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PubMed1999

[Hospital admission for asthma. Descriptive analysis and prognostic factors after discharge].

BACKGROUND: Few authors have looked at admissions in Spain of patients with acute asthma attacks. The aim of this study was to determine the clinical profile of such patients and analyze factors influencing disease course after release. METHODS: Asthmatics admitted to our hospital were enrolled prospectively over 12 consecutive months. The patients were telephoned one and four months after release. Demographic and clinical data were collected in addition to data on exacerbations, readmissions, treatment and medical follow-up. RESULTS: Sixty-five patients (44 women and 21 men, mean age 45, SD 19). Most (54%) were admitted in autumn and the most common cause of exacerbation was respiratory tract infection (68%). Before admission, 54% had severe asthma, 32% had moderate asthma and 14% had mild asthma. At least one exacerbation occurred for 54% of patients, while 38% required emergency assistance and 19% were readmitted. Two patients (3%) died of asthma. Multiple factor logistic regression analysis showed a relation between the appearance of exacerbation after release and greater severity of asthma and the absence of long-lasting (beta-adrenergic drugs. Readmission was related to shorter duration of treatment with oral glucocorticoids after release and a higher number of prior hospital admissions. CONCLUSIONS: 1) Admission due to asthma occurs mainly in autumn and is probably related to respiratory infections, rather than exclusively to severe asthma. 2) After release, short-term morbidity and mortality due to the disease are high. 3) Disease severity itself and inadequate treatment are both related to poor clinical course after release.

Adult↗
PubMed2002

Distal radius fractures in older women: a 10-year follow-up study of descriptive characteristics and risk factors. The study of osteoporotic fractures.

OBJECTIVES: To determine the incidence of distal radius fractures and the characteristics of those fractures and to identify the key risk factors. DESIGN: Prospective cohort study, mean follow-up of 9.8 years. SETTING: Four clinical centers, one each in Baltimore, Maryland; Minneapolis, Minnesota; Pittsburgh, Pennsylvania; and Portland, Oregon. PARTICIPANTS: Nine thousand seven hundred four white women aged 65 and older, enrolled in the multicenter Study of Osteoporotic Fractures. METHODS: Five hundred twenty-seven distal radius fractures were confirmed by physician review of radiology reports; characteristics of the fractures were noted. Information was also collected on lifestyle, demographics, bone mineral density (BMD), and clinical and performance measures. RESULTS: The overall incidence of fracture was 7.3/1,000 person-years. Twenty-seven percent of the fractures were intra-articular; 73% were extra-articular. The independent predictors of fracture were decreased BMD (per 0.1 g/cm(2)) at the distal radius ( relative risk ( RR)=1.8, 95% confidence interval ( CI)=1.6-2.1), a history of recurrent falls ( RR=1.6, 95% CI=1.2-2.0), and having had a previous fracture since age 50 ( RR=1.3, 95% CI=1.1-1.6). Current use of oral estrogen was protective ( RR=0.6, 95% CI=0.4-0.8). For women aged 75 and older, poor cognitive status was also a predictor of wrist fracture. Intra-articular fractures occurred more than twice as frequently in women with diabetes mellitus. CONCLUSIONS: This is the first large long-term comprehensive study of distal radius fractures in older people. The results indicate that factors predictive of distal radius fractures can easily be assessed in routine clinical practice and can identify women at high risk for fracture. Selected preventive strategies could be designed to reduce the incidence of these fractures.

Aged↗
PubMed2004

Descriptive epidemiology and risk factors for head and neck cancer.

Although more common in developing countries, over 11,000 deaths will occur in the United States from head and neck cancer in 2004. Squamous cell carcinomas account for the vast majority of cases in the United States and the majority of these are related to exposure to tobacco and alcohol. Newer data suggest a genetic contribution. This group is the focus of primary and secondary preventative efforts.

Carcinoma, Squamous Cell↗
PubMed1991

Descriptive study of prognostic factors influencing survival of compensated silicotic patients.

The objective of this study was to assess survival and the prognostic influencing survival of compensated silicotic patients. All workers compensated for silicosis in the Province of Quebec from 1938 to 1985 (n = 1,165) were included. Clinical data were those collected during the exam that led to a compensation decision. Due to missing data, a subcohort of 961 patients was used for multivariate analysis of clinical prognostic factors with the Cox proportional hazards model. The following factors made an independent contribution to survival: age at compensation, smoking, dyspnea, expectoration, abnormal breath sounds, radiographic appearance, and vital capacity. On the basis of the model, patients with small opacities alone on their chest radiograph and who did not have dyspnea, expectoration, or abnormal breath sounds had a survival similar to the average Quebec man; other patients had a poorer survival. We conclude that it is possible to identify at the time of compensation, silicotic patients who are likely to have a life expectancy similar to that of the general population. Symptoms and physical signs as well as radiographic and lung function abnormalities appear to be useful prognostic indicators in compensated silicotic patients.

