The riskfactorsfor development of severe infection are presented in Table 1. Patients > 50 years of age were at higher risk of severe infection. Intubation time and time in the intensive care unit after transplantation were also significant clinical riskfactorsforinfection. There was a trend toward increased risk of infection among patients who had diabetes, CMV-negative serostatus in the case of patients who had received a transplant from a CMV-positive donor, and in patients with a longer extracorporeal circulation time. As for the association between medication and increased risk of developing severe infection, treatment with tacrolimus tended to be a risk factor. Pre-transplant concentrations of total proteins and albumin were similar in both groups (infected vs uninfected patients; see Supplementary Table S1). Pre-transplant hypoalbuminemia, infection before transplant, previous mechanical ventilation and high-urgency waiting list status were not associated with risk of infection (Table1).
The extended access to HPV vaccines against certain specific HPV types has motivated studies to determine cross-protection conferred by such vaccines and the role of multiple HPV infections in the development of cervical lesions. It has been demonstrated that there is a direct association between the severity of a lesion and coinfection events, which has been shown to depend on the number of HPV infecting types. Such association has been observed both in coinfections with HR-HPV types, as well as with low risk (LR) types . Follow-up studies have reported that those women infected with one HPV type at the beginning of the study have an increased risk of acquiring a second HPV type . Even though it is wide known that HPV infection prevalence varies in different regions given the population characteristics and the techniques used for detection, this study shows similar data to those reported for Latin America in the last two years, in which infection rates equal or greater than 50.0% were found [22,23]. As has been previously described, using more than one generic primer set allowed us to detect a greater number of infected women , as well as a better coinfection estimate .
0.05 was set as the threshold for statistical significance. Results. Results. Results. Results. Results. One hundred and forty-eight of the 466 (31.7%) patients devel- oped a fever. Eighty-three of the 148 fever patients subsequently had blood drawn for cultures and 9/83 (10.8%) patients developed bacteremia as defined by a blood culture analysis. Cholangiolithiasis (P = 0.006), Child-Pugh class A designation (P = 0.001), Child- Pugh class C designation (P = 0.005) and hepatitis C virus infection (P = 0.011) were significantly correlated with fever in these pa- tients. No statistically significant correlations were found between the other factors (age, gender, clinical manifestation, diabetes mellitus, cholangiolithiasis, etc.) and bacteremia, with the exception of periprocedure cholangiolithiasis, which was significantly corre- lated with blood culture-defined bacteremia (P < 0.05). Conclusions. Conclusions. Conclusions. Conclusions. Conclusions. Cholangiolithiasis is a risk factor forinfection after a TIPS procedure in the periprocedure period.
Because of the informative value of fibrosis stage there is an interest for clinician to assess the speed of the fibrosis progression. The distribution of fibrosis progression rates suggests the presence of at least 3 populations: one popula- tion of “rapid fibrosers”, a population of “intermediate fi- brosers” and one population of “slow fibrosers” (Figure 3). Therefore the expressions of a mean (or median) fibrosis progression rate per year (stage at the first biopsy/ duration of infection) and of a mean expected time to cirrhosis does not signify that the progression to cirrhosis is universal and inevitable. Using the median fibrosis progression rate, in un- treated patients, the median expected time to cirrhosis is 30 years; 33% of patients has an expected median time to cir- rhosis of less than 20 years and 31% will progress to cirrho- sis in more than 50 years, if ever (Figure 3).
