Abstract P550: High Uric Acid Levels Correlate With Treatment- Resistant Hypertension

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Badhma Valaiyapathi ◽  
Mohammed Siddiqui ◽  
Suzanne Oparil ◽  
David A Calhoun ◽  
Tanja Dudenbostel
Keyword(s):  
Uric Acid ◽  
Retrospective Study ◽  
Resistant Hypertension ◽  
Missing Values ◽  
Antihypertensive Agents ◽  
Treatment Resistance ◽  
Patient Characteristics ◽  
Control Group ◽  
Increased Risk ◽  
The University

Background: Serum uric acid (sUA) levels have been found to be positively associated with increased risk of hypertension (HTN), independent of other cardiovascular risk factors. The role of sUA elevation in patients with resistant hypertension (RHTN) is unknown. We hypothesized that sUA levels are higher in RHTN patients compared to patients with controlled HTN. Methods: This retrospective study included, 140 patients from the University of Alabama at Birmingham Hypertension Clinic. Patient characteristics including body mass index (BMI), office blood pressure (BP) and sUA levels were analyzed. RHTN was defined as office BP > 140/90 mmHg on ≥ 3 or more different antihypertensive agents including a diuretic. Patients with RHTN were compared with a control group with controlled hypertension. Patients with sUA levels <3 mg/dl, who were on treatment with allopurinol, and those with missing values were excluded from the study. Results: Patient characteristics of 91 included patients were: 53.4% female, 40.7% African American, mean age 58.8 ± 12.4 years, mean BMI 33.1 ± 7.5 kg/m 2 , mean sUA 6.6 ± 1.9 mg/dL. Mean sUA was higher among RHTN patients compared to the control group (p = 0.0031). Treatment resistance was found to be strongly correlated with sUA levels of ≥ 6 mg/dl (p = 0.0065). Conclusion: In this retrospective study, sUA levels were found to be significantly higher among resistant HTN patients compared to controlled HTN patients, indicating that high sUA levels (≥ 6 mg/dl) may play a role in treatment resistance among hypertensive patients.

scholarly journals Sonographic Signs of Adenomyosis in Women with Endometriosis Are Associated with Infertility

2021 ◽  
Vol 10 (11) ◽  
pp. 2355
Author(s):  
Dean Decter ◽  
Nissim Arbib ◽  
Hila Markovitz ◽  
Daniel S. Seidman ◽  
Vered H. Eisenberg
Keyword(s):  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Conservative Management ◽  
Transvaginal Ultrasound ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Increased Risk ◽  
And Control

We compared the prevalence of ultrasound signs of adenomyosis in women with endometriosis who underwent surgery to those who were managed conservatively. This was a retrospective study of women evaluated at a tertiary endometriosis referral center who underwent 2D/3D transvaginal ultrasound. Adenomyosis diagnosis was based on the presence of at least three sonographic signs. The study group subsequently underwent laparoscopic surgery while the control group continued conservative management. Statistical analysis compared the two groups for demographics, symptoms, clinical data, and sonographic findings. The study and control groups included 244 and 158 women, respectively. The presence of any, 3+, or 5+ sonographic signs of adenomyosis was significantly more prevalent in the study group (OR = 1.93–2.7, p < 0.004, 95% CI; 1.24–4.09). After controlling for age, for all findings but linear striations, the OR for having a specific feature was higher in the study group. Women in the study group with ≥ 5 sonographic signs of adenomyosis had more than twice the risk of experiencing infertility (OR = 2.31, p = 0.012, 95% CI; 1.20–4.45). Sonographic signs of adenomyosis are more prevalent in women with symptomatic endometriosis who underwent surgery compared with those who continued conservative management. Women with 5+ findings have a significantly increased risk of infertility. Adenomyosis on ultrasound should be considered in the management decisions regarding these patients.

