جستجوی مقالات مرتبط با کلیدواژه « risk factors » در نشریات گروه « پزشکی »

The outbreak of the Covid-19 has been a serious threat to the health and lives of many people. This study aimed to determine the survival rate and its contributing factors in Covid-19 patients who were hospitalized in hospitals in Fars province.

This study is a hospital-based carried out on 119429 of Covid-19 hospitalized patients in the south of Iran within 2019 – 2022. Information of demographics and clinical characteristics, symptoms, and comorbidity of patients were extracted from medical records. The Kaplan–Meier curve and the Log rank test were used to compare survival rate in different groups. Cox regression was employed to determine the factors that affect survival.

The mean age of the participants was 51.5 year. The density incidence of death was estimated to be 16.8, 4.6, and 43.9 per 1000 person-days for all of patient, intensive care unit patients, and intubated patients, respectively. The Multiple Cox Regression results suggested that risk of mortality is 5.61 times higher in patients over 75 years, 3 times higher in patients admitted to the intensive care unit, and 3.4 times higher in intubated patients. Also, the risk of mortality was higher in men and those with underlying disease.

We found out that being elder, being a male, hospitalization in the intensive care unit, and being intubated would increase the risk of mortality. Thus, it is treatment management of hospitalized patients is necessary, especially elderly patients and those with underlying diseases.

The purpose of this study was to assess the risk factors and clinical characteristics of cardiovascular and cerebrovascular events in elderly hemodialysis patients.

Elderly patients undergoing hemodialysis (HD) at Deqing County People’s Hospital in Zhejiang, China, from May 2020 to May 2023 were enrolled in this study. They were divided into two groups depending on the occurrence of cardiovascular or cerebrovascular events: the case group and the control group.

A total of 106 patients were enrolled in this study. Among them, 49 patients experienced cardiovascular or cerebrovascular events, resulting in an incidence rate of 46.23%. According to whether cardiovascular or cerebrovascular events occurred, 57 patients were assigned to the control group, and 49 patients were assigned to the case group. Comparing the basic information and clinical indicators of the two groups, significant differences were observed in patients with hypertensive nephropathy and diabetic nephropathy (P < .05). There were also significant differences in dialysis duration, smoking history, systolic and diastolic blood pressures, uric acid, blood glucose, total cholesterol (TC), low-density lipoprotein cholesterol (TG), C-reactive protein (CRP), and PTH (parathyroid hormone) levels and platelet-to-lymphocyte ratio (PLR), between the two groups (P < .05). Multivariate logistic regression analysis revealed that longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH, and blood glucose levels, smoking history, elevated PLR, and CRP were independent risk factors for cardiovascular and cerebrovascular events. The ROC curve showed that these risk factors predicted cardiovascular and cerebrovascular events in patients.

Patients with underlying diseases such as hypertensive or diabetic nephropathy are more likely to experience cardiovascular and cerebrovascular events. Longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH and blood glucose levels, and boosted inflammatory reaction are risk factors for these events among elderly HD patients. The purpose of this study is to provide practical guidelines for clinical treatment. Comprehensive measures such as active intervention of risk factors, rational drug use and regular examination should be taken to improve the overall health level to the greatest extent for elderly patients with high-risk HD.

To investigate the risk factors of Programmed Cell Death Protein 1 (PD-1), Programmed Cell Death Ligand 1(PD-L1) inhibitor associated acute kidney injury (AKI) in patients with primary non-small cell lung cancer (NSCLC) and construct a predictive model.

120 NSCLC patients were selected as the research subjects and their clinical data were collected. Patients were divided into AKI and Non-AKI (N-AKI) group based on the development of AKI. Exploring the risk factors of PD-1P/D-L1 inhibitor related AKI in NSCLC patients using multivariate logistic regression analysis and visualized the logistic regression analysis to obtain a nomogram model. Meanwhile, evaluate the predictive value of the model.

The results of multivariate analysis showed that the presence of extrarenal immune related adverse reactions (irAEs) is a risk factor for PD-1/PD-L1 inhibitor related AKI in NSCLC patients; At the same time, the risk of developing PD-1/PD-L1 inhibitor related AKI in NSCLC patients increases with increasing serum creatinine (SCr) and C-reactive protein (CRP) levels, decreasing baseline estimated glomerular filtration rate (eGFR) levels (P < .05). The analysis results of receiver operator characteristic curve (ROC), calibration curve, and decision curve show that the model has good discrimination and accuracy, and can achieve a high clinical benefit rate.

