Atrial fibrillation and obesity

ESC CardioMed ◽  
2018 ◽  
pp. 2232-2235
Author(s):  
Rajiv Mahajan ◽  
Dennis H. Lau ◽  
Prashanthan Sanders
Keyword(s):  
Atrial Fibrillation ◽  
Randomized Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Therapeutic Benefit ◽  
Sleep Apnoea ◽  
Attributable Risk ◽  
Associated Risk Factors ◽  
Epidemiological Link

Obesity is increasingly recognized as a significant risk factor for the burgeoning prevalence of atrial fibrillation (AF). With the growing epidemic of obesity, it is poised to soon have the highest attributable risk of AF. While often associated with co-morbid conditions such as hypertension, diabetes, and sleep apnoea, all known to be associated with AF, there is increasing evidence of a direct pathogenic role of obesity in forming the substrate for AF. Interestingly, a randomized study and observational cohorts have reported that weight loss and treatment of associated risk factors is associated with a reduction in AF symptoms and burden and improved likelihood of maintaining sinus rhythm. This chapter focuses on the epidemiological link between these conditions, the potential mechanisms of this association, and the emerging evidence that treating obesity may have a therapeutic benefit in the management of AF.

Staphylococcus aureus carriage in care homes: identification of risk factors, including the role of dementia

2010 ◽  
Vol 138 (5) ◽  
pp. 686-696 ◽  
Author(s):  
G. LASSETER ◽  
A. CHARLETT ◽  
D. LEWIS ◽  
I. DONALD ◽  
R. HOWELL-JONES ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Care Homes ◽  
Prevalence Survey ◽  
Nasal Swabs ◽  
Agar Media ◽  
Associated Risk Factors

SUMMARYThe aim of this study was to investigate the prevalence and associated risk factors of methicillin-susceptible and methicillin-resistant Staphylocccus aureus (MSSA and MRSA) carriage in care homes, with particular focus on dementia. A point-prevalence survey of 748 residents in 51 care homes in Gloucestershire and Greater Bristol was undertaken. Dementia was assessed by the clock test or abbreviated mini-mental test. Nasal swabs were cultured for S. aureus on selective agar media. Multivariable analysis indicated that dementia was not a significant risk factor for MSSA (16·2%) or MRSA (7·8%); and that residents able to move around the home unassisted were at a lower risk of MRSA (P=0·04). MSSA carriage increased with increasing age (P=0·03) but MRSA carriage decreased with increasing age (P=0·05). Hospitalization in the last 6 months increased the risk of MSSA (P=0·04) and MRSA (P=0·10). We concluded that cross-infection through staff caring for more dependent residents may spread MRSA within care homes and from the recently hospitalized. Control of MSSA and MRSA in care homes requires focused infection control interventions.

scholarly journals The Relationship Between Bullying Victimization and Perpetration and Non-suicidal Self-injury: A Systematic Review

2021 ◽  
Author(s):  
Gianluca Serafini ◽  
Andrea Aguglia ◽  
Andrea Amerio ◽  
Giovanna Canepa ◽  
Giulia Adavastro ◽  
...  
Keyword(s):  
Peer Victimization ◽  
Significant Risk ◽  
Positive Association ◽  
Significant Risk Factor ◽  
Future Research ◽  
Bullying Victimization ◽  
Self Injury ◽  
Long Run ◽  
Bully Victims

AbstractExperience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI). This study had three aims: to systematically investigate the association between bullying and NSSI, analyze the possible mechanisms underlying the two phenomena, and evaluate any differences between bullying victimization and bullying perpetration with respect to NSSI. A systematic search about the association between bullying victimization and perpetration and NSSI was conducted using specific databases (PubMed, Scopus, Science Direct). The following keywords were used in all database searches: "bullying" AND "NSSI" OR "peer victimization" and NSSI. The searches in PubMed, Scopus and Science Direct revealed a total of 88 articles about bullying or peer victimization and NSSI. However, only 29 met our inclusion criteria and were used for the present review. Overall, all studies examined victimization; four studies also evaluated the effects of perpetration and one included bully-victims. According to the main findings, both being a victim of bullying and perpetrating bullying may increase the risk of adverse psychological outcomes in terms of NSSI and suicidality in the short and the long run. To the best of our knowledge, this is the first review to systematically evaluate the relation between bullying victimization/perpetration and NSSI. The main results support a positive association. Future research should evaluate the possible role of specific mediators/moderators of the association between experience of bullying and NSSI.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents

2018 ◽  
Vol 41 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Frédéric Rafflenbeul ◽  
Catherine-Isabelle Gros ◽  
François Lefebvre ◽  
Sophie Bahi-Gross ◽  
Raphaëlle Maizeray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Root Resorption ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Data Sets ◽  
Maxillary Canine ◽  
3D Data ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.