Risk of infection following colonoscopy and sigmoidoscopy in symptomatic patients

Endoscopy ◽  
2017 ◽  
Vol 49 (08) ◽  
pp. 754-764 ◽  
Author(s):  
Jiun-Nong Lin ◽  
Chang-Bi Wang ◽  
Chih-Hui Yang ◽  
Chung-Hsu Lai ◽  
Hsi-Hsun Lin
Keyword(s):  
Health Insurance ◽  
Retrospective Study ◽  
Confidence Interval ◽  
National Health Insurance ◽  
Control Group ◽  
Research Database ◽  
Concordance Index ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Common Infections

Abstract Background and study aims Previous studies describing the incidence of infection after colonoscopy and sigmoidoscopy are limited. The aim of this study was to determine the incidence of infection, and to propose a nomogram to predict the probability of infection following colonoscopy and sigmoidoscopy in symptomatic patients. Patients and methods A nationwide retrospective study was conducted by analyzing the National Health Insurance Research Database of Taiwan. The incidence of infection within 30 days after colonoscopy and sigmoidoscopy was assessed and compared with a control group matched at a ratio of 1:1 based on age, sex, and the date of examination. Results  In all, 112 543 patients who underwent colonoscopy or sigmoidoscopy and 112 543 matched patients who did not undergo these procedures were included. The overall incidence of infection within 30 days after colonoscopy and sigmoidoscopy was 0.37 %, which was significantly higher than that of the control group (0.04 %; P < 0.001). Diverticulitis, peritonitis, and appendicitis were the most common infections. Patients who underwent colonoscopy or sigmoidoscopy had a 9.38-fold risk of infection (95 % confidence interval, 6.81 – 12.93; P < 0.001) compared with the control group. The predicted infection-free rates of the nomogram were closely aligned with the actual infection-free rates, with a bootstrapping concordance index of 0.763. Conclusions Colonoscopy and sigmoidoscopy are associated with an increased risk of infection, which may occur after these procedures. Our nomogram may provide clinicians with an easy tool to evaluate the risk of infection after colonoscopy and sigmoidoscopy in symptomatic patients.

scholarly journals C-Section Prevalence Among Obese Mothers and Neonatal Hypoglycemia: a Cohort Analysis of the Department of Gynecology and Obstetrics of the University of Lübeck

2017 ◽  
Vol 77 (05) ◽  
pp. 487-494 ◽  
Author(s):  
Kay Neumann ◽  
Ineke Indorf ◽  
Christoph Härtel ◽  
Christoph Cirkel ◽  
Achim Rody ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Cohort Analysis ◽  
Mode Of Delivery ◽  
World Health ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
General Obesity ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
The University

Abstract Introduction Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns. Materials and Methods A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics of the University of Lübeck, Germany was conducted over a period of eleven years with the primary outcome as non-elective C-sections and hypoglycemia of newborns from obese mothers. Patients were divided into six subgroups according to WHO weight classifications as follows: control group body mass index (BMI) 18.5 – 24.9 kg/m2, n = 7712; general obesity BMI ≥ 25 kg/m2, n = 4227; overweight BMI 25 – 29.9 kg/m2, n = 2628; obesity I° BMI 30 – 34.9 kg/m2, n = 1017; obesity II° BMI 35 – 39.9 kg/m2, n = 370; obesity III° BMI ≥ 40 kg/m2, n = 212. Results Analysis of the primary outcome shows an increased incidence of non-elective C-sections with an elevated BMI (general obesity vs. control group: 20.5 vs. 15.9%, p < 0.001; OR 1.3; 95% CI 1.2 – 1.4) and elevated rates of neonatal hypoglycemia in newborns of obese mothers (general obesity vs. control group: 0.6 vs. 0.3%, p < 0.05; OR 1.8; 95% CI 1.0 – 3.0). Conclusions Obesity is an essential obstetric risk factor. Obese women face an increased risk of non-elective C-sections, and newborns of obese mothers suffer from elevated rates of hypoglycemia.