Dyspnea↗
PubMedDate not supplied

[Congenital urological anomalies: epidemiological description and associated risk factors in Colombia 2001-2004].

OBJECTIVE: To determine the incidence of congenital anomalies of the urinary tract in Colombia and study their association with maternal risk factors. METHODS: We performed a register based, case control study using the data from the ECLAMC (Colaborative latinoamerican Study for Congenital Malformations) in Colombia, between June, 2001 and December, 2004. Positive Registries for any urological anomaly were selected. Calculations for the incidence of each abnormality were done. Odds ratio were estimated for 11 maternal variables. RESULTS: 83 positive registries were found. The established incidence was 0.43%. These anomalies accounted for 9.4% of the total of malformations. The obtained rate (x 10,000 births) for each anomaly was: hypospadias 17.7; chryptorchidism 13.3; hydronephrosis 2.6; cystic renal disease 2.6; undeterminate sex 2.6; unilateral renal agenesis 1.3; micropenis 1.9; bilateral renal agenesis 0.7; patent urachus 0.3. The risk for renal defects increased with preterm birth, odds ratio OR= 3.66; 95% IC [1.13 - 13.82] and maternal chronic disease OR = 6, 18; 95% CI [1.09 - 34.98]. A deterministic association was found with consanguinity between the parents. The positive associations for genital defects were: low birth weight OR = 4.07; 95% CI [2.00 - 8.25], preterm birth OR= 3.80; 95% CI [1.87 - 7.72], presence of malformated individuals in the family OR = 2.30; 95% CI [1.02 - 5.25], and smoking during pregnancy OR = 5.36; CI [1.01 - 28.51]. A deterministic association was found with alcohol ingestion during pregnancy. CONCLUSIONS: The prevalence of anomalies of the urinary tract in Colombia is considerably lower in comparison with European and North American statistics. The birth weight is the most important risk factor for anomalies like hypospadias and chriptorchidism. Consanguinity between the parents and alcohol ingestion during the pregnancy are determinant on the risk for renal and genital anomalies, respectively. Variables like smoking during pregnancy and chronic maternal disease must be deeply explored in the future to determine their role in the etiology of these defects.

Colombia↗
PubMed2004

Nosocomial bloodstream infection in human immunodeficiency virus-infected patients in Taiwan: descriptive epidemiology and risk factors for mortality.

BACKGROUND AND PURPOSE: Nosocomial bloodstream infection (NBSI) is common in patients with human immunodeficiency virus (HIV) infection. This study evaluated the incidence, causative pathogens, and outcome of NBSIs in hospitalized HIV-infected patients at a university hospital in Taiwan. METHODS: The medical records of all HIV-infected patients who developed NBSIs from June 1994 to June 2003 were retrospectively reviewed. A standardized case record form was used to collect demographic, clinical, laboratory, and microbiologic data. RESULTS: During the study period, 57 episodes of NBSIs occurred in 51 HIV-infected patients whose median age was 37 years (range, 23 to 60 years). All of the patients were at HIV infection stage C. The incidence of NBSIs was 2.3 per 1000 person-days of hospitalization (41.4 per 1000 discharges). More than three-fourths of the 57 episodes (77.2%) were classified as primary NBSIs. Other infection foci included respiratory tract (6 episodes), urinary tract (3), surgical site (2), and skin (2). Staphylococcus species were the leading pathogens (42.1%). The crude and attributable mortality rates in patients with NBSIs during the study period were 38.6% and 26.1%, respectively. Multivariate analysis using a logistic regression model revealed that shock and hypoalbuminemia at the onset of NBSIs were the 2 factors predictive of mortality. CONCLUSIONS: NBSIs in hospitalized patients in the late stage of HIV infection were associated with a high attributable mortality rate. Staphylococcus species were the leading pathogen responsible for NBSIs. Presentations of shock and hypoalbuminemia were predictive of mortality.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Descriptive epidemiology and risk factors of depression in the elderly].

Depressive symptoms are frequent among the elderly, and seriously impair their quality of life. The prevalence of depressive symptoms is difficult to evaluate on account of several epidemiological problems, such as the various definitions of "depression", which often prevent comparisons between studies. The second major difficulty is related to the selection bias due to differences in populations studied, and to the high risk of refusal to participate among the depressed subjects. Nevertheless, the prevalence has been estimated, in general population, from 1 to 4% for major depression according to the DSM-IV criteria, and from 8 to 16% for depressive symptoms which may require treatment. The heterogeneity of the symptomatology of depression in the elderly, with atypical clinical feature, leads to underestimate its diagnosis and lack of proper medical care. However, effective treatments exist and most cases of depression among elderly are treatable. In the literature, many risk factors of depression among the elderly have been identified : female sex, low socio-economical level, bereavement, prior depression, co-morbidities, disability, cognitive deterioration and vascular factors. To decrease the consequences of depression and to improve the quality of life of the elderly, the screening and treatment of depression should be strengthened in the general elderly population.

