Browsing by Subject "Health Status"
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Item Assessing Water Fluoride Levels in Rural Rajasthan, India(2014-02-04) Mehta, Kajal; Sreeramoju, PranaviINTRODUCTION: Skeletal and dental fluorosis are crippling diseases associated with consumption of water with excess fluoride. The diseases manifest with symptoms such as severe staining, pitting, enamel damage and cracking of teeth in dental fluorosis to stiffness, joint pain, crippling, kyphosis, invalidism, and GI complications in skeletal fluorosis. Fluorosis is an endemic public health issue in many developing regions around the world, including areas of India. A study conducted in Rajasthan, India shows the prevalence of dental fluorosis to be 70.6-100% in village children and 68-100% in village adults. Prevalence of skeletal fluorosis was 5.2% among children and ranged from 7.4% to 37.7% in adults. The present study hopes to address the underlying problem of fluorosis in Rajasthan, India by analyzing water quality in the region. METHODS: This study is a retrospective observational study based on water data collected over a ten month period by the Jal Bhagirathi Foundation (JBF) in Jodhpur, India for a European Union funded water monitoring project. The water data are from the nearby Jalore, Barmer and Jaisalmer Districts, with water samples from all drinking water sources including handpumps, deep bore wells, tube wells, government run pipelines, ponds, lakes, and reverse osmosis water purification systems. The water samples were collected by trained JBF staff in sterile 1L containers, and the water quality testing was carried out by the on-site chemistry lab manager. Fluoride levels were tested within 24 hours of water sampling using a benchtop multiparameter meter and a fluoride electrode in 100 mL water. Additional tests for color, odor, turbidity, pH, alkalinity, total dissolved solutes, and presence of fecal bacteria were performed on each sample. RESULTS/OUTCOMES: The data were analyzed for frequency of fluoride levels above the recommended level of 1 parts per million (ppm). Of the water samples tested for fluoride concentration, 57 of 156 samples (36.5%) showed concentrations above 1ppm. The mean fluoride concentration of all tested water samples was .81ppm, with a standard deviation of .73ppm. CONCLUSION: The results demonstrate over one-third of the sampled drinking water is potentially toxic to the health of its consumers. This incidence is particularly alarming in the arid conditions of Rajasthan where rural inhabitants have limited water resources, leading them to rely heavily on these harmful supplies. These results provide an impetus to approach the problem by increasing community education of unsafe drinking water sources and methods of purification, including home systems and community-wide solutions like reserve osmosis plants.Item Characterizing Morphea Subsets Using a Multi-Center, Prospective, Cross-Sectional Analysis of Morphea in Adults and Children(2020-05-01T05:00:00.000Z) Prasad, Smriti; Jacobe, Heidi; Haley, Robert; Chong, Benjamin F.BACKGROUND: There are few prospective studies in morphea. Most that exist focus exclusively on adults or children, or are insufficiently powered. Others are retrospective, which have limitations in understanding subsets. As a result, there is limited understanding of the demographic and clinical features of morphea, particularly of the less frequent subtypes. There is also little known about the differences between adults and children. OBJECTIVE: To determine the clinical and demographic features of the inception cohort of two prospectively-collected datasets and to determine novel latent disease phenotypes among this cohort. METHODS: This is a cross sectional analysis of initial visits of the Morphea in Adults and Children (MAC) and the National Registry of Childhood-Onset Scleroderma (NRCOS) cohorts, two prospectively collected databases that collect demographic, physical exam and clinical data. We performed traditional univariate analyses as well as multivariate analyses, include a principal component analysis (PCA) of certain variables. RESULTS: Of the total 944 participants, 500 (53%) had pediatric onset morphea, and 444 (47%) had adult onset morphea. Whites (76%) and females (78%) comprised the majority of participants. The median age at onset was 16 years overall. Five factors were extracted from the PCA based on the inflection point in the scree plot (CF1-5). CF2 described a clustering of patients with depression and high comorbidities of headaches, joint pain, muscle pain, and fatigue. Based on this, we did a post-hoc analysis on the quality of life measures collected in adults, which was derived from the SKINDEX 29+3. CONCLUSION: We've described