Primary NSCLC patients with extrarenal irAEs, high levels of SCr and CRP, and low levels of eGFR have a higher risk of AKI after PD-1/PD-L1 inhibitor treatment. Establishing a predictive model with high accuracy is more conducive to early detection of high-risk patients.

Stunting can be prevented by early detection when the mother is pregnant. Early detection can be carried out by looking for risk factors of stunting during pregnancy so that interventions can be early detected. This study aims to assess complications during pregnancy (disease and infection) and risk factors associated with stunting.

The type of research was observational analytic with a case‑control design on 450 mothers who were selected with simple random sampling (150 mothers who have stunting babies aged 0–2 months and 300 mothers who have not stunting babies aged 0–2 months in Malang Regency, Indonesia. This study used secondary data by looking at medical records, namely, laboratory examinations in the mother’s book and cohort records at the public health center. This study was conducted from December 2021 to August 2022. Bivariate analysis with Chi‑square and multivariate logistic regression was carried out to determine the variables that most influenced the incidence of stunting.

The results of multivariate analysis with logistic regression of maternal complications during pregnancy, which are a risk as a factor causing stunting, are Sexually Transmitted Infections (STIs) (Odds Ratio [OR]: 6.36; 95% Confidence Interval [CI]: 2.97–13.62), coronavirus disease 2019 (COVID‑19) accompanied by pneumonia (OR: 5.12; 95% CI: 1.87–14.052), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (OR: 4.63; 95% CI: 1.10–19.59), hepatitis B (OR: 3.97; 95% CI: 1.253–12.565), pre‑eclampsia (OR: 3.88; 95% CI: 1.81–8.30), and heart disease (OR: 3.373; 95% CI: 0.99–11.40).

After recognizing the maternal factors that cause stunting, intervention should immediately be carried out on pregnant women with diseases (pre‑eclampsia and heart disease) and infections (STI, COVID‑19 + pneumonia, HIV/AIDS, and hepatitis B) to prevent stunting early.

Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, and child. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.

This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partum women (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June 2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, the Edinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and the analysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors for depressive symptoms.

According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant woman group in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity (women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs. 28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-risk pregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factors were a significant risk.

Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first and second trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

Abdominal surgery is considered a high-risk procedure for the development of surgical site infection (SSI). Few studies have evaluated the relative importance of surgical site infection risk factors in terms of consistency in abdominal surgery. Therefore, this comprehensive review article mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of SSIs in abdominal surgery.

A literature review was conducted using electronic databases and search engines such as Scopus, PubMed, and Web of Science up to March 16, 2023. There was no language restriction for the papers to be included in the study. The relative consistency of the risk factors was measured and evaluated using the methodology of the Joanna Briggs Institute. Original peer-reviewed cohort and case-control studies were included if all types of SSIs were included. Meta-analysis was performed to determine the pooled estimates of SSI incidences.

Of 14,237 identified records, 107 articles were included in the review. The pooled incidence of SSI was 10.6% (95% CI: 9.02–12.55%, χ2=12986.44, P<0.001). Operative time and higher wound class were both significant consistent risk factors for SSI incidence. Patients’ educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were all candidates for consistent risk factors, with insufficient evidence. 

The findings of the present study indicated that SSI in abdominal surgery was a multifactorial phenomenon with a considerable risk and had different risk factors with various relative importance. Determining the relative importance of the risk factors for the prevention and control of SSI is strongly recommended. This manuscript has been released as a preprint at the research square: (https://doi.org/10.21203/rs.3.rs-3219597/v1).

