Significant Associated Risk Factors Research Articles

Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

Objective. To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006).Study design. Secondary analysis of previously collected data from a nationally representative cross-sectional survey.Results. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor.Conclusion. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

De novo stress urinary incontinence after negative prolapse reduction stress testing for total vaginal mesh procedures: incidence and risk factors

The primary objective was to estimate the incidence of de novo stress urinary incontinence after total vaginal mesh procedures in women with negative preoperative urodynamics with prolapse reduction. Secondary objective was to identify associated risk factors. A retrospective cohort study with a nested case-control study of women who underwent total vaginal mesh procedures without midurethral sling after a negative preoperative urodynamics. Sixty patients were included in the final analysis. Fifteen (25%) patients were diagnosed with de novo stress urinary incontinence. Although no significant associated risk factors were identified, there was a trend for higher gravidity and better anterior wall support among women who had stress urinary incontinence develop. The incidence of de novo stress urinary incontinence after total vaginal mesh procedures in this cohort was 25%. Patients should be appropriately counseled regarding the same.

Caracterización de niños y adolescentes con trastornos del espectro autista en una institución de Bogotá, Colombia

ObjectiveTo determine the profile of children and adolescents diagnosed with autism spectrum disorder (ASD) in a comprehensive care centre in Bogota, Colombia. Material and methodsA descriptive-correlational study with a sample of patients who had attended the institution from 2003 to 2009. Demographic and clinical aspects were evaluated and a correlation between the diagnosis and severity being analysed in search for risk factors. ResultsA total of138 patients were studied. The average age of onset was 21 months, and diagnosis had been made at 45 months. There was a male predominance (6.15:1). The predominant diagnosis was autistic syndrome (83%), followed by pervasive developmental disorder not otherwise specified (17%). There was no pathological background in the family history, during pregnancy or during the neonatal period. Motor development during the first year was normal but acquisition of language skills was compromised. The specific signs of ASD as regards the disorder in itself, communication skills, spontaneous speech, verbal comprehension, attention, imitation, use of objects, self-care and symbolic play were significantly related to the severity of the disease. ConclusionsDiagnosis of ASD is still delayed in our population and usually after referral from someone other than a health professional. The most important problems were found in communication skills and relationships with peers. The study did not show significant associated risk factors.

Recent Korean Perspective of Deep Vein Thrombosis After Total Knee Arthroplasty

This prospective study was performed on 311 consecutive knees in 227 patients for total knee arthroplasty. The aim was to assess the recent incidence of deep vein thrombosis (DVT) after total knee arthroplasty without chemoprophylaxis in Koreans, the efficacy of plasma d-dimer levels as a screening test, and the associated risk factors. Deep vein thrombosis was found in 79 knees (26.60%). There were 9 cases (3.03%) of proximal DVT, 70 cases (23.57%) of distal DVT, and no symptomatic pulmonary embolism. Although this cohort had limited number of patients by a single surgeon, there is still low incidence of proximal DVT in Koreans with rare pulmonary embolism occurrence compared with those of the Western. High postoperative d-dimer levels were correlative, but no appropriate cutoff value was found. Obesity was a significant associated risk factor.

241 Particularities of the epidemiology of lower-extremities peripheral artery disease in Central Africa

In the western countries, a high prevalence of lower-extremities peripheral artery disease (LE-PAD) is reported in the elderly. The epidemiological transition in the developing countries might also involve this affection, but data regarding LE-PAD in Sub-Saharan Africa are unknown. We sought to determine the prevalence and risk factors for LE-PAD in the general elder population in 2 Sub-Saharan African countries: Congo and Central African Republic. We performed 2 cross-sectional studies in the populations aged >65 years in two representative districts of Brazzaville, Congo and Bangui, Central African Republic. Demographic data, as well as medical history, were collected along with clinical and biological data to determine the traditional cardiovascular disease risk factors. The ankle-brachial index (ABI) was used to define LE-PAD, when ABI <0.90. An ABI >1.40 was considered to define medial calcinosis (MC). Among the 997 participants (age 73.6+6.5 yrs, 40.7% males), 239 (24.0%) had LE-PAD, while 69 (6.9%) had MC. Adjusted for age, gender and study site, factors significantly associated with LE-PAD were hypertension (OR=1.75, 95%CI: 1.24-2.48, p=0.002) and daily alcohol consumption (OR=0.72, 95%CI: 0.53-0.98, p=0.04). A borderline association was found with a body-mass index >30kg/m 2 (OR=1.56, 95%CI: 0.95-2.58, p=0.08). Of note, neither smoking nor diabetes were found as significant associated risk factors. Adjusted for age, gender and study site, factors significantly associated with MC were schooling ( vs. no school education, OR=3.20, 95%CI: 1.69-6.04, p=0.0003) and hypertension (OR=0.38, 95%CI: 0.22-0.66, p=0.0006), while alcohol consumption (OR=0.63, 95%CI: 0.37-1.07, p=0.09) and heart rate (OR=1.23, 95%CI: 0.98-1.56, p=0.07) presented a borderline association. In this first population study in Central Africa, we found a very high prevalence of LE-PAD in the elderly, and highlight particularities regarding the associated risk factors, different from data published in western countries.

