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1.
Int. braz. j. urol ; 47(1): 8-19, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134333

ABSTRACT

ABSTRACT Objective: Recently, several studies have found that obesity had a protective effect against varicocele, but no meta-analysis has confirmed this finding. Therefore, we conducted this meta-analysis to investigate the association between body mass index (BMI) and varicocele. Material and Methods: We searched for studies in PubMed, Science Direct and the Cochrane Library from inception until February 2018. The association between BMI and varicocele was assessed by pooling the odds ratios (ORs). Results: Eleven eligible studies with a total study population of 1.376.658 participants were included in our analysis. According to BMI, the subjects were defined as belonging to the obese, overweight and underweight groups. Our results showed that the obese group had a lower risk of varicocele when compared with the normal weight group (odds ratio [OR] 0.46, 95% confidence intervals [CIs] 0.37-0.58). Additionally, an overweight BMI had a protective effect against varicocele (OR 0.70, 95% CIs, 0.56-0.86). However, underweight patients had a more than 30% higher risk of varicocele (OR 1.31, 95% CI, 1.04-1.64). Furthermore, there was no publication bias in any of the analyses. Conclusions: Our study demonstrates that BMI is negatively associated with the presence of varicocele.


Subject(s)
Humans , Male , Varicocele/epidemiology , Body Mass Index , Odds Ratio , Overweight/complications , Overweight/epidemiology , Obesity/complications
3.
Cad. Saúde Pública (Online) ; 37(6): e00294720, 2021. tab, graf
Article in English | LILACS | ID: biblio-1278624

ABSTRACT

Abstract: This study illustrates the use of a recently developed sensitivity index, the E-value, helpful in strengthening causal inferences in observational epidemiological studies. The E-value aims to determine the minimum required strength of association between an unmeasured confounder and an exposure/outcome to explain the observed association as non-causal. Such parameter is defined as E - v a l u e = R R + R R R R - 1, where RR is the risk ratio between the exposure and the outcome. Our work illustrates the E-value using observational data from a recently published study on the relationship between indicators of prenatal care adequacy and the outcome low birthweight. The E-value ranged between 1.45 and 5.63 according to the category and prenatal care index evaluated, showing the highest value for the "no prenatal care" category of the GINDEX index and the minimum value for "intermediate prenatal care" of the APNCU index. For "inappropriate prenatal care" (all indexes), the E-value ranged between 2.76 (GINDEX) and 4.99 (APNCU). These findings indicate that only strong confounder/low birthweight associations (more than 400% increased risk) would be able to fully explain the prenatal care vs. low birthweight association observed. The E-value is a useful, intuitive sensitivity analysis tool that may help strengthening causal inferences in epidemiological observational studies.


Resumo: O estudo ilustra o uso de um índice recém-desenvolvido para análise de sensibilidade, o valor de E, útil para embasar inferências causais em estudos epidemiológicos observacionais. O valor de E busca identificar a força mínima da associação entre um fator de confusão não medido e uma exposição/desfecho que seria necessária para explicar a associação observada enquanto não causal, definido como valor de E - v a l u e = R R + R R R R - 1, onde RR é a razão de riscos entre a exposição e o desfecho. Aqui, o valor de E é exemplificado através de dados observacionais de um estudo recém-publicado sobre a relação entre indicadores de adequação da assistência pré-natal e o baixo peso ao nascer enquanto desfecho. O valor de E variou entre 1,45 e 5,63, a depender da categoria e do índice de assistência pré-natal avaliado, com o valor máximo para a categoria "sem assistência pré-natal" do índice GINDEX e o mínimo para "assistência pré-natal intermediária" do índice APNCU. Na categoria "assistência pré-natal inadequada" (todos os índices), o valor de E variou entre 2,76 e 4,99 (índices GINDEX e APNCU, respectivamente). Isso indica que apenas associações fortes entre um fator de confusão e baixo peso ao nascer (aumento de risco maior que 400%) seria capaz de explicar plenamente a associação entre assistência pré-natal e baixo peso ao nascer. O valor de E é uma ferramenta útil e intuitiva para análise de sensibilidade, que pode ajudar a fortalecer as inferências causais em estudos epidemiológicos observacionais.


Resumen: El presente estudio ilustra el uso de un índice desarrollado recientemente para el análisis de la sensibilidad, el E-value, útil para el fortalecimiento de las inferencias causales en los estudios epidemiológicos observacionales. El E-value tiene por objetivo identificar la fortaleza de asociación mínima necesaria entre un factor de confusión no calculable y una exposición/resultado que sería necesario para explicar la asociación observada como no-causal, y está definida como E - v a l u e = R R + R R R R - 1, donde RR es la ratio de riesgo entre la exposición y el resultado. Aquí, el E-value es ilustratado con datos observacionales de un estudio recientemente publicado para mostrar la relación entre indicadores de adecuación de cuidado prenatal y el resultado de bajo peso al nacer. El E-value varió entre 1,45 and 5,63, dependiendo de la categoría y el índice cuidado prenatal evaluado, con su valor más alto para la categoría "no cuidado prenatal" del índice GINDEX y el mínimo para el "cuidado prenatal intermedio" del índice APNCU. En la categoría "inapropiado cuidado prenatal" (todos los índices) el E-value varió entre 2,76 y 4,99 (los índices GINDEX y APNCU, respectivamente). Esto indica que solamente un factor de confusión fuerte/asociaciones bajo peso al nacer (incrementaron el riesgo más de un 400%) habría hecho posible explicar completamente la asociación observada cuidado prenatal vs bajo peso al nacer. El E-value es una herramienta de análisis de sensibilidad útil, intuitiva, que puede ayudar a fortalecer las inferencias causales en los estudios epidemiológicos observacionales.