Precise categorization of the causes of ischemic stroke (IS) is crucial for optimizing stroke treatment and assessing the prognosis of patients. This cross-sectional study aimed to determine the risk factors and various subcategories of IS in Iranian patients. The study included all patients with IS referred to Golestan Hospital (Ahvaz, Iran) for one year. Their demographics and clinical data were collected. The etiology of IS was classified based on the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. A total of 1100 patients with IS were evaluated, 658 were male and 442 were female. They had an average age of 66 years (ranging between 20 and 99 years). The majority of them were in the 61-80 age group. The prevalence of risk factors for IS included hypertension (HTN) (71.4%), diabetes (50.4%), smoking (42.4%), history of previous stroke (28%), dyslipidemia (15.4%), and cardiovascular disease (22.5%). Three months after admission, the mortality rate was 10.7% and the majority of patients exhibited a lower level of disability based on the modified Rankin Score (mRS) compared to the time of admission. The frequency of all risk factors, except for HTN, differed significantly between genders (P<0.05). Furthermore, the prevalence of risk factors varied significantly among different stroke etiologic subgroups (P<0.05). The most common etiological factors identified by TOAST classification were associated with large artery atherosclerosis (LAA) and small artery occlusion (SAO). Significant variations were observed in the prevalence of different etiologic subtypes of stroke among genders and across different age groups.

Returns to the Emergency Department (ED) and unplanned readmissions within 90 days of shoulder arthroplasty represent a significant financial burden to healthcare systems. Identifying the reasons and risk factors could potentially reduce their prevalence.  A retrospective review of primary anatomic (aTSA) and reverse shoulder arthroplasty (rTSA) cases from January 2016 through August 2023 was performed. Demographic patient and surgical data, including age, diagnosis of anxiety or depression, body mass index (BMI), smoking status, age-adjusted Charlson Comorbidity Index (ACCI), modified 5-item fragility index (mFI-5), and hospital length of stay (LOS) was collected. Patient visits to the ED within 12 months prior to surgery were recorded. Predictors for return to the ED within 90 days postoperatively and any readmissions were determined.  There were 338 cases (167 aTSA and 171 rTSA), of which 225 (67%) were women. Patients with anxiety (OR=2.44, 95% CI 1.11–5.33; P=0.026), surgical postoperative complications (OR=3.22, 95% CI 1.36–7.58; P=0.008), ED visit within 3 months prior to surgery (OR=3.80, 95% CI 1.71–8.45; P=0.001), ED visit 3 to 6 months prior to surgery (OR=2.60, 95% CI 1.12–6.05; P=0.027), and ED visit 6 to 12 months prior to surgery (OR=2.12, 95% CI 1.02–4.41; P=0.045) were more likely to have ED visit within 90 days postoperatively. Patients with prior ipsilateral shoulder surgery (OR=3.32, 95% CI 1.21–9.09; P=0.02), surgical postoperative complications (OR=13.92, 95% CI 5.04–38.42; P<0.001), an ED visit within 3 to 6 months preoperatively (OR=8.47, 95% CI 2.84–25.27; P<0.001), and an mFI-5 ≥2 (OR=3.66, 95% CI 1.35–9.91; P=0.011) were more likely to be readmitted within 90 days.  Patients who present to the ED within 12 months prior to shoulder arthroplasty, those with anxiety, those with surgical complications and those with higher fragility should be monitored closely during the early postoperative period to minimize returns to the ED and/or unplanned readmissions.  Level of evidence: III

Brucellosis, a zoonotic disease, poses a significant health and economic challenge in many parts of the world, including Mediterranean and Middle Eastern countries. This study aimed to investigate the risk factors and recurrence of brucellosis, focusing on demographic variables such as age, gender, occupation, place of residence, and the spatiotemporal pattern of the population.

The study design was cross-sectional.The authors enrolled all Brucella cases registered in the infectious disease surveillance system of Fars province from 2014 to 2018 in the study. They performed a multivariate analysis of the disease risk factors using a Poisson regression model and a multivariate analysis of the risk factors associated with brucellosis recurrence using a logistic regression model.

The incidence of brucellosis in Fars province exhibited a decreasing trend. The findings revealed that the sex ratio of patients who consumed unpasteurized dairy products, the mean age of patients per month, and the proportion of people living in rural areas relative to the total number of patients with brucellosis were significantly associated with the risk of brucellosis. Moreover, the probability of disease recurrence was higher in colder seasons compared to spring.

A higher ratio of lightweight livestock to heavyweight livestock was identified as a risk factor for brucellosis, indicating the more significant role of lightweight livestock in the incidence of brucellosis in Fars province. Therefore, controlling the disease in lightweight livestock is of paramount importance, and the vaccination of these livestock should be more strictly monitored and implemented.

