Determinant factors

决定因素
  • 文章类型: Journal Article
    背景:在低资源环境中,妊娠相关的肾损伤导致急性肾损伤的高负担,并导致孕产妇和围产期的发病率和死亡率。很少有研究在资源有限的国家检查急性肾损伤的影响。对埃塞俄比亚妊娠特异性疾病的研究非常有限。本研究旨在确定妊娠相关急性肾损伤的特点,结果和相关因素。
    方法:在提格雷的艾德综合专科医院进行了一项回顾性研究,以评估妊娠相关急性肾损伤的临床特征和母胎结局。埃塞俄比亚,从2017年1月1日至2021年12月31日。使用描述性统计学方法分析产妇和胎儿的结局。多变量逻辑回归用于确定因变量和自变量之间的关联。
    结果:在2017年1月1日至2021年12月31日期间在艾德综合专科医院分娩的27,350名母亲中,共有187名妇女发生了与妊娠相关的急性肾损伤,患病率为每100,000名新生儿68名。先兆子痫,在本研究中,脓毒症和因脱水和出血引起的肾前原因是妊娠相关急性肾损伤的最常见原因.8.6%(n=16)的患者需要血液透析。在187例妊娠相关急性肾损伤中,143(76.5%)完全恢复,30(16%)部分恢复。死亡率为7.5%。先前存在的慢性肾脏疾病(AOR=30.13;95%CI:2.92,310.84),使用血管活性药物(AOR=5.77;95%CI:1.47,22.67),单位肌酐升高(AOR=1.65;95%CI:1.11,2.45)和与急性肾损伤相关的并发症(AOR=5.26;95%CI:1.73,16.00)是复合终点(部分肾恢复和死亡)的决定因素.
    结论:本研究强调资源有限环境下的急性肾损伤是孕产妇和胎儿发病和死亡的重要原因。绝大多数妊娠相关急性肾损伤患者从肾损伤中完全恢复。妊娠相关急性肾损伤的主要原因为子痫前期,脓毒症和肾前出血和脱水相关。先前存在的肾脏疾病,使用血管升压药,单位肌酐的增加和与急性肾损伤相关的并发症是伴随胎儿死亡的决定因素.对于妊娠相关的急性肾损伤,需要在产前护理和及时治疗期间采取适当的预防策略。
    BACKGROUND: Pregnancy-related kidney injury contributes to a high burden of acute kidney injury in low-resource settings and causes maternal and perinatal morbidity and mortality. Few studies have examined the impact of acute kidney injury in resource-limited countries, with very limited research on pregnancy-specific disorders in Ethiopia. This study aimed to determine the characteristics of pregnancy-related acute kidney injury, outcomes and associated factors.
    METHODS: A retrospective study was conducted to evaluate the clinical profile and maternal-fetal outcome of pregnancy-related acute kidney injury at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Maternal and fetal outcomes were analyzed using descriptive statistics. Multivariate logistic regression was used to determine the association between the dependent and independent variables.
    RESULTS: Of 27,350 mothers who delivered at Ayder Comprehensive Specialized Hospital between January 1, 2017, and December 31, 2021, a total of 187 women developed pregnancy-related acute kidney injury, a prevalence rate of 68 per 100,000 births. Preeclampsia, sepsis and pre-renal causes due to dehydration and hemorrhage were the most common causes of pregnancy-related acute kidney injury in this study. Hemodialysis was needed in 8.6% (n = 16) of patients. Of the 187 pregnancy-related acute kidney injuries, 143 (76.5%) recovered completely and 30 (16%) partially. The mortality rate was 7.5%. Preexisting chronic kidney disease (AOR = 30.13; 95% CI: 2.92, 310.84), use of vasoactive agents (AOR = 5.77; 95% CI: 1.47, 22.67), increase in creatinine per unit (AOR = 1.65; 95% CI: 1.11, 2.45) and complications related to acute kidney injury (AOR = 5.26; 95% CI: 1.73, 16.00) were determinants of the composite endpoints (partial renal recovery and death).
    CONCLUSIONS: This study emphasizes acute kidney injury in resource-limited settings is a significant cause of maternal and fetal morbidity and mortality. The vast majority of patients with pregnancy-related acute kidney injury recovered completely from kidney injury. The main causes of pregnancy-related acute kidney injury were preeclampsia, sepsis and pre-renal associated with hemorrhage and dehydration. Preexisting renal disease, use of vasopressors, increase in creatinine per unit and complications associated with acute kidney injury were determining factors for concomitant fetomaternal mortality. Appropriate preventive strategies during prenatal care and prompt treatment are needed for pregnancy-related acute kidney injury.
