scholarly journals High myopia is protective against diabetic retinopathy via thinning retinal vein: A report from Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT)

2020 ◽  
Vol 17 (4) ◽  
pp. 147916412094098
Author(s):  
Zhong Lin ◽  
Dong Li ◽  
Gang Zhai ◽  
Yu Wang ◽  
Liang Wen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Cohort Study ◽  
Confidence Interval ◽  
Proliferative Diabetic Retinopathy ◽  
Odds Ratio ◽  
Chinese Population ◽  
High Myopia ◽  
Negatively Associated ◽  
Type 2 Diabetic Mellitus ◽  
Central Retinal Venular Equivalent

Purpose: To investigate the association between high myopia and diabetic retinopathy, and its possible mechanism, in a northeastern Chinese population with type 2 diabetic mellitus. Methods: Patients were included from Fushun Diabetic Retinopathy Cohort Study. High myopia was defined as spherical equivalent of autorefraction less than −5D. Results: A total of 1817 patients [688 (37.9%) diabetic retinopathy, 102 (5.6%) high myopia] were included. Compared to eyes without high myopia, the frequency of diabetic retinopathy and non-proliferative diabetic retinopathy was significantly less in eyes with high myopia (23.5% vs 38.7%, p = 0.002; 22.5% vs 35.3%, p = 0.005). Eyes with high myopia were less likely to have diabetic retinopathy (multivariate odds ratio, 95% confidence interval: 0.39, 0.22–0.68) or non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 0.40, 0.23–0.70). High myopia was negatively associated with central retinal venular equivalent (multivariate β, 95% confidence interval: −37.1, −42.3 to −31.8, p < 0.001). Furthermore, central retinal venular equivalent (per 10 μm increase) had a significant association with diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.17–1.31) as well as non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.18–1.31). Conclusions: High myopia was negatively associated with both diabetic retinopathy and non-proliferative diabetic retinopathy in this northeastern Chinese population. This protective effect may have been partially achieved via thinning retinal veins.

scholarly journals High-Mobility Group Box-1 and Endothelial Cell Angiogenic Markers in the Vitreous from Patients with Proliferative Diabetic Retinopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Abu El-Asrar ◽  
Mohd Imtiaz Nawaz ◽  
Dustan Kangave ◽  
Marwan Abouammoh ◽  
Ghulam Mohammad
Keyword(s):  
Diabetic Retinopathy ◽  
Endothelial Cell ◽  
Confidence Interval ◽  
Proliferative Diabetic Retinopathy ◽  
Odds Ratio ◽  
High Mobility ◽  
High Mobility Group ◽  
Enzyme Linked Immunosorbent Assay ◽  
Vascular Endothelial ◽  
Angiogenic Markers

The aim of this study was to measure the levels of high-mobility group box-1 (HMGB1) in the vitreous fluid from patients with proliferative diabetic retinopathy (PDR) and to correlate its levels with clinical disease activity and the levels of vascular endothelial growth factor (VEGF), the angiogenic cytokine granulocyte-colony-stimulating factor (G-CSF), the endothelial cell angiogenic markers soluble vascular endothelial-cadherin (sVE-cadherin), and soluble endoglin (sEng). Vitreous samples from 36 PDR and 21 nondiabetic patients were studied by enzyme-linked immunosorbent assay. HMGB1, VEGF, sVE-cadherin, and sEng levels were significantly higher in PDR patients than in nondiabetics (P=0.008; <0.001; <0.001; 0.003, resp.). G-CSF was detected in only 3 PDR samples. In the whole study group, there was significant positive correlation between the levels of HMGB1, and sVE-cadherin (r=0.378,P=0.007). In PDR patients, there was significant negative correlation between the levels of sVE-cadherin and sEng (r=−0.517,P=0.0005). Exploratory regression analysis identified significant associations between active PDR and high levels of VEGF (odds ratio = 76.4; 95% confidence interval = 6.32–923) and high levels of sEng (odds ratio = 6.01; 95% confidence interval = 1.25–29.0). Our findings suggest that HMGB1, VEGF, sVE-cadherin and sEng regulate the angiogenesis in PDR.

scholarly journals Association of central arterial stiffness with the presence and severity of diabetic retinopathy in Asians with type 2 diabetes

