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Putative Risk Factors (putative + risk_factor)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Cognitive effects of memantine in postmenopausal women at risk of dementia: a pilot study

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009
T. E. Wroolie
Background,,, To determine the effects of memantine on cognition in a normal population of postmenopausal women with putative risk factors for Alzheimer's disease (AD) using a built-in control for the genetic risk factor for AD (apoE-,4 status). Methods,,, A prospective, open-label, 6-month pilot medication trial with memantine and follow-up after discontinuance conducted at the Center for Neuroscience in Women's Health, Stanford University School of Medicine. Neuropsychological data were collected on 22 community-dwelling postmenopausal women (11 apoE-,4 carriers and 11 apoE-,4 non-carriers) with at least one putative risk factor for AD. Results,,, ApoE-,4 status was not a significant predictor of change in neuropsychological performance. Changes associated with memantine treatment for entire sample included significant declines in some variables associated with verbal learning and memory that improved upon medication withdrawal. A positive medication effect was noted with executive functions and possibly category fluency. Trend-level improvements were seen in motor dexterity of the non-dominant hand and maintained even after drug discontinuance. Conclusions,,, Treatment with memantine appeared to have differential effects on cognitive performance in a population of women with putative risk factors for AD. ApoE-,4 carrier status did not account for observed changes in cognition. [source]

The role of paracetamol in the pathogenesis of asthma

CLINICAL & EXPERIMENTAL ALLERGY, Issue 1 2010
H. Farquhar
Summary Paracetamol use represents a putative risk factor for the development of asthma. There is convincing epidemiological evidence that the risk of asthma may be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult life. A dose-dependent association has also been observed in these different age groups in different populations world-wide. An association has also been shown between paracetamol use in both rhinoconjunctivitis and eczema. There is biological plausibility with paracetamol use leading to decreased glutathione levels resulting in increased oxidant-induced inflammation and potentially enhanced T-helper type 2 responses. At the population level, patterns of paracetamol use might explain, to some extent, the world-wide variation in the prevalence of asthma and related disorders, particularly the high rates in English-speaking countries, which have high per capita prescription and over-the-counter use of paracetamol. A temporal association also exists between the international trends of increasing paracetamol use and increasing prevalence of asthma over recent decades. Further research is urgently required, in particular randomized-controlled trials (RCTs) into the long-term effects of frequent paracetamol use in childhood, to determine the magnitude and characteristics of any such risk. Importantly, RCTs will also enable evidence-based guidelines for the recommended use of paracetamol to be developed. Cite this as: H. Farquhar, A. Stewart, E. Mitchell, J. Crane, S. Eyers, M. Weatherall and R. Beasley, Clinical & Experimental Allergy, 2010 (40) 32,41. [source]

Gender differences in unipolar depression: an update of epidemiological findings and possible explanations

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2003
C. Kuehner
Objective: To give an update on epidemiological findings on sex differences in the prevalence of unipolar depression and putative risk factors. Material and methods: Systematic review of the literature. Results: Recent epidemiological research yields additional evidence for a female preponderance in unipolar depression, holding true across different cultural settings. Current explanations include artefacts, genetic, hormonal, psychological and psychosocial risk factors. Rather consistently, intrapsychic and psychosocial gender role related risk factors have been identified which may contribute to the higher depression risk in women. Gender role aspects are also reflected in endocrine stress reactions and possibly influence associated neuropsychological processes. Conclusion: There is a need for more integrative models taking into account psychological, psychosocial, and macrosocial risk factors as well as their interactions, which also connect these factors with physiological and endocrine responses. Furthermore, it is conceivable that across the life span, as well as across cultural settings, individual risk factors will add with varying emphasis to the higher prevalence of depression in women. [source]

Survey of major chronic iIlnesses and hospital admissions via the emergency department in a randomized older population in Randwick, Australia

