Regression Odds Ratio Research Articles

Seasonal affective disorder associate with common chronic diseases and symptoms in a population-based study

BackgroundSeasonal affective disorder (SAD) is a recurrent mood disorder with 22%–42% of the patients experiencing symptoms even after 5–11 years after diagnosis, and 33%–44% developing non-seasonal symptoms. The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases in the general Finnish population.MethodsThe global seasonality score (GSS) and the experiences of problems due to the seasonal variations from FINNRISK 2012 dataset were used to measure the seasonality in 4689 Finns aged 25–74 years living in five geographical regions in Finland, and assess their association with common non-communicable diseases (NCDs). The regression models and odds ratios were adopted to analyze the associations adjusted for covariates.ResultsThe prevalence of SAD in the Finnish general population is 21%. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood and energy level, while 40% had seasonal variations is weight and appetite. Angina pectoris and depression were significantly associated with seasonality, including seasonal variations in sleep duration, mood, weight, appetite, social activity and energy level. Depression was significantly associated with the increased odds for experiencing a problem due to the seasonal variations (OR = 4.851, P < 0.0001) and SAD symptoms (OR = 4.075, P < 0.0001), and with the GSS (P < 0.0001).ConclusionOur data suggest that seasonality is associated with depression and angina pectoris. The co-occurrence of the seasonal variations in mood and behavior with common NCDs warrants the need for future research to have insights into the etiology and potentially shared pathways and mechanisms of action.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Retrospective study of low-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy

Objective To evaluate the efficacy of 30％ and 50％ dose photodynamic therapy (PDT) for acute central serous chorioretinopathy (CSC).Methods A retrospective cohort study.Ninety-two eyes of 88 patients with CSC,diagnosed by best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR),indirect ophthalmoscope,fundus colorized photography,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (SD-OCT) treated with 30％ and 50％ doses of verteporfin respectively between March 2007 and August 2013,were enrolled.The eyes were divided into 50％ dose group (49 eyes) and 30％ dose group (43 eyes).The differences of age (t=-1.45),gender (x2=0.011),eyes (x2 =2.140),mean logMAR BCVA (t=-0.40),mean central retinal thickness (CRT) and the maximum thickness of serous retinal detachment (SRD) between two groups were not significant (P＞0.05).The difference of spot size between two groups was significant (t=-2.84,P＜0.05).The follow-up time was ranged from 6 to 68 months,with a mean of (17.16 ±11.30) months.The difference of follow-up between two groups was significant (P＞0.05).The BCVA,cure rate,recurrence rate and the changes of CRT and maximum SRT were observed by SD-OCT.Results The subretinal fluid (SRF) of 31 eyes (72.09％) in the 30％ dose group and that of 47 eyes (95.92％) in the 50％ dose PDT group was absorbed completely respectively.The cure rates in the 30％ dose PDT group was significantly less than that in the 50％ dose group (x2=10.077,P=0.020).There was a significant negative association between the cure rate and spot size by Logistic regression (odds ratio＞1,P=0.040).The difference of changes in the BCVA of logMAR in 50％ dose group was better than that in 30％ dose group after more than 12 months after PDT (P=0.036).On 3,6,12 and more than 12 months after PDT,the difference in CRT in 50％ dose group and 30％ dose group were not statistically significant (P =0.068,0.060,0.082,0.067).The difference in maximum thickness of SRD was not statically significant (P＞0.05).SRF was appeared in 8 eyes (25.81％) of 31 eyes in the 30％ dose group,while SRF was appeared in 1 eye (2.13％) of 47 eyes in the 50％ dose group.The recurrence rate of 30％ dose group was much higher than that of 50％ dose group (P＜0.05).Conclusions For acute CSC treated by PDT,the curative effect of 50 ％ dose group is better than the 30 ％ dose group. Key words: Central serous chorioretinopathy /therapy; Photosensitizing agents/administration & dosage; Photochemotherapy; Treatment outcome

Developing a predictive tool for post-operative delirium in orthopaedic settings in Hong Kong

