Dissertations / Theses on the topic 'Knee Diseases Risk factors'
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Ingham, Sarah Louise. "Knee pain in the community : risk factors, incidence, and outcome." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/11134/.
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Background: Knee pain affects 1 in 4 people over 55 years, and is a leading cause of disability in the elderly (Peat et al, 2001). Whilst the prevalence of knee pain has been examined, the natural history of knee pain and associated risk factors remain unknown (O’Reilly, 1996). Objectives: to determine in a community sample over a 10 year period: [1] the incidence of knee pain; [2] the outcome of knee pain; and [3] risk factors for both incidence and outcome of knee pain. Materials and method: This was a retrospective cohort study. Baseline data were collected between 1996-1999, and the cohort was reviewed during 2007-2008. Knee pain was defined as pain around the knee for most days of at least a month. Participants without knee pain at baseline who developed knee pain during the subsequent 10 years were defined as incident cases. Participants with knee pain at baseline who reported worsening of symptoms, improvement of symptoms, no change in symptoms, or who underwent TKR during the past 10 years were defined as outcome cases. Other measures included: age of onset and time from baseline to the first episode of knee pain. Putative risk factors measured at baseline included age, gender and body mass index (BMI); risk factors assessed at follow-up included knee malalignment and foot angulation. Relative risk (RR) was estimated using odds ratio (OR) or hazard ratio (HR) depending on outcomes. Confounding factors were adjusted using logistic regression or COX regression. Results: 9,429 participants were questioned at baseline (2,868 knee pain positive/6,397 knee pain negative). After 10 years, 5,479 were eligible for follow-up. Of them 3,109 responded and 424 underwent x-rays at both baseline and follow-up. The baseline age of this cohort ranged between 40-83 years, with a mean age of 57 years old; 1,725 (55.5%) were women. The incident rate for knee pain cases during the 10 year follow-up period was 742/2,156 (34.4%); this was similar in men (32%) and women (35%). During the 10 year period 250 (27.4%) of the 914 people with pain at baseline experienced worsening of their symptoms, with 81 (8.9%) requiring total knee joint replacements (TKR). A number of risk factors were explored. Obesity (OR 2.19; 95%CI 1.49, 3.22) and varus malalignment (OR 2.82; 95%CI 1.57, 5.06) significantly associated with incident knee pain, whereas back pain (aOR 1.47; 95%CI 1.02, 2.10) and physical work (aOR 1.88; 95%CI 1.02, 3.50) were related to poor outcome. Conclusions: For people over the age of 40 years old, 1 in 3 will develop significant knee pain in the next 10 years. Of people with knee pain, 1 in 4 will worsen over a 10 year period and 1 in 11 will require surgery. A number of risk factors were identified including both systemic/constitutional and more local biomechanical factors. This could have practical implications for primary and secondary prevention particularly in relation to modifiable risk factors, such as reduction in BMI, occupational protection of the knees and possible adjustment of knee malalignment.
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Wills, Andrew K. "Gait kinematics and risk factors for overuse anterior knee pain." Thesis, University of Surrey, 2006. http://epubs.surrey.ac.uk/844510/.
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Overuse anterior knee pain (AKP) is precipitated by activity and affects up to 30% of young and active populations. There is little empirical evidence for the multitude of cited risk factors for the condition and a lack of prospective studies. The main aim of this PhD was to examine the role of gait kinematics as a risk factor for AKP. The first study examined variables other than gait that may need to be controlled or statistically adjusted for in future studies to avoid masking true risk factors or effects. A prospective study of military recruits was undertaken into the effect of prior activity levels, aerobic fitness and social and medical history on the development of AKP. The incidence of AKP was high (8.6%; 95% CI: 6.8-10.4) despite the short 12-week exposure to training. Heavy smokers (odds ratio (OR): 6.37) and individuals with a previous ankle injury (OR; 2.48) had an increased risk of AKP that was independent of lifestyle factors. The association between 3D gait kinematics and patellofemoral pain syndrome (PFPS) was then explored prospectively. Principle components analysis was applied to reduce the gait data into its main factors and multivariate logistic regression was used to explore the association between these factors and PFPS. Three factors from treadmill running explained 47% of the variance between individuals who developed PFPS and those that remained injury-free. These factors contained increased hip and tibial internal rotation, increased hip adduction and decreased knee internal rotation during stance. These results contradicted findings from case-control studies. The association between variability in gait movement patterns and PFPS was assessed using the continuous relative phase method. The main risk factor was reduced inter-stride variability in the joint coordination relationships that contained tibial rotation. The main limitation of the gait study was the small sample size of the PFPS group (n=7). A study was thus undertaken to cross-validate the findings in a new sample with PFPS. This new sample was captured using a 3-year follow up study of the original gait cohort. The results were not replicated in the new PFPS group, and there were no other gait characteristics correlated with PFPS. The lack of validation was attributed to differences in the symptom-complex between the case groups of the two studies. To date, all published evidence for an association between gait and AKP originates from case-control studies. The key issue with this design is inferring the correct temporal sequence of a finding. Thus, to assess the effect of PFPS on gait and inform the interpretation of these studies, a repeated measures study of 6 subjects before and after the onset of PFPS was undertaken. Despite the mild symptoms of the group and the absence of pain during testing, the subjects showed some subtle gait inhibition post onset of PFPS. This questions the use of the case-control study to validly quantify risk factors in gait. Future research should cross-validate the significant risk factors found' in these studies, explore other potentially salient variables such as patellofemoral alignment and examine the causes of these risk factors. It is hoped that such work will benefit the prevention and treatment of AKP.
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Boling, Michelle Clara Padua Darin A. "A prospective investigation of biomechanical risk factors for anterior knee pain." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,1740.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Sep. 16, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Interdisciplinary Human Movement Science School of Medicine." Discipline: Human Movement Science; Department/School: Medicine.
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Kerr, Gillian. "Cerebrovascular diseases, vascular risk factors and socioeconomic status." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1892/.
