scholarly journals Use of carbapenems and glycopepdides is significant risk for multidrug resistant Acinetobacter baumannii infections

2018 ◽  
Vol 12 (02) ◽  
pp. 67-72
Author(s):  
Salih Hosoglu ◽  
Eyup Arslan ◽  
Emel Aslan ◽  
Özcan Deveci
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Acinetobacter Baumannii ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Time Interval ◽  
And Control

Introduction: Multi-drug resistant Acinetobacter baumannii (MDR-Ab) infections are an important healthcare problem globally. The aim of this study was to evaluate risk factors associated with MDR-Ab infections in hospitalized patients in Turkey. Methodology: A case-control study was performed in a tertiary care 1,303-bed university hospital, among case patients with MDR-Ab infections. The hospital records of case and control patients were retrospectively evaluated over a year. Patients who were hospitalized in the same department and in the same time interval as the case patients, without MDR-Ab infection or colonization, were chosen for control group. Demographic characteristics, Acute Physiology And Chronic Health Evaluation II (APACHE II) scores, comorbid diseases, use of invasive tools and duration of usage, and duration of use of antibiotics were recorded for all patients. Comparisons between case and control groups for possible risk factors were performed. Results: In total, 95 cases and 95 controls were included in the study. Univariate analysis highlighted several variables as risk factors for MDR-Ab infections. Multivariate analysis showed that only antibiotic usage over seven days (OR = 2.38, CI = 1.18-4.83, p = 0.016) was found to be a significant risk factor. When antibiotic treatment patterns in both groups were compared, the use of carbapenems (p = 0.001) and glycopeptide antibiotics (p=0.001) in patient treatment were found significantly higher in the MDR-Ab case group. Conclusion: This study showed us that previous antibiotic use is a significant risk factor for MDR-Ab infections. The use of carbapenems and glycopeptides should be considered as primary risk factors for developing MDR-Ab infection.

scholarly journals Sex differences in clinical presentation in acute MI

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Ashwin Kodliwadmath ◽  
Naren V. Nimbal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Care Hospital ◽  
Acute Mi

Background: Acute myocardial infarction differs in women and men with respect to risk factors and clinical presentation. There are studies carried out worldwide on this issue but few from India. This study was done to study the sex based differences in the risk factors and clinical features of acute MI in patients with Indian ethnicity.Methods: Comparative prospective study consisting of 100 women as study group and 100 men as control group with acute MI, who were admitted in a tertiary care hospital, from December 2016 to June 2017.Results: Chest pain was the main complaint in majority of the women (82%) and men (88%). Radiation of chest pain (87%) and sweating (90%) were significantly present in men compared to women (65% and 62% respectively), while breathlessness was significantly present in women (78%) compared to men (64%) and fatigue in women (76%) significantly more than men (55%). Smoking was a significant risk factor in men (69%) compared to women (5%), while diabetes mellitus was a significant risk factor in women (62%) compared to men (39%).Conclusions: Women with acute MI had more atypical presentation of symptoms, similar risk factors, compared to men except for smoking which was more significant in men and diabetes more common in women.

scholarly journals Risk factors for mortality in children with Wilms tumor

2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Wilms Tumor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Stage Iii ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Potential Risk Factors

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 

scholarly journals High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Anak Agung Gde Putra Wiraguna ◽  
Made Wardhana ◽  
Made Kusuma Dewi Maharani
Keyword(s):  
Oxidative Stress ◽  
Risk Factor ◽  
Acne Vulgaris ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
High Plasma ◽  
Matched Pair ◽  
Control Group ◽  
H2o2 Level ◽  
And Control

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion.Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne.Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS.Results: H2O2 mean level in the case and control group, respectively 0.68 ± 0.03 and 0.42 ± 0.04 µmol/ml. High H2O2 level was determined from cut-off point >0.62 µmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p<0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 ± 0.06 and 0.74 ± 0.07 U/ml. Low catalase level was determined from the cut-off point <0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p<0.001; 95% CI: 5.18-77.21; OR: 20.00).Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.

