scholarly journals Comparative Evaluation of Orthostatic Hypotension in Patients with Diabetic Nephropathy

2021 ◽  
pp. 1-7
Author(s):  
Gamze Aytaş ◽  
Rümeyza Kazancıoğlu ◽  
Ömer C. Elçioğlu ◽  
Meltem Gürsu ◽  
A. Serra Artan ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Orthostatic Hypotension ◽  
Electronic Device ◽  
Channel Blockers ◽  
Factors Affecting ◽  
Clinical Criteria ◽  
Measure Blood Pressure ◽  
Significant Difference ◽  
Male Patients ◽  
Very High

<b><i>Introduction:</i></b> Orthostatic hypotension (OH) affects 5–20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison with nondiabetic chronic kidney disease (NDCKD) patients. <b><i>Method:</i></b> Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. <b><i>Results:</i></b> 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, <i>p</i> = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, <i>p</i> = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 [10.00–32.00] mm Hg vs. 24.00 [13.75–30.25] mm Hg, <i>p</i> = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 [2.00–13.00] mm Hg vs. 6.00 [2.00–9.00] mm Hg, <i>p</i> = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, <i>p</i> = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (<i>p</i> = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (<i>p</i> = 0.049). <b><i>Conclusion:</i></b> OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.

scholarly journals Study of Gender-based In-Hospital Mortality Difference in Patients with Acute Myocardial Infarction

2018 ◽  
Vol 32 (2) ◽  
pp. 119-124
Author(s):  
NK Majumder ◽  
MR Khan ◽  
Nupur Kar ◽  
M Akhtaruzzaman ◽  
TA Choudhury ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Female Group ◽  
Male Counterpart ◽  
Factors Affecting ◽  
Female Patients ◽  
Significant Difference ◽  
Male Patients ◽  
Gender Based

Background: In-hospital mortality in female patients with acute myocardial infarction (AMI) and factors affecting this may be different from those of their male counterpart. The aim of the current study was to compare the in-hospital mortality between female and male patients with AMI and to compare the differences in age, risk factors, treatment given and complications between them.Methods: Total 200 nonrandomised patients with a definite diagnosis of AMI admittedover a period of one year (January 2008 - December 2008) were enrolled in the study, in which 100 female patients were considered as cases and 100 male patients as controls. Both groups were studied prospectively.Datawere collected in prefixed questionnaire and data sheet and were analysed using SPSS software.Results: mean age of the female patients was significantly higher than that of their male counterpart (57.0±10.1 years and 53.3±10.3 years respectively, p=0.029). Diabetes mellitus and hyperlipidemia were significantly higher in females than those in males (39% vs 24%, p=0.022 and 45% vs 32%, p=0.040 respectively), while smoking was staggeringly higher among the males (59%) compared to the females (4%) (p<0.001). However, no significant difference was observed between the groups in terms of hypertension (p=0.666).Pre-hospital delay (more than 12 hours after onset of chest pain) was significantly higher in the female group than that in the male group (72% vs 58%,p=0.038). Streptokinase was significantly underused in females (15.6%) compared to that used in males (32.2%) (p=0.011). The use of b-receptor blockerswas also significantly less in females than that in males (63% vs 75%, p=0.046).Death was significantly higher in the females (21%) than that in the males (10%) (p=0.032). Unstable angina, re-infarction and congestive heart failure were somewhat higher in the female subjects compared to their male counterparts (40% vs 34%, 2% vs 1% and 32% vs 23% respectively) though the differences did not seem significant (p=0.380, p=0.561 and p=0.154 respectively). Arrhythmias did not differ significantly between the groups (p1>0.05).Conclusion: Female patients with AMI had significantly higher in-hospital mortality. Early hospitalization and optimal treatment are crucial to decrease mortality in female patients.Bangladesh Heart Journal 2017; 32(2) : 119-124

scholarly journals Calcium Channel Blockers Are Associated with Nocturia in Men Aged 40 Years or Older

2021 ◽  
Vol 10 (8) ◽  
pp. 1603
Author(s):  
Satoshi Washino ◽  
Yusuke Ugata ◽  
Kimitoshi Saito ◽  
Tomoaki Miyagawa
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Cross Sectional Study ◽  
Channel Blockers ◽  
Prescription Medications ◽  
Normal Blood Pressure ◽  
Cross Sectional ◽  
Significant Difference ◽  
Male Patients

