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Academic literature on the topic 'Patella Diseases Risk factors'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Patella Diseases Risk factors"

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Bi, Zhaodong, and Zeying Xie. "Examination, Diagnosis, and Treatment Techniques of Patellar Tendinitis." Highlights in Science, Engineering and Technology 8 (August 17, 2022): 426–33. http://dx.doi.org/10.54097/hset.v8i.1188.

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Patellar tendinitis is one of the most common complications of patellar fracture in the adolescent population. This study specifically focuses on patellar fracture to introduce the causes and risks, examination, and treatment techniques of patellar tendinitis. Results show that the physical activity and overuse are the primary exopathic factors of patellar tendinitis, and tight thigh muscles, imbalanced muscles, overweight, patella alta, and the lower extremity skeletal alignment problems are the endopathic factors of patellar tendinitis. The examination includes both self-examination and medical examination. When the diagnosis is conducted, differentiating patellar tendinitis from other similar diseases is needed. The common treatments include conservative treatment and medical therapy. The conservative treatment is convenient and highly cost-effective, however, it usually needs a longer treatment period without significant effectiveness. Medical therapy is the last and most effective form of treatment, which includes wire loop fastening internal fixation, tension band fixation, Nickel-titanium patellar fixator, patellar plate fixation, partial patellar resection, and reconstruction of the patellar ligament. These five medical methods have their own characteristics. The wire loop fastening internal fixation is only used as a basis for joint fixation. The tension band fixation has a low rate of fixation failure while has a high loosening rate. Nickel-titanium patellar fixator can promote the early recovery of motor function. Patellar plate fixation is stable and reliable as well as has a low failure rate. Partial patellar resection and reconstruction of the patellar ligament can reduce knee degeneration, but it may result in postoperative knee t-pain and long-term traumatic patellar arthritis.
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Murphy, Michael V., Dongyi (Tony) Du, Wei Hua, Karoll J. Cortez, Melissa G. Butler, Robert L. Davis, Thomas A. DeCoster, et al. "Risk Factors for Surgical Site Infections Following Anterior Cruciate Ligament Reconstruction." Infection Control & Hospital Epidemiology 37, no. 7 (March 31, 2016): 827–33. http://dx.doi.org/10.1017/ice.2016.65.

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OBJECTIVETo determine the effect of graft choice (allograft, bone-patellar tendon-bone autograft, or hamstring autograft) on deep tissue infections following anterior cruciate ligament (ACL) reconstructions.DESIGNRetrospective cohort study.SETTING AND POPULATIONPatients from 6 US health plans who underwent ACL reconstruction from January 1, 2000, through December 31, 2008.METHODSWe identified ACL reconstructions and potential postoperative infections using claims data. A hierarchical stratified sampling strategy was used to identify patients for medical record review to confirm ACL reconstructions and to determine allograft vs autograft tissue implanted, clinical characteristics, and infection status. We estimated infection rates overall and by graft type. We used logistic regression to assess the association between infections and patients’ demographic characteristics, comorbidities, and choice of graft.RESULTSOn review of 1,452 medical records, we found 55 deep wound infections. With correction for sampling weights, infection rates varied by graft type: 0.5% (95% CI, 0.3%-0.8%) with allografts, 0.6% (0.1%–1.5%) with bone-patellar tendon-bone autografts, and 2.5% (1.9%–3.1%) with hamstring autograft. After adjusting for potential confounders, we found an increased infection risk with hamstring autografts compared with allografts (odds ratio, 5.9; 95% CI, 2.8–12.8). However, there was no difference in infection risk among bone-patellar tendon-bone autografts vs allografts (odds ratio, 1.2; 95% CI, 0.3–4.8).CONCLUSIONSThe overall risk for deep wound infections following ACL reconstruction is low but it does vary by graft type. Infection risk was highest in hamstring autograft recipients compared with allograft recipients and bone-patellar tendon-bone autograft recipients.Infect Control Hosp Epidemiol 2016;37:827–833
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Kim, Eunju, Changyong Choe, Jae Gyu Yoo, Sang-Ik Oh, Younghun Jung, Ara Cho, Suhee Kim, and Yoon Jung Do. "Major medical causes by breed and life stage for dogs presented at veterinary clinics in the Republic of Korea: a survey of electronic medical records." PeerJ 6 (July 3, 2018): e5161. http://dx.doi.org/10.7717/peerj.5161.