scholarly journals Risk for Occurrence of Laryngeal Cancer Among Current Cigarette Smokers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 13s-13s ◽  
Author(s):  
I. Pavlovska ◽  
B. Taushanova ◽  
B. Zafirova
Keyword(s):  
Risk Factor ◽  
Cigarette Smoking ◽  
Laryngeal Cancer ◽  
Malignant Tumors ◽  
Smoking Habit ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Control Group

Background: Cancer is a leading cause of death worldwide. It is on the second place as a death cause in developed countries and among the three leading death causes in adults in developing countries. Every year, worldwide, approximately 10 million persons have been diagnosed with malignant tumors (in every locations), and more than 6 million of these people die. According to many studies, several risk factors are brought in connection with laryngeal cancer (LarC). The most significant and generally accepted is alcohol consumption and the habit of cigarette smoking. Cigarette smoking habit caused about 30% of all cancers, due to which it represents the most significant risk factor for occurrence of these disorders in humans. Aim: Aim of the study was to determine the existence of the eventual causal associations among the cigarette smoking and development and distribution of the laryngeal cancer. Methods: This study is an analytical type of case-control study. It elaborated 185 patients, suffering from laryngeal cancer and the same number of persons without malignant disease (control group-CG). Risk analyses were done using unconditional logistic regression, which provides results in the form of adjusted odds ratio. The odds ratios and their 95% confidence intervals (CI) were computed. Results: Among patients were 79% of current smokers (CS), 18.3% of former smokers (FS) and only 2.7% of never smokers (NS), compared with 40.5% of CS, 28.7% of FS and 30.8% of NS among controls. More than a half of the CS has been smoking 21-40 cigarettes per day (c/day) (54.8%), while in CG members this percent was 29.3%. Group of so called “heavy” smokers (> 40c/day), includes 13.7% of patients, and only 4% from CG. Majority of CS with LarC had smoking length, ranging from 31-45 years (56.2%). CS had 16.03 (95% CI, 6.25-41.12), times significantly higher risk to become ill from LarC, compared with NS. CS who were smoking < 20 c/day had 10.49 (95% CI, 3.87-28.45), while those who were smoking > 20 c/day, had 45.6 (95% CI, 16.55-125.67), times significantly higher risk to become ill, compared with NS. Univariate analysis in CS showed significantly higher risk for the persons to become ill, who were smoking > 40 years, compared with those who were smoking < 40 years (OR=3.73; 95% CI 2.03-6.84). The risk of occurring LarC has been four times (95% CI, 2.35-7.88), significantly higher in the CS who are smoking > 20 years, > 20 c/day, compared with those, who in the same time period, smoke < 20 c/day. Conclusion: Cigarette smoking is by far the most important risk factor for laryngeal cancer. Concerted control of smoking appears to be an urgent priority in LarC prevention, including efforts to prevent adolescents from starting to smoke.

Association of Low Back Pain with Common Risk Factors: A Community Based Study

2014 ◽  
Vol 25 (2) ◽  
pp. 50-55 ◽  
Author(s):  
Mohammad Moin Uddin ◽  
Aminuddin A Khan ◽  
Ahsanul Hoque Chowdhury ◽  
Ranjan Kumar Guha
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Back Pain ◽  
Back Pain ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Body ◽  
Control Group ◽  
Low Back ◽  
Community Based

Abstract Background Low back pain is very common in Asian communities. It is a major cause of activity limitation. Its risk factors were not studied well in Asian communities. This study was performed in the rural area to see the association of some common posture related and modifiable risk factors of low back pain. Methods This is a community based case-control study. Participants of both sexes between 30 and 60 years were selected who had low back pain. Data were collected with a semi-structured questionnaire and fifty-one participants were interviewed from which 32 had back pain (cases). Risk factor association was compared with age and ethnicity matched 19 patients without low back pain (control group). Results The point prevalence of low backache was 63%. Mean age of the patients was 45.8 (±10.8 SD) years. Seventy per cent of the back pain patients were females and 30% were males. Back pain was significantly associated with the risk factor ‘bending and twisting movements of the body’ (OR= 4.6 with 95% CI= 1.1 to 18.9, p= 0.041). It was not found to be significantly associated with the other studied risk factors. Conclusion Low back pain had a very high prevalence in rural Bangladesh. Bending and twisting movements of spine was the only posture related significant risk factor of low back pain.

