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Increased Odds (increased + odds)

Distribution by Scientific Domains
Medical Sciences93%
2 Other Domains7%
Distribution within Medical Sciences
Obstetrics & Gynecology13%
Neurology10%
Urology6%
14 Other Subdomains61%

Terms modified by Increased Odds

  • increased odds ratio
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    Selected Abstracts

    Lower urinary tract symptoms in relation to lifestyle and medical conditions in Japanese workers

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2009
    Kentaro Tomita
    Objectives: To examine the association of medical conditions and lifestyle with lower urinary tract symptoms (LUTS) in a population of Japanese male workers. Methods: A questionnaire survey on LUTS was conducted at the time of a periodic health examination among workers of a group of engineering and shipbuilding companies in Southern Kanto, Japan. A total of 1278 (85%) men responded. LUTS were assessed by using a modified International Prostate Symptom Score questionnaire. Men having at least one point of the score were regarded as positive. Logistic regression analysis was used to examine the relation of the LUTS to age, smoking, drinking, body mass index, and medical treatment of diabetes mellitus, hypertension, and dyslipidemia. Results: Age was a strong determinant of LUTS. Men undergoing medical treatment for diabetes mellitus were significantly more likely to have LUTS than men without treatment (multivariate-adjusted odds ratio, 1.8; 95% confidence interval, 1.0,3.2). Increased odds of LUTS were also observed in men undergoing medical treatment for hypertension or dyslipidemia. Smoking, drinking alcohol, and obesity were not related to LUTS. Conclusions: Our present findings, together with previous epidemiological and experimental evidence, suggest that LUTS might share common etiological factors with diabetes mellitus, hypertension, and dyslipidemia. [source]

    Epidemiology of slow and fast colonic transit using a scale of stool form in a community

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2007
    R. S. CHOUNG
    Summary Background, Measurement of gastrointestinal transit is commonly performed in the clinic, but data on transit in the community are lacking. Aim, To estimate the prevalence of slow and fast colonic transit using stool form, and potential risk factors. Methods, A validated self-reported gastrointestinal symptom questionnaire was mailed to 4196 randomly selected members of the community (response rate 54%). One question asked the subject to self-report their stool form using the Bristol Stool Scale. Results, Overall, 18%, 9% and 73% met stool form criteria for slow, fast or normal colonic transit, respectively. Increased odds for slow transit were observed with a higher Somatic Symptom Checklist score (OR = 1.6; 1.3,2.0), while a decreased odds for slow transit was observed in males relative to females (OR = 0.6; 0.5,0.8). An increased odds for fast transit was observed with higher Somatic Symptom Checklist score (OR = 2.3; 1.7,2.9) and a history of cholecystectomy (OR = 1.8; 1.2,2.8). Increasing body mass index (per 5 units) was associated with decreased odds for slow (OR = 0.85; 0.78,0.93), and an increased odds for fast (OR = 1.1; 1.04,1.24) colonic transit. Conclusion, Based on stool form assessment, nearly one in five community members may have slow colonic transit and one in 12 have accelerated colonic transit. [source]

    Severe falciparum malaria and acquired childhood language disorder

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2006
    Julie A Carter BSc (Hons) MSc PhD
    Language disorders have been reported after severe falciparum malaria but the deficits have not been described in detail. We assessed language outcome in three groups of children aged 6 to 9 years (n=487): those previously admitted to Kilifi District Hospital, Kenya, with cerebral malaria (CM; n=152; mean age 7y 4 mo [SD 1y 1mo]; 77 males, 75 females); or those with malaria and complicated seizures (M/S; n=156; mean age 7y 4mo [SD 1y 2mo]; 72 males, 84 females); and those unexposed to either condition (n=179; mean age 7y 6mo [SD 1y 1mo]; 93 males, 86 females). Median age at hospital admission was 28 months (interquartile range [IQR] 19 to 44 mo) among children with a history of CM and 23 months (IQR 12 to 35mo) among children with a history of M/S. A battery of eight assessments covering the major facets of speech and language was used to measure language performance. Cognitive performance, neurological/motor skills, behaviour, hearing, and vision were also measured. Eighteen (11.8%) of the CM group, 14 (9%) of the M/S group, and four (2.2%) of the unexposed group were found to have a language impairment. CM (odds ratio 3.68,95% confidence interval 1.09 to 12.4, p=0.04) was associated with significantly increased odds of an impairment-level score relative to the unexposed group. The results suggest that falciparum malaria is one of the most common causes of acquired language disorders in the tropics. [source]

    Factors associated with microcephaly at school age in a very-low-birthweight population

    DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2003
    Claudia A Chiriboga MD MPH
    The neonatal predictors of microcephaly, defined as a head circumference <5th centile in children born preterm, has not been systematically assessed. Children were drawn from the Developmental Epidemiology Network (DEN) cohort of very low-birth weight children (VLBW: 500,1500g) born from 1991 to 1993 at three sites in the USA. Neurological assessments were carried out among 198 singleton children (mean age 6 years 8 months, SD 0.5 years). Ninety-six children (48.5%) were male. Microcephaly was observed in 30 children (15%) and, using multivariate analysis, it was found to be associated with gestational age <26 weeks and bronchopulmonary dysplasia (BPD). Sonography-defined white-matter damage (WMD, i.e. echolucency or echodensities) was not associated with increased odds of microcephaly, while occurrence of intraventricular hemorrhage (IVH) was in univariate but not multivariate analysis. In analyses that excluded children with IVH/WMD, odds of microcephaly increased in dose-related fashion according to number of days on ventilator: >5 days, OR=4.5; 95%CI=1.4 to 15; >10 days, OR=5.7; 95%CI=1.7 to 19; >15 days OR=8.3; 95% CI=2.3 to 29.2. Among children without BPD, microcephaly was not associated with differences in IQ, while IQ scores among children with BPD or any ventilation were disproportionately lower among those with microcephaly. In multivariate analyses predicting IQ at age 7 years, microcephaly was found to modify the association between neonatal lung disease and IQ. [source]

