scholarly journals Lymphopenic community acquired pneumonia, an unnoticed phenotype associated to mortality in non immuno-suppressed patients: a retrospective cohort study

2017 ◽  
Author(s):  
Jesus F Bermejo-Martin ◽  
Catia Cilloniz ◽  
Raul Mendez ◽  
Raquel Almansa ◽  
Albert Gabarrus ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Fold Increase ◽  
Multivariate Regression Analysis ◽  
Community Acquired Pneumonia ◽  
Post Discharge ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Immunological Phenotype ◽  
Hospital Clinic

AbstractBackgroundThe role of neutrophil and lymphocyte counts as predictors of prognosis in Community Acquired Pneumonia (CAP) has not been appropriately studied.MethodsThis was a retrospective study to evaluate by multivariate regression analysis, the association between neutrophil and lymphocyte counts with mortality at 30-days post discharge in two large cohorts of hospitalized patients with CAP and no prior immunosupression: a multicentric with 1550 patients recruited at 14 hospitals in Spain and a unicentric with 2840 patients recruited at the Hospital Clinic-Barcelona.FindingsThe unicentric cohort accounted with a higher proportion of critically ill patients: 586 (20·6%) vs 131 (8·5%) and non survivors 245 (8·6%) vs 74 (4·8%). Lymphopenia (< 1000 lymphocytes/mm3) was present in the 52·8% of the patients in both cohorts. A sub-group of lymphopenic patients, those with lymphocyte counts below decil 3 (677 lymphocytes/mm3 in the multicentric cohort and 651 lymphocytes/mm3 in the unicentric one), showed > 2-fold increase in the risk of mortality, independently of the CURB-65 score, critical illness and receiving an appropriated antibiotic treatment: (OR [CI95%], p) (2·18 [1·21- 3·92], 0·009) and (2·33 [1·61-3·33], <0·001) respectively. Neutrophil counts were not associated with mortality risk.InterpretationLymphopenia is present in a half of the patients with CAP needing of hospitalization, in absence of antecendents of immunosupression. Lymphopenic CAP with lymphocyte counts < 664 lymphocytes/mm3 constitutes a particular immunological phenotype of the disease which is associated to an increased risk of mortality.FundingCibeRes, 2009 Support to Research Groups of Catalonia 911, IDIBAPS, SEPAR, SVN

Relation of Fatigue with Alexithymia and Depression in Psychiatric Outpatients

2007 ◽  
Vol 105 (2) ◽  
pp. 539-545
Author(s):  
Thomas N. Wise ◽  
Michael J. Sheridan
Keyword(s):  
Primary Care ◽  
Regression Analysis ◽  
Psychosocial Stress ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Psychiatric Outpatients ◽  
The Mean

The complaint of fatigue is common in community, primary care, and psychiatric settings. Fatigue is often associated with depression and psychosocial stress. This report investigated the role of alexithymia and depression in fatigue as reported in a sample of 151 psychiatric outpatients (75 men and 76 women) who completed all scales. The mean age of the sample was 45.5 yr. ( SD = 12.5), and mean education was 16.2 yr. ( SD = 2.4). Fatigue was inversely correlated with education (–.16) and positively correlated with depression (.44), anxiety (.30), and alexithymia (.35). However, in a multivariate regression analysis, only depression and alexithymia remained significant ( p ≤ .01).

scholarly journals Supper Timing and Cardiovascular Mortality: The Japan Collaborative Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3389
Author(s):  
Jingyun Tang ◽  
Jia-Yi Dong ◽  
Ehab S. Eshak ◽  
Renzhe Cui ◽  
Kokoro Shirai ◽  
...  
Keyword(s):  
Hemorrhagic Stroke ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Stroke Mortality ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Study Participants

Evidence on the role of supper timing in the development of cardiovascular disease (CVD) is limited. In this study, we examined the associations between supper timing and risks of mortality from stroke, coronary heart disease (CHD), and total CVD. A total of 28,625 males and 43,213 females, aged 40 to 79 years, free from CVD and cancers at baseline were involved in this study. Participants were divided into three groups: the early supper group (before 8:00 p.m.), the irregular supper group (time irregular), and the late supper group (after 8:00 p.m.). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for stroke, CHD, and total CVD according to the supper time groups. During the 19-year follow-up, we identified 4706 deaths from total CVD. Compared with the early supper group, the multivariable HR of hemorrhagic stroke mortality for the irregular supper group was 1.44 (95% confidence interval [CI]: 1.05–1.97). There was no significant association between supper timing and the risk of mortality from other types of stroke, CHD, and CVD. We found that adopting an irregular supper timing compared with having dinner before 8:00 p.m. was associated with an increased risk of hemorrhagic stroke mortality.

scholarly journals Thyroid hormones modulate irisin concentrations in patients with recently onset hypothyroidism following total thyroidectomy

