Inflammation in Peritoneal Dialysis: A Latin-American Perspective

2007 ◽  
Vol 27 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Liliana González-Espinoza ◽  
Fabiola Martin del Campo ◽  
Paulo C. Fortes ◽  
Roberto Pecoits-Filho
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Peritoneal Dialysis ◽  
Latin American ◽  
High Mortality ◽  
Mortality Risk ◽  
Adult Population ◽  
High Energy ◽  
Increased Risk ◽  
Sanitary Conditions

Peritoneal dialysis (PD) patients present an extremely high mortality rate, but the mechanisms mediating the increased risk of mortality observed in this group of patients are still largely unknown, which limits the perspective of effective therapeutic strategies. The leading hypothesis that tries to explain this high mortality risk is that PD patients are exposed to a number of traditional risk factors for cardiovascular disease (CVD) already at the onset of their chronic kidney disease (CKD), since many of these risk factors are common to both CVD and CKD. Of particular importance, chronic inflammation recently emerged as an important novel risk factor related to multiple complications of CKD. There are many stimuli of the inflammatory response in CKD patients, such as fluid overload, decreased cytokine clearance, presence of uremia-modified proteins, presence of chronic infections, metabolic disturbances (including hyperglycemia), obesity. Many of these factors are related to PD. Latin America has made some progress in economic issues; however, a large portion of the population is still living in poverty, in poor sanitary conditions, and with many health-related issues, such as an increasing elderly population, low birth weights, and increasingly high energy intake in the adult population, which, in combination with changes in lifestyle, has provoked an increase in the prevalence of obesity, diabetes, and CVD. Therefore, in Latin America, there seems to be a peculiar situation combining high prevalence of low education level, poor sanitary conditions, and poverty with increases in obesity, diabetes, and sedentary lifestyle. Since inflammation and mortality risk are intimately related to both sides of those health issues, in this review we aim to analyze the peculiarities of inflammation and mortality risk in the Latin-American PD population.

scholarly journals Prevalence of Comorbidities and Risk Factors for Comorbidities in Patients with Spondyloarthritis in Latin America: A Comparative Study with the General Population and Data from the ASAS-COMOSPA Study

2017 ◽  
Vol 45 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Wilson Bautista-Molano ◽  
Robert Landewé ◽  
Rubén Burgos-Vargas ◽  
José Maldonado-Cocco ◽  
Anna Moltó ◽  
...  
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Risk Factor ◽  
General Population ◽  
Latin American ◽  
Systematic Evaluation ◽  
Specific Data ◽  
Increased Risk ◽  
Risk Ratios ◽  
Age And Sex

Objective.Increased risk of comorbidities has been reported in spondyloarthritis (SpA). The objective of this study was to determine the prevalence and risk of developing comorbidities in patients with SpA in 3 Latin American (LA) countries, and to compare that prevalence with the general population.Methods.Data were analyzed from 390 patients with SpA enrolled in the Assessment of SpondyloArthritis international Society of Comorbidities in SpA study from Argentina, Colombia, and Mexico. Age- and sex-standardized prevalence (95% CI) was estimated for arterial hypertension (AHT), tuberculosis (TB), and malignancies. Age- and sex-specific data from the general population were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study for AHT, the Global TB report, and the GLOBOCAN project for malignancies. Data analyzed for AHT were confined to Colombia and Mexico. The prevalence in patients with SpA was compared with the prevalence in the general population per age- and sex-specific stratum, resulting in standardized risk ratios (SRR).Results.In total, 64% of the patients with SpA were male, with a mean age of 45 years (SD 14.7). The most common comorbidities in the 3 LA countries were AHT (25.3%, 95% CI 21.2–30.0), hypercholesterolemia (21.5%, 95% CI 17.6–26.0), and osteoporosis (9.4%, 95% CI 6.8–12.9). AHT prevalence in Colombia and Mexico was 21.4% (95% CI 15.4–28.9) and was higher than the general population (12.5%, 95% CI 11.4–13.7), resulting in an SRR of 1.5. TB prevalence in the 3 LA countries was 3.3% (95% CI 1.8–5.7), which was significantly higher than in the general population (0.32%), leading to an SRR of 10.3. The prevalence of malignancies was not increased.Conclusion.Patients with SpA in LA are at increased risk of AHT and TB in comparison to the general population. While this sample of patients may not be entirely representative of the patient population in each country, a systematic evaluation of these comorbidities in all patients with SpA still may help to monitor these conditions better.