EMERGENCY MEDICINE AUSTRALASIA, Issue 4 2002
Daniel KY Chan
Abstract Objective: To find out if patients with chronic illnesses living in the community are at risk of unplanned hospital admissions through emergency departments; what types of chronic illnesses may be putative risk factors; and if an increase in the number of chronic illnesses may be associated with increased risk. Methods: The survey included the completion of a standardized questionnaire for medical illnesses in a random sample of older people dwelling in the community and analysis of admission records to our hospital. The principal diagnoses for admissions were recorded. The risk factors for admissions were analysed. Results: Five hundred and twenty-six (239 men and 287 women) people aged 55 years and over were interviewed. Musculoskeletal disorders, hypertension, gastrointestinal disorders and ischaemic heart disease were the most frequently reported of the chronic illnesses surveyed. A total number of 70 people from the survey group with a total of 115 admissions through emergency departments were recorded. Using logistic regression model, hypertension, ischaemic heart disease and age were found to be risk factors for emergency admissions amongst this group of community-dwelling residents. The ratios were 2.03 (95% confidence interval (CI): 1.2,3.44), 2.02 (95% CI: 1.16,3.49) and 1.05 (95% CI: 1.02,1.09), respectively. Furthermore, multiple (three or more) chronic illnesses were found to be a strong predictor of hospital admission via emergency department (chi-square = 16.647, DF = 1, P -value < 0.001). Conclusion: We conclude that there was significant association between multiple chronic diseases and emergency admissions for older people. Of these, hypertension and ischaemic heart disease were found to be significant predictors. Age per se was found to be of borderline significance. [source]

Pathways to cannabis abuse: a multi-stage model from cannabis availability, cannabis initiation and progression to abuse

ADDICTION, Issue 3 2009
Nathan A. Gillespie
ABSTRACT Aims Although previous twin studies have modeled the association between drug initiation and abuse, none has included the obvious risk factor of drug availability. Our aim is to determine whether the genetic and environmental risk factors for cannabis availability also generate variation in cannabis initiation and/or progression to DSM-IV symptoms of abuse. Design We used multi-stage modeling, also known as causal-common-contingent (CCC) analysis, to partition the genetic and environmental factors into common and stage-specific components. Participants This report is based on data collected from 1772 adult males from the Mid Atlantic Twin Registry. Measurements The twins participated in two structured interviews which included clinical and non-clinical measures of cannabis abuse as well as retrospective assessments of perceived cannabis availability between ages 8 and 25 years. Findings Cannabis availability explained almost all the shared environmental risks in cannabis initiation and abuse. The influence of availability on the symptoms of abuse was indirect and mediated entirely by cannabis initiation. Conclusion These findings have begun to elucidate the causal processes underlying the liability to drug use and abuse in terms of putative risk factors. Specifically, our results show that the latent shared environmental factors in cannabis initiation and abuse can be explained by measured aspects of the shared environment,those responsible for variation in cannabis availability. [source]

Artificial neural networks as statistical tools in epidemiological studies: analysis of risk factors for early infant wheeze

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2004
Andrea Sherriff
Summary Artificial neural networks (ANNs) are being used increasingly for the prediction of clinical outcomes and classification of disease phenotypes. A lack of understanding of the statistical principles underlying ANNs has led to widespread misuse of these tools in the biomedical arena. In this paper, the authors compare the performance of ANNs with that of conventional linear logistic regression models in an epidemiological study of infant wheeze. Data on the putative risk factors for infant wheeze have been obtained from a sample of 7318 infants taking part in the Avon Longitudinal Study of Parents and Children (ALSPAC). The data were analysed using logistic regression models and ANNs, and performance based on misclassification rates of a validation data set were compared. Misclassification rates in the training data set decreased as the complexity of the ANN increased: h = 0: 17.9%; h = 2: 16.2%; h = 5: 14.9%, and h = 10: 9.2%. However, the more complex models did not generalise well to new data sets drawn from the same population: validation data set misclassification rates: h = 0: 17.9%; h = 2: 19.6%; h = 5: 20.2% and h = 10: 22.9%. There is no evidence from this study that ANNs outperform conventional methods of analysing epidemiological data. Increasing the complexity of the models serves only to overfit the model to the data. It is important that a validation or test data set is used to assess the performance of highly complex ANNs to avoid overfitting. [source]

Prevalence and Potential Risk Factors of Female Sexual Difficulties: An Urban Iranian Population-Based Study