Summary Aims A prospective study was conducted to develop a Common Risk-factor Assessment Predictive Tool (CAP) for identifying factors associated with post-operative delirium (POD) in orthopaedic surgery. A high, moderate and low risk score system was developed. The incidence rate of POD was also determined. Background POD has been reported as contributing to complications and poor outcomes, consequently affecting recovery and health-care provision. Methods Thirteen risk factors were evaluated. Regression coefficient and odds ratios were used to determine the association of the risk factors with POD. These were then used to develop a tool. Validation of these associated risk factors was carried out to check their effectiveness in predicting the development of POD. Findings Fifty nine of 277 patients developed POD. Four major risk factors were identified: visual impairment ( p =0.011; scored as 2), cognitive impairment ( p p =0.028; scored as 3) and use of urinary catheterisation ( p =0.046; scored as 3). Using a 12-point score system the cut-off values were 4.5 (61.0% sensitivity and 85.8% specificity) and 7 (11.9% sensitivity and 95% specificity) respectively. Conclusion The tool can predict different levels of risk for POD. Nurses can use the tool to communicate patients' risk of POD and identify potential preventive strategies.

Association of Anthropometric and Metabolic Variables with Cardiovascular Disease among Urban and Rural Origin

Problem statement: We have examined the prevalence and association of cardiovascular diseases with respect to obesity and metabolic risk factors clustering among urban and rural Punjabi males aged 20-55 years. Obesity has been defined by increased Waist Circumference (WC), Body Mass Index (BMI) and Waist Hip Ratio (WHR). Metabolic traits such as increased total cholesterol, triglycerides and lipoproteins have also detrimental effect on the development of cardiovascular disease. Approach: This cross-sectional study was carried out on a total of 400 urban and rural origin Punjabi males (200 each from urban and rural). The anthropometric, physiometric and metabolic assessments were through standard procedures. Statistical analysis includes descriptive statistics, correlation, multivariate regression analysis and odds ratios. Results: It observed that males of rural population were at a higher risk to develop cardiovascular diseases compared to their urban counterparts. Rural males had significantly (p<0.001) higher mean values of cardiovascular risk factors with respect to BMI, weight, waist circumference, WHR, fasting glucose, total cholesterol, triglyceride, HDL and CHO-HDL ratio. SBP and DBP have positive association with waist-to-hip ratio, body mass index; waist circumference, skinfolds, pulse pressure, alcohol consumptions, food habit, HDL and triglyceride. Conclusion: Cardiovascular disease risk is found more in rural male Punjabi population due to consumption of more dietary products and leading of more sedentary lifestyle due to the overuse of mechanized substances for agriculture and personal use.

Decreased urine albumin:creatinine ratios in infants of diabetic mothers: does exposure to diabetic pregnancies alter fetal renal development?

Offspring of diabetic mothers experience an increased risk for type 2 diabetes but it is not known whether diabetic pregnancies also confer a higher inter-generational risk for diabetic complications. Because microalbuminuria is a sensitive indicator of glomerular damage, we compared the urine albumin:creatinine ratios (ACRs) between 65 infants of diabetic mothers (InfDM+) and 59 infants of non-diabetic mothers (InfDM-), and repeated the comparisons in 21 InfDM+ and 19 InfDM- when children were 5-19 months old. ACRs were higher among neonates compared with normal reference values for adults, but declined with increasing age. The only independent predictor of higher ACRs in a logistic regression model (⩾13 mg/mmol v. <13 mg/mmol) was the presence of delivery complications (odds ratio 2.95; P = 0.015). Neither high nor low birth weight was associated with higher neonatal ACRs. The most unique finding of the study was that InfDM+ had significantly lower ACRs than InfDM- [mean = 12.9 (median = 6.0) v. mean = 16.6 (median = 11.5), respectively at P = 0.05] even after adjusting for other variables using logistic regression (odds ratio 0.25; P = 0.001). In contrast, by 5-19 months, there was a trend toward higher ACRs among InfDM+ compared with InfDM- [mean = 6.3 mg/mmol (median = 1.9) v. mean = 3.0 mg/mmol (median = 2.5), respectively at P = 0.25]. Lower ACRs in InfDM+ may be due to developmental changes in fetal kidneys induced by hyperinsulinemia. Although the implications of this observation are unclear, it is possible that exposure to a diabetic intrauterine environment might influence the later risk for renal disease.