2020 ◽  
Author(s):  
R. Bocale ◽  
A. Barini ◽  
A. D‘Amore ◽  
M. Boscherin ◽  
S. Necozione ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Hormones ◽  
Total Thyroidectomy ◽  
Replacement Therapy ◽  
Thyroid Function ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Levothyroxine Replacement ◽  
Circulating Levels

Abstract Purpose Irisin is a newly discovered adipo-myokine known for having significant effects on body metabolism. Currently, there is a discussion regarding the relation between thyroid function and irisin concentration. This study was designed to evaluate the influential role of levothyroxine replacement therapy on circulating levels of irisin in patients with recently onset hypothyroidism following total thyroidectomy. Methods Circulating levels of thyroid hormones, irisin and other metabolic parameters, were assessed in 40 recently thyroidectomized patients (34 females, mean age 50.1 ± 15.2 years) at baseline (5–7 day after surgery) and after 2 months under replacement therapy with levothyroxine. Results At baseline, circulating levels of thyroid hormones were indicative of hypothyroidism (TSH 12.7 ± 5.0 μU/mL, FT3 1.9 ± 0.7 pg/mL, FT4 8.7 ± 3.6 pg/mL). Mean serum irisin concentrations significantly increased after 2 months under replacement therapy with levothyroxine (from 2.2 ± 0.6 to 2.9 ± 0.6 μg/mL, p < 0.0001). Variations of circulating levels of irisin under levothyroxine replacement therapy were directly correlated with those of FT3 (Rho = 0.454, p = 0.0033) and FT4 (Rho = 0.451, p = 0.0035). Multivariate regression analysis revealed that changes in thyroid hormones concentrations explained up to 10% of the variations of serum irisin levels under levothyroxine replacement therapy (FT3 R2 = 0.098, FT4 R2 = 0.103). Conclusion Our study suggests that levothyroxine replacement therapy mildly influences irisin metabolism in patients with recently onset hypothyroidism following total thyroidectomy.

scholarly journals Relation of Perceived Stigma to Adverse Events of Medications in Patients with Epilepsy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ekaterina Viteva
Keyword(s):  
Adverse Events ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Medical Documentation ◽  
Clinical Factors ◽  
Perceived Stigma ◽  
Increased Risk ◽  
Study Results ◽  
Study Participants ◽  
Patients With Epilepsy

Purpose. We aimed to assess the influence of adverse events (AEs) of antiepileptic drugs (AEDs) on perceived stigma of Bulgarian patients with epilepsy. Methods. Our study was based on questionnaires (Liverpool Adverse Events Profile (LAEP) and stigma scale), information from medical documentation, and an interview on clinical factors of 153 consecutive patients with epilepsy. Results. Perceived stigma was observed in 64.71% of the study participants. There was a significant association between perceived stigma and the total LAEP score (p<0.05, F=13.71). Patients who reported AEs had an increased risk of perceiving stigma compared to those who did not experience AEs. A significant correlation between perceived stigma and the presence of neurological and psychiatric AEs (p<0.001, r=+0.60) and a mild correlation between perceived stigma and the presence of nonneurological AEs (p<0.01, r=+0.20) were verified. In a multivariate regression analysis the only predictors of perceived stigma were AED polytherapy and the presence of neurological and psychiatric AEs. Conclusions. AEs of AEDs in patients with epilepsy significantly correlate with perceived stigma. Our study results will be useful in the campaign to overcome stigma predictors.

Is Sclerostin Level Associated with Cardiovascular Diseases in Hemodialysis Patients?

2018 ◽  
Vol 46 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Gokce Kundakci Gelir ◽  
Sule Sengul ◽  
Gokhan Nergizoglu ◽  
Sehsuvar Ertürk ◽  
Neval Duman ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Pulse Wave ◽  
Positive Association ◽  
Multivariate Regression Analysis ◽  
Hemodialysis Patients ◽  
Male Gender ◽  
Regression Analyses ◽  
Sclerostin Level ◽  
Statin Use

Background/Aims: The objective of this study is to evaluate the relation between sclerostin, arterial stiffness, and cardiovascular events (CVE) in hemodialysis patients (HD). Methods: Sclerostin level and carotid-femoral pulse wave velocity (PWV) in 97 HD patients and sclerostin level in 40 controls were measured. Results: Sclerostin level was significantly higher in patients than in controls. Sclerostin associated positively with age, male gender, cardiovascular disease, statin use, BMI, and PWV while negatively with alkaline phosphatase, parathormone (PTH), Kt/V, cinacalcet and vitamin D use in univariable correlation analyses. Sclerostin associated positively with male gender and statin use but negatively with PTH in multivariate regression analyses. During observation, 30 fatal or nonfatal CVEs were observed. While univariate correlation analysis showed a positive association between PWV and sclerostin, there was no relation between the two in multivariate regression analysis. Conclusion: Further studies are needed to understand the role of sclerostin in predicting PWV changes in HD patients.