Epidemiology of Hypertension and Diabetes Mellitus in Latin America

2020 ◽  
Vol 16 ◽  
Author(s):  
Patricio Lopez-Jaramillo ◽  
Jose Lopez-Lopez ◽  
Daniel Cohen ◽  
Natalia Alarcon-Ariza ◽  
Margarita Mogollon-Zehr
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Latin America ◽  
Cardiovascular Diseases ◽  
Latin American ◽  
Premature Mortality ◽  
Increased Risk ◽  
And Control

: Hypertension and type 2 diabetes mellitus are two important risk factors that contribute to cardiovascular diseases worldwide. In Latin America hypertension prevalence varies from 30 to 50%. Moreover, the proportion of awareness, treatment and control of hypertension is very low. The prevalence of type 2 diabetes mellitus varies from 8 to 13% and near to 40% are unaware of their condition. In addition, the prevalence of prediabetes varies from 6 to 14% and this condition has been also associated with increased risk of cardiovascular diseases. The principal factors linked to a higher risk of hypertension in Latin America are increased adiposity, low muscle strength, unhealthy diet, low physical activity and low education. Besides being chronic conditions, leading causes of cardiovascular mortality, both hypertension and type 2 diabetes mellitus represent a substantial cost for the weak health systems of Latin American countries. Therefore, is necessary to implement and reinforce public health programs to improve awareness, treatment and control of hypertension and type 2 diabetes mellitus, in order to reach the mandate of the Unit Nations of decrease the premature mortality for CVD.

scholarly journals How Does Frailty Factor Into Mortality Risk Assessment of a Middle-Aged and Geriatric Trauma Population?

2017 ◽  
Vol 8 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Sanjit R. Konda ◽  
Ariana Lott ◽  
Hesham Saleh ◽  
Sebastian Schubl ◽  
Jeffrey Chan ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Functional Independence ◽  
High Energy ◽  
Low Energy ◽  
Geriatric Trauma ◽  
Inpatient Mortality ◽  
Middle Aged ◽  
Trauma Population ◽  
Increased Risk ◽  
Significant Difference

Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population. Methods: A total of 1486 patients aged 55 years and older who met the American College of Surgeons Tier 1 to 3 criteria and/or who had orthopedic or neurosurgical traumatic consultations in the emergency department between September 2014 and September 2016 were included. The STTGMAORIGINAL and STTGMAFRAILTY scores were calculated. Additional “frailty variables” included preinjury assistive device use (disability), independent ambulatory status (functional independence), and albumin level (nutrition). The ability of the STTGMAORIGINAL and the STTGMAFRAILTY models to predict inpatient mortality was compared using area under the receiver operating characteristic curves (AUROCs). Results: There were 23 high-energy inpatient mortalities (4.7%) and 20 low-energy inpatient mortalities (2.0%). When the STTGMAORIGINAL model was used, the AUROC in the high-energy and low-energy cohorts was 0.926 and 0.896, respectively. The AUROC for STTGMAFRAILTY for the high-energy and low-energy cohorts was 0.905 and 0.937, respectively. There was no significant difference in predictive capacity for inpatient mortality between STTGMAORIGINAL and STTGMAFRAILTY for both the high-energy and low-energy cohorts. Conclusion: The original STTGMA tool accounts for important frailty factors including cognition and general health status. These variables combined with other major physiologic variables such as age and anatomic injuries appear to be sufficient to adequately and accurately quantify inpatient mortality risk. The addition of other common frailty factors that account for does not enhance the STTGMA tool’s predictive capabilities.

scholarly journals An overview of the epidemiology of periodontal diseases in Latin America

2007 ◽  
Vol 21 (spe) ◽  
pp. 8-15 ◽  
Author(s):  
Rui Vicente Oppermann
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Latin American ◽  
Oral Hygiene ◽  
Periodontal Diseases ◽  
Aggressive Periodontitis ◽  
Epidemiological Studies ◽  
Socioeconomic Background ◽  
Industrialized Countries ◽  
Modifiable Factors

The aim of the present review was to identify the presence of periodontal diseases and the relative importance of known risk factors in Latin American countries. The retrieved data are sparse and inconsistent, lacking information for the majority of the countries. Gingivitis is ubiquitous in the region, affecting all ages independently of the socioeconomic background. The extension of bleeding may vary greatly, ranging from 40% to 70% of sites. The prevalence of aggressive periodontitis is higher in Latin America than in industrialized countries. Prevalence ranges from 0.3% to 4.5%, and the localized form is the less prevalent. The prevalence of chronic periodontitis is high, with a large variation (40-80%) probably due to differences in methodology and diagnostic criteria. Regional differences may be relevant. Known risk factors are present in the populations studied. Non-modifiable factors such as age, gender and genetics have been associated in Brazilian and Chilean populations. Tobacco smoking and diabetes are relevant risk factors. The importance of socioeconomic status, although present as a risk factor, has been largely underestimated. Oral hygiene is extremely deficient in the area although it is a cultural habit in most populations. It can be concluded that periodontal diseases are highly prevalent in Latin American populations. Its prevalence and extent are associated with known risk factors. Oral hygiene habits are deficient. Well designed epidemiological studies with external validity are needed.

