Predictors of laxative use in inpatients with schizophrenia on clozapine

2021 ◽  
pp. 103985622110423
Author(s):  
Vladimir Sazhin ◽  
Pushkal Pushkal

Objectives: Constipation, a clinical manifestation of gastrointestinal hypomotility, is a common and potentially serious complication of clozapine therapy, requiring laxatives for its prevention and treatment. We explored the predictive factors of the increased laxative use in inpatients receiving a long-term clozapine therapy. Methods: In the cross-sectional study of 93 patients in a psychiatric rehabilitation hospital, we examined a four-week prevalence of laxative use and a range of demographic and clinical factors associated with the number of prescribed laxatives. Results: Seventy-four percent of inpatients with schizophrenia were prescribed laxatives, and they were statistically significant older and taking higher daily doses of clozapine. In generalized Poisson regression analysis, the clozapine dose, age, and comorbid diabetes mellitus and hypothyroidism were independently associated with the number of concurrently used laxatives. No association was found between the laxatives and gender, duration of clozapine treatment, and the number of other medications with a potential to cause constipation. Conclusion: The clozapine dose, age, diabetes mellitus, and hypothyroidism were shown to be the independent predictors of the increased laxative use among inpatients on clozapine and might be associated with the increased risk of clozapine-induced constipation and gastrointestinal hypomotility.

2019 ◽  
Vol 8 ◽  
pp. 204800401986323 ◽  
Author(s):  
Dina Eufemia D San Gabriel ◽  
Julia Slark

Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.


2021 ◽  
Vol 35 ◽  
pp. 205873842110485
Author(s):  
Yi-Hsuan Chen ◽  
Wen-Cheng Li ◽  
Yi-Chuan Chen ◽  
Wei-Chung Yeh ◽  
Wei Yu ◽  
...  

Objective: Being overweight is associated with an increased risk of diabetes mellitus, hypertension, and cardiovascular disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) can independently predict the risk of cardiovascular disease. This study is aimed to investigate whether Lp-PLA2 was associated with an overweight status. Methods: This was a cross-sectional study that enrolled 3760 Chinese adults (age, 18–50 years) who underwent medical examination department of Xiamen Chang-Gung Hospital (XCGH) from 2018 to 2020. To explore the distribution of overweight classifications in the Chinese population, we evaluated the correlation of the overweight status with Lp-PLA2, after correcting for possible influencing factors. Results: The Lp-PLA2 level was greater in male than in female subjects ( p < 0.001). Subjects with a central overweight status had a greater Lp-PLA2 level than those with normal weight and a peripheral overweight status, in both male and female cohorts. The Lp-PLA2 level was significantly greater in those with additional comorbidities (namely diabetes mellitus (DM), hypertension (HTN), overweight, and metabolic syndrome (MetS)). The age-adjusted and LDL-adjusted Lp-PLA2 level also was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−), HTN (−), DM (−), and HTN (+) subgroups. Conclusion: Lp-PLA2 is associated with sex, central overweight status, diabetes, hypertension, and MetS in adults aged < 50 years and the age-adjusted and LDL-adjusted Lp-PLA2 was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−) and HTN (−) and DM (−) and HTN (+) subgroups.


2019 ◽  
Vol 72 (suppl 2) ◽  
pp. 30-35
Author(s):  
Ana Carolina Ottaviani ◽  
Estefani Serafim Rossetti ◽  
Mariélli Terassi ◽  
Allan Gustavo Brigola ◽  
Bruna Moretti Luchesi ◽  
...  

ABSTRACT Objective: evaluate the factors associated with the risk of diabetes mellitus in older caregivers. Method: this is a cross-sectional study conducted with 326 older caregivers enrolled in Family Health Units. Data were collected using a sociodemographic characterization questionnaire, clinical and care information, and the Finnish Diabetes Risk Score to assess the risk of developing diabetes. Results: 35.5% of the caregivers presented a high risk of developing diabetes. The factors associated with the risk of developing diabetes were: use of medication (OR = 3.88), satisfactory or poor health assessment (OR = 1.72), and the fact of being female (OR = 0.48). Conclusion: more than one third of older caregivers present high risk of developing diabetes. Therefore, being female, living with other people, using medication, and having a poor health assessment are factors associated with increased risk of developing diabetes.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Oswin Mwemezi ◽  
Paschal Ruggajo ◽  
Jonathan Mngumi ◽  
Francis F Furia

