scholarly journals Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

2021 ◽  
Author(s):  
Thomas G Beach ◽  
Aryck Russell ◽  
Lucia I Sue ◽  
Anthony J Intorcia ◽  
Michael J Glass ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Respiratory Infections ◽  
Lewy Bodies ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Logistic Regression Models ◽  
Age Related ◽  
Increased Risk ◽  
Male Sex

There has been a markedly renewed interest in factors associated with pneumonia, a leading cause of death worldwide, due to its frequent concurrence with pandemics of influenza and Covid-19 disease. Reported predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, obesity, pre-existing cardiopulmonary conditions and diabetes. Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia. We investigated the prevalence of autopsy-proven pneumonia in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study, between the years 2006 and 2019 and before the beginning of the Covid-19 pandemic. Of 691 subjects dying at advanced ages (mean 83.4), pneumonia was diagnosed postmortem in 343 (49.6%). There were 185 subjects without dementia or parkinsonism while clinicopathological diagnoses for the other subjects included 319 with Alzheimer disease dementia, 127 with idiopathic Parkinson disease, 72 with dementia with Lewy bodies, 49 with progressive supranuclear palsy and 78 with vascular dementia. Subjects with one or more of these neurodegenerative diseases all had higher pneumonia rates, ranging between 50 and 61%, as compared to those without dementia or parkinsonism (40%). In multivariable logistic regression models, male sex and a non-summer death both had independent contributions (ORs of 1.67 and 1.53) towards the presence of pneumonia at autopsy while the absence of parkinsonism or dementia was a significant negative predictor of pneumonia (OR 0.54). Male sex, dementia and parkinsonism may also be risk factors for Covid-19 pneumonia. The apolipoprotein E4 allele, as well as obesity, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, cardiomegaly and cigarette smoking history, were not significantly associated with pneumonia, in contradistinction to what has been reported for Covid-19 disease.

scholarly journals Mucociliary Clearance of Different Respiratory Conditions: A Clinical Study

2020 ◽  
Author(s):  
Juliana Souza Uzeloto ◽  
Dionei Ramos ◽  
Bruna Spolador de Alencar Silva ◽  
Mariana Belon Previatto de Lima ◽  
Rebeca Nunes Silva ◽  
...  
Keyword(s):  
Mucociliary Clearance ◽  
Respiratory Infections ◽  
Age Groups ◽  
Smoking History ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Younger Age ◽  
Increased Risk ◽  
Respiratory Conditions

Abstract Introduction Mucociliary clearance (MCC) is the first line of defense of the pulmonary system. Mucociliary clearance impairment may lead to increased risk of respiratory infections, lung injury, pulmonary repair problems, chronic dysfunctions and progression of respiratory diseases. Objective To characterize the MCC of active and passive smokers and individuals with chronic obstructive pulmonary disease (COPD) and compare the MCC behaviors between men and women of different age groups. Methods Patients with COPD (current smokers and ex-smokers) and apparently healthy individuals (current smokers, passive smokers and nonsmokers) were evaluated. All of the subjects underwent lung function and MCC evaluation (saccharin transport test [STT]). Smokers (with or without COPD) were questioned about the smoking history. Results A total of 418 individuals aged 16 to 82 years old, of both genders, were evaluated. The STT values of active and passive smokers were statistically higher than those of the control group (p < 0.01). Men of the control group had lower values of STT than active smokers (9.7 ± 7.1 and 15.4 ± 10.1 minute, respectively, p < 0.01). In addition, higher MCC velocity was observed in women that are current smokers (11.7 ± 6.8 minute) compared with men (15.4 ± 10.1 minute) in this group (p = 0.01). Among the younger age groups (< 50 years old), only passive smokers presented higher STT in relation to the control group. Conclusion Passive and active smoking are factors that influence negatively the MCC, and passive smokers may present losses of this mechanism at a younger age. Additionally, male smokers present worse MCC than male nonsmokers.

