Fold Increase In Odds Research Articles

The intergenerational association of preterm birth: A systematic review and meta-analysis.

Around half of preterm births lack identifiable causes, indicating the need for further investigation to understand preterm birth risk factors. Existing studies on the intergenerational association of preterm birth showed inconsistency in effect size and direction. This systematic review and meta-analysis aimed to review existing studies and provide comprehensive evidence on the intergenerational association of preterm births. We searched MEDLINE, Embase and Maternity and Infant Care databases, from the inception of each database to 04 April 2024. Eligibility criteria included studies that reported on women who had given birth and had recorded information about a family history of preterm birth in one or both of the child's biological parents. Data were extracted by two independent reviewers. A random-effects model was used to compute pooled estimates using odds ratios. Sixteen eligible studies with a total of 2 271 612 mothers were included. The findings indicated a 1.44 (OR = 1.44, 95% CI: 1.34, 1.54) fold increase in odds of giving preterm births among women who were born preterm. Additionally, having a sibling born preterm (OR = 1.53, 95% CI: 1.24, 1.87) and having a partner born preterm (OR = 1.12, 95% CI: 1.01, 1.25) were associated with increased likelihood of giving preterm births among women. The study revealed that women with a family history of preterm birth face an increased risk of giving preterm births. Screening pregnant women for a family history of preterm birth is essential, with those having a positive family history requiring closer follow-up.

Patient factors associated with unplanned sedation after intra-articular lidocaine for shoulder dislocation

BackgroundRecent evidence suggests that intra-articular lidocaine (IAL) is an appropriate analgesic alternative to intravenous sedation (IV sedation) during shoulder dislocation reduction, however little is known about patient factors associated with IAL failure and need for subsequent IV sedation. Avoiding crossover is important, as repeated reduction attempts have been previously shown to increase the rate of procedural complications. ObjectivesTo identify patient level factors associated with crossover from IAL to IV sedation and associated complication rates and operational impacts. MethodsThis retrospective observational cohort study evaluated the patient characteristics associated with crossover to unplanned IV sedation after IAL among adult patients undergoing ED reduction of an isolated, acute anterior shoulder dislocation from 2013 to 2021 in an urban, academic hospital system. Univariate analysis and multivariate logistic regression were used. ResultsIn total, 630 participants were identified who received IAL or procedural sedation. Of these, 182 (28.9 ​%) received IAL of whom 49 (26.9 ​%) subsequently required unplanned IV sedation. Participants had 1.205 (95 ​% CI 1.030, 1.418) fold increase in odds of unplanned sedation for every 10-year increase in age. Crossover to IV sedation was associated with greater rates of adverse events, ED length of stay, and quantity of opioids received compared to either IAL or IV sedation alone. ConclusionsParticipants with unplanned IV sedation after IAL had more adverse events than those who received either method alone. Older age was associated with unplanned sedation after IAL. Prospective studies are needed to further define patient factors likely to contribute to failure of IAL.

The determinants of pregnancy health literacy among youth in Bogalay Township, Ayeyarwaddy Region, Myanmar

Background: Focusing on adolescent reproductive health is very important, as 16% of the world's population is adolescents. This study aimed to identify the determinants of teenage pregnancy health literacy among youth and explore the perception of teenage pregnancy among youth and their guardians.Methods: We conducted a cross-sectional study with a mixed-method approach to identify the determinants and perception of pregnancy health literacy among youth in Bogale Township, Ayeyarwaddy region, Myanmar, between July and December 2020. We did the face-to-face personal interviews with guided self-administered questionnaires among 310 youth and individual depth interviews with 12 youth and 12 of their parents.Results: About 43% (95% CI 37.1%, 48.1%) were well-versed in pregnancy health literacy issues. This study discovered that youth with high school education and less had a 6.8 (95% CI =1.4, 34.7) fold increase in odds of having poor pregnancy health literacy compared to those with higher education. Moreover, youth who could not earn their income was approximately 5.7 times more likely to have poor pregnancy health literacy than those who could earn. The majority of youth requested to disseminate reproductive health information through various media and channels and that health facilities be well-equipped to provide reproductive health care services to teenagers.Conclusions: Sexual and reproductive health education/teaching programs and adolescents-friendly reproductive health services should be effectively implemented to prevent teenage pregnancy and ensure safer sex practices among teenagers. School-based sexual education programs must involve and assist parents and teachers in taking a more active role in SRH education in schools.