Objective. To identify individual riskfactorsfor malaria infection of inhabitants in the residual transmission focus on the Paciﬁc coast of Oaxaca, Mexico. Materials and Meth- ods. A population-based, matched case-control study was conducted from January 2002 to July 2003 comparing the frequency of exposure to individual riskfactors in subjects presenting clinical malaria and uninfected controls. A malaria case was deﬁned as an individual living in the study area presenting malaria symptoms and a Plasmodium vivax-positive thick blood smear; controls were individuals negative to P. vivax parasites and antibodies of the same gender and with ± ﬁve years as the case. A standardized questionnaire was used to record information about the individual riskfactors associated with malaria episodes in cases and two controls for each case. Results. In a multiple conditional logistic regression model analysis of data from 119 cases and 238 controls, 18 out of 99 variables were signiﬁcantly associated (p< 0.05) with increased risk of malaria, including: being born in another locality (RM 3.16, 95% IC 1.16-6.13); speaking only an autochthonous language (RM= 2.48, 95% IC 1.19-3.77); having poor knowledge about malaria (RM= 2.26 95% IC 1.10-4.66 P< 0.02); the amount of vegetation around the house (RM= 20.43, 95% IC 5.98-70.87, P< 0.000; RM= 3.78, 95% IC 1.21-11.80, for 60-100% and 30-59%, respectively);
face and content of a new scale for measuring HAIs risk in hospitalized adults. Materials and Methods: A methodologi- cal study conducted to develop and validate the face and content of the Adult Inpatients InfectionRisk Assessment scale, which underwent evaluation by a committee of 23 experts with experience in HAIs. The scale’s validity was tested using the Content Validity Index (CVI). Results: 15 items were retained in the scale, grouped into two dimensions: intrinsic and extrinsic factors. Certain minor adjustments were needed to improve the clarity of some items. Items’ CVIs ranged from 0.83 to 1.0 and the scale’s mean CVI was 0.90. Discussion: The Adult Inpatients InfectionRisk Assessment scale can be used as a technology of low cost for the measurement of the risk of infection, which allows the planning of more accurate and organized interventions of the health team targeting at preventive and safe care during hospitalization. Conclusions: Key words: Risk Assessment; Validation Studies; Infection Control; Patient Safety.
Primary biliary cirrhosis (PBC) is a cholestatic liver disease characterised by the immune-mediated destruc- tion of biliary epithelial cells in small intrahepatic bile ducts. The disease is characterised by circulating anti-mitochondrial antibodies (AMA) as well as disease specific anti-nuclear antibodies (ANA), cholestatic li- ver biochemistry, and characteristic histology. The disease primarily affects middle-aged females, and its incidence is apparently increasing worldwide. Epidemiological studies have indicated several riskfactorsfor the development of PBC, with family history of PBC, recurrent urinary tract infection, and smoking be- ing the most widely cited. Smoking has been implicated as a risk factor in several autoimmune diseases, in- cluding the liver, by complex mechanisms involving the endocrine and immunological systems to name a few. Studies of smoking in liver disease have also shown that smoking may progress the disease towards fi- brosis and subsequent cirrhosis. This review will examine the literature surrounding smoking as a risk fac- tor for PBC, as well as a potential factor in the progression of fibrosis in PBC patients.
The characteristics of our sample did not allow us to determine if the prevalence of IAB was related to the length of HIV infection as this variable was inversely correlated with age in our sample. Furthermore, our sample is relatively small and our study does not have the statistical power to identify all the riskfactors involved in the prevalence of IAB. Also, the lack of a con- trol group of HIV uninfected patients made impossible for us to directly assess the impact of HIV infection in the incidence of IAB. In order to limit this, we have resorted to compare our results with those previously published.
Statistical analysis: To identify correlates of perceived risk of HIV infection, PWID who reported higher per- ceived risk of HIV infection were compared with those who reported having the same or lower perceived risk of HIV infection. Participants who were missing data on the dependent variable, perception of HIV infectionrisk (n=75), or who were previously HIV positive and aware of their HIV status (n=7) were excluded. Thus, 974 PWID were included in this analysis. Descriptive statistics, such as frequencies and means, were cal- culated for variables potentially associated with HIV risk perception. The two groups were compared with respect to these variables using chi-squared and Fisher’s exact tests for binary variables and Mann Whitney U test for continuous variables. Logistic regression with robust variance estimation via generalized estimating equation was used to examine bivariate relationships between perceived risk of HIV infection and factors potentially associated with it. All factors that yielded a p-value≤0.10 were considered for inclusion in the final multivariable model. To correct for sampling bias due
If other riskfactorsfor HIV infection, apart from the number of partners are considered (such as the inconsistent use of the condom, the practice of oral and anal sex, sexual relations with foreigners- considering it to be an additional risk factor if the person comes from an area with a high prevalence of intravenous drug addiction, tattoos and the use of non- disposable syringes), it is undoubtable that the studied group has the riskfactorsfor HIV infection if their sexual partners are infected, as well as the conditions to be effective transmission vectors of this virus. Adding to these considerations, the frequency of STD is also significant, since these favour an increase in the risk of
18 years and older were included. Demographic and behavioral riskfactors were assessed by using a ques- tionnaire. Collected data included age, sexual behavior, tobacco and alcohol use, and HIV-related history. In order to detect lesions in the upper airway, oral and pharyngeal visual examinations were performed, as well as a video laryngoscopy (Storz 90º rigid endoscope). All patients underwent a neck examination through palpa- tion for detection of palpable cervical lymph nodes. Sample collection
Multivariate comparison of participants and non-partici- pants in the follow-up examination was performed using logistic regression to identify predictors of participation. Prevalence of HR-HPV infection in 2001 and 2006 was compared, using prevalence rate ratios. Riskfactorsfor HR-HPV incidence and persistence (age, marital status, schooling, number of children, age of first sexual inter- course, lifetime number of sexual partners, high-risk sexual partner, condom use, history of sexually transmitted dis- ease, hormonal contraception, smoking, history of previous Pap tests, and an abnormal baseline Pap test) were exam- ined with univariate analysis; variables significant at P value < 0.2 were then entered in multivariate models. Sex- ual behavioral changes in the study period were explored as riskfactorsfor HR-HPV incidence. Statistical analyses were performed using SPSS version 17 for Windows.
