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Rev Port Cir Cardiotorac Vasc ; 28(1): 39-44, 2021 Apr 08.
Article En | MEDLINE | ID: mdl-33834653

INTRODUCTION: Ruptured abdominal aortic aneurysm's treatment relies on the emergent surgery, considering preoperative prognosis. There are several scores that estimate perioperative mortality of ruptured abdominal aortic aneurysm, however, the accuracy of such algorithms in some populations remains unknown. OBJECTIVE: Compare the prognostic validity of the Weingarten score with the Glasgow Aneurysm Score and the Vancouver Scoring System. Validation of three prognostic ruptured abdominal aortic aneurysms tools for the Portuguese population. MATERIAL AND METHODS: A retrospective analysis of consecutive patients with ruptured abdominal aortic aneurysm surgically treated, in a peripheral and in a referral hospital between 2012 and 2016 was performed. The 30-day mortality discriminative power was analysed using each score. RESULTS: 120 patients were included. The mean Glasgow Aneurysm Score was 98.53 ± 19.57, the Vancouver Scoring System was 3.64 ± 1.43. The Weingarten score classified 51 (43.2%) patients as stable and 67 (56.8%) as unstable. The three scores demonstrated some predictive value concerning mortality, although Glasgow Aneurysm Score demonstrated the highest area under the ROC curve (0.74) and the best discriminatory capacity for cut-off points with higher specificity. Neither of the scores demonstrated clinically useful predictive value. CONCLUSIONS: The Weingarten score did not present as a superior prediction model of preoperative mortality in ruptured abdominal aortic aneurysm. None of the scores, even when optimized for a higher specificity, could select which patients will not benefit from surgical intervention. The Glasgow Aneurysm Score was validated for the Portuguese population.

Aortic Aneurysm, Abdominal , Aortic Rupture , Aortic Aneurysm, Abdominal/surgery , Aortic Rupture/surgery , Decision Support Techniques , Hospital Mortality , Humans , Predictive Value of Tests , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Vascular Surgical Procedures
Bone Joint J ; 103-B(4): 704-710, 2021 Apr.
Article En | MEDLINE | ID: mdl-33789472

AIMS: With novel promising therapies potentially limiting progression of Dupuytren's disease (DD), better patient stratification is needed. We aimed to quantify DD development and progression after seven years in a population-based cohort, and to identify factors predictive of disease development or progression. METHODS: All surviving participants from our previous prevalence study were invited to participate in the current prospective cohort study. Participants were examined for presence of DD and Iselin's classification was applied. They were asked to complete comprehensive questionnaires. Disease progression was defined as advancement to a further Iselin stage or surgery. Potential predictive factors were assessed using multivariable regression analyses. Of 763 participants in our original study, 398 were available for further investigation seven years later. RESULTS: We identified 143/398 (35.9%) participants with DD, of whom 56 (39.2%) were newly diagnosed. Overall, 20/93 (21.5%) previously affected participants had disease progression, while 6/93 (6.5%) patients showed disease regression. Disease progression occurred more often in patients who initially had advanced disease. Multivariable regression analyses revealed that both ectopic lesions and a positive family history of DD are independent predictors of disease progression. Previous hand injury predicts development of DD. CONCLUSION: Disease progression occurred in 21.5% of DD patients in our study. The higher the initial disease stage, the greater the proportion of participants who had disease progression at follow-up. Both ectopic lesions and a positive family history of DD predict disease progression. These patient-specific factors may be used to identify patients who might benefit from treatment that prevents progression. Cite this article: Bone Joint J 2021;103-B(4):704-710.

Disease Progression , Dupuytren Contracture/diagnosis , Aged , Female , Humans , Male , Middle Aged , Netherlands , Prospective Studies , Risk Factors , Surveys and Questionnaires
Bone Joint J ; 103-B(4): 635-643, 2021 Apr.
Article En | MEDLINE | ID: mdl-33789473