Poor Appetite Is Associated with Six Month Mortality in Hospitalised Older Men and Women.

Appetite loss is common in hospitalised older individuals but not routinely assessed. Poor appetite in hospital has previously been identified as predictive of greater mortality in the six months following discharge in a single study of female patients. The present study aimed to assess this association in a larger sample including both hospitalised men and women. Longitudinal observational study with six month follow up. Acute hospital wards in a single large hospital in England. Older inpatients aged over 70 years. Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) during hospital stay. Deaths during six month follow-up period were recorded. Association between SNAQ score during hospital admission and death 6 months post-discharge was assessed using binary logistic regression in unadjusted and adjusted analysis. 296 participants (43% female, mean age 83 years (SD 6.9)) were included in this study. Prevalence of poor appetite (SNAQ score <14) was 41%. In unadjusted analysis a SNAQ score of <14 was associated with a 2.47 increase in odds of mortality at six months (OR 2.47 (95% CI 1.27,4.82)). This association remained after adjusting for number of comorbidities (Charlson index), length of stay and gender (OR 2.62 (95% CI 1.30, 5.27)). In unadjusted continuous analysis, every one point decrease in SNAQ score led to a 1.20 fold increase in odds of mortality at six months (OR 1.20 (95% CI 1.06-1.36)). This association remained in adjusted analysis (OR 1.22 (95% CI 1.07-1.39)). Poor appetite is common in hospitalised older people. We have confirmed the association, previously reported in older women, between poor appetite during hospital stay and greater mortality at six months post-discharge but in a larger study including older men and women. Further research is needed to understand the mechanisms of poor appetite, which lead to increased mortality.

Bioaerosol production by patients with tuberculosis during normal tidal breathing: implications for transmission risk

BackgroundThe size and concentration of exhaled bioaerosols may influence TB transmission risk. This study piloted bioaerosol measurement in patients with TB and assessed variability in bioaerosol production during normal tidal...

Relationship between handedness and persistent emotional distress in adults experiencing an earthquake.

Post-traumatic emotional distress follows exposure to trauma and may be affected by atypical cerebral lateralisation. We aimed to explore the relationship between handedness and emotional dysfunction in people exposed to a nat-ural disaster. About 22 months after an earthquake, 326 exposed adults completed the Edinburgh Handedness Inventory, the Impact of Events Scale-Revised, and the Insomnia Severity Index. Mixed-handed people, compared to right-handed, had a 3.3 fold increase in odds to have emotional distress. Consistent left-handers scored higher than consistent right- and mixed-handers on the ISI scale. Findings support that lateral preference is associated with emotion-al distress in people exposed to trauma.

A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus

AimsWomen with gestational diabetes (GDM) have a 20% risk of developing diabetes in the 10 years following pregnancy, but the risk may be as high as 70% in higher risk populations. Guidelines recommend screening for diabetes postpartum, but screening rates are low. We evaluated the effect of a physician reminder on postpartum screening and in women with GDM. MethodsWe conducted a retrospective chart review among women with GDM seen at our urban, academic endocrine clinic in Toronto, Canada between 2006 and 2010. Our primary outcome was to evaluate the effect of a reminder checklist on postpartum diabetes screening rates. ResultsWe included 314 women in our study, 173 had a checklist on their chart. Women had a mean age of 34.9 years, 45% were Caucasian and 23% had a previous GDM. The checklist was associated with a 3 fold increase in odds of being screened postpartum, and nearly 4 fold increase in postpartum follow up visits (OR 2.99, 95% CI 1.84–4.85 and OR 3.71, 95% CI 2.26–6.11). ConclusionA physician based reminder system is an effective way to improve postpartum screening rates. To further increase screening rates, a multilevel approach targeting both patients and physicians is required.

015 Temporal trends in head injury outcomes from 2003 to 2010 in England and Wales, and the effect of specialist neurosciences care: a Cohort Study

Objectives and BackgroundsHead injury (HI) is the leading cause of death in trauma, and case fatality rates after blunt HI did not improve in England and Wales between 1994 and...