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BackgroundAge and breed are considered the greatest risk factors for disease prevalence and mortality in companion dogs. Understanding the prevalence of diseases, in relation to age and breed, would support appropriate guidance for future health care strategies and provide useful information for the early diagnosis of diseases. The purpose of this study was to investigate the major medical causes for dogs visiting primary-care veterinary clinics in the Republic of Korea, stratified by age and breed.MethodsA total of 15,531 medical records of canine patients were analyzed from 11 veterinary clinics who shared data from January 1, 2016 to December 31, 2016. An electronic medical record (EMR) system was used for data collection, which included the animal identification number, age, breed, gender, neuter status, clinical information, and diagnosis. EMR data were classified using the International Classification of Disease system from the World Health Organization; presenting signs or diagnoses were identified according to breed and life stage.ResultsWithin the age groups, preventive medicine (16.7% confidence intervals (CI) [15.9–17.5]) was the most common cause for clinic visits for the <1 year and 1–3 year groups. Additionally, neutering surgery (6.6% CI [6.0–7.1]) and patella luxation (1.4% CI [1.8–2.7]) were frequently performed in these age groups. In the 4–6 year group, otitis externa (8.8% CI [7.8–10.0]) and dermatitis or eczema (8.5% CI [7.5–9.6]) were common medical problems. In older dogs (>10 year), the prevalences of heart disease, kidney disease, Cushing’s disease, and mammary tumors were higher than in the other age groups. Small and toy breed dogs comprised 67.7% of all dogs in this analysis. For all breeds, otitis externa, dermatitis or eczema, vomiting, and diarrhea were common medical problems.DiscussionThis study identified the most common medical disorders and differences in prevalences of diseases, according to age and breeds. The information from EMRs for dogs visiting primary-care veterinary clinics can provide background knowledge that is required to enable a better understanding of disease patterns and occurrence by age and breeds. The information from this study could enable the creation of strategies for preventing diseases and enable the identification of health problems for more effective disease management in companion dogs.
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Ristic, Vladimir, Mirsad Maljanovic, Vladimir Harhaji, and Miroslav Milankov. "Infections after reconstructions of anterior cruciate ligament." Medical review 67, no. 1-2 (2014): 11–15. http://dx.doi.org/10.2298/mpns1402011r.

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Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2%) were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9%) had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%), other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03%) had this complication, while the incidence was 1.52% (7/460) in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels, experience of surgeon and proper antibiotics.
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Schilaty, Nathan D., Nathaniel A. Bates, Thomas L. Sanders, Aaron J. Krych, Michael J. Stuart, and Timothy E. Hewett. "Incidence of Second Anterior Cruciate Ligament Tears (1990-2000) and Associated Factors in a Specific Geographic Locale." American Journal of Sports Medicine 45, no. 7 (March 1, 2017): 1567–73. http://dx.doi.org/10.1177/0363546517694026.

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Background: Second anterior cruciate ligament (ACL) tears after reconstruction occur at a reported rate of 20% to 30%. This high frequency indicates that there may be factors that predispose an athlete to graft failure and ACL tears of the contralateral knee. Purpose: To determine the incidence of second ACL injuries in a geographic population-based cohort over a 10-year observation period. Study Design: Descriptive epidemiological study. Methods: International Classification of Diseases, 9th Revision (ICD-9) codes relevant to the diagnosis of an ACL tear and the procedure code for ACL reconstruction were searched across the Rochester Epidemiology Project, a multidisciplinary county database, between the years of 1990 and 2000. This cohort of patients was tracked for subsequent ACL injuries through December 31, 2015. The authors identified 1041 patients with acute, isolated ACL tears. These patients were stratified by primary and secondary tears, sex, age, activity level, side of injury, sex by side of injury, and graft type. Results: Of the 1041 unique patients with a diagnosed ACL tear in Olmsted County, Minnesota, from 1990 to 2000, there were 66 (6.0%) second ACL tears; 66.7% of these tears occurred on the contralateral side. A second ACL injury was influenced by graft type ( P < .0001), election of ACL reconstruction ( P = .0060), and sex by side of injury ( P = .0072). Nonparametric analysis of graft disruption by graft type demonstrated a higher prevalence of second ACL tears with allografts compared with hamstring ( P = .0499) or patellar tendon autografts ( P = .0012). Conclusion: The incidence of second ACL tears in this population-based cohort was 6.0%, with 66.7% of these tears occurring on the contralateral side from the original injury. There was a high population incidence of second ACL injuries in female patients younger than age 20 years. The utilization of patellar tendon autografts significantly reduced the risk of second ACL injuries compared with allografts or hamstring autografts in this cohort.
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Ristic, Vladimir, Vukadin Milankov, Miodrag Vranjes, Mirko Obradovic, and Mile Bjelobrk. "Results of surgical treatment of the patellar tendon rupture." Medical review 74, no. 3-4 (2021): 90–97. http://dx.doi.org/10.2298/mpns2104090r.