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Infant, Low Birth Weight , Brazil/epidemiology , Epidemiologic Studies , Odds Ratio
4.
Rev. enferm. Cent.-Oeste Min ; 11: 4162, 20210000.
Article in Portuguese | LILACS, BDENF | ID: biblio-1291589

ABSTRACT

Objetivos: Avaliar o conhecimento, atitude e prática sobre aleitamento materno entre puérperas, em alojamento conjunto de uma maternidade com selo de Hospital Amigo da Criança e descrever os motivos do desmame precoce em gestações anteriores. Método: Inquérito com 157 puérperas em alojamento conjunto com análise descritiva e inferencial. Resultados: Faixa etária e paridade associaram-se ao conhecimento e à atitude. Mulheres acima de 26 anos (OR=0,672 [IC=0,564-0,801]) e multíparas (OR =0,750 [IC =0,661-0,851]) têm mais chance de possuírem saberes adequados. A idade mais elevada (OR =0,356 [IC =0,172-0,735]), planejamento da gravidez (OR =0,275 [IC =0,093-0,815]) e multiparidade (OR =0,475 [IC =0,229-0,985]) foram fatores de proteção à atitude. A consulta pré-natal associou-se à prática (p=0,023) e enquanto fator de proteção (OR=0,313 [IC=0,112-0,873]) ao aleitamento. Conclusão: A Enfermagem pode auxiliar positivamente no conhecimento, na atitude e na prática sobre aleitamento, auxiliando no cuidado preventivo do trauma mamilar como causa importante do desmame precoce(AU)


Purposes: To evaluate the knowledge, attitude, and practices related to breastfeeding among postpartum women in a maternity ward which holds the Child-Friendly Hospital seal (Selo Hospital Amigo da Criança) and to describe the reasons for early weaning in previous pregnancies. Method: A survey with 157 postpartum women at a joint maternity ward with descriptive and inferential analysis. Results: Age and parity were associated with knowledge and attitude. Women over 26 (OR=0.672 [CI=0.564- 0.801]) and multiparous women (OR = 0.750 [CI =0.661-0.851]) are more likely to have adequate knowledge. Higher ages (OR =0.356 [CI =0.172-0.735]), pregnancy planning (OR =0.275 [CI =0.093-0.815]) and multiparity (OR =0.475 [CI =0.229-0.985]) were associated to protection and attitude. Prenatal consultation was associated with practice (p=0.023), while protective factor (OR=0.313 [CI=0.112-0.873]) was associated to breastfeeding. Conclusion: Nursing can be a positive assistance when it comes to knowledge, attitude, and practice about breastfeeding, helping in the preventive care of nipple trauma becoming an important cause of early weaning(AU)


Objetivos: Evaluar el conocimiento, la actitud y la práctica de la lactancia materna entre las puérperas en una sala de maternidad con un sello del Hospital Amigo del Niño y describir las razones del destete temprano en embarazos anteriores. Método: Se trata de una encuesta con 157 mujeres puérperas en alojamiento conjunto con análisis descriptivo e inferencial. Resultados: El grupo de edad y la paridad se asociaron con el conocimiento y la actitud. Las mujeres mayores de 26 años (OR=0,672 [CI=0,564-0,801]) y las mujeres multiparosas (OR = 0,750 [CI =0,661- 0,851]) son más propensas a tener un conocimiento adecuado. La edad más alta (OR =0.356 [CI =0.172-0.735]), la planificación del embarazo (OR =0.275 [CI =0.093-0.815]) y la multiparidad (OR =0.475 [CI =0.229-0.985]) fueron factores protectores a la actitud. La consulta prenatal se asoció con la práctica (p=0,023) y como factor protector (OR=0,313 [CI=0,112-0,873]) con la lactancia materna. Conclusión: La enfermería puede ayudar positivamente en el conocimiento, la actitud y la práctica sobre la lactancia materna, ayudando en la atención preventiva del trauma mamilar, como una causa importante del destete temprano(AU)


Subject(s)
Humans , Female , Rooming-in Care , Breast Feeding , Odds Ratio , Health Knowledge, Attitudes, Practice , Nursing , Knowledge
5.
Rev. enferm. UERJ ; 28: e46505, jan.-dez. 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1120172

