PMID:19854706

  13. Meta-analysis identifies a MECOM gene as a novel predisposing factor of osteoporotic fracture

    PubMed Central

    Hwang, Joo-Yeon; Lee, Seung Hun; Go, Min Jin; Kim, Beom-Jun; Kou, Ikuyo; Ikegawa, Shiro; Guo, Yan; Deng, Hong-Wen; Raychaudhuri, Soumya; Kim, Young Jin; Oh, Ji Hee; Kim, Youngdoe; Moon, Sanghoon; Kim, Dong-Joon; Koo, Heejo; Cha, My-Jung; Lee, Min Hye; Yun, Ji Young; Yoo, Hye-Sook; Kang, Young-Ah; Cho, Eun-Hee; Kim, Sang-Wook; Oh, Ki Won; Kang, Moo II; Son, Ho Young; Kim, Shin-Yoon; Kim, Ghi Su; Han, Bok-Ghee; Cho, Yoon Shin; Cho, Myeong-Chan; Lee, Jong-Young; Koh, Jung-Min

    2014-01-01

    Background Osteoporotic fracture (OF) as a clinical endpoint is a major complication of osteoporosis. To screen for OF susceptibility genes, we performed a genome-wide association study and carried out de novo replication analysis of an East Asian population. Methods Association was tested using a logistic regression analysis. A meta-analysis was performed on the combined results using effect size and standard errors estimated for each study. Results In a combined meta-analysis of a discovery cohort (288 cases and 1139 controls), three hospital based sets in replication stage I (462 cases and 1745 controls), and an independent ethnic group in replication stage II (369 cases and 560 for controls), we identified a new locus associated with OF (rs784288 in the MECOM gene) that showed genome-wide significance (p=3.59×10−8; OR 1.39). RNA interference revealed that a MECOM knockdown suppresses osteoclastogenesis. Conclusions Our findings provide new insights into the genetic architecture underlying OF in East Asians. PMID:23349225

  14. Add-on perampanel and aggressive behaviour in severe drug-resistant focal epilepsies.

    PubMed

    Juhl, S; Rubboli, G

    This study aimed to investigate the incidence of aggressiveness in patients with severe drug-refractory focal epilepsy (DRE) who started perampanel (PER) as add-on treatment, and to identify possible predisposing factors. Data on 49 consecutive patients with severe DRE who initiated PER were retrospectively collected. Twelve of the 49 patients experienced aggressiveness as adverse event related to PER treatment, one third of them on low (2-4 mg/day) PER dosages. PER was discontinued in 10/12 patients because of aggressive behaviors. Aggressiveness could appear after several months or even more than one year of PER treatment. One third of patients with PER-related aggressiveness had intellectual disabilities and 5/12 patients took levetiracetam as a concomitant antiepileptic drug. Our study suggests that the occurrence of aggressive behaviors in patients with severe DRE is not uncommon during PER treatment and that it may occur after months or even years of treatment with a stable dosage, requiring PER discontinuation in the great majority of patients.

  15. Responses to Cytokines and Interferons that Depend upon JAKs and STATs.

    PubMed

    Stark, George R; Cheon, HyeonJoo; Wang, Yuxin

    2018-01-02

    Many cytokines and all interferons activate members of a small family of kinases (the Janus kinases [JAKs]) and a slightly larger family of transcription factors (the signal transducers and activators of transcription [STATs]), which are essential components of pathways that induce the expression of specific sets of genes in susceptible cells. JAK-STAT pathways are required for many innate and acquired immune responses, and the activities of these pathways must be finely regulated to avoid major immune dysfunctions. Regulation is achieved through mechanisms that include the activation or induction of potent negative regulatory proteins, posttranslational modification of the STATs, and other modulatory effects that are cell-type specific. Mutations of JAKs and STATs can result in gains or losses of function and can predispose affected individuals to autoimmune disease, susceptibility to a variety of infections, or cancer. Here we review recent developments in the biochemistry, genetics, and biology of JAKs and STATs. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  16. Opportunistic Pathogenic Yeasts

    NASA Astrophysics Data System (ADS)

    Banerjee, Uma

    Advances in medical research, made during the last few decades, have improved the prophylactic, diagnostic and therapeutic capabilities for variety of infections/diseases. However, many of the prophylactic and therapeutic procedures have been seen in many instances to exact a price of host-vulnerability to an expanding group of opportunistic pathogens and yeasts are one of the important members in it. Fortunately amongst the vast majority of yeasts present in nature only few are considered to have the capability to cause infections when certain opportunities predisposes and these are termed as ‘opportunistic pathogenic yeasts.’ However, the term ‘pathogenic’ is quite tricky, as it depends of various factors of the host, the ‘bug’ and the environment to manifest the clinical infection. The borderline is expanding. In the present century with unprecedented increase in number of immune-compromised host in various disciplines of health care settings, where any yeast, which has the capability to grow at 37 ° C (normal body temperature of human), can be pathogenic and cause infection in particular situation

  17. The role of oxidative stress in menopause

    PubMed Central

    Doshi, Sejal B.; Agarwal, Ashok

    2013-01-01

    This review will discuss the concept of reproductive aging, which includes the definition of menopause, its symptoms, and predisposing conditions. It will elaborate upon the contributory factors implicated in the pathogenesis of menopause, focusing most prominently on oxidative stress. Specifically, this paper will explain how oxidative stress, in the form of free radicals and antioxidant deficiencies, has been directly linked to the decline of estrogen during reproductive aging. Additionally, this paper will elaborate upon the treatment options aimed at mitigating the menopausal symptoms and hormonal deficiencies that can lead to various disease processes. Treatment options such as hormonal therapy, antioxidant supplementation, and lifestyle modification have been explored for their effectiveness in treating and preventing the symptoms and sequelae of menopause. The majority of information in this review was obtained through PubMed and the National Library of Medicine. While most references in this paper are original research articles, a limited number of references are comprehensive reviews on the topic. PMID:24672185

  18. Initiation, adherence, and retention in a randomized controlled trial of directly administered antiretroviral therapy.

    PubMed

    Maru, Duncan Smith-Rohrberg; Bruce, R Douglas; Walton, Mary; Mezger, Jo Anne; Springer, Sandra A; Shield, David; Altice, Frederick L

    2008-03-01

    Directly administered antiretroviral therapy (DAART) can improve health outcomes among HIV-infected drug users. An understanding of the utilization of DAART-initiation, adherence, and retention-is critical to successful program design. Here, we use the Behavioral Model to assess the enabling, predisposing, and need factors impacting adherence in our randomized, controlled trial of DAART versus self-administered therapy (SAT) among 141 HIV-infected drug users. Of 88 participants randomized to DAART, 74 (84%) initiated treatment, and 51 (69%) of those who initiated were retained in the program throughout the entire six-month period. Mean adherence to directly observed visits was 73%, and the mean overall composite adherence score was 77%. These results were seen despite the finding that 75% of participants indicated that they would prefer to take their own medications. Major causes of DAART discontinuation included hospitalization, incarceration, and entry into drug-treatment programs. The presence of depression and the lack of willingness to travel greater than four blocks to receive DAART predicted time-to-discontinuation.

  19. Initiation, Adherence, and Retention in a Randomized Controlled Trial of Directly Administered Antiretroviral Therapy

    PubMed Central

    Maru, Duncan Smith-Rohrberg; Bruce, R. Douglas; Walton, Mary; Mezger, Jo Anne; Springer, Sandra A.; Shield, David

    2009-01-01

    Directly administered antiretroviral therapy (DAART) can improve health outcomes among HIV-infected drug users. An understanding of the utilization of DAART—initiation, adherence, and retention—is critical to successful program design. Here, we use the Behavioral Model to assess the enabling, predisposing, and need factors impacting adherence in our randomized, controlled trial of DAART versus self-administered therapy (SAT) among 141 HIV-infected drug users. Of 88 participants randomized to DAART, 74 (84%) initiated treatment, and 51 (69%) of those who initiated were retained in the program throughout the entire six-month period. Mean adherence to directly observed visits was 73%, and the mean overall composite adherence score was 77%. These results were seen despite the finding that 75% of participants indicated that they would prefer to take their own medications. Major causes of DAART discontinuation included hospitalization, incarceration, and entry into drug-treatment programs. The presence of depression and the lack of willingness to travel greater than four blocks to receive DAART predicted time-to-discontinuation. PMID:18085432