Abstract 5569: The association between statin use and risk of biochemical recurrence in men treated with radical prostatectomy in a cohort of men with inherited forms of prostate cancer

Abstract Background: Evidence exists that statin medications are associated with decreased risk of advanced prostate cancer. The risk factors for prostate cancer are increasing age, African-American race and family history of the disease. To date, studies of the association between statin medication and risk of prostate cancer have not considered men with familial or hereditary prostate cancer. Methods: Men enrolled in the University of Michigan Prostate Cancer Genetics Project (PCGP) who had been previously diagnosed with prostate cancer and treated with radical prostatectomy were surveyed as to their past and current statin medication use status, type of statin medication, duration of statin medication use and their incidence of biochemical recurrence. PCGP is a large, family-based study of inherited forms of prostate cancer. The PCGP enrollment criteria included families with two or more living-affected family members in a first-degree or second-degree relationship. The risk of biochemical recurrence (BCR) was modeled using logistic regression models and odds ratios and 95% confidence intervals were calculated. Results: Of 595 unrelated men with past radical prostatectomy surveyed, 91 men experienced BCR. At time of survey, 40% of men were current statin users. Median follow-up time was 67 months for statin users was 75 months for non-statin users. Current statin-use at time of recurrence was associated with a decreased risk of BCR (OR = 0.685; 95% C.I.:0.438 – 1.072; p=0.09); while ever statin-use was not associated with risk of BCR in multivariate models adjusted for age and BMI. Discussion: This represents the only study to date to assess statin medication use and the risk of biochemical recurrence in men with familial and hereditary prostate cancer. Given the importance of family history as a risk factor for prostate cancer, these findings should be confirmed in other studies and may implicate subgroups of men at risk for prostate cancer who may benefit from statin medication use. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5569. doi:10.1158/1538-7445.AM2011-5569

Artificial intelligence, complex system analysis and simulation modeling for early detection of lung cancer

18127 Background: Early detection (ED) of non-small cell lung cancer (LC) is the key to the cancer problem solving and practically regulates effectiveness of surgery. We examined immunologic factors associated with early LC. Methods: In trial (1987–2006) the data of consecutive and monitored 94 LC patients (LCP) after lobectomies (age=58.3±0.8 years; tumor size=2.32±0.07 cm; m=80, f=14) with pathologic stage IA (T1N0M0) (squamous=36, adenocarcinoma=53, large cell=5; G1=32, G2=38, G3=24), 282 patients with lung non-malignant pathology (NMP) (m=188, f=94; pneumonectomies=5, lobectomies=179, segmentectomies=98; non-malignant tumours=100; abscess=112; tuberculoma=70) and 120 healthy donors (HD) (m=69, f=51) were reviewed. Variables selected for ED study were input levels of 64 immunity blood parameters, sex, age. Representativeness of samplings was reached by means of randomisation based on unrepeated random selection. Logistic regression, clustering, discriminant analysis, neural networks computing, structural equation modeling, Monte Carlo and bootstrap simulation were used to determine any significant regularity. Results: Logistic regression modeling displayed that ED of LC significantly depended on: CD8, CD4, CD16, neutrophils, monocytes (P=0.002–0.041). Neural networks computing, genetic algorithm selection and bootstrap simulation discovered relationships between early LC and blood lymphocytes (rank=1), T-lymphocytes (2), CD4 (3), CD16 (4), B- lymphocytes (5), CD1 (6), NST-A2 (7), CD8 (8), NST-SP (9), NST-A1 (10), monocytes (11), eosinophils (12). Conclusions: Correct recognition of LCP with stage IA (T1N0M0) from NMP and HD was 81.7% by logistic regression (odds ratio=6.39), 84.1% by discriminant analysis and 99.2% by neural networks computing (area under ROC curve=0.99; error=0.063). No significant financial relationships to disclose.