ABSTRACT

Objetivo: analisar a associação entre danos à saúde e qualidade de vida no trabalho de enfermeiros hospitalares. Método: estudo quantitativo, descritivo, transversal, com 145 enfermeiros, aprovado pela comissão de ética sob protocolos 1.634.051 e 1.643.912. Utilizaram-se estatísticas descritivas, análises bivariadas, teste qui-quadrado, cálculo da razão de chance e intervalos de confiança. Resultados: observou-se que o consumo de medicamentos provocado/agravado pelo trabalho aumentou em 2,31 vezes a chance de o enfermeiro ter baixa qualidade de vida no trabalho; transtornos do sono provocados/agravados pelo trabalho aumentou em 3,15 vezes a chance de ter baixa qualidade de vida no trabalho; cefaleia frequente provocada/agravada pelo trabalho aumentou a chance em 1,98 vezes de ter baixa qualidade de vida no trabalho. Conclusão: condições de trabalho impactam na saúde e qualidade de vida do trabalho do enfermeiro. Ambientes de trabalho adequados proporcionam satisfação pessoal e profissional, além de manterem a qualidade da força de trabalho do enfermeiro.


Objective: to examine the association between health harm and quality of life in the work of hospital nurses. Method: this quantitative, descriptive, cross-sectional study, with 145 nurses, after approval by research ethics committee ­ protolcols 1.634.051 and 1.643.912. Descriptive statistics, bivariate analyses, chi-square test, odds ratio and confidence intervals were used. Results: the odds of nurses' quality of life at work being poor were found to be increased 2.31 times by work-related or - aggravated medicine consumption; 3.15 times by work-related or -aggravated sleep disorders; and 1.98 times by frequent workrelated or -aggravated headache. Conclusion: working conditions impact on nurses' health and quality of life at work. Appropriate work environments favor personal and professional satisfaction and maintain the quality of the nurse's workforce.


Objetivo: examinar la asociación entre daños a la salud y calidad de vida en el trabajo de enfermeras hospitalarias. Método: estudio cuantitativo, descriptivo, transversal, con 145 enfermeros, previa aprobación del comité de ética en investigación - protolcols 1.634.051 y 1.643.912. Se utilizó estadística descriptiva, análisis bivariados, prueba de chi-cuadrado, razón de probabilidades e intervalos de confianza. Resultados: se encontró que las probabilidades de que la calidad de vida de las enfermeras en el trabajo sea deficiente aumentaban 2,31 veces por el consumo de medicamentos relacionados con el trabajo o agravados; 3,15 veces por trastornos del sueño relacionados con el trabajo o agravados; y 1,98 veces por dolor de cabeza frecuente relacionado con el trabajo o agravado. Conclusión: las condiciones laborales repercuten en la salud y la calidad de vida de las enfermeras en el trabajo. Los entornos laborales adecuados favorecen la satisfacción personal y profesional y mantienen la calidad de la fuerza laboral de la enfermería.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Quality of Life , Working Conditions , Occupational Health , Hospitals, University , Nurses , Self Medication , Sleep Wake Disorders , Brazil , Chi-Square Distribution , Confidence Intervals , Odds Ratio , Epidemiology, Descriptive , Cross-Sectional Studies , Workplace , Headache , Job Satisfaction
6.
Int. braz. j. urol ; 46(5): 691-704, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134242

ABSTRACT

ABSTRACT Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. Results: With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR−, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.


Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Biomarkers, Tumor , Odds Ratio , ROC Curve , Sensitivity and Specificity , Antigens, Neoplasm
7.
Acta bioquím. clín. latinoam ; 54(3): 257-266, set. 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1130600

ABSTRACT

EL HOMA-IR (homeostasis model assessment-insulin-resistance) es un estimador de insulinorresistencia (IR) pero depende de la determinación de insulina. Los índices triglicéridos-glucosa (T-G)-circunferencia de la cintura (CC) (T-G-CC) o triglicéridos-glucosa-índice de masa corporal (TG- IMC) podrían ser sustitutos. Los objetivos de este trabajo consistieron en investigar en personas con riesgo de desarrollar diabetes tipo 2 (DT2): a) los índices T-G, T-G-CC y T-G-IMC como estimadores de HOMA-IR>2,1; b) determinar su poder discriminante. Se realizó un estudio prospectivo en el que se estudiaron 223 individuos ≥45 años con riesgo de desarrollar diabetes tipo 2 (DT2). La relación T-G se calculó como ln [triglicéridos (mg/dL) x glucemia (mg/dL)/2]. La relación T-G-CC y T-G-IMC fue el producto de T-G por CC o IMC. Se utilizó análisis de regresión logística y se calcularon las áreas bajo las curvas ROC (receiver operating characteristic curves) (ABC) para comparar las asociaciones de T-G, T-G-CC y T-G-IMC con HOMA-IR>2,1. Mediante análisis discriminante se evaluó la clasificación de los sujetos entre HOMA-IR>2,1 y HOMA-IR≤2,1. ABC, sensibilidad, especificidad, poder predictivo positivo y negativo para T-G-CC y T-G-IMC fueron mayores que para T-G, con los siguientes valores de corte: T-G=8,75, T-G-CC=821 y T-G-IMC=255. Los odds ratios (OR) para HOMA-IR>2,1, ajustados para confusores, fueron: T-G>8,75, OR: 4,85 (IC 95% 2,73-8,62); T-G-CC>821, OR: 10,41 (IC 95% 5,55-19,53); T-GIMC> 255, OR: 10,41 (IC 95% 5,55-19,53). Con el análisis discriminante T-G>8,75 clasificó correctamente 69,2% individuos con HOMA-IR≤2,1 y 68,3% con HOMA-IR>2,1; T-G-CC y T-G-IMC clasificaron 74,4% y 78,2% respectivamente (p<0,001 en todos los casos). Se concluyó que T-GCC> 821 y T-G-IMC>255 fueron mejores estimadores de HOMA-IR>2,1 que T-G>8,75. Estas son determinaciones simples y accesibles y podrían ser útiles en la práctica clínica y en estudios epidemiológicos.