Background. HIV-associated renal dysfunction is common among infected patients; the growing burden of this condition may be partly accounted for by improved survival attributed to sustained viral suppression with antiretroviral therapies (ART). Some ART regimens are nephrotoxic and may potentially contribute to renal dysfunction observed in these patients. This study aimed at investigating the prevalence of renal dysfunction among people living with HIV (PLHIV) on ART attending the care and treatment clinic (CTC). Methods. A cross-sectional study was conducted between June and October 2019 among adults living with HIV on ART for 6 months or more attending CTC at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 287 participants were screened for proteinuria and microalbuminuria using the Cybow 300 urine analyzer. Serum creatinine was tested for all participants, and it was used to estimate glomerular filtration rate (eGFR) using the CKD-EPI formula. Results. Out of 287 participants (72.1% female, mean age ± SD: 46.7 ± 10.6 years), about one-third (32.8%) had eGFR less than 90 ml/min, whereas 7% had eGFR less than 60 ml/min. Microalbuminuria and proteinuria were detected in 38.6% and 25.1% of participants, respectively. In the multivariate analysis, predictive determinants for renal dysfunction were higher viral loads (OR 2.5 (1.1–5.8), p=0.031), diabetes mellitus (OR 5.5 (1.6–18.6), p=0.006), and age above 60 years (OR 2.8 (1.0–7.3), p=0.041); however, this was not the case for serum CD4 counts (OR 1.25 (0.7–2.3), p=0.46). Conclusion. High prevalence of renal dysfunction among PLHIV on ART was noted in this study. Viral loads above 1000 cp/ml and diabetes mellitus were noted to be associated with increased risk for renal dysfunction.


Author(s):  
Blanche Cunégonde Omgba Etoundi ◽  
Lionel Fabrice Djomkam Youmsi ◽  
Danielle Émilie Mbock ◽  
Valère Cynthia Kayo Tayou ◽  
Martin Luther Koanga Mogtomo

Background: The increased nutritional needs associated with the initiation of antiretroviral therapy exposes HIV-positive patients to an uncontrolled diet. This places them at an increased risk for diabetes mellitus and highlights the role of nutritional habits in the development of diabetes mellitus amongst HIV patients. Aim: In this study, we sought to investigate the feeding habits and their effect on the occurrence of diabetes amongst HIV-positive patients at the Nylon District hospital. Materials and Methods: A hospital-based cross-sectional study was carried out over eight months. A total of 182 participants were randomly selected of which 134 were HIV-positive and 48 HIV-negative. Blood samples were collected after at least an eight-hour fast. Results: The prevalence of diabetes in the HIV-positive group was 19 % compared to 10 % in the HIV-negative group. The total cholesterol and triglyceride levels were higher in HIV-negative participants compared to HIV-positive participants. Consumption of dairy products more than once per day (OR= 0.71, 95 % CI: 0.27-1.89), vegetable consumption more than once per day (OR= 0.79, 95 % CI: 0.25-2.56), more than one meal per day (OR= 0.13 95% CI: 0.02-1.04), breakfast more than twice per week (OR= 0.91 95 % CI: 0.2-4.11), and practicing physical exercise (OR= 0.7 95 % CI: 0.28-1.78), reduced the odds of having diabetes in HIV positive participants. Conclusion: The HIV status has an impact on the occurrence of diabetes mellitus in these patients, and it is highly associated with the feeding habits and the lifestyle of these patients. Keywords: HIV, diabetes mellitus, feeding habits, lifestyle, lipid profile.


Author(s):  
I. Yu. Torshin ◽  
A. M. Lila ◽  
A. V. Naumov ◽  
I. S. Sardaryan ◽  
T. E. Bogacheva ◽  
...  