THE JOURNAL OF SEXUAL MEDICINE, Issue 11 2009
Azita Goshtasebi MD
ABTSRACT Introduction., Female sexual dysfunction is common, a multifactorial phenomenon with a potential to cause marital strain, impaired fertility, and poor quality of life. Epidemiologic data are scarce and little is known about the prevalence of sexual difficulties and the exact role of putative risk factors in Iran. Aim., To determine the prevalence of female sexual difficulties and the potential risk factors in an urban Iranian population. Methods., A cross-sectional study was performed in the province of Kohgilooyeh,Boyerahmad (KB) in the southwest of Iran and involved sexually active urban women aged 15 years and over, selected via a quota-based cluster sampling method. The study used an ad hoc questionnaire covering the demographic and reproductive variables as well as the data related to sexual difficulties. Data were analyzed using multiple logistic regression models. The main outcome measures were the prevalence rates and the predictors of sexual difficulties. Main Outcome Measures., The prevalence of female sexual difficulties and the associated risk factors. Results., One thousand four hundred fifty-six sexually active women living in the urban areas of KB province in 2005 were selected. The mean age of the sample was 34.04 ± 9.2 (16,71) years and the mean number of completed grades was 7.18 (±4.8). More than 52% of the participants had experienced at least one type of sexual difficulty. The greatest and smallest frequencies were observed for orgasm difficulty (21.3%, confidence interval[CI]0.95 = 19.2,23.4%) and lubrication difficulty (11.9%, CI0.95 = 10.2,13.6%). Age, education, contraceptive modality, and obstetric/gynecologic procedures were all associated with at least one type of sexual dysfunction. Conclusion., Similar to previous studies, we found a relatively high prevalence of sexual difficulties in this urban population of low socioeconomic status. However, our results concerning the role of some demographic and reproductive variables in producing sexual difficulties were different from those reported by other researchers. Goshtasebi A, Vahdaninia M, and Rahimi Foroshani A. Prevalence and potential risk factors of female sexual difficulties: An urban Iranian population-based study. J Sex Med 2009;6:2988,2996. [source]

The Platysma Myocutaneous Flap: Underused Alternative for Head and Neck Reconstruction,

THE LARYNGOSCOPE, Issue 7 2002
Wayne M. Koch MD
Abstract Objectives The use, advantages, and disadvantages of the platysma flap were assessed. Study Design Retrospective review of the medical records of patients undergoing platysma flap reconstruction of the upper aerodigestive tract from 1987 to 2001. Methods Information regarding the tumor, surgical procedure, flap design, and outcome emphasizing complications and function was extracted. Associations between putative risk factors for flap failure and outcome were assessed using the ,2 test. Results Thirty-four patients underwent reconstruction with platysma flaps. Surgical defects included the oropharynx, oral cavity, and hypopharynx. Nine patients had had prior radiation therapy and all had some dissection of the ipsilateral neck. There were 5 postoperative fistulas (15%), flap desquamation was noted in 6 cases (18%), and 2 patients experienced loss of the distal skin closing the donor site. Complications were not associated with prior radiation. Hospital stay ranged from 5 to 21 days (mean, 10 d). There were no returns to the operating room or need for additional reconstruction. All but 1 patient resumed a normal diet within 3 months of surgery. There were no recurrences of cancer in the dissected neck regions. Conclusions The platysma flap is simple and versatile with properties similar to the radial forearm free flap. The rate of complications is similar to other published series, and problems encountered were manageable using conservative methods with excellent functional and cosmetic outcomes. These facts support the contention that the platysma myocutaneous flap can serve as a viable alternative to free tissue transfer and has advantages over pectoralis major pedicled flaps for reconstruction of many head and neck defects. [source]

Hepatitis C virus infection rates and risk factors in an Australian hospital endoscopy cohort