    Parental alcohol dependence and the transmission of adolescent behavioral disinhibition: a study of adoptive and non-adoptive families

    ADDICTION, Issue 4 2009
    Serena M. King
    ABSTRACT Aim To examine the genetic and environmental influences of parental alcoholism on offspring disinhibited behavior. Design We compared the effect of parental alcoholism history on offspring in adoptive and non-adoptive families. In families with a history of parental alcohol dependence, we examined the effect of exposure to parental alcoholism symptoms during the life-time of the adolescent. Setting Assessments occurred at the University of Minnesota from 1998 to 2004. Participants Adolescents adopted in infancy were ascertained systematically from records of three private Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in in-person assessments. Measurements For adolescents, measures included self- reports of delinquency, deviant peers, substance use, antisocial attitudes and personality. For parents, we conducted DSM-IV clinical assessments of alcohol abuse and dependence. Findings A history of parental alcohol dependence was associated with higher levels of disinhibition only when adolescents were related biologically to their rearing parents. Within families with a history of parental alcoholism, exposure to parental alcohol misuse during the life-time of the adolescent was associated with increased odds of using alcohol in adopted adolescents only. Conclusions These findings suggest that the association between a history of parental alcohol dependence and adolescent offspring behavioral disinhibition is attributable largely to genetic rather than environmental transmission. We also obtained some evidence for parental alcohol misuse as a shared environmental risk factor in adoptive families. [source]

    Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study

    ADDICTION, Issue 2 2006
    Tim Rhodes
    ABSTRACT Objectives To estimate the prevalence of HIV, hepatitis C virus (HCV) and syphilis in injecting drug users (IDUs) in Russia. Methods Unlinked anonymous cross-sectional survey of 1473 IDUs recruited from non-treatment settings in Moscow, Volgograd and Barnaul (Siberia), with oral fluid sample collection for HIV, HCV antibody (anti-HIV, anti-HCV) and syphilis testing. Results Prevalence of antibody to HIV was 14% in Moscow, 3% in Volgograd and 9% in Barnaul. HCV prevalence was 67% in Moscow, 70% in Volgograd and 54% in Barnaul. Prevalence of positive syphilis serology was 8% in Moscow, 20% in Volgograd and 6% in Barnaul. Half of those HIV positive and a third of those HCV positive were unaware of their positive status. Common risk factors associated with HIV and HCV infection across the cities included both direct and indirect sharing of injecting equipment and injection of home-produced drugs. Among environmental risk factors, we found increased odds of anti-HIV associated with being in prison in Moscow, and some association between official registration as a drug user and anti-HIV and anti-HCV. No associations were found between sexual risk behaviours and anti-HIV in any city. Conclusions HIV prevalence among IDUs was markedly higher than city routine surveillance data suggests and at potentially critical levels in terms of HIV prevention in two cities. HCV prevalence was high in all cities. Syphilis prevalence highlights the potential for sexual risk and sexual HIV transmission. Despite large-scale testing programmes, knowledge of positive status was poor. The scaling-up of harm reduction for IDUs in Russia, including sexual risk reduction, is an urgent priority. [source]

    Multilevel Analysis of the Chronic Care Model and 5A Services for Treating Tobacco Use in Urban Primary Care Clinics

    HEALTH SERVICES RESEARCH, Issue 1 2009
    Dorothy Y. Hung
    Objective. To examine the chronic care model (CCM) as a framework for improving provider delivery of 5A tobacco cessation services. Methods. Cross-sectional surveys were used to obtain data from 497 health care providers in 60 primary care clinics serving low-income patients in New York City. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate the probability of full 5A service delivery, adjusting for provider covariates and clustering effects. We examined associations between provider delivery of 5A services, clinic implementation of CCM elements tailored for treating tobacco use, and the degree of CCM integration in clinics. Principal Findings. Providers practicing in clinics with enhanced delivery system design, clinical information systems, and self-management support for cessation were 2.04,5.62 times more likely to perform all 5A services ( p<.05). CCM integration in clinics was also positively associated with 5As delivery. Compared with none, implementation of one to six CCM elements corresponded with a 3.69,30.9 increased odds of providers delivering the full spectrum of 5As ( p<.01). Conclusions. Findings suggest that the CCM facilitates provider adherence to the Public Health Service 5A clinical guideline. Achieving the full benefits of systems change may require synergistic adoption of all model components. [source]

    Family history of Crohn's disease is associated with an increased risk for Crohn's disease of the pouch

    INFLAMMATORY BOWEL DISEASES, Issue 2 2009
    Bo Shen MD
    Abstract Background: Crohn's disease (CD) of the pouch can occur in patients with restorative proctocolectomy and ileal pouch,anal anastomosis originally performed for a preoperative diagnosis of ulcerative colitis (UC). CD of the pouch was often observed in patients with a family history of CD. The purpose was to determine whether the family history of CD increased the risk for CD of the pouch in patients who underwent restorative proctocolectomy. Methods: A total of 558 eligible patients seen in the Pouchitis Clinic were enrolled, including 116 patients with CD of the pouch and 442 patients with a normal pouch or other pouch disorders. Demographic and clinical variables were included in the study. Multivariable logistic regression analyses were performed. Results: The adjusted multivariate logistic analyses revealed that the risk for CD of the pouch was increased in patients with a family history of CD, with an odds ratio (OR) of 3.22 (95% confidence interval [CI] 1.56,6.67), or with a first-degree relative with CD (OR = 4.18, 95% CI, 1.48,11.8), or with a greater number of family members with CD (OR = 2.00 per family member, 95% CI, 1.19,3.37), adjusting for age, gender, smoking status, duration of IBD, duration of having a pouch, and a preoperation diagnosis of indeterminate colitis or CD. In addition, patients of younger age and longer duration of having a pouch had a higher risk for CD of the pouch. A diagnosis of CD of the pouch was associated with a poor outcome, with a greater than 5-fold estimated increased odds of pouch failure (OR = 5.58, 95% CI, 2.74,11.4). Conclusions The presence of a family history of CD is associated with an increased risk for CD of the pouch, which in turn has a high risk for pouch failure. (Inflamm Bowel Dis 2008) [source]