  20. Osteosarcoma Models: From Cell Lines to Zebrafish

    PubMed Central

    Mohseny, Alexander B.; Hogendoorn, Pancras C. W.; Cleton-Jansen, Anne-Marie

    2012-01-01

    High-grade osteosarcoma is an aggressive tumor most commonly affecting adolescents. The early age of onset might suggest genetic predisposition; however, the vast majority of the tumors are sporadic. Early onset, most often lack of a predisposing condition or lesion, only infrequent (<2%) prevalence of inheritance, extensive genomic instability, and a wide histological heterogeneity are just few factors to mention that make osteosarcoma difficult to study. Therefore, it is sensible to design and use models representative of the human disease. Here we summarize multiple osteosarcoma models established in vitro and in vivo, comment on their utilities, and highlight newest achievements, such as the use of zebrafish embryos. We conclude that to gain a better understanding of osteosarcoma, simplification of this extremely complex tumor is needed. Therefore, we parse the osteosarcoma problem into parts and propose adequate models to study them each separately. A better understanding of osteosarcoma provides opportunities for discovering and assaying novel effective treatment strategies. “Sometimes the model is more interesting than the original disease” PJ Hoedemaeker (1937–2007). PMID:22566751

  1. Proper packaging for food and no-food products to avoid injuries.

    PubMed

    Passali, Desiderio; Gregori, Dario; Foltran, Francesca

    2012-05-14

    This paper aims to present data on proper packaging for food and no-food products to avoid injuries. Data collection was made from the Susy Safe data base and the results of the literature research. Fatal and near fatal foreign bodies injuries may occur at any age, however it is a particular problem for infants and young children due to a variety of predisposing factors. Safety packaging is therefore a landmark and a model for accident prevention. Taken the lack of researches and specificity on this subject, it is warmly suggested that a broader and deeper exploration, both at customer's and public health levels, has to be made, highlighting major risks and complications. Packaging classes are extremely composite, therefore accuracy in data registry must be achieved, since from a preventive point of view it is basilar not only knowing the nature of the foreign body but also having information on its origin. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Effects of a hypocaloric diet on obesity biomarkers: prevention of low-grade inflammation since childhood.

    PubMed

    Amati, L; Marzulli, G; Martulli, M; Chiloiro, M; Jirillo, E

    2010-01-01

    Body mass index (BMI), serum cytokines and serum obesity markers were evaluated in 33 obese children before, during and after a hypocaloric diet. The cytometric bead array "human inflammatory kit" was used for the evaluation of serum interleukin (IL)-1beta, IL-6, IL-10 and tumor necrosis factor-alpha. On the other hand, the following obesity biomarkers were evaluated by means of a flowcytomix-human obesity 9 plex kit: Soluble Isoform of CD40 Ligand; Soluble Intercellular Adhesion Molecule-1; Leptin; Monocyte Chemoattractant Protein 1; Myeloperoxidase; Osteoprotegerin; Resistin and Soluble TNF-receptors. Actually, throughout the study modifications of BMI were negligible and, therefore, serum cytokines and obesity markers did not show any significant changes in comparison with baseline values. On the other hand, at the different time points considered the majority of obesity markers were higher than normal controls, thus indicating a low grade inflammation in childhood obesity. Therefore, attempts at reducing this inflammatory status in children which predisposes to the metabolic syndrome outcome are discussed.

  3. Nutrition in the First 1000 Days: The Origin of Childhood Obesity.

    PubMed

    Mameli, Chiara; Mazzantini, Sara; Zuccotti, Gian Vincenzo

    2016-08-23

    Childhood obesity is a major global issue. Its incidence is constantly increasing, thereby offering a threatening public health perspective. The risk of developing the numerous chronic diseases associated with this condition from very early in life is significant. Although complex and multi-factorial, the pathophysiology of obesity recognizes essential roles of nutritional and metabolic aspects. Particularly, several risk factors identified as possible determinants of later-life obesity act within the first 1000 days of life (i.e., from conception to age 2 years). The purpose of this manuscript is to review those key mechanisms for which a role in predisposing children to obesity is supported by the most recent literature. Throughout the development of the human feeding environment, three different stages have been identified: (1) the prenatal period; (2) breast vs. formula feeding; and (3) complementary diet. A deep understanding of the specific nutritional challenges presented within each phase might foster the development of future preventive strategies.

  4. Polymicrobial bacteremia caused by Escherichia coli, Edwardsiella tarda, and Shewanella putrefaciens.

    PubMed

    Wang, I-Kuan; Lee, Ming-Hsun; Chen, Yu-Ming; Huang, Chiu-Ching

    2004-09-01

    Edwardsiella tarda, a member of Enterobacteriaceae, is found in freshwater and marine environments and in animals living in these environments. This bacterium is primarily associated with gastrointestinal diseases, and has been isolated from stool specimens obtained from persons with or without clinical infectious diseases. Shewanella putrefaciens, a saprophytic gram-negative rod, is rarely responsible for clinical syndromes in humans. Debilitated status and exposure to aquatic environments are the major predisposing factors for E. tarda or S. putrefaciens infection. A 61-year-old woman was febrile with diarrhea 8 hours after ingesting shark meat, and two sets of blood cultures grew Escherichia coli, E. tarda and S. putrefaciens at the same time. She was successfully treated with antibiotics. We present this rare case of polymicrobial bacteremia caused by E. coli, E. tarda and S. putrefaciens without underlying disease, which is the first found in Taiwan. This rare case of febrile diarrhea with consequent polymicrobial bacteremia emphasizes that attention should always be extended to these unusual pathogens.

  5. Rare missense variants in POT1 predispose to familial cutaneous malignant melanoma

    PubMed Central

    Shi, Jianxin; Yang, Xiaohong R.; Ballew, Bari; Rotunno, Melissa; Calista, Donato; Fargnoli, Maria Concetta; Ghiorzo, Paola; Paillerets, Brigitte Bressac-de; Nagore, Eduardo; Avril, Marie Francoise; Caporaso, Neil E.; McMaster, Mary L.; Cullen, Michael; Wang, Zhaoming; Zhang, Xijun; Bruno, William; Pastorino, Lorenza; Queirolo, Paola; Banuls-Roca, Jose; Garcia-Casado, Zaida; Vaysse, Amaury; Mohamdi, Hamida; Riazalhosseini, Yasser; Foglio, Mario; Jouenne, Fanélie; Hua, Xing; Hyland, Paula L.; Yin, Jinhu; Vallabhaneni, Haritha; Chai, Weihang; Minghetti, Paola; Pellegrini, Cristina; Ravichandran, Sarangan; Eggermont, Alexander; Lathrop, Mark; Peris, Ketty; Scarra, Giovanna Bianchi; Landi, Giorgio; Savage, Sharon A.; Sampson, Joshua N.; He, Ji; Yeager, Meredith; Goldin, Lynn R.; Demenais, Florence; Chanock, Stephen J.; Tucker, Margaret A.; Goldstein, Alisa M.; Liu, Yie; Landi, Maria Teresa

    2014-01-01

    Although CDKN2A is the most frequent high-risk melanoma susceptibility gene, the underlying genetic factors for most melanoma-prone families remain unknown. Using whole exome sequencing, we identified a rare variant that arose as a founder mutation in the telomere shelterin POT1 gene (g.7:124493086 C>T, Ser270Asn) in five unrelated melanoma-prone families from Romagna, Italy. Carriers of this variant had increased telomere length and elevated fragile telomeres suggesting that this variant perturbs telomere maintenance. Two additional rare POT1 variants were identified in all cases sequenced in two other Italian families, yielding a frequency of POT1 variants comparable to that of CDKN2A mutations in this population. These variants were not found in public databases or in 2,038 genotyped Italian controls. We also identified two rare recurrent POT1 variants in American and French familial melanoma cases. Our findings suggest that POT1 is a major susceptibility gene for familial melanoma in several populations. PMID:24686846

  6. The Association of Birth Complications and Externalizing Behavior in Early Adolescents: Direct and Mediating Effects

    PubMed Central

    Liu, Jianghong; Raine, Adrian; Wuerker, Anne; Venables, Peter H.; Mednick, Sarnoff

    2012-01-01

    Prior studies have shown that birth complications interact with psychosocial risk factors in predisposing to increased externalizing behavior in childhood and criminal behavior in adulthood. However, little is known about the direct relationship between birth complications and externalizing behavior. Furthermore, the mechanism by which the birth complications predispose to externalizing behavior is not well explored. This study aims to assess whether birth complications predispose to early adolescent externalizing behavior and to test whether Intelligence Quotient (IQ) mediates relationships between predictor and outcome variables. We used data from a prospective, longitudinal birth cohort of 1,795 3-year-old boys and girls from Mauritius to test hypotheses. Birth complications were assessed from hospital record data, malnutrition from a pediatric exam at age 3 years, psychosocial adversity from parental interviews at age 3 years, and externalizing behavior problems from parental ratings at age 11 years. We found that babies with birth complications are more likely to develop externalizing behavior problems at age 11. Low IQ was associated with birth complications and was found to mediate the link between early predictors and later externalizing behavior. These prospective, longitudinal findings have potential clinical implications for the identification of early adolescent externalizing behavior and for public health attempts to prevent the occurrence of child externalizing behavior problems. PMID:22485069

  7. [Factors Influencing Participation in Financial Incentive Programmes of Health Insurance Funds. Results of the Study 'German Health Update'].