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

scholarly journals Epigenetic Marker of Telomeric Age is Associated with Exacerbations and Hospitalizations in Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Ana I Hernández Cordero ◽  
Chen Xi Yang ◽  
Xuan Li ◽  
Stephen Milne ◽  
Virginia Chen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Dna Methylation ◽  
Health Status ◽  
Pulmonary Disease ◽  
Cox Proportional Hazards Model ◽  
Chronological Age ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Increased Risk

Abstract Background: Chronic obstructive pulmonary disease (COPD) is an age-related condition that has been associated with early telomere attrition; the clinical implications of telomere shortening in COPD are not well known. In this study we aimed to determine the relationship of the epigenetic regulation of telomeric length in peripheral blood with the risk of exacerbations and hospitalization in patients with COPD. Methods: Blood DNA methylation profiles were obtained from 292 patients with COPD enrolled in the placebo arm of the Macrolide Azithromycin to Prevent Rapid Worsening of Symptoms Associated With Chronic Obstructive Pulmonary Disease study (MACRO) and who were followed for 1-year. We calculated telomere length based on DNA methylation markers (DNAmTL) and related this biomarker to the risk of exacerbation and hospitalization and health status (St. George respiratory questionary score [SGRQ]) over this time using a Cox proportional hazards model. We also used linear models to investigate the associations of DNAmTL with the rates of exacerbations and hospitalizations (adjusted for chronological age, lung function, race, sex, smoking, and body mass index).Results: Participants with short DNAmTL demonstrated increased risk of exacerbation (P=0.02) and hospitalization (P=0.03) compared to those with longer DNAmTL. DNAmTL age acceleration was associated with higher rates of exacerbation (P=1.35x10-04) and hospitalization (P=5.21x10-03) and poor health status (SGRQ) independent of chronological age (P=0.03).Conclusion: Telomeric age based on blood DNA methylation is associated with COPD exacerbation and hospitalization and thus is a promising biomarker for poor outcomes in COPD.

scholarly journals The Association Between Smoking History and Intensive Phase Treatment Success of Pulmonary Tuberculosis Patients in Dr. Zainoel Abidin Hospital Banda Aceh

2019 ◽  
Vol 38 (4) ◽  
pp. 232-8
Author(s):  
Risa Fitria ◽  
Feni Fitriani Taufik ◽  
Dewi Behtri Yanifitri
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Success ◽  
Smoking Habit ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Important Indicator ◽  
Intensive Phase ◽  
Increased Risk ◽  
Banda Aceh

Background: Many diseases are associated with smoking such as malignant disease, cardiovascular, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), arthritis, impotence, infertility, Alzheimer’s Disease, tuberculosis and others. Smoking is proven to disrupt the ciliary mucosal clearance and it is associated with an increased risk of pulmonary tuberculosis. Sputum conversion is an important indicator to assess the success of TB treatment. This study aims to determine the relation between smoking history and the success intensive phase treatment of pulmonary tuberculosis at Dr Zainoel Abidin Hospital. Method: Prospective cohort study in patients with pulmonary tuberculosis acid-fast bacilli (AFB) positive (+) smokers and non smokers who visited the Integrated Tuberculosis Care (PTT), at outpatient and inpatient pulmonary infection RSU Dr. Zainoel Abidin hospital Banda Aceh from 28 November 2015 until 1 February 2016. Results: A total of 38 subjects were divided into 2 groups (19 subjects with 19 subjects smokers and non-smokers). All subjects smokers are male while nonsmoker subjects consisted of male and female. The results of the first month study (p=0.009), there are 14 non smoker subjects with AFB conversion (73,7%) and 5 subjetcs without AFB conversion. Among smoking subjects there are 6 subjets (31.6%) with AFB conversion and 13 subjects (68.4% ) without AFB conversion. In the second month (p=0,202), more than half subjects who are non-smokers had AFB conversion, 17 subjects (89.5%) and 2 subjects (10.5%) had no AFB conversion. In smokers group there are 14 subjects (73.7% ) had AFB conversion and 5 subject (26.3%) had no conversion. Conclusion: There was a significant relation between smoking habit and the occurrence of first-month AFB sputum. (J Respir Indo. 2018; 38: 232-8)

scholarly journals Epigenetic marker of telomeric age is associated with exacerbations and hospitalizations in chronic obstructive pulmonary disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ana I. Hernández Cordero ◽  
Chen Xi Yang ◽  
Xuan Li ◽  
Stephen Milne ◽  
Virginia Chen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Dna Methylation ◽  
Health Status ◽  
Pulmonary Disease ◽  
Cox Proportional Hazards Model ◽  
Chronological Age ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Increased Risk