    Risky weight control among university students

    INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2006
    Hala Tamim PhD
    Abstract Objective The objectives of the current study were to investigate risky weight control measures (vomiting or pills) among university students in Lebanon and to assess their relation to demographic, scholastic, and health risk behavioral characteristics. Method The study used a cross-sectional design. A proportionate random sample of 2,013 students was selected from public and private universities in Greater Beirut. Each participant completed a self-administered anonymous questionnaire. Results Among participating students, 123 (6.1%) reported practicing risky weight control measures. Multivariate analysis indicated that younger females, cigarette smokers, engaged/married students, and those with a higher body mass index (BMI) were at increased odds of performing risky weight control measures. Conclusion Health awareness measures need to be proposed and, if possible, implemented to better define the motives and methods of weight reduction among Lebanese youth. © 2005 by Wiley Periodicals, Inc. [source]

    The Socio-economic Integration of the Ethiopian Community in Israel

    INTERNATIONAL MIGRATION, Issue 3 2004
    Shira Offer
    ABSTRACT Using data from the 1995 Israeli Census of Population, this study examines the demographic, human capital, and labour force characteristics of the Ethiopian community in Israel and its determinants of employment. The results provide strong evidence for the overall disadvantaged socio-economic status of the Ethiopian community and reveal substantial gaps in educational and occupational attainment between Ethiopian Israelis and members of other ethnic groups in Israeli society. Ethiopian Israelis have substantially lower levels of education, lower employment rates, and are more likely to have low-skilled occupations. However, multivariate analyses show that the determinants of employment of Ethiopian Israelis are relatively similar to those of other ethnic groups. Education and veteran status are found to be especially important factors associated with increased odds of employment. Although the rates of return from education are lower among Israelis of Ethiopian origin compared to other ethnic groups, this study suggests that education constitutes the major avenue for upward mobility in the Ethiopian community. Nevertheless, considering their current disadvantaged position, the question of whether Ethiopian immigrants will manage in the long run to climb up the socio-economic ladder and significantly improve their status, or whether they run the risk of becoming a marginalized ethnic group in Israeli society, remains a major concern. Implications for the formation of a new cleavage in Israeli society and the emergence of a stratification system based on race are discussed. [source]

    Vertebral Fractures in Beijing, China: The Beijing Osteoporosis Project

    JOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2000
    Xu Ling
    Abstract Women in China have much lower risk of hip fracture than women in Europe or North America but their risk of vertebral fractures is not known. Lateral spine radiographs, hip and lumbar spine bone density, and potential risk factors for and consequences of vertebral fractures were assessed in a random sample of 402 women age 50 years or older living in Beijing, China. The prevalence of vertebral fractures, defined by vertebral morphometry, increased from 5% (95% CI, 1,9%) in 50- to 59-year olds to 37% (27-46%) among women age 80 years or older. The age-standardized prevalence of vertebral fractures was 5.5% lower than found by similar methods for women in Rochester, MN, U.S.A. Each SD lower spine bone mineral density (BMD) was associated with a 2.4-fold (1.7-3.5) increased odds of having a vertebral fracture. Women with a history of heavy physical labor had a lower risk of vertebral fractures. Vertebral fractures were associated with decreased height loss and limited physical function but not chronic back pain. Women in Beijing, China have lower bone density and a slightly lower rate of vertebral fracture than white women in the United States. Low bone density and more sedentary occupations increase the risk of fracture in women living in urban China. [source]

    Dental Service Utilization among Urban and Rural Older Adults in China , A Brief Communication

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2007
    Bei Wu PhD
    Abstract Objectives: China's health care system is bifurcated in nature between rural and urban areas. In addition, there is a huge gap in socioeconomic status between rural and urban residents. The purpose of the study was to examine the factors related to dental visits among elders in rural and urban areas of Shanghai, China. Methods: Using a stratified random sampling method, a cross-sectional, face-to-face survey was conducted among elders aged 60 years and above in Shanghai during 2003-04. A total of 1,044 older respondents were included in the sample. Results: There was a significant urban and rural difference in dental visit rates over the 12-month period of the study. Results from the logistic regression analysis suggested that residing in urban areas was a significant positive factor related to dental visits. In addition, being younger, being able to pay out-of-pocket medical expenses, having had regular medical checkups, having a higher number of limitations because of chronic conditions, and being more concerned about eating a healthy diet were associated with increased odds of dental visits. Conclusions: Results suggest that urban,rural differences, as reflected in the socioeconomic status gap, disparity in medical insurance coverage, and access to dental care, have a significant impact on the use of dental services by Chinese elders. Individual sociodemographic characteristics, health status, and health attitude are important explanatory variables. [source]

    Substance Abuse Treatment and Hospitalization among a Cohort of HIV-Infected Individuals with Alcohol Problems