HOMA-IR ((homeostasis model assessment-insulin-resistance) is a surrogate estimator of insulin resistance (IR) but it depends on insulin determination. Triglyceride-glucose-waist circumference (T-G-WC) or triglyceride-glucose-body mass index (BMI) (T-G-BMI) could be substitutes. The objectives of this work were: to investigate in people at risk of developing type 2 diabetes (T2D): a) T-G, T-G-CC and T-G-BMI as estimators of HOMA-IR>2.1 and b) to determine their discriminating power. A prospective study was conducted studying 223 individuals ≥45 years of age at risk of developing type 2 diabetes (T2D). The T-G ratio was calculated as ln [triglycerides (mg/dL) x glycemia (mg/dL)/2]. The T-G-CC and T-G-BMI ratio was the product of T-G by CC or BMI. Logistic regression analysis was used and the areas under the receiver operating characteristic curves (ROC) curves were calculated to compare the associations of T-G, T-G-CC and T-G-BMI with HOMA-IR>2.1. Using a discriminant analysis, the classification of the subjects between HOMA-IR>2.1 or HOMA-IR≤2.1 was evaluated. AUC, sensitivity, specificity, positive and negative predictive powers for T-G-CC and T-G-BMI were higher than for T-G, with the following cut-off values: TG=8.75, T-G-CC=821 and T-G-BMI=255. Odds ratios (OR) for HOMA-IR>2.1, adjusted for confounders, were: T-G>8.75, OR 4.85 (95% CI 2.73-8.62); T-G-CC>821, OR 10.41 (95% CI 5.55-19.53); T-G-BMI>255, OR 10.41 (95% CI 5.55-19.53). With the discriminant analysis T-G>8.75, 69.2% correctly classified with HOMA-IR≤2.1 and 68.3% with HOMA-IR>2.1; T-G-CC and T-G-BMI correctly classified 74.4% and 78.2% respectively (p <0.001 in all cases). It is concluded that T-G-CC>821 and T-G-BMI>255 were better estimators of HOMA-IR>2.1 than T-G>8.75. T-G-WC and T-G-BMI are simple and reliable determinations and could be useful in clinical practice and epidemiological studies.


O HOMA-IR (homeostasis model assessment-insulin-resistance) e um estimador de resistencia a insulina (RI), mas depende da determinacao da insulina. Triglicerideos-glicose (T-G), circunferencia da cintura (CC) (T-G-CC) ou triglicerideos-glicose-indice de massa corporal (T-G-IMC) poderiam ser substitutos. Os objetivos desse trabalho foram investigar em pessoas com risco de desenvolver diabetes tipo 2 (DT2): a) os indices T-G, T-G-CC e T-G-IMC como estimadores de HOMA-IR> 2,1; b) determinar seu poder discriminante. Um estudo prospectivo foi realizado em 223 pessoas ≥45 anos com risco de desenvolver diabetes tipo 2 (DT2). A razao T-G foi calculada como ln [triglicerideos (mg/dL) x glicemia (mg/dL)/2]. A razao T-G-CC e T-G-IMC foi o produto de T-G por CC ou IMC. A analise de regressao logistica foi utilizada e as areas sob as curvas ROC (receiver operating features) ABC foram calculadas para comparar as associacoes de T-G, T-G-CC e T-G-IMC com HOMA-IR>2.1. Por meio de analise discriminante, avaliou-se a classificacao dos sujeitos entre HOMA-IR>2,1 e HOMA-IR≤2,1. ABC, sensibilidade, especificidade, poder preditivo positivo e negativo para TG-CC e TG-IMC foram maiores que para TG, com os seguintes valores de corte: TG=8,75, TG-CC=821 e TG-IMC=255. Odds Ratios (OR) para HOMA-IR>2,1, ajustados para fatores de confusao, foram: TG>8,75, OR 4,85 (IC95% 2,73-8,62); T-G-CC>821, OR 10,41 (IC 95% 5,55-19,53); T-G-IMC>255, OR 10,41 (IC 95% 5,55-19,53). Com a analise discriminante T-G>8,75, 69,2% foram classificados corretamente com HOMA-IR≤2,1 e 68,3% com HOMA-IR>2,1; T-G-CC e T-G-IMC classificaram 74,4% e 78,2%, respectivamente (p<0,001 em todos os casos). Conclui-se que T-G-CC>821 e TG- IMC>255 foram melhores estimadores de HOMA-IR>2,1 que T-G>8,75. Elas sao determinacoes simples e acessiveis e poderiam ser uteis na pratica clinica e em estudos epidemiologicos.