Child marriage is a detrimental practice with negative consequences for girls' health and well-being. This study aims to identify the prevalence of child marriage and associated risk factors within the Madhesi community.

A cross-sectional study was conducted in a sub-metropolitan city of Lumbini Province, Nepal, in 2023. A total of 352 married women were randomly selected using simple random sampling and interviewed using a structured questionnaire between March 28th and April 17th. Descriptive categorical variables were expressed as proportions. Risk factors associated with child marriage were measured using the Chi-square test and multivariate logistic regression analysis. All statistical analyses were performed using SPSS version 26.

The majority of respondents (36.1%) were in the age group 21-25, with a mean age of 25.90 years ± 4.6 years.  Most respondents (48.9%) received only basic-level education, with the majority (72.4%) reporting their parents as having no formal education. The primary family occupation was farming (40.1%). The prevalence of child marriage was high (77.0%), with a median marriage age of 18 years. Logistic regression analysis revealed significant risk factors including lower education levels of respondents and their parents, husband's occupation, lack of awareness about the legal marriage age, limited decision-making power regarding marriage, belief in the dowry system, discussions with friends about child marriage, and occurrence of child marriage among friends.

Despite legal prohibition, child marriage remains prevalent in the Madhesi community. Educational interventions targeting women and parents, empowering women with decision-making authority, and addressing the dowry system are crucial for reducing this harmful practice.

This paper discusses a comprehensive analysis of age differences in the manifestation of peripheral blood stem cells (PBSC) in individuals who have been diagnosed with COVID-19. The purpose of this research was to examine how age affects the body's response to the virus and identify factors that increase the likelihood of severe consequences in older people. By combining data from multiple studies, scientists compared levels of PBSC expression in younger and older individuals. The results showed that older individuals had higher levels of PBSC expression than their younger counterparts, highlighting the impact of age on the body's response to the virus. Additionally, a strong connection was found between increased PBSC expression levels and the severity of the disease, as well as poorer outcomes in older individuals. These findings suggest that levels of PBSC expression could be used as an important marker for monitoring the progression and seriousness of the disease in individuals with COVID-19, especially in older age groups. This analysis sheds light on age-related differences in PBSC expression among individuals affected by COVID-19 and underscores the crucial role played by age in understanding the body's response to the virus and identifying individuals at a higher risk of severe consequences. Future studies should delve deeper into the mechanisms behind these age-related variances and explore treatment strategies targeting PBSC expression in older individuals battling COVID-19.

With the increasing proportion of the elderly population, neurodegenerative diseases such as dementia are becoming more prevalent worldwide. Vascular risk factors are considered significant targets for cognitive decline prevention. We reviewed the effect of cardiovascular risk factors on cognitive decline prevention in the elderly to evaluate the quantity and quality of evidence in managing the elderly population with cognitive decline. Data analysis was available from 25 studies that explored the effects of controlling cardiovascular risk factors on the risk of cognitive impairment. These risk factors include diabetes mellitus, high blood pressure, high cholesterol levels, and exercise and physical activity. The most positive evidence was found for exercise and physical activity. On the other hand, diabetes mellitus and cholesterol modifications showed no positive impact on cognitive function. Studies on hypertension control were incongruous. There is a need for large-sample, robust randomized clinical trials to provide sufficient evidence for the modification of various cardiovascular risk factors in preventing cognitive decline.

Social anxiety disorder (SAD) which is characterized by persistent fear of social situations is increasingly relevant, particularly among students in today’s competitive society. This study assesses the prevalence of SAD and identifies associated factors among health care students.

A web-based cross-sectional study was conducted from March to May 2023 and included 325 participants from five colleges in Kathmandu City, Nepal. The sample size was calculated using the formula Z²pq/d². The participants were selected via the purposive sampling method. SAD was assessed using the 17-item social phobia inventory instrument. Logistic regression analysis identified significant predictors (P<0.05).