Demographic Indicators and Risk of Infection with Human Herpesvirus Type 8 in Central Italy

A cross-sectional study was conducted in Latium and Abruzzo Regions (Central Italy) to estimate the prevalence of infection with human herpesvirus type 8 (HHV-8) and the association between demographic indicators and risk of HHV-8 infection. Sera from 416 healthy individuals (>or=45 years of age), originally recruited in a multicentric case-control study on classic Kaposi's sarcoma (KS), were tested for antibodies against HHV-8. The association between demographic indicators (i.e., urban/rural residence, occupation) and HHV-8 seropositivity was assessed by means of multiple logistic regression (MLR) odds ratios (OR) and 95% confidence intervals (CI), adjusted for age and occupation. Overall, 20.4% of the study participants had antibodies against HHV-8, 23.2% of the men and 17.0% of the women (p = 0.15). HHV-8 seropositivity rates significantly increased with age (p = 0.01), from 10.0% in those under 65 years of age to 24.9% in 75 years or older (MLROR = 2.4). By multivariate analysis, a significantly 2-fold higher risk of HHV-8 was found in individuals living in rural areas, as compared to those living in metropolitan/urban areas (MLR-OR = 2.0, 95% CI: 1.1-3.5), and in farmers, as compared to white collars (MLR-OR = 2.1, 95% CI: 1.1-4.1). The study findings suggest that demographic factors such as age, urban/rural residence, and occupation are associated with HHV-8 seropositivity among adult individuals living in central Italy.

Artificial intelligence, complex system analysis and simulation modeling in recognition of N1–2 lymph node metastases of non-small cell lung cancer

17123 Background: Precise recognition of N1–2 lymph node metastases (RLN) of non-small cell lung cancer (LC) means great importance in prediction LC patients (LCP) survival after surgery. We examined the immunologic factors associated with LCP with N0 and N1–2. Methods: In trial (1987–2005) the data of consecutive 289 LCP after complete pneumonectomies/lobectomies and mediastinal lymph node dissection (age = 58.1 ± 0.5 years; tumor size = 4.4 ± 0.1 cm; m = 260, f = 29) with pathologic stage I-III (T1–4N0–2M0) (squamous = 169, adenocarcinoma = 102, large cell = 18; G1 = 67, G2 = 110, G3 = 112; T1 = 100, T2 = 114, T3 = 54, T4 = 21; N0 = 147, N1 = 70, N2 = 72; pneumonectomies = 135, bi/lobectomies = 154) was reviewed. Variables selected for ED study were input levels of 64 immunity blood parameters, sex, age. Representativeness of samplings was reached by means of randomisation based on unrepeated random selection. Logistic regression, clustering, discriminant analysis, neural networks computing, structural equation modeling, Monte Carlo and bootstrap simulation were used to determine any significant regularity. Results: Logistic regression modeling displayed that RLN of LC significantly depended on: CDw26, CD16, phagocytic number, ratio of lymphocytes, T-lymphocytes, CD4+2H to LC cells (P = 0.003–0.043). Neural networks computing, genetic algorithm selection and bootstrap simulation revealed relationships between N1–2 and blood IgM (rank = 1), eosinophils (2), T-lymphocytes (3), CD8 (4), phagocytic number (5), CD8+VV (6), CDw26 (7), B-lymphocytes (8), IS2 (9), CD4 (10), CD4+2H (11), NST-A2 (12), monocytes (13), index of thymus function (14), IgA (15). Conclusions: Correct RLN of LC was 79.2% by logistic regression (odds ratio = 15.65), 82.0% by discriminant analysis and 99.6% by neural networks computing (area under ROC curve = 0.99; error = 0.059). No significant financial relationships to disclose.

