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Multivariate Regression Models (multivariate + regression_models)
Selected AbstractsInformal Caregiving Time and Costs for Urinary Incontinence in Older Individuals in the United StatesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002Kenneth M. Langa MD OBJECTIVES: To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals. DESIGN: Multivariate regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people aged 70 and older (N = 7,443). SETTING: Community-dwelling older people. PARTICIPANTS: National population-based sample of community-dwelling older people. MEASUREMENTS: Weekly hours of informal caregiving, and imputed cost of caregiver time, for community-dwelling older people who reported (1) no unintended urine loss, (2) incontinence that did not require the use of absorbent pads, and (3) incontinence that required the use of absorbent pads. RESULTS: Thirteen percent of men and 24% of women reported incontinence. After adjusting for sociodemographics, living situation, and comorbidities, continent men received 7.4 hours per week of care, incontinent men who did not use pads received 11.3 hours, and incontinent men who used pads received 16.6 hours (P < .001). Women in these groups received 5.9, 7.6, and 10.7 hours (P < .001), respectively. The additional yearly cost of informal care associated with incontinence was $1,700 and $4,000 for incontinent men who did not and did use pads, respectively, whereas, for women in these groups, the additional yearly cost was $700 and $2,000. Overall, this represents a national annual cost of more than $6 billion for incontinence-related informal care. CONCLUSIONS: The quantity of informal caregiving for older people with incontinence and its associated economic cost are substantial. Future analyses of the costs of incontinence, and the cost-effectiveness of interventions to prevent or treat incontinence, should consider the significant informal caregiving costs associated with this condition. [source] Intima,media thickness of the abdominal aorta of neonate with different gestational agesJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2007Esad Koklu MD Abstract Purpose. To determine aortic intima,media thickness (aIMT) values in newborns with different gestational ages and to asses the effect of antenatal steroids on aIMT. Methods. Two hundred forty newborns from healthy mothers had their distal abdominal aIMT measured during abdominal sonographic examination. The neonates were divided into 4 groups (60 in each group) according to gestational age: group I (25,28 weeks), group II (29,32 weeks), group III (33,37 weeks), and group IV (38,42 weeks). Results. The interobserver and intersubject intraclass correlation coefficient was 0.93 and 0.94, respectively. Mean aIMT was 0.316 mm, 0.335 mm, 0.348 mm, and 0.385 mm, respectively, in group I, II, III, and IV, increasing significantly with gestational age at birth (p < 0.0001). There was no apparent effect of antenatal steroid use on aIMT. Multivariate regression models for mean aIMT demonstrated a significant association with aortic lumen diameter (p < 0.0001). Conclusion. Abdominal aIMT can be reproducibly measured in neonates and may be a useful tool for epidemiologic studies. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source] Effects of temperature on isotopic enrichment in Daphnia magna: implications for aquatic food-web studiesRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 14 2003M. Power Laboratory experiments were conducted with Daphnia magna and Hyalella sp. grown on a single food source of known isotopic composition at a range of temperatures spanning the physiological optima for each species. Daphnia raised at 26.5°C were enriched in ,13C and ,15N by 3.1 and 2.8,, respectively, relative to diet. Daphnia raised at 12.8°C were enriched 1.7 and 5.0, in ,13C and ,15N, respectively. Results imply a significant negative relationship between the ,13C and ,15N of primary consumers when a temperature gradient exists. Similar responses were observed for Hyalella. Results indicate a general increase in ,13C enrichment and decrease in ,15N enrichment as temperature rises. Deviations from the commonly applied isotopic enrichment values used in aquatic ecology were attributed to changes in temperature-mediated physiological rates. Field data from a variety of sources also showed a general trend toward ,13C enrichment with increasing temperature in marine and lacustrine zooplankton. Multivariate regression models demonstrated that, in oligotrophic and mesotrophic lakes, zooplankton ,13C was related to lake-specific POM ,13C, lake surface temperature and latitude. Temperature-dependent isotopic separation (enrichment) between predator and prey should be taken into consideration when interpreting the significance of isotopic differences within and among aquatic organisms and ecosystems, and when assigning organisms to food-web positions on the basis of observed isotope values. Copyright © 2003 John Wiley & Sons, Ltd. [source] Monitoring the fractionation of a whey protein isolate during dead-end membrane filtration using