Risk factors and prophylaxis of irinotecan induced cholinergic syndrome in sight of supportive care.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 216-216
Author(s):  
Hiroyuki Fujii ◽  
Taizo Hirata ◽  
Takuya Mura ◽  
Yuko Okada ◽  
Takuo Ito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Response Rate ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Anticancer Therapy ◽  
Cancer Type ◽  
Chemotherapeutic Regimen ◽  
Cholinergic Syndrome

216 Background: Irinotecan Induced Cholinergic Syndrome (IICS), manifesting in such events as early diarrhea and diaphoresis, is well-known adverse effect of irinotecan. These symptoms occur within the first 24 hours of irinotecan administration and can be ameliorated with anticholinergic agents. Although IICS is transient and tends to be underestimated, diarrhea and abdominal pain during drug infusion are inflictive and make patients reluctant to undergo anticancer therapy. Methods: First, to identify the risk factors that are associated with IICS, 132 consecutive patients who were treated with a chemotherapeutic regimen that included irinotecan at Kure Medical Center between 2012 and 2017 were retrospectively analyzed from the aspect of sex, age, dose, cancer type, regimen, kidney function, and renal function. Secondly, to determine the response rate of butylscopolamine bromide for IICS, we injected butylscopolamine bromide 20mg into the irinotecan infusion bag and administered both agents through the intravenous line together to patients who experienced IICS. Results: IICS occurred 14 of 132 patients (10.6%); these 14 patients were given butylscopolamine bromide by coinjection for total 119 cycles. Univariate analysis indicated that dose (p = 0.0029), cancer type (p = 0.0023) and regimen (p = 0.0005) was associated with IICS. Patients with symptoms tended to be administered a higher irinotecan dose than those without symptoms (127.9±20.4mg/m2 and 99.6±34.1mg/m2). By logistic regression analysis, a higher dose (dose > 105mg/m2) was identified a significant risk factor for IICS (Odds Ratio = 10.9; 95% Confidence Interval: 2.0 to 96.7; p = 0.0121). 13 patients (105 cycles) of 14 patients (119 cycles) who were administered butylscopolamine bromide, experienced complete or partial improvement of IICS. The response rate was nearly 90%. Conclusions: A higher dose of irinotecan is a significant risk factor for IICS. To avoid creating a disincentive for patients to undergo anticancer therapy, the prevention of IICS is paramount. As prophylaxis of IICS, mixing butylscopolamine bromide into the irinotecan infusion bag was remarkably effective.

scholarly journals Asphyxia as a Risk Factor for Neonatal Hypoglycemia

2018 ◽  
Vol 37 (2) ◽  
pp. 111-116
Author(s):  
Luthfina Mufidati ◽  
Alifah Anggraini ◽  
Tunjung Wibowo
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Large For Gestational Age ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
Cohort Data

Introduction: Hypoglycemia leads to brain developmental disturbances and abnormality on its function. Perinatal stress including asphyxia is a significant cause of neonatal hypoglycemia, thus, it is important to prevent it by controlling its relevant confounding variables. The aims of this study were to identify the risk factors of neonatal hypoglycemia and its related variables, focusing on the role of asphyxia in neonatal hypoglycemia.Material and Methods: We conducted a nested case control study using a cohort data from South East Asia Regional Neonatal-Perinatal Database year 2013 of the Maternal and Perinatal Unit, Dr. Sardjito General Hospital Yogyakarta. We randomly selected neonatal hypoglycemia as a case and neonatal without hypoglycemia as a control group. We identify the risk factors from the cohort data. Logistic regression analyses were performed to investigate the association between hypoglycemia and risk factors.Results: A total of 1563 newborns were recruited in this study. Five hundred and twenty newborns were excluded due to incomplete data and major congenital anomalies. By simple randomization sampling, we selected 52 newborns in cases group and 104 newborns in control group. In multivariate models, being asphyxia, low birth weight (LBW), large for gestational age (LGA), and early onset of neonatal sepsis showed significant effects on risk of hypoglycemia, OR= 2.8 (95% CI: 1.01 – 7.80), OR 7.1 (95% CI 1.54-32.37), OR 37.2 (95% CI 6.28-219.85), and OR 40.6 (95% CI 10.84-152.01), respectively.Conclusion: Asphyxia, LBW, LGA and early onset neonatal sepsis were significant risk factor for neonatal hypoglycemia.