Background: The associations of nocturia with hypertension and anti-hypertensive agents (AHTs) remain to be validated. Methods: This cross-sectional study examined whether blood pressure and/or frequently used classes of AHTs had consistent associations with nocturia. Methods: A total of 418 male patients aged ≥ 40 years were retrospectively assessed in terms of the International Prostate Symptom Score (IPSS), prescription medications, and blood pressure. Nocturia was evaluated using item 7 of the IPSS, and two or more episodes of nocturia per night was considered to indicate clinically important nocturia. Results: Patients taking calcium channel blockers (CCBs), but not other AHTs, experienced more episodes of nocturia than patients not taking AHTs (1.77 ± 1.07, 1.90 ± 1.19, and 1.48 ± 0.98 in CCBs alone, CCBs + other AHTs, and other AHTs alone, vs. 1.35 ± 1.08 in not taking AHTs; p = 0.014, p < 0.0001, and p = 0.91, respectively), whereas there was no significant difference in the number of nocturia episodes between patients with elevated and normal blood pressure. In multivariate analysis, CCB (odds ratio (OR) = 2.68, p < 0.0001) and age (OR = 1.06, p < 0.0001) were independently associated with clinically important nocturia. Conclusion: CCB was associated with nocturia, while AHTs other than CCBs and elevated blood pressure were not.

scholarly journals Prognosis of stent implantation on variant angina with severe organic stenosis

2019 ◽  
Author(s):  
Haiqiang SANG ◽  
Yaohui JIANG ◽  
Zhe WANG ◽  
Rujie ZHENG
Keyword(s):  
Stent Implantation ◽  
Cardiac Death ◽  
Cardiovascular Events ◽  
Coronary Revascularization ◽  
Channel Blockers ◽  
Variant Angina ◽  
Antiplatelet Medication ◽  
Significant Difference ◽  
Very High ◽  
Fatal Myocardial Infarction

Abstract Objective: To explore the prognosis of stent implantation on variant angina (VA) with severe organic stenosis. Background: Vasospasm is the pathogenesis of VA. Most VA patients are effective on calcium channel blockers (CCB) or nitrates, and the prognosis is generally good, but organic stenosis is a risk factor for VA. Method: We collected 141 VA patients treated with CCB and (or) nitrates in the First Affiliated Hospital of Zhengzhou University from December 2010 to June 2019. VA patients with diameter stenosis ≥50% were enrolled .They were divided into two groups according to the presence of stent implantation. The main adverse cardiovascular events (MACE) were observed including cardiogenic death, non-fatal myocardial infarction, readmission due to angina attack, coronary revascularization and heart failure. Results: 69 cases were included: 33 cases received stent implantation and 36 cases received medical treatment. The proportion of left anterior descending (LAD)(48% vs 44%,p=0.737 )which was the culprit coronary artery was very high. Diameter stenosis (84.3%±6.5 %VS 59.9%±010.1%，P<0.001)in stenting group was higher than that in stent-free group. Following up for 24 ± 23 months, there was no significant difference in the incidence of MACE (9% VS 11%) including cardiac death (3% VS 2.8%), coronary revascularization (0% VS 3%) and readmission due to angina (6% VS 5.6%), and effectiveness (88% VS 89%) between the two groups. CONCLUSION: Although the two groups showed similar clinical outcomes, with anti-spastic and antiplatelet medication, stent implantation was of benefit to the prognosis of VA with severe organic stenosis.

Attitudes toward the use of TELL tools in English language learning among Vietnamese Tertiary English majors

2019 ◽  
Vol 5 (5) ◽  
pp. 581-596
Keyword(s):  
Language Learning ◽  
Language Proficiency ◽  
English Language ◽  
English Language Learning ◽  
Guided Learning ◽  
Positive Attitudes ◽  
Significant Difference ◽  
English Majors ◽  
Very High ◽  
Different Levels

Technology plays a crucial role in the self-guided learning of a second language in general and English in particular. Nevertheless, many students in different contexts still ignore the application of technology-enhanced language learning (TELL) tools in enhancing their foreign language proficiency. Therefore, this study is conducted to investigate the attitudes towards the use of TELL tools in English-language learning (ELL) among English majors at one university in Vietnam. To collect data, 197 English majors participated in finishing the questionnaire, and 20 students were invited to join the interviews. The findings are that the majority of students have positive attitudes towards the use of TELL tools and the frequency of using these tools is very high. In addition, the results also reveal that there is no significant difference in attitudes towards and frequency of using TELL tools in learning English in terms of the year of study. However, students of different levels of academic achievements have different attitudes towards using TELL tools and use TELL tools to learn English differently. Received 2nd May 2019; Revised 16th July 2019, Accepted 20th October 2019

Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 27 (37) ◽  
pp. 6373-6383 ◽  
Author(s):  
Leila Jouybari ◽  
Faezeh Kiani ◽  
Farhad Islami ◽  
Akram Sanagoo ◽  
Fatemeh Sayehmiri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Tissue ◽  
Reference Lists ◽  
Meta Analysis ◽  
Cancer Risks ◽  
Hair Samples ◽  
Significant Difference ◽  
Mean Differences ◽  
Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

scholarly journals On the Average Coefficient of Dominance of Deleterious Spontaneous Mutations