fluorescence and chemometric methodsBIOTECHNOLOGY PROGRESS, Issue 1 2010Rand Elshereef Abstract During membrane-based separation of proteins, changes in protein concentration of the permeate and retentate streams occurs over time. The current work proposes a new approach for monitoring the changes in concentrations of proteins in both permeate and retentate by making use of data collected using fluorescence spectroscopy and intrinsic protein fluorescence analyzed by multivariate statistical techniques. Whey protein isolate consists mainly of ,-lactalbumin (,-LA), ,-lactoglobulin (,-LG), and small proportion of bovine serum albumin (BSA) and was used as a model system in this study. A fiber optic probe (FOP) was used to acquire multiwavelength fluorescence spectra for permeate and retentate streams at different times during UF-based separation of the components from a multicomponent solution. Multivariate regression models were developed for predicting the concentrations of ,-LA, ,-LG, and BSA by establishing a calibration model between data acquired using the FOP and the corresponding protein concentration levels measured by size-exclusion chromatography. The model was validated using FOP data that were not previously used for calibration of the regression models. This comparison showed that concentrations of ,-LA, ,-LG, and BSA could be predicted directly from FOP data within reasonable accuracy by making use of multivariate calibration tools. This approach has several attractive features including that it is nondestructive, fast, and relatively simple to perform. This technique has potential practical applications as it could offer the opportunity for in situ monitoring of membrane filtration processes by tracking individual protein transmission and selectivity of fractionation. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2010 [source] Prenatal and postnatal parental smoking and acute otitis media in early childhoodACTA PAEDIATRICA, Issue 1 2010SE Håberg Abstract Aim:, To explore the associations between acute otitis media in early childhood and prenatal and postnatal tobacco smoke exposure. Methods:, Subjects were 32 077 children born between 2000 and 2005 in the Norwegian Mother and Child Study with questionnaire data on tobacco smoke exposure and acute otitis media up to 18 months of age. Multivariate regression models were used to obtain adjusted relative risks for acute otitis media. Results:, Acute otitis media was slightly more common in children exposed to parental smoking. The incidence from 0 to 6 months was 4.7% in unexposed children and 6.0% in children exposed both prenatally and postnatally. After adjusting for postnatal exposure and covariates, the relative risk for acute otitis media 0,6 months when exposed to maternal smoking in pregnancy was 1.34, 95% confidence interval: 1.06,1.69. Maternal smoking in pregnancy was associated with acute otitis media up to 12 months of age. Compared with non-exposed children, there was a slightly increased risk of recurrent acute otitis media for children exposed both prenatally and postnatally with a relative risk of 1.24, 95% confidence interval: 1.01,1.52. Conclusion:, Even in a cohort with relatively low exposure levels of parental smoking, maternal smoking in pregnancy was associated with an increased risk of acute otitis media in early childhood. [source] Safety of Selective Serotonin Reuptake Inhibitor Use Prior to Coronary Artery Bypass GraftingCLINICAL CARDIOLOGY, Issue 6 2010Glen L. Xiong MD Background Selective serotonin reuptake inhibitors (SSRIs) have been shown to increase bleeding risks. This study examined the association of perioperative coronary artery bypass grafting (CABG) bleeding risks and SSRI use prior to CABG. Hypothesis SSRI may be associated with increased bleeding risks after CABG resulting in elevated reoperation rates due to bleeding complications. Methods Patients who underwent CABG between 1999 and 2003 (n = 4794) were identified in a tertiary medical center. SSRI use (n = 246) was determined using inpatient pharmacy records. Outcomes included primary end point of reoperation due to bleeding complications and other secondary measures. Multivariate regression models were constructed to adjust for baseline differences between SSRI and control groups. Results Reoperation due to bleeding complications among SSRI users was not significantly different (odds ratio [OR]: 1.14 (0.52,2.47); P = 0.75) compared to the control group. Other secondary outcomes and 30-day mortality (2.0% in SSRI vs 2.1% in control group; P = 0.92) between the 2 groups were similar. However, the adjusted total volume of postoperative red blood cell (RBC) units transfused was higher in the SSRI group. Conclusion We conclude that there is no compelling evidence to limit the use of SSRIs among patients with coronary artery disease who undergo CABG given the current evidence. Further research may be needed on individual SSRI medications. Copyright © 2010 Wiley Periodicals, Inc. [source] The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related ConditionsDEPRESSION AND ANXIETY, Issue 9 2010Josh Nepon M.D. Abstract Background: Previous work has suggested that anxiety disorders are associated with suicide attempts. However, many studies have been limited by lack of accounting for factors that could influence this relationship, notably personality disorders. This study aims to examine the relationship between anxiety disorders and suicide attempts, accounting for important comorbidities, in a large nationally representative sample. Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2. Face-to-face interviews were conducted with 34,653 adults between 2004 and 2005 in the United States. The relationship between suicide attempts and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, posttraumatic stress disorder (PTSD)) was explored using multivariate regression models controlling for sociodemographics, Axis I and Axis II disorders. Results: Among individuals reporting a lifetime history of suicide attempt, over 70% had an anxiety disorder. Even after adjusting for sociodemographic factors, Axis I and Axis II disorders, the presence of an anxiety disorder was significantly associated with having made a suicide attempt (AOR=1.70, 95% confidence interval (CI): 1.40,2.08). Panic disorder (AOR=1.31, 95% CI: 1.06,1.61) and PTSD (AOR=1.81, 95% CI: 1.45,2.26) were independently associated with suicide attempts in multivariate models. Comorbidity of personality disorders with panic disorder (AOR=5.76, 95% CI: 4.58,7.25) and with PTSD (AOR=6.90, 95% CI: 5.41,8.79) demonstrated much stronger associations with suicide attempts over either disorder alone. Conclusion: Anxiety disorders, especially panic disorder and PTSD, are independently associated with suicide attempts. Clinicians need to assess suicidal behavior among patients presenting with anxiety problems. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Effect of Plant Factors, Sugar Contents, and Control Methods on the Top Borer (Scirpophaga nivella F.) Infestation in Selected Varieties of SugarcaneENTOMOLOGICAL RESEARCH, Issue 3 2005Abdul KHALIQ ABSTRACT Sugarcane (Saccharum officinarum L.) varieties CP-43/33 and L-118 susceptible, BF-162 and SPSG-26 resistant while CP-72/2086 as intermediate were screened for studies on top borer, Scirpophaga nivella Fabricus (Pyralidae: Lepidoptera). Morpho-physio chemical plant factors as well as quality of sugar were examined to elucidate the relationship between pest infestations. The observations on leaf thickness 0.735* and moisture contents 0.771* showed positive and significant correlation with the pest infestation at tillering stage. Total minerals, manganese and copper contents did not show significant correlation with the pest infestation, whereas nitrogen, potassium, calcium, magnesium and ferrous contents manifested positive and significant correlation with the pest infestation. Phosphorous, carbohydrates, fats and zinc produced significant and adverse effect on the pest infestation at tillering stage. Zinc contents with contrasting behaviors appeared to be the most important character with co-efficient value of 0.764 followed by ferrous with positive sign. The effect of borer infestation was significantly negative on pol (sucrose), Brix contents (total soluble solids), and CCS (commercial cane sugar). The coefficient of determination value was 0.821, obtained by computing fiber content, pol, Brix and CCS factors together for multivariate regression models. Application of trash mulching at the time of sowing proved to be the most effective treatment with minimum infestation (3.91%) of borer and maximum protection level (62.87%) followed by Furadan®, removal of dead hearts + spike thrust, hand collection of egg masses, and cutting of shoots at 15 days interval. [source] Availability of Safety Net Providers and Access to Care of Uninsured PersonsHEALTH SERVICES RESEARCH, Issue 5 2004Jack Hadley Objective. To understand how proximity to safety net clinics and hospitals affects a variety of measures of access to care and service use by uninsured persons. Data Sources. The 1998,1999 Community Tracking Study household survey, administered primarily by telephone survey to households in 60 randomly selected communities, linked to data on community health centers, other free clinics, and safety net hospitals. Study Design. Instrumental variable estimation of multivariate regression models of several measures of access to care (having a usual source of care, unmet or delayed medical care needs, ambulatory service use, and overnight hospital stays) against endogenous measures of distances to the nearest community health center and safety net hospital, controlling for characteristics of uninsured persons and other area characteristics that are related to access to care. The models are estimated with data from a nationally representative sample of uninsured people. Principal Findings. Shorter distances to the nearest safety net providers increase access to care for uninsured persons. Failure to account for the endogeneity of distance to safety net providers on access to care generally leads to finding little or no safety net effects on access. Conclusions. Closer proximity to the safety net increases access to care for uninsured