    ALCOHOLISM, Issue 3 2005
    Anita Palepu
    Background: We examined the association of substance abuse treatment services on hospitalization among participants in the HIV-Alcohol Longitudinal Cohort (HIV-ALC) study of HIV-infected individuals with a history of alcohol problems. Methods: A standardized questionnaire that inquired about demographics, substance use, use of substance abuse treatment services, and hospitalization was administered to 349 HIV-ALC participants. We defined substance abuse treatment services as any of the following in the past 6 months: 12 weeks in a half-way house or residential facility, 12 visits to a substance abuse counselor or mental health professional, or participation in any methadone maintenance program. Results: Almost one third of this cohort were hospitalized in the past 6 months. Substance abuse treatment was not significantly associated with hospitalization adjusted odds ratio (AOR) 1.0; 95% confidence interval (CI) 0.7,1.5), whereas homelessness (AOR 2.3; 95% CI 1.5,3.6), injection drug use (AOR 1.7; 95% CI 1.0,2.7), severity of alcohol dependence (AOR 1.02; 95% CI 1.00,1.05), CD4 cell count (AOR 0.999; 95% CI 0.998,1.00), and HIV RNA (AOR 1.1; 95% CI 1.0,1.2) were independently associated with increased odds of hospitalization over time. Conclusions: Engagement in substance abuse treatment was not associated with a decrease in hospital use by HIV-infected individuals with a history of alcohol problems. The period of substance abuse treatment may present an opportunity to address health care utilization patterns of HIV-infected individuals. [source]

    Frequency and predictors of de novo hepatocellular carcinoma in patients awaiting orthotopic liver transplantation during the model for end-stage liver disease era,

    LIVER TRANSPLANTATION, Issue 2 2008
    Carla W. Brady
    In the current system of allocation, patients awaiting orthotopic liver transplantation (OLT) remain at risk of developing de novo hepatocellular carcinoma (HCC) and removal from the waiting list. Using the United Network for Organ Sharing database, we calculated the rate and identified predictors of de novo HCC in patients listed for OLT between February 2002 and December 2004. Among 8566 patients, 1167 (13.6%) developed de novo HCC. Predictors of increased odds of de novo HCC were older age, male gender, Asian race, other race, hepatitis C, and hepatitis B. A sensitivity analysis of 2067 patients waiting at least 6 months found that 16.2% developed de novo HCC. Older age [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03, 1.07], male gender (OR 2.01; 95% CI 1.49, 2.71), Asian race (OR 2.39; 95% CI 1.20, 4.76), other race (OR 1.94; 95% CI 1.40, 2.68), hepatitis C (OR 2.36; 95% CI 1.76, 3.16), and hepatitis B (OR 1.96; 95% CI 1.19, 3.23) remained predictors of increased odds of de novo HCC, and alcoholic liver disease (OR 1.40; 95% CI 1.06, 1.86) emerged as a predictor of increased odds of de novo HCC. A significant proportion of patients listed for OLT develop de novo HCC. Identifying predictors of HCC in these patients may facilitate timely HCC screening and diagnosis. Liver Transpl 14:228,234, 2008. © 2008 AASLD. [source]

    The effect of parental mental health on proxy reports of health-related quality of life in children with sickle cell disease,

    PEDIATRIC BLOOD & CANCER, Issue 4 2010
    Julie A. Panepinto MD, MSPH
    Abstract Background The objectives of this study were to evaluate factors that influence agreement between parent-proxy and child self-report of health-related quality of life (HRQL) in sickle cell disease. We hypothesized that the mental health of the parent, parental HRQL and child characteristics would affect agreement. Procedure In a cross-sectional study of children with sickle cell disease, HRQL of the child and the parent's HRQL and mental health were assessed. The effect of parent and child characteristics on agreement between parent-proxy and child self-report of HRQL were determined. Results Rates of agreement between parent-proxy and child self-report of HRQL ranged between 42% and 49%. Parents with increased symptoms of distress had an increased odds of reporting a worse physical (Odds Ratio (OR) 1.12) and psychosocial HRQL (OR 1.10) compared to the child's self-report. Severe sickle cell disease was associated with an increased odds of the parent reporting the child's physical HRQL was worse, (OR 4.68) compared to the child's self-report. Conclusions Greater symptoms of distress in the parent are associated with worse parent-proxy report of the child's HRQL. Severe sickle cell disease is associated with greater disagreement between parent-proxy and child self-report of HRQL. These findings broaden our understanding of factors that influence proxy-reporting of a child's HRQL. Pediatr Blood Cancer. 2010;55:714,721. © 2010 Wiley-Liss, Inc. [source]

    Factors associated with women's risk of rape in the military environment,

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2003
    Anne G. Sadler R.N.
    Abstract Background Health hazards specific to women workers have not been adequately documented. This study assessed military environmental factors associated with rape occurring during military service, while controlling for pre-military trauma experiences. Methods A national cross-sectional survey of 558 women veterans serving in Vietnam or in subsequent eras was obtained through structured telephone interviews. Results Rape was reported by 28% (n,=,151) of participants, with consistent rates found across eras. Military environmental factors were associated with increased likelihood of rape, including: sexual harassment allowed by officers (P,<,0.0001), unwanted sexual advances on-duty (P,<,0.0001) and in sleeping quarters (P,<,0.0001). Conclusion Violence towards military women has identifiable risk factors. Work and living environments where unwanted sexual behaviors occurred were associated with increased odds of rape. Officer leadership played an important role in the military environment and safety of women. Assailant alcohol and/or drug abuse at time of rape was notable. Interventions and policies based on modifiable environmental risk factors are needed to increase protection for women in the workplace. Am. J. Ind. Med. 43:262,273, 2003. Published 2003 Wiley-Liss, Inc. [source]

    Characteristics of Crashes With Farm Equipment That Increase Potential for Injury