Respiratory infection in congenital cardiac disease. Hospitalizations in young children in Spain during 2004 and 2005: the CIVIC Epidemiologic Study

To evaluate the rate of hospitalization for acute respiratory tract infection in children less than 24 months with haemodynamically significant congenital cardiac disease, and to describe associated risk factors, preventive measures, aetiology, and clinical course. We followed 760 subjects from October 2004 through April 2005 in an epidemiological, multicentric, observational, follow-up, prospective study involving 53 Spanish hospitals. Of our cohort, 79 patients (10.4%, 95% CI: 8.2%-12.6%) required a total of 105 admissions to hospital related to respiratory infections. The incidence rate was 21.4 new admissions per 1000 patients-months. Significant associated risk factors for hospitalization included, with odds ratios and 95% confidence intervals shown in parentheses: 22q11 deletion (8.2, 2.5-26.3), weight below the 10th centile (5.2, 1.6-17.4), previous respiratory disease (4.5, 2.3-8.6), incomplete immunoprophylaxis against respiratory syncytial virus (2.2, 1.2-3.9), trisomy 21 (2.1, 1.1-4.2), cardiopulmonary bypass (2.0, 1.1-3.4), and siblings aged less than 11 years old (1.7, 1.1-2.9). Bronchiolitis (51.4%), upper respiratory tract infections (25.7%), and pneumonia (20%) were the main diagnoses. An infectious agent was found in 37 cases (35.2%): respiratory syncytial virus in 25, Streptococcus pneumoniae in 5, and Haemophilus influenzae in 4. The odds ratio for hospitalization due to infection by the respiratory syncytial virus increases by 3.05 (95% CI: 2.14 to 4.35) in patients with incomplete prophylaxis. The median length of hospitalization was 7 days. In 18 patients (17.1%), the clinical course of respiratory infection was complicated and 2 died. Hospital admissions for respiratory infection in young children with haemodynamically significant congenital cardiac disease are mainly associated with non-cardiac conditions, which may be genetic, malnutrition, or respiratory, and to cardiopulmonary bypass. Respiratory syncytial virus was the most commonly identified infectious agent. Incomplete immunoprophylaxis against the virus increased the risk of hospitalization.

Congenital brachial palsy: incidence, causes, and outcome in the United Kingdom and Republic of Ireland

Objectives: To determine the incidence and study the causes and outcome of congenital brachial palsy (CBP). Design: Active surveillance of newborn infants using the British Paediatric Surveillance Unit notification system...

Impact of the 1997 American Diabetes Association criteria on classification of glucose intolerance among Kuwaitis below 50 years of age.

Type 2 (non-insulin-dependent) diabetes is emerging as a leading chronic non-communicable disease among the adult Kuwaiti population. Based on the World Health Organization and similar reports the projected estimates for subjects suffering from type 2 diabetes by the years 2000 and 2010 show a striking tendency to high rates of the disease in our area. We report the prevalence rates of glucose intolerance among a relatively young adult Kuwaiti population below 50 years of age and the effect of implementing the recent 1997 American Diabetes Association diagnostic criteria on the frequency of type 2 diabetes, impaired glucose tolerance and impaired fasting glucose among this group. The overall prevalence rate for the three categories of glucose intolerance reached as high as 15.8% (95% CI, 14.2 to 17.4). Age, though all subjects were below 50 years, parental history of type 2 diabetes, diastolic blood pressure and serum triglycerides were found to be significant associated risk factors for the development of type 2 diabetes. Obesity was an apparent significant factor associated with the three forms of glucose intolerance (p < 0.001). Obesity and physical inactivity were documented in both non-diabetic and more so in diabetic Kuwaiti adults, which should form the basis of any immediate intervention programme. An integrated approach to the prevention of the described critical risk factors associated with type 2 diabetes is highly recommended in Kuwait. Research, focused on genetics of type 2 diabetes in the highly susceptible Kuwaiti population, should be planned.

Perineal excision of rectal prolapse with posterior levator ani repair in elderly high-risk patients.

Perineal excision of rectal prolapse with simultaneous posterior levator ani repair was used to treat 41 elderly patients with rectal procidentia. The majority of the patients had significant associated risk factors. This procedure was performed with minimal morbidity and no mortality. A significant improvement in anal continence was seen in 78 percent of patients. The recurrence rate of rectal prolapse was 4.8 percent.

551 SUDDEN INFANT DEATH IN INTENSIVE CARE UNIT GRADUATES

The graduates of neonatal intensive care units (NICU) are a group of high risk infants. Few studies have documented the risk of sudden infant death syndrome (SIDS) in this special group of infants. We decided to document the incidence of SIDS and some risk factors associated with it as part of our High Risk Infant Follow-up Program, since January 1980 to September 1984, 917 infants have been discharged from our NICU. Eight infants died of SIDS during this period with an incidence of 0.87% among total NICU graduates. Further division into birth weight specific SIDS mortality rate revealed 3.8% (2/53) for BW between 500-1000 gm, 2.5% (3/120) for BW between 1001 to 1500 gm, 2.9% (5/173) for BW between 500 to 1500 gm 0.3% (1/348) for BW between 1500 to 2500 gm and 0.5% (2/396) for BW of >2500 gm. Mean age at death was 4 months, ranging from 1 to 6 months of age. Fifty percent of the deaths occurred in the winter season. Significant associated risk factors included low socioeconomic status (75% of SID infants), single mothers (62.5%), and race (50% black, 25% Hispanic, and 25% white). There was an equal distribution of sexes. This study reveals a 4 fold increase in the risk of SIDS in NICU graduates and 15 times increased risk in the VLBW infants of NICU graduates compared to that of general infant population.