Abstract Background Chronic obstructive pulmonary disease (COPD) is an age-related condition that has been associated with early telomere attrition; the clinical implications of telomere shortening in COPD are not well known. In this study we aimed to determine the relationship of the epigenetic regulation of telomeric length in peripheral blood with the risk of exacerbations and hospitalization in patients with COPD. Methods Blood DNA methylation profiles were obtained from 292 patients with COPD enrolled in the placebo arm of the Macrolide Azithromycin to Prevent Rapid Worsening of Symptoms Associated with Chronic Obstructive Pulmonary Disease (MACRO) Study and who were followed for 1-year. We calculated telomere length based on DNA methylation markers (DNAmTL) and related this biomarker to the risk of exacerbation and hospitalization and health status (St. George Respiratory Questionnaire [SGRQ]) score over time using a Cox proportional hazards model. We also used linear models to investigate the associations of DNAmTL with the rates of exacerbation and hospitalization (adjusted for chronological age, lung function, race, sex, smoking, body mass index and cell composition). Results Participants with short DNAmTL demonstrated increased risk of exacerbation (P = 0.02) and hospitalization (P = 0.03) compared to those with longer DNAmTL. DNAmTL age acceleration was associated with higher rates of exacerbation (P = 1.35 × 10–04) and hospitalization (P = 5.21 × 10–03) and poor health status (lower SGRQ scores) independent of chronological age (P = 0.03). Conclusion Telomeric age based on blood DNA methylation is associated with COPD exacerbation and hospitalization and thus a promising biomarker for poor outcomes in COPD.

scholarly journals Association Between Male Sex and Outcomes of Coronavirus Disease 2019 (COVID-19)—A Danish Nationwide, Register-based Study

2020 ◽  
Author(s):  
Kristian Kragholm ◽  
Mikkel Porsborg Andersen ◽  
Thomas A Gerds ◽  
Jawad H Butt ◽  
Lauge Østergaard ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Risk Ratio ◽  
Cox Regression ◽  
Chronic Obstructive ◽  
Average Risk ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Increased Risk ◽  
Male Sex ◽  
Artery Disease

Abstract Background and Objectives Male sex has been associated with severe coronavirus disease 2019 (COVID-19) infection. We examined the association between male sex and severe COVID-19 infection and if an increased risk remains after adjustment for age and comorbidities. Methods Nationwide register-based follow-up study of COVID-19 patients in Denmark until 16 May 2020. Average risk ratio comparing 30-day composite outcome of all-cause death, severe COVID-19 diagnosis or intensive care unit (ICU) admission for men versus women standardized to the age and comorbidity distribution of all patients were derived from multivariable Cox regression. Included covariates were age, hypertension, diagnoses including obesity, alcohol, sleep apnea, diabetes, chronic obstructive pulmonary disease, previous myocardial infarction (MI), ischemic heart disease (IHD), heart failure (HF), atrial fibrillation (AF), stroke, peripheral artery disease, cancer, liver, rheumatic, and chronic kidney disease (CKD). Results Of 4842 COVID-19 patients, 2281 (47.1%) were men. Median age was 57 [25%–75% 43–73] for men versus 52 [38–71] for women (P &lt; .001); however, octogenarians had equal sex distribution. Alcohol diagnosis, diabetes, hypertension, sleep apnea, prior MI and IHD (all P &lt; .001) as well as AF, stroke, and HF (all P = .01) were more often seen in men, and so was CKD (P = .03). Obesity diagnosis (P &lt; .001) were more often seen in women. Other comorbidity differences were insignificant (P &gt; .05). The fully adjusted average risk ratio was 1.63 [95% CI, 1.44–1.84]. Conclusions Men with COVID-19 infection have &gt;50% higher risk of all-cause death, severe COVID-19 infection, or ICU admission than women. The excess risk was not explained by age and comorbidities.