Blood Products: A Significant Risk Factor for Long-Term Catheter-Related Bloodstream Infections in Cancer Patients

2001 ◽  
Vol 22 (03) ◽  
pp. 165-166 ◽  
Author(s):  
Hend A. Hanna ◽  
Issam Raad
Keyword(s):  
Risk Factor ◽  
Cancer Patients ◽  
Randomized Study ◽  
Significant Risk ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Significant Risk Factor ◽  
Recent Analysis ◽  
Blood Products ◽  
Central Venous

Abstract Data obtained from a previous prospective randomized study in cancer patients conducted at our institution were analyzed to investigate risk factors for catheter-related (CR) bloodstream infections (BSIs). Our recent analysis showed that the administration of blood products through central venous catheters was a risk factor for CR BSI, whereas thrombocytopenia during catheterization may have provided protection against CR BSI, as did central venous catheter insertion under maximal sterile barrier precautions.

Abstract 17312: Hand1 Impairs Angiogenesis in Heart and Placenta

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Jennifer A Courtney ◽  
Helen N Jones
Keyword(s):  
Histological Analysis ◽  
Heart Defects ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Placental Development ◽  
Hypoplastic Left Heart ◽  
Septal Defects ◽  
And Function ◽  
Left Heart Syndrome

Introduction: Congenital heart defects affect approximately 1% of live births, often requiring complex surgeries at birth. The most significant risk factor for surgery survival is birthweight. Proper placental development and function is vital for normal fetal growth. We have previously demonstrated abnormal placental development and vascularization in human CHD placentas. Hand1 has roles in heart and placental development and has been implicated in multiple types of CHD including double right outlet, hypoplastic left heart syndrome, and septal defects. We utilized the Hand1 A126fs/+ mouse to investigate the role of Hand1 in placentation and vascularization. Methods: Hand1 A126fs/+ female mice were time-mated with Nkx2.5cre or Cdh5cre males. Feto-placental units were harvested at E10.5 and E12.5 for histological analysis, vascular assessment by IHC for CD-31, and RNA expression by qPCR. Results: Nkx2.5cre/Hand1 a126fs/+ fetuses demonstrated embryonic lethality by E10.5 due to lack of placental labyrinth formation and vascularization (Figure 1). In contrast, ablation of Hand1 in vascular endothelium (Cdh5cre) did not disrupt placental labyrinth or heart at E12.5. Expression of VegFb, Ang1, Ang2, Flt1, Flk was reduced in Hand1 A126fs/+ ; Nkx2.5cre placentas compared to control littermates, but VegFa expression was increased. Conclusion: Our data demonstrate that Hand1 expression in placental trophoblast, but not endothelium, is necessary for vascularization of the labyrinth and may disrupt multiple angiogenic factors known to be expressed in trophoblast. Alterations in Hand1 may represent a mechanism for abnormal placentation in cases of CHD. Figure 1. H/E (A-C) and CD31 (D-F) images of Hand1 +/+ (A, D), Hand1 A126fs/+ ; Nkx2.5cre (B, E), and Hand1 A126fs/+ ; Cdh5cre (C, F) placentas at day E12.5. Hand1A 126fs/+ ; Nkx2.5cre placentas fail to form labyrinth and fetal vasculature, while Hand1 A126fs/+ ; Cdh5cre placentas develop normally at this timepoint.

scholarly journals The Critical Role of Biliary Candidiasis in Development of Surgical Site Infections after Pancreatoduodenectomy: Results of Prospective Study Using a Selective Culture Medium for Candida Species