Association between hypoxia-inducible factor-1 alpha rs11549465 (1772 C>T) polymorphism and metabolic syndrome

2021 ◽  
pp. 1-15
Author(s):  
Uzma Zafar ◽  
Zaima Ali ◽  
Saba Khaliq ◽  
Khalid Lone
Keyword(s):  
Metabolic Syndrome ◽  
Hypoxia Inducible Factor ◽  
Control Group ◽  
Cross Sectional ◽  
Hypoxia Inducible Factor 1 ◽  
Increased Risk ◽  
Significant Difference ◽  
Venous Sample ◽  
In The Wild ◽  
The University

Abstract Objectives: To find the association of single nucleotide polymorphism of hypoxia-inducible factor-1 alpha, rs11549465 (1772 Cytosine > Thymine) with metabolic syndrome, and to compare the anthropometric and biochemical variables in different genotypes of hypoxia-inducible factor-1 alpha. Methods: The cross-sectional comparative study was conducted at the University of Health Sciences, Lahore, Pakistan, from July 2016 to April 2019, and comprised patients of metabolic syndrome selected from the Sheikh Zayed Hospital, Lahore. Healthy controls were also enrolled. Fasting venous sample was taken for the determination of study parameters. The genetic variant of hypoxia-inducible factor-1 alpha was analysed by restriction fragment length polymorphism polymerase chain reaction. Data was analysed using SPSS 22. Results: Out of 400 subjects, 200(50%) each were patients and controls. The frequency of CC genotype of hypoxia-inducible factor-1 alpha Cytosine > Thymine in patients was 166(83%) and in controls 147(73.5%); CT genotype was 34(17%) and 53(26.5%) respectively, while TT genotype was not observed. There was a significant association of the C allele and CC genotype (p=0.03) with the increased risk of metabolic syndrome (p=0.02). On comparison of study variables in the two genotypes, systolic blood pressure, anthropometric and lipid parameters were significantly higher in the wild CC genotype compared to CT in the control group (p<0.05), but there was no significant difference in the patients (p>0.05). Conclusion: Major allele C of hypoxia-inducible factor-1 alpha 1772 Cytosine > Thymine was found to be associated with increased risk of metabolic syndrome. Continuous...

Novel device therapies for resistant hypertension

2018 ◽  
pp. 717-730
Author(s):  
Kenneth Chan ◽  
Manish Saxena ◽  
Melvin D. Lobo
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Antihypertensive Agents ◽  
Cardiovascular Morbidity ◽  
Office Blood Pressure ◽  
Morbidity And Mortality ◽  
Hypertensive Patients ◽  
Novel Device ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk

Resistant hypertension (RHTN) is defined as uncontrolled office blood pressure (>140/90 mmHg) despite treatment with maximum tolerated doses of three or more antihypertensive agents from at least three different classes, including a diuretic. The prevalence of RHTN is about 8–18% in hypertensive patients and confers greatly increased risk of cardiovascular morbidity and mortality.

O-074 No methylome differences observed in IVF children born after embryo culture in different culture media

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Koeck ◽  
J Tost ◽  
F Busato ◽  
D Consten ◽  
J Van Echten-Arends ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Embryo Culture ◽  
Missing Values ◽  
Culture Media ◽  
Controlled Trial ◽  
In Vitro Fertilisation ◽  
Control Group ◽  
P Value ◽  
Artificial Environment ◽  
Increased Risk