AIMS: Debate continues regarding the optimum management of periprosthetic distal femoral fractures (PDFFs). This study aims to determine which operative treatment is associated with the lowest perioperative morbidity and mortality when treating low (Su type II and III) PDFFs comparing lateral locking plate fixation (LLP-ORIF) or distal femoral arthroplasty (DFA). METHODS: This was a retrospective cohort study of 60 consecutive unilateral (PDFFs) of Su types II (40/60) and III (20/60) in patients aged ≥ 60 years: 33 underwent LLP-ORIF (mean age 81.3 years (SD 10.5), BMI 26.7 (SD 5.5); 29/33 female); and 27 underwent DFA (mean age 78.8 years (SD 8.3); BMI 26.7 (SD 6.6); 19/27 female). The primary outcome measure was reoperation. Secondary outcomes included perioperative complications, calculated blood loss, transfusion requirements, functional mobility status, length of acute hospital stay, discharge destination and mortality. Kaplan-Meier survival analysis was performed. Cox multivariate regression analysis was performed to identify risk factors for reoperation after LLP-ORIF. RESULTS: Follow-up was at mean 3.8 years (1.0 to 10.4). One-year mortality was 13% (8/60). Reoperation was more common following LLP-ORIF: 7/33 versus 0/27 (p = 0.008). Five-year survival for reoperation was significantly better following DFA; 100% compared to 70.8% (95% confidence interval (CI) 51.8% to 89.8%, p = 0.006). There was no difference for the endpoint mechanical failure (including radiological loosening); ORIF 74.5% (56.3 to 92.7), and DFA 78.2% (52.3 to 100, p = 0.182). Reoperation following LLP-ORIF was independently associated with medial comminution; hazard ratio (HR) 10.7 (1.45 to 79.5, p = 0.020). Anatomical reduction was protective against reoperation; HR 0.11 (0.013 to 0.96, p = 0.046). When inadequately fixed fractures were excluded, there was no difference in five-year survival for either reoperation (p = 0.156) or mechanical failure (p = 0.453). CONCLUSION: Absolute reoperation rates are higher following LLP fixation of low PDFFs compared to DFA. Where LLP-ORIF was well performed with augmentation of medial comminution, there was no difference in survival compared to DFA. Though necessary in very low fractures, DFA should be used with caution in patients with greater life expectancies due to the risk of longer term aseptic loosening. Cite this article: Bone Joint J 2021;103-B(4):635-643.

Femoral Fractures/surgery , Fracture Fixation, Internal/methods , Periprosthetic Fractures/surgery , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip , Blood Loss, Surgical/prevention & control , Blood Loss, Surgical/statistics & numerical data , Bone Plates , Female , Femoral Fractures/mortality , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Periprosthetic Fractures/mortality , Postoperative Complications/epidemiology , Prosthesis Failure , Recovery of Function , Reoperation/statistics & numerical data , Retrospective Studies , Risk Factors , Survival Rate
Article Zh | MEDLINE | ID: mdl-33794609

Objective:To investigate the risk factors affecting the surgical outcome of severe tracheal stenosis. Methods:The data of 36 patients with severe tracheal stenosis were analyzed retrospectively. All patients underwent tracheal stenosis resection with primary end-to-end anastomosis.Six factors including the location of tracheal stenosis, the length of resected trachea, the degree of stenosis, scar constitution, diabetes and gastroesophageal reflux disease were analyzed by univariate analysis and multivariate Logistic regression analysis. Results:Finally, 23 cases were extubated,including 19 cases with successful extubation and 4 cases with granulation tissue removed by bracing laryngoscope.Univariate analysis showed that the location of tracheal stenosis, the length of resected trachea,scar constitution, diabetes and gastroesophageal reflux disease were the risk factors affecting the surgical efficacy of severe tracheal stenosis.The multivariate Logistic regression coefficients of each factor were 2.857, 1.761, 3.123, -1.066, 3.545 respectively. Conclution: The risk factors affecting the outcome of severe tracheal decannulation rate were the location of tracheal stenosis, the length of resected trachea, scar constitution, diabetes and gastroesophageal reflux disease. Among them, the stenosis position, the length of the resected trachea, scar constitution and gastroesophageal reflux disease had more significant effects on the prognosis of the operation, and the comprehensive evaluation of these risk factors before operation was conducive to improve the surgical effect.