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009
Karen Vickery
Abstract Objective: To determine the reservoir and risk factors of HCV infection in a hospital population. Methods: The presence of anti-HCV in 2,119 endoscopy patients was related to putative risk factors for exposure using the SAS statistical package. Results: Most of the 4.7% of anti-HCV positive patients had multiple risk factors for HCV exposure. The risk was significantly increased in patients; with a previous history of hepatitis (36.4 fold), past history of injecting drugs (IDU) (32.1 fold), those born in North Africa, Middle East and Mediterranean countries (4.3 fold), had been tattooed before 1980s (3.3 fold), from 1980s-1990s (5.9 fold), had acupuncture before 1980s (3.8 fold), had a blood transfusion (3.6 fold), had clotting factors or growth hormone (4 fold), had contact with someone diagnosed with hepatitis in 1990s (4.1 fold). Of the anti-HCV patients 38 had a history of IDU, 43 were migrants and 10 were both. Conclusion: Anti-HCV prevalence was five times higher than predicted by the passive surveillance scheme and 20% of patients were unaware of their infection. Only one of these patients reported IDU. The evidence of HCV intersecting epidemics between developing and developed countries in Australia was strongly supported. Implications: The study provides a rational basis for targeted programs to identify asymptomatic HCV carriers who might benefit from the new antiviral treatment. [source]

Prospective Multicenter Bronchiolitis Study: Predicting Intensive Care Unit Admissions

ACADEMIC EMERGENCY MEDICINE, Issue 10 2008
Dorothy Damore MD
Abstract Objectives:, The authors sought to identify predictors of intensive care unit (ICU) admission among children hospitalized with bronchiolitis for ,24 hours. Methods:, The authors conducted a prospective cohort study during two consecutive bronchiolitis seasons, 2004 through 2006, in 30 U.S. emergency departments (EDs). All included patients were aged <2 years and had a final diagnosis of bronchiolitis. Regular floor versus ICU admissions were compared. Results:, Of 1,456 enrolled patients, 533 (37%) were admitted to the regular floor and 50 (3%) to the ICU. Comparing floor and ICU admissions, multivariate ED predictors of ICU admission were age <2 months (26% vs. 53%; odds ratio [OR] = 4.1; 95% confidence interval [CI] = 2.1 to 8.3), an ED visit the past week (25% vs. 40%; OR = 2.2; 95% CI = 1.1 to 4.4), moderate/severe retractions (31% vs. 48%; OR = 2.6; 95% CI = 1.3 to 5.2), and inadequate oral intake (31% vs. 53%; OR = 3.3; 95% CI = 1.6 to 7.1). Unlike previous studies, no association with male gender, socioeconomic factors, insurance status, breast-feeding, or parental asthma was found with ICU admission. Conclusions:, In this prospective multicenter ED-based study of children admitted for bronchiolitis, four independent predictors of ICU admission were identified. The authors did not confirm many putative risk factors, but cannot rule out modest associations. [source]

Cognitive effects of memantine in postmenopausal women at risk of dementia: a pilot study

Human prostate cancer risk factors,,§

CANCER, Issue S10 2004
David G. Bostwick M.D.
Abstract Prostate cancer has the highest prevalence of any nonskin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating androgens will develop microscopic prostate cancer if they live long enough. This review is a contemporary and comprehensive, literature-based analysis of the putative risk factors for human prostate cancer, and the results were presented at a multidisciplinary consensus conference held in Crystal City, Virginia, in the fall of 2002. The objectives were to evaluate known environmental factors and mechanisms of prostatic carcinogenesis and to identify existing data gaps and future research needs. The review is divided into four sections, including 1) epidemiology (endogenous factors [family history, hormones, race, aging and oxidative stress] and exogenous factors [diet, environmental agents, occupation and other factors, including lifestyle factors]); 2) animal and cell culture models for prediction of human risk (rodent models, transgenic models, mouse reconstitution models, severe combined immunodeficiency syndrome mouse models, canine models, xenograft models, and cell culture models); 3) biomarkers in prostate cancer, most of which have been tested only as predictive factors for patient outcome after treatment rather than as risk factors; and 4) genotoxic and nongenotoxic mechanisms of carcinogenesis. The authors conclude that most of the data regarding risk relies, of necessity, on epidemiologic studies, but animal and cell culture models offer promise in confirming some important findings. The current understanding of biomarkers of disease and risk factors is limited. An understanding of the risk factors for prostate cancer has practical importance for public health research and policy, genetic and nutritional education and chemoprevention, and prevention strategies. Cancer 2004. © 2004 American Cancer Society. [source]