Background. Bacterial infections are often associated with significant morbidity and mortality in cirrhosis. The common practice of outdoor barefoot walking in the developing world may predispose cirrhotic indivi- duals to skin infection. Aims. To determine the prevalence, riskfactors, spectrum of infective organism and outcome of bacterial skin infection in cirrhosis. Methods. Consecutive newly diagnosed patients with cirrhosis (n = 200) between September 2007 and September 2008 were studied. Patients with congestive heart failure (n = 50) and chronic kidney disease (n = 50) on follow up at the same institution served as controls. Baseline demographic details, history of outdoor barefoot walking, details of skin infection along with cultures from skin and blood were obtained. The association between patient factors and risk of skin infection was evaluated using logistic regression. Results. Alcoholism was the predominant etiology for cirr- hosis. (50%) Most of them were of Child B cirrhosis. Walking on barefoot was found to be similar in cases and controls. 21(10.5%) patients with cirrhosis had skin infection, three fourth of them had a history of ba- refoot walking. None of the controls had skin infection. Cellulitis with hemorrhagic bullae, leg ulcers, in- fected callosity and abscess were observed. The infective organism could be isolated in 17 patients. Escherichia coli was the most frequent organism identified. Logistic regression showed outdoor barefoot walking and serum albumin < 2.5 gm/dL as riskfactorsfor skin infection. Four patients died. Conclusion. The prevalence of skin infection in cirrhosis was 10.5% with a mortality of 19%. Escherichia coli was the commonly implicated organism. Outdoor barefoot walking was a strong risk factor for skin infection in cirr- hosis.
Univariate analysis was performed for each compli- cation (analyzing patients in two groups: complication present vs. absence of complication). All variables with a p value inferior to 0.10 in the univariate analysis were considered as potential riskfactors and were entered into multivariate backward logistic regression analysis. The variables representing the lowest riskfor each complication was considered to be the refe- rence group (odds ratio [OR] = 1). OR and 95% con- fidence intervals (95% CI) were calculated for each outcome (complication) (wound infection, anastomotic leakage, intestinal obstruction, incisional hernia, rein- tervention after ileostomy closure, overall medical complications, and mortality). p < 0.05 was conside- red to be statistically significant. All data were analyzed using SPSS statistic version 22.0 (IBM Corporation, Armonk, New York, NY).
In the univariate analysis of nonmelanoma skin cancer, the use of both MMF and FK in the first 3 months emerged as protective factors, whereas AZA was a risk factor and cyclosporine had no effect. This was due to the influence of these drugs on the incidence of SCC; in BCC there was no modification, in agreement with the results of the study by Caforio et al, which showed that a high rejection score was a risk factor for skin tumor of the SCC type but not BCC. 3 It is noteworthy that the group of patients exposed to FK showed no SCC, which suggests it is a strong protective factor, but it must be remembered that this was a small group of patients. The beneficial role of MMF at the onset of cancer has been described previously in vitro 15 and 16 and in vivo, 17 and 18 as has the deleterious effect of AZA, 19 but there is little information about the effect of calcineurin inhibitors on the appearance of skin tumors in cardiac transplantation.