scholarly journals Lymphopenic Community Acquired Pneumonia (L-CAP), an Immunological Phenotype Associated with Higher Risk of Mortality

EBioMedicine ◽  
2017 ◽  
Vol 24 ◽  
pp. 231-236 ◽  
Author(s):  
Jesus F. Bermejo-Martin ◽  
Catia Cilloniz ◽  
Raul Mendez ◽  
Raquel Almansa ◽  
Albert Gabarrus ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Risk Of Mortality ◽  
Immunological Phenotype

Pulmonary Complications of Sickle Cell Anemia

Chest Imaging ◽  
2019 ◽  
pp. 141-145
Author(s):  
Constantine Raptis
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
Acute Chest Syndrome ◽  
Globin Chain ◽  
Cell Disease ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
History Of

“Sickle cell disease” describes the spectrum of pathology in patients with at least one HbS chain and one other abnormal β‎ globin chain. Although patients with sickle cell disease often present with a simple community acquired pneumonia, acute chest syndrome must be considered in patients presenting with chest pain and fever, as it carries an increased risk of mortality, especially in adults. A few other entities, including rib infarction and subdiaphragmatic pathologies, can mimic the symptoms of acute chest syndrome. Finally, the findings of sickle cell disease on chest radiography will be discussed. Radiologists must be familiar with these findings in order to accurately interpret imaging studies, especially when the history of sickle cell is not provided.

scholarly journals Increased Risk of Multiple Outpatient Surgeries in African-American Carriers of Transthyretin Val122Ile Mutation Is Modulated by Non-Coding Variants

2019 ◽  
Vol 8 (2) ◽  
pp. 269 ◽  
Author(s):  
Renato Polimanti ◽  
Yaira Nuñez ◽  
Joel Gelernter
Keyword(s):  
African American ◽  
Medical History ◽  
Fold Increase ◽  
Upstream Region ◽  
Negative Consequences ◽  
Hepatic Expression ◽  
Increased Risk ◽  
History Of ◽  
Coding Variants

Background: African-Americans (AAs) have a 3.5% carrier prevalence of Transthyretin (TTR) Val122Ile mutation (rs76992529), which is the genetic cause of a hereditary form of amyloidosis. Methods: We investigated the medical history of Val122Ile carriers and assessed the role of a non-coding variation in 4361 unrelated AAs. Results: We observed that the Ile122 allele was associated with a 6.8-fold increase in the odds of having 10 or more outpatient surgeries (p = 7.81 × 10−5). Stratifying the analysis by sex, the Ile122 allele was associated with a 15.2-fold increase in the odds of having 10 or more outpatient surgeries in men (p = 6.49 × 10−7). A similar sex difference was observed with respect to the association of Val122Ile with musculoskeletal and connective-tissue disorders in an independent cohort of British subjects (n = 361,194, p = 2.47 × 10−13; nmale = 167,020, pmale = 4.02 × 10−24). In Val122Ile African-American carriers, we observed that haplotypes in the upstream region regulating TTR hepatic expression are associated with having 10 or more outpatient surgeries (p = 2.56 × 10−9). Conclusions: TTR Val122Ile showed a large effect with respect to an extreme phenotype identified in medical history that may be related to osteoarthritis, an early sign of the disease. Additionally, the non-coding variation appears to accelerate the negative consequences associated with Val122Ile mutation via TTR expression regulation.

scholarly journals Role of Adipokines in Atherosclerosis: Interferences with Cardiovascular Complications in Rheumatic Diseases

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Morena Scotece ◽  
Javier Conde ◽  
Rodolfo Gómez ◽  
Verónica López ◽  
Jesús Pino ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cardiovascular Complications ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Pathologic Alteration ◽  
Holistic Vision

Patients with rheumatic diseases have an increased risk of mortality by cardiovascular events. In fact, several rheumatic diseases such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis are associated with a higher prevalence of cardiovascular diseases (CVDs). Although traditional cardiovascular risk factors have been involved in the pathogenesis of cardiovascular diseases in rheumatic patients, these alterations do not completely explain the enhanced cardiovascular risk in this population. Obesity and its pathologic alteration of fat mass and dysfunction, due to an altered pattern of secretion of proinflammatory adipokines, could be one of the links between cardiovascular and rheumatic diseases. Indeed, the incidence of CVDs is augmented in obese individuals with rheumatic disorders. Thus, in this paper we explore in detail the relationships among adipokines, rheumatic diseases, and cardiovascular complications by giving to the reader a holistic vision and several suggestions for future perspectives and potential clinical implications.

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