persons. However, the improvements in access to care are relatively small compared with similar measures of access to care for insured persons. Modest expansion of the safety net is unlikely to provide a full substitute for insurance coverage expansions. [source] The association between early hemodynamic variables and outcome in normothermic comatose patients following cardiac arrestACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010C. TORGERSEN Background: Currently, few data exist on the association between post-cardiac arrest hemodynamic function and outcome. In this explorative, retrospective analysis, the association between hemodynamic variables during the first 24 h after intensive care unit admission and functional outcome at day 28 was evaluated in 153 normothermic comatose patients following a cardiac arrest. Methods: Medical records of a multidisciplinary intensive care unit were reviewed for comatose patients (Glasgow Coma Scale ,9) admitted to the intensive care unit after successful resuscitation from an in- or an out-of-hospital cardiac arrest. The hourly variable time integral of hemodynamic variables during the first 24 h after admission was calculated. At day 28, outcome was assessed as favorable or adverse based on a Cerebral Performance Category of 1,2 and 3,5, respectively. Bi- and multivariate regression models adjusted for relevant confounding variables were used to evaluate the association between hemodynamic variables and functional outcome. Results: One hundred and fifty-three normothermic comatose patients were admitted after a cardiac arrest, of whom 64 (42%) experienced a favorable outcome. Neither in the adjusted bivariate models (r2, 0.61,0.78) nor in the adjusted multivariate model (r2, 0.62,0.73) was the hourly variable time integral of any hemodynamic variable during the first 24 h after intensive care unit admission associated with functional patient outcome at day 28 in all patients as well as in patients after an in- or an out-of-hospital cardiac arrest. Conclusion: Commonly measured hemodynamic variables during the first 24 h following intensive care unit admission due to a cardiac arrest do not appear to be associated with the functional outcome at day 28. [source] Does arm length indicate cognitive and functional reserve?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2005Seul-Ki Jeong Abstract Background This study aimed to examine whether arm length and height were associated with cognitive and functional abilities. Methods Screening interviews were conducted in 235 community dwelling individuals aged 65 and over. The assessment scales included the Korean version of modified Mini-Mental State Examination (K-mMMSE) for cognition, and the Korean Instrumental Activities of Daily Living (K-IADL) for functional ability. All the participants were examined clinically and a diagnosis of dementia was ascertained. Anthropometric measurements included total arm span and height. Results Both arm length and height correlated significantly with the cognitive and functional scales. In the multivariate regression models, their associations were significant, independent of age, sex, education, and other variables. Shorter arm length was also significantly associated with dementia; while, height lost significance after an adjustment for the potential confounders. Conclusions Arm length and height could indicate cognitive and functional ability. Arm length, which was known to be less prone to degenerative processes, might be more stable as an indicator for cognitive and functional reserve capacity than height. Copyright © 2005 John Wiley & Sons, Ltd. [source] Local,regional boundary shifts in oribatid mite (Acari: Oribatida) communities: species,area relationships in arboreal habitat islands of a coastal temperate rain forest, Vancouver Island, CanadaJOURNAL OF BIOGEOGRAPHY, Issue 9 2007Zoë Lindo Abstract Aim, This study investigates the species,area relationship (SAR) for oribatid mite communities of isolated suspended soil habitats, and compares the shape and slope of the SAR with a nested data set collected over three spatial scales (core, patch and tree level). We investigate whether scale dependence is exhibited in the nested sampling design, use multivariate regression models to elucidate factors affecting richness and abundance patterns, and ask whether the community composition of oribatid mites changes in suspended soil patches of different sizes. Location, Walbran Valley, Vancouver Island, Canada. Methods, A total of 216 core samples were collected from 72 small, medium and large isolated suspended soil habitats in six western redcedar trees in June 2005. The relationship between oribatid species richness and habitat volume was modelled for suspended soil habitat isolates (type 3) and a nested sampling design (type 1) over multiple spatial scales. Nonlinear estimation parameterized linear, power and Weibull function regression models for both SAR designs, and these were assessed for best fit using R2 and Akaike's information criteria (,AIC) values. Factors affecting oribatid mite species richness and standardized abundance (number per g