Subject(s)
Humans , Triglycerides , Power, Psychological , Epidemiologic Studies , Logistic Models , Odds Ratio , Confounding Factors, Epidemiologic , ROC Curve , Sensitivity and Specificity , Classification , Area Under Curve , Courtship , Diabetes Mellitus, Type 2 , Diabetes Mellitus, Type 2/complications , Glucose , Goals , Insulin , Persons , Organization and Administration , Association , Blood Glucose , Insulin Resistance , Body Mass Index , Discriminant Analysis , Risk , Regression Analysis , Waist Circumference
8.
Ciênc. Saúde Colet ; 25(4): 1483-1490, abr. 2020. tab
Article in English | LILACS | ID: biblio-1089519

ABSTRACT

Abstract This study aimed to investigate whether attitudes towards body weight dissatisfaction is associated with perceived health and impairments in sleep among a national population-based sample of Brazilian adolescents. This is a cross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 100.182 students (70.8% were between 14 to 15) in ninth-grade, enrolled in public and private schools were eligible for data analysis. Variables were measured using a questionnaire and binary logistic regression was used. There was association between attitudes towards body weight dissatisfaction and perceived health (not controlling weight = OR: 2.19, 95%CI: 2.00-2.40; trying to lose = OR: 1.90, 95%CI: 1.75-2.05; gain = OR: 2.22, 95%CI: 2.01-2.46; maintain = OR: 1.81, 95%CI: 1.54-2.14). Adolescents were also more likely to present impairments in sleep (not controlling weight = OR: 1.21, 95%CI: 1.11-1.32; trying to lose = OR: 1.16, 95%CI: 1.08-1.25; gain = OR: 1.43, 95%CI: 1.28-1.61; maintain = OR: 1.43, 95%CI: 1.22-2.68). Dissatisfaction is an additional concern in the daily life of adolescents, which is associated to depreciation of the quality of sleep and decrement of psychological well-being.


Resumo Este estudo teve como objetivo investigar se as atitudes em relação à insatisfação com o peso corporal (PC) estão associadas à saúde percebida e ao comprometimento do sono em uma amostra de base populacional de estudantes brasileiros. A Pesquisa Nacional de Saúde do Escolar possui delineamento transversal e foram elegíveis para as análises 100.182 estudantes do nono ano. Foi utilizado regressão logística binária para analisar a associação entre as variáveis investigadas, obtidas por meio de questionário. Houve associação entre as atitudes em relação à insatisfação com o PC e a saúde percebida, indicando que aqueles insatisfeitos com o PC apresentaram maior OR para a percepção negativa de saúde (não controlando o peso = OR: 2,19, IC95%: 2,00-2,40, tentando perder = OR: 1,90, IC95%: 1,75-2,05; ganhar = OR: 2,22, IC95%: 2,01-2,46; manter = OR: 1,81, IC95%: 1,54-2,14) e para o comprometimento do sono (não controlando o peso = OR: 1,21, IC95%: 1,11-1,32; tentando perder = OR: 1,16, IC95%: 1,08-1,25; ganhar = OR: 1,43,95 % CI: 1,28-1,61; manter = OR: 1,43, IC95%: 1,22-1,68) em relação àqueles satisfeitos com o PC. A insatisfação é uma preocupação adicional na vida diária dos adolescentes, que está associada à depreciação da qualidade do sono e à diminuição do bem-estar psicológico.


Subject(s)
Humans , Male , Female , Adolescent , Personal Satisfaction , Sleep Wake Disorders/epidemiology , Body Weight , Health Knowledge, Attitudes, Practice , Adolescent Health , Body Image , Brazil , Confidence Intervals , Logistic Models , Odds Ratio , Mental Health , Cross-Sectional Studies , Health Surveys
9.
Article in English | WPRIM | ID: wpr-785429