Pooled Analyses of Polychlorinated Biphenyls (PCBs) Exposure and CYP1A1 Genetic Polymorphisms on Breast Cancer Risk

ISEE-0616 Abstract: An increased risk of breast cancer for women with high polychlorinated biphenyl (PCB) body burden has not been established, however, there is emerging evidence that the association between PCB exposure and breast cancer risk is modified by variants in the CYP1A1 gene. To further examine this relationship we pooled and analyzed data from five existing studies with PCB measurements and CYP1A1 genotypes. We assembled five datasets, consisting of 1838 breast cancer cases and 1989 controls. Pooled odd ratios (ORs) and 95% confidence intervals of breast cancer were assessed for PCB quartiles. CYP1A1 polymorphisms (CYP1A1*2C, CYP1A1*2A) and the interaction between PCB levels and these SNPs were estimated using logistic regression. Analyses were stratified European American (EA) or African American (AA), and menopausal status. In pre-menopausal EA women the odds of breast cancer was almost 1.6 times greater in women with the low versus high PCB levels. This effect was reversed in AA women, such that AA women show a 1.3 increase in odds of breast cancer associated with high versus low PCB levels. The only genetic effect of significance was seen in post-menopausal EA women with the CYP21A1*2C variant, who were found to have a 1.5 fold increase in odds of breast cancer. The combined effect of PCB levels and CYP1A1 genotypes on breast cancer demonstrates a significant interaction between high PCB and the CYP1A1*2C variant in postmenopausal EA women (P = 0.026), causing a two fold increase in odds of breast when compared to women with common allele and low PCB levels. There was no significant interaction with CYP1A1*2A. These analyses demonstrate that PCB body burden modifies the odds of breast cancer in AA and EA women differently and that the association between PCBs burden and breast cancer may be modified by CYP1A1*2C polymorphisms among EA postmenopausal women.

An in vivo passive protection assay for the evaluation of immunity in AVA-vaccinated individuals

Samples of human plasma from anthrax vaccine adsorbed (AVA, BioThrax™)-vaccinated individuals were used to demonstrate passive protection of A/J mice from a lethal challenge with the Sterne strain of anthrax bacteria. The maximum concentration of human anti-protective antigen IgG in mouse sera 24 h after injection of 260 μg of anti-PA IgG was 134 μg/ml, declining to 91 μg/ml at 72 h (half-life = 101.7 h). Mice showed significant survival ( p ≤ 0.001) after injection of serial dilutions up to 1:4 of the standard plasma and challenged with 100 LD 50. Similarly, mice injected with the standard anti-AVA plasma and challenged up to 5 days post-treatment also survived ( p ≤ 0.001). Using a cohort of human plasma to measure passive protection, the best correlation between passive protection and an in vitro assay was found to be with the quantitative toxin neutralization assay (minimum fold increase in odds of survival: 2.71, p = 0.0062). These results demonstrate a reliable in vivo neutralization method that correlates with standard in vitro measures of neutralizing antibody levels in plasma from individuals vaccinated with the standard anthrax vaccine. This analytical method may provide additional opportunities to compare the efficacy of improved anthrax vaccines with the licensed vaccine.

Low HDL levels and the risk of death, sepsis and malignancy

High density lipoprotein (HDL) plays an important role as an anti-atherogenic molecule, but also possesses anti-inflammatory and anti-angiogenic properties. The effect of extremely low levels of HDL on the risk of sepsis and malignancy were therefore examined. A retrospective analysis of patients hospitalized at the Edith Wolfson Medical center was conducted. Patients were divided into Group 1: 108 patients with serum HDL levels < or =20 mg/dl. Group 2: 96 patients with serum HDL levels > or =65 mg/dl. Medical history and laboratory data was recorded. The mean HDL levels in Group 1 were 16.1 +/- 33 mg/dl compared to 74.9 +/- 12.6 mg/dl in Group 2. Using a multivariate logistic regression analysis, low HDL was inversely associated with death (OR 0.96, 95% 0.93-0.99, P = 0.02), 3.98 fold increase in odds of fever (OR 3.98, 95% CI 1.3-11.8, P = 0.01), and 6.7-fold increase in the risk of cancer (OR 6.68, 95% CI 1.8-24.5, P = 0.004). HDL serum levels were inversely associated with sepsis. For each 1 mg/dl increase in HDL, a relative 11% decrease in odds of sepsis was observed (OR 0.886, 95% CI 0.8-0.976, P = 0.01). Extremely low serum HDL levels (< or =20 mg/dl) are associated with an increased risk of death, sepsis and malignancy.