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hiroyuki Kato ◽  
Yusuke Iizawa ◽  
Kei Nakamura ◽  
Kazuyuki Gyoten ◽  
Aoi Hayasaki ◽  
...  
Keyword(s):  
Risk Factor ◽  
Candida Species ◽  
Critical Role ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Preoperative Assessment ◽  
Significant Risk Factor ◽  
High Level ◽  
New Evidence

In accordance with previous reports, the incidence of biliary candidiasis (BC) after pancreaticoduodenectomy (PD) was reported to be 0 to 5%, and the clinical significance of BC still has been elusive. In this study, we prospectively evaluated the precise incidence of BC after PD using the CHROMagar Candida plate in an attempt to elucidate whether BC has a significant impact on the clinical outcomes after PD.Patients and Method. From November 2014 to March 2016, the consecutive 51 patients who underwent PD were enrolled for this study. The bile juice was prospectively collected through the biliary stent tube on postoperative days (POD) 3, 7, and 14 and directly incubated onto the CHROMagar Candida plate for the cultivation of various Candida species. In the presence or absence of BC, we compared the incidence of SSIs.Results. The incidence of postoperative BC was 15% on POD 3, 24% on POD 7, and 39% on POD 14, respectively. Taken together, 22 patients out of 51 (43.1%) developed BC after PD. Moreover, the incidence of SSIs was significantly higher in patients with BC than in those without it (71% versus 7%, p=0.005). BC was selected as the only significant risk factor of SSIs after PD among the various risk factors. Even though a cause of BC is unknown, high level of alkaline phosphatase (cut-off line >300 IU/L) was selected as the only preoperative risk factor of the development of BC.Conclusion. We elucidated new evidence in which BC could be the independent cause of SSIs after PD and should not be recognized as just contamination artifacts. Preoperative assessment for identifying carriers of Candida species might be essential for reducing the incidence of SSIs after PD.

scholarly journals Obstructive sleep apnoea and polymorphisms: implications for anaesthesia care

2020 ◽  
pp. S14-S18
Author(s):  
CJ Coté
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Active Compound ◽  
Standard Dose ◽  
Significant Risk ◽  
Drug Efficacy ◽  
Significant Risk Factor ◽  
Sleep Apnoea ◽  
Blood Levels ◽  
Markers Of Inflammation ◽  
Obstructive Sleep

With a worldwide obesity pandemic, the incidence of obstructive sleep apnoea (OSA) is increasing; obesity is the most significant risk factor in children. Increasing evidence suggests that OSA is in part mediated through markers of inflammation. Systemic and pulmonary hypertension, right ventricular hypertrophy, prediabetes, and other conditions are common. Adenotonsillectomy improves only ~70% of children; 30% require other interventions, e.g. weight loss programs. The gold standard for diagnosis is a sleep-polysomnogram which are expensive and not readily available. The McGill oximetry score (saw-tooth desaturations during obstruction and arousal) is more cost-effective. Repeated episodes of desaturation alter the opioid receptors such that analgesia is achieved at much lower levels of opioid than in patients undergoing the same procedure but without OSA. This response is of great concern because a standard dose of opioids may be a relative overdose. Polymorphism variations in cytochrome CYP2D6 have major effects upon drug efficacy and side effects. Codeine, hydrocodone, oxycodone, and tramadol are all prodrugs that require CYP2D6 for conversion to the active compound. CYP2D6 is quite variable and patients can be divided into 4 classes: For codeine for example, poor metaboliser (PM) have virtually no conversion to morphine, intermediate metabolisers (IM) have some conversion to morphine, extensive metabolisers (EM) have a normal rate of conversion to morphine, and ultra-rapid metabolisers (RM) convert excessive amounts of codeine to morphine. Such variations result in some patients achieving no analgesia because there is reduced conversion to the active moiety whereas others convert an excessive amount of drug to the active compound thus resulting in relative or actual overdose despite appropriate dosing. Thus, OSA patients may have both opioid sensitivity due to recurrent desaturations and altered drug metabolism resulting in higher than intended blood levels of opioid. OSA patients should only receive one-third to half the usual dose of opioid. In those under the age of six, an effort should be made to avoid opioids altogether and use opioid sparing techniques such as alternating acetaminophen and ibuprofen.

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