ABSTRACT

PURPOSE: Patients with secondary hyperparathyroidism are at high risk for developing postoperative hypocalcemia. However, there are limited data regarding predictors of postoperative hypocalcemia in renal failure patient with secondary hyperparathyroidism. This study aimed to determine the clinical presentations of renal hyperparathyroidism and the predictors of early postoperative hypocalcemia after total parathyroidectomy.METHODS: Data of patients with renal hyperparathyroidism who underwent total parathyroidectomy between January 2007 to December 2014 were reviewed retrospectively. Patients were divided into 2 cohort groups according to their serum calcium levels within 24 hours of parathyroidectomy: the hypocalcemia group (calcium levels of 2 mmol/L or less), and the normocalcemia group (calcium levels more than 2 mmol/L). With the use of multivariable logistic regression analyses, the predictors of early postoperative hypocalcemia after total parathyroidectomy in patients with renal hyperparathyroidism were investigated.RESULTS: Among 68 patients, 56 patients (82.4%) were symptomatic preoperatively. Fifty patients (73.5%) presented with bone pain and 14 patients (20.6%) had muscle weakness. Early postoperative hypocalcemia occurred in 25 patients (36.8%). Preoperative alkaline phosphatase level was the predictor of early postoperative hypocalcemia (adjusted odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P = 0.002).CONCLUSION: Results from our study show that most of the patients with renal hyperparathyroidism were symptomatic preoperatively and the most common clinical presentations were bone pain and muscle weakness. The significant predictor of early postoperative hypocalcemia after total parathyroidectomy was the preoperative alkaline phosphatase levels.


Subject(s)
Alkaline Phosphatase , Calcium , Cohort Studies , Humans , Hyperparathyroidism , Hyperparathyroidism, Secondary , Hypocalcemia , Logistic Models , Muscle Weakness , Odds Ratio , Parathyroid Hormone , Parathyroidectomy , Renal Insufficiency , Retrospective Studies
10.
Article in English | WPRIM | ID: wpr-811214

ABSTRACT

OBJECTIVE: The causal association of human papillomavirus (HPV) in uterine cervical cancer was well established and this oncogenic virus was reported to be a biomarker for overall recurrence and central pelvic recurrence. The objective of the present systematic review and meta-analysis was to assess the role of HPV DNA testing in early detection of recurrence among cervical cancer survivors after radiotherapy.METHODS: We performed a systematic review and meta-analysis by means of searching electronic databases for published articles between January 1984 and June 2018, on the basis of standard systematic review guidelines prescribed by major agencies namely Cochrane Collaboration (https://www.cochrane.org) and Campbell Collaboration (https://www.campbellcollaboration.org). The meta-analysis component was further modified appropriately for the synthesis of sensitivity and specificity results.RESULTS: A total of 1,055 cervical cancer cases who had received pelvic radiation with or without chemotherapy from ten cohort studies were evaluated. The overall pooled sensitivity and specificity of HPV DNA testing was 0.84 (95% confidence interval [CI]= 0.66–0.94) and 0.35 (95% CI=0.20–0.54) respectively. The positive likelihood ratio was 1.3 (95% CI=1.0–1.7) and the negative likelihood ratio was 0.45 (95% CI=0.18–1.10) with an estimated diagnostic odds ratio of 3 (95% CI=1–9).CONCLUSION: The screening for HPV DNA testing during follow-up facilitates early detection of recurrence after radiotherapy.


Subject(s)
Cervix Uteri , Cohort Studies , Cooperative Behavior , DNA , Drug Therapy , Female , Follow-Up Studies , Human Papillomavirus DNA Tests , Humans , Mass Screening , Odds Ratio , Oncogenic Viruses , Radiotherapy , Recurrence , Sensitivity and Specificity , Survivors , Uterine Cervical Neoplasms
11.
Article in English | WPRIM | ID: wpr-811140

ABSTRACT

BACKGROUND: Soybean food consumption has been considered as a possible way to lower incidence of cardiometabolic syndrome (CMS) among Asians. However, results from studies investigating its efficacy on CMS in Asians have been inconsistent.METHODS: We analyzed the association between soybean intake frequency and prevalence of CMS based on data from the Korea National Health and Nutrition Examination Survey 2007 to 2011. Data of 9,287 women aged 20 to 64 years were analyzed. Food frequency questionnaire was used to assess soybean food consumption frequency. General linear model and multivariable logistic regression model were used to examine the association of soybean intake quintile with CMS and its risk factors. Least square means of metabolic factors mostly showed no significant relevance except liver indexes.RESULTS: Compared to participants in the 1st quintile (<2 times/week of soybean food), odds ratios (OR) for CMS and abdominal obesity (AO) in the 4th quintile (8.5 times/week<soybean food≤17 times/week) were 0.73 (95% confidence interval [CI], 0.57 to 0.95) and 0.72 (95% CI, 0.58 to 0.90), respectively. After excluding Tofu products, ORs of CMS, AO, high blood pressure, and hypertriglyceridemia were lower than those without excluding Tofu products. However, results still did not show significant inverse linear trend across frequency quintiles.CONCLUSION: Our findings suggest that soybean intake of 8.5 to 17 times/week was inversely associated with CMS in Korean women. The relation between soybean intake >17 times/week and CMS varied depending on soybean food items.


