[High-risk pregnancy. Diagnosis and therapy of high risk].
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Adult↗
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Results for “High risk”
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[Pregnancy of high risk. I: detection of high prenatal risk and its repercussion on the newborn infant].
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Female↗
University of North Carolina Caries Risk Assessment Study: comparisons of high risk prediction, any risk prediction, and any risk etiologic models.
The purpose of this analysis is to compare three different statistical models for predicting children likely to be at risk of developing dental caries over a 3-yr period. Data are based on 4117 children who participated in the University of North Carolina Caries Risk Assessment Study, a longitudinal study conducted in the Aiken, South Carolina, and Portland, Maine areas. The three models differed with respect to either the types of variables included or the definition of disease outcome. The two "Prediction" models included both risk factor variables thought to cause dental caries and indicator variables that are associated with dental caries, but are not thought to be causal for the disease. The "Etiologic" model included only etiologic factors as variables. A dichotomous outcome measure--none or any 3-yr increment, was used in the "Any Risk Etiologic model" and the "Any Risk Prediction Model". Another outcome, based on a gradient measure of disease, was used in the "High Risk Prediction Model". The variables that are significant in these models vary across grades and sites, but are more consistent among the Etiologic model than the Predictor models. However, among the three sets of models, the Any Risk Prediction Models have the highest sensitivity and positive predictive values, whereas the High Risk Prediction Models have the highest specificity and negative predictive values. Considerations in determining model preference are discussed.
Child↗
Detection of high-risk subjects for high altitude diseases.
The variability in sensitivity to acute mountain sickness among individuals is a phenomenon well known to physicians and high altitude alpinists. The measurement of cardiac and respiratory responses to hypoxia (FIO2 = 0.115) at rest and during exercise (50% VO2max) allows the detection of those subjects who are more liable to suffer from high altitude diseases. In a retrospective study performed on 288 subjects evaluated with a hypoxic test during a Mountain medicine consultation, we found that the most clinically susceptible subjects had at least one abnormal response to the hypoxic tests, especially during exercise. The observation of one or several abnormal values in cardiac or respiratory responses to hypoxia leads us to advise a modification in the alpine or trekking objective, an increase in the acclimatization time and/or prevention by acetazolamide.
Altitude Sickness↗
First experiences with HLA-matched corneal grafts in high risk cases.
In highly vascularized corneas the number of graft failures caused by irreversible rejections is higher than in non-or slightly vascularized corneas. The importance of antigen compatibility is demonstrated, especially in these 'high risk' cases. Ten highly vascularized corneas were grafted with HLA-matched donor material; only one reversible rejection was seen in this group. Nine non-or slightly vascularized corneas were grafted with donor material chosen a random. Retrospective HLA matching was performed. Three irreversible rejections were seen in this group. The number of HLA incompatibilities was high.
Corneal Transplantation↗
B-mode echoencephalography in the normal and high risk infant.
Commercially available high resolution, contact, gray scale imaging systems can now dependably visualize the normal and abnormal ventricular system as well as some other intracranial structures in all newborns. On 25 normal infants and 41 high risk infants, 135 B-mode echoencephalograms were performed. The technique for obtaining these scans is described. The normal lateral ventricle at the midbody in term infants is 0.9--1.3 cm wide (mean, 1.1 cm). Normal ratio of lateral ventricle to hemisphere is 28% (range, 24%--30%). High risk premature infants have a ratio of 31% (range, 24%--34%). The demonstration of hydrocephalus and cystic intracranial masses is reliable and the correlation with computed tomography is excellent. Postoperative or high risk infants can be repeatedly evaluated without radiation, at a lower cost, and more rapidly with ultrasound than with computed tomography. Ventricular size can be closely monitored and shunt failure detected at any early stage.
Cerebral Hemorrhage↗
The high-risk infant environment. Part 1. The role of the neonatal intensive care unit in the outcome of high-risk infants.
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Air↗
Etiological relevance of comparisons of high-risk and low-risk groups.
The prospective study of groups at high risk for pathology is viewed as an increasingly important strategy in research on the etiology and possible prevention of a wide range of disorders. Yet, relatively little attention has been paid to proper and improper etiological interpretations of results based on studies of such groups. The comparison of groups at high risk and low risk for pathology, prior to the development of relevant disturbances in the subjects, cannot provide evidence that a given factor or a characteristic of the groups does or does not contribute to the etiology of the disturbances which will develop in the subjects. For the data to become etiologically relevant, they must be studied as possible antecedents to disturbances identified by following up the subjects. On the other hand, comparisons of high-risk versus low-risk groups are most appropriately interpreted as reflecting the characteristics, correlates and/or consequences of the risk criterion, and such comparisons may thus contribute to better understanding of the true meaning and ramifications of the risk criterion. Considerable caution must be exercised both by high-risk researchers and by observers of high-risk studies in interpreting the significance of results of these studies.
Diseases in Twins↗
Defining and managing high-risk acute myeloid leukemia (AML) in 2026.