    PubMed

    Jordan, S; von der Lippe, E; Starker, A; Hoebel, J; Franke, A

    2015-11-01

    The statutory health insurance can offer their insured incentive programmes that will motivate for healthy behaviour through a financial or material reward. This study will show results about what factors influence financial incentive programme participation (BPT) including all sorts of statutory health insurance funds and taking into account gender differences. For the cross-sectional analysis, data were used from 15,858 participants in the study 'Germany Health Update' (GEDA) from 2009, who were insured in the statutory health insurance. The selection of potential influencing variables for a BPT is based on the "Behavioural Model for Health Service Use" of Andersen. Accordingly, various factors were included in logistic regression models, which were calculated separately by gender: predisposing factors (age, education, social support, and health awareness), enabling factors (income, statutory health insurance fund, and family physician), and need factors (smoking, fruit and vegetable consumption, sports, body mass index, and general health status). In consideration of all factors, for both sexes, BPT is associated with age, health awareness, education, use of a family physician, smoking, and sports activities. In addition, income, body mass index, and diet are significant in women and social support and kind of statutory health insurance fund in men. It is found that predisposing, enabling and need factors are relevant. Financial incentive programmes reach population groups with greatest need less than those groups who already have a health-conscious behaviour, who receive a reward for this. In longitudinal studies, further research on financial incentive programmes should investigate the existence of deadweight effects and whether incentive programmes can contribute to the reduction of the inequity in health. © Georg Thieme Verlag KG Stuttgart · New York.

  8. A screening algorithm for early detection of major depressive disorder in head and neck cancer patients post-treatment: Longitudinal study.

    PubMed

    Henry, Melissa; Rosberger, Zeev; Ianovski, Lola E; Hier, Michael; Zeitouni, Anthony; Kost, Karen; Mlynarek, Alex; Black, Martin; MacDonald, Christina; Richardson, Keith; Zhang, Xun; Fuhrmann, Fabienne; Chartier, Gabrielle; Frenkiel, Saul

    2018-06-01

    The primary purpose of this study was to identify predictors of Major Depressive Disorder in head and neck cancer (HNC) patients in the immediate post-treatment period (ie, at 3 months post-diagnosis), with a focus on previously unexamined historical and contextual factors. Prospective longitudinal study of 223 consecutive adults (72% participation) newly diagnosed with a first occurrence of primary HNC, including validated psychometric measures, Structured Clinical Interviews for DSM Disorders, and medical chart reviews. The 3-month period prevalence of Major Depressive Disorder was 20.4%; with point prevalences of 6.8% upon HNC diagnosis, 14.2% at 3 months, and 22.6% lifetime. Patients most susceptible to developing Major Depressive Disorder in the immediate post-treatment period: were diagnosed with advanced-stage cancer rather than early-stage cancer (O.R. = 4.94, P = 0.04), received surgery only (O.R. = 8.73, P = 0.04), presented a lifetime history of Anxiety Disorder on SCID-I (O.R. = 6.62; P = 0.01), and indicated higher pre-treatment levels of anxiety on the HADS (O.R. = 0.45, P = 0.05). Our results outline the predominant role of anxiety upon diagnosis as a precursor to post-treatment Major Depressive Disorder, suggesting the need for identification and prophylactic treatment of anxiety upon diagnosis in head and neck cancer patients. Further investigation into pathways by which pre-treatment anxiety predisposes to post-treatment Major Depressive Disorder in this population is warranted. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Arterial elastic fiber structure. Function and potential roles in acute aortic dissection.

    PubMed

    Pratt, B; Curci, J

    2010-10-01

    The lethality of acute aortic dissection is well recognized. Successful treatment and prevention of aortic dissection is going to be dependent upon an improved understanding of the molecular and physiologic events which predispose to dissection development and propagation. In this review, we will focus on the elastic fiber, one of the critical elements of the aortic wall matrix. Mechanical or functional failure of the elastin in the wall of the aorta likely predisposes to dissection as well as the post-dissection aortic degeneration with aneurysm formation. Insight into the role of the elastin and the elastic fiber in aortic dissection has recently been accelerated by research into the molecular mechanisms associated with hereditary propensity for aortic dissection, such as Marfan syndrome. These studies have implicated both structural and metabolic contributions of alterations in the scaffolding proteins in matrix elastic fibers. In particular, increased transforming growth factor-β (TGF-β) activity may play a prominent role in predisposing the aortic wall to dissection. The events which predispose to post-dissection aortic degeneration are somewhat less well defined. However, the loss of the structural integrity of the remaining elastic fibers leaves the wall weaker and prone to dilatation and rupture. It appears likely that the upregulation of several potent proteases, particularly those of the matrix metalloproteinase (MMP) family such as MMP-9, are participating in the subsequent matrix damage. Novel medical treatments based on this pathologic data have been proposed and in some cases have made it to clinical trials. The ongoing study evaluating whether therapeutic inhibition of TGF-β may be useful in reducing the risk of aortic dissection in patients at high risk represents one promising new strategy in the treatment of this deadly disease.

  10. Factors associated with mental health services referrals for children investigated by child welfare.

    PubMed

    Fong, Hiu-Fai; Alegria, Margarita; Bair-Merritt, Megan H; Beardslee, William

    2018-05-01

    Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers' decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed data from 1956 children 2-17 years old from the Second National Survey of Child and Adolescent Well-being. We examined associations of children's predisposing, enabling, and need-related factors and caseworkers' work environment characteristics with referral to mental health services. Caseworkers referred 21.0% of children to mental health services. In multivariable analyses controlling for potential covariates, factors associated with increased odds of caseworker referral included: older child age; child sexual abuse (versus neglect); child out-of-home placement; caregiver mental health problems; prior maltreatment reports; clinically significant child behavioral problems; and child welfare agency collaborative ties with mental health providers (all p < .05). Factors associated with decreased odds of caseworker referral included child Black race (versus White race) and lack of insurance (versus Private insurance) (all p < .05). In summary, children's need for mental health services was positively associated with caseworker referral to services but certain predisposing and enabling factors and caseworker work environment characteristics also correlated with services referral. Interventions to reduce disparities in services referral by race and insurance type are critically needed. These may include child welfare agency implementation of policies for mental health screening, assessment, and services referral based on clinical need and establishment of child welfare-mental health agency collaborative ties. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Antecedents and consequences of workplace violence against nurses: A qualitative study.

    PubMed

    Najafi, Fereshteh; Fallahi-Khoshknab, Masoud; Ahmadi, Fazlollah; Dalvandi, Asghar; Rahgozar, Mehdi

    2018-01-01

    To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors. Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence. Qualitative descriptive design. In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data. Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses. Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession. Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence. © 2017 John Wiley & Sons Ltd.

  12. Genes, stress, and depression.

    PubMed

    Wurtman, Richard J

    2005-05-01

    A relationship between genetic makeup and susceptibility to major depressive disorder (MDD) has long been suspected on the basis of family and twin studies. A metaanalysis of reports on the basis of twin studies has estimated MDD's degree of heritability to be 0.33 (confidence interval, 0.26-0.39). Among families exhibiting an increased prevalence of MDD, risk of developing the illness was enhanced in members exposed to a highly stressful environment. Aberrant genes can predispose to depression in a number of ways, for example, by diminishing production of growth factors that act during brain development. An aberrant gene could also increase or decrease a neurotransmitter's release into synapses, its actions, or its duration of activity. The gene products of greatest interest at present are those involved in the synthesis and actions of serotonin; among them, the serotonin-uptake protein localized within the terminals and dendrites of serotonin-releasing neurons. It has been found that the Vmax of platelet serotonin uptake is low in some patients with MDD; also, Vmax is highly correlated in twins. Antidepressant drugs such as the selective serotonin reuptake inhibitors act on this uptake protein. The specific genetic locus causing serotonin uptake to be lower in some patients with major depression involves a polymorphic region (5-HTTLPR) in the promoter region of the gene for the uptake protein. The gene itself exists as several alleles, the short "S" allele and the long "L" allele. The S variant is associated with less, and the L variant with more, of the uptake protein. The effect of stressful life events on depressive symptoms in young adults was found to be significantly stronger among SS or SL subjects than among LL subjects. Neuroimaging studies showed that people with the SS or SL alleles exhibited a greater activation of the amygdala in response to fearful stimuli than those with LL. It has been reported recently that mutations in the gene that controls serotonin synthesis in the human brain (tryptophan hydroxylase) also predispose to mood disturbances. It may be asked whether people who lack a psychiatric history should be advised to avoid stressful environments if they are found to carry the SS or SL alleles.