dry weight) were analysed by anova and linear regression models. Results, Sixty-seven species of oribatid mites were identified from 9064 adult specimens. Surface area and moisture content of suspended soils contributed to the variation in species richness, while overall oribatid mite abundance was explained by moisture and depth. A power-law function best described the isolate SAR (S = 3.97 × A0.12, R2 = 0.247, F1,70 = 22.450, P < 0.001), although linear and Weibull functions were also valid models. Oribatid mite species richness in nested samples closely fitted a power-law model (S = 1.96 × A0.39, R2 = 0.854, F1,18 = 2693.6, P < 0.001). The nested SAR constructed over spatial scales of core, patch and tree levels proved to be scale-independent. Main conclusions, Unique microhabitats provided by well developed suspended soil accumulations are a habitat template responsible for the diversity of canopy oribatid mites. Species,area relationships of isolate vs. nested species richness data differed in the rate of accumulation of species with increased area. We suggest that colonization history, stability of suspended soil environments, and structural habitat complexity at local and regional scales are major determinants of arboreal oribatid mite species richness. [source] Respiratory Function as a Marker of Bone Health and Fracture Risk in an Older Population,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2009Alireza Moayyeri Abstract Identification of those at high risk of osteoporosis and fractures using clinically available tests beyond BMD measures is a major clinical challenge. We examined forced expiratory volume in 1 s (FEV1), an easily obtainable measure of respiratory function, as a clinical measure for fracture prediction. In the context of the European Prospective Investigation into Cancer-Norfolk Study, 8304 women and 6496 men 42,81 yr of age underwent a health check including spirometry and heel quantitative ultrasonography between 1997 and 2000 and were followed up for incident hip fractures until 2007. The main outcome measures were broadband ultrasound attenuation (BUA) of the heel (cross-sectional analysis) and hip fracture risk (prospective analysis). In multivariate regression models, a 1-liter increase in FEV1 was associated with a statistically significant 2.2-dB/MHz increase in BUA, independent of age, smoking, height, body mass index, history of fracture, and use of corticosteroids. Mean FEV1 was significantly lower among 84 women and 36 men with hip fracture compared with other participants. In multivariate proportional-hazard regression models, the relative risk (RR) of hip fracture associated with a 1-liter increase in FEV1 was 0.5 (95% CI, 0.3,0.9; p < 0.001) for both men and women. RR of hip fracture for a 1 SD increase in FEV1 was approximately equivalent to a 0.5 SD increase in BUA among women (1 SD among men) and an ,5-yr decrease in age among both men and women. Middle-aged and older people with low respiratory function are at increased risk of osteoporosis and hip fracture. FEV1, an easy, low-cost, and feasible clinical measure, may help improve the identification of high-risk groups. [source] Self-reported gingivitis and tooth loss poorly predict C-reactive protein levels: a study among Finnish young adultsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2008Pekka V. Ylöstalo Abstract Objectives: Our aim in this cross-sectional study was to investigate whether self-reported gingivitis and tooth loss were associated with elevated levels of C-reactive protein (CRP) using the same study population where these dental conditions have earlier been associated with prevalent angina pectoris. Material and Methods: The study population consisted of those Northern Finland birth cohort 1966 members who lived in Northern Finland or in the Helsinki region (n=8463) at the time of the survey (1996,1997). The participation rate in a health examination was 71% (n=6033). Gingivitis and tooth loss were determined on the basis of self-reported questions. Prevalence proportion ratios (PPR) and 95% confidence intervals (CI) were estimated using multivariate regression models. Results: The results showed that self-reported gingivitis and tooth loss were weakly associated with elevated levels of CRP (>3 mg/l): adjusted PPR 1.1, CI 1.0,1.3 and PPR 1.1, CI 0.7,1.7, respectively. The proportion of variation in CRP explained by self-reported gingivitis and tooth loss was small, being <1%. Conclusion: The results suggest that self-reported gingivitis and tooth loss have a miniscule effect on CRP levels among a general population of young adults. [source] Mental health status of vulnerable tsunami-affected communities: A survey in Aceh Province, IndonesiaJOURNAL OF TRAUMATIC STRESS, Issue 3 2007Renato Souza The authors determined the prevalence of severe emotional distress and depressive symptoms using the Hopkins Symptoms Checklist-25 (HSCL; Derogatis, Lipman, Rickels, Uhlenhuth, & Covi, 1974) in tsunami-affected communities that had experienced armed conflict arising from the ongoing independence movement in Aceh Province, Indonesia. We also evaluated determinants of severe