Subject(s)
Asian Continental Ancestry Group , Diabetes Mellitus , Eating , Female , Humans , Hypertension , Hypertriglyceridemia , Incidence , Korea , Linear Models , Liver , Logistic Models , Nutrition Surveys , Obesity, Abdominal , Odds Ratio , Prevalence , Risk Factors , Soy Foods , Soybeans
12.
Article in English | WPRIM | ID: wpr-811107

ABSTRACT

PURPOSE: Radical lymph node dissection for right-sided colon cancer is technically challenging. No clear guideline is available for surgical resection of clinical stage I right-sided colon cancer. This study was designed to review the pathologic stage of clinical stage I right-sided colon cancer and determine the relevant extent of surgical resection.METHODS: Patients were treated for clinical stage I right-sided colon cancers (cecal, ascending, hepatic flexure, and proximal transverse colon) between July 2006 and December 2014 at a tertiary teaching hospital. Open surgery was not included because laparoscopic surgery is an initial major procedure in the institution.RESULTS: During the study period, 80 patients diagnosed with clinical stage I right-sided colon cancer were classified into 2 groups according to the pathology: stage 0/I and II/III. Tumor sizes were larger in the stage II/III group (P = 0.003). The stage II/III group had higher rates of vascular (P = 0.023) and lymphatic invasion (P = 0.023) and lower rates of well differentiation (P = 0.022). During follow-up, 1 case of local and 4 cases of systemic recurrences were found. Multivariate analysis to confirm odds ratios affecting change from clinical stage I to pathological stage II/III showed that tumor size (P = 0.010) and the number of retrieved lymph nodes (P = 0.046) were risk factors.CONCLUSION: For right-sided colon cancer, even with clinical stage I included, radical lymph node dissection should be performed for exact staging with sufficient number of lymph nodes. This will help determine appropriate adjuvant treatment, especially in large tumor sizes.


Subject(s)
Colon , Colon, Ascending , Colon, Transverse , Colonic Neoplasms , Follow-Up Studies , Hospitals, Teaching , Humans , Laparoscopy , Lymph Node Excision , Lymph Nodes , Multivariate Analysis , Odds Ratio , Pathology , Recurrence , Retrospective Studies , Risk Factors
13.
Article in English | WPRIM | ID: wpr-811104

ABSTRACT

BACKGROUND: Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses.METHODS: Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ² test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses.RESULTS: In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02–1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17–3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02–1.79).CONCLUSIONS: Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.


Subject(s)
Child , Cross-Sectional Studies , Disinfectants , Guanidine , Humans , Humidifiers , Logistic Models , Odds Ratio , Rhinitis , Rhinitis, Allergic
14.
Article in English | WPRIM | ID: wpr-811103

ABSTRACT

BACKGROUND: This study aimed to identify the relationship between exposure to bisphenol A (BPA) and seafood consumption using a nationally representative data of the general Korean population.METHODS: This study was conducted on 5,402 adults aged 19 years and older (2,488 men, 2,914 women) based on the second Korean National Environmental Health Survey (2012–2014). We stratified the data according to gender and analyzed urinary BPA concentrations in terms of sociodemographic characteristics, health behavior, dietary factor, and seafood consumption. In the high and low BPA exposure groups, the odds ratios (ORs) were calculated using logistic regression analysis according to the top 75th percentile concentration.RESULTS: In men, large fish and tuna and other seafood categories had significantly higher ORs before and after adjustment in the group who consumed seafood more than once a week than in the group who rarely consumed seafood, with an adjusted value of 1.97 (95% confidence interval [CI]: 1.12–3.48) and 1.74 (95% CI: 1.10–2.75), respectively. In the shellfish category, the unadjusted OR was 1.61 (95% CI: 1.00–2.59), which was significantly higher in the group who consumed seafood more than once a week than in the group who rarely consumed seafood. However, the OR after adjusting for the variables was not statistically significant. In women, the frequency of seafood consumption and the concentration of urinary BPA were not significantly associated.CONCLUSIONS: BPA concentration was higher in men who frequently consumed large fish and tuna, shellfish and other seafood in this study.


Subject(s)
Adult , Environmental Health , Female , Health Behavior , Humans , Logistic Models , Male , Odds Ratio , Seafood , Shellfish , Tuna
15.
Article in English | WPRIM | ID: wpr-810988

ABSTRACT

OBJECTIVE: To examine time trends in ultrasonography (US)-guided 14-gauge core needle biopsy (CNB) for breast lesions based on the lesion size, Breast Imaging-Reporting and Data System (BI-RADS) category, and pathologic findings.MATERIALS AND METHODS: We retrospectively reviewed consecutive US-guided 14-gauge CNBs performed from January 2005 to December 2016 at our institution. A total of 22,297 breast lesions were included. The total number of biopsies, tumor size (≤ 10 mm to > 40 mm), BI-RADS category (1 to 5), and pathologic findings (benign, high risk, ductal carcinoma in situ [DCIS], invasive cancer) were examined annually, and the malignancy rate was analyzed based on the BI-RADS category.RESULTS: Both the total number of US scans and US-guided CNBs increased while the proportion of US-guided CNBs to the total number of US scans decreased significantly. The number of biopsies classified based on the tumor size, BI-RADS category, and pathologic findings all increased over time, except for BI-RADS categories 1 or 2 and category 3 (odds ratio [OR] = 0.951 per year, 95% confidence interval [CI]: 0.902, 1.002 and odds ratio = 0.979, 95% CI: 0.970, 0.988, respectively). Both the unadjusted and adjusted total malignancy rates and the DCIS rate increased significantly over time. BI-RADS categories 4a, 4b, and 4c showed a significant increasing trend in the total malignancy rate and DCIS rate.CONCLUSION: The malignancy rate in the results of US-guided 14-gauge CNB for breast lesions increased as the total number of biopsies increased from 2005 to 2016. This trend persisted after adjusting for the BI-RADS category.