  13. Recognizing, Differentiating, and Referring Students with Absence Seizures: What Factors Affect Preservice Teachers' Decision Making?

    ERIC Educational Resources Information Center

    Nasewicz, Nicole

    2009-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) and epilepsy are common pediatric disorders that often occur co-morbidly. Both disorders predispose children to a wide range of school-related problems, some of which are the same and others vastly different. Fortunately, with early diagnosis and comprehensive disease management, the long-term…

  14. Pathways into the Criminal Justice System for Individuals with Intellectual Disability

    ERIC Educational Resources Information Center

    Raina, Poonam; Arenovich, Tamara; Jones, Jessica; Lunsky, Yona

    2013-01-01

    Background: Studies focusing on pathways in the criminal justice system for individuals with intellectual disability are limited in that they only study individuals once they are involved in the system and do not consider the pathways into it. The purpose of this study is to examine predisposing factors that lead to various outcomes for…

  15. Sensitivity to Punishment and Explanatory Style as Predictors of Public Speaking State Anxiety. Brief Reports

    ERIC Educational Resources Information Center

    Kopecky, Courtney; Sawyer, Chris; Behnke, Ralph

    2004-01-01

    Recent biological theories of state anxiety have focused on temperament and neurophysiology as factors that predispose some people to be particularly at risk of debilitating levels of performance anxiety. The present study extends Gray's (1982; Gray & McNaughton, 2000) reinforcement sensitivity theory by proposing a linkage between sensitivity to…

  16. Populus tremuloides mortality near the southwestern edge of its range

    Treesearch

    Thomas J. Zegler; Margaret M. Moore; Mary L. Fairweather; Kathryn B. Ireland; Peter Z. Fule

    2012-01-01

    Mortality and crown dieback of quaking aspen (Populus tremuloides) were extensive on the Williams Ranger District, Kaibab National Forest in northern Arizona. We collected data from a random sample of 48 aspen sites to determine the relationship of predisposing site and stand factors and contributing agents to ramet mortality. Mortality of overstory (P10.1 cm DBH)...

  17. Teachers' Perceptions on Senior High School Readiness of Higher Education Institutions in the Philippines

    ERIC Educational Resources Information Center

    Acosta, Imee C.; Acosta, Alexander S.

    2016-01-01

    The focus of this study is on the readiness of higher education institutions in the Philippines to the implementation of the Senior High School program of the new K-12 curriculum. Data were collected through a survey questionnaire. The findings reveal five predisposing factors, namely: eligibility, staffing guidelines, course streamlining,…

  18. Schizophrenia in High-Risk Children: Sex Differences in Predisposing Factors.

    ERIC Educational Resources Information Center

    Mednick, Sarnoff A.; And Others

    Reported is a research program to observe children at high risk for schizophrenia and explore possibilities of prevention. Characteristics of the high risk group (n=207) observed during 1962 are discussed, and a theory which suggests that schizophrenia is an evasion of life is explained. Among results of a diagnostic assessment conducted 10 years…

  19. Women in Nontraditional Occupations. Choice and Turnover.

    ERIC Educational Resources Information Center

    Waite, Linda J.; Berryman, Sue E.

    A project was designed to identify factors that predispose young women to choose and remain in sex-atypical jobs in the military and in civilian firms. Data were from the National Longitudinal Survey of Youth Labor Market Behavior, a longitudinal study with annual interviews from 1979 through 1983 of youth between the ages of 14 and 21 in the…

  20. A Longitudinal Study of Factors Producing High School Dropout among Handicapped and Non-Handicapped Students. Final Report.

    ERIC Educational Resources Information Center

    Brennan, Tim; Anderson, Frank

    This report presents findings from a multi-year project on handicapped and non-handicapped high school dropouts, including a longitudinal study of high school students in five Colorado school districts and a social ecological study to identify community characteristics which predispose a school district to high dropout rates. The longitudinal…

  1. A case study of nitrogen saturation in western U.S. forests

    Treesearch

    Mark E. Fenn; Mark A. Poth

    2001-01-01

    Virtually complete nitrification of the available ammonium in soil and nitrification activity in the forest floor are important factors predisposing forests in the San Bernardino Mountains of southern California to nitrogen (N) saturation. As a result, inorganic N in the soil solution is dominated by nitrate. High nitrification rates also generate elevated nitric oxide...

  2. Enhancement of innate immunity with granulocyte colony-stimulating factor did not mitigate disease in pigs infected with a highly pathogenic Chinese PRRSV strain

    USDA-ARS?s Scientific Manuscript database

    Porcine reproductive and respiratory syndrome virus (PRRSV) is responsible for one of the most economically important diseases in swine worldwide. It causes reproductive failure in sows and pneumonia in pigs that predisposes them to secondary bacterial infections. Methods to control PRRSV and/or lim...

  3. Surgical extractions for periodontal disease in a Western Lowland gorilla.

    PubMed

    Huff, John F

    2010-01-01

    This case report describes surgical exraction of multiple premolar and molar teeth in a Western Lowland gorilla. Postoperative photographs and radiographs indicated complete healing of the extraction sites. This case report includes a review of gorilla dental anatomy, oral disease in primates, pathogenesis of periodontal disease, predisposing factors to periodontal disease, and principles of surgical tooth extraction.

  4. There's an app for that: content analysis of paid health and fitness apps.

    PubMed

    West, Joshua H; Hall, P Cougar; Hanson, Carl L; Barnes, Michael D; Giraud-Carrier, Christophe; Barrett, James

    2012-05-14

    The introduction of Apple's iPhone provided a platform for developers to design third-party apps, which greatly expanded the functionality and utility of mobile devices for public health. This study provides an overview of the developers' written descriptions of health and fitness apps and appraises each app's potential for influencing behavior change. Data for this study came from a content analysis of health and fitness app descriptions available on iTunes during February 2011. The Health Education Curriculum Analysis Tool (HECAT) and the Precede-Proceed Model (PPM) were used as frameworks to guide the coding of 3336 paid apps. Compared to apps with a cost less than US $0.99, apps exceeding US $0.99 were more likely to be scored as intending to promote health or prevent disease (92.55%, 1925/3336 vs 83.59%, 1411/3336; P<.001), to be credible or trustworthy (91.11%, 1895/3336 vs 86.14%, 1454/3349; P<.001), and more likely to be used personally or recommended to a health care client (72.93%, 1517/2644 vs 66.77%, 1127/2644; P<.001). Apps related to healthy eating, physical activity, and personal health and wellness were more common than apps for substance abuse, mental and emotional health, violence prevention and safety, and sexual and reproductive health. Reinforcing apps were less common than predisposing and enabling apps. Only 1.86% (62/3336) of apps included all 3 factors (ie, predisposing, enabling, and reinforcing). Development efforts could target public health behaviors for which few apps currently exist. Furthermore, practitioners should be cautious when promoting the use of apps as it appears most provide health-related information (predisposing) or make attempts at enabling behavior, with almost none including all theoretical factors recommended for behavior change.