Objective: analysis of the osteoarthritis (OA) comorbidity taking into account the microelement status and genetic polymorphisms of the examined patients, determination of the prospects for the OA prevention and therapy.Material and methods. A cross-sectional study of a multiethnic cohort (n=655, mean age 43±14 years, 95% CI 29–70) formed on the basis of the Institute of Microelements database, was carried out. For all participants, the content of the 62 elements of the Element Periodic Table profile in hair was identified and variants of 120 nucleotide polymorphisms associated with various pathologies were definedResults. The study found that 18 of the 27 ICD-10 diagnoses examined were comorbid with OA. Osteoarthritis was comorbid with pathologies with a pronounced component of inflammation (ulcerative colitis, atherosclerosis, unspecified encephalopathy, obesity, diabetes mellitus, essential (primary) hypertension, urine calculus, acute myocardial infarction, cholelithiasis, etc.). The core of OA comorbidity was established, which included following pathologies: chronic cerebral ischemia, diabetes mellitus, thrombophlebitis, atherosclerosis, cholelithiasis. Seven profiles of the most frequent combinations of these diagnoses were identified. The presence of 2 out of 5 of these pathologies was recorded in 92% of patients with OA (n=50) and only in 2% of control patients (n=600), which corresponded to an extreme increase in the risk of OA (OR 56.3, 95% CI 17.4–181.6, p<10–20). Analysis of the 62 elements profile of the Element Periodic Table content in hair showed that reduced levels of silicon, molybdenum, vanadium and calcium are significantly associated with OA. As a result of studying data on 120 nucleotide polymorphisms, OA was significantly associated with the LPL Ser447Stop CC, LPL N291S AA, NOS3 E298D GG, and MTHFR 677 CC genotypes, which regulate lipid metabolism and inflammation.Conclusion. Based on the obtained results the prospects for the use of chondroitin sulfate and glucosamine sulfate in patients with an increased risk of OA development are shown.


2021 ◽  
Vol 1 (2) ◽  
pp. 50-58
Author(s):  
Richard K.D. Ephraim

Background: Diabetes mellitus is an important risk factor associated with tuberculosis (TB). This study investigated the prevalence and determinants of hyperglycemia among newly diagnosed pulmonary tuberculosis patients in the Agona Swedru Municipality. Method: A hospital-based cross-sectional study was conducted from December 2015 to April 2016. One hundred (100) newly diagnosed pulmonary tuberculosis patients at the Agona Swedru Municipal Hospital (ASMH) were enrolled for the study. Socio-demographic, clinical and anthropometric measurements were collected and fasting blood glucose (FBG) measured using standard protocols. Data was analyzed using Statistical Package for Social Sciences (SPSS) software version 20.0. Result: Of the 100 participants, 26% had hyperglycemia. The significant factors associated with increased risk of hyperglycemia among participants were history of diabetes mellitus (OR = 8.17, p= 0.004), severity of infection (OR = 23.64, p < 0.001) and duration of symptoms (OR= 2.63, p= 0.042). Conclusion: Hyperglycemia was common among newly diagnosed pulmonary tuberculosis patients. History of diabetes mellitus, severity of infection, and duration of symptoms were the determinants of hyperglycemia in pulmonary tuberculosis. Regular screening of hyperglycemia is essential in the management of tuberculosis. Finally, further studies should be conducted on glucose levels among pulmonary tuberculosis patients using higher sample size to increase the understanding of the subject.


2020 ◽  
Vol 7 (4) ◽  
pp. 1036
Author(s):  
Patric Paul ◽  
Induprabhayadev Prabhakaran ◽  
Meer Chisthi

Background: Necrotizing fasciitis refers to the rapidly progressive inflammation of the fascia, with secondary necrosis of subcutaneous tissues. Due to the high mortality, it is considered a surgical emergency, needing timely diagnosis and appropriate treatment with early debridement. The aim of the study was to analyse the clinical profile of patients with necrotizing fasciitis so as to determine the mortality and the risk factors associated with mortality and other poor outcomes.Methods: This retrospective cross-sectional study was conducted in a tertiary hospital in Kerala, from January 2016 through January 2018. 175 cases were identified through the ICD codes for necrotizing fasciitis and Fournier’s gangrene in the discharge and death registers; and data were obtained about these patients. The data were analyzed to assess the study objectives.Results: In this study mortality was found to be 22.7%. Diabetes mellitus was found to be the most common co-morbid disease and had a significant association with increased risk of amputation. Mixed growth (type I NF) was the most common microbiological isolate and Pseudomonas was the most common gram-negative isolate. 4 cases of MRSA were recorded. Klebsiella infection was found to have increased risk of undergoing limb amputation. 7.4% of the patients required amputation during hospital stay for infection control.Conclusions: Necrotizing fasciitis has a high mortality. Diabetes mellitus was found to be the most common co-morbid disease. Increased blood glucose and low serum albumin had a significant association with an increased risk of amputation. Proper control of these factors is essential to reduce mortality from this condition.


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