scholarly journals Major Cardiovascular Risk Factors in Latin America: A Comparison with the United States. The Latin American Consortium of Studies in Obesity (LASO)

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e54056 ◽  
Author(s):  
J. Jaime Miranda ◽  
Victor M. Herrera ◽  
Julio A. Chirinos ◽  
Luis F. Gómez ◽  
Pablo Perel ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Latin America ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Latin American ◽  
The United States

scholarly journals A Dietary Intervention of Bioactive Enriched Foods Aimed at Adults at Risk of Metabolic Syndrome: Protocol and Results from PATHWAY-27 Pilot Study

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1814 ◽  
Author(s):  
Achim Bub ◽  
Corinne Malpuech-Brugère ◽  
Caroline Orfila ◽  
Julien Amat ◽  
Alice Arianna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Pilot Study ◽  
Dietary Intervention ◽  
Adult Population ◽  
Serum Triglyceride ◽  
Beta Glucan ◽  
Double Blind ◽  
Pilot Studies ◽  
Increased Risk

Around a quarter of the global adult population have metabolic syndrome (MetS) and therefore increased risk of cardiovascular mortality and diabetes. Docosahexaenoic acid, oat beta-glucan and grape anthocyanins have been shown to be effective in reducing MetS risk factors when administered as isolated compounds, but their effect when administered as bioactive-enriched foods has not been evaluated. Objective: The overall aim of the PATHWAY-27 project was to evaluate the effectiveness of bioactive-enriched food consumption on improving risk factors of MetS. A pilot study was conducted to assess which of five bioactive combinations provided within three different food matrices (bakery, dairy or egg) were the most effective in adult volunteers. The trial also evaluated the feasibility of production, consumer acceptability and gastrointestinal tolerance of the bioactive-enriched food. Method: The study included three monocentric, parallel-arm, double-blind, randomised, dietary intervention trials without a placebo. Each recruiting centre tested the five bioactive combinations within a single food matrix. Results: The study was completed by 167 participants (74 male, 93 female). The results indicated that specific bioactive/matrix combinations have effects on serum triglyceride or HDL-cholesterol level without adverse effects. Conclusion: The study evidenced that bioactive-enriched food offers a promising food-based strategy for MetS prevention, and highlighted the importance of conducting pilot studies.

scholarly journals 1498. Assess Risk Factors, Mortality, and Healthcare Utilization Associated with Clostridioides difficile Infection (CDI) in 4 Latin American Countries

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S545-S545
Author(s):  
Holly Yu ◽  
Nestor Flaster ◽  
Adrian Casanello ◽  
Daniel Curcio
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Hospital Admission ◽  
Healthcare Utilization ◽  
Latin American ◽  
Conditional Logistic Regression ◽  
Developed Countries ◽  
Hospital Death ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract Background In contrast to Europe and North America, little is known about Clostridioides difficile infection (CDI) in Latin America, especially about risk factors, mortality, and healthcare utilization. Methods We conducted a retrospective, case–control study at eight hospital centers in Brazil, Mexico, Argentina, and Chile. Hospital databases and medical records were used to identify nosocomial CDI cases from January 1, 2014 to December 31, 2017. CDI cases were patients with diarrhea and a positive CDI testing ≥72 hours after hospital admission. Two controls with no CDI diagnosis and diarrhea were matched to each CDI case and were required to (1) have a length of hospital stay (LOS) ≥ 3 days, (2) be admitted ±14 days from the case, and (3) share the same ward. Risk factors associated with CDI were assessed by conditional logistic regression. Mortality and healthcare utilization were compared between cases and controls. Results A total of 1,443 patients (≥18 years old) who met eligibility criteria were selected (481 cases and 962 controls). Comparing cases to controls, the mean age and gender representation were similar (age: 58.7 vs. 56.7 years, P = 0.269; male: 56.3% vs. 53.4%, P = 0.293), but comorbidity was higher (mean Charlson Comorbidity index: 4.3 vs. 3.6, p Conclusion Antibiotic exposure, existing medical conditions, and recent hospital admission are CDI major risk factors in Latin America. CDI also increased in-hospital death risk and LOS. These findings are consistent with published literature in developed countries. Disclosures All authors: No reported disclosures.