    THE JOURNAL OF RURAL HEALTH, Issue 4 2007
    Corinne Peek-Asa MPH
    ABSTRACT:,Context:Crash fatality and injury rates are higher on rural roadways than other roadway types. Although slow-moving farm vehicles and equipment are risk factors on rural roads, little is known about the characteristics of crashes with farm vehicles/equipment.Purpose:To describe crashes and injuries for the drivers of farm vehicles/equipment and non-farm vehicles involved in an injury crash. Passengers are not included in this analysis.Methods:Injury crashes were included that involved a farm vehicle/equipment and at least one non-farm vehicle reported in Iowa Department of Transportation crash data from 1995 to 2004. Odds ratios were calculated through logistic regression to identify increased odds for injury among drivers of non-farm vehicles and farm vehicles/equipment. We examined frequently occurring crash characteristics to identify crash scenarios leading to the highest odds for injury.Findings:Non-farm vehicle drivers were 5.23 times more likely to be injured than farm vehicle/equipment drivers (95% CI = 4.12,6.46). The absence of restraint use was a significant predictor of injury for both farm vehicle/equipment drivers (OR = 2.85; 95% CI = 1.14,7.13) and non-farm vehicle drivers (OR = 2.53; 95% CI = 1.54,4.15). Crash characteristics increasing the odds of injury for non-farm vehicle drivers included speeding, passing the farm vehicle/equipment, driving on a county road, having a frontal impact collision, and crashing in darkness. Ejection was the strongest predictor of injury for the farm vehicle/equipment driver.Conclusion:Non-farm vehicle drivers were much more likely to be injured than farm vehicle/equipment drivers, suggesting that farm vehicle/equipment crash prevention should be a priority for all rural road users. Prevention strategies that reduce motor vehicle speed, assist in safe passing, increase seat belt use, and increase conspicuousness of the farm vehicle/equipment are suggested. [source]

    Searching for Links between Endotoxin Exposure and Pregnancy Loss: CD14 Polymorphism in Idiopathic Recurrent Miscarriage

    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 4 2003
    Jari Karhukorpi
    Problem: Lipopolysaccharide (LPS) (endotoxin) is a well-known inducer of abortions in mice. In addition it has been proposed that gut-derived LPS of gram-negative bacteria may play a role in triggering idiopathic recurrent miscarriage (IRM) in humans. CD14 is one of the key molecules that mediates the effects of LPS. Promoter region polymorphism (,159C/T) in the CD14 gene is functionally important by regulating CD14 levels. High-producing CD14 genotype (TT) associates with deleterious effects of gut-derived LPS in hepatic cirrhosis in humans. It is not known whether women with IRM are genetically more prone to suffer from toxic effects of LPS. Method of study: By using polymerase chain reaction we analyzed the CD14 promoter region polymorphism in 38 women with IRM and in 127 normal controls of Finnish origin. Results: There were no significant differences in the CD14(,159C/T) allele or the genotype frequencies between the IRM women and the controls. However, there was a trend associating the presence of the T allele with increased odds of miscarriage. Conclusions: Although we were not able to find a statistically significant association between CD14 genotypes and IRM in our relatively small study population, a further study with a larger sample size is warranted to explore the role of high-producing CD14 genotypes in IRM. Also studies highlighting environmental LPS triggers and other intrinsic mediators of LPS signalling are needed to solve the enigmatic role of LPS in IRM in humans. [source]

    Prevalence of and risk factors for prostatitis in African American men: The Flint Men's Health Study

    THE PROSTATE, Issue 1 2009
    Lauren P. Wallner
    Abstract INTRODUCTION Prostatitis is a common, yet ill-defined condition without clear diagnostic criteria and treatment strategies. Previous studies examining the prevalence and correlates of prostatitis are limited in their inclusion of primarily white populations. The objective of the current study was to identify prevalence of and risk factors for prostatitis in a population-based sample of African-American men. METHODS In 1996, a probability sample of 703 African-American men, aged 40,79, residing in Genesee County, Michigan without a prior history of prostate cancer/surgery provided responses to a structured interview-administered questionnaire which elicited information regarding sociodemographics, current stress and health ratings, and past medical history, including history of physician diagnosed prostatitis, BPH and sexually transmitted diseases. Logistic regression was used to identify predictors of prostatitis after adjustment for age. RESULTS Forty-seven (6.7%) of the 703 men reported a history of prostatitis. Increased frequency of sexual activity and physical activity were significantly associated with decreased odds of disease. Moderate to severe lower urinary tract symptoms (LUTS) and a history of BPH were significantly associated with prostatitis after adjustment for age. CONCLUSION After adjustment for age, LUTS severity and history of BPH were associated with increased odds of prostatitis. BMI, physical activity and sexual frequency were associated with decreased odds of prostatitis. Finally, poor emotional and physical health, high perceived stress and low social support were associated with an increased risk of prostatitis history. Importantly, these findings suggest that the primary risk factors for this condition are largely modifiable and highlight potential targets for future prevention. Prostate 69: 24,32, 2009. © 2008 Wiley,Liss, Inc. [source]

    Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study

    ANNALS OF NEUROLOGY, Issue 5 2006
    Gregory W. Albers MD
    Objective To determine whether prespecified baseline magnetic resonance imaging (MRI) profiles can identify stroke patients who have a robust clinical response after early reperfusion when treated 3 to 6 hours after symptom onset. Methods We conducted a prospective, multicenter study of 74 consecutive stroke patients admitted to academic stroke centers in North America and Europe. An MRI scan was obtained immediately before and 3 to 6 hours after treatment with intravenous tissue plasminogen activator 3 to 6 hours after symptom onset. Baseline MRI profiles were used to categorize patients into subgroups, and clinical responses were compared based on whether early reperfusion was achieved. Results Early reperfusion was associated with significantly increased odds of achieving a favorable clinical response in patients with a perfusion/diffusion mismatch (odds ratio, 5.4; p = 0.039) and an even more favorable response in patients with the Target Mismatch profile (odds ratio, 8.7; p = 0.011). Patients with the No Mismatch profile did not appear to benefit from early reperfusion. Early reperfusion was associated with fatal intracranial hemorrhage in patients with the Malignant profile. Interpretation For stroke patients treated 3 to 6 hours after onset, baseline MRI findings can identify subgroups that are likely to benefit from reperfusion therapies and can potentially identify subgroups that are unlikely to benefit or may be harmed. Ann Neurol 2006 [source]

    Maternal height and length of gestation: Does this impact on preterm labour in Asian women?