Evaluation of Hospital Room Assignment and Acquisition of Clostridium difficile Infection

2011 ◽  
Vol 32 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Megan K. Shaughnessy ◽  
Renee L. Micielli ◽  
Daryl D. DePestel ◽  
Jennifer Arndt ◽  
Cathy L. Strachan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clostridium Difficile ◽  
Tertiary Care ◽  
Significant Risk ◽  
Extended Period ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Icu Discharge

Background and Objective.Clostridium difficile spores persist in hospital environments for an extended period. We evaluated whether admission to a room previously occupied by a patient with C. difficile infection (CDI) increased the risk of acquiring CDI.Design.Retrospective cohort study.Setting.Medical intensive care unit (ICU) at a tertiary care hospital.Methods.Patients admitted from January 1, 2005, through June 30, 2006, were evaluated for a diagnosis of CDI 48 hours after ICU admission and within 30 days after ICU discharge. Medical, ICU, and pharmacy records were reviewed for other CDI risk factors. Admitted patients who did develop CDI were compared with admitted patients who did not.Results.Among 1,844 patients admitted to the ICU, 134 CDI cases were identified. After exclusions, 1,770 admitted patients remained for analysis. Of the patients who acquired CDI after admission to the ICU, 4.6% had a prior occupant without CDI, whereas 11.0% had a prior occupant with CDI (P = .002). The effect of room on CDI acquisition remained a significant risk factor (P = .008) when Kaplan-Meier curves were used. The prior occupant's CDI status remained significant (P = .01; hazard ratio, 2.35) when controlling for the current patient's age, Acute Physiology and Chronic Health Evaluation III score, exposure to proton pump inhibitors, and antibiotic use.Conclusions.A prior room occupant with CDI is a significant risk factor for CDI acquisition, independent of established CDI risk factors. These findings have implications for room placement and hospital design.

scholarly journals Study of Risk Factor for Congenital Heart Diseases in Children at Rural Hospital of Central India

2013 ◽  
Vol 33 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Amar M Taksande ◽  
Krishna Vilhekar
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Significant Risk ◽  
Central India ◽  
Significant Risk Factor ◽  
Control Group ◽  
History Of

Introduction: Congenital heart disease is the most common congenital problem that accounts for up to 25% of all congenital malformations. Hence this study was aimed at improving the knowledge related to risk factors associated with CHD in a rural Indian scenario. It was a hospital- based case control study. Materials and Methods: The children up to twelve year of age with clinical suspicion of CHD were subjected to chest x-ray and electrocardiography, and final diagnosis was confirmed by echocardiography (n=209) as cases. The control group (n=418) were randomly selected from children without CHD who were admitted during the same period. The etiological factors like environmental, infections, drugs, and maternal factors were analyzed by using EPI 6 version. Results: In cases group, 56% were male and 44% female children. 82% cases presented at age of less than 5 years and 18% after 5 year. Exposure to smoking (OR=10.45), tobacco intake by mother (OR=8.28) and family history of CHD (OR=7.21) were the significant risk factor present in cases. Conclusion: The risk factors for CHD child identified were exposure to smoking and tobacco intake by mother, family history of CHD, antenatal infection in 1st trimester and history of diabetic mother. DOI: http://dx.doi.org/10.3126/jnps.v33i2.8254   J Nepal Paediatr Soc. 2013; 33(2):121-124

Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

2020 ◽  
pp. 1-7
Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Risk Adjustment ◽  
Community Hospital ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bivariate Analysis ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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