Los datos se analizaron por medio del programa estadístico R versión 3.0.0 (R CoreTeam (2013). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org/). Se describieron todas las variables estudiadas, determinando frecuencias para las categóricas, y medidas de tendencia central y medidas de dispersión, para las cuantitativas, tanto para los 150 pacientes que entraron inicialmente a la cohorte como para los que se siguieron posteriormente. Para el análisis estadístico los desenlaces se agruparon en eventos cardiovasculares no fatales, fatales y muerte por causa no cardiovascular. Se calculó la prevalencia de cada uno de ellos. Para el grupo de pacientes que completó el seguimiento, se evaluó la distribución normal de todas las variables cuantitativas con el Shapiro-Wilks test y la realización de histogramas de frecuencia. Se compararon las variables estudiadas entre el grupo de pacientes que presentaron eventos cardiovasculares (fatales y no fatales) y aquellos que no, usando la prueba del ji 2 o el test exacto de Fisher para las variables categóricas, la prueba de t de Student para las variables numéricas con distribución paramétrica y el test de Wilcoxon para variables no paramétricas. Se realizó un análisis de regresión logística para determinar la contribución de los factores de riesgo no tradicionales en la aparición de eventos cardiovasculares. Se calcularon odds ratio (OR) e intervalos de confianza (IC 95%).
running at 80% of his maximum velocity. It is obvious from Equation 5, that activation of quadriceps and the synchronization with the hamstrings are also crucial for the loads supported by each of the hamstring body muscles. However, a lack of information exists in the scientific literature about hamstrings and quadriceps activation during isokinetic tests in soccer (Oliviera et al. 2009). However, the muscle forces have been studied using simultaneously isokinetic and electromyography measures in sports as Australian Football or Track and Field but not in soccer (Opar et al., 2013, Kellis et al., 1998, Onishi et al., 2002, Hassani, et al. 2006, Sole et al. 2011, Oliveria, et al. 2012). It has been found that electromyographic activation of biceps femoris during eccentric contraction was smaller in the previously injured leg (Opar et al., 2013). A reduction on the electrical activity means a decrease in the recruitment number of motor units and/or a decrease in the stimulation frequency of fiber(Opar et al. 2013). More research is needed to demonstrate that a reduction on the electric activity of the muscle represents more risk of hamstring injury (Opar, 2012). Oliveira et al (2009) studied the force and electromyographic response of hamstrings and quadriceps during isometric contraction in 10 professional players. They found a strong relationship between the H:Q ratios calculated from the isometric force and from EMG records. The isometric force H:Q ratio reached values of 0.6 while EMG ratios ranged between 0.8 and 1.0. In accordance with Oliviera et al. (2009), the EMG activation patterns should be taken into consideration when the rehabilitation and prevention exercises are being designed.
Foundation: the high incidence and prevalence of chronic non-communicable diseases make their attention become imminent in the projections of the health system to strengthen the management and control of the different riskfactors accompanying them. Objective: to determine the behavior of the main chronic non communicable diseases and riskfactors in the supposedly healthy population in Cienfuegos. Methods: a correlational descriptive study was conducted in the trimester from July 1 to September 30, 2018, in blood donors of the Provincial Bank of Cienfuegos. The universe consisted of 1,200 donors who attended a donation in the study period and it shows 66 donors who met the inclusion and exclusion criteria. The variables studied were: age, sex, skin color, chronic diseases, smoking and obesity. The data were processed and analyzed with statistical methods according to the study carried out (prevalence rate, frequency, percentage and Pearson's X2).
Specific actions are recommended at different stages of the intervention to improve retention. First, the selection criteria should be expanded to define a less vulnerable group (those who are less distressed, less anxious, and are satisfied with their partners) within the high risk sample, and to provide them with alternative intervention strategies. This assures that only those at higher risk, and thus those who are more motivated, are selected for study inclusion. Second, it is necessary to take more time to explore and resolve barriers to attend and comply with longitudinal interventions in non- employed mothers and in those with lower education in order to increase the likelihood of their attending the course. In summary, this first study on the prevention of postpartum depression in Mexico has some similarities with international research trials as well as some unique aspects. In both cases, the results are relevant to future studies on the prevention of postpartum depression, particularly in this country.
Finally, a history of alcohol consumption was reported by more controls than patients in our population, indicat- ing that this factor was inversely related to the risk of de- veloping MS. Since exposure is measured retrospectively in case-control studies, the possibility of a recall bias cannot be excluded as patients may over- or underestimate their history of exposure. In addition, the inclusion of preva- lent cases into the study may have introduced a selection bias, as patients may stop drinking following diagnosis. If the patient stopped drinking due to MS symptoms, this may explain our finding of a reduction in risk in drinkers.