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009
    Ben Chong-Pun CHAN
    Background: Both maternal height and ethnicity may influence the gestation length, but their independent effect is unclear. Aim: This study was performed to examine the relationship between maternal height and gestational length in women with singleton pregnancies in a Chinese and southeast Asian population. Methods: A retrospective cohort study was performed on women carrying singleton pregnancies with spontaneous labour in a 48-month period managed under our department to determine the relationship between maternal height, expressed in quartiles, with the mean gestational age and incidence of preterm labour. Results: Of the 16 384 women who delivered within this period, the 25th, 50th and 75th percentile values of maternal height were 153 cm, 156 cm and 160 cm respectively. Excluded from analysis were 6597 women because of multifetal pregnancy, teenage pregnancy (maternal age , 19 years old), induction of labour or elective caesarean section, or incomplete data due to no antenatal booking in our hospital. Significant differences were found in the maternal weight and body mass index, incidences of multiparity and smokers, gestational age and birthweight among the four quartiles. There was significantly increased incidence of preterm birth between 32 and 37 weeks gestation in women with shorter stature. Conclusions: In our population, maternal height has an influence on gestational length, and the lower three quartiles was associated with increased odds of labour at > 32 to < 37 weeks. This effect should be taken into consideration in the adoption of international recommendations in obstetric management and intervention. [source]

    The urban and rural divide for women giving birth in NSW, 1990,1997

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2000
    Christine L. Roberts
    ABSTRACT OBJECTIVE: To examine trends in the pregnancy profile and outcomes of urban and rural women. METHODS: Data were obtained from the NSW Midwives Data Collection on births in NSW, 1990,1997. Associations between place of residence (urban/rural) and maternal factors and pregnancy outcomes were examined, including changes over time. RESULTS: From 1990 to 1997 there were 685,631 confinements in NSW and these mothers resided as follows: 76% metropolitan, 5% large rural centres, 8% small rural centres, 11% other rural areas and 1% remote areas. Rural mothers were more likely to be teenagers, multiparous, without a married or de facto partner, public patients and smokers. Births in rural areas declined, particularly among women aged 20,34 years. Infants born to mothers in remote communities were at increased odds of stillbirth and tow Apgar scores (all women) and small,for,gestational,age (SGA) (Indigenous women only). CONCLUSIONS: The profile of pregnant women in rural NSW is different from their urban counterparts and is consistent with relative socioeconomic disadvantage and possibly suboptimal maternity services in some areas. While increased risk of SGA is associated with environmental factors such as smoking and nutrition, the reasons for increased risk of stillbirth are unclear. Although there does not appear to be an increased risk of preterm birth for rural women this may be masked by transfer of high,risk pregnancies interstate. IMPLICATIONS: Maternity services need to be available and accessible to all rural women with targeting of interventions known to reduce low birthweight and perinatal death. [source]

    Antiretroviral therapy and preterm delivery,a pooled analysis of data from the United States and Europe

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2010
    CL Townsend
    Please cite this paper as: Townsend C, Schulte J, Thorne C, Dominguez K, Tookey P, Cortina-Borja M, Peckham C, Bohannon B, Newell M, for the Pediatric Spectrum of HIV Disease Consortium, the European Collaborative Study and the National Study of HIV in Pregnancy and Childhood. Antiretroviral therapy and preterm delivery,a pooled analysis of data from the United States and Europe. BJOG 2010;117:1399,1410. Objective, To investigate reported differences in the association between highly active antiretroviral therapy (HAART) in pregnancy and the risk of preterm delivery among HIV-infected women. Design, Combined analysis of data from three observational studies. Setting, USA and Europe. Population, A total of 19 585 singleton infants born to HIV-infected women, 1990,2006. Methods, Data from the Pediatric Spectrum of HIV Disease project (PSD), a US monitoring study, the European Collaborative Study (ECS), a consented cohort study, and the National Study of HIV in Pregnancy and Childhood (NSHPC), the United Kingdom and Ireland surveillance study. Main outcome measure, Preterm delivery rate (<37 weeks of gestation). Results, Compared with monotherapy, HAART was associated with increased preterm delivery risk in the ECS (adjusted odds ratio [AOR] 2.40, 95% CI 1.49,3.86) and NSHPC (AOR 1.43, 95% CI 1.10,1.86), but not in the PSD (AOR 0.92, 95% CI 0.67,1.26), after adjusting for relevant covariates. Because of heterogeneity, data were not pooled for this comparison, but heterogeneity disappeared when HAART was compared with dual therapy (P = 0.26). In a pooled analysis, HAART was associated with 1.5-fold increased odds of preterm delivery compared with dual therapy (95% CI 1.19,1.87, P = 0.001), after adjusting for covariates. Conclusions, Heterogeneity in the association between HAART and preterm delivery was not explained by study design, adjustment for confounders or a standard analytical approach, but may have been the result of substantial differences in populations and data collected. The pooled analysis comparing HAART with dual therapy showed an increased risk of preterm delivery associated with HAART. [source]

