• Title/Summary/Keyword: Clinical risk factors

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Clinical Risk Factor Analysis for Breast Cancer: 568,000 Subjects Undergoing Breast Cancer Screening in Beijing, 2009

  • Pan, Lei;Han, Li-Li;Tao, Li-Xin;Zhou, Tao;Li, Xia;Gao, Qi;Wu, Li-Juan;Luo, Yan-Xia;Ding, Hui;Guo, Xiu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5325-5329
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    • 2013
  • Objectives: Although there are many reports about the risk of breast cancer, few have reported clinical factors including history of breast-related or other diseases that affect the prevalence of breast cancer. This study explores these risk factors for breast cancer cases reported in Beijing in 2009. Materials and Methods: Data were derived from a Beijing breast cancer screening performed in 2009, of 568,000 women, from 16 districts of Beijing, all aged between 40 and 60 years. In this study, multilevel statistical modeling was used to identify clinical factors that affect the prevalence of breast cancer and to provide more reliable evidence for clinical diagnostics by using screening data. Results and Conclusion: Those women who had organ transplants, compared with those with none, were associated with breast cancer with an odds ratio (OR)=65.352 [95% confidence interval (CI): 8.488-503.165] and those with solid breast mass compared with none had OR=1.384 (95% CI: 1.022-1.873). Malignant tendency was strongly associated with increased risk of breast cancer, OR=207.999(95% CI: 151.950-284.721). The risk of breast cancer increased with age, $OR_1$=2.759 (95% CI: 1.837-4.144, 56-60 vs. 40-45), $OR_2$=2.047 (95% CI: 1.394-3.077, 51-55 vs. 40-45), $OR_3$=1.668 (95% CI: 1.145-2.431). Normal results of B ultrasonic examination show a lower risk among participants, OR= 0.136 (95% CI: 0.085-0.218). Those women with ductal papilloma compared with none were associated with breast cancer, OR=6.524 (95% CI: 1.871-22.746). Therefore, this study suggests that clinical doctors should pay attention to these high-risk factors.

Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors (HMG CoA-reductase inhibitors를 복용하는 환자의 잠재적 약물상호작용 연구)

  • Lee, Kyeong Ju;Kim, Kyung Rim;Seong, Jae Min;Ryu, Seung Wan;Lee, Hyun Yoon;Cho, Sekyoung;Cheong, Yeji;Nam, Ki Nam;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.31-35
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    • 2020
  • Objective: The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. Methods: The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. Results: A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. Conclusion: There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

Risk Factors of Blood and Body Fluid Exposure in Clinical Nurses (임상간호사의 혈액과 체액 노출 위험요인)

  • Shin, Eun-Jung;Park, Ho-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.368-375
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    • 2006
  • Purpose: The purpose of this study was to investigate the risk factors of exposure to blood and body fluid by clinical nurses. Method: The participants in this descriptive study were 276 clinical nurses involved in nursing care in a general hospital located in Seoul. The collected data were analyzed using a logistic regression model. Results: The annual exposure rate to blood and body fluid by clinical nurses was 66.3%, and the ratio was higher in the exposed group than in the non-exposed group for nurses under the age of 25, nurses who were unmarried, nurses with low clinical experience, and nurses who work night shifts more than six days a week. Clinical nurses who were unmarried were 1.9 times more likely to have been exposed compared to married nurses. Nurses whose work experience was less than 18 months were 2.7 times more at risk than nurses with more than 18 months of experience. Also, nurses whose fatigue scores were high had an increased chance of exposure (1.9 times). Conclusion: It is necessary to provide intensive training programs for clinical nurses who are in the early months of their career and are likely to be young and unmarried, in order to prevent exposure to blood and body fluid. Administrative supports to self-control and hospital ward operation measures to relieve nurses' fatigue should be provided.

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Mycoplasma pneumoniae pneumonia in children: Clinical characteristics and risk factors of refractory pneumonia by age (소아 마이코플라스마 폐렴: 나이에 따른 임상적 특징과 불응성폐렴의 위험 요인)

  • Kim, Hyung Young;Park, Hee Ju
    • Allergy, Asthma & Respiratory Disease
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    • v.6 no.6
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    • pp.295-302
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    • 2018
  • Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (< 6 years old) and school-age (${\geq}6$ years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH > 722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44-6.50) and ferritin > 177 ng/mL (OR, 5.38; 95% CI, 1.61-19.49) were significant risk factors for RMPP, while LDH > 645 IU/L (OR, 4.12; 95% CI, 1.64-10.97) and ferritin > 166 ng/mL (OR, 5.51; 95% CI, 1.59-22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children.

Epidemiological, and molecular investigation of Canine parvovirus-2 infection in Egypt