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Cerebrovascular disease, has an enormous, and increasing, impact on global health. As well as causing clinical stroke, cerebrovascular disease is thought to be a major contributor to cognitive decline and dementia. Socioeconomic status (SES) is associated with risk of stroke. Those in the lowest SES group are estimated to be at twice the risk of stroke compared to those in the highest SES group. Those with low SES may also have a more severe stroke and a poorer outcome. It is imperative that the extent and mechanism of this association is clarified. This thesis aims to determine if the association between SES and stroke is explained by a greater prevalence of traditional vascular risk factors amongst those of low SES. It also explains the link with a novel risk factor, poor oral health. Lastly it addresses the long-term cognitive outcome in older people at risk of vascular disease. A systematic review and meta-analysis was undertaken to establish if vascular risk factors explain the association between SES and stroke incidence / post-stroke mortality. This demonstrated that lower SES was associated with an increased risk of stroke and that a greater burden of vascular risk factors in those with low SES explained about 50% of the additional risk of stroke. However this meta-analysis could not clarify what vascular risk factors are most critical. Low SES was also associated with increased mortality risk in those who have a stroke although study results were heterogeneous and this link was not readily explained by known vascular risk factors. A prospective study of 467 consecutive stroke and transient ischameic attack (TIA) patients from three Scottish hospitals was undertaken with the aim of establishing whether those with low SES carry higher levels of vascular risk factors, have a more severe stroke and have equal access to stroke care services and investigations. Stroke / TIA patients with low SES were younger and more likely to be current smokers but there was no association with other vascular risk factors /co-morbidity. Those who had lower SES had a more severe stroke. The lowest SES group were less likely to have neuroimaging or an electrocardiogram although differences were not significant on multivariate analysis. There was however equal access to stroke unit care. A secondary analysis of a prospective cohort study of 412 stroke patients was conducted. The aim was to explore oral health after acute stroke and assess if poor oral health explains the association between SES and stroke. Dry mouth amongst acute stroke patients was very common, however there was no association between oral health and low SES. There was an association of dry mouth with pre-stroke disability and Urinary Tract Infection. There was also a link with oral Candida glabrata colonisation, although the clinical relevance of this is uncertain. In the acute phase after stroke there was no convincing association of dry mouth with dysphagia or pneumonia. Therefore there was no association between SES and poor oral health as measured in this study but oral health may still be part of the explanation of the association between SES and acute stroke and this needs further investigation. Vascular disease is an important contributor to cognitive decline and dementia. Low SES may be associated with an increased risk of cognitive decline in later life and vascular disease may be a mediating factor. More effective prevention of vascular disease may slow cognitive decline and prevent dementia in later life, particularly in low SES groups. Lipid lowering with statins might be effective in preventing dementia but so far evidence from randomised control trials does not show benefit from statins in preventing cognitive decline and dementia. However the duration of follow-up in these trials was short and there may be benefit in the long-term. My aim was therefore to establish if long-term follow-up of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) study was feasible. I found that it was feasible to follow-up 300 elderly survivors from the Scottish arm of the PROSPER study and the methods could be extended to the whole group. As expected nearly half of the PROSPER participants were dead. Additionally a large proportion of traceable participants had significant cognitive impairment. Smoking cessation, control of blood pressure and management of other vascular risk factors should be made a priority in areas of low SES. Additionally further research is needed to fully clarify the association between SES and stroke incidence. Avenues for exploration might include the possibilities of poorer access to effective stroke care, reduced uptake of care and poorer oral health in lower SES groups. In addition public health campaigns regarding smoking cessation should be directed at lower SES groups. I have shown that a large scale follow-up of the PROSPER participants is feasible and may determine new and novel risk factors for dementia and assess the long-term effect of a period of treatment with pravastatin.
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Hurtig, Wennlöf Anita. "Cardiovascular risk factors in children /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-179-2/.
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Bottomley, Nicholas J. "Anteromedial osteoarthritis : a surgical perspective of incidence, progression and risk factors." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:34c87265-bbae-4018-b120-ef1d6bed73aa.
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Anteromedial osteoarthritis of the knee (AMOA) has been defined anatomically, histologically and radiologically and yet little is known about the epidemiology of the disease or the risk factors involved in the development of the disease. The broad aim of this thesis was to combine clinical insight with the utilisation of modern, large epidemiological datasets to provide information to inform better the clinical management of patients with AMOA. Specifically, the prevalence and incidence of AMOA, the time taken to progress from early disease to severe disease that may require surgical intervention, the radiological characterisation of disease and the assessment of mechanical risk factors implicit in the development of this pattern of disease are investigated. A cross-sectional study of the radiological prevalence of AMOA in a symptomatic cohort in a specialist secondary care knee clinic showed that AMOA was the commonest pattern of knee OA, present in more than 60% of symptomatic subjects. Less than 25% of subjects with AMOA presented with advanced or 'bone-on-bone' disease, emphasising the clinical importance of understanding the progression from earlier stages of disease to this advanced stage. A 20-year longitudinal radiographic study was performed on 1000 women to describe the prevalence, incidence and progression of AMOA. The prevalence of AMOA was 43% and the incidence over 20-years was 0.4. Life table analysis showed that the risk of developing advanced AMOA in a previously normal knee was 2.6%. Of those subjects with early radiological AMOA, 11% progressed to advanced 'bone-on-bone' disease within 10 years and 37% within 20 years. The role of mechanical risk factors in the development of AMOA showed that both anatomical limb and proximal tibial alignment were significantly more varus aligned in those that developed AMOA at 20-years. Assessment of the shape of the medial tibial plateau in a longitudinal MRI study showed that the angle of the upslope at the anterior aspect of the plateau was significantly increased in the group that subsequently developed AMOA. To enable AMOA to be studies in future MRI studies, the MRI description of the disease was defined. In summary, AMOA was shown to be the most common pattern of knee OA both in symptomatic surgical cohorts and in the community. The progression of the disease from an early stage to an advanced stage, which may require surgical intervention, was described for the first time. To enable better the recognition of AMOA in modern epidemiological studies, the MRI description of AMOA was defined and the clinical relevance of modern MRI was discussed. The anatomical alignment of the limb, the alignment of the proximal tibia and the morphology of the tibial plateau were all shown to have a role in the development of AMOA. Addressing these mechanical factors may provide a therapeutic surgical target for the management of patients with AMOA.
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Ekegren, Christina Louise. "Agreement and validity of observational risk screening guidelines in evaluating ACL injury risk factors." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/1622.
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Study Design: Methodological study.
Objectives: To examine the agreement and validity of using observational risk screening guidelines to evaluate ACL injury risk factors.
Background: Post-pubescent females have an increased risk of anterior cruciate ligament (ACL) injury compared with their male counterparts partly due to their high-risk landing and cutting strategies. There are currently no scientifically-tested methods to screen for these high risk strategies in the clinic or on the field.
Methods and Measures: Three physiotherapists used observational risk screening guidelines to rate the neuromuscular characteristics of 40 adolescent female soccer players. Drop jumps were rated as high risk or low risk based on the degree of knee abduction. Side hops and side cuts were rated on the degree of lower limb 'reaching'. Ratings were evaluated for intrarater and interrater agreement using kappa coefficients. 3D motion analysis was used as a gold standard for determining the validity of ratings.
Results: Acceptable intrarater and interrater agreement (k≥0.61) were attained for the drop jump and the side hop, with kappa coefficients ranging from 0.64 to 0.94. Acceptable sensitivity (≥0.80) was attained for the side hop and the side cut, with values ranging from 0.88 to 1.00. Acceptable specificity (≥0.50) was attained for the drop jump, with values ranging from 0.64 to 0.72.
Conclusion: Observational risk screening is a practical and cost-effective method of screening for ACL injury risk. Based on levels of agreement and sensitivity, the side hop appears to be a suitable screening task. Agreement was acceptable for the drop jump but its validity needs further investigation.
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So, Hon-cheong, and 蘇漢昌. "Genetic architecture and risk prediction of complex diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B4452805X.
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Heath, Douglas. "Factors Affecting Occupant Risk of Knee-Thigh-Hip Injury in Frontal Vehicle Collisions." Digital WPI, 2010. https://digitalcommons.wpi.edu/etd-theses/422.