  5. Acute Methanol Poisoning: Prevalence and Predisposing Factors of Haemorrhagic and Non-Haemorrhagic Brain Lesions.

    PubMed

    Zakharov, Sergey; Kotikova, Katerina; Vaneckova, Manuela; Seidl, Zdenek; Nurieva, Olga; Navratil, Tomas; Caganova, Blazena; Pelclova, Daniela

    2016-08-01

    The purpose was to study the prevalence and predisposing factors of brain lesions in survivors of acute methanol poisoning. Clinical data on 106 patients with methanol poisoning were collected during the Czech mass poisoning outbreak. Of 83 survivors, in 46 (55%) patients, follow-up examinations including magnetic resonance imaging of brain (MR) were performed 3-8 and 24-28 months after discharge from the hospital. Of 46 patients with a median age of 49 (interquartile range, 35-57) years, 24 (52%) patients had a total of 40 abnormal brain findings with haemorrhagic lesions detected in 15 (33%) and non-haemorrhagic lesions found in 9 (19%) patients. The patients with haemorrhagic brain lesions were more acidemic (lower arterial blood pH, higher base deficit) and had higher glycaemia and lactacidaemia on admission than those without haemorrhages (all p < 0.05). Thirteen of 32 (41%) of patients with systemic anticoagulation and 2 of 14 (14%) of patients without it had haemorrhagic lesions (p = 0.080). Bleeding complications during the treatment occurred in 4 of 15 (27%) patients, and 5 of 15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In three cases with a series of computer tomography (CT)/MR performed during hospitalization, the necrotic lesions in the brain remained non-haemorrhagic during hospitalization and haemorrhagic lesions were detected on the follow-up MR examinations only. No association between brain haemorrhages and systemic anticoagulation during dialysis was found: brain haemorrhages might occur in severely poisoned patients treated without systemic anticoagulation, whereas treatment with high doses of heparin might not lead to brain haemorrhages. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  6. Neurodevelopment, GABA System Dysfunction, and Schizophrenia

    PubMed Central

    Schmidt, Martin J; Mirnics, Karoly

    2015-01-01

    The origins of schizophrenia have eluded clinicians and researchers since Kraepelin and Bleuler began documenting their findings. However, large clinical research efforts in recent decades have identified numerous genetic and environmental risk factors for schizophrenia. The combined data strongly support the neurodevelopmental hypothesis of schizophrenia and underscore the importance of the common converging effects of diverse insults. In this review, we discuss the evidence that genetic and environmental risk factors that predispose to schizophrenia disrupt the development and normal functioning of the GABAergic system. PMID:24759129

  7. Myeloproliferative neoplasms in five multiple sclerosis patients☆

    PubMed Central

    Thorsteinsdottir, Sigrun; Bjerrum, Ole Weis; Hasselbalch, Hans Carl

    2013-01-01

    The concurrence of myeloproliferative neoplasms (MPNs) and multiple sclerosis (MS) is unusual. We report five patients from a localized geographic area in Denmark with both MS and MPN; all the patients were diagnosed with MPNs in the years 2007–2012. We describe the patients' history and treatment. A potential link between MS and MPNs has not been previously recognized. This observation calls attention to potential environmental factors and/or previously unrecognized genetic factors predisposing these patients to both MS and MPNs. PMID:24371783

  8. Neurodevelopment, GABA system dysfunction, and schizophrenia.

    PubMed

    Schmidt, Martin J; Mirnics, Karoly

    2015-01-01

    The origins of schizophrenia have eluded clinicians and researchers since Kraepelin and Bleuler began documenting their findings. However, large clinical research efforts in recent decades have identified numerous genetic and environmental risk factors for schizophrenia. The combined data strongly support the neurodevelopmental hypothesis of schizophrenia and underscore the importance of the common converging effects of diverse insults. In this review, we discuss the evidence that genetic and environmental risk factors that predispose to schizophrenia disrupt the development and normal functioning of the GABAergic system.

  9. THE ROLE OF PREDISPOSING FACTORS IN EXPERIMENTAL FUNGUS INFECTIONS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sheldon, W.H.; Bauer, H.

    Among other factors, the influence of ionizing radiations on susceptibility to fungus diseases is reviewed. X irradiation singly or in combination with cortisone administration has been employed in the study of experimental fungus diseases, and it has been shown that total-body radiation enhaaced infection with Candida albicans, Blastomyces dermatididis, and Cryptococcus neoformans in mice. Enhanced susceptibility to fungus infections following radiation therapy has also been reported, the mechanism resulting in lowered host resistance being presumably the same as in other infections. (BBB)

  10. Tinea cruris in children.

    PubMed

    Patel, Gopal A; Wiederkehr, Michael; Schwartz, Robert A

    2009-09-01

    Tinea cruris is an intensely pruritic fungal infection of the groin and adjacent skin. Also known as crotch rot and jock itch, it can be a troubling important entity that at times is a clinical, diagnostic, and therapeutic challenge. Predisposing factors include heat, humidity, and hyperhidrosis, common accompaniments of high school-aged athletes. Furthermore, obesity and diabetes mellitus, additional risk factors for tinea cruris, are reaching unprecedented levels in adolescents. Treatment options range from improving hygiene to topical antifungal agents and systemic antifungal agents, the latter with potentially dangerous side effects.

  11. Breaking the silence. Battered women's perspectives on medical care.

    PubMed

    Rodriguez, M A; Quiroga, S S; Bauer, H M

    1996-03-01

    To determine the barriers to identification and management of domestic violence from the battered women's perspective. Qualitative research methods using semistructured focus groups. Urban and suburban community-based organizations serving women and their families in the San Francisco Bay (Calif) area. Fifty-one women with histories of domestic violence comprised eight focus groups divided as follows: two groups of Latino (n=14), two groups of white (n=14), Asian (n=14), and two groups of African-American (n=9) women. Participants from all ethnic groups identified major factors that affect identification and management of battered women in the health care setting. Factors that interfere with patient disclosure included threats of violence from the partner, embarrassment, adherence to gender roles, concerns about police involvement and lack of trust in the health care provider. One factor that predisposed a woman to seek help from providers was a need for the providers to exhibit compassion, awareness, and respect for the patient's need to make the final decisions about her situation. Most participants said that providers should take the initiative to ask directly about domestic violence, establish a supportive patient-provider relationship, and refer battered women to available community resources. The major institutional barriers to using the health care system included the high cost of medical care and long waiting periods. Many battered women experience social, institutional, and provider barriers to obtaining help from the health care system for problems related to domestic violence. Providers as well as institutions can overcome these barriers through an understanding of the social context of domestic violence and the victim's needs. Identification may be improved through a trusting patient-provider relationship and by direct questioning about domestic violence.

  12. Pastoralists' knowledge and practices towards clinical bovine dermatophilosis in cattle herds of North-Central Nigeria: the associated factors, burden and economic impact.

    PubMed

    Alhaji, Nma Bida; Isola, Tajudeen Opeyemi

    2018-02-01

    Dermatophilosis is a contagious disease of high economic importance. The study assessed knowledge/awareness and clinical burden of and mitigation measures practised against clinical bovine dermatophilosis in pastoral herds of North-Central Nigeria and associated socio-cultural factors that predisposed to its occurrence in herds. A cross-sectional survey was conducted between October 2015 and September 2016. Questionnaires were administered on pastoralists and clinical assessment of cattle with gross pathological lesions indicative of dermatophilosis conducted. Associated economic impact was estimated. All 384 selected pastoralists participated in the survey. The majorities of nomadic (97.4%) and sedentary (68.2%) pastoralists significantly (p < 0.05) reported to have heard about dermatophilosis. Majorities of the sedentary (91.7%) and nomadic (97.4%) pastoralists mentioned the use antibiotics to manage the disease. Pastoralists in age group 70-79 years were more likely (OR 15.22; 95% CI 4.69, 49.34) to possess satisfactory knowledge about the disease. Culture of giving out cattle as gift or payment for dowry was more likely (OR 28.56; 95% CI 15.64, 52.12) to influence dermatophilosis occurrence in herds. Overall clinical dermatophilosis burden was 3.6% (95% CI 3.46, 3.80) and the annual economic impact was estimated at 908,463.9 USD. This study has given an idea to the status of pastoralists' levels of awareness about dermatophilosis in Nigeria, which can be harnessed by policy makers to develop its mitigation measures. Significant influence of pastoralists' socio-cultural activities on dermatophilosis occurrence in herds was identified. Surveillance and control programmes towards dermatophilosis that take these factors into consideration will be beneficial to the herders.