The majority of participants (63.7%) were in the 22-25 age group, with a mean age of 22.84±2.25 years. The prevalence of SAD was 39.1%, with a mean of the social phobia inventory score of 16.73±11.85. Significant risk factors included being female (adjusted odds ratio [AOR]=1.9; 95% confidence interval [CI], 1.1, 3.4), history of mental illness (AOR=2.9; 95% CI, 1.2, 6.8), parental criticism (AOR=2.4; 95% CI, 1.1, 5.2), overprotection (AOR=2.6; 95% CI, 1.6, 4.2), excessive anger (AOR=3.9; 95% CI, 1.3, 11.3), conflicts with parents (AOR=2.1; 95% CI, 1.3, 3.4), exposure to abuse (AOR=2.7; 95% CI, 1.5, 5.0), experiences of bullying (AOR=2.8; 95% CI, 1.5, 5.2), and dissatisfaction with height, weight, color of skin, and facial features.

This study reveals a high prevalence of SAD among health science students, emphasizing the importance of public health interventions targeting identified risk factors. Early prevention and control strategies should be implemented by both parents and colleges.

The significance of men’s health before embarking on pregnancy has been acknowledged in the past decade. Identifying and mitigating risk factors to ensure successful fertility and favorable pregnancy outcomes is crucial. In Iran, preconception care primarily targets women. There is limited knowledge about men’s preconception health. This study was undertaken to assess the health status of men before pregnancy in couples in Ahvaz health centers.

In this descriptive study, 384 married men were chosen from couples registered at health centers in Ahvaz, Iran, between 2019 and 2020. Inclusion criteria included the intention for pregnancy within the next three months or having a pregnant woman in her first trimester. Data were collected using a demographic information form and the General Health Questionnaire, and the obtained data were analyzed using SPSS 22 software.

Based on the results, 72.9% of men exhibited at least one pre-pregnancy male risk factor: abnormal body mass index (33.9%), hypertension (10%), borderline or abnormal blood glucose levels (20.8%), a condition impacting reproductive health (17.18%), significant mental health issues (37.2%), drug use (14.3%), substance abuse (38%), and exposure to environmental and occupational hazards (51.3%).

The majority of men have at least one risk factor associated with unfavorable pregnancy or fertility outcomes.

Effective self-management practices post-stroke have been shown to decrease mortality rates and enhance the quality of life for patients. While existing studies have explored various factors impacting self-management, further investigation is necessary to identify key determinants that influence self-management and aid in preventing recurrent strokes. This study aims to identify the factors that influence self-management among stroke survivors to prevent recurrent attacks. A cross-sectional study was conducted in April 2023 a stroke foundation in Bali, Indonesia, involving 116 post-stroke patients recruited through non-probability consecutive sampling. Data collection utilized the Stroke Self-Management Questionnaire, with analysis performed using chi-square and logistic regression methods. Gender and age did not exhibit significant associations with self-management. However, regression analysis revealed that education (P=0.002, OR=2.136), previous stroke history (P<0.001, OR=4.122), and pre-existing medical conditions (P=0.011, OR=7.151) were significantly correlated with self-management. The study highlights the significance of education level, prior stroke experience, and comorbid conditions as influential factors affecting self-management and the likelihood of recurrent stroke attacks. Understanding these determinants is crucial for designing tailored interventions and support systems to enhance self-management practices in stroke patients.

This study aimed to investigate the prevalence and potential risk factors of Staphylococcus aureus nasal carriage in household pets (cats and dogs) and their owners in Chlef province in Algeria and to determine the isolates antibiotic resistance profiles.

S. aureus was isolated from nasal swabs, identified by culture on mannitol salt agar (MSA), and confirmed by polymerase chain reaction (PCR) amplification of the nuc gene. Methicillin-resistant S. aureus (MRSA) isolates were identified by their resistance to cefoxitin and PCR targeting the mecA gene. Panton-Valentine leukocidin (PVL) toxin genes were screened by PCR. Antimicrobial resistance was determined by disc diffusion method. The effect of risk factors on S. aureus nasal carriage was evaluated using a multivariable generalized linear model (GLM).

A total of 110 nasal swabs were collected: 29, 31, and 50 from dogs, cats, and their owners, respectively. The nasal carriage rate of S. aureus was 25% in household pets (22.6% in cats and 27.6% in dogs) and 22% in their owners. MRSA isolates were recovered only from pets (6.6%); 25% of them were multidrug resistant (MDR). One MDR MRSA isolate was PVL-positive. The age of dogs was the only risk factor significantly associated with S. aureus nasal carriage.

The results revealed that nasal carriage of S. aureus in household pets was relatively high, raising concern about their potential risk to human health and stressing the importance of active surveillance of S. aureus carriage in pets.