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Every year, millions of people are killed or injured in motor vehicle accidents in the United States. Although recent improvements to occupant restraint systems, such as seatbelts and airbags, have significantly decreased life threatening injuries, which usually occur to the chest or head, they have done little to decrease the occurrence of lower extremity injuries. Although lower extremity injuries are not usually life threatening, they can result in chronic disability and high psychosocial cost. Of all lower extremity injuries, injuries to the knee-thigh-hip (KTH) region have been shown to be among the most debilitating. This project used a finite element (FE) model of the KTH region to study injury. A parametric investigation was conducted where the FE KTH was simulated as a vehicle occupant positioned to a range of pre-crash driving postures. The results indicate that foot contact force and knee kinematics during impact affects the axial force absorbed by the KTH region and the likelihood of injury. The results of the study could be used to reevaluate the lower extremity injury thresholds currently used to regulate vehicle safety standards. Also, the results could be used to provide guidelines to vehicle manufacturers for developing safer occupant compartments.
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Lo, Ling-fun, and 盧玲芬. "Cardiac risk factors in Hong Kong adults." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B25797463.
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Abstract
Many studies have been conducted in Caucasian populations on the optimal body mass index cut-off for obesity, as well as the relationship between body mass index and percentage body fat and their associations with cardiovascular risk factors. However, few studies of this kind have been conducted in the Hong Kong Chinese population, This research is deemed to be important due to ethnic differences between Asians and Caucasians, Therefore, this dissertation aims to determine any ethnic differences from a sample of the local Hong Kong Chinese population, in order to advance health care policies controlling known cardiovascular risk factors.
A total of 800 subjects were randomly selected from a pool of subjects participated in a Hong Kong Cardiovascular Risk Factor Prevalence study conducted in 1994-1996. These subjects were contacted and 453 disease-free subjects (210 males and 243 females) consented to participate in the current study, Data collected included serum and blood pressure measurements, body mass index, percentage body fat measured by bioelectrical impedance analysis, and a self-completed cardiovascular risk factor questionnaire,
The mean age of the 453 subjects was 51.64 years (SD=12.3). When obesity was defined as percentage body fat ~ 25 and 2: 30 in males and females respectively, 23 kg/m2 was found to be the optimum cut-off value, with 78% correct classification (95% CI = 69%-87%). The corresponding sensitivity and specificity were 88% (95% CI = 81 %-95%) and 67% (95% CI = 57%-77%) respectively. On the other hand, if obesity was defined as percentage body fat ~ 25 and 2: 35 in males and females respectively, then 25 kg/m2 was found to be the best cut-off value with 82% correct classification
(95% CI = 74%-90%). The corresponding sensitivity and specificity were 78% (95% CI = 69%-87%) and 85% (95% Cl = 78%-92%) respectively.
Moreover, body mass index was found to be quadratically body fat. The quadratic relationship did not appear two genders, except that the percentage body fat of of females by 9.97 (SE=0.33).
Finally, except for total cholesterol, high density lipoprotein cholesterol, and fasting glucose, body mass index did not provide any substantial information additional to percentage body fat on serum and blood pressure measurements. was the only measure on which percentage body fat did additional to body mass index. When waist-hip body mass index and percentage body fat,. except for
body mass index did not have additional information on measurements when percentage body fat or/and
[n conclusion, the optimal body mass index cut-off for obesity in Hong Kong Chinese was lower than the 30kg/m2 recommended by the World Health Organization, a clear reflection of ethnic difference between Asians and Caucasians. The quadratic relationship between percentage body fat and body mass index was similar in Hong Kong Chinese as in Caucasians and Blacks. Moreover, percentage body fat together with waist-hip-ratio were found to be better indicators of cardiovascular risk factors in Hong Kong. This was the first time such findings were found in the Hong Kong Chinese population.
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Rantala, A. (Asko). "Risk factors and carotid atherosclerosis in hypertensive and control subjects." Doctoral thesis, University of Oulu, 2001. http://urn.fi/urn:isbn:9514264657.
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Abstract
Different metabolic and environmental factors affect the blood pressure level, constituting a cluster, especially in hypertensives, that leads to an increased risk of cardiovascular diseases. The present research was designed to determine the prevalence and the predictors of the metabolic syndrome and the role of insulin and blood pressure in carotid atherosclerosis in 600 treated male and female hypertensives aged 40-59 years and 600 age- and sex-matched controls.
The prevalence of the metabolic syndrome in different population-based cohorts varied, depending on the
definition, from 0.8% to 35.3%, being lowest in control men and women and highest in hypertensive men. 73.8%
of a random, middle-aged, urban population showed at least one cardiovascular risk factor, and 91.3% of all
hypertensive subjects showed at least one cardiovascular risk factor in addition to hypertension itself. The
independent predictors of the metabolic syndrome were waist circumference, uric acid, total cholesterol and
gamma-glutamyl transpeptidase. Hypertension had a significant effect on carotid intima-media thickness and the
prevalence of plaques in men, but its effect in women was not significant. A long duration of hypertension
resulted in greater intima-media thickness and a higher prevalence of plaques, particularly in men. There were
significant associations between gamma-glutamyl transpeptidase and the components of the metabolic syndrome
after adjustment for alcohol consumption and also in teetotallers. There were inconsistent associations
between the different insulin measures and the intima-media thickness as a measure of carotid atherosclerosis.
The exclusion of diabetic subjects did not change the results.
In conclusion, a cluster of metabolic abnormalities related to hypertension is frequent among both controls and treated hypertensive subjects. Hypertensive subjects have higher prevalences of carbohydrate and lipoprotein aberrations and structural and functional cardiovascular complications than age- and sex-matched controls.
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Murphy, Georgina Anne Veronica. "Chronic non-communicable diseases and risk factors in rural Uganda." Thesis, University of Cambridge, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.707995.
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Sjögren, Per. "Cardiovascular risk factors, diet and the metabolic syndrome /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-894-0/.
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Jamison, Steven T. "The Association between the Core and Anterior Cruciate Ligament Injury Risk Factors." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1343697914.
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Norvell, Daniel C. "Knee pain and symptomatic osteoarthritis after traumatic unilateral lower extremity amputation : prevalence and risk factors /." Thesis, Connect to this title online; UW restricted, 2003. http://hdl.handle.net/1773/10863.
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Apekey, Tanefa Antoinette. "Weight loss diets : effects on risk factors of diet related diseases." Thesis, University of Lincoln, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.496080.
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Rafnsson, Snorri Björn. "Cardiovascular diseases, risk factors and cognitive decline in the general population." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/30665.
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The principal aim of the present study was to examine the longitudinal change in cognitive test performance in relation to major clinical CVDs and vascular risk factors in a population-based sample of older people. The analysis is based on a cohort of 809 men and 783 women aged 55-74 years which in 1987/8 was randomly selected from the general population of Edinburgh. The findings from the present study further add to those of previous investigations demonstrating a relationship between CVDs, vascular risk factors, and cognitive decline in older people. Specifically, they reveal that, even in the absence of overt stroke, clinical CVDs are associated with a greater cognitive decline in the elderly, independently of potential confounding by a wide range of vascular risk factors. Also, the relationships between several vascular risk factors and cognitive decline proved to be independent of co-existing vascular pathology. Based on these findings, further study is needed to determine the combined effects of CVDs and multiple risk factors on cognitive outcomes in samples of older people. In addition, what the likely pathological mechanisms are underlying cognitive decline associated with atherosclerotic disease and vascular risk factors risk factors needs to be addressed in future studies. From a perspective of preventing or delaying vascular-based cognitive decline and impairment, more research is required to assess the effectiveness of both individual and population-based strategies targeting vascular disease and risk factors in older age groups. Finally, further investigation is needed to address the potential impact of subtle cognitive deficits on indictors of the quality of life and the capability of self-maintenance of elderly vascular patients, on adherence to medical treatment and rehabilitation, and further cognitive decrements and survival.