2019 ◽  
Vol 16 (6) ◽  
pp. 498-505 ◽  
Author(s):  
Xiao Zhang ◽  
Su Chi Lim ◽  
Subramaniam Tavintharan ◽  
Lee Ying Yeoh ◽  
Chee Fang Sum ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Arterial Stiffness ◽  
Confidence Interval ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Proliferative Diabetic Retinopathy ◽  
Odds Ratio ◽  
Pulse Wave ◽  
Augmentation Index

Objective: Arterial stiffness has been associated with diabetic retinopathy; however, the information is limited in Asians. We aim to examine the association of central arterial stiffness with the presence and severity of diabetic retinopathy in type 2 diabetes mellitus patients in Singapore. Methods: Arterial stiffness was estimated by carotid-femoral pulse wave velocity and augmentation index using applanation tonometry method. Digital colour fundus photographs from 1,203 patients were assessed for diabetic retinopathy. Diabetic retinopathy severity was categorized into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Logistic regression model was used to evaluate the associations of diabetic retinopathy with pulse wave velocity and augmentation index. Results: Diabetic retinopathy was diagnosed in 391 (32.5%) patients, including 271 non-proliferative diabetic retinopathy and 108 proliferative diabetic retinopathy. Diabetic retinopathy have higher pulse wave velocity (11.2 ± 3.3 vs 9.5 ± 2.6 m/s, p < 0.001) and augmentation index (28.4 ± 9.4 vs 26.1 ± 10.6%, p < 0.001) than non-diabetic retinopathy. After multivariable adjustment, pulse wave velocity [odds ratio = 1.11 (95% confidence interval = 1.05–1.17), p < 0.001] and augmentation index [odds ratio = 1.03 (95% confidence interval = 1.01–1.04), p = 0.009] was associated with diabetic retinopathy. In severity analyses, pulse wave velocity was associated with non-proliferative diabetic retinopathy [odds ratio = 1.10 (95% confidence interval = 1.03–1.17), p = 0.002] and proliferative diabetic retinopathy [odds ratio = 1.15 (95% confidence interval = 1.06–1.25), p = 0.001] ( p-trend < 0.001). Augmentation index showed significant associations with non-proliferative diabetic retinopathy [odds ratio = 1.02 (95% confidence interval = 1.01–1.04), p = 0.008], but not with proliferative diabetic retinopathy [odds ratio = 1.01 (95% confidence interval = 0.98–1.04), p = 0.36] ( p-trend = 0.03). Conclusion: Central arterial stiffness was associated with the presence and severity of diabetic retinopathy in type 2 diabetes mellitus patients, suggesting its etiologic implication in diabetic retinopathy.

β-Blockers, Tachycardia, and Survival Following Sepsis: An Observational Cohort Study

2021 ◽  
Author(s):  
Dmitri Guz ◽  
Shira Buchritz ◽  
Alina Guz ◽  
Alon Ikan ◽  
Tania Babich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cohort Study ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Internal Medicine Wards ◽  
Β Blockers

Abstract Background Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. Methods We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). Results A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age [interquartile range], 74 [62–82] vs 81 [68–87] years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177–.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148–.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. Conclusions Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

scholarly journals Understanding patterns and factors associated with place of death in patients with end-stage kidney disease: A retrospective cohort study

2016 ◽  
Vol 31 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Natasha Lovell ◽  
Chris Jones ◽  
Dawn Baynes ◽  
Sarah Dinning ◽  
Katie Vinen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Place Of Death ◽  
Renal Unit ◽  
End Stage Kidney Disease ◽  
End Stage

Background: Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. Aim: To understand patterns of place of death in patients with end-stage kidney disease known in one UK renal unit. Design: A retrospective cohort study of all patients with chronic kidney disease stage 4–5, age ⩾75 and known to one UK renal unit, who died between 2006 and 2012. Patients were categorised into three management pathways: haemodialysis, conservative and pre-dialysis. Results: A total of 321 patients (mean age, 82.7; standard deviation, 5.21) died (61.7% male). In all, 62.9% died in hospital (95% confidence interval, 57.5%–68.1%), 21.8% died in their usual place of residence (95% confidence interval, 17.5%–26.6%) and 15.3% died in an inpatient palliative care unit (95% confidence interval, 11.6%–19.5%). Management pathway and living circumstances were most strongly associated with place of death. Patients on the conservative pathway had four times the odds of dying out of hospital (odds ratio, 4.0; 95% confidence interval, 2.1–7.5; p < 0.01). Patients living alone were less likely to die out of hospital (odds ratio, 0.3; 95% confidence interval, 0.1–0.6; p < 0.01). There were also changes in place of death over time, with more patients dying out of hospital in 2012 compared to 2006 (odds ratio, 3.1; 95% confidence interval, 1.0–9.7; p < 0.05). Conclusion: Most patients with end-stage kidney disease die in hospital, but patients managed without dialysis are significantly more likely to die outside of hospital. Planning ahead is key to be able to meet preference for place of death.