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Introduction. The aim of the study was to report surgical treatment results of complete patellar tendon ruptures reconstructed by different surgical procedures. Material and Methods. This study included 35 patients, 26 males and 9 females, with an average age of 39 (range, 16 - 66) years. Seventeen patients had the risk factors (48.6%), including 11 with prior surgeries of the same knee: 7 reconstructions of the anterior cruciate ligament, 3 total knee replacement surgeries, and one intramedullary nailing. In 27 patients (77.1%), the surgery was performed during the first seven days after the injury. The following procedures were applied: patellar tendon repair with suture anchors in 5 cases; 13 transpatellar suturing through transpatellar tunnels; additional strengthening with wires and screws was performed in 7 patients; 7 reconstructions with bone-tendon-bone allograft taken from the bone bank, and in 3 patients contralateral bonetendon-bone autografts were used. Results and Discussion. The average Lysholm score was 86.1 (range, 27 - 100). Excellent results were found in 19 cases (54.2%), satisfactory in 10 (28.6%), and unsatisfactory in 6 patients (17.1%) who had chronic diseases and total knee replacement. The patients with timely diagnosis had significantly better results (90.1) than patients with chronic tendon injuries (72.6 points). Conclusion. Good results of acute rupture reconstruction are achieved by transosseous techniques or suture anchors. The surgery is much more complicated in neglected and chronic ruptures, and the results are worse. Surgical procedures, such as the patellar tendon reconstruction by bone-tendon-bone graft, additionally strengthened with wiring and screws, contribute to stable fixation, enable early rehabilitation, and prevent stiffness and muscle weakness.
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TUDORACHI, Nicoleta-Bianca, Iuliana EVA, Mihaela MOSCALU, Rami AL- HIARY, Aurelian-Corneliu MORARU, Bogdan BARBIERU, Costin STANCIU, Calin CORCIOVA, and Valeriu ARDELEANU. "Evaluating risk factors involved in the alteration of biomechanics in relation to knee osteoarthritis." Balneo Research Journal 10, Vol 10 No. 4 (December 10, 2019): 574–79. http://dx.doi.org/10.12680/balneo.2019.305.

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The knee joint is very complex in terms of degrees of mobility and for normal biomechanics it is necessary for all the anatomical structures at this level to be within physiological limits. Problems can be caused by a number of risk factors such as age, sex, weight, or local risk factors such as patellar changes represented by patela alta or patella baja, which can lead to instability of the lower limb. Risk factors that may influence the development and progression of knee osteoarthritis have been evaluated. Changes in patellar position in relation to knee osteoarthritis were also studied. A group of 377 patients hospitalized for unilateral or bilateral knee pain with instability were included in the study. 239 of the 377 starting group presented knee osteoarthritis, constituting the study group. The risk factors analyzed were age, patient sex, BMI, weight status, anatomical changes in position of the patella (patella alta and patella baja), COBB angle and spine deviation. The results indicated that obesity, anatomical changes in the position of the patella, (patella alta), COBB angle and spine deviations represent significant risk factors in the onset of knee osteoarthritis. Key words: risk factors, joint instability, knee osteoarthritis,
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Christensen, Tyson C., Thomas L. Sanders, Ayoosh Pareek, Rohith Mohan, Diane L. Dahm, and Aaron J. Krych. "Risk Factors and Time to Recurrent Ipsilateral and Contralateral Patellar Dislocations." American Journal of Sports Medicine 45, no. 9 (May 2, 2017): 2105–10. http://dx.doi.org/10.1177/0363546517704178.

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Background: Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability. Purpose: To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated. Study Design: Cohort study; Level of evidence, 3. Methods: This population-based study included 584 patients with a first-time lateral patellar dislocation occurring between 1990 and 2010. A retrospective review was conducted to gather information about the injury, subsequent dislocations (ipsilateral or contralateral), and structural characteristics including trochlear dysplasia, patella alta, and tibial tubercle to trochlear groove (TT-TG) distance. Risk factors were assessed to delineate associations with subsequent dislocations and time to recurrence. Results: At a mean follow-up of 12.4 years, 173 patients had ipsilateral recurrence, and 25 patients had a subsequent contralateral dislocation. At 20 years, the cumulative incidence of ipsilateral recurrence was 36.0%, while the cumulative incidence of contralateral dislocations was 5.4%. Trochlear dysplasia (odds ratio [OR], 18.1), patella alta (OR, 10.4), age <18 years at the time of the first dislocation (OR, 2.4), elevated TT-TG distance (OR, 2.1), and female sex (OR, 1.5) were associated with recurrent ipsilateral dislocations. Time to recurrence was significantly decreased in patients with trochlear dysplasia (23.0 months earlier time to recurrence; P < .001), elevated TT-TG distance (18.5 months; P < .001), patella alta (16.4 months; P = .001), and age <18 years at the time of the first dislocation (15.4 months; P < .001). Risk factors for subsequent contralateral dislocations included patella alta and trochlear dysplasia. Conclusion: At 20 years after a first-time lateral patellar dislocation, the cumulative incidence of recurrent ipsilateral patellar dislocations was 36.0%, compared with 5.4% for contralateral dislocations. Trochlear dysplasia, elevated TT-TG distance, patella alta, age <18 years at the time of the first dislocation, and female sex were associated with ipsilateral recurrence. Trochlear dysplasia, elevated TT-TG distance, patella alta, and age <18 years at the time of the first dislocation were predictive of a statistically significant decrease in time to recurrence.
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Bengana, B., A. Ladjouze-Rezig, S. Ayoub, N. B. Raaf, C. Aimeur, A. Boukabous, and S. Lefkir. "POS1127 ULTRASOUND ASSESSMENT OF GOUT LESIONS IN AN ALGERIAN POPULATION WITH ASYMPTOMATIC HYPERURICEMIA." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 843.1–843. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1161.