    Evidence of placental haemorrhage and preterm delivery

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2010
    JW Gargano
    Please cite this paper as: Gargano J, Holzman C, Senagore P, Reuss M, Pathak D, Williams M, Fisher R. Evidence of placental haemorrhage and preterm delivery. BJOG 2010;117:445,455. Objective, To evaluate evidence of placental haemorrhage (PH) obtained through maternal interviews, patient charts and placental pathology examinations as potential indicators of a ,bleeding pathway' to preterm delivery (PTD). Design, Prospective cohort. Setting, Fifty-two clinics in five communities in Michigan, USA (1998,2004). Population, A subset (n = 996) of cohort participants with complete placental pathology data. Methods, First-trimester bleeding and placental abruption were ascertained by mid-trimester interviews and chart review, respectively. Disc-impacting blood clot was defined as a gross placental examination finding of a blood clot impacting adjacent tissue. Microscopic haemorrhage was defined as ,high' (top quintile) scores on an aggregate measure of placental pathology findings suggestive of atypical maternal vessel haemorrhage. These four PH indicators were compared with one another and with risk of PTD assessed by logistic regression analyses. Main outcome measures, Preterm delivery and PTD subtypes (i.e. <35 weeks, 35,36 weeks; spontaneous, medically indicated) compared with term deliveries. Results, Placental abruption cases had 2.3-fold to 5.5-fold increased odds of the other three PH indicators. Disc-impacting blood clots and microscopic haemorrhage were associated with one another (odds ratio [OR] = 4.6), but not with first-trimester bleeding. In a multivariable model that included all four PH indicators and confounders, risk of PTD < 35 weeks was elevated with first-trimester bleeding (OR = 1.9 [1.0, 3.4]), placental abruption (OR = 5.2 [1.7, 16.2]), disc-impacting blood clots (OR = 2.3 [1.0, 5.0]) and microscopic haemorrhage (OR = 2.4 [1.4, 4.2]). Conclusions, Multiple clinical and subclinical PH indicators are associated with PTD, particularly early PTD. [source]

    The sex ratio of pregnancies complicated by hospitalisation for hyperemesis gravidarum

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2004
    Melissa A. Schiff
    Objective To evaluate the sex ratio among pregnancies complicated by first trimester hyperemesis gravidarum and extend previous findings to include a measure of severity. Design Population-based case control study. Setting All non-federal hospitals in Washington State. Population Two thousand and one hundred and ten pregnant women hospitalised for hyperemesis gravidarum and 9783 pregnant women without hyperemesis gravidarum. Methods The infant sex ratio for pregnant women admitted to the hospital for hyperemesis gravidarum was evaluated using the Washington State hospital discharge database linked to the birth certificate database for years 1987,1996. Cases were pregnant women hospitalised for hyperemesis gravidarum (International Classification for Diseases,9th edition [ICD-9] diagnosis code 643) in the first trimester. Controls were women who experienced a singleton live birth and were not hospitalised for hyperemesis in Washington State during the same time period. Regression analysis with general estimating equations was used to calculate an odds ratio (OR) and 95% confidence interval (CI) to assess the association of hyperemesis gravidarum with infant sex ratio. Main outcome measure Infant sex ratio. Results Pregnant women hospitalised for hyperemesis gravidarum in the first trimester had a 50% increased odds of having a female infant compared with controls (OR 1.5, 95% CI 1.4, 1.7). Women hospitalised for three or more days had the greatest odds of having a female infant compared with control women (OR 1.8, 95% CI 1.5, 2.0). Conclusion Hyperemesis gravidarum is associated with an increase in female live births and may be a marker for high oestrogen levels in utero. [source]

    Dizziness Presentations in U.S. Emergency Departments, 1995,2004

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2008
    Kevin A. Kerber MD
    Abstract Objectives:, The objectives were to describe presentation characteristics and health care utilization information pertaining to dizziness presentations in U.S. emergency departments (EDs) from 1995 through 2004. Methods:, From the National Hospital Ambulatory Medical Care Survey (NHAMCS), patient visits to EDs for "vertigo-dizziness" were identified. Sample data were weighted to produce nationally representative estimates. Patient characteristics, diagnoses, and health care utilization information were obtained. Trends over time were assessed using weighted least squares regression analysis. Multivariable logistic regression analysis was used to control for the influence of age on the probability of a vertigo-dizziness visit during the study time period. Results:, Vertigo-dizziness presentations accounted for 2.5% (95% confidence interval [CI] = 2.4% to 2.6%) of all ED presentations during this 10-year period. From 1995 to 2004, the rate of visits for vertigo-dizziness increased by 37% and demonstrated a significant linear trend (p < 0.001). Even after adjusting for age (and other covariates), every increase in year was associated with increased odds of a vertigo-dizziness visit. At each visit, a median of 3.6 diagnostic or screening tests (95% CI = 3.2 to 4.1) were performed. Utilization of many tests increased over time (p < 0.01). The utilization of computerized tomography and magnetic resonance imaging (CT/MRI) increased 169% from 1995 to 2004, which was more than any other test. The rate of central nervous system diagnoses (e.g., cerebrovascular disease or brain tumor) did not increase over time. Conclusions:, In terms of number of visits and important utilization measures, the impact of dizziness presentations on EDs is substantial and increasing. CT/MRI utilization rates have increased more than any other test. [source]