  13. Predisposing, enabling, and need factors associated with high service use in a public mental health system.

    PubMed

    Lindamer, Laurie A; Liu, Lin; Sommerfeld, David H; Folsom, David P; Hawthorne, William; Garcia, Piedad; Aarons, Gregory A; Jeste, Dilip V

    2012-05-01

    The purpose of this study was twofold: (1) To investigate the individual- and system-level characteristics associated with high utilization of acute mental health services according to a widely-used theory of service use-Andersen's Behavioral Model of Health Service Use -in individuals enrolled in a large, public-funded mental health system; and (2) To document service utilization by high use consumers prior to a transformation of the service delivery system. We analyzed data from 10,128 individuals receiving care in a large public mental health system from fiscal years 2000-2004. Subjects with information in the database for the index year (fiscal year 2000-2001) and all of the following 3 years were included in this study. Using logistic regression, we identified predisposing, enabling, and need characteristics associated with being categorized as a single-year high use consumer (HU: >3 acute care episodes in a single year) or multiple-year HU (>3 acute care episodes in more than 1 year). Thirteen percent of the sample met the criteria for being a single-year HU and an additional 8% met the definition for multiple-year HU. Although some predisposing factors were significantly associated with an increased likelihood of being classified as a HU (younger age and female gender) relative to non-HUs, the characteristics with the strongest associations with the HU definition, when controlling for all other factors, were enabling and need factors. Homelessness was associated with 115% increase in the odds of ever being classified as a HU compared to those living independently or with family and others. Having insurance was associated with increased odds of being classified as a HU by about 19% relative to non-HUs. Attending four or more outpatient visits was an enabling factor that decreased the chances of being defined as a HU. Need factors, such as having a diagnosis of schizophrenia, bipolar disorder or other psychotic disorder or having a substance use disorder increased the likelihood of being categorized as a HU. Characteristics with the strongest association with heavy use of a public mental health system were enabling and need factors. Therefore, optimal use of public mental services may be achieved by developing and implementing interventions that address the issues of homelessness, insurance coverage, and substance use. This may be best achieved by the integration of mental health, intensive case management, and supportive housing, as well as other social services.

  14. The genetic predisposition and the interplay of host genetics and gut microbiome in Crohn disease.

    PubMed

    Jianzhong, Hu

    2014-12-01

    Extensive genetic studies have identified more than 140 loci predisposing to Crohn disease (CD). Several major CD susceptibility genes have been shown to impair biological function with regard to immune response to recognizing and clearance of bacterial infection. Recent human microbiome studies suggest that the gut microbiome composition is differentiated in carriers of many risk variants of major CD susceptibility genes. This interplay between host genetics and its associated gut microbiome may play an essential role in the pathogenesis of CD. The ongoing microbiome research is aimed to investigate the detailed host genetics-microbiome interacting mechanism. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Gas gangrene caused by clostridium perfringens involving the liver, spleen, and heart in a man 20 years after an orthotopic liver transplant: a case report.

    PubMed

    Kitterer, Daniel; Braun, Niko; Jehs, Margit C; Schulte, Bernhard; Alscher, M Dominik; Latus, Joerg

    2014-04-01

    Despite advances in immunosuppression and liver transplant in the past, mortality and morbidity caused by infections remain major problems. We present a 71-year-old man who was admitted to our internal intensive care unit with septicemia. Upon admission, he had poorly localized epigastric pain and fever of 2 days ' duration. Twenty years earlier, he had undergone an orthotopic liver transplant. Testing revealed a high C-reactive protein level, elevated liver enzymes, and an acute kidney injury. A computer tomography scan showed 2 circular, non--rim-enhancing, totally emphysematous intrahepatic lesions. Additionally, gas could be seen in the portal veins mainly, as well as in the biliary system, in the right auricle, and the splenic veins. To the best of our knowledge, he showed no malignant lesion or predisposing trauma. Empirically, treatment with broad-spectrum antibiotics was begun, and the patient was transferred to the operating suite. When surgery began, blood cultures revealed the presence of gram-positive bacilli, which were identified as Clostridium perfringens. Seven hours after the surgery, the patient developed asystole and died. In septic patients presenting with severe hemolysis, Clostridium perfringens infection must be considered in the absence of a malignant lesion or a predisposing trauma; a previous episode of gastroenteritis might be a predisposing trauma by impairing the barrier of the intestinal flora, leading to Clostridium perfringens infection.

  16. Traumatic injury may be a predisposing factor for cerebrovascular accident.

    PubMed

    Wojcik, Jodi B; Benns, Matthew V; Franklin, Glen A; Harbrecht, Brian G; Broughton-Miller, Kimberly D; Frisbie, Michelle C; Smith, Jason W; Pentecost, Karina M; Bozeman, Matthew C

    2013-01-01

    The purpose of the study was to assess whether trauma may be an independent risk factor for stroke. Evidence has shown that trauma patients experience a hypercoagulable state postinjury, increasing the risk of thrombotic events. A case-controlled, retrospective analysis was performed on admitted trauma patients over a 2-year period. Results revealed that trauma patients are 1.6 times more likely to have a cerebrovascular accident (CVA) during their hospital admission, when compared with nontrauma patients with similar CVA risk factors. Several statistically significant differences between the groups were identified. On the basis of these results, trauma appears to be an independent, nonmodifiable risk factor for CVA.

  17. Scald burn, a preventable injury: Analysis of 4306 patients from a major tertiary care center.

    PubMed

    Sahu, Shamendra Anand; Agrawal, Karoon; Patel, Pankaj Kumar

    2016-12-01

    Scalds have distinct epidemiological and predisposing risk factors amongst all types of burns. Though scald affects all age groups, the brunt falls on the minor age groups. It may result in major physical disabilities and significant loss of school years. Apart from the economic burden on family, major scald burn may compromise overall development of the affected children. Most of the scald injuries occur in domestic settings and are preventable. Despite improvement in living conditions, the incidence of scald burn has failed to decline. Our aim was to study the detailed epidemiology and severity of scald burn amongst all age groups. A retrospective study was carried out from the records of all burn patients who attended a tertiary burn care center from January 2013 and December 2014. Data of the patients with scald injury was segregated and analyzed using Microsoft excel spreadsheet. 10,175 burn patients attended the burn casualty during the study period, of which 42.3% had sustained scald. 56.85% of patients were under 15 years of age with preschool children (36.4%) being the prime victims of scald. The % TBSA involved is also relatively larger in children. Scald follows definite seasonal variation peaking in winters. 36.8% patients arrived to the hospital without any first aid. 74.2% of patients reported to casualty with in 24hours after sustaining scald injury. The median time interval between injury and reporting to casualty was 3hours 30minutes. This study concludes that the scald is injury of all age groups, though majority of them are children. The first aid is not given to large number of patients and late reporting is quite common. These are the factors which may affect the course of scald burn. Spreading public awareness regarding safe household practises and educating them for proper first aid management after scald may have significant impact on the burden of care and outcome. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  18. Surgical management of recurrent urinary tract infections: a review

    PubMed Central

    Bergamin, Paul A.

    2017-01-01

    There are many causes of recurrent urinary tract infections (rUTI) which are amenable to surgical management. This usually follows a lengthy trial of conservative management. Aetiological classification of rUTI requiring surgical management may be divided into congenital or acquired. Predisposing factors are classified into two groups; those providing a source for organisms, or by maintaining favourable conditions for the proliferation of organisms. Sources of infections include calculi, fistulae or abscesses. Conditions which predispose to bacterial proliferation include malignancies, foreign bodies, high post void residuals, and neuropathic bladders. Removal of identified sources, treating the obstruction, and improving urinary drainage, are all goals of surgical management. Surgical options for rUTI management can range from minimally invasive procedures such as endoscopic or percutaneous, through to more invasive requiring laparoscopic or an open approach. Surgery remains a very important and viable solution. PMID:28791234

  19. Rumen conditions that predispose cattle to pasture bloat.

    PubMed

    Majak, W; Howarth, R E; Cheng, K J; Hall, J W

    1983-08-01

    Rumen contents from the dorsal sac were examined before alfalfa ingestion to determine factors that predispose cattle to pasture bloat. Chlorophyll concentration, buoyancy of particulate matter, and rates of gas production were significantly higher in cattle that subsequently bloated than in those that did not. Higher chlorophyll in bloat cases indicated accumulation of suspended chloroplast particles in the dorsal sac, perhaps due to increased buoyancy of the particulate matter. The higher fermentation rates (in the presence of glucose) suggested that the latent capacity for gas production was due to microbial colonization of suspended feed particles. Chlorophyll 4 h after feeding was also higher in bloated as compared to unbloated animals. In short, the microbial colonization and retention of particulate matter provided active inocula for promoting rapid legume digestion. Consequently, gas production was enhanced when feeding commenced, but the fermentation gases were trapped by the buoyant, frothy ingesta, resulting in the condition of pasture bloat.

  20. What is dynapenia?

    PubMed Central

    Clark, Brian C.; Manini, Todd M.