Diabetes duration may modify the association between genetic variation in the glycoprotein Ia subunit of the platelet collagen receptor and risk of severe diabetic retinopathy: a working hypothesis

2003 ◽  
Vol 89 (01) ◽  
pp. 142-148 ◽  
Author(s):  
Elisabeth Agardh ◽  
Gayle Teramura ◽  
Prashart Gaur ◽  
Lakshmi Gaur ◽  
Carl-David Agardh ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Genetic Variation ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Integrin Subunit ◽  
Patients With Diabetes ◽  
Collagen Receptor ◽  
Risk Of Retinopathy

SummaryGenetic factors appear to contribute to the severity and progression of diabetic retinopathy. We assessed the associations of the C807T and Glu505Lys variants of the glycoprotein Ia ( 2 integrin) subunit of the platelet/endothelial collagen receptor and risk of retinopathy in a population-based survey of 288 diabetic patients in one Swedish community. Neither variant was associated with retinopathy risk overall. However, the 807T variant was associated with increased risk of severe retinopathy, and the association was modified by diabetes duration. Among patients with diabetes of longer duration ( 25 years), the 807T variant was strongly associated with risk of severe retinopathy (odds ratio 7.49, 95% confidence interval 1.75 to 32.1). There was no association between the 807T variant and risk of severe retinopathy among patients with diabetes duration <25 years. The Lys505 variant of glycoprotein Ia was associated with an odds ratio for severe retinopathy of 1.88 (95% confidence interval 0.83 to 4.24). Overall, there was a significant interaction between glycoprotein Ia genotype and duration of diabetes on the risk of retinopathy (P-value for interaction = 0.019).These results suggest the hypothesis that genetic variation of platelet glycoprotein Ia may play a particularly important role during the advanced stages of diabetic retinopathy.

scholarly journals Thyroid Function Within the Normal Range and the Risk of Depression: A Population-Based Cohort Study

2014 ◽  
Vol 99 (4) ◽  
pp. 1213-1219 ◽  
Author(s):  
Marco Medici ◽  
Nese Direk ◽  
W. Edward Visser ◽  
Tim I. M. Korevaar ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Depressive Symptoms ◽  
Confidence Interval ◽  
Thyroid Function ◽  
Odds Ratio ◽  
Elderly Persons ◽  
Normal Range ◽  
Baseline Serum ◽  
Increased Risk ◽  
Depressive Syndromes

Context: Overt hypo- and hyperthyroidism are associated with an increased risk of depression. Little is known about the effects of variation in thyroid function within the normal range on the risk of depression. Objective: The objective of the study was to examine the association between normal-range thyroid function and the risk of depression. Design, Setting, and Participants: This was a cohort study in 1503 Dutch men and women, aged 70.6 (7.3) (mean [SD]) years. At baseline, serum TSH, thyroperoxidase antibody levels, and depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D)] were assessed. A CES-D of 16 or greater is indicative of a depressive disorder. During follow-up (mean 8.0 y), participants were continuously monitored for the occurrence of incident depressive syndromes (n = 156). Results: Cross-sectionally, persons in the lowest TSH tertile (0.3–1.0 mU/L) had more depressive symptoms [CES-D score (mean): 7.95 vs 6.63, P = .014] as well as an increased risk of a CES-D of 16 or greater [10.7% vs 5.0%, odds ratio (95% confidence interval) 2.22 (1.18–4.17)], compared with persons in the highest normal range TSH tertile (1.6–4.0 mU/L). In the prospective analyses, persons in the lowest TSH tertile who were depression free at baseline had a higher risk of incident depressive syndromes [12.3% vs 7.6%, odds ratio (95% confidence interval) 1.85 (1.10–3.11)]. Thyroid autoimmunity (thyroperoxidase antibody positivity) was not associated with CES-D scores or incident depressive syndromes. Conclusions: Elderly persons with low-normal TSH levels have more concurrent depressive symptoms as well as a substantially increased risk of developing a depressive syndrome in the subsequent years. This study identifies low-normal TSH as an important risk factor for depression in the elderly.