emotional distress. The data were collected for the purposes of a mental health assessment. In our sample (N = 262), 83.6% demonstrated severe emotional distress, and 77.1% demonstrated depressive symptoms. In multivariate regression models, severe emotional distress was positively associated with the number of tsunami-related deaths among household members. Our data suggests a need for effective interventions in this vulnerable population. [source] Patterns of medication use in the immigrant population resident in Spain: associated factorsPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2009P. Carrasco-Garrido PhD Abstract Purpose This study mainly aimed at to ascertain to ascertain the prevalence of the consumption of medications, prescribed and self-medicated, among the immigrant population (economic immigrants and not economic immigrants) resident in Spain, and to identify the factors associated with such consumption in this population. Methods We have worked with individualized secondary data, collected in the Spanish National Health Survey carried out in 2006 and 2007 (SNHS-06), from the Ministry of Health and Consumer Affairs. A total of 2055 subjects born outside Spain, aged 16 years or over, were analysed. The independent variables were sociodemographic and health-related, and the dependent variable was medication use. Using logistic multivariate regression models we have estimated the independent effect of each of these variables on the medication consumption. Results The 55.8% of immigrant population responded affirmatively to having consumed some type of medication. The drugs that registered the highest consumption prevalence were analgesics (53.09%). It should be stressed here that 8.75% of the not economic immigrant population has consumed antibiotics. The variables that were independently and significantly associated with a greater probability of medication consumption were: sex, age, presence of chronic disease, use of alternative medicines and a negative perception of health. The most strongly associated variable is medical consultation. Conclusions The prevalence of medication use higher among economic immigrant women. In our population, the use of alternative medicines use and medical visits to the physician are associated with higher consumption. Copyright © 2009 John Wiley & Sons, Ltd. [source] Predictive factors of self-medicated drug use among the Spanish adult populationPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2008P. Carrasco-Garrido PhD Abstract Purpose Our study aimed at describing the prevalence of self-medicated drug use among the Spanish adult population and to identify the predictive factors of such self-medication in Spain. Methods Descriptive, cross-sectional study covering the Spanish adult population, using data drawn from the 2003 Spanish National Health Survey (ENSS). A total of 19,514 subjects were analysed. The independent variables were socio-demographic and health-related, and the dependent variable was self-medicated drug use. Using logistic multivariate regression models we have estimated the independent effect of each of these variables on the self-medicated consumption. Results The 18.1% of all Spaniards indulge in self-medication. Our study shows that 45% of all cold and influenza medication and 39.4% of analgesics consumed by the population involve self-medication. It should be stressed here that 17.7% of persons who took antibiotics did so in the form of self-medication. The variables that were independently and significantly associated with a greater probability of self-medicated consumption were: sex; lower age; higher educational level; consumption of alcohol; smoking habit; use of alternative medical products; absence of chronic disease and a positive perception of health. Conclusions In Spain, the prevalence of self-medicated drug use is higher in women than men. In our population, the influence of unhealthy lifestyles, such as alcohol and tobacco consumption, is related to a higher likelihood of self-medication. Copyright © 2007 John Wiley & Sons, Ltd. [source] Psychotropics use in the Spanish elderly: predictors and evolution between years 1993 and 2003,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2007P. Carrasco-Garrido PhD Abstract Purpose This study mainly aimed at describing the prevalence of psychotropic medication consumption in the Spanish elderly population between the years 1993 and 2003. Methods Descriptive, cross-sectional study covering the Spanish population aged 65 years and over, using data drawn from the 1993 and 2003 Spanish National Health Surveys (ENSS). A total of 9570 interviews were analysed (3436 from 1993 and 6134 from 2003). The independent variables were sociodemographic and health-related, and the dependent variable was total consumption of psychotropic medication. Using logistic multivariate regression models, we have analysed the temporal evolution of psychotropic medication consumption between 1993 and 2003. Results The prevalence of consumption was significantly higher in women (6.7% from 1993 and 26.4 % from 2003) versus men (2.4% from 1993 and 10.6% from 2003) (p,<,0.001). Multivariate