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  • 文章类型: Journal Article
    食品处理人员的食品处理实践会对食品的卫生状况产生重大影响。这项研究的目的是确定埃塞俄比亚食品处理人员中与卫生食品处理实践相关的患病率和因素。
    PubMed,科学直接,谷歌学者,和Cochrane图书馆数据库被用来查找文章。仅考虑符合纳入标准的横断面研究。采用STATA第16版统计软件进行Meta分析。使用CochraneQ检验统计量和I2检验确定研究的异质性。使用随机效应模型来计算卫生食品处理实践的汇总患病率。
    为了估计埃塞俄比亚卫生食品处理实践的总体流行程度,纳入了33项综述研究中的9项。在这项研究中,卫生食品处理实践的患病率为48.36%(95%CI:39.74-56.99)。与卫生食品处理实践相关的因素包括;缺乏食品安全培训(OR=5.38;95%CI:1.71,16.89),消极态度(OR=3.28;95%CI:1.50,7.13),无法使用洗手设施(OR=4.84;95%CI:1.72,13.65),缺乏定期体检(OR=5.37;95%CI:3.13,9.23),和缺乏中等教育(OR=2.51;95%CI:1.46,4.32)。
    在这项研究中,埃塞俄比亚食品处理人员中卫生食品处理习惯的流行率极低.不卫生的食品处理做法归因于缺乏食品安全培训,定期体检,洗手设施,对食品卫生实践的不利态度,缺乏正规教育。因此,食品经营者应接受持续的食品安全和卫生培训。
    UNASSIGNED: The food handling practices of food handlers can have a significant impact on the hygienic status of the food. The aim of this study was to determine the prevalence and factors associated with hygienic food handling practices among food handlers in Ethiopia.
    UNASSIGNED: PubMed, Science Direct, Google Scholar, and the Cochrane Library databases were used to find articles. Only cross-sectional studies that met the criteria for inclusion were considered. STATA version 16 statistical software was used to perform the meta-analysis. The study\'s heterogeneity was determined using Cochrane Q test statistics and the I 2 test. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices.
    UNASSIGNED: To estimate the pooled prevalence of hygienic food handling practices in Ethiopia, 9 out of 33 reviewed studies were included. The prevalence of hygienic food handling practices was found to be 48.36% (95% CI: 39.74-56.99) in this study. Factors associated with hygienic food handling practices included; lack of food safety training (OR = 5.38; 95% CI: 1.71, 16.89), negative attitude (OR = 3.28; 95% CI: 1.50, 7.13), lack of access to handwashing facilities (OR = 4.84; 95% CI: 1.72, 13.65), lack of regular medical checkup (OR = 5.37; 95% CI: 3.13, 9.23), and lack of secondary education (OR = 2.51; 95% CI: 1.46, 4.32) among food handlers.
    UNASSIGNED: In this study, the prevalence of hygienic food handling practices among Ethiopian food handlers was significantly low. Unhygienic food handling practices were attributed to a lack of food safety training, regular medical checkups, handwashing facilities, an unfavorable attitude toward food hygiene practices, and a lack of formal education. As a result, food handlers should receive ongoing food safety and hygiene training.
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  • 文章类型: Journal Article
    Adolescent-parent sexual communication is an effective strategy to make healthy decisions, delay and protect from risky behavior. Thus, this systematic review and meta-analysis aimed to synthesize and estimate the level of adolescent- parent communication on sexual and reproductive health issues in Ethiopia.
    UNASSIGNED: Cross-sectional studies were systematically searched using databases such as PubMed, Google Scholar, Cochrane Library and gray literature. Information was extracted using a standardized form of JBI. Data were analyzed using the \'meta\' packages of the Stata software (version 11.0). I-squared statistic was applied to check the heterogeneity of studies. Funnel plot and Egger\'s test were used to check for publication bias. P-value <0.05 on the Egger test was considered indicative of statistically significant publication bias.
    UNASSIGNED: A total of 359 articles were identified, of which 19 were eligible for meta-analysis. Adolescent-parent communications on SRH issues were significantly reported within the range of 25.3% to 36.9% and more preferred to discuss with their friends. The overall pooled level of adolescent parent communication was 40.70 (95%CI: 34.26-47.15). Adolescents who lived in urban areas, having good knowledge of SRH issues, adolescents who agreed on the importance of discussion and adolescents who ever had sexual intercourse were more likely to discuss SRH issues with their parents.