Early coping strategies do not influence the prognosis after whiplash injuries

This is a 1-year prospective study to investigate the prognostic value of coping strategies such as catastrophising for persistent pain after a whiplash injury. A consecutive series of 96 patients who were seen in the emergency room in the acute phase after the injury were followed prospectively for 1 year. Age, gender and whether or not pain in the neck preceded the accident was recorded. Cases involving fractures or dislocations of the cervical spine, head trauma or pre-existing neurological disorders were not included. The mean interval between the accident and the initial examination was 3+/-2(S.D.) days. Coping was measured using the Coping Strategies Questionnaire (CSQ). The outcome parameter was self-reported neck pain at 1 year after the motor vehicle accident. At 1 year, 34% of the patients had neck pain. Women developed chronic neck pain more often than men (71% versus 29%); they also had significantly higher coping activity, such as diverting attention, praying or hoping (p<0.05), catastrophising and increasing behavioural activities (p<0.0001). Women reported pain in the neck or shoulder more often before the accident and this was the only statistically significant predictor of chronic symptoms when analysed by logistic regression (odds ratio 4.5). To conclude, we found no evidence that the different coping patterns during the early phase after a whiplash injury influenced the prognosis.

Predictors of invalid neuropsychological test performance after traumatic brain injury

Objective: To investigate the usefulness of the Test of Memory Malingering (TOMM) and the California Verbal Learning Test-Second Edition (CVLT-II) in assessing invalid test performance after traumatic brain injury (TBI).Design: Consecutive 3-year series of rehabilitation referrals (n = 132).Methods and procedures: Percentage of participants who failed validity criteria was determined. Hierarchical logistic regression analysis and odds ratios were used to identify predictors of invalid test performance.Results: Twenty patients (15%) performed in the invalid range when held to a priori specified criteria for invalid test performance (i.e. TOMM <45/50 on Trial 2 or CVLT-II <15/16 on Forced-Choice recognition trial). Both psychiatric history and financial compensation seeking were associated with an almost 4-fold increase in likelihood of invalid responding.Conclusions: The TOMM and CVLT-II are sensitive to the potential impact of current financial compensation seeking and prior psychiatric history on neuropsychological test performance after TBI.

A Review of Some Individual- and Community-Level Effect Size Indices for the Study of Risk Factors for Child and Adolescent Development

This article discusses the computation and application of various epidemiological measures of effect in educational and developmental research. Specifically, epidemiology provides a potentially important perspective for studies identifying risk factors for healthy child development. For example, it allows for the examination of both individual-level risk (the impact of risk factors on individuals experiencing them) and community-level risk (the impact of risk factors on the overall number of cases within a population). In terms of individual-level risk, issues related to the use and interpretation of the risk-ratio, the odds-ratio, and the logistic regression odds-ratio are reviewed. In addition, community-level measures of effect, such as the population-attributable fraction percentage, are examined. Implications of the design methodology (cohort study, case-control study, or representative study) on the choice and use of these measures of effect are discussed. Data from a large-scale ongoing project in developmental epidemiology are presented throughout the article for illustrative purposes.

Coinfections by HIV, hepatitis B and hepatitis C in imprisoned injecting drug users.

In order to know the prevalence and risk factors for coinfections by human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among injecting drug users (IDUs), a cross-sectional study was carried out in two prisons of the province of Cantabria, northern Spain. Three hundred and sixty-two IDU inmates were recruited. All inmates were interviewed and their blood tested for HIV, HBV and HCV. Crude and multiple risk factor adjusted for (by polychotomous logistic regression) odds ratios were calculated. Prevalence of HBV-HCV coinfection (42.5%) was higher than HIV-HBV-HCV coinfection (37.3%), whereas monoinfections were very uncommon (overall: 13%). Long-term injectors and reincarceration were the foremost risk factors for both coinfections, showing a trend between the degree of association and the number of viruses infecting a patient. No significant relationship between coinfection status and sexual practices was observed. The results related to coinfections are consistent with previous studies of prevalence and risk factors for HIV, HBV and HCV, in indicating that the high rates of coinfections among IDU inmates emphasise the need to harm-reduction policy across prisons in Spain.