Subject(s)
Biopsy , Biopsy, Large-Core Needle , Breast Neoplasms , Breast , Carcinoma, Intraductal, Noninfiltrating , Image-Guided Biopsy , Information Systems , Odds Ratio , Retrospective Studies , Ultrasonography
16.
Article in English | WPRIM | ID: wpr-810973

ABSTRACT

BACKGROUND: Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes.METHODS: This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.RESULTS: In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91–1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15–1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women.CONCLUSION: ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.


Subject(s)
Acetaldehyde , Alcohol Drinking , Aldehyde Dehydrogenase , Asian Continental Ancestry Group , Blood Pressure , Cardiovascular Diseases , Cohort Studies , Female , Genotype , Humans , Hypertension , Linear Models , Logistic Models , Male , Odds Ratio , Oxidoreductases , Risk Factors
17.
Article in English | WPRIM | ID: wpr-810968

ABSTRACT

BACKGROUND: This study described and analysed the features of powered mobility device (PMD)-related injuries and compared elderly and younger adult injuries.METHODS: Data from Korea Emergency Department-based Injury In-depth Surveillance (EDIIS) database involving eight emergency departments in 2011–2016 were analysed. The inclusion criteria were injuries sustained during the use of PMDs. The variables were compared between adults aged ≥ 65 years and younger adults. Primary and secondary outcomes were severe trauma and poor clinical course accordingly. The logistic regression analysis was used to identify risk factors for study outcomes.RESULTS: A total of 231 adults were enrolled, of whom 150 were ≥ 65 years of age. The total number of PMD-related injuries and the proportion of elderly injured patients increased annually, and most injuries occurred on the roadway and did not involve crash opponents. By multivariate analysis, patients aged ≥ 65 years had a higher injury severity score (adjusted odds ratio [AOR], 2.78; 95% confidence interval [CI], 1.50–5.40) and had a higher incidence of intensive care unit admissions, surgery, and death (AOR, 2.42; 95% CI, 1.16–5.28).CONCLUSION: Given the higher number and severity of injuries sustained among elderly adults ≥ 65 years of age shown in this study, we recommend that safety educations, such as the use of protective equipment and the safe driving on the roadway, are considered for PMD users ≥ 65 years of age.


Subject(s)
Adult , Aged , Emergencies , Emergency Service, Hospital , Epidemiology , Humans , Incidence , Injury Severity Score , Intensive Care Units , Korea , Logistic Models , Multivariate Analysis , Odds Ratio , Risk Factors , Wheelchairs
18.
Article in English | WPRIM | ID: wpr-810951

ABSTRACT

BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.


Subject(s)
Caregivers , Child , Cross-Sectional Studies , Emergencies , Hospitalization , Humans , Korea , Logistic Models , Lower Extremity , Odds Ratio , Play and Playthings , Risk Factors , Social Control, Formal , Wounds and Injuries
19.
Article in English | WPRIM | ID: wpr-829018

ABSTRACT

Objective@#To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35-74 years.@*Methods@#Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties.@*Results@#A total of 69,332 participants aged 35-74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg ( : 0.185-0.248). The results showed that both Quartile 1 (0.119-0.185 mg/kg) and Quartile 4 (0.249-0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186-0.219 mg/kg (Quartile 2), crude odds ratios ( s) (95% ) were 1.227 (1.003-1.502) and 1.280 (1.048-1.563). The values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted (95% ) of 1.203 (1.018-1.421) relative to the reference group (Quartile 2), the values was 0.030. No significant results were seen for the Quartile 3 group (0.220-0.248 mg/kg) compared to the reference group.@*Conclusion@#Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35-74 years.


Subject(s)
Adult , Aged , China , Epidemiology , Diabetes Mellitus , Epidemiology , Diet , Female , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Risk Factors , Selenium , Metabolism , Soil , Chemistry
20.
Article in English | WPRIM | ID: wpr-762182

ABSTRACT

PURPOSE: Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study. METHODS: We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed. RESULTS: The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77–15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40–40.74). CONCLUSIONS: Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.


Subject(s)
Allergens , Analgesics , Animals , Antipyretics , Asian Continental Ancestry Group , Asthma , Bronchial Hyperreactivity , Cats , Child , Classification , Cohort Studies , Comorbidity , Dermatophagoides pteronyssinus , Disease Management , Humans , Methacholine Chloride , Odds Ratio , Ownership , Parturition , Phenotype , Prevalence , Rhinitis, Allergic , Risk Factors , Skin
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