the clinical and demographic features in the largest cohort of morphea patients to date. Here we describe subsets of patients that have been previously described, such as a group of patients with depression and somatic symptoms.Item [News](1984-04-30) Williams, AnnItem [News](1984-08-30) Weeter, DeborahItem [News](1983-04-20) Floyd, CarolItem [News](1984-02-17) Rutherford, SusanItem [UT News](1985-08-28) Harrell, AnnItem Weightbearing and Activity Restriction Treatments and Quality of Life in Patients with Perthes Disease(2021-05-01T05:00:00.000Z) Do, Dang-Huy; Kim, Harry K. W.; Huo, Michael; Wells, JoelBACKGROUND: Weightbearing and activity restrictions are commonly prescribed during the active stages of Perthes disease. These restrictions, ranging from cast or brace treatment with nonweightbearing to full weightbearing with activity restrictions, may have a substantial influence on the physical, mental, and social health of a child. However, their impact on the patient's quality of life is not well-described. OBJECTIVES: After controlling for confounding variables, are restrictions on weightbearing and activity associated with physical health measures (as expressed by the Patient-Reported Outcome Measurement Information System [PROMIS] mobility, PROMIS pain interference, and PROMIS fatigue), mental health measures (PROMIS depressive symptoms and PROMIS anxiety), and social health measures (PROMIS peer relationships)? METHODS: Between 2013 and 2020, 211 patients with Perthes disease at a single institution were assigned six PROMIS measures to assess physical, mental, and social health. Patients who met the following eligibility criteria were analyzed: age 8 to 14 years old, completion of six PROMIS measures, English-speaking, and active stage of Perthes disease (Waldenstrom Stage I, II, or III). Weightbearing and activity restrictions were clinically recommended to patients in the initial through early reossification stages of Perthes disease when patients had increasing pain, loss of hip motion, loss of hip containment, progression of femoral head deformity, increased hip synovitis, and femoral head involvement on magnetic resonance imaging (MRI), or as a postoperative regimen. Patients were categorized into four intervention groups based on weightbearing and activity regimen. We excluded 111 patients who did not meet the inclusion criteria. The following six pediatric self-report PROMIS measures were assessed: mobility, pain interference, fatigue, depressive symptoms, anxiety, and peer relationships. Analysis of variance (ANOVA) was used to compare differences between the mean PROMIS T-scores of these weightbearing/activity regimens. Results were assessed with a significance of p < 0.05 and adjusted for Waldenstrom stage, gender, age of diagnosis, and history of major surgery using multivariate regression analysis. RESULTS: After controlling for confounding variables, the mild- (β regression coefficient -15 [95% CI -19 to -10]; p < 0.001), moderate- (β -19 [95% CI -24 to -14]; p < 0.001), and severe- (β -25 [95% CI -30 to -19]; p < 0.001) restriction groups were associated with worse mobility T-scores compared with the no-restriction group, but no association was detected for the pain interference or fatigue measures. Weightbearing and activity restrictions were not associated with mental health measures (depressive symptoms and anxiety). Weightbearing and activity restrictions were not associated with social health measures (peer relationships). Earlier Waldenstrom stage was associated with worse pain interference (β 10 [95% CI 2 to 17]; p = 0.01) and peer relationships scores (β -8 [95% CI -15 to -1]; p = 0.03); female gender was linked with worse depressive symptoms (β 7 [95% CI 2 to 12]; p = 0.005) and peer relationships scores (β -6 [95% CI -12 to 0]; p = 0.04); and earlier age at diagnosis was associated with worse peer relationships scores (β 1 [95% CI 0 to 2]; p = 0.03). History of major surgery had no connection to any of the six PROMIS measures. CONCLUSION: We found that weightbearing and activity restriction treatments are associated with poorer patient-reported mobility in the active stages of Perthes disease after controlling for confounding variables, but not pain interference, fatigue, depressive symptoms, anxiety, or peer relationships. Understanding how these treatments are associated with Perthes disease patients' quality of life can aid in decision-making for providers, help set expectations for patients and their parents, and provide opportunities for better education and preparation. Because of the chronic nature of Perthes disease, future studies may focus on longitudinal trends in patient-reported outcomes to better understand the overall impact of this disease and its treatment.