  • Eman Farag Ammar;Yamen Mohammed Hegazy;Magdy Al-gaabary;Samah M. Mosad;Mohamed Salem;Mohamed Marzok;Fadhel Housawi;Mohamed Al-ali;Abdulrahman Alhaider;Amin Tahoun
    • Journal of Veterinary Science
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    • v.25 no.4
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    • pp.56.1-56.13
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    • 2024
  • Importance: Canine parvovirus enteritis (CPE) is a contagious viral disease of dogs caused by the canine parvovirus-2 (CPV-2) associated with high morbidity and mortality rates. CPV-2 has a high global evolutionary rate. Molecular characterization of CPV-2 and understanding its epidemiology are essential for controlling CPV-2 infections. Objective: This study examined the risk factors and survival outcomes of dogs infected with CPV-2. Molecular characterization of CPV-2 genotypes circulating in Egypt was performed to determine the evolution of CPV-2 nationally and globally. Methods: An age-matched case-control study was conducted on 47 control and 47 CPV-infected dogs. Conditional logistic regression analysis examined the association between the potential risk factors and CPE in dogs. Survival analysis was performed to determine the survival pattern of the infected dogs. Thirteen fecal samples from infected dogs were collected to confirm the CPV genotype by CPV-2 VP2 gene sequencing, assembly of nucleotide sequences, and phylogenic analysis. Results: Unvaccinated and roamer dogs had eight and 2.3 times higher risks of CPV infection than vaccinated dogs and non-roamer dogs, respectively. The risk of death from CPE was high among dogs without routine visits to veterinary clinics and among non-roamer dogs. Molecular characterization of CPV-2 confirmed its genotype identity and relationship with the CPV-2 c and b clade types. Conclusions and Relevance: This study highlights the potential factors for CPE control, especially vaccination and preventing dogs from roaming freely outside houses. Isolated CPV genotypes are closely related to southern Asian genotypes, suggesting a substantial opportunity for global transmission.

Risk Factors Predicting Unfavorable Neurological Outcome during the Early Period after Traumatic Brain Injury

  • Park, Jung-Eon;Kim, Sang-Hyun;Yoon, Soo-Han;Cho, Kyung-Gi;Kim, Se-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.90-95
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    • 2009
  • Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

  • Yang, Kyungmi;Park, Won;Huh, Seung Jae;Bae, Duk-Soo;Kim, Byoung-Gie;Lee, Jeong-Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.39-47
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    • 2017
  • Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

The Mental Health of Ethnic Minority Youths in South Korea and Its Related Environmental Factors: A Literature Review

  • Lee, Yeeun;Lee, Minji;Park, Subin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.3
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    • pp.88-99
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    • 2019
  • Objectives: With increasing concerns for the rapidly growing minority population in South Korea, this literature review addressed a range of mental health risks among multiethnic youths (MY) in South Korea by 1) comparing mental health outcomes with those of native-born youths and 2) identifying multiple layers of relevant environmental factors, from family and school relationships to culture. Methods: We reviewed 54 studies that fulfilled specific inclusion criteria. Results: Multiple common risk/protective factors, including family separation, family relationship quality, parental socioeconomic and mental health status, social relationships at school, and cultural acceptance, were noted. Conclusion: In general, empirical evidence indicates that minority youths have relatively heightened risks for emotional and behavioral problems. Future studies must elucidate the complex interplay between multiple risk and protective factors and the long-term adaptation and mental health service utilization of MY.

Risk Factors for Duodenal Stump Leakage after Laparoscopic Gastrectomy for Gastric Cancer

  • Gu, Lihu;Zhang, Kang;Shen, Zefeng;Wang, Xianfa;Zhu, Hepan;Pan, Junhai;Zhong, Xin;Khadaroo, Parikshit Asutosh;Chen, Ping
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.81-94
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    • 2020
  • Purpose: Duodenal stump leakage (DSL) is a potentially fatal complication that can occur after gastrectomy, but its underlying risk factors are unclear. This study aimed to investigate the risk factors and management of DSL after laparoscopic radical gastrectomy for gastric cancer (GC). Materials and Methods: Relevant data were collected from several prospective databases to retrospectively analyze the data of GC patients who underwent Billroth II (B-II) or Rouxen-Y (R-Y) reconstruction after laparoscopic gastrectomy from 2 institutions (Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and HwaMei Hospital, University of Chinese Academy of Sciences). The DSL risk factors were analyzed using univariate and multivariate analysis regression. Results: A total of 810 patients were eligible for our analysis (426 with R-Y, 384 with B-II with Braun). Eleven patients had DSL (1.36%). Body mass index (BMI), elevated preoperative C-reactive protein (CRP) level, and unreinforced duodenal stump were the independent risk factors for DSL. DSL was diagnosed in 2-12 days, with a median of 8 days. Seven patients received conservative treatment, 3 patients received puncture treatment, and only 1 patient required reoperation. All patients recovered successfully after treatment. Conclusions: The risk factors of DSL were BMI ≥24 kg/㎡, elevated preoperative CRP level, and unreinforced duodenal stump. Nonsurgical treatments for DSL are preferred.

The Correlation of Pulse Wave Velocity and Atherosclerotic Risk Factor in Stroke Patients

  • Jin, Bok Hee;Han, Min Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.1
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    • pp.28-34
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    • 2015
  • Pulse wave velocity (PWV) is used to non-invasively estimate the severity of arteriosclerosis by measuring arterial stiffness. Increased arterial stiffness measured by PWV stands for progressive arteriosclerosis and is caused by atherosclerotic risk factors. This study is focused on how brachial-ankle pulse wave velocity (baPWV) is related to the leading risk factors for arteriosclerosis or atherosclerosis. Subjects were 114, 69 males and 45 females who are in 60's and had baPWV test for acute stroke. The results are as follows: the group with increased arterial stiffness showed significant increase in HbA1c, total cholesterol, BSBP (brachial artery systolic blood pressure), BDBP (brachial artery diastolic blood pressure), CSBP (central artery systolic blood pressure), CDBP (central artery diastolic blood pressure), augmentation index (AIx) and diabetes mellitus. Correlation analysis between baPWV and atherosclerotic risk factor showed significant relationship in age, HbA1c, LDL cholesterol, BSBP, BDBP, CSBP, CDBP and augmentation index. baPWV was independently related to age and BSBP in multiple linear regression analysis. The group with increased arterial stiffness was independently related to BDBP in multiple logistic regression analysis. This study might be meaningful in evaluating the relationship between arterial stiffness and atherosclerotic risk factor in a new way, and be helped to make various studies for cardiovascular disease.