Risk factors for cervical presence of human papillomavirus DNA among women at risk for HIV infection. DIANAIDS Collaborative Study Group.

Risk factors for cervical infection with human papillomavirus (HPV) were assessed among 236 Italian women at risk for human immunodeficiency virus (HIV) infection (intravenous drug users (IVDU) or sexual partners of males at risk for HIV infection). All study participants underwent a structured interview, determination of HIV serostatus and detection of HPV cervical infection by means of polymerase chain reaction (PCR). Overall, the cervical presence of HPV DNA was ascertained in 86 of these 236 women (36.4%), while squamous intraepithelial lesions (SIL) were diagnosed in 57 (24.1%). HPV-infected and non-infected women did not differ in age, education and cigarette smoking. A statistically significant trend in the risk of HPV infection with increasing number of lifetime sexual partners was noted (P = 0.01), but such trend was attenuated in multivariate analysis (multiple logistic regression (MLR) odds ratio (OR) for > or = 20 partners vs 1 = 1.6, 95% confidence intervals (CI): 0.4-5.9). A nearly threefold higher risk of HPV cervical infection emerged among IVDU women (MLR-OR: 2.7, 95% CI: 1.4-5.0), and this difference was not influenced by HIV serostatus. The prevalence of HIV infection was higher among HPV-positive than HPV-negative women (62.8% and 54.0%, respectively) (MLR-OR = 1.9, 95% CI: 0.9-3.8), and the proportion of women with less than 200 CD4+ cells/mm3 was slightly and not significantly higher among HPV-positive (47.1%) than negative women (37.2%).

Vaginal infection and preterm labour

To study the vaginal flora of women in preterm labour (PTL) and determine whether the presence of specific vaginal microflora is significantly associated with onset of PTL. A comprehensive prospective study of the vaginal microflora of women in early labour comparing women in PTL with term controls. Microbiological assessment included cultures for aerobic and anaerobic bacteria, yeasts, genital mycoplasmas and Trichomonas vaginalis. Multiple logistic regression analysis was used to adjust for confounding obstetric and demographic variables. The Queen Victoria Hospital, Adelaide. 428 Women in PTL compared to 568 women in labour at term. PTL and preterm prelabour rupture of membranes (PPROM) in relation to specific vaginal microflora. After multiple logistic regression analysis, two distinct bacteriological groupings were associated with PTL less than 37 weeks gestation, namely, the bacterial vaginosis group of organisms, Gardnerella vaginalis and Bacteroides spp., and a group of enteropharyngeal organisms, E. coli, Klebsiella spp., Haemophilus spp. and S. aureus. G. vaginalis was found in 12% of women in PTL compared to 6% at term [regression odds ratio (ROR) 1.8, 95% confidence intervals (CI) 1.1-3.1] whereas Bacteroides spp. were detected in 45% of women in PTL compared with 35% at term (ROR 1.6, CI 1.2-2.1). The prevalence of G. vaginalis (17%) and Bacteroides spp. (50%) was even higher in women in PTL less than 34 weeks gestation. The enteropharyngeal group of organisms were more commonly present in women in PTL less than 37 weeks (E. coli 10% vs 6%, ROR 1.4, CI 0.8-2.4; Klebsiella spp. 3% vs less than 1%, ROR 5.4, CI 1.1-26.7; Haemophilus spp. 2% vs less than 1%, ROR 5.5, CI 1.1-28.6; S. aureus 6% vs 4%, ROR 1.8, CI 0.9-3.3) and were isolated even more frequently in women in PTL less than 34 weeks (E. coli 15%; Klebsiella spp. 4%; S. aureus 7%). Bacteroides spp., Klebsiella spp., and Haemophilus spp. were all found to be associated with PPROM. There are two distinct bacteriological groupings commonly found in women in PTL, especially in PTL less than 34 weeks gestation. These bacteriological groups are women with bacterial vaginosis in pregnancy and women who demonstrate enteropharyngeal bacteria in the vagina.