    Predictors of Mortality in Patients with Delirium Tremens

    ACADEMIC EMERGENCY MEDICINE, Issue 8 2008
    Ayesha Khan MD
    Abstract Objectives:, The objectives were to identify factors that may help predict mortality for patients with delirium tremens (DT). Methods:, The authors conducted a 1:1 gender- and age-matched case,control study of patients hospitalized for DT. Using McNemar chi-square tests and conditional logistic regression (CLR), risk factors for death, including demographics, location of diagnosis, vital sign derangements, treatment methods, and comorbid conditions, were evaluated. Crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Results:, Thirty-five patients with DT died between January 2000 and June 2006. The majority (31; 88.6%) were male with a mean (±standard deviation [SD]) age of 51.7 (±7.6) years. Hyperthermia in the first 24 hours of DT diagnosis (OR = 10.0, 95% CI = 2.3 to 42.7), persistent tachycardia (OR = 24.0, 95% CI = 3.3 to 177.4), and use of restraints (OR = 7.50, 95% CI = 1.7 to 32.8) were associated with increased mortality by univariate analysis, while an emergency department (ED) diagnosis of DT (OR = 0.18, 95% CI = 0.05 to 0.6) and use of clonidine (OR = 0.10, 95% CI = 0.01 to 0.78) were associated with decreased mortality. In the CLR model, restraint use and hyperthermia were the only variables that remained significant (OR = 5.8, 95% CI = 1.0 to 32.2; and OR = 6.1, 95% CI = 1.2 to 30.4, respectively). Conclusions:, The use of restraints and hyperthermia is associated with increased odds of death for patients with DT. This study highlights the need for further research into modifiable factors influencing mortality from DT. [source]

    Urinary diversion and morbidity after radical cystectomy for bladder cancer,

    CANCER, Issue 2 2010
    John L. Gore MD
    Abstract BACKGROUND: The rate of continent urinary diversion after radical cystectomy for bladder cancer varies by patient and provider characteristics. Demonstration of equivalent complication rates, independent of diversion type, may decrease provider reluctance to perform continent reconstructions. The authors sought to determine whether continent reconstructions confer increased complication rates after radical cystectomy. METHODS: From the Nationwide Inpatient Sample, the authors used International Classification of Disease (ICD-9) codes to identify subjects who underwent radical cystectomy for bladder cancer during 2001-2005. They determined acute postoperative medical and surgical complications from ICD-9 codes and compared complication rates by reconstruction type using the nearest neighbor propensity score matching method and multivariate logistic regression models. RESULTS: Adjusting for case-mix differences between reconstructive groups, continent diversions conferred a lower risk of medical, surgical, and disposition-related complications that was statistically significant for bowel (3.1% lower risk; 95% confidence interval [95% CI], ,6.8% to ,0.1%), urinary (1.2% lower risk; 95% CI, ,2.3%, to ,0.4%), and other surgical complications (3.0% lower risk; 95% CI, ,6.2% to ,0.4%), and discharge other than home (8.2% lower risk; 95% CI, ,12.1% to ,4.6%) compared with ileal conduit subjects. Older age and certain comorbid conditions, including congestive heart failure and preoperative weight loss, were associated with significantly increased odds of postoperative medical and surgical complications in all subjects. CONCLUSIONS: Mode of urinary diversion after radical cystectomy for bladder cancer is not associated with increased risk of immediate postoperative complications. These results may encourage broader consideration of continent urinary diversion without concern for increased complication rates. Cancer 2010. © 2010 American Cancer Society. [source]

    Cancer incidence after localized therapy for prostate cancer

    CANCER, Issue 5 2006
    Kihyuck Moon MD
    Abstract BACKGROUND. Second cancers may occur in patients who have undergone radiation therapy. The risk for these adverse events after therapy is uncertain. In this study, the authors examined the size and significance of the observed association between occurrences of secondary cancers 5 years after radiotherapy in a large population of men with incident prostate cancer. METHODS. Men with incident prostate cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) registry and were distinguished by the type of treatment received, tumor stage, tumor grade, and age at diagnosis. SEER data also were used to identify occurrences of secondary cancer beginning 5 years after the date patients were diagnosed with prostate cancer. Multivariate logistic regression analysis was used to estimate the adjusted odds of the subsequent occurrence of other cancers associated with types of radiation therapy received and was adjusted for the type of surgery, tumor grade, stage, and patient age. RESULTS. Compared with men who received no prostate cancer-directed radiation, men who received external beam radiation therapy (EBRT) as their only form of radiation therapy had statistically significant increased odds of developing secondary cancers at several sites potentially related to radiation therapy, including the bladder (odds ratio [OR], 1.63; 95% confidence interval [95% CI], 1.44,1.84) and rectum (OR, 1.60; 95% CI, 1.29,1.99). Men who received EBRT also had statistically significant higher odds of developing secondary cancers at sites in the upper body and other areas not potentially related to radiation therapy, including the cecum (OR, 1.63; 95% CI, 1.10,1.70), transverse colon (OR, 1.85; 95% CI, 1.30,2.63), brain (OR, 1.83; 95% CI, 1.22,2.75), stomach (OR, 1.38; 95% CI, 1.09,1.75), melanoma (OR, 1.29; 95% CI, 1.09,1.53), and lung and bronchus (OR, 1.25; 95% CI, 1.13,1.37) compared with the odds among men who received no radiation therapy. Men who received radiation therapy in the form of radioactive implants or isotopes, either in isolation or combined with beam radiation, did not have significantly different odds of secondary cancer occurring at any of the 20 most common sites. CONCLUSIONS. Patients who received with EBRT had significantly higher odds of developing second cancers both overall and in the areas that were exposed to radiation. It is noteworthy that, to the authors' knowledge, this report shows for the first time that, despite the higher doses of radiation delivered, patients who received radioactive implants had the lowest odds of developing second cancers. Cancer 2006. © 2006 American Cancer Society. [source]