Tracheal Stenosis , Anastomosis, Surgical , Humans , Retrospective Studies , Risk Factors , Trachea/surgery , Tracheal Stenosis/surgery , Treatment Outcome
Article Zh | MEDLINE | ID: mdl-33794611

Objective:To evaluate the risk factors for metastasis of the lymph nodes posterior to the right recurrent laryngeal nerve in thyroid micropapillary carcinoma(PTMC) by Meta-analysis. Methods:We searched domestic and foreign databases for relevant studies published up to June, 2020. Two independent reⅥewers performed literature screening and data extraction according to the inclusion and exclusion criteria. Then, Meta-analysis was performed using Revman 5.3 software. Results:A total of 5 articles were included, with a total of 1884 subjects.The results of the study showed that the rate of lymph node metastasis in PTMC Ⅵb area was 10.8% (203/1884). The risk factors for metastasis included patients' age <45 years old, male, right lobe tumor Diameter ≥0.5 cm, invading the envelope, Ⅵa lymph node metastasis. Conclusion:Ⅵb lymph node dissection is recommended when there exists age<45 years, male sex, right lobe tumor≥0.5 cm, capsular invasion or Ⅵa lymph node metastasis.

Carcinoma, Papillary , Thyroid Neoplasms , Carcinoma, Papillary/surgery , Humans , Lymph Nodes , Male , Middle Aged , Neck Dissection , Recurrent Laryngeal Nerve , Retrospective Studies , Risk Factors , Thyroid Gland , Thyroid Neoplasms/surgery , Thyroidectomy
Article Zh | MEDLINE | ID: mdl-33794614

Objective:To investigate the clinical and ultrasonic features of papillary thyroid microcarcinoma (PTMC) and the risk factors of central lymph node metastasis (CLNM), to provide help for individualized treatment. Methods:One hundred and eighty-five patients with PTMC confirmed by surgery and pathology and underwent prophylactic CLN dissection were retrospectively analyzed. According to lymph node metastasis, patients were divided into metastasis group and non metastasis group. The size, shape, echo, aspect ratio, edge, protruding capsule, nodule location, calcification and calcification were analyzed. The relationship between clnm and ultrasonographic features, sex, age, single/multiple, whether or not with Hashimoto thyroiditis was analyzed. Results:Among 185 patients with PTMC, 55 cases had lymph node metastasis, and the metastasis rate was 30.0%. In univariate analysis, clnm of PTMC was significantly correlated with gender, age, tumor size, protruding capsule, type of calcification and single / multiple (all P<0.05). In multivariate logistic regression analysis, tumor size, single/multiple, protruding capsule, gender and age were the risk factors of clnm. According to the ROC curve, when the age was 49.5 years old and the mass size was 4.8 mm, the diagnostic test yoden index reached the maximum value. Conclusion:When the risk factors of male, ≤49.5 years old, tumor size≥4.8 mm, multiple and protruding capsule appeared in PTMC patients, preventive CLN clearance should be taken actively.

Thyroid Neoplasms , Ultrasonics , Carcinoma, Papillary , Humans , Lymph Nodes/diagnostic imaging , Lymphatic Metastasis , Male , Middle Aged , Retrospective Studies , Risk Factors , Thyroid Neoplasms/diagnostic imaging
Anticancer Res ; 41(4): 2193-2195, 2021 Apr.
Article En | MEDLINE | ID: mdl-33813433

BACKGROUND/AIM: Since January 2020, coronavirus disease (COVID-19) cases have been confirmed in Japan, and the number of patients with COVID-19 has been increasing. Two emergency declarations have been made previously and one is currently in effect. Based on our experience of a situation that could affect cancer treatment, this study retrospectively examined the correlation between perioperative anticancer therapy and COVID-19 incidence in patients with breast cancer. PATIENTS AND METHODS: Patients who underwent perioperative anticancer therapy for breast cancer at our hospital from February 2020 to February 2021 were included in this study. The presence or absence of COVID-19, timing of anticancer drug initiation, and clinical data were collected. RESULTS: No cases of COVID-19 were diagnosed in patients receiving perioperative anticancer therapy at our hospital. CONCLUSION: Regimen modification, active use of supportive care, and patient lifestyle were factors reducing the incidence of COVID-19.

Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Breast Neoplasms , Perioperative Care/methods , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant/statistics & numerical data , Combined Modality Therapy , Female , Humans , Immunocompromised Host , Incidence , Japan/epidemiology , Middle Aged , Neoadjuvant Therapy/statistics & numerical data , Perioperative Care/adverse effects , Perioperative Care/statistics & numerical data , Retrospective Studies , Risk Factors , /physiology
Anticancer Res ; 41(4): 2165-2169, 2021 Apr.
Article En | MEDLINE | ID: mdl-33813428

BACKGROUND/AIM: In centrally-located lung cancer treatment, it is difficult to attain a sufficient resection margin. It is important to investigate recurrent styles in centrally-located lung cancer patients. PATIENTS AND METHODS: Primary lung cancer located at the hilar area that requires pneumonectomy or sleeve lobectomy is defined as centrally-located lung cancer. Early recurrence was defined as that within 1 year after surgery. RESULTS: This study included 43 centrally-located lung cancer patients. Ten patients underwent pneumonectomy and 33 underwent sleeve lobectomy. Eleven patients experienced early recurrence. Non-squamous cell carcinoma (p=0.012), tumor size>64 mm (p<0.001) and pathological N2 (p=0.012) were significant predictors for early recurrence by univariate analysis. Also, tumor size >64 mm (p=0.006) and pathological N2 (p=0.019) were independent predictors by multivariate analysis. CONCLUSION: Non-squamous cell carcinoma, tumor size and pathological N2 were significant predictors of early recurrence in centrally-located lung cancer. The type of surgical procedure did not affect recurrence development.

Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Lymph Nodes/pathology , Tumor Burden/physiology , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/pathology , Female , Follow-Up Studies , Humans , Lung Neoplasms/pathology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local , Neoplasm Staging , Pneumonectomy/adverse effects , Pneumonectomy/methods , Postoperative Period , Prognosis , Retrospective Studies , Risk Factors , Time Factors
Anticancer Res ; 41(4): 2177-2182, 2021 Apr.
Article En | MEDLINE | ID: mdl-33813430

BACKGROUND/AIM: To investigate the impact of PDZ-binding kinase (PBK) on the clinical outcome of patients with oral squamous cell carcinoma (OSCC) who received radiotherapy. PATIENTS AND METHODS: PBK immunoreactivity of cancer specimens obtained from 179 patients with primary OSCC was analyzed by immunohistochemistry. RESULTS: High PBK expression in tumor cells tended to be associated with advanced N-stage. The 5-year survival rate was greater for patients with high total PBK expression than in those with low PBK expression. After adjustment, high PBK remained associated with a favorable outcome. In subgroups according to tumor stage, the prognostic role was significant in patients with stage III/IV rather than those with stage I/II disease. CONCLUSION: We suggest that PBK expression should be used as an independent prognostic marker for patients with OSCC treated with radiotherapy, especially for those with advanced-stage disease.

Biomarkers, Tumor/metabolism , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/radiotherapy , Mitogen-Activated Protein Kinase Kinases/metabolism , Mouth Neoplasms/diagnosis , Mouth Neoplasms/radiotherapy , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Immunohistochemistry , Life Style , Male , Middle Aged , Mitogen-Activated Protein Kinase Kinases/physiology , Mouth Neoplasms/mortality , Mouth Neoplasms/pathology , Neoplasm Metastasis , Neoplasm Staging , Prognosis , Retrospective Studies , Risk Factors , Squamous Cell Carcinoma of Head and Neck/diagnosis , Squamous Cell Carcinoma of Head and Neck/mortality , Squamous Cell Carcinoma of Head and Neck/pathology , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Survival Analysis , Taiwan/epidemiology
Anticancer Res ; 41(4): 2197-2201, 2021 Apr.
Article En | MEDLINE | ID: mdl-33813434

BACKGROUND/AIM: To evaluate complications and risk factors associated with transumbilical incision as an organ removal site in laparoscopic pancreatectomy (LP). PATIENTS AND METHODS: In total, 52 patients who underwent LP between 2009 and 2017 were included in this study. The development of superficial surgical site infection (SSI) and transumbilical port-site incisional hernia was recorded. RESULTS: None of the patients had SSI. However, three (5.77%) presented with transumbilical incisional hernia. No variables were significantly associated with the risk of transumbilical incisional hernia. CONCLUSION: No evident risk factors correlated with hernia formation. Hence, incisional hernia might have occurred at a certain probability. In some cases, it was caused by technical problems. However, the use of transumbilical incision as an organ removal site was feasible, and a new incision for organ removal alone was not required.