Aged↗
PubMed1989

[Disabilities during aging: descriptive approach and risk factors. 4-year longitudinal study of an aged rural population].

A longitudinal survey has been conducted from 1982 to 1986 in a rural population of 645 persons aged 60 and over. The aim of this study is to analyse the evolution of disabilities in this population and the main risk factors. The incidence of disabilities within 4 years is more important in the oldest birth-cohort groups and this result suggests a cumulative effect of the ageing process and chronic diseases. Indeed, the assessment of predictive factors shows that age and reported morbidity are related to the incidence of disabilities, but two other factors are strongly related to the loss of functional abilities after age adjustment: socioeconomic status and the feeling of uselessness. We conclude that disability in the elderly is not an inevitable consequence of the physiological ageing process and that a preventive approach should be based on a multidimensional concept: physical, social and psychological.

Aged↗
PubMedDate not supplied

The Behavioral Risk Factor Surveys: IV. The descriptive epidemiology of exercise.

Telephone interview data from aggregated state surveys showed that about 21 percent of the U.S. adult population expends greater than or equal to 3 kcal/kg-day in vigorous leisure-time exercise. Three kilocalories per kilogram-day is equivalent to the amount commonly recommended to maximally reduce the incidence of coronary heart disease. Approximately 36 percent of the U.S. population reported no vigorous leisure-time exercise. Men, younger persons, and the more highly educated were most likely to expend greater than or equal to 3 kcal/kg-day, but for no subgroup did the rate exceed 30 percent. People who did not smoke, were not obese, and who did wear seat belts are also more likely to expend energy in vigorous leisure-time exercise. The prevalence of alcohol misuse is similar for all exercise categories. The proportion of people who expend greater than or equal to 3 kcal/kg-day is unrelated to self-reported occupational physical effort. Given the established and presumed benefits of physical activity, a substantial portion of the U.S. population would probably benefit from regular, vigorous, leisure-time exercise.

Adolescent↗
PubMedDate not supplied

[Descriptive epidemiology of risk factors in cerebrovascular disorders:a study in Muro d'Alcoi].

We evaluated cerebrovascular risk factors and the values of cholesterol and triglicerides in the survey in Muro d'Alcoi using a door-to-door randomised interview. We found 14.9% hypertensives, 5.5% persons with diabetes, 1.2% with heart diseases and 42.1 persons with tabaccoism into the 646 persons evaluated. The Serum Cholesterol levels were high and we observed that 62% of males and 63.8% of females had values higher than 200 mg/dl. Our study showed that 24.8% of males and 12% of females presented values of triglicerides higher than 150 mg/dl. The data of risk factors were comparable with the findings described in Beniarres, Lorcha and Planes, located in the same healthy area.

Adolescent↗
PubMed1995

Descriptive study of prognostic factors influencing survival of patients with primary tracheal tumors.

From 1977 to 1992, 23 patients with primary tumors of the trachea were reviewed. Nineteen of these patients had squamous cell carcinomas, 2 had adenoid cystic carcinomas, 1 had a small cell carcinoma, 1 had a poorly differentiated carcinoma, and 1 had a pleomorphic adenoma. The prognosis of squamous cell, small cell and poorly differentiated carcinomas appeared to be grave, especially in association with vocal cord palsy (26%). Short-term survival occurred in 7 to 9 patients with tumors in the upper-middle third of trachea and 4 of them had concurrent acute respiratory distress. Cough (65.2%), dyspnea (91.3%), and hemoptysis (47.8%) were the most common symptoms. For patients with hoarseness, dysphagia, and cervical lymphadenopathy, the prognosis was poor (p < 0.0010). Two patients (8.7%) had multiple malignancies and all died within 1 year. Smoking was not only a risk factor as reported in previous studies, but also a significant prognostic factor (p = 0.0020) in our series. Emergent irradiation ( < 40 Gy in our cases) was useful in alleviating acute respiratory distress, but worthwhile survival was only obtained by the combination of surgery and radiation therapy (p = 0.0200, compared with surgery or irradiation, respectively). There was a significant correlation between prognosis and histologic type, tumor location, clinical presentation, smoking history and management, but not roentography or tumor size. These factors can be used to assess the survival of patients with primary tracheal tumors.

Carcinoma, Squamous Cell↗