scholarly journals Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

2020 ◽  
Author(s):  
Katherine E Goodman ◽  
Laurence S Magder ◽  
Jonathan D Baghdadi ◽  
Lisa Pineles ◽  
Andrea R Levine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Risk ◽  
Age Groups ◽  
Patient Characteristics ◽  
Chronic Complications ◽  
Risk Of Death ◽  
Relative Risks ◽  
Increased Risk ◽  
Metabolic Comorbidities

Abstract Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from COVID-19 remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April – June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66,646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12,388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26 – 1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96 – 1.06), and hypertension without chronic complications was only a risk factor in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17 – 2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; p-values ≤ 0.002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.

scholarly journals The Potential Therapeutic Value of Medicinal Plants in the Management of Metabolic Disorders

Molecules ◽  
2020 ◽  
Vol 25 (11) ◽  
pp. 2669 ◽  
Author(s):  
Trevor T. Nyakudya ◽  
Thulani Tshabalala ◽  
Rachael Dangarembizi ◽  
Kennedy H. Erlwanger ◽  
Ashwell R. Ndhlala
Keyword(s):  
Risk Factors ◽  
Medicinal Plants ◽  
South African ◽  
Health Benefits ◽  
Well Being ◽  
High Energy ◽  
Biologically Active ◽  
Potential Health ◽  
Increased Risk ◽  
The Impact

Metabolic syndrome (MetS) is a prevalent, multifactorial and complex disease that is associated with an increased risk of developing diabetes and other major cardiovascular complications. The rise in the global prevalence of MetS has been attributed to genetic, epigenetic, and environmental factors. The adoption of sedentary lifestyles that are characterized by low physical activity and the consumption of high-energy diets contributes to MetS development. Current management criteria for MetS risk factors involve changes in lifestyle and the use of pharmacological agents that target specific biochemical pathways involved in the metabolism of nutrients. Pharmaceutical drugs are usually expensive and are associated with several undesirable side effects. Alternative management strategies of MetS risk factors involve the use of medicinal plants that are considered to have multiple therapeutic targets and are easily accessible. Medicinal plants contain several different biologically active compounds that provide health benefits. The impact of phytochemicals present in local medicinal plants on sustainable health and well-being of individuals has been studied for many years and found to involve a plethora of complex biochemical, metabolic, and physiological mechanisms. While some of these phytochemicals are the basis of mainstream prescribed drugs (e.g., metformin, reserpine, quinine, and salicin), there is a need to identify more medicinal plants that can be used for the management of components of MetS and to describe their possible mechanisms of action. In this review, we assess the potential health benefits of South African ethnomedicinal plants in protecting against the development of health outcomes associated with MetS. We aim to provide the state of the current knowledge on the use of medicinal plants and their therapeutically important phytochemicals by discussing the current trends, with critical examples from recent primary references of how medicinal plants are being used in South African rural and urban communities.

Overview of Peritoneal Dialysis in Latin America

2007 ◽  
Vol 27 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Roberto Pecoits-Filho ◽  
Hugo Abensur ◽  
Alfonso M. Cueto-Manzano ◽  
Jorge Dominguez ◽  
José Carolino ◽  
...  
Keyword(s):  
Latin America ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Latin American ◽  
Personal Communication ◽  
Term Outcome ◽  
Long Term Outcome ◽  
American Society ◽  
Stage Renal Disease ◽  
End Stage

Latin America is a heterogeneous region comprised of 20 countries, former colonies of European countries, in which Latin-derived languages are spoken. According to the Latin American Society of Nephrology and Hypertension/ Sociedad Latino Americana de Nefrologia e Hipertensión (SLANH), the acceptance rate for renal replacement therapy is 103 new patients per million population. In Latin America, hemodialysis is the predominant form of replacement therapy for end-stage renal disease; however, some countries employ peritoneal dialysis (PD) in 30% or more patients. In particular, Mexico is the country with the largest PD utilization in the world, and furthermore, it is estimated that approximately 25% of the world's PD population may be found Latin America. Data concerning clinical practice and long-term outcome of PD in Latin America are scarce, although regional registries are increasing in number and quality. In this review article, we present an overview of the situation of PD in several countries of Latin America, based on the registry of the SLAHN, national registries, and personal communication with PD experts from different countries.

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