    2012-01-01

    Dynapenia (pronounced dahy-nuh-pē-nē-a, Greek translation for poverty of strength, power, or force) is the age-associated loss of muscle strength that is not caused by neurologic or muscular diseases. Dynapenia predisposes older adults to an increased risk for functional limitations and mortality. For the past several decades, the literature has largely focused on muscle size as the primary cause of dynapenia; however, recent findings have clearly demonstrated that muscle size plays a relatively minor role. Conversely, subclinical deficits in the structure and function of the nervous system and/or impairments in the intrinsic force-generating properties of skeletal muscle are potential antecedents to dynapenia. This review highlights in the contributors to dynapenia and the etiology and risk factors that predispose individuals to dynapenia. In addition, we address the role of nutrition in the muscular and neurologic systems for the preservation of muscle strength throughout the life span. PMID:22469110

  1. What is dynapenia?

    PubMed

    Clark, Brian C; Manini, Todd M

    2012-05-01

    Dynapenia (pronounced dahy-nuh-pē-nē-a, Greek translation for poverty of strength, power, or force) is the age-associated loss of muscle strength that is not caused by neurologic or muscular diseases. Dynapenia predisposes older adults to an increased risk for functional limitations and mortality. For the past several decades, the literature has largely focused on muscle size as the primary cause of dynapenia; however, recent findings have clearly demonstrated that muscle size plays a relatively minor role. Conversely, subclinical deficits in the structure and function of the nervous system and/or impairments in the intrinsic force-generating properties of skeletal muscle are potential antecedents to dynapenia. This review highlights in the contributors to dynapenia and the etiology and risk factors that predispose individuals to dynapenia. In addition, we address the role of nutrition in the muscular and neurologic systems for the preservation of muscle strength throughout the life span. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Posterior impingement syndromes of the ankle.

    PubMed

    Lee, Justin C; Calder, James D F; Healy, Jeremiah C

    2008-06-01

    Acute, or repetitive, compression of the posterior structures of the ankle may lead to posterior ankle impingement (PAI) syndrome, posteromedial ankle impingement (PoMI) syndrome, or Haglund's syndrome. The etiology of each of these conditions is quite different. Variations in posterior ankle osseous and soft tissue anatomy contribute to the etiology of PAI and Haglund's syndromes. The presence of an os trigonum or Stieda process is classically associated with PAI syndrome, whereas a prominent posterosuperior tubercle of the os calcis or Haglund's deformity is the osseous predisposing factor in Haglund's syndrome. PoMI has no defined predisposing anatomical variants but typically follows an inversion-supination injury of the ankle joint. This article discusses the biomechanics, clinical features, imaging, and management of each of these conditions. Magnetic resonance imaging (MRI) provides the optimal tool in posterior ankle assessment, and this review focuses on the MRI findings of each of the conditions just listed.

  3. How artificial intelligence tools can be used to assess individual patient risk in cardiovascular disease: problems with the current methods.

    PubMed

    Grossi, Enzo

    2006-05-03

    In recent years a number of algorithms for cardiovascular risk assessment has been proposed to the medical community. These algorithms consider a number of variables and express their results as the percentage risk of developing a major fatal or non-fatal cardiovascular event in the following 10 to 20 years The author has identified three major pitfalls of these algorithms, linked to the limitation of the classical statistical approach in dealing with this kind of non linear and complex information. The pitfalls are the inability to capture the disease complexity, the inability to capture process dynamics, and the wide confidence interval of individual risk assessment. Artificial Intelligence tools can provide potential advantage in trying to overcome these limitations. The theoretical background and some application examples related to artificial neural networks and fuzzy logic have been reviewed and discussed. The use of predictive algorithms to assess individual absolute risk of cardiovascular future events is currently hampered by methodological and mathematical flaws. The use of newer approaches, such as fuzzy logic and artificial neural networks, linked to artificial intelligence, seems to better address both the challenge of increasing complexity resulting from a correlation between predisposing factors, data on the occurrence of cardiovascular events, and the prediction of future events on an individual level.

  4. Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China.

    PubMed

    Wu, Yangfeng; Benjamin, Emelia J; MacMahon, Stephen

    2016-06-14

    With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved. © 2016 American Heart Association, Inc.

  5. Prevention and Control of Cardiovascular Disease in the Rapidly Changing Economy of China

    PubMed Central

    Wu, Yangfeng; Benjamin, Emelia J.; MacMahon, Stephen

    2016-01-01

    With one fifth of the world’s total population, China’s prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. To understand China’s current cardiovascular epidemic, requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The later have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the health care system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that four priorities should be taken: pursue multi-sectorial government and non-government strategies targeting the underlying causes of CVD (the “whole-of-government and whole-of-society” policy); give priority to prevention; reform the health care system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the four priorities, the pandemic of CVD and other major NCDs in China will be reversed and the global sustainable development goal achieved. PMID:27297347

  6. Genes of the class II and class III major histocompatibility complex are associated with typhoid fever in Vietnam.

    PubMed

    Dunstan, S J; Stephens, H A; Blackwell, J M; Duc, C M; Lanh, M N; Dudbridge, F; Phuong, C X; Luxemburger, C; Wain, J; Ho, V A; Hien, T T; Farrar, J; Dougan, G

    2001-01-15

    The influence of genes of the major histocompatibility complex (MHC) class II and class III loci on typhoid fever susceptibility was investigated. Individuals with blood culture-confirmed typhoid fever and control subjects from 2 distinct geographic locations in southern Vietnam were genotyped for HLA-DRB1 and HLA-DQB1 alleles, the gene that encodes tumor necrosis factor (TNF)-alpha (TNFA [-238] and TNFA [-308]), the gene that encodes lymphotoxin-alpha, and alleles of the TNF-alpha microsatellite. HLA-DRB1*0301/6/8, HLA-DQB1*0201-3, and TNFA*2 (-308) were associated with susceptibility to typhoid fever, whereas HLA-DRB1*04, HLA-DQB1*0401/2, and TNFA*1 (-308) were associated with disease resistance. The frequency of all possible haplotypes of the 3 individually associated loci were estimated and were found to be significantly different in typhoid case patients and control subjects (chi2=55.56, 32 df; P=.006). Haplotypes that were either protective (TNFA*1 [-308].DRB1*04) or predisposed individuals to typhoid fever (TNFA*2 [-308].DRB1*0301) were determined. This report identifies a genetic association in humans between typhoid fever and MHC class II and III genes.

  7. How social media meet patients’ questions: YouTube™ review for mouth sores in children.

    PubMed

    Di Stasio, D; Romano, A; Paparella, R S; Gentile, C; Serpico, R; Minervini, G; Candotto, V; Laino, L

    2018-01-01

    Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube™ is increasingly being used by patients to obtain health-related information. The aim of this work is to examine the quality of information offered by YouTube™ about mouth sores in children (MSC). Searching the term ‘mouth sores in children’, (MSC) displayed 12.300 results. Of the top 60 videos analyzed, 31 were excluded following exclusion criteria. The major source of upload was from healthcare information channels (HC-41,38%), followed by individual users (HP-25.59%), healthcare professionals (IU-17.24%) and generalist information channels (HC-13.78%); 20.69% of them deal with predisposing factors, and related pathologies, the majority of these propose home remedies (60.72%) rather than topical analgesic drugs (21.43%), antimicrobials (7.14%) and topical steroids (3.57). Most of the videos analyzed were slightly useful (68.97%). Information about mouth sores in children on YouTube™ was poor regardless of the upload source. Analyzing health content on social platforms is a starting point for providing greater quality of health-related information.

  8. [Achromobacter xylosoxidans bacteremia in a patient with community-acquired pneumonia].

    PubMed

    de Fernández, M I; Bugarín, G; Arévalo, C E

    2001-01-01

    Achromobacter xylosoxidans is a rare cause of bacteremia, and little information on treatment is available. The majority of patients who have developed Achromobacter bacteremia have presented predisposing causes to the infection. A case of community-acquired pneumonia and bacteremia due to A. xylosoxidans in a previously healthy patient is reported. Achromobacter is usually resistant to ampicillin, cephalosporins (1st, 2nd, and 3rd generation), aminoglycosides, and fluoroquinolones. Piperacillin, piperacillin-tazobactam, and trimethoprim-sulfamethoxazole inhibit most isolates.

  9. Discrimination and Delayed Health Care Among Transgender Women and Men: Implications for Improving Medical Education and Health Care Delivery.