Laparoscopy/methods , Pancreas/pathology , Pancreatectomy/methods , Pancreatic Diseases/surgery , Umbilicus/surgery , Adult , Aged , Aged, 80 and over , Cohort Studies , Databases, Factual , Female , Humans , Incisional Hernia/diagnosis , Incisional Hernia/epidemiology , Incisional Hernia/etiology , Japan/epidemiology , Laparoscopy/adverse effects , Laparoscopy/statistics & numerical data , Male , Middle Aged , Pancreas/surgery , Pancreatectomy/adverse effects , Pancreatectomy/statistics & numerical data , Pancreatic Diseases/epidemiology , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Retrospective Studies , Risk Factors , Specimen Handling/adverse effects , Specimen Handling/methods , Surgical Wound Infection/diagnosis , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Umbilicus/pathology , Young Adult
Angiol Sosud Khir ; 27(1): 24-32, 2021.
Article Ru | MEDLINE | ID: mdl-33825725

AIM: The study was aimed at comparing efficacy of conventional conservative therapy and comprehensive treatment including a plasmid VEGF-165-gene therapy drug in 'no-option' chronic limb-threatening ischaemia with different prevalence of trophic ulcers and infection during a 1-year follow-up period. PATIENTS AND METHODS: A total of 101 patients (54% being men and 46% women, mean age 69 years) with 'no-option' chronic limb-threatening ischaemia underwent comprehensive conservative treatment. They were subdivided into 4 groups according to the WIFI classification: WIFI 130 (n=38), 131 (n=23), 230 (n=16), 231 (n=24). The control group patients (n=58) received standard treatment using a PGE1 analogue (Vasaprostan) and the study group patients (n=43) underwent standard conservative treatment (SCT) in combination with gene therapy. The end points of the study were as follows: major amputation rate, amputation-free survival, total mortality, and ulcer healing rate during a 1-year of follow up. RESULTS: Major amputation rate in the control and study groups amounted to 35 and 28% (p=0.48), respectively, with amputation-free survival of 53 and 63% (p=0.35), total mortality of 21 and 12% (p=0.23), ulcer healing rate of 31 and 51% (p=0.04), respectively. The WIfI classification made it possible to single out a subgroup of patients (WIfI combination 130) yielding other statistically significant results: major amputation rate 27% and 0% (p=0.03), amputation-free survival 59 and 94% (p=0.025), ulcer healing rate 50 and 88% (p=0.016), respectively. CONCLUSION: Using plasmid-based VEGF-165 gene therapy in the subgroup with the WIfI combination 130 decreases the major amputation rate (p=0.03), increases amputation-free survival (p=0.025) and promotes ulcer healing (p=0.016) compared with the standard therapy during 1-year follow up. No significant differences in the compared groups were revealed by all endpoints of the study for other combinations analysed. The total mortality rate in patients with limb-threatening ischaemia does not depend on either the initial severity of ulcer or the selcted methods of conservative treatment.

Conservative Treatment , Limb Salvage , Aged , Amputation , Female , Humans , Ischemia/surgery , Kaplan-Meier Estimate , Male , Predictive Value of Tests , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome , Wound Healing
Angiol Sosud Khir ; 27(1): 169-174, 2021.
Article Ru | MEDLINE | ID: mdl-33825745

Hereditary thrombophilia is rare pathology giving rise to a ninefold increase in the risk for the development of thromboembolism in infants. The problem is multifactorial and characterized by high mortality, especially in neonates. Infants who develop thrombosis, particularly those with no family history, are often subjected to testing for hereditary thrombophilia. However, genetic testing for thrombophilia does not change the plan of treatment but makes it possible to perform prevention of thrombosis within the risk periods for the patient. Poor awareness of paediatricians, the complexity of carrying out genetic testing, the absence of approaches supported by evidence-based medicine due to shortage of high-quality clinical trials and no guidelines on prevention of thromboembolism in infants, as well as the frequent occurrence of diversified causes and diseases in different age groups make the problem significant for modern medicine. Further studies are needed to address many unanswered as yet questions.