scholarly journals Deep sedation using propofol target-controlled infusion for gastrointestinal endoscopic procedures: a retrospective cohort study*

2020 ◽  
Author(s):  
María. E. García Guzzo ◽  
María Sol Fernandez ◽  
Delfina Sánchez Novas ◽  
Sandra S. Salgado ◽  
Sergio A. Terrasa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Gastrointestinal Endoscopy ◽  
Oxygen Desaturation ◽  
Endoscopic Procedures ◽  
Target Controlled Infusion

Abstract Background: Propofol sedation is effective for gastrointestinal endoscopic procedures, but its narrow therapeutic window highlights the importance of identifying an optimal administration technique regarding effectiveness and safety. This study aimed to determine the incidence of significant adverse events in adult patients scheduled for gastrointestinal endoscopy under anaesthetist-performed sedation using propofol target-controlled infusion and determine its potentially improved safety over other anaesthetic strategies. Methods: This single-centre, retrospective cohort study took place in a tertiary referral university hospital. Medical records of 823 patients (age >18 years, American Society of Anesthesiologists physical status classification scores I–III) who had undergone elective gastrointestinal endoscopy under propofol target-controlled infusion sedation during September 2018 were reviewed. Outcomes included hypoxia, hypotension, and bradycardia events, requirement of vasoactive drugs, unplanned tracheal intubation or supraglottic device insertion, and need for advanced cardiac life support. Results: The most frequently encountered adverse event was oxygen desaturation <95% with an incidence of 22.35%. Vasoactive drug administration, hypotension, and oxygen desaturation <90% followed, with incidences of 19.2%, 12.64%, and 9.92%, respectively. Only 0.5% of patients required advanced airway management. Multivariate analysis revealed an association between hypotension events, colonoscopic procedures, and propofol doses (odds ratio: 3.08, 95% confidence interval: 1.43 to 6.61; P=0.004 and odds ratio: 1.14, 95% confidence interval: 1.00 to 1.29; P=0.046). A strong dose-effect relationship was found between hypoxia and obesity; patients with body mass index ≥40 were nine times (odds ratio: 10.22, confidence interval: 95% 2.83 to 36.99) more likely to experience oxygen desaturation <90% events. Conclusions: Propofol sedation using target-controlled infusion appears to be a safe and effective anaesthetic technique for gastrointestinal endoscopic procedures with low rates of adverse events and could be more widely adopted in clinical practice.

scholarly journals The clinical implications of sinus tachycardia in mild COVID-19 infection: A retrospective cohort study

2021 ◽  
Vol 9 ◽  
pp. 205031212110549
Author(s):  
Jenny Yi Chen Hsieh ◽  
Juliana Yin Li Kan ◽  
Shaikh Abdul Matin Mattar ◽  
Yan Qin
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Sinus Tachycardia ◽  
High Dependency ◽  
General Wards

Objectives: This study aims to estimate the prevalence of sinus tachycardia in hospitalized patients with mild COVID-19 infection and to identify the clinical, radiological, and biological characteristics associated with sinus tachycardia. Methods: A retrospective cohort study was conducted on patients with mild COVID-19 infection and sinus tachycardia during hospitalization. Outcomes measured included incidences of venous thromboembolism, high-dependency/intensive care unit admission, laboratory parameters, and radiological findings. Results: A total of 236 COVID-19 positive patients admitted to Singapore General Hospital isolation general wards from 1 June 2020 to 30 June 2020 were included in this study. Ninety-seven (41.1%) patients had sinus tachycardia on or during their admission. All patients were monitored in general wards and discharged to community quarantine facilities. None required oxygen support or high-dependency/intensive care unit admission. Sinus tachycardia was associated with increased C-reactive protein level (odds ratio = 1.033, 95% confidence interval = 1.002–1.066), abnormal chest X-ray findings (odds ratio = 3.142, 95% confidence interval = 1.390–7.104), and longer hospitalization (odds ratio = 1.117, 95% confidence interval = 1.010–1.236). There was no significant statistical association between sinus tachycardia and incidences of venous thromboembolism. Conclusion: This study suggests that patients with mild COVID-19 infection and concurrent sinus tachycardia are more likely to have higher inflammatory marker levels, abnormal imaging, and prolonged hospitalization. However, no significant association between sinus tachycardia and thromboembolism is identified in mild COVID-19 infection.

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