    PubMed

    Jaffee, Kim D; Shires, Deirdre A; Stroumsa, Daphna

    2016-11-01

    The transgender community experiences health care discrimination and approximately 1 in 4 transgender people were denied equal treatment in health care settings. Discrimination is one of the many factors significantly associated with health care utilization and delayed care. We assessed factors associated with delayed medical care due to discrimination among transgender patients, and evaluated the relationship between perceived provider knowledge and delayed care using Anderson's behavioral model of health services utilization. Multivariable logistic regression analysis was used to test whether predisposing, enabling, and health system factors were associated with delaying needed care for transgender women and transgender men. A sample of 3486 transgender participants who took part in the National Transgender Discrimination Survey in 2008 and 2009. Predisposing, enabling, and health system environment factors, and delayed needed health care. Overall, 30.8% of transgender participants delayed or did not seek needed health care due to discrimination. Respondents who had to teach health care providers about transgender people were 4 times more likely to delay needed health care due to discrimination. Transgender patients who need to teach their providers about transgender people are significantly more likely to postpone or not seek needed care. Systemic changes in provider education and training, along with health care system adaptations to ensure appropriate, safe, and respectful care, are necessary to close the knowledge and treatment gaps and prevent delayed care with its ensuing long-term health implications.

  10. Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study.

    PubMed

    Behr, Joshua G; Diaz, Rafael

    2016-01-01

    First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department. Representative randomized sample of 1,443 adult patients triaged ESI levels 4-5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization.

  11. Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit.

    PubMed

    Nanas, S; Kritikos, K; Angelopoulos, E; Siafaka, A; Tsikriki, S; Poriazi, M; Kanaloupiti, D; Kontogeorgi, M; Pratikaki, M; Zervakis, D; Routsi, C; Roussos, C

    2008-09-01

    To investigate risk factors of critical illness polyneuromyopathy (CIPM) in a general multidisciplinary intensive care unit (ICU). Prospective observational study in a 28-bed university multidisciplinary ICU. Four hundred and seventy-four (323 M/151 F, age 55 +/- 19) consecutive patients were prospectively evaluated. All patients were assigned admission Acute Physiology and Chronic Health Evaluation (APACHE II; 15 +/- 7) and Sequential Organ Failure Assessment (SOFA; 6 +/- 3) scores and were subsequently evaluated for newly developed neuromuscular weakness. Other potential causes of new-onset weakness after ICU admission were excluded before CIPM was diagnosed. Forty-four (23.8%) of 185 patients developed generalized weakness that met the criteria for CIPM. Patients with CIPM had higher APACHE II (18.9 +/- 6.6 vs 15.6 +/- 6.4, P = 0.004) and SOFA scores (8.4 +/- 2.9 vs 7.1 +/- 2.9, P = 0.013). According to multivariate logistic regression analysis, the following risk factors were independently associated with the development of CIPM: severity of illness at the time of ICU admission, administration of aminoglycoside antibiotics and high blood glucose levels. Analysis according to severity of illness stratification revealed the emergence of Gram (-) bacteremia as the most important independent predisposing factor for CIPM development in less severely ill patients. CIPM has a high incidence in the ICU setting. Our study revealed the association of aminoglycosides, hyperglycemia and illness severity with CIPM development, as well as the association between Gram (-) bacteremia and development of CIPM in less severely ill patient population.

  12. Predisposing factors to severe external root resorption associated to orthodontic treatment.

    PubMed

    Picanço, Gracemia Vasconcelos; de Freitas, Karina Maria Salvatore; Cançado, Rodrigo Hermont; Valarelli, Fabricio Pinelli; Picanço, Paulo Roberto Barroso; Feijão, Camila Pontes

    2013-01-01

    The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

  13. Health behavior and perceptions among African American women with metabolic syndrome

    PubMed Central

    Malayala, Srikrishna Varun; Raza, Ambreen

    2016-01-01

    Background Metabolic syndrome is a cluster of different risk factors (abdominal obesity, insulin resistance, high blood pressure, and high cholesterol) that predispose to the development of cardiovascular diseases. African American women (AAW) are easily predisposed to metabolic syndrome due to higher levels of insulin resistance. Various sociodemographic factors further contribute to higher prevalence. Aim This study evaluates the current prevalence of metabolic syndrome in AAW and identifies the related sociodemographic risk factors. Methods The study utilized 2007–11 National Health and Nutrition Examination Survey (NHANES) data sets from the Centers for Disease Control (CDC). The sample was divided into two groups: AAW with and without metabolic syndrome. Sociodemographic, physical examination, laboratory parameters, and health perceptions were compared between the two groups. Results Out of the available sample of 30,442 individuals, 1918 (6.4%) met the inclusion criteria (AAW, age>20, non-pregnant women). The prevalence of metabolic syndrome was 47%. Older age, lower education level, low socioeconomic status, unmarried status, low physical activity level, and smoking were associated with higher prevalence of metabolic syndrome (p<0.001). The prevalence of borderline hypertension, hypertension, diabetes, stroke, and cardiovascular diseases was significantly higher in AAW with metabolic syndrome (p<0.001). Conclusion In spite of the focus on prevention of cardiovascular risk factors and elimination of ethnic and gender disparities, metabolic syndrome is still widely prevalent in AAW and poses a threat to the goals of Healthy People 2020. PMID:26908390

  14. The role of exogenous risk factors of antituberculosis treatment failure.

    PubMed

    Lesnic, Evelina; Ustian, Aurelia; Pop, Carmen Monica

    2016-01-01

    The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. The study of exogenous risk factors in vulnerable groups will contribute to the precocious detection of patients predisposed to failing the tuberculosis treatment and will permit the initiation of measures centered on patient that will favor the increase of treatment quality and success rate.

  15. The role of exogenous risk factors of antituberculosis treatment failure

    PubMed Central

    LESNIC, EVELINA; USTIAN, AURELIA; POP, CARMEN MONICA

    2016-01-01

    Background and aim The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. Methods The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. Results The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. Conclusions The study of exogenous risk factors in vulnerable groups will contribute to the precocious detection of patients predisposed to failing the tuberculosis treatment and will permit the initiation of measures centered on patient that will favor the increase of treatment quality and success rate. PMID:27547060

  16. Factors Predisposing, Enabling and Reinforcing Routine Screening of Patients for Preventing Fetal Alcohol Syndrome: A Survey of New Jersey Physicians.

    ERIC Educational Resources Information Center

    Donovan, Carole L.

    1991-01-01

    Survey of 58 physicians revealed that they did not routinely ask their pregnant patients about alcohol consumption for several reasons: physician bias resulting from own abuse, lack of training, poor awareness of problem and effects, denial that Fetal Alcohol Syndrome occurs in private practice, time limitations, disinterest, fear of offending…

  17. Inherited and predisposing factors in the development of gastric dilatation volvulus in dogs.

    PubMed

    Bell, Jerold S

    2014-09-01

    This review article summarizes what is known as well as what is undetermined concerning the inherited and environmental pathogenesis of gastric dilatation volvulus in dogs. The disorder primarily affects large and giant, deep-chested breeds. A concise description of a typical dog affected with gastric dilatation volvulus is presented. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Preliminary Findings of Serum Creatinine and Estimated Glomerular Filtration Rate (eGFR) in Adolescents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Lan-Ping; Hsieh, Molly; Lin, Pei-Ying

    2010-01-01

    The present study aimed to describe the kidney function profile--serum creatinine and estimated glomerular filtration rate (eGFR), and to examine the relationships of predisposing factors to abnormal serum creatinine in people with intellectual disabilities (ID). Data were collected by a cross-sectional study of 827 aged 15-18 years adolescents…

  19. Influence of forest canopy and snow on microclimate in a declining yellow-cedar forest of southeast Alaska

    Treesearch

    Paul E. Hennon; David V. D' Amore; Dustin T. Witter; Melinda B. Lamb

    2010-01-01

    Site factors predispose yellow-cedar (Chamaecyparis nootkatensis D. Don (Spach)) to a widespread climate-induced mortality in southeast Alaska. We investigated the influence of canopy cover and snow on microclimate at two small watersheds across a range of declining yellow-cedar stands on Baranof and Chichagof Islands in southeast Alaska. Two...

  20. Individuality and Contextual Influences on Drug Dependence: A 15-Year Prospective Longitudinal Study of Adolescents from Harlem

    ERIC Educational Resources Information Center

    Brook, Judith S.; Lee, Jung Yeon; Brown, Elaine N.; Finch, Stephen J.; Brook, David W.

    2012-01-01

    In this 15-year longitudinal study the authors investigated individual and contextual factors that predispose adolescents from a disadvantaged urban area to drug dependence in adulthood. Adolescents were recruited from schools serving East Harlem in New York City. Of the 838 participants followed to adulthood, 59% were women, 55% were African…

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