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Alamian, Arsham. "Multiple Behavioral Risk Factors for Chronic Diseases and Public Health Implications." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/1382.
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Cozens, Russel David. "Insect and disease risk factors in established interior spruce plantations." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24426.
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Forest insects and diseases active in immature interior spruce stands in the central interior of British Columbia and their possible implications in forest management practices have been surveyed. Collection records, spanning the period 1949 to 1982, from the Forest Insect and Disease Survey of the Canadian Forestry Service were reviewed for the Prince George Timber Supply Area and the pest incidence in immature interior spruce stands summarized.
Twenty-two plantations, established between 1963 and 1973, were surveyed to determine the relative incidence of the major insect and pathogen pests of immature spruce in Supply Block 'G' of the Prince George Timber Supply Area. A bud midge, likely Rhabdophaga swainei Felt (Diptera: Cecidomyiidae), and a terminal weevil, Pissodes strobi Peck (Coleoptera: Curculionidae), were found to consistently infest and damage a significant number of immature interior spruce trees.
A spruce stand stocking profile was developed as a basis for discussion of management practices in plantations and immature stands. The stocking profile can be used in the determination of not only pest management policy decisions but in stand management decisions affecting stand density and, ultimately, merchantable yield at harvest.
The findings confirmed that forest management must be actively practiced throughout the life of a forest stand. To be successful, however, stand management guidelines and merchantable yield projections are required. These guidelines and projections must include the influences of insects and diseases upon the forest crop in their development model. This information is particularly important in the development of complete Timber Supply Area plans and for the flagging of pest hazard periods during the development of spruce forests.Forestry, Faculty of
Graduate
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Tsuro, Urgent. "Modelling the impact of risk factors affecting TB treatment." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1019782.
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The Tuberculosis infection rate has been generally escalating due to poor health conditions in the Gweru district of Zimbabwe. The study therefore seeks to identify the risk factors that affect TB treatment in the Gweru district. A cross sectional study was carried out in which a questionnaire was employed for data collection on 113 respondents. A binary logistic regression model was employed for data analysis. A total of 98 TB patients were interviewed: [50 respondents (44.0%) had Multi-drug resistant Tuberculosis and 63 respondents (56.0%) had general Tuberculosis). Before being enrolled into the study, an informed consent form was given to each of the participants. The data was then put into excel and later transferred to SPSS for analysis. Out of the 14 potential risk factors of TB treatment, only 6 variables (side effects, gender, alcohol use, HIV status, smoking during the treatment period and having been pre-exposed to TB drugs) were statistically significant in their association with treatment failure.
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Villar, M. Tracey A. "Risk factors for impaired lung function in the elderly." Thesis, University of Southampton, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339372.
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Bolinder, Gunilla. "Long-term use of smokeless tobacco : cardiovascular mortality and risk factors /." Stockholm, 1997. http://www.kibic.ki.se/ki/diss/971024boli.html.
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Scott, Andrew. "The influence of walking on risk factors associated with metabolic syndrome." Thesis, Canterbury Christ Church University, 2008. http://create.canterbury.ac.uk/12120/.
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Metabolic syndrome (MetS) represents a cluster of metabolic abnormalities, characterised by the presence of 3 or more of 1) abdominal obesity, 2) insulin resistance, 3) hypertension, 4) dyslipidaemia, and 5) emerging risk factors, such as pro-thrombotic and pro-inflammatory states, which are each independent cardiovascular disease (CVD) risk factors. This clustering of risk factors is reported to increase the odds ratio for cardiovascular and all-cause mortality above the risk associated with the individual components (Wilson, 2004). The precise aetiology of MetS is currently unknown, however an energy-dense diet, particularly high in carbohydrate, and an inactive lifestyle or low fitness may interact with a genetic susceptibility to contribute to the pathophysiology of MetS (Bouchard, 2007). Therefore the purpose of the studies included in this thesis were to determine whether accumulative brisk walking may improve risk factors associated with MetS and whether one single session of brisk walking at a moderate intensity may improve risk factors associated with MetS in middle-aged men at risk of MetS. Study one recruited 85 males aged 38-73 onto a 24-week randomised controlled trial with participants allocated to control (CON), single 30 minute daily brisk walking (SBW) or accumulative 30 minutes of daily brisk walking (ABW; 3×10 min or 2×15 min) groups. Measures included aerobic fitness (OO2max), body composition and selected blood variables. The main findings were that 24 weeks of accumulating 150 min·wk-1 of brisk walking at ~65% HRmax significantly improved insulin sensitivity, which was associated with decreased abdominal adiposity, assessed by waist circumference, and was at least as effective as a single daily session of equal volume in middle-aged men at risk of MetS. Study two investigated the 24-hour effect of walking for 30 minutes at 50% OO2max (30×50%), 30 minutes at 65% OO2max (30×65%) and 60 minutes at 50% OO2max (60×50%) compared to rest (CON) on cardiovascular control, resting metabolism and selected blood variables. The main findings were that a single 30 minute walking session at 50% OO2max favourably improved cardiovascular control, indicated by decreased heart rate and systolic blood pressure, thus decreasing the workload of the heart, whereas increasing the intensity of the walk to 65% OO2max attenuated this effect, while increasing the duration to 60 minutes had no additional effect compared to 30 minutes at 50% OO2max in men at risk of MetS.
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Hergens, Maria-Pia. "Swedish moist snuff and the risk of cardiovascular diseases /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-372-6/.
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Larsson, Helena. "Premature discharge from military service : risk factors and preventive interventions /." Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-435-0/thesis.pdf.
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Barrett, Sheila C. "Risk factors of type 2 diabetes and cardiovascular diseases among Jamaican adolescents." FIU Digital Commons, 2009. http://digitalcommons.fiu.edu/etd/1413.
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Purpose: The purpose of the study was to examine Jamaican adolescents in a school setting, for risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs).
Methods: A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents (112 males and 164 females) ages 14-19 years (15.6±1.2), randomly selected from grades 9-12 from ten high schools on the island. Thirteen risk factors were examined. Risk factors were compared with BMI levels and demographics. A sub-study validated finger prick testing of fasting blood glucose, total cholesterol, and HbAlc versus venous testing in 59 subjects.
Results: Prevalence of overweight was 33.0% (n=91) with mean BMI of 23.74±7.74. Approximately 66.7% of subjects reported > 3 risk factors. The number of T2DM and CVDs risk factors increased for subjects with BMI above 25. One third of the overweight subjects were classified with the metabolic syndrome. High BMI was associated with high waist circumference (r =.767, p
(r = .180, p.05). Percentage bias for the methods of blood testing met the reference standards for fasting blood glucose but not for total cholesterol and HbAlc. Bland Altman tests of agreement between the two methods indicated good agreement for all three tests.
Conclusion: Jamaican adolescents are at high risk for T2DM and CVDs as seen in other study populations. Effective programs to prevent T2DM and CVDs are needed. Family history of diseases, anthropometric measures, and gender identified more subjects at risk than did the biochemical measures. Comparison between finger prick and venous blood methods suggested that finger prick is an adequate method to screen for risk factors in children and adolescents.