Abstract Study question Does human embryo culture in different IVF culture media lead to DNA methylation alterations in IVF offspring? Summary answer Genome-wide analyses identified no significant DNA methylation differences between culture medium groups in IVF children (neonates or 9-year olds) from two culture media studies. What is known already During in vitro fertilisation (IVF) treatments, embryos undergo preimplantation development in an artificial environment, while concurrently undergoing epigenetic reprogramming. Adversity during this period, such as peri-conception calorie restriction, has been linked to persistent DNA methylation aberrations and increased risk of cardiometabolic disease. Early environmental adversity is suspected in IVF offspring as they are born with lower birthweights and show increased risk of cardiometabolic dysfunction in adulthood as compared to their naturally-conceived counterparts. This is further supported by the observation from two culture media trials (MEDIUM0 and MEDIUM1) that embryo culture in different culture media leads to differences in birthweight. Study design, size, duration We recruited singleton offspring from two IVF culture media trials. The MEDIUM0 study, a pseudo-randomized trial comparing G3 (Vitrolife) and K-SICM (Cook), was conducted from 2003-2006. At the 9-year follow-up, saliva was collected (cohort-A). The MEDIUM1 study, a multi-center randomized controlled trial comparing G5 (Vitrolife) and HTF (Lonza), was conducted from 2010-2012. Umbilical cord blood (UCB) was collected at birth (cohort-B). Participants/materials, setting, methods DNA methylation was analysed in 120 saliva samples (65 G3, 55 Cook) and 106 UCB samples (47 HTF, 59 G5) using the Infinium MethylationEPIC array (Illumina). Mixed effects linear models, correcting for (gestational) age, sex, sample composition and batch effects alongside maternal age, pregnancy complications and IVF centre for cohort-B, were implemented at single or aggregated sites. Methylation outliers were defined as values over three interquartile ranges below or above 25th and 75th percentiles respectively. Main results and the role of chance 111 of the 120 saliva samples (60 G3, 51 Cook) and 105 of the 106 UCB samples (47 HTF, 58 G5) passed our quality control criteria. We filtered sites on sex chromosomes, and based on quality, proximity to single-nucleotide polymorphisms, and proportion of missing values, leaving 650,000-700,000 of the 850,000 sites included on the EPIC array for our analyses. To account for heterogeneity in the cellular composition of our samples we estimated their cell compositions using a reference-based approach. First, we investigated individual CpG sites, finding no differentially methylated sites in either cohort after correction for multiple testing (false discovery rate adjusted p. value threshold &lt; 0.1). Sites were then aggregated into regions based on their allocations to genes, promoters and CpG islands. No differentially methylated regions were identified in either cohort. A targeted analysis of DNA methylation of imprinting genes showed no differentially methylated sites or regions. To examine the contribution of stochastic epigenetic alterations we quantified the number of methylation outliers per sample. Although this revealed a predominance of hypomethylation outliers, there was no difference in the total number or distribution of DNA methylation outliers between the two culture media groups of cohort-A and cohort-B. Limitations, reasons for caution This analysis is currently limited by the lack of comparison to a naturally-conceived control group. As such, we cannot yet conclude whether IVF embryo culture, in any medium, is associated with DNA methylation aberrations. Additionally, given the large number of comparisons, we may lack power to detect small differences. Wider implications of the findings Although there are disparities in birth weight and childhood growth after embryo culture in different media, we observed no DNA methylation alterations preserved postnatally. Whether DNA methylation of these individuals deviates from that of naturally-conceived individuals will be determined in the near future. Trial registration number MEDIUM1: NTR 1979 /NL1866 (Netherlands Trial Registry)

Abstract 15: Medication Inadequacy Accounts for Two-Third of Uncontrolled Hypertension Following Intracerebral Hemorrhage in a Multinational Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kay Cheong Teo ◽  
Alessandro Biffi ◽  
Ian Y Leung ◽  
William C Leung ◽  
Yujie Wang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Resistant Hypertension ◽  
Odds Ratio ◽  
Severe Hypertension ◽  
Massachusetts General Hospital ◽  
Antihypertensive Agents ◽  
Uncontrolled Hypertension ◽  
Multivariate Logistic Regression ◽  
History Of ◽  
The University