analysis, highlighted the association between increased psychoactive drug intake and sex, nervous, depressive, sleep disorders and negative perception of health, displayed a strong association with consumption of psychoactive drugs across the 2 years. Conclusions In Spain, the prevalence of psychoactive drug consumption is higher among elderly women than men, and increases with negative perception of health. The prevalence of consumption was significantly higher in the year 2003. Copyright © 2006 John Wiley & Sons, Ltd. [source] The effect of alcohol on radiographic progression in rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 5 2010M. J. Nissen Objective Alcohol consumption reduces the risk of development of rheumatoid arthritis (RA) and significantly attenuates the development of erosive arthritis in animal models. It remains unknown whether alcohol consumption influences joint damage progression in RA. This study was undertaken to compare the rates of radiographic damage progression in alcohol drinkers and nondrinkers in a large prospective cohort of patients with RA. Methods All patients in the population-based Swiss Clinical Quality Management in RA registry database with at least 2 sequential radiographs were included. Joint erosions were assessed in 38 joints in the hands and feet using a validated scoring method. The rate of progression of erosions was analyzed using multivariate regression models for longitudinal data and was adjusted for potential confounders. Results The study included 2,908 patients with RA with a mean of 4 sequential radiographs and 3.9 years of followup. A trend toward reduced radiographic progression existed in drinkers compared with nondrinkers, with a mean rate of erosive progression of 0.99% (95% confidence interval [95% CI] 0.89,1.09) and 1.13% (95% CI 1.01,1.26) at 1 year, respectively. Alcohol consumption displayed a J-shaped dose-response effect, with a more favorable evolution in occasional consumers (P = 0.01) and daily consumers (P = 0.001) as compared with nondrinkers, while heavy drinkers demonstrated worse radiographic evolution (P = 0.0001). We found significant effect modification by sex, with male drinkers displaying significantly less erosive progression compared with male nondrinkers (mean 0.86% [95% CI 0.70,1.03] versus 1.35% [95% CI 1.02,1.67]; P = 0.007). Conclusion Our findings indicate a trend toward reduced radiographic progression in alcohol drinkers compared with nondrinkers, specifically in occasional and daily alcohol consumers. In particular, male patients with RA who consume alcohol demonstrate less radiographic progression than do male nondrinkers. [source] The effectiveness of anti,tumor necrosis factor therapy in preventing progressive radiographic joint damage in rheumatoid arthritis: A population-based studyARTHRITIS & RHEUMATISM, Issue 1 2006Axel Finckh Objective To compare the effectiveness of 3 therapeutic strategies in preventing progressive joint damage, in a population-based cohort. The 3 strategies were infliximab with concomitant disease-modifying antirheumatic drugs (DMARDs), etanercept with concomitant DMARDs, and etanercept alone. Methods We used sequential radiographs to assess all patients who were treated with infliximab or etanercept for >10 months. The rates of erosion progression and joint space narrowing (JSN) were analyzed using multivariate regression models for longitudinal data, with adjustment for potential confounders. Results A total of 372 patients treated with anti,tumor necrosis factor (TNF) therapies met the inclusion criteria. The baseline characteristics of the patients assigned to the 3 strategies were not significantly different, except that, as expected, more patients were receiving combination therapy with infliximab. The combination of infliximab plus DMARDs was significantly more effective than etanercept alone for controlling erosion progression (P < 0.001), but the effectiveness of the 2 combination-treatment strategies was similar (P = 0.07). The combination of infliximab plus DMARDs was also more effective at controlling progressive JSN compared with etanercept alone (P = 0.04) or etanercept plus DMARDs (P = 0.02). Treatment with anti-TNF agents (infliximab or etanercept) plus concomitant DMARDs was more effective than treatment with etanercept alone for controlling erosion progression (P = 0.045). Conclusion When combined with traditional DMARDs, both etanercept and infliximab appear to offer similar protection against progressive structural joint damage, and combination therapy with either of these agents appears to be more effective than treatment with etanercept alone. [source] Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancerAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009Karin C. H. M. BISSELING Background:, Diagnosis of epithelial ovarian cancer (EOC) in young women has major implications including those to their reproductive potential. We evaluated depression, anxiety and body image in patients with stage I EOC treated with fertility sparing surgery (FSS) or radical surgery (RS). We also investigated fertility outcomes after FSS. Methods:, A