Acute myeloid leukemia (AML) remains a highly heterogeneous malignancy in which outcomes are particularly poor for patients classified as having high-risk disease. Traditionally, high-risk AML has been defined by adverse baseline genetic features, including complex cytogenetics, TP53 alterations, and mutations associated with secondary or therapy-related disease. However, this static, genetics-centered definition is increasingly insufficient in the modern therapeutic era. Emerging evidence supports a more dynamic and context-dependent model in which risk is shaped not only by molecular architecture but also by treatment intensity, patient fitness, measurable residual disease (MRD), and evolving resistance mechanisms. Advances in genomic profiling have refined risk stratification frameworks, including ELN 2022 for intensively treated patients and the ELN 2024 classification for those receiving less-intensive therapies. In parallel, MRD has emerged as a powerful biomarker that reclassifies patients during treatment, identifying those with persistent, therapy-resistant disease despite morphologic remission. Biologically, high-risk AML is driven by the interplay of clonal evolution, epigenetic plasticity, leukemic stem cell persistence, and protective microenvironmental and immune interactions, all of which contribute to relapse. Therapeutically, the landscape has expanded to include targeted agents, venetoclax-based combinations, and transplantation strategies, yet outcomes remain limited in key high-risk subsets, particularly TP53-mutated disease and post-venetoclax relapse. Accordingly, current strategies emphasize rational combination therapies, MRD-guided treatment adaptation, and approaches targeting both leukemic cells and their supportive niches. In 2026, high-risk AML is best understood as a dynamic, treatment-context-dependent state. Improving outcomes will require integration of precision diagnostics, biologically informed therapy, and adaptive strategies designed to anticipate and overcome resistance.
Humans↗
Coronary risk factors and the severity of angiographic coronary artery disease in members of high-risk pedigrees.
Affected members of early coronary pedigrees in Utah are at markedly increased risk for the development of clinical coronary heart disease (CHD). The relationship between the presence of coronary risk factors and the severity of angiographic coronary artery disease (CAD) in 53 members of high-risk Utah pedigrees was examined. Mean angiographic severity scores were higher in familial hypercholesterolemia or familial low high-density lipoprotein cholesterol (HDL-C) pedigrees than in type III hyperlipidemia or familial combined hyperlipidemia pedigrees. One sibling pair with hyperhomocyst(e)inemia had the highest mean angiographic severity scores. Clinical CHD (p less than 0.0001), increasing low-density lipoprotein cholesterol (LDL-C) (p = 0.0107), and decreasing HDL-C (p = 0.0068) were significant predictors of angiographic CAD severity. There appeared to be an interaction between gender and body mass index but not between gender and serum lipids in the prediction of angiographic CAD severity. Results of the present study in members of high-risk Utah pedigrees are consistent with results from other angiographic studies in non-high-risk persons. Of particular interest is the suggested independent predictive value of low HDL-C for angiographic CAD severity in members of high-risk pedigrees.
Coronary Angiography↗
Advances and disappointments, indications and restrictions regarding HLA-matched corneal grafts in high risk cases.
54 corneas, 49 high risk cases and 5 low risk cases, were grafted with HLA-matched donor material. The importance of antigen compatibility especially in high risk cases is demonstrated. The percentage of irreversible rejections and reversible rejections in this group is markedly smaller as compared with our own "at random" material and the "at random" material of other authors. The follow-up period is 3--21 months.
ABO Blood-Group System↗
A Cocaine High-Risk Situations Questionnaire: development and psychometric properties.
Although high-risk situations have been identified for alcoholism, opiate abuse, and smoking, further research is needed to identify high-risk situations for cocaine abuse. A 233-item Cocaine High-Risk Situations Survey was developed based on a comprehensive literature review and was administered to 179 cocaine users in treatment. Situations that occurred infrequently or that were not often associated with cocaine use were eliminated and the remaining 89 items were factor analyzed using half the sample with confirmatory factor analysis on the remainder of the sample. Only one factor was found for frequency of cocaine use in these situations. The 21 items with high factor loadings and a diverse range of content were retained for subsequent analyses and renamed the Cocaine High-Risk Situations Questionnaire (CHRSQ). Reliability and convergent and discriminant validity of this scale were demonstrated. Frequency of alcohol use in the same situations was not significantly related to cocaine use and abuse, supporting discriminant validity. The findings suggest that the frequency of ongoing cocaine use is not determined by specific situations. Theoretical and clinical implications are discussed.
Adaptation, Psychological↗
[Neurodevelopmental examination of high risk infants (author's transl)].
While the high risk infants' prognosis for normal development has been greatly improved by modern neonatal intensive care, premature birth, low birthweight and perinatal complications involving compromised brain function still represent major risk factors. Different criteria for admission and assessment methods are the reason that recent publications cite neurological sequelae in high risk infants that range from 4.4 to 28%. The need for an effective screening instrument enableing the pediatrician to test and evaluate neurological function, maturation and integrity, is quite obvious. The author has selected a group of neurological items according to results of Touwen's (1976) longitudinal study on neurological maturation in infancy. In addition, Prechtl's (1968) optimality concept was applied in our study. This new standardized neurological examination was used to evaluate 163 high risk infants with a corrected age of 3 and 6 months. The results demonstrate statistically significant differences between the neurological status of full-term and premature infants, and similarly between those with minimal risk and perinatal brain distress. The rather steep increase of neurological optimality scores by age of 6 months implies a high rate of self-repair or catch-up in maturation of the nervous system. We speculate that early extrauterine stimulation of the premature does not accelerate the development of brain function in a similar way as it does other organ functions, but it may slow down maturation.