Introduction: Intracerebral hemorrhage (ICH) survivors often have severe hypertension and require multiple antihypertensive agents for blood pressure (BP) control. Adequate BP control is vital for ICH prevention, but the majority of ICH survivors have uncontrolled hypertension. To understand how we might improve BP control, we aimed to identify contributors to uncontrolled hypertension, and determine antihypertensive requirements as well as predictors of the need of ≥3 antihypertensives after ICH. Methods: We studied 1172 ICH survivors from two independent ICH cohorts: Massachusetts General Hospital (MGH) and the University of Hong Kong (HKU). We defined uncontrolled hypertension (BP ≥140/90 mmHg), inadequately medicated hypertension (uncontrolled hypertension on ≤2 antihypertensives), and resistant hypertension (uncontrolled hypertension on ≥3 antihypertensive classes or controlled hypertension on ≥4 classes) six months after ICH. Baseline predictors of the need for ≥3 antihypertensive agents were derived using multivariate logistic regression. Results: At six months post-ICH, 64.3% (502/781) of MGH ICH survivors and 32.7% (128/391) of HKU had uncontrolled hypertension. Resistant hypertension accounted for 33.5% and 29.7% of uncontrolled hypertension in the respective cohorts, while the remaining patients qualified for the designation of inadequately medicated hypertension. Excluding patients with inadequately medicated hypertension, 60.0% of patients in MGH and 37.2% in HKU required ≥3 antihypertensive agents. Age <65 years (odds ratio (OR) 1.80, p <0.001), admission systolic BP of >190 mmHg (OR 3.46, p <0.001) and a history of hypertension before ICH (OR 3.39, p <0.001) predicted the need for ≥3 antihypertensives after ICH. Conclusion: Medication inadequacy accounts for around two-thirds of uncontrolled hypertension after ICH, providing an opportunity for intervention to prevent hypertension-related complications, including ICH recurrence. As most ICH survivors required ≥3 antihypertensives for adequate BP control, early inpatient initiation of triple antihypertensive combination therapy should be considered, especially in patients with admission systolic BP of >190 mmHg, known hypertension and aged <65 years.

scholarly journals Severity of Occlusal Disharmonies in Down Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Danielle Bauer ◽  
Carla A. Evans ◽  
Ellen A. BeGole ◽  
Larry Salzmann
Keyword(s):  
Down Syndrome ◽  
Retrospective Study ◽  
Private Practice ◽  
Open Bite ◽  
Control Group ◽  
Class Iii ◽  
Dental Anomalies ◽  
Missing Teeth ◽  
Panoramic Radiographs ◽  
The University

Objective. To quantify the severity of malocclusion and dental esthetic problems in untreated Down syndrome (DS) and untreated non-Down syndrome children age 8–14 years old using the PAR and ICON Indices.Materials and Methods. This retrospective study evaluated pretreatment study models, intraoral photographs, and panoramic radiographs of 30 Down syndrome and two groups of 30 non-Down syndrome patients (private practice and university clinic) age 8–14 years. The models were scored via PAR and ICON Indices, and descriptive characteristics such as Angle classification, missing or impacted teeth, crossbites, open bites, and other dental anomalies were recorded.Results. The DS group had significantly greater PAR and ICON scores, as well as 10 times more missing teeth than the non-DS group. The DS group possessed predominantly Class III malocclusions, with the presence of both anterior and posterior crossbites in a majority of the patients. The non-DS group had mostly Class I or II malocclusion with markedly fewer missing teeth and crossbites. The DS group also had more severe malocclusions based upon occlusal traits such as open bite and type of malocclusion.Conclusion. The DS group had very severe malocclusions, while the control group from the university clinic had more severe malocclusions than a control group from a private practice.

scholarly journals Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Su-Lin Lim ◽  
Claudia Canavarro ◽  
Min-Htet Zaw ◽  
Feng Zhu ◽  
Wai-Chiong Loke ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Chronic Gastritis ◽  
Eating Habits ◽  
Control Group ◽  
Multivariate Logistic Regression ◽  
Meal Timing ◽  
Increased Risk

Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world’s population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; P<0.001) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; P<0.001). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; P<0.001) and gastritis (95% CI 1.5–8.5; P<0.001), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis.

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