Genetics ◽  
2000 ◽  
Vol 155 (4) ◽  
pp. 1991-2001 ◽  
Author(s):  
A García-Dorado ◽  
A Caballero
Keyword(s):  
Deleterious Mutations ◽  
Spontaneous Mutations ◽  
Partial Dominance ◽  
High Viability ◽  
Significant Difference ◽  
Plausible Hypothesis ◽  
Average Coefficient ◽  
Series Of Experiments ◽  
Very High ◽  
Balancer Chromosome

Abstract T. Mukai and co-workers in the late 1960s and O. Ohnishi in the 1970s carried out a series of experiments to obtain direct estimates of the average coefficient of dominance (h¯) of minor viability mutations in Drosophila melanogaster. The results of these experiments, although inconsistent, have been interpreted as indicating slight recessivity of deleterious mutations, with h¯≈0.4. Mukai obtained conflicting results depending on the type of heterozygotes used, some estimates suggesting overdominance and others partial dominance. Ohnishi's estimates, based on the ratio of heterozygous to homozygous viability declines, were more consistent, pointing to the above value. However, we have reanalyzed Ohnishi's data, estimating h¯ by the regression method, and obtained a much smaller estimate of ~0.1. This significant difference can be due partly to the different weighting implicit in the estimates, but we suggest that this is not the only explanation. We propose as a plausible hypothesis that a putative nonmutational decline in viability occurring in the first half of Ohnishi's experiment (affecting both homozygotes and heterozygotes) has biased upward the estimates from the ratio, while it would not bias the regression estimates. This hypothesis also explains the very high h¯≈0.7 observed in Ohnishi's high-viability chromosomes. By constructing a model of spontaneous mutations using parameters in the literature, we investigate the above possibility. The results indicate that a model of few mutations with moderately large effects and h¯≈0.2 is able to explain the observed estimates and the distributions of homozygous and heterozygous viabilities. Accounting for an expression of mutations in genotypes with the balancer chromosome Cy does not alter the conclusions qualitatively.

scholarly journals Predictors of outcome in pleomorphic xanthoastrocytoma

2020 ◽  
Author(s):  
Antonio Dono ◽  
Victor Lopez-Rivera ◽  
Ankush Chandra ◽  
Cole T Lewis ◽  
Rania Abdelkhaleq ◽  
...  
Keyword(s):  
Tumor Size ◽  
Postoperative Radiotherapy ◽  
Treatment Strategies ◽  
Pleomorphic Xanthoastrocytoma ◽  
Survival Outcomes ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Male Patients

Abstract Background Pleomorphic xanthoastrocytomas (PXA) are circumscribed gliomas that typically have a favorable prognosis. Limited studies have revealed factors affecting survival outcomes in PXA. Here, we analyzed the largest PXA dataset in the literature and identify factors associated with outcomes. Methods Using the Surveillance, Epidemiology, and End Results (SEER) 18 Registries database, we identified histologically confirmed PXA patients between 1994 and 2016. Overall survival (OS) was analyzed using Kaplan-Meier survival and multivariable Cox proportional hazard models. Results In total, 470 patients were diagnosed with PXA (males = 53%; median age = 23 years [14-39 years]), the majority were Caucasian (n = 367; 78%). The estimated mean OS was 193 months [95% CI: 179-206]. Multivariate analysis revealed that greater age at diagnosis (≥39 years) (3.78 [2.16-6.59], P &lt; .0001), larger tumor size (≥30 mm) (1.97 [1.05-3.71], P = .034), and postoperative radiotherapy (RT) (2.20 [1.31-3.69], P = .003) were independent predictors of poor OS. Pediatric PXA patients had improved survival outcomes compared to their adult counterparts, in which chemotherapy (CT) was associated with worse OS. Meanwhile, in adults, females and patients with temporal lobe tumors had an improved survival; conversely, tumor size ≥30 mm and postoperative RT were associated with poor OS. Conclusions In PXA, older age and larger tumor size at diagnosis are risk factors for poor OS, while pediatric patients have remarkably improved survival. Postoperative RT and CT appear to be ineffective treatment strategies while achieving GTR confer an improved survival in male patients and remains the cornerstone of treatment. These findings can help optimize PXA treatment while minimizing side effects. However, further studies of PXAs with molecular characterization are needed.