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Iliadou, Anastasia. "Genetic epidemiological approaches to the study of risk factors for cardiovascular diseases /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-548-4.
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Han, Guangming. "Prevalence of Chronic Diseases and Risk Factors for Death among Elderly Americans." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/math_theses/108.
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The main aim of this study is to explore the effects of risk factors contributing to death in the elderly American population. To achieve this purpose, we constructed Cox proportional hazard regression models and logistic regression models with the complex survey dataset from the national Second Longitudinal Study of Aging (LSOA II) to calculate the hazard ratios (HR)/odds ratios (OR) and confidence interval (CI) of risk factors. Our results show that in addition to chronic disease conditions, many risk factors, such as demographic factors (gender and age), social factors (interaction with friends or relatives), personal health behaviors (smoking and exercise), and biomedical factors (Body mass index and emotional factors) have significant effects on death in the elderly American population. This will provide important information for elderly people to prolong lifespan regardless of whether they have chronic disease/diseases or not.
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Lau, Ming-ho, and 劉明昊. "Risk factors of hand foot mouth diseases outbreaks in kindergartens inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994901.
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Language, Sarah. "Prevalence and risk factors of chronic diseases of lifestyles in endurance runners." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29796.
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Background: Chronic diseases of lifestyle (CDL) are associated with high rates of morbidity and mortality in South Africa. Although prevalence of CDL has been established in the general population, there is limited research regarding the prevalence and risk factors for CDL in individuals taking part in regular physical activity. Endurance running is a popular sport, with growing levels of participation. Anecdotally, many individuals who participate in endurance running do not undergo formal pre-participation cardiovascular screening. It is also unclear if endurance runners are meeting the World Health Organisation’s recommended weekly moderate to vigorous intensity physical activity hours, or if they have other risk factors for CDL. It is therefore important to establish the prevalence and risk factors of CDL in this active population. Aim and Objectives: The aim of this study was to determine the prevalence of CDL and the associated risk factors in endurance runners in South Africa. The specific objectives of the study were: (a) to determine the presence of risk factors for the development of chronic diseases of lifestyle, including body mass index (BMI), waist circumference, body fat percentage, blood pressure, blood glucose, blood cholesterol, smoking history, dietary intake and weekly physical activity time in South African endurance runners; (b) to determine the presence of non-modifiable risk factors to the development of CDL, namely age and income, in South African endurance runners; (c) to determine whether South African endurance runners are fulfilling the World Health Organization’s recommended weekly moderate to vigorous intensity physical activity hours; and (d) to assess whether there are any relationships between the running characteristics, namely weekly training hours, running speed and level of competition; and the risk factors for chronic diseases of lifestyle. Methods: This study had an analytical, cross-sectional design. Two hundred participants between the ages of 18 to 69 years old, who reported endurance running as their main sport, and ran at least three kilometres twice a week for the past year were included in the study. Participants were excluded if they were pregnant or within six months post-partum, had an injury that required a minimum of two weeks rest or did not complete the questionnaire or physical testing component of the testing process. Participants were recruited through local running clubs and running races in the areas of Nelspruit, Mpumalanga and Cape Town, Western Cape. All participants gave written informed consent, and completed a questionnaire including socio-demographic characteristics, running training characteristics, the International Physical Activity Questionnaire short questionnaire, the modified Borg scale of perceived exertion, and the five-a-day community evaluation tool. Body mass, stature, skin folds and waist circumference were assessed. Blood pressure was measured using an automatic blood pressure monitor. A finger prick test was used to determine random blood glucose and cholesterol concentrations. Participants were requested to fast for three hours prior to testing to standardise the test in a non-fasted state (20). Results: One hundred and twenty four (62%) participants were found to have at least one risk factor for CDL. A high BMI was the most common risk factor for CDL (n=90; 45%). Nineteen participants (9.5%) did not meet the recommended duration of 150 minutes of physical activity per week. Seven percent of female participants (n=7) smoked, which is equivalent to the female population average of South Africa. Multiple risk factors were identified in fifty seven (28.5%) participants, ranging from two risk factors (n=37; 18.5%) to six risk factors (n=1; 0.5%). The majority of participants had no prior medical diagnosis of CDL or risk factors for CDL. The overall self-reported prevalence of a medically diagnosed CDL was 5.5% (n=11). Type 2 diabetes was the most commonly diagnosed CDL (n=6; 3%). Waist circumference, systolic blood pressure and cholesterol were significantly elevated in the older age group. There were no significant differences in risk factors for CDL according to income status. Female runners had significantly higher average sitting times compared to male runners. In addition, participants with a BMI ≥ 25 kg.m-2 had significantly slower 10 km running speeds and lower average weekly training distance, compared to participants with BMI within normal ranges. Conclusion: A high prevalence of risk factors for CDL was identified in South African endurance runners. The majority of endurance runners included in this sample are fulfilling the World Health Organisation’s recommended weekly moderate to vigorous intensity hours. However, the endurance runners in this study remain at risk for developing a CDL due to the presence of other risk factors for CDL. The knowledge and awareness of risk factors for CDL among South African endurance runners needs to be further investigated. Health care professionals are required to improve the prevention and management of risk factors of CDL through education and promotion of healthy lifestyles. A stronger emphasis on the prevention of risk factors for CDL in South African endurance runners is needed.
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Teel, William Baldwin. "A population-based case-control study risk factors for connective tissue diseases /." Thesis, Connect to this title online; UW restricted, 1997. http://hdl.handle.net/1773/10893.
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Aderem, Jodi. "The biomechanical risk factors associated with preventing and managing iliotibial band syndrome in runners : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96803.
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Thesis (MScPhysio)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Introduction: Iliotibial band syndrome (ITBS), an overuse injury, is the second most common running injury and the main cause of lateral knee pain in runners. Due to the increasing number of runners worldwide there has been an increase in its occurrence. Runners with ITBS typically experience symptoms just after heel strike at approximately 20°-30° of knee flexion (impingement zone) during the stance phase of running. A variety of intrinsic and extrinsic risk factors may be responsible for why some runners are more prone to developing symptoms during the impingement zone as opposed to others. Abnormalities in running biomechanics is an intrinsic risk factor which has been most extensively described in literature but little is known about its exact relationship to ITBS. Objectives: The purpose of this systematic review was to provide an up to date evidence synthesis of the biomechanical risk factors associated with ITBS. These risk factors may need to be considered in the prevention or management of ITBS in runners. A clinical algorithm is also presented. Methods: A systematic review with meta-analysis was conducted. An electronic search was performed in PubMed, PEDro, SPORTSDisc and Scopus of literature published up-until May 2014. Cross-sectional and cohort studies were eligible for inclusion if they evaluated the lower limb biomechanics of runners with ITBS or those who went onto developing it. All studies included in the review were methodologically appraised. Evidence was graded according to the level of evidence, consistency of evidence and the clinical impact. Data was described narratively using tables or narrative summaries where appropriate. A meta-analysis was conducted for biomechanical risk factors which were reported in at least two studies, provided that homogeneity in the outcomes and samples were present. Results: A total of 11 studies were included (1 prospective and 10 cross-sectional). Overall the methodological score of the studies was moderate. Increased peak hip adduction and knee internal rotation during the stance phase may predict the development of ITBS in female runners. These biomechanical risk factors may need to be screened for ITBS prevention, despite the evidence base being limited to a single study. Currently there is no conclusive evidence that any of the biomechanical parameters need to be considered when managing runners with ITBS. Stellenbosch University https://scholar.sun.ac.za iii Conclusion: Biomechanical differences may exist between runners with ITBS and those who may develop ITBS compared to healthy runners. Although a large variety of biomechanical risk factors were evaluated, the evidence base for screening or managing these risk factors for runners with ITBS is limited. This is due to a small evidence base, small clinical effect and heterogeneity between study outcomes and findings. Further prospective and cross-sectional research is required to ascertain if abnormalities in running biomechanics may be related to why runners develop ITBS or to ascertain which risk factors may be involved when managing these runners.