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Background:Hyperuricemia is a common biological abnormality, often clinically asymptomatic. However, it can announce a gout and be linked to many diseases such as metabolic syndrome, high blood pressure or kidney disease.In fact, the majority of learned societies do not recommend any urate lowering therapy (ULT) as long as the hyperuricemia remains asymptomatic. But it turns out that part of the population with asymptomatic hyperuricemia (AH) develops a gout after a few years particularly with genetic predisposition, but also on certain risk factors that need to be confirmed.By this way, musculoskeletal ultrasound (MUS) can detect “asymptomatic gout” by visualizing signs of urate deposits (UD) in subjects with AH.Objectives:Our main objective is already to estimate the prevalence of specific signs of gout in Algerian population with AH and assess the factors exposing to UD.Methods:This is a descriptive cross-sectional study from January 2017 to February 2019, with the recruitment of subjects with AH and serum urate level > 60 mg / L, who do not take any ULT and have not associated any chronic inflammatory rheumatism, where we performed a MUS of the knees, metatarsophalangeal joints MTP1, MTP2 and metacarpophalangeal joint MCP2 and MCP3 with the Achilles, patellar and quadricipital tendons.Results:We retained 258 subjects with AH, 132 women and 126 men (sex ratio = 0.95), the mean age was 59 years, the mean body mass index (BMI) was 28.4 kg / m2, 42 patients were under diuretics, 37 patients reported being on low-dose of aspirin 100 mg daily.The mean rate of serum urate levels was 78 ± 10 mg / L, the prevalence of UD found at the MUS was 22% (n = 58), among them 36 % (21/58) had a sign of the double contour DC on the MTP1 and 29% (17/58) on the knee, 7% (4/58) had tophi on the MTP1 and 3% (2/58) had urate aggregates. The factors reported to be linked to UD in the sample were: the male gender (p = 0.0016); the high uric acid level (p= 0.0355); BMI (p = 0.0427); taking diuretics for women (p= 0.0002).Conclusion:Through this work, it is clear that elementary ultrasound lesions related to gout disease are common in a population with AH and concerned one fifth of subjects in our study with a higher risk in men and subjects with obesity and high uric acid level, but also in women taking diuretics. These results need to be enhanced with a randomized controlled study in order to better determine the predisposing factors for gout in any subject with AH.Disclosure of Interests:None declared.
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Maney, Alistair J., Christopher M. Frampton, and Simon W. Young. "Age and Prosthetic Design as Risk Factors for Secondary Patella Resurfacing." Journal of Arthroplasty 35, no. 6 (June 2020): 1563–68. http://dx.doi.org/10.1016/j.arth.2020.01.018.

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Dissertations / Theses on the topic "Patella Diseases Risk factors"

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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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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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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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(Uncorrected OCR) 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. II
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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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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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Books on the topic "Patella Diseases Risk factors"

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P, De Bono D., ed. Cardiovascular risk factors. London: Gower Medical Pub., 1993.

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1961-, Gaziano J. Michael, ed. Atlas of cardiovascular risk factors. Philadelphia: Developed by Current Medicine, 2005.

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F, Johanson John, ed. Gastrointestinal diseases: Risk factors and prevention. Philadelphia: Lippincott, 1997.

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Ogata, Yorimasa, ed. Risk Factors for Peri-implant Diseases. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-39185-0.

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Roehrig, Karla L. Risk factors and disease prevention. Columbus, Ohio (456 Clinic Dr., Columbus 43210): Dept. of Family Medicine, College of Medicine, Ohio State University, 1985.

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M, Gotto Antonio, ed. Multiple risk factors in cardiovascular disease. Dordrecht: Kluwer Academic Publishers, 1992.

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Brockway, Ilona. Risk factors contributing to chronic disease. Canberra: Australian Institute of Health and Welfare, 2012.

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Lautenschlager, Irmeli. Cytomegalovirus infections: Risk factors, causes and management. Hauppauge, N.Y: Nova Science Publishers, 2011.

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Maga, Asofa'afetai. American Samoa NCD risk factors: STEPS report. [Pago Pago, American Samoa: Department of Health], 2007.

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Clinical manual of total cardiovascular risk. London: Springer, 2009.