Over-expression of IL-6 coding gene in the peripheral blood of migraine with aura patients

2021 ◽  
pp. 1-5
Author(s):  
Mahdi Ramezani ◽  
Alireza Komaki ◽  
Mohammad Mahdi Eftekharian ◽  
Mehrdokht Mazdeh ◽  
Soudeh Ghafouri-Fard
Keyword(s):  
Migraine With Aura ◽  
Peripheral Blood ◽  
Healthy Subjects ◽  
Migraine Without Aura ◽  
P Value ◽  
Healthy Controls ◽  
Over Expression ◽  
Significant Difference ◽  
Male Patients ◽  
Years Lived With Disability

Migraine is a common disorder which is placed among the top ten reasons of years lived with disability. Cytokines are among the molecules that contribute in the pathophysiology of migraine. In the current study, we evaluated expression levels of IL-6 coding gene in the peripheral blood of 120 migraine patients (54 migraine without aura and 66 migraine with aura patients) and 40 healthy subjects. No significant difference was detected in expression of IL-6 between total migraine patients and healthy controls (Posterior beta = 0.253, P value = 0.199). The interaction effect between gender and group was significant (Posterior beta =-1.274, P value = 0.011), therefore, we conducted subgroup analysis within gender group. Such analysis revealed that while expression of this gene is not different between male patients and male controls (Posterior beta =-0.371, P value > 0.999), it was significantly over-expressed in female patients compared with female controls (Posterior beta = 0.86, P= 0.002). Expression of IL-6 was significantly higher in patients with aura compared with controls (Posterior beta = 0.63, adjusted P value = 0.019). However, expression of this cytokine coding gene was not different between patients without aura and healthy subjects (Posterior beta = 0.193, adjusted P value = 0.281). Therefore, IL-6 might be involved in the pathophysiology of migraine among females and migraine with aura among both sexes.

Factors affecting progression to permanent atrial fibrillation in an unselected population of patients with non-permanent form of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V.L Malavasi ◽  
E Fantecchi ◽  
V Tordoni ◽  
L Melara ◽  
A Barbieri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Significant Difference ◽  
History Of ◽  
Unselected Population ◽  
Cox Proportional Hazard Regression

Abstract Background Natural history of atrial fibrillation (AF) shows a progression of arrhythmia from non-permanent to permanent AF. Permanent AF was found associated with a worse prognosis than non-permanent one. Aim To assess the factors associated with progression to permanent AF in an unselected population of AF patients with non-permanent AF. Methods In this prospective study we enrolled in- as well as out-patients with non-permanent AF and age ≥18 years, with at least one episode of ECG-documented AF within 1 year. The patients were followed-up at 1 month and every 6 months thereafter. Results Out of 523 patients, 314 (60%) were in non-permanent AF (80 [25.5%] paroxysmal AF, 165 [52.5%] persistent AF, 69 [2%] first diagnosed AF), mostly male (188, 59.9%), median age 71 years (IQ range 62–77), median CHA2DS2VASc 3 (1–4), median HATCH score 1 (1–2). After a median follow-up of 701 (IQ range 437–902) days, 66 patients (21%) showed permanent AF. CHA2DS2VASc and HATCH scores were incrementally associated to progression to permanent AF (CHA2DS2VASc χ2 p=0.001; HATCH χ2 p=0.017; p for trend CHA2DS2VASc &lt;0.001, HATCH p=0.001). At multivariable Cox proportional hazard regression the following variables were significantly associated with AF progression: age (hazard ratio [HR] 1.041; 95% CI: 1.004–1.079; p=0.028), at least moderate left atrial (LA) enlargement (&gt;42 ml/m2) (HR 2.092; 95% CI: 1.132–3.866; p=0.018), antiarrhythmics drugs after the enrollment (HR 0.087; 95% CI: 0.011–0.662; p=0.018), EHRA score &gt;2 (HR 0.351; 95% CI: 0.158–0.779; p=0.010) and Valvular HD (HR 2.161; 95% CI: 1.057–4.420; p=0.035). Adding LA dilation to HATCH score (HATCH-LA) and assigning 2 points based on multivariable Cox regression, HATCH-LA was statistically better in ROC curves in prediction of AF progression vs HATCH score (area under the curve 0.695 vs 0.636; DeLong p=0.0225). Survival-free curves on freedom from permanent AF using as discriminator HATCH-LA score ≤2 vs &gt;2 led to a statistically significant difference (χ2=16.080 p&lt;0.001), but the same was not found for HATCH score (χ2 =3.099; p=0.078). Conclusions In patients without permanent AF, progression of AF was independentely related to age, LA dilation, AF symptoms severity, antiarrhythmic drugs and Valvular HD. HATCH score predicted AF progression and adding to it LA dilation (at least moderate) improved patients stratification for the risk of evolution to permanent AF. Funding Acknowledgement Type of funding source: None

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