AFRIKAANSE OPSOMMING: Inleiding: Iliotibiale-band-sindroom (ITBS), ’n besering vanweë oormatige gebruik, is die tweede algemeenste hardloopbesering en die hoofoorsaak van laterale kniepyn by hardlopers. Namate die getal hardlopers wêreldwyd toeneem, neem die voorkoms van hierdie toestand ook toe. Hardlopers met ITBS ervaar tipies simptome ná die hakslag met die knie ongeveer 20-30° gebuig (die wrywingsone of “impingement zone”) gedurende die staanfase van hardloop. Verskeie intrinsieke en ekstrinsieke risikofaktore kan ’n rol speel in waarom sommige hardlopers meer geneig is as ander om gedurende die wrywingsone simptome te ervaar. Abnormaliteite in hardloopbiomeganika is ’n intrinsieke risikofaktor wat reeds omvattend in die literatuur beskryf is. Tog is weinig bekend oor presies hoe dit met ITBS verband hou. Oogmerke: Die doel van hierdie stelselmatige ondersoek was om ’n sintese te bied van die jongste bewyse van die biomeganiese risikofaktore van ITBS. Hierdie risikofaktore kan dalk oorweeg word om ITBS by hardlopers te voorkom of te bestuur. ’n Kliniese algoritme word ook aangebied. Metodes: ’n Stelselmatige ondersoek is met behulp van meta-ontleding onderneem. PubMed, PEDro, SPORTSDisc en Scopus is elektronies deurgesoek vir literatuur wat tot en met Mei 2014 verskyn het. Deursnee en kohortstudies is ingesluit indien dit gehandel het oor die biomeganika in die onderste ledemate van hardlopers wat ITBS het of later ontwikkel het. Alle studies wat deel was van die ondersoek is metodologies geëvalueer. Bewyse is aan die hand van bewysvlak, bewyskonsekwentheid en kliniese impak beoordeel. Data is narratief beskryf met behulp van tabelle of narratiewe opsommings waar dit toepaslik was. ’n Meta-ontleding is onderneem waar biomeganiese risikofaktore in minstens twee studies aangemeld is, mits daar homogeniteit in die uitkomste sowel as die steekproewe was. Resultate: Altesaam 11 studies is ingesluit (een prospektief en tien deursnee). Die metodologiese telling van die studies was oorwegend gemiddeld. Verhoogde spitsheupadduksie en interne knierotasie gedurende die staanfase kan op die ontwikkeling van ITBS by vrouehardlopers dui. Hierdie biomeganiese risikofaktore kan dalk nagegaan word vir ITBS-voorkoming, al was die bewysbasis beperk tot ’n enkele studie. Daar is tans geen afdoende bewys dat enige van die biomeganiese parameters oorweeg behoort te word in die bestuur van langafstandatlete met ITBS nie. Gevolgtrekking: Daar bestaan dalk biomeganiese verskille tussen hardlopers wat ITBS het of kan ontwikkel en gesonde hardlopers. Hoewel ’n groot verskeidenheid biomeganiese risikofaktore beoordeel is, is die bewysbasis vir die toets of bestuur daarvan by atlete met ITBS beperk. Dít is vanweë die klein hoeveelheid bewyse, die klein kliniese impak, en heterogeniteit tussen studie-uitkomste en bevindinge. Verdere prospektiewe en deursneenavorsing word vereis om te bepaal of abnormaliteite in hardloopbiomeganika ’n rol kan speel in waarom langafstandhardlopers ITBS ontwikkel, of om vas te stel watter risikofaktore ter sprake kan wees in die bestuur van hierdie hardlopers.
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Heydon, Emma Elizabeth. "Telomere length and cardiovascular disease risk factors in South Asians." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708496.
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De, Wet Cornelia Susanna. "Feline hyperthyroidism in Hong Kong : prevalence and risk factors." Diss., University of Pretoria, 2008. http://hdl.handle.net/2263/30591.
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Feline hyperthyroidism is an important disorder in middle-aged and older cats. The cause and pathogenesis of the disease is still unknown and there are few published incidence rates or prevalence estimates. A descriptive cross-sectional study was conducted to determine the prevalence of and potential risk factors for feline hyperthyroidism in Hong Kong. Serum thyroxine (T4) was measured in 305 cats 10 years and older that presented at various veterinary clinics in Hong Kong between June 2006 and August 2007. The veterinarians taking the samples completed a questionnaire regarding the health of each cat. Each owner completed a questionnaire regarding vaccination history, internal and external parasite control, diet and the environment of their cat. Serum total T4 concentration was determined by use of a commercially available radioimmunoassay kit (Coat-a-count®, DPC®). For total T4 the feline reference interval was 12.8-50.0 nmol/L (1.0-3.9 ug/dL). All cats with a serum total T4 concentration of greater than 50.0 nmol/L were classified as hyperthyroid. Alanine aminotransferase (ALT) and alkaline phosphatase (ALP) activities were measured in all the samples. The prevalence of feline hyperthyroidism in Hong Kong was estimated at 3.93% (95% CI : 2.05-6.77) and there was no significant difference in prevalence between healthy (3.16%) and sick (4.37%) cats. This demonstrates that although this disease is present in Hong Kong, the prevalence is lower than the reported prevalence in other parts of the world. Risk factors that were examined included age, sex, breed, number of cats in household, vaccinations, parasite control, indoor environment, type of diet and type of water. Risk factors for hyperthyroidism identified by multivariate analysis were age and breed. Affected cats were more likely to be older (>15 years) and domestic shorthair cats were less likely to be diagnosed with hyperthyroidism than the other breeds combined. There was no statistically significant relationship between sex, vaccinations, parasite control or indoor environment and the development of hyperthyroidism. There was also no statistically significant relationship between the consumption of a canned food diet by the cats and hyperthyroidism. There were no characteristic clinical features amongst the cats that were hyperthyroid and only one cat exhibited the typical clinical syndrome of ravenous appetite with severe weight loss. The lack of distinctive clinical signs could be due to the presence of a mild or early form of the disease, but can also be due to an atypical form of the disease. This study showed that the disease needs to be considered if any of the following factors are present in an older cat : polyphagia, diarrhoea, and a significant raise in ALT and ALP activities. This study concluded that the prevalence of hyperthyroidism in cats in Hong Kong is less than in most other parts of the world, despite the presence of previously identified risk factors. Comparative epidemiological studies will be necessary to compare the presence of possible risk factors between feline populations in Hong Kong and elsewhere.Dissertation (MSc)--University of Pretoria, 2008.