Presence of Renal Simple Cysts Is Associated With Increased Risk of Abdominal Aortic Aneurysms

Angiology ◽  
2014 ◽  
Vol 71 (5) ◽  
pp. 465-470 ◽  
Author(s):  
Bong Gun Song ◽  
Yong Hwan Park
Keyword(s):  
Screening Program ◽  
High Sensitivity ◽  
Aortic Aneurysms ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Abdominal Aortic ◽  
Increased Risk ◽  
Structural Weakness

We compared the incidence of renal simple cysts in 271 patients with abdominal aortic aneurysm (AAA) and 1387 patients without AAA (controls) using computed tomography (CT) angiography and abdominal CT, as a health screening program. The AAA group had significantly higher prevalence of renal simple cysts (55% vs 19%, P = .001) and chronic obstructive pulmonary disease (COPD; 12% vs 1%, P = .011) than the controls. After propensity score matching (n = 164), the prevalence of renal simple cysts was still significantly higher in the AAA group. In multivariate analysis, independent predictors of AAA were age, male gender, smoking history, hypertension, high-sensitivity C-reactive protein, creatinine, COPD, and renal simple cysts. The structural weakness predisposing for renal simple cysts may be associated with the initiation of AAA formation. More studies are needed to determine whether the presence of renal simple cysts can be considered as a risk factor for AAA.

Risk Factors for Developing Postprocedural Microemboli following Carotid Interventions

2007 ◽  
Vol 14 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Maureen M. Tedesco ◽  
Sheila M. Coogan ◽  
Ronald L. Dalman ◽  
Jason S. Haukoos ◽  
Barton Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Characteristics ◽  
Time Frame ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Mri Scans ◽  
History Of ◽  
Distal Protection

Purpose: To determine risk factors predictive of microemboli found on diffusion-weighted magnetic resonance imaging (DW-MRI) following carotid angioplasty and stenting (CAS) with distal protection and carotid endarterectomy (CEA). Methods: A retrospective review was conducted of all carotid interventions at a single institution between 2004 and 2006. In that time frame, 64 carotid interventions (34 CAS, 30 CEA) were performed in 63 male patients (mean age 69.5 years, range 52 to 91) with DW-MRI scans available for review. Patient characteristics, including age, gender, smoking history, diabetes mellitus, hypertension, hyperlipidemia, obesity (body mass index >30), coronary artery disease (CAD), chronic obstructive pulmonary disease, peripheral vascular disease, and atrial fibrillation, were documented. For the CAS patients, anatomical and procedural characteristics, including fluoroscopy time, contrast volume, performance of an arch angiogram, and lesion anatomy, were recorded. Bivariate analyses were performed to determine which parameters were associated with the occurrence of acute postprocedural microemboli found on DW-MRI by 2 blinded neuroradiologists. Results: Twenty-four (71%) of the 34 CAS patients and 1 (3%) of the 30 CEA patients demonstrated new cerebral microemboli postoperatively. In the bivariate analyses of all patient, anatomical, and procedural characteristics, only a history of CAD was associated with an increased risk of microemboli; 20 (80%) of the 25 patients who had postprocedure microemboli had CAD compared to 18 (46%) of 39 patients without microemboli (p=0.007). Twenty (53%) of the 38 (59%) patients with CAD developed microemboli compared to 5 (19%) of the 26 patients without CAD (p=0.007). All other patient, procedural, and anatomical characteristics were not found to be independent risk factors predictive of postprocedure microemboli. Conclusion: CAS with distal protection carries a significantly greater risk for developing new microemboli compared to CEA. Of all the risk factors analyzed, only a history of CAD emerged as an independent risk factor for the development of microemboli following carotid intervention. This finding may influence the decision to perform CAS in patients deemed high risk solely due to the presence of CAD.