Thromboembolism , Thrombophilia , Thrombosis , Heart Atria/diagnostic imaging , Humans , Infant , Infant, Newborn , Risk Factors , Thromboembolism/diagnosis , Thromboembolism/etiology , Thromboembolism/prevention & control , Thrombophilia/complications , Thrombophilia/diagnosis , Thrombophilia/genetics , Vena Cava, Inferior/diagnostic imaging
Angiol Sosud Khir ; 27(1): 182-190, 2021.
Article Ru | MEDLINE | ID: mdl-33825747

Peripheral artery disease is a common and acute social burden worldwide. The main method of treatment of PAD consists in open surgical or endovascular revascularization. However, despite steady growth of the number and quality of interventions, the incidence of lower-limb amputation still remains at a high level. Lower-limb amputation is a severe psychological blow for the patient and leads to significant deterioration of his or her quality of life, as well as has an extremely negative prognosis concerning the frequency of subsequent complications and survival. Consequences of amputations include not only severe disability but also an unfavourable prognosis of life, thus determining the necessity of adequate prevention of such events. Reconstructive and endovascular operations, as well as amputations are associated with a significant increase of the probability of the development of major adverse cardiovascular events, the frequency of repeat hospitalizations and, finally, the cost of treatment. Prescribing pathogenetically substantiated antithrombotic therapy is considered to be one of the methods to improve the results of surgical treatment and prognosis for the patient. Presented in the article is a literature review making it possible to assess the risks and consequences of amputations in patients with PAD, as well as to determine therapy capable of improving the prognosis.

Endovascular Procedures , Peripheral Arterial Disease , Amputation , Endovascular Procedures/adverse effects , Female , Humans , Limb Salvage , Lower Extremity , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/surgery , Prognosis , Quality of Life , Risk Factors , Treatment Outcome
Rev Bras Epidemiol ; 24: e210015, 2021.
Article En, Pt | MEDLINE | ID: mdl-33825775

OBJECTIVE: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. METHODS: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016-2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). RESULTS: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 - 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 - 6.2), widowhood (HR = 2.2; 95%CI 1.4 - 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 - 4..6), current smoking (HR = 2.1; 95%CI 1.2 - 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 - 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 - 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 - 5.7). CONCLUSION: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.

Independent Living , Mortality , Aged , Aged, 80 and over , Brazil/epidemiology , Cause of Death/trends , Female , Humans , Independent Living/statistics & numerical data , Longitudinal Studies , Male , Middle Aged , Mortality/trends , Risk Factors , Socioeconomic Factors
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(2): 340-344, 2021 Mar.
Article Zh | MEDLINE | ID: mdl-33829712

Objective: To explore the relationship between abdominal obesity and diabetes among middle-aged and older adults with normal body mass index (BMI) and to provide reference information for formulating targeted diabetes prevention and control measures for this population. Methods: Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) done in 2015. Middle-aged and older adults who were aged 45 and older and had normal BMI were included in the study. According to their status of diabetes, the subjects were divided into two groups, non-diabetes and diabetes groups. χ 2 test was used to investigate the difference between two groups. Logistic regression was used to do the multivariate analysis of factors influencing diabetes. Results: A total of 5 197 middle-aged and older adults with normal BMI ranging between 18.5 and 24 kg/m 2 were included. The prevalence of diabetes was 11.26% (585/5 197) and the prevalence of abdominal obesity was 41.56% (2 160/5 197). Univariate analysis showed that the difference in age, residence, the status of hypertension, dyslipidemia and abdominal obesity between non-diabetic group and the diabetic group were statistically significant ( P<0.01). The prevalence of diabetes among adults with abdominal obesity was 14.2% (307/2 160) and that among people with no abdominal obesity was 9.2% (278/3 037). Compared with people with no abdominal obesity, the prevalence of diabetes among people with abdominal obesity was higher and the difference were statistically significant ( P<0.01). Multivariate logistic regression analysis showed that, among middle-aged and older adults with normal BMI, those with abdominal obesity, aged 60 years and older, living in urban areas, having hypertension and having dyslipidemia had higher probability of developing diabetes. Conclusion: Abdominal obesity and diabetes are becoming a serious problem among middle-aged and older adults with normal BMI and abdominal obesity may be related to higher risks of diabetes. It is recommended that more attention is given to abdominal obesity in this population to reduce the possibilities of diabetes.