Companion Animal Clinical Studies
unrestricted
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Geyser, Maria Magdalena. "Risk factors precipitating exacerbations in adult asthma patients presenting at Kalafong Hospital, Pretoria." Diss., Access to E-Thesis, 2006. http://upetd.up.ac.za/thesis/available/etd-08192008-110157/.
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Valencia, Celina I., and Celina I. Valencia. "Modeling social factors of HIV risk in Mexico." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625554.
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Background: Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is an urgent public health issue in Mexico. Mexico has witnessed a 122% increase in reported prevalence of HIV since 2001 (Holtz et al., 2014). Country estimates suggest there are between 140,000-230,000 individuals living with HIV in Mexico (CENSIDA, 2014). While approximately 50% of individuals living with HIV in Mexico are unaware that they are living with the virus (CENSIDA, 2014). Despite a federal universal HIV program implemented in 2011, HIV in Mexico has not reached a chronic infectious disease status as seen in other regions of the globe (Deeks, 2013). The mortality rate among individuals with HIV/AIDS in Mexico is 4.2 per 100,000 (CENSIDA, 2014). There is a paucity of findings regarding social and epidemiological data focused on populations outside traditional at risk populations of HIV in Mexico (Martin-Onraët et al., 2016). Analyzing aggregate country level data for Mexico provides necessary insights to better understanding previously unconsidered social factors that are informing sexual and reproductive health trends influencing HIV health patterns.
Methods: Secondary analyses were performed on Mexico's Encuesta Nacional de Salud y Nutrición 2012 (ENSANUT). Mexico’s ENSANUT is a probabilistic aggregate national dataset with a multistage stratified cluster sampling design (Janssen et al., 2013). ENSANUT is Mexico’s equivalent to the National Health and Nutrition Examination Survey (NHANES) in the United States. Data is collected via self-report interviews conducted at the participant's home. A structured questionnaire was administered to individuals 20 years of age and older (≥ 20) where sexual and reproductive data was collected from participants. The ENSANUT adult study sub-sample (n=46,227) is comprised of 42.75% men and 57.25% women. A general linear model (GLM), principal component analysis (PCA), chi-squares (χ²), and logistic regressions were applied to the study adult subsample to disentangle social factors associated with sexually transmitted infections (STIs) in the population. Quantitative analyses were conducted on SAS 9.4.
Findings: Men were more likely to have a STI diagnosis (OR=3.60; 95% CI 3.00, 4.32, p=<0.001). Previous HIV testing was found to be protective for STI diagnosis across both genders (OR=0.82, 95% CI 0.72, 0.94, p=<0.001). Co-infections of HIV/gonorrhea and HIV/syphilis (n=20) were the highest in the study population. The latent variable model indicates mental health and access to health care resources are critical for positive sexual and reproductive health outcomes in Mexico. Mental health was found to be non-protective for STI risk among the study population (OR=1.59, 95% CI 1.41, 1.81, p=<0.0001).
Policy recommendations: 1. Increased access and utilization of HIV resources and mental health services would benefit the study population. Further qualitative research is needed to better understand the barriers to health care access and utilization in these two domains; 2. Increase in preventative programs and health initiatives that encourage established strategies for positive sexual and reproductive health outcomes. These strategies include: universal human papillomavirus (HPV) vaccines, wide availability of Pre-Exposure Prophylaxis (PrEP), and routine HIV/STI screenings; 3. Alternative data collection strategies for ENSANUT which are culturally appropriate for sexual and reproductive health constructs.
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Lau, Ming-ho. "Risk factors of hand foot mouth diseases outbreaks in kindergartens in Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994901.
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Chong, Boon Hor, and 鍾文一. "Risk of ischemic stroke and recurrent hemorrhagic stroke in Chinese population." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47323450.
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Stroke is a devastating, neurological dysfunction due to brain blood supply disturbance. It is responsible for increasingly high rate of mortality and disability worldwide. This thesis comprises two original studies involving 868 patients at risk of ischemic stroke and/or hemorrhagic stroke.
The first study investigated aspirin’s effect among patients with intracranial hemorrhage. Unlike Caucasians which hemorrhagic strokes account for 10-15% of all strokes; in Chinese, intracranial hemorrhages strike up to 35%. After such, anti-platelet agent like aspirin is often avoided for fear of recurrent intracranial hemorrhages, despite compelling indications. However, clinical data is limited. In this single-centered observational study, we included 440 consecutive Chinese patients with a first spontaneous intracranial hemorrhage surviving the first month performed during 1996-2010. 56 patients (12.7%) of these 440 patients were prescribed aspirin after intracranial hemorrhage (312 patient-aspirin years). After a mean follow-up of 62.2 ± 1.8 months, 47 patients had recurrent intracranial hemorrhage(10.7%, 20.6 per 1,000 patient years). Patients prescribed aspirin did not have higher risk of recurrent intracranial hemorrhage compared with those without (22.7 per 1,000 patient-aspirin years vs. 22.4 per 1,000 patient years, p=0.70). Multivariate analysis identified age > 60 years and hypertension as independent predictors for recurrent intracranial hemorrhage. In a subgroup analysis: the incidence of combined vascular events including recurrent intracranial hemorrhage, ischemic stroke, and acute coronary syndrome was statistically lower in patients prescribed aspirin than without (52.4 per 1,000 patient-aspirin years, vs. 112.8 per 1,000 patient-years, p=0.04). Implications of the results: despite having a substantial risk for recurrent intracranial hemorrhage, post-intracranial hemorrhage ones are at risk for thrombotic vascular events and management goal should thus focus on ameliorating overall cardiovascular risk instead of preventing recurrent intracranial hemorrhage. Hence, thrombo-prophylaxis should still be considered.
The second study investigated the relation between premature atrial complexes and new-onset atrial fibrillation together with other cardiovascular events. Premature atrial complexes though taken as benign phenomenon, are common in patients with underlying conditions such as coronary heart disease, chronic rheumatic heart disease. While prompt management of atrial fibrillation may prevent ischemic stroke, atrial fibrillation is often unfound until ischemic stroke occurs. In this study, 428 patients without atrial fibrillation but complained of palpitations, dizziness or syncope were recruited. 107 patients with >100 premature atrial complexes/day were defined to have frequent premature atrial complexes. After a mean follow-up of 6.1 ±1.3 years, 31 patients (29%) with frequent premature atrial complexes developed atrial fibrillation compared with 29 patients (9%) with premature atrial complexes?100/day (p<0.01). Cox regression analysis revealed: frequent premature atrial complexes, age>75 years and coronary artery disease were independent predictors. In secondary endpoint (ischemic stroke, congestive heart failure, and death), patients with frequent premature atrial complexes were more at risk than those without (34.5% vs. 19.3%) (Hazard ratio: 1.95, 95% confidence interval: 1.37-3.50, p=0.001). Cox regression analysis showed: age> 75 years, coronary artery disease and frequent premature atrial complexes were independent predictors. These permit early identification of high risks patients of new atrial fibrillation and other events, thus promoting appropriate preventive treatment.published_or_final_version
Medicine
Master
Master of Philosophy
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Vlasyk, L. Yu. "The behavioral risk factors of major non-communicable diseases among economically active population." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18309.
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Angkurawaranon, C. "Urbanization and internal migration as risk factors for non-communicable diseases in Thailand." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2267958/.
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Urbanization, which is driven mainly by the expansion of cities and urban migration, is considered one of the key drivers of non-communicable diseases (NCDs) in developing countries. This research aims to investigate the patterns and associations between different levels of urban exposures and NCD risk factors, NCD morbidity and NCD mortality in Thailand, to better understand the mechanisms underlying the link between urbanization and NCD in Thailand. Using several study designs and analytical techniques, the research described in this thesis found that the process of migration and living in an urban environment were associated with lower social trust and higher levels of emotional problems. Urban environments were also associated with behavioural and physiological risk factors for NCDs, including smoking, heavy alcohol consumption, inadequate physical activity, inadequate fruit/vegetable consumption, high BMI, and high blood pressure. Both early life urban exposure and accumulation of urban exposure throughout life potentially play a role in these increases in behavioural and physiological risk factors for NCDs. Early life urban exposure was also found to be associated with an increased risk of developing obesity in adulthood. Increased psychosocial, behavioural and physiological risk factors associated with living in an urban environment may not translate directly into increased prevalence of biological risk factors for NCDs (such as high cholesterol), the development of NCDs, or into NCD-related mortality. It is likely that biological risk factors for NCDs, as well as NCD incidence and mortality are more amendable to change from the positive influences of urbanization through higher socioeconomic status and potential access to better health care.
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Lu, Yuan. "Impact of Multiple Risk Factors and Preventive Interventions on Cardiovascular Diseases and Disparities." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:14117763.
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Major cardiovascular risk factors have changed over the past 3-4 decades throughout the world. While adiposity and diabetes are rising worldwide, blood pressure and cholesterol are declining in high-income and even some middle-income countries, possibly due to improvements in diet or better diagnosis and treatment; the same risk factors have remained unchanged or even increased in low-income countries. To formulate effective prevention and health system policies, there is need to understand the implications of these diverse trends for cardiovascular diseases (CVDs).
This dissertation focuses on quantifying the impact of multiple risk factors and preventive interventions on CVDs and their disparities at the population level. Answering this question requires information on how much of the effects of adiposity on CVDs are mediated through other metabolic risk factors (i.e. high blood pressure, high serum cholesterol and high blood glucose), which themselves have other determinants. The first paper quantifies the direct as well as the mediated effects of excess weight on coronary heart disease (CHD) and stroke through blood pressure, serum cholesterol and blood glucose. The analyses use data of 97 prospective cohorts with more than 1.8 million participants. This allows for assessing whether the extent of mediation is modified by geographical region, study period, and other characteristics of study populations. The second paper revisits the above question using causal inference models and further quantifies the role of inflammatory markers as potential mediators. The analyses use individual-level data from 9 prospective cohort studies that have high-quality measurements of metabolic and inflammatory biomarkers. The third paper uses national data sources in the United States (US) and estimates the distributions of 10-year risk of fatal CHD by race. It also assesses the effects of different population-wide and targeted interventions on CHD risk distributions and their disparities between blacks and whites.
Our findings suggest that nearly half of excess risk for CHD and three-quarters of excess risk for stroke due to excess weight were mediated through three metabolic risk factors: blood pressure, cholesterol, and glucose. Inflammatory biomarkers had much smaller roles than the combination of metabolic risk factors. In the US, the distribution of 10-year CHD risk was shifted to the right among blacks compared to whites and had a heavier tail, leading to a substantially larger proportion of blacks in the high-risk group. A risk-based intervention that identifies and treats these individuals could substantially reduce both the overall risk of CHD and its racial disparities. These results together provide the quantitative evidence on the impact of cardiovascular risk factors and selected interventions on CVDs and their disparities.
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Ljungberg, Liza. "Angiotensin-Converting Enzyme : Effects of Smoking and Other Risk Factors for Cardiovascular Diseases." Licentiate thesis, Linköping : Department of Medical and Health Sciences, Linköping University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-16704.
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Charbonneau, Guylaine. "Anthropometric correlates and underlying risk factors for type 2 diabetes mellitus among Inuit." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97924.
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Type 2 diabetes mellitus (DM) is an emerging problem among Inuit of Circumpolar Countries. However, Canadian Inuit health surveillance data are limited. Data from the Nunavik Health Survey were used to evaluate the prevalence of overweight and obesity using the observed body mass index (BMIob) and the standardized BMI adjusted for sitting height (BMIstd). Also, data from Pangnirtung, Nunavut in the Baffin Region pilot health screening were used to evaluate anthropometric correlates of indices of insulin resistance. Obesity among the Nunavik study population (29.8%) is more prevalent than among general Canadians (23.1%), but the prevalence rates are more comparable when using BMIstd (21.5%). In Pangnirtung, anthropometric measures BMIob, BMIstd, waist circumference and percent body fat were associated with indices of insulin resistance/sensitivity (p ≤ 0.05). BMIstd showed similar results to BMIob and does not better predict the indices of insulin resistance/sensitivity.
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Appannah, Geeta. "Dietary patterns, obesity and cardiovascular risk factors in young people." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648138.
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Phoku, Nkosinathi Terrence. "Cardiovascular risk factors among 15-20 years old rural subjects residing in Dikgale Demographic Surveillance Site (DDSS), Limpopo Province." Thesis, University of Limpopo (Turfloop Campus), 2013. http://hdl.handle.net/10386/1048.
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Thesis (M.Sc. (Chemical Pathology) --University of Limpopo, 2013Cardiovascular diseases (CVDs) are among one of the well documented conditions and pose a significant health burden in the world as they areconsidered to be of adult onset. However, recent studies have shown that in developed countries CVD risk factors are becoming prevalent in young people which isof great concern. Therefore, the aim of this study was to determine if CVD risk factors are present in young subjects aged 15-20 years of age residing in a rural area of a developing country. Methods: Subjects aged between 15-20 years who participated in the “Gene - Environment interaction project” were included in this sub-study. Total cholesterol, triglycerides, HDL-cholesterol, LDLcholesterol, insulin, glucose, creatinine, Lp(a), apoB, apoA-1 and hs-CRPwere determined. Blood pressure, physical activity (number of steps/day), weight, height, waist circumference and hip circumference were obtained from the database. Subjects with CRP levels above 10mg/L and creatinine levels above 130 mmol/L were excluded. Results: The present study showed an overall high prevalence of some CVD risk factors. There was high prevalence of insulin resistance (23.0% in females and 34.7% in males), and high hs-CRP (18.4% in females, 12.9% in males). The prevalence of low HDL-C levels was high (55.2% in females and 16.8 % in males), however, the prevalence of abnormal levels of other lipids such as total cholesterol/HDL-cholesterol ratio was low in both males and females. The prevalence of an increased apoB/apoA ratio was significantly higher in females 26.4% compared to males 7.9%. The prevalence of overweight (12.6%) and obesity (9.2%) was higher in females than in males (overweight 1%, obesity 0 %). The prevalence of hypertension was comparable between the two genders (5.7% in females and 10.9 % in males). Conclusion: The results showed a relatively high prevalence of non-traditional risk factors for cardiovascular diseases in adolescents residing in a rural area, Limpopo Province, while the prevalence of traditional risk factors such as total cholesterol and triglycerides was low.
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Grooten, Wim. "Work and neck/shoulder pain : risk and prognostic factors /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-848-7/.
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