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Book chapters on the topic "Patella Diseases Risk factors"

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Seo, Jeong Hun. "Risk Factors." In Diseases of the Gallbladder, 157–69. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-6010-1_15.

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Eriksen, Michael, and Carrie Whitney. "Risk Factors: Tobacco." In Global Handbook on Noncommunicable Diseases and Health Promotion, 115–36. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7594-1_8.

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Combarros, Onofre. "Genetic Risk Factors for Alzheimer’s Disease." In Neurodegenerative Diseases, 49–64. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6380-0_4.

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Clerici, Francesca. "Nongenetic Risk Factors for Alzheimer’s Disease." In Neurodegenerative Diseases, 77–92. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6380-0_6.

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Vannuccini, Silvia, Michela Torricelli, Filiberto Maria Severi, and Felice Petraglia. "Risk Factors for Gestational Diseases." In Neonatology, 1–14. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-18159-2_151-1.

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Vannuccini, Silvia, Michela Torricelli, Filiberto Maria Severi, and Felice Petraglia. "Risk Factors for Gestational Diseases." In Neonatology, 27–40. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-29489-6_151.

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De Bonis, Maria, Michela Torricelli, and Felice Petraglia. "Risk Factors for Gestational Diseases." In Neonatology, 21–25. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-1405-3_4.

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Ferrari, Raffaele, Claudia Manzoni, and Parastoo Momeni. "Genetic Risk Factors for Sporadic Frontotemporal Dementia." In Neurodegenerative Diseases, 147–86. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-72938-1_9.

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Riley, Leanne, Pascal Bovet, Nick Banatvala, and Melanie Cowan. "Surveillance of NCDs and their risk factors." In Noncommunicable Diseases, 34–42. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003306689-6.

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Bovet, Pascal, Nick Banatvala, Richard Cooper, and Leanne Riley. "Surveillance of NCDs and their risk factors." In Noncommunicable Diseases, 28–33. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003306689-5.

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Conference papers on the topic "Patella Diseases Risk factors"

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Doherty, M. "SP0005 Risk factors for osteoarthritis." In Annual European Congress of Rheumatology, Annals of the rheumatic diseases ARD July 2001. BMJ Publishing Group Ltd and European League Against Rheumatism, 2001. http://dx.doi.org/10.1136/annrheumdis-2001.27.

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Wu, Weiwei. "Statistical Analysis of Risk Factors for Generalized Cervical Diseases." In International Conference on Health Big Data and Intelligent Healthcare. SCITEPRESS - Science and Technology Publications, 2022. http://dx.doi.org/10.5220/0011371100003438.

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Mutiara, E., Syarifah, and L. D. Arde. "Risk Factors of Non-communicable Diseases in Medan City." In International Conference of Science, Technology, Engineering, Environmental and Ramification Researches. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0010081006210627.

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Reynosa-Silva, Ileana Cecilia, Dionicio Ángel Galarza-Delgado, Iris Jazmin Colunga-Pedraza, José Ramón Azpiri-López, Iván de Jesús Hernández-Galarza, Karla Paola Cuéllar-Calderón, Marielva Castro-González, and Carolina Marlene Martínez-Flores. "THU0682 UNDERDIAGNOSIS OF TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATIC DISEASES." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.945.

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Masyan, H., NS Esatoglu, AM Celik, V. Hamuryudan, H. Yazıcı, and E. Seyahi. "THU0317 Cardiovascular risk factors and comorbid diseases in takayasu arteritis." In Annual European Congress of Rheumatology, 14–17 June, 2017. BMJ Publishing Group Ltd and European League Against Rheumatism, 2017. http://dx.doi.org/10.1136/annrheumdis-2017-eular.6280.

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Pijalović, Velma, Jasmina Selimović, and Tea Mioković. "RELATIONSHIP BETWEEN CARDIOVASCULAR RISK FACTORS AND SOCIO-ECONOMIC FACTORS: THE EXAMPLE OF SOUTH-EASTERN EUROPEAN COUNTRIES." In HEALTH MANAGEMENT WITH SPECIAL ATTENTION TO CARDIOVASCULAR DISEASES. Akademija nauka i umjetnosti Bosne i Hercegovine, 2018. http://dx.doi.org/10.5644/pi2018.177.04.

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Korkmaz Ekren, P., I. Nesil, F. Yargucu Zihni, A. Y. Guruz, S. Toz, N. Turgay, and A. Sayiner. "Risk Factors of Pneumocystis Jirovecii Pneumonia in Patients with Rheumatic Diseases." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6837.

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Klester, Elena, Karolina Klester, Yakov Shoykhet, Valeriy Elykomov, Valentina Yarkova, Antonina Berdyugina, and Etiborhon Mukhtarova. "Risk factors of interstitial lung diseases in patients with rheumatoid arthritis." In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa1365.