scholarly journals Recurrent syncope in patients with a pacemaker and bradyarrhythmia

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.J.Y Lee ◽  
J.M Davidsen ◽  
R Skals ◽  
C Torp-Pedersen ◽  
P Soegaard
Keyword(s):  
Sinus Node ◽  
Pacemaker Implantation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Conduction Abnormality ◽  
Cox Proportional Hazard ◽  
Av Conduction ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Male Sex

Abstract Objectives To investigate the risk of recurrent syncope and all-cause mortality after implantation of a pacemaker in patients with bradyarrhythmia. Background A pacemaker is generally recommended when syncope is caused by bradyarrhythmias to prevent a new syncope. However, the occurrence and risk of recurrent syncope in patients with bradyarrhythmia after pacemakerimplantation are still unknown. Methods Patients with a prior syncope and an implantation of pacemaker were identified. Cumulative incidences of 5-years were estimated for the outcomes stratified into groups according to the type of bradyarrhythmia; and type of pacemaker. The risk of recurrent syncope and all-cause mortality were estimated using adjusted cox proportional hazard regressions. Results We identified 8,663 patients with a prior syncope and pacemaker implantation (median age of 78,1 years (SD 69,1–84,8) and 55,1% males). The 5-year cumulative incidence of recurrent syncope was 19,3% (95% confidence intervals (CI) 18,4–20,2). Factors associated with a significant increased risk of recurrent syncope were male sex, age 80 years and above, alcohol related disease, bleeding, chronic obstructive pulmonary disease, chronic kidney disease, stroke, and malignancy. Atrial fibrillation was associated with a significantly decreased risk of recurrent syncope. Patients with an advanced AV conduction abnormality had a lower associated risk of syncope compared to patients with sinus node dysfunction (HR 0,85, 95% CI 0,76–0,94, p=0,003). Conclusions One fifth of the cohort had a recurrence syncope after five years. Besides older age and male sex, several comorbidities were found to be associated with a higher risk of recurrence of syncope. Clinicians need to be attentive that a large proportion of patients with bradyarrhythmia suffer from syncope even when treated with a pacemaker. Funding Acknowledgement Type of funding source: None

scholarly journals Malnutrition According to GLIM Criteria Is Associated with Mortality and Hospitalizations in Rehabilitation Patients with Stable Chronic Obstructive Pulmonary Disease

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 369
Author(s):  
Vanesa Dávalos-Yerovi ◽  
Ester Marco ◽  
Dolores Sánchez-Rodríguez ◽  
Xavier Duran ◽  
Delky Meza-Valderrama ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Cox Regression ◽  
Negative Impact ◽  
Fat Free Mass ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients ◽  
Increased Risk ◽  
Post Hoc

Malnutrition has a negative impact on patients with chronic pulmonary obstructive disease (COPD). The purpose of this study was to assess the prevalence of malnutrition, defined by the Global Leadership Initiative for Malnutrition (GLIM), in stable COPD patients referred to pulmonary rehabilitation, and to explore potential associations of malnutrition according to GLIM, and its components, with increased risk of mortality and hospitalizations in 2 years. In a post-hoc analysis of a prospective cohort of 200 rehabilitation patients with stable COPD, main outcome variables were hospital admissions, length of stay, and mortality during a 2-year follow-up. Covariates were malnutrition according to GLIM and its phenotypic criteria: unintentional weight loss, low body mass index (BMI), and low fat-free mass (FFM). Univariate and multivariate analysis were performed using logistic and proportional hazard Cox regression. Malnutrition according to GLIM showed 45% prevalence and was associated with increased mortality risk. Low age-related BMI and FFM were independently associated with mortality, which persisted after adjustment for age and lung function. Malnutrition and low BMI were also associated with increased risk of hospitalization. Malnutrition according to GLIM criteria was highly prevalent in rehabilitation patients with COPD and was associated with nearly 3 times greater mortality and hospitalization risk.

Sign in / Sign up

Export Citation Format

Share Document