    UNASSIGNED: The overall pooled level of adolescent-parent communication was 40.70%, and also adolescent-parent communications were dominantly reported with the ranges of 25.3% to 36.9%. Being urban dweller, being knowledgeable, and being agreed on the importance of discussion were significantly associated with adolescent-parent communication. Cultural taboo, shame and lack of communication skills were reasons that hindered communication between parents and adolescents. Therefore, program implementers should work to increase adolescent-parent communication.
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  • 文章类型: Journal Article
    The total fertility rate (TFR) in the Middle East and North Africa has experienced a declining trend in recent years. Accordingly, the present study was conducted to provide a clear picture of the most critical factors affecting the TFR decline in this region.
    This study was a systematic review between the years 2000 and 2016. The different databases like Cochrane, PubMed, Scopus, and Science Direct and the Google Scholar search engine were used. At first, 270 articles and then 18 articles were selected and meticulously read for the final analysis.
    The results indicated a declining trend in the TFR in the Middle East and North Africa, as in other parts of the world. Regarding the causes of this declining trend, several factors were identified and categorized into five main factors of health care-related, cultural, economic, social, and political.
    While taking advantage of the experiences, it is necessary to identify the five main factors and their related issues and hence consider them in the population policy-making.
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  • 文章类型: Journal Article
    UNASSIGNED: The epidemiology of neural tube defect (NTD) is face ignorance from the global community. However, the problem is complex and it is a cause for child mortality and morbidity. We provide the latest insights with respect to determinant factors of NTD.
    UNASSIGNED: Google Scholar and PubMed were systematically searched to identify potential research articles concerning the epidemiology and its determinant factors of NTD.
    UNASSIGNED: The epidemiology of Neural tube defects increased in some countries. The epidemiology and determinant factors were varies across countries,geographical regions and socioeconomic status of the populations. In general, the determinant factors of NTD were summarized as behavioral, nutrition-related, environmental, medical illness, and health service-related factors.
    UNASSIGNED: Birth defect is fatal which affects the new generation; specifically, NTD is the problem of middle- and low-income countries. It is a direct cause for neonatal and perinatal mortality rate globally. Even if little factors identified, yet conducting experimental and clinical trial researches are a better approach to slow down the progress.
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  • 文章类型: Journal Article
    目的:确定胰高血糖素样肽-1受体激动剂(GLP-1A)和二肽基肽酶-4抑制剂(DPP-4I)的疗效决定因素。
    方法:MEDLINE和EMBASE在2011年01月01日至2014年15月08日之间进行了为期12-52周的随机对照试验,报告了糖化血红蛋白(HbA1c)从基线的变化作为主要终点,并报告了有关肠促胰岛素疗效预测因子的数据。
    结果:在4172项研究中发现,77项研究报告了基线HbA1c的数据,年龄,性别,种族,体重指数(BMI),和糖尿病病史与HbA1c变化的关系。对于DPP-4I,47项研究中有37项报告了基线HbA1c较高的患者中HbA1c的下降幅度更大。大多数DPP-4I研究报告在人口统计学特征或BMI方面没有疗效差异。在报告GLP-1A的17项研究中,在9项研究中,有7项研究报告了基线较高的HbA1c预测了更大的反应;13项研究报告了其他因素的数据,没有一致的发现。
    结论:目前的证据表明,较高的基线HbA1c与DPP-4I和GLP-1A疗法在降低HbA1c方面具有更大的疗效相关。其他潜在预测因子的作用在研究中不太一致,需要进一步调查。
    OBJECTIVE: To identify the determinants of efficacy of glucagon-like peptide-1 receptor agonists (GLP-1A) and dipeptidyl peptidase-4 inhibitors (DPP-4I).
    METHODS: MEDLINE and EMBASE were searched between 01/01/2011 and 15/08/2014 for randomized controlled trials of 12-52weeks\' duration, which reported the change in glycated hemoglobin (HbA1c) from baseline as the primary end point, and reported data about predictors of efficacy of incretins.
    RESULTS: Among 4172 studies found, 77 studies reported data on baseline HbA1c, age, sex, ethnicity, body mass index (BMI), and history of diabetes in relation to change in HbA1c. For DPP-4I, 37 out of 47 studies reported a greater decrease in HbA1c among patients with higher baseline HbA1c. Most DPP-4I studies reported no variation in efficacy in regard to demographic characteristics or BMI. Among 17 studies reporting on GLP-1A, baseline higher HbA1c was reported as predictive of a greater response in 7 out of 9 studies; 13 studies reported data about other factors, without consistent findings.
    CONCLUSIONS: Current evidence suggests that higher baseline HbA1c is associated with a greater efficacy of both DPP-4I and GLP-1A therapies in lowering HbA1c. The roles of other potential predictors are less consistent across studies and require further investigation.
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