Diabetes Mellitus , Hypertension , Obesity, Abdominal , Aged , Body Mass Index , China/epidemiology , Diabetes Mellitus/epidemiology , Humans , Hypertension/epidemiology , Longitudinal Studies , Middle Aged , Obesity, Abdominal/complications , Obesity, Abdominal/epidemiology , Prevalence , Risk Factors
Rev Saude Publica ; 55: 2, 2021.
Article En, Pt | MEDLINE | ID: mdl-33825797

OBJECTIVE: To estimate the prevalence of musculoskeletal symptoms and analyze their associated factors in professionals from administrative sectors working predominantly in sitting position. METHODS: This is a cross-sectional study with data obtained from 451 workers from a federal public institution in Southern Brazil. The dependent variable was the number of musculoskeletal symptoms in the prior 12 months, measured using the Nordic Musculoskeletal Questionnaire. In the analyses, 19 independent variables were investigated, divided into four categories: sociodemographic, behavioral, occupational and health characteristics. Univariate analysis and multiple Poisson regression with robust variance were performed. The independent variables were inserted into blocks with stepwise backward criterion, considering the value for Wald statistics equal to 0.20. The effect measures were expressed in a relative increase (RI) in the mean value, and the data were analyzed for a 5% significance level. RESULTS: The estimated prevalence of musculoskeletal symptoms in the prior 12 months was 90% (confidence interval - 95%CI 87-93). In the final model of regression analysis, the variables female gender (RI = 14.75%), low (RI = 100.02%) and moderate (RI = 64.06%) work ability index, use of medications (RI = 48.06%) and waist circumference at risk (RI = 15.59%) had a significant association with the increase in the mean number of symptoms; schooling with technical education acted as a protective factor, reducing the mean by 36.46%. CONCLUSIONS: The high prevalence of musculoskeletal symptoms found and the associated factors indicate the need to propose specific actions and care for this population, such as immediate treatment of symptoms and changes in the organization and work environment, to achieve balance and harmony in the demands of prolonged sitting work and avoid its impact effect of this condition on public health.

Administrative Personnel , Musculoskeletal Diseases , Occupational Diseases , Sitting Position , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Musculoskeletal Diseases/epidemiology , Occupational Diseases/epidemiology , Prevalence , Risk Factors , Surveys and Questionnaires
Infect Dis Poverty ; 10(1): 45, 2021 Mar 31.
Article En | MEDLINE | ID: mdl-33789752

BACKGROUND: The management of discharge COVID-19 patients with recurrent positive SARS-CoV-2 RNA is challenging. However, there are fewer scientific dissertations about the risk of recurrent positive. The aim of this study was to explore the relationship between SARS-COV-2 RNA positive duration (SPD) and the risk of recurrent positive. METHODS: This case-control multi-center study enrolled participants from 8 Chinese hospital including 411 participants (recurrent positive 241). Using unadjusted and multivariate-adjusted logistic regression analyses, generalized additive model with a smooth curve fitting, we evaluated the associations between SPD and risk of recurrent positive. Besides, subgroup analyses were performed to explore the potential interactions. RESULTS: Among recurrent positive patients, there were 121 females (50.2%), median age was 50 years old [interquartile range (IQR): 38-63]. In non-adjusted model and adjusted model, SPD was associated with an increased risk of recurrent positive (fully-adjusted model: OR = 1.05, 95% CI: 1.02-1.08, P = 0.001); the curve fitting was not significant (P = 0.286). Comparing with SPD < 14 days, the risk of recurrent positive in SPD > 28 days was risen substantially (OR = 3.09, 95% CI: 1.44-6.63, P = 0.004). Interaction and stratified analyses showed greater effect estimates of SPD and risk of recurrent positive in the hypertension, low monocyte count and percentage patients (P for interaction = 0.008, 0.002, 0.036, respectively). CONCLUSION: SPD was associated with a higher risk of recurrent positive and especially SPD > 28 day had a two-fold increase in the relative risk of re-positive as compared with SPD < 14 day. What's more, the risk may be higher among those with hypertension and lower monocyte count or percentage.

/virology , RNA, Viral/isolation & purification , /isolation & purification , Adult , /pathology , Case-Control Studies , Female , Hospitalization , Humans , Male , Middle Aged , Pharynx/virology , RNA, Viral/genetics , Recurrence , Risk Factors , Time Factors , Virus Shedding