Age Factors↗
Prophylactic antibiotics in high-risk cesarean section.
A brief perioperative course of ampicillin was recommended for high-risk patients undergoing cesarean section at our institution. High-risk patients were defined as those with two or more of the following factors: general anesthesia, obesity, hematocrit less than or equal to 30%, and labor prior to delivery. Fifteen percent of high-risk patients who received prophylactic antibiotics experienced postoperative febrile morbidity compared to 63% for the high-risk untreated group (P less than 0.001). Twenty-five percent of low-risk patients (less than 2 risk factors) developed this complication. Endometritis was the leading cause of postoperative febrile morbidity. Postoperative stay was only slightly decreased in the prophylactically treated group (5.9 vs 6.2 days). Prophylactic amplicillin given perioperatively was an effective agent in reducing post-cesarean-section febrile morbidty among high-risk patients.
Ampicillin↗
Newborn high-risk hearing screening by maternal questionnaire.
State-wide, high-risk hearing screening is made possible in Utah through the use of a questionnaire designed for maternal response during hospitalization. The mothers of those determined high risk are sent a follow-up questionnaire when the infant is 6 to 8 months of age, and a determination is made for audiological testing on the basis of her response. Questionnaires (26352) were received on 50,700 live births, of which 4,591 (17.4%) were categorized high risk. Of the high-risk infants, 181 (3.9%) were determined at risk after follow-up, and 54 (20.8%) of these were found hearing impaired. Questionnaire item analysis is presented. Concerns regarding response validity and low return rate are discussed as is the pilot use of the birth certificate as the initial screening device.
Female↗
Risk factors inducing the persistence of high-risk genital papillomaviruses in the normal cervix.
To evaluate the risk factors associated with persistence of human papillomaviruses (HPV) types 16, 18, and 33 in the normal cervix, a prospective study was carried out in Belgium of 323 women without cytological evidence of cervical intraepithelial neoplasia. Demographic and clinical data were obtained by interview, and HPV DNA was assayed in cervical-swab specimens using the Fast Multiplex Polymerase Chain Reaction-based screening and confirmatory tests. A multivariable linear regression model was constructed using four well-known risk factors: the use of an oral contraceptive which is either triphasic, or monophasic and containing ethynylestradiol in association with either norethysterone, or levonorgestrel, or lynestrenol, or gestoden, or estrogenic and containing estriol (P = 8 x 10(-5)), a positive history of genital herpes simplex virus (HSV) infection (P = 10(-4)), an age inferior or equal to 30 years (P = 0.012), and cigarette smoking (P = 0.020). Crude and adjusted relative risks were calculated for each HPV persistence predictor. The data and the results of the molecular biology of high-risk genital HPVs are consistent with the hypothesis that the use of an oral contraceptive containing simultaneously and continuously both a potent estrogen and a high activity progestative is necessary to enhance significantly HPV transcription. These observations are also consistent with the hypothesis that the oral contraceptives and HSV genital infection are responsible for HPV persistence in the normal cervix but not for HPV-induced cervical transformation.(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
[Risk factors and high-risk groups in the prevention of tuberculosis].
Starting from the premise that in the methodology of tuberculosis control priority should be given to the higher risk groups, the authors tried to identify such groups and list them in the order of their priority within the district of a dispensary serving a population of about 400,000 inhabitants. On comparing the results of the detection of risk factors among the population in general with that per endangered groups it was found that the former presented a decrease (from 1.09 to 0.44 per thousand) and the latter an increase (from 0.91 to 1.5 per thousand). The 126 747 examinations for risk factors revealed a succesive increase in the detection indices as follows: 0.76 per thousand among students, 1.36 per thousand in silicogen risk enterprises, 2.07 per thousand among the workers on building sites, 2.22 per thousand among diabetics, 2.76 per thousand among contacts, 2.85 per thousand among hyperergic subjects, 3.89 per thousand among former patients no longer on the files, 4.17 per thousand among alcoholics and patients under psychical treatment, 6.01 per thousand among patients with minimal lesions and 6.82 thousand among those with sequelae.
Adolescent↗
[Acute "high risk" and "low risk" juvenile lymphatic leukemia (proceedings)].
After an initial blood and thorax examination, 97 children with ALL were divided into "high risk" and "low risk" groups. From the 20 new "high risk" patients seen between 1972 and 1975 about one quarter were still alive 3 years later, the corresponding proportion from 37 "low risk" patients being about two thirds. Despite increased therapy, the number of early relapses does not appear to have decreased in the new "high risk" cases seen between 1976/77. An investigation of cell surface markers established that T-ALL always occurred in the "high risk" group, whereas B-negative/T-negative ALL was found not only in the "low risk" group but also occasionally in the "high risk" group.
B-Lymphocytes↗