retrospective study was undertaken in which 62 patients completed questionnaires related to anxiety, depression, body image and fertility outcomes. Additional information on adjuvant therapy after FSS and RS and demographic details were abstracted from medical records. Both bi- and multivariate regression models were used to assess the relationship between demographic, clinical and pathological results and scores for anxiety, depression and body image. Results:, Thirty-nine patients underwent RS and the rest, FSS. The percentage of patients reporting elevated anxiety and depression (subscores , 11) were 27% and 5% respectively. The median (interquartile range) score for Body Image Scale (BIS) was 6 (3,15). None of the demographic or clinical factors examined showed significant association with anxiety and BIS with the exception of ,time since diagnosis'. For depression, post-menopausal status was the only independent predictor. Among those 23 patients treated by FSS, 14 patients tried to conceive (seven successful), resulting in seven live births, one termination of pregnancy and one miscarriage. Conclusion:, This study shows that psychological issues are common in women treated for stage I EOC. Reproduction after FSS is feasible and led to the birth of healthy babies in about half of patients who wished to have another child. Further prospective studies with standardised instruments are required. [source] Mercury Exposure Increases Circulating Net Matrix Metalloproteinase (MMP)-2 and MMP-9 ActivitiesBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 4 2009Anna L. B. Jacob-Ferreira We investigated whether there is an association between the circulating levels of MMP-2, MMP-9, their endogenous inhibitors (the tissue inhibitors of metalloproteinases; TIMPs) and the circulating Hg levels in 159 subjects environmentally exposed to Hg. Blood and plasma Hg were determined by inductively coupled plasma-mass spectrometry (ICP-MS). MMP and TIMP concentrations were measured in plasma samples by gelatin zymography and ELISA respectively. Thiobarbituric acid-reactive species (TBARS) were measured in plasma to assess oxidative stress. Selenium (Se) levels were determined by ICP-MS because it is an antioxidant. The relations between bioindicators of Hg and the metalloproteinases levels were examined using multivariate regression models. While we found no relation between blood or plasma Hg and MMP-9, plasma Hg levels were negatively associated with TIMP-1 and TIMP-2 levels, and thereby with increasing MMP-9/TIMP-1 and MMP-2/TIMP-2 ratios, thus indicating a positive association between plasma Hg and circulating net MMP-9 and MMP-2 activities. These findings provide a new insight into the possible biological mechanisms of Hg toxicity, particularly in cardiovascular diseases. [source] Usefulness of Brain Natriuretic Peptide Level at Implant in Predicting Mortality in Patients with Advanced But Stable Heart Failure Receiving Cardiac Resynchronization TherapyCLINICAL CARDIOLOGY, Issue 11 2009Aiman El-Saed MD Abstract Background Brain natriuretic peptide (BNP) level has emerged as a predictor of death and hospital readmission in patients with heart failure (HF). The value of baseline BNP assessment in advanced HF patients receiving cardiac resynchronization defibrillator therapy (CRT-D) has not been firmly established. Hypothesis We hypothesized that a baseline BNP level would predict all cause mortality and HF hospitalization in HF patients receiving cardiac resynchronization therapy. Methods A retrospective chart review of all patients having BNP assessment prior to implantation of a CRT-D for standard indications during 2004 and 2005 was conducted at the Veterans Affairs Pittsburgh Healthcare System. The primary endpoint was all-cause mortality and the secondary endpoint was HF-related hospitalization. We used findings from the receiver operating characteristic (ROC) curve to define low (<492 pg/mL) and high (,492 pg/mL) BNP groups. Results Out of 173 CRT-D recipients, 115 patients (mean age 67.0 ± 10.7 years, New York Heart Association [NYHA] class 2.9 ± 0.3, left ventricular ejection fraction [LVEF] 22.5% ± 9.6%, QRS 148.3 ± 30.4 ms) had preimplantation BNP measured (mean 559 ± 761 pg/mL and median 315 pg/mL). During a mean follow-up time of 17.5 ± 6.5 mo, 27 deaths (23.5%) and 31 HF hospitalizations (27.0%) were recorded. Compared to those with low BNP (n = 74), those of high BNP (n = 41) were older, had lower LVEF, higher creatinine levels, suffered more deaths, and HF hospitalizations. In multivariate regression models, higher BNP remained a significant predictor of both the primary endpoint (hazard ratio [HR]: 2.89, 95% confidence interval [CI] 1.06,7.88, p = 0.038) and secondary endpoint (HR: 4.23, 95% CI: 1.68,10.60, p = 0.002). Conclusions Baseline BNP independently predicted mortality and HF hospitalization in a predominantly older white male population of advanced HF patients receiving CRT-D. Elevated BNP levels may identify a vulnerable HF population with a particularly poor prognosis despite CRT-D. Copyright © 2009 Wiley Periodicals, Inc. [source] | ||||||||||||||||||||||||||||