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Mukhtar, Hamid, Khalda F. Ali, and Hafiz Farooq Ahmad. "Gender-wise Analysis of Diseases and Risk Factors in Saudi Population." In 2021 International Conference of Women in Data Science at Taif University (WiDSTaif ). IEEE, 2021. http://dx.doi.org/10.1109/widstaif52235.2021.9430228.

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Rehman, Atiq Ur, Tanvir Alam, and Samir Brahim Belhaouari. "Investigating Potential Risk Factors for Cardiovascular Diseases in Adult Qatari Population." In 2020 IEEE International Conference on Informatics, IoT, and Enabling Technologies (ICIoT). IEEE, 2020. http://dx.doi.org/10.1109/iciot48696.2020.9089468.

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Reports on the topic "Patella Diseases Risk factors"

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Trachunthong, Deondara, Suchintana Chumseng, Worrayot Darasawang, and Mathuros Tipayamongkholgul. Risk Factors and National Burden of Selected Noncommunicable Diseases in People Living with HIV: Systematic Review, Meta-Analysis and, Disability-Adjusted Life Years protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2022. http://dx.doi.org/10.37766/inplasy2022.9.0018.

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Review question / Objective: 1. Are the prevalence/incidence of four major groups of NCDs including MetS, DM, CVD, and CKD different among adults with and without HIV infection? 2. Are there relationships between HIV status, ART (ART use, short and long-term effects of ART), traditional risk factors (BMI), and the development of four major NCDs? 3. Does the trend of NCDs burden attributable to HIV in Thailand increase according to the time? Information sources: 1. Electronic databases: the following databases will be searched: PubMed/Medline, Scopus, Embase, Cochrane Library Thai journals online (ThaiJO), Thai digital collection (TDC), Thai journal index (TJI), and Thai-journal citation index (TCI). 2. Authors or experts in the field will be contacted through emails for any relevant data, results and information.
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Lines, Lisa M., Marque C. Long, Jamie L. Humphrey, Crystal T. Nguyen, Suzannah Scanlon, Olivia K. G. Berzin, Matthew C. Brown, and Anupa Bir. Artificially Intelligent Social Risk Adjustment: Development and Pilot Testing in Ohio. RTI Press, September 2022. http://dx.doi.org/10.3768/rtipress.2022.rr.0047.2209.

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Prominent voices have called for a better way to measure, predict, and adjust for social factors in healthcare and population health. Local area characteristics are sometimes framed as a proxy for patient characteristics, but they are often independently associated with health outcomes. We have developed an “artificially intelligent” approach to risk adjustment for local social determinants of health (SDoH) using random forest models to understand life expectancy at the Census tract level. Our Local Social Inequity score draws on more than 150 neighborhood-level variables across 10 SDoH domains. As piloted in Ohio, the score explains 73 percent of the variation in life expectancy by Census tract, with a mean squared error of 4.47 years. Accurate multidimensional, cross-sector, small-area social risk scores could be useful in understanding the impact of healthcare innovations, payment models, and SDoH interventions in communities at higher risk for serious illnesses and diseases; identifying neighborhoods and areas at highest risk of poor outcomes for better targeting of interventions and resources; and accounting for factors outside of providers’ control for more fair and equitable performance/quality measurement and reimbursement.
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Daudelin, Francois, Lina Taing, Lucy Chen, Claudia Abreu Lopes, Adeniyi Francis Fagbamigbe, and Hamid Mehmood. Mapping WASH-related disease risk: A review of risk concepts and methods. United Nations University Institute for Water, Environment and Health, December 2021. http://dx.doi.org/10.53328/uxuo4751.

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The report provides a review of how risk is conceived of, modelled, and mapped in studies of infectious water, sanitation, and hygiene (WASH) related diseases. It focuses on spatial epidemiology of cholera, malaria and dengue to offer recommendations for the field of WASH-related disease risk mapping. The report notes a lack of consensus on the definition of disease risk in the literature, which limits the interpretability of the resulting analyses and could affect the quality of the design and direction of public health interventions. In addition, existing risk frameworks that consider disease incidence separately from community vulnerability have conceptual overlap in their components and conflate the probability and severity of disease risk into a single component. The report identifies four methods used to develop risk maps, i) observational, ii) index-based, iii) associative modelling and iv) mechanistic modelling. Observational methods are limited by a lack of historical data sets and their assumption that historical outcomes are representative of current and future risks. The more general index-based methods offer a highly flexible approach based on observed and modelled risks and can be used for partially qualitative or difficult-to-measure indicators, such as socioeconomic vulnerability. For multidimensional risk measures, indices representing different dimensions can be aggregated to form a composite index or be considered jointly without aggregation. The latter approach can distinguish between different types of disease risk such as outbreaks of high frequency/low intensity and low frequency/high intensity. Associative models, including machine learning and artificial intelligence (AI), are commonly used to measure current risk, future risk (short-term for early warning systems) or risk in areas with low data availability, but concerns about bias, privacy, trust, and accountability in algorithms can limit their application. In addition, they typically do not account for gender and demographic variables that allow risk analyses for different vulnerable groups. As an alternative, mechanistic models can be used for similar purposes as well as to create spatial measures of disease transmission efficiency or to model risk outcomes from hypothetical scenarios. Mechanistic models, however, are limited by their inability to capture locally specific transmission dynamics. The report recommends that future WASH-related disease risk mapping research: - Conceptualise risk as a function of the probability and severity of a disease risk event. Probability and severity can be disaggregated into sub-components. For outbreak-prone diseases, probability can be represented by a likelihood component while severity can be disaggregated into transmission and sensitivity sub-components, where sensitivity represents factors affecting health and socioeconomic outcomes of infection. -Employ jointly considered unaggregated indices to map multidimensional risk. Individual indices representing multiple dimensions of risk should be developed using a range of methods to take advantage of their relative strengths. -Develop and apply collaborative approaches with public health officials, development organizations and relevant stakeholders to identify appropriate interventions and priority levels for different types of risk, while ensuring the needs and values of users are met in an ethical and socially responsible manner. -Enhance identification of vulnerable populations by further disaggregating risk estimates and accounting for demographic and behavioural variables and using novel data sources such as big data and citizen science. This review is the first to focus solely on WASH-related disease risk mapping and modelling. The recommendations can be used as a guide for developing spatial epidemiology models in tandem with public health officials and to help detect and develop tailored responses to WASH-related disease outbreaks that meet the needs of vulnerable populations. The report’s main target audience is modellers, public health authorities and partners responsible for co-designing and implementing multi-sectoral health interventions, with a particular emphasis on facilitating the integration of health and WASH services delivery contributing to Sustainable Development Goals (SDG) 3 (good health and well-being) and 6 (clean water and sanitation).
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Steinmann, Peter. Do interventions for educating traditional healers about STDs and HIV improve their knowledge and behaviour? SUPPORT, 2017. http://dx.doi.org/10.30846/170409.

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Traditional healers are important healthcare providers in a number of societies for a variety of healthcare concerns, including sexually transmitted diseases (STDs) and HIV. However, some traditional healing practices are risk factors for HIV infection, such as male circumcision using unsterilized equipment. The provision of training for traditional healers about STDs, HIV and evidence based medicine is seen as a way to improve their knowledge, reduce risk behaviours, and improve acceptance of and collaboration with formal health services. Training could also increase referrals to the formal health services.
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FEDOTKINA, S. A., O. V. MUZALEVA, and E. V. KHUGAEVA. RETROSPECTIVE ANALYSIS OF THE USE OF TELEMEDICINE TECHNOLOGIES FOR THE PREVENTION, DIAGNOSIS AND TREATMENT OF HYPERTENSION. Science and Innovation Center Publishing House, 2021. http://dx.doi.org/10.12731/978-0-615-67320-2-4-22.

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Introduction. The economic losses associated with disability due to diseases of the circulatory system, as well as the costs of providing medical care to patients suffering from heart and vascular diseases, are increasing annually. The state preventive measures currently being carried out are of a delayed nature. The results of the medical examination of the population of the Russian Federation in recent years (2015-2019) indicate that the incidence of cardiovascular diseases, including hypertension, is at a fairly high level. In the middle of the last century, the Concept of risk factors for the development of chronic non-communicable diseases were formulated, in the structure of which cardiovascular diseases, including arterial hypertension, occupies one of the primary positions. The concept is based on the results of promising epidemiological studies, and, at present, is a methodological basis for planning and organizing primary prevention of cardiovascular diseases. The purpose of the study. Based on the analysis of literary sources (including foreign ones) containing experience in the use of telemedicine technologies, to assess their significance for the prevention, diagnosis and treatment of hypertension, as well as forecasting improvements in the quality of medical care when adapting to the use of clinical recommendations. Materials and methods. The article provides an analytical review of the use of modern telemedicine technologies in the prevention of hypertension. The results of the study and their discussion. The analysis of literary sources has shown that in the context of the progress of information and telecommunication technologies in the healthcare system, a fundamentally new direction has appeared in the organization and provision of medical care to the population - telemedicine, which will ensure the modern level of prevention, detection and treatment of chronic non-communicable diseases, and also determines positive medical, social and economic performance indicators. To date, updates in the legislative framework of the Russian Federation are aimed at ensuring that medical care with the use of telemedicine technologies is more widespread, taking into account the standards of medical care and clinical recommendations. Conclusion. Based on a review of literature sources, it has been established that the modern solution to the problem of improving the quality of medical care for patients, including those with hypertension, diseases is medical care using telemedicine technologies that prove their medical, social and economic effectiveness.
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Adlakha, Deepi, Jane Clarke, Perla Mansour, and Mark Tully. Walk-along and cycle-along: Assessing the benefits of the Connswater Community Greenway in Belfast, UK. Property Research Trust, 2021. http://dx.doi.org/10.52915/ghcj1777.

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Physical inactivity is a risk factor for numerous chronic diseases, and a mounting global health problem. It is likely that the outdoor physical environment, together with social environmental factors, has a tendency to either promote or discourage physical activity, not least in cities and other urban areas. However, the evidence base on this is sparse, making it hard to identify the best policy interventions to make, at the local or city level. This study seeks to assess the impact of one such intervention, the Connswater Community Greenway CCG), in Belfast, in Northern Ireland, UK. To do that it uses innovative methodologies, ‘Walk-along’ and ‘Cycle-along’ that involve wearable sensors and video footages, to improve our understanding of the impact of the CCG on local residents. The findings suggest that four characteristics of the CCG affect people’s activity and the benefits that the CCG created. These are physical factors, social factors, policy factors and individual factors. Each of these has many elements, with different impacts on different people using the greenway.
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Wierup, Martin, Helene Wahlström, and Björn Bengtsson. How disease control and animal health services can impact antimicrobial resistance. A retrospective country case study of Sweden. O.I.E (World Organisation for Animal Health), April 2021. http://dx.doi.org/10.20506/bull.2021.nf.3167.

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Data and experiences in Sweden show that it is possible to combine high productivity in animal production with the restricted use of antibiotics. The major key factors that explain Sweden’s success in preventing AMR are: Swedish veterinary practitioners were aware of the risk of AMR as early as the 1950s, and the need for prudent use of antibiotics was already being discussed in the 1960s. Early establishment of health services and health controls to prevent, control and, when possible, eradicate endemic diseases reduced the need for antibiotics. Access to data on antibiotic sales and AMR made it possible to focus on areas of concern. State veterinary leadership provided legal structures and strategies for cooperation between stakeholders and facilitated the establishment of coordinated animal health services that are industry-led, but supported by the State.
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.

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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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Cao, Xianling, Xuanyou Zhou, Naixin Xu, Songchang Chang, and Chenming Xu. Association of IL-4 and IL-10 Polymorphisms with Preterm Birth Susceptibility: A Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0044.

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Review question / Objective: The aim of our systematic review and meta-analysis was to summarize the effects of IL-4 and IL-10 gene polymorphism and clarify their possible association with PTB. Condition being studied: World Health Organization (WHO) defines preterm birth (PTB) as babies born alive before 37 weeks of pregnancy are completed. The new estimates show that the prevalence of PTB during 2014 ranged from 8.7% to13.4% of all live births, about 15 million preterm babies born each year. Besides, PTB is the leading cause of death worldwide for children below 5 years of age. Babies born preterm are at an increased risk of short-term and long-term complications attributed to immaturity of multiple organ systems, such as cerebral palsy, intellectual disabilities, vision and hearing impairments, and impaired cognitive development. PTB has become a worldwide public health problem, but its etiology remains unclear. Accumulating evidence shows that PTB is a syndrome that can be attributed to a variety of pathological processes(5). Inflammatory diseases and genetic background are known risk factors for PTB, many studies had shown that genetic variations in proinflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-1 α (IL-1 α) are associated with increased risk of PTB, but the relationship between genetic polymorphism in anti-inflammatory cytokines and risk of PTB remains controversial.
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Rao, Krishna D., Andrés I. Vecino Ortiz, Tim Roberton, Angélica Lopez Hernandez, and Caitlin Noonan. Open configuration options Future Health Spending in Latin America and the Caribbean: Health Expenditure Projections & Scenario Analysis. Inter-American Development Bank, April 2022. http://dx.doi.org/10.18235/0004185.

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Abstract:
Latin American and Caribbean countries will face significant increases in future health expenditures. A variety of factors are responsible - population growth and aging, the epidemiological transition to noncommunicable diseases (NCDs), and economic growth and technology, among others. Increasing health expenditures are particularly concerning to countries in Latin America and the Caribbean (LAC) given growing levels of debt, insufficient fiscal revenues, and high out-of-pocket payments. The projected average annual per capita CHE growth rate from 2018-2050 is slightly higher in Latin American countries (3.2%) than in the Caribbean (2.4%). The share of health expenditure in GDP is projected to increase to 2030 in all LAC countries except for Guyana. The effect of demographics and epidemiology on health spending growth are more modest. Among strategies to control NCD risk factors, a focus on hypertension control generally had the strongest effect on restraining CHE growth except in countries where smoking is particularly prevalent. The main driver of health expenditure growth is economic growth and technology, demonstrating the importance of adopting policies such as explicit prioritization systems and benefit plans that establish common rules for payers and providers that encourage cost-effective